Your Eldercare Compass
Helpful tips for family caregivers

Dad lost weight!

A recent visit may have revealed surprising changes, such as little food in the cupboard, a loved one’s loss of appetite, or his or her unexpected weight loss.

Talk with the doctor first. A weight loss of 5% over 6–12 months is considered worthy of medical attention. (For a 130-pound woman, that would be seven pounds. For a 200-pound man, that would be 10 pounds.) About 75% of the time there is a medical reason, so have the doctor check it out.

But then there’s the 25% of the time when it’s not a medical problem.

Eating is a multifaceted activity. It certainly satisfies feelings of hunger. But it is also a taste sensation, a cultural activity, a reminder of our tie to times past, and sometimes a social activity. It also requires the ability to shop and to cook.

Check out these possible reasons for unexplained weight loss, and their remedies.

Access to food

• Money. Many elders needlessly limit purchases. A review of the budget, or shopping together, may help. If finances are limited, consider senior dining programs and food banks.
• Shopping. Your parent may have difficulty getting to a grocery store. Arrange for rides to get there. Or consider a taxi or ride-sharing service. If he or she is homebound, consider meal delivery services, such as Meals on Wheels.
• Cooking. Cooking is physically demanding. Standing. Lifting. Carrying. Help prepare meals in advance. Or identify shortcuts, such as precut vegetables.

Appetite and eating

• Flavor. We lose the sense of taste and smell as we age. And salt-restricted diets are often bland. Suggest cooking with more herbs and spices.
• Pain. Pain decreases appetite. Also check with the dentist for problems with dentures or teeth.
• Depression. Feelings of sadness, hopelessness, or loneliness commonly reduce appetite. So can eating alone from the loss of a partner through death or divorce. Have your loved one evaluated for depression. Look for ways to reduce isolation, particularly at mealtime.
• Medication. Some medications cause nausea or constipation. Others bring on a depressed mood. Still others reduce the ability to taste and smell. Ask the pharmacist about side effects and possible alternative drugs.

Memory loss can result in forgetting how to cook, not recognizing hunger pains, or not cooking out of fear of leaving the stove on. Consider having microwavable meals prepared and delivered.

Overuse of alcohol leads to loss of appetite and malnutrition. But a bit of alcohol with a meal can stimulate appetite. Strive for balance.

Family Caregiver Happiness Project

Happiness is universally desired. But do you know how to increase your happiness? In his book, Stumbling on Happiness, Harvard professor Daniel Gilbert explains that it’s not about big goals or events. The better house, the extra-long vacation, don’t really make us much happier.

Instead, happiness is closer at hand. It evolves from our day-to-day experience. Little achievements, a shift in attitude, a pleasant activity, all add up to more cheer. The sum total of little victories results in a better overall feeling about life.

The Caregiving Happiness Project is currently exploring how family caregivers can create happiness despite ongoing stress.

You can participate in this study! The project supplies a monthly theme and an online support community. Themes include simple ideas such as “space,” “quiet,” and “learn.” For example, here’s how two participants interpreted November’s theme of “let go”:

• One woman challenged her belief that “uncomfortable behavior in dementia is never accepted.” When company visited, she reminded herself to “let go.” She relaxed about her mother’s behavior. And she found that “it was okay; her challenges were accepted.”
• Another participant decided to “let go” of old family photos. As she took the albums apart, she found pleasure in sending packets of pictures to other relatives to enjoy.

The goal is to explore simple strategies and find the ones that work for you. Participants use surveys that measure their happiness when they start the project, and again at its finish. To assess the impact of happiness on health, they are also checking their blood pressure and weight.

Empower yourself to get more joy from your life. Don’t wait for happiness to arrive “once things settle down.” Check out the Caregiving Happiness Project. Or create your own simple strategies to make your day better, starting this moment.

What is hoarding?

Perhaps you wonder if your family member is a “hoarder.” (You may even harbor secret fears about yourself!) We all have cherished possessions. From trophies to teacups. Spare buttons to cans of half-used paint. But hoarding is different.

Most of us can determine when we have “enough.” And we can decide to stop buying things and/or start donating or recycling them or throwing them away. Not so for those with a hoarding disorder.

The characteristics of hoarding include

• a large number of possessions that appear to be useless or of limited value
• significant distress when trying to discard or part with those possessions
• amassing so much clutter that rooms cannot be used as they were originally intended

At its most extreme, hoarding creates social and environmental problems such that the person gets isolated and cannot maintain a safe or healthy home environment.

A hoarder continually brings in more belongings despite having no room to store them. You might first notice piles of papers that pose a fall hazard in hallways. Or belongings stacked high on tables or in the sink. It’s as if these surfaces are for storage, not eating meals or washing dishes. Hoarders become too embarrassed by the clutter and will not allow others to come inside the home. With severe hoarding, mold, bacteria, insects, or rodents start creating a health problem for neighbors as well as for the person who hoards. (At this late stage, the local fire department and/or Adult Protective Services may begin an eviction process.)

Hoarders are people who are unable to determine what is valuable and necessary. Everything seems to be important and to need saving. It becomes too emotionally painful to throw any of it away. This is a disorder, not a decision. You can’t shame a hoarder into changing. And if you force a cleanup, sadly it may harm your relationship. Often it takes extreme action, such as threat of eviction, to cause the person to seek help.

If your relative show signs of hoarding, talk to the doctor. Ask for a referral to a counselor or therapist who specializes in treating this disorder.