Your Eldercare Compass
Helpful tips for family caregivers

Transitioning from curative care

At some point, the burdens of treatment may just become too much for your loved one: The nausea of chemo. The rigors of dialysis. Wearying trips to the ER. Perhaps the person you care for is already having these thoughts, to let nature take its course and stop fighting for health that stubbornly eludes them. They may wish to enjoy the time they have left—months, weeks, days—without futile treatments. To prioritize peace and comfort. Imagine time and energy to visit with those they love. The opportunity to eat what they want—ice cream, anyone? Or to simplify their meds—no more cholesterol pills.

Supporting your loved one’s quality of life can be profoundly rewarding. Both you and your relative may find it emotionally liberating to let go of complexity. Instead of spending energy on unproductive cures, you can create loving memories. A simplified schedule presents more time for reminiscing and intimate sharing between you, the person you care for, and other family members. Facing the end, reconciliation is common. Long-held grudges often disappear as people realize their bonds with loved ones are more important than the ill will they have carried.

If this sounds appealing to your relative, you don’t have to go it alone. Transitioning from curative care does not mean no care at all. Hospice can provide your loved one with many different types of support. And the services are paid for completely by Medicare and Medicaid!

• Weekly visits from a nurse to help manage pain and other difficult symptoms
• Equipment needed for comfort, such as a hospital bed, delivered to the home
• Bathing and grooming of your loved one several times a week by a nurse’s aide
• A social worker or chaplain to support emotional or spiritual needs
• All the medications your family member needs to stay comfortable (pain, trouble breathing, etc.)
• Instead of 911 calls and grueling trips to the ER, you can call hospice—anytime, 24/7. A nurse can provide guidance and have any needed medications or supplies delivered. Hospice care won’t stop the inevitable, but it can make for a softer landing.

None of us will be here forever. But on the last leg of the journey, it’s nice to have discomforts managed and caring professionals available for guidance and support.

Managing arthritis pain

The most common arthritis is osteoarthritis, which occurs most often in the hands, knees, hips, lower back, neck, and feet. It affects roughly half of those age 65 and over. With osteoarthritis, the smooth layer of cartilage between the bones in the joints deteriorates, causing bone to scrape directly on bone. Ouch! If your loved one has stiffness or pain associated with this condition, it very likely limits their ability to enjoy their usual activities. Fortunately, there are many ways to relieve pain and reduce wear and tear.

• Weight loss. If the arthritis involves the hips or knees, a weight loss of even 10 pounds can make a significant difference.
• Low-impact exercise. Motion is lotion. Think in terms of fluid movements and low-impact activities such as tai chi, swimming, biking. Check for special arthritis exercise classes sponsored at senior centers.
• Hot and cold compresses. Moist heat helps relieve immediate pain. Cold can be used after exercise to reduce muscle pain.
• Topical creams. Ointments with capsaicin—an extract of chili peppers—have been shown to provide relief for some people. But the ointment must be applied four times a day.
• Assistive devices. A cane can take some of the burden off knees and hips. Other devices may help with tasks that involve grabbing and opening. Ask the doctor for a session with an occupational therapist.
• Omega-3 fats. These fats tend to reduce the inflammation of the joints. They are found in oily fish such as salmon and tuna, and in walnuts. They can also be taken as supplements.
• Over-the-counter pain relievers. Acetaminophen, ibuprofen, and naproxen are effective for short-term relief. Using them for longer than 10 days at a stretch is not advised.
• Supplements. Studies done on glucosamine and chondroitin reveal mixed results. These compounds can also change the effectiveness of other medications. Check with the doctor or pharmacist before trying them.

How to get durable power of attorney

There may come a time when your loved one will need help handling financial matters. Maybe filing taxes. Or interacting with Social Security. Or signing a contract to move into a new residence. If your relative is unable to do these things because of illness or problems with dementia, you will need to show a document proving they chose you to act on their behalf. This document is called “durable power of attorney” (DPOA). A simple “power of attorney” (not durable) is useful only while a person is able to make decisions. Incapacity voids it.

Under what circumstances. It’s important to discuss the potential challenges of the future while your loved one is of sound mind. Often a DPOA is signed to take effect immediately—with the understanding that the power won’t be exploited. Other families prefer a “springing” DPOA, which goes into effect only when a physician certifies incapacity. This limitation sounds good. In reality, though, it can cause delays and complications.

For how long. A person can revoke (change their mind about) a DPOA at any time, as long they are mentally competent. Otherwise, it is valid until death. Upon death, a person’s financial affairs must be handled by whoever was legally named as “executor” or “trustee” of the estate.

How to create a DPOA. Fill-in-the-blank DPOA forms are available online. Typically, they are signed with a notary who officially confirms the signer’s identity and free will. A notary may be available at your relative’s bank. Some notaries are “mobile” and make house calls.

Incapacitated and no DPOA. To take charge financially without a completed DPOA, you must be appointed by the courts. Not surprisingly, this is a lengthy process.

Consult with an attorney. Giving someone the ability to access bank accounts and make financial decisions is not small. Your loved one would be wise to get legal counsel before completing a DPOA.