Unfortunately, the sudden confusion, known as delirium, among the hospitalized elderly is an awful side effect of an inpatient stay. Your caree is hospitalized for one reason but, because of the hospitalization, becomes worse.

On Friday, The New York Times New Old Age Blog featured a program that helps those hospitalized elderly suffering from delirium. (You’ll want to bookmark the article, Preventing Hospital Delirium, because you’ll find the tips to be incredibly helpful). The Hospital Elder Life Program (HELP), developed by Dr. Sharon K. Inouye and colleagues at the Yale University School of Medicine, has been adopted by more than 200 hospitals. According to the HELP website, two million older Americans this year will develop delirium and functional decline during a hospitalization.

The HELP program offers tips for clinicians to help prevent delirium in hospitalized older adults, including meeting the patients’ needs for nutrition, fluids, and sleep as well as keeping them as mobile as possible. The website also offers tips for family caregivers to help prevent delirium in their hospitalized caree. You can read the tips here.

What’s been your experience with delirium in your hospitalized caree? Please share your stories and tips on how to cope in our comments section, below.

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Today, I wanted to share a tool clinicians use to measure pain in persons with dementia who, as the disease progresses, often cannot share the cause and severity of their pain. The tool, called Pain Assessment in Advanced Dementia (PAINAD) scale, measures five specific indicators of pain: the caree’s breathing, vocalization, facial expression, body language, and consolability.

Although a tool for clinician, you may find it helpful. You can find the scale and a case study use of it at NursingCenter.com.

It’s awful to wonder what’s wrong with your caree and not know if your caree feels pain. And, pain, Dan said, can be a trigger which leads to challenging behavior. He suggested that a common ailment as we age—arthritis—may not be treated appropriately in persons with dementia. Their untreated pain may create behavior such as agitation. Understanding your caree’s pain can help you discuss treatment options with your caree’s physician.

After you’ve had a chance to review the scale, share your thoughts about whether you think it will be helpful in our comments section, below.

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Some resources for you:

Community colleges: Check with your local community college about caregiving training. Some colleges received funding to offer the training; you can learn more here.

Powerful Tools for Caregivers: This six-week class for family caregivers focuses on teaching skills and building confidence. You also receive The Caregiver Helpbook, developed specifically for the course. To learn if a class is offered in your community, you can contact your local Area Agency on Aging (search here: http://www.eldercare.gov/) or your local Alzheimer’s Association chapter.

The American Red Cross: This organization also developed a family caregiver training course. You can check with your local office to see if/when they offer classes. You can learn more about the training here.

Caregiving.com: We offer two types of classes, which delve deeper into a topic discussed during our free webinars. We offer classes you can participate in from home, so it’s convenient. You can take one of the classes, a four-week webinar series, at your convenience. You can learn more about September classes, which help you embrace the power of your limits, here.

And, when you take a class, let us know. We’d love to learn what you learn.

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Products made specifically to occupy a care recipient so a family caregiver can get a break are available from several companies, among them:

Collector’s Choice Music: Purchase your care recipient’s favorite music, including Big Band, classical/opera and soundtracks. Also available are old radio shows. Visit www.ccmusic.com or call 800-993-6344.

Innovative Caregiving Resources: Researchers from the Gerontology Center at the University of Utah concluded that video respites work-and developed their own series as result. The videos are now available through an unrelated company, Innovative Caregiving Resources. Videos cater to a wide range of care recipients; in “Ladies…Let’s Chat” female care recipients will enjoy a visit with Diane and her  grandchildren and in  “Lunchbreak with Tony” male care recipients take a lunch break and discuss first cars and stick ball.  Other videos are geared toward specific ethnicities (Hispanic, African Americans, Jewish) and toward holidays, such as Christmas. For more information, visit www.videorespite.com or call 1-800-249-5600 .

NASCO: Its online catalog, at http://www.enasco.com/senioractivities/, features products to captivate your care recipient. You’ll products for persons with Alzheimer’s, as well as puzzles, games, sing-a-long videos and arts and crafts. You’ll want to peruse this company’s catalog and/or web site; it offers great ideas on how to keep you care recipient occupied with meaningful activites. Call for catalog: 800-558-9595.

Alzheimer’s Store: You’ll find products that keep your care recipient occupied and safe. Products are categorized by stages (Early Stage, Middle Stage and Later Stage), wandering, safety, forgetfullness. Visit www.alzstore.com or call 800-752-3238.

If we’ve missed any resources, please be sure to share!

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To register, visit here or call 1-800-896-3650.

One tip he suggested was to “Remember the future.” Sounds like a oxymoron, doesn’t it? How can we have a memory of an event that has yet to occur?

The more I gave thought to this, the more I thought: What a cool idea. When you remember the future, you focus on the outcomes of an event or experience—how you will feel, how you will act, what you will create. Remembering the future takes you out of the present fear and worry and opens the opportunities to feel good.

In your caregiving role, you can remember the future. Remembering the future is a way of writing your caregiving story. You truly have the power to end the story your way. Some ways you may remember the future:

• “After my caregiving role ended, my siblings and I found peace with each other.”
• “When my caregiving role ended, I understood my care recipient so much better. Understanding my care recipient means I understand myself that much better. I am grateful for this opportunity to learn, grow and forgive.”
• “When my caregiving role ended, I gave myself the time I needed to regroup. During that time of healing, I took care of myself so that I could make the most of the next phase in my life. Caregiving gives clarity. I now have the focus I want to create the life I deserve.”
• “When my caregiving role ended, I knew my care recipient felt wrapped in love. And, I felt blessed that we both managed our experience together to the best of our abilities.”
• “When my caregiving role ended, I could find comfort in the knowing I always did the best I could. No matter what obstacle, challenge or problem, I focused on doing the best I could. And, more importantly, I forgave myself along the way.”
• “When my caregiving ended, I felt great about the strong, loving, focused person I became. While not easy, my caregiving experience helped me become the best I am today.”
• “When my caregiving role ended, I started the business I long dreamed of. Now, I am a successful business owner making a difference in the world.”
• “When my caregiving role ended, I traveled the world. It was wonderful.”
• “When my caregiving role ended, I was blessed to be in great shape. I had decided my health was a priority so to take care to eat right and exercise. Now that I’m healthy, I find myself living life at a different level.”
• “When my caregiving role ended, I missed my care recipient very much. I did my best every day to live a good life. I had good days and bad days. I was gentle with myself as I found my new footing. I leaned on my support system, which helped me find my way. I am now in a better place than I ever thought possible.”
• “When my caregiving role ended, I found ways to honor my care recipient’s memory on a regular basis. I miss my care recipient dearly, but am comforted by the rituals which keep loving memories close to my heart.”
• “When my caregiving role ended, I thought for sure that caregiving would get the best of me. But, it didn’t. I took the good from the experience in order to make my life better. I am surrounded by riches and blessings greater than my imagination.”

Feel it, believe it, see it. This is the vision to reflect on during your dark moments.

We’d love to hear how you will remember your future; feel free to share in our comments section. Some questions to ask yourself to bring that future closer to you:

After caregiving ends for you, consider:

–What will be your proudest moments?
–How did you express your feelings for and about your care recipient?
–How did your life change for the better?
–How did your relationships change for the better?
–Which lifelong dream came true for you?

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You can put a freeze credit reports of persons over 65 years of age for free. (You can freeze yours, too, but you typically pay fee if you are under 65.) Freezing a care recipient’s credit report means that new credit can’t be opened in his or her name, protecting your care recipient from fraudulent use of his or her credit.

You’ll want to freeze credit reports at all three credit bureaus. Here’s the contact information:

Equifax

Experian

TransUnion

You’ll also want to check your care recipient’s credit reports to ensure accuracy. You can request free annual reports for both of you: http://www.annualcreditreport.com

For more information about security freezes and protecting yourself and your care recipient from identity theft read this article: http://redtape.msnbc.com/2007/11/now-a-way-to-st.html

This 18-page booklet provides tips to lessen the stress and enhance the comfort of the patient, deal with anxiety or agitation, and work with hospital staff and doctors. It also includes helpful checklists for planning ahead for emergency and scheduled hospital stays, and lists agencies and other publications that might be useful resources.

The booklet is an expanded, reformatted version of a publication produced by the North Carolina Division of Aging and Adult Services in conjunction with the Joseph and Kathleen Bryan Alzheimer’s Disease Research Center at Duke University.

To download or order free copies of “Hospitalization Happens: A Guide to Hospital Visits for Individuals with Memory Loss,” visit www.nia.nih.gov/Alzheimers/Publications/happens.htm or call the Alzheimer’s Disease Education and Referral (ADEAR) Center toll-free at 800-438-4380. Bulk quantities (25 or more) may be ordered by visiting www.niapublications.org/adearorder/bulk.asp.

Oh, boy, is that common!

Your day is so full of action and worries that downtime can seem to doom you. No worries—we’ve got a great suggestion.

Create two lists, Job Jar and When I Can I Will, that stay put on your fridge so your lists can be easily updated.

Job Jar List
Your brother-in-law calls and says, “I have a free afternoon this weekend. I’ll stop to help out.” Your instinct may be to answer, “That’s okay, I’ve got everything under control” simply because you may think, “What in the world can he help with?”

Plenty!

As you go about your day, take note of chores to which you say, “I should do that, but I just don’t have time.” Maybe it’s fixing the knicks in the wall from the wheelchair, or cleaning out the car, or picking up books at the library. These are great chores to assign to others!

When I Can I Will List
When you have an idea of an place or activity you’d like to enjoy, write it down. For instance, when a new movie opens that looks good, write it down. When a friend suggests a great place to take a walk, write it down. When you pass a restaurant that looks good, write it down. When you think, I’d love to do that some day, write it down.

These two lists work well together. When a volunteer offers to help, ask them to choose a chore from your Job Jar list. While they help out, take some time for yourself; you’ll have plenty of ideas from your When I Can, I Will list.

Two Journals

Keep journals—one about your care recipient and one about you.

The journal about your care recipient contains a synopsis of day-to-day care needs; meals, bowel movements, weight, medications, moods, difficulties. You also record doctor visits, recommendations and treatment options.

Your care recipient’s journal is a great resource for you as seek the best care options possible, as well as you detail the reality of your care recipient’s care needs. It also becomes a manual for those who may have to step in and take your place on a short-term basis.

The journal about you chronicles your experiences–what hurts, what aches, what works, what succeeds. This is for your eyes only, so feel free to describe exactly how you feel. Your journal can become a great place to vent. (See our Journaling 101 series.)

With two lists and two journals, you build a strong foundation for your caregiving journey.

In 1990, I decided to make a career change—and landed into a job managing a congregate nutrition site for older adults in Lambertville, N.J. In addition to providing a hot lunch-time meal to local seniors, we also delivered Meals on Wheels to homebound seniors in Hunterdon County, a beautiful, rural area along the Delaware River north of Trenton.

Meals on Wheels depends on volunteer drivers. So, when I didn’t have a volunteer to drive a route, I packed my two-door, mint green Toyota Tercel with meals for about 20 homebound seniors and hit the road.

What an amazing, eye-opening experience. And, what an introduction to an incredible program.

In my opinion, Meals on Wheels is one of the best programs for older adults. Not because a meal (which often can be stretched into two) arrives daily, but because a smiling volunteer with a warm heart arrives every day with a meal. For family caregivers who work or who live a distance away, the program provides peace of mind: If a volunteer spots a problem when delivering a meal, he immediately alerts the office staff.

It’s the best back-up pair of eyes and ears you’ll ever find. And, for about $5!

To learn about Meals on Wheels in your area, contact your local Area Agency on Aging. For a referral to you local agency, call the ElderCare Locator at 1-800-677-1116.