A question in my mail box: "How can I encourage someone with a bad attitude who is caring for an elderly relative?"

"My grandmother has dementia, but physically she is healthy," my friend explained. "Because of her dementia, she lives with her daughter, but this has created a lot of stress for her daughter and she now has a bad attitude about taking care of her mother. I live too far away to help? Do you have any suggestions I could give to encourage her daughter?"

Bless her heart! I can only imagine the difficulty of caring for a person with dementia who is physically able to move around.

While caring for my mother had its own set of difficulties, she was physically incapacitated and it was like caring for a newborn who could not get up and walk away. The stress of worrying about where an elderly person with dementia might wander off, or dealing with a non-compliant or combative person with dementia must be very difficult.

This afternoon I had lunch with a very good friend whose circumstances are very similar to that of the person who asked for suggestions, so I asked my friend today how she is able to maintain a positive attitude while caring for her elderly mother.

1. Understand that it takes an anointing from God. Every morning she asks the Lord to anoint her for the task of caring for the needs of her mother and the rest of her family. My friend knows that she cannot do this without the strength and wisdom that comes from God alone.

2. Surrender. Along with praying for daily anointing, she daily surrenders her life - her plans, her desires - to the Lord. "You know the hymn 'I Surrender All'?" she asked. "That is what I have to do. 'All to Jesus, I surrender. I surrender all'."

3. Find help. My friend compiled a list of people she could call on to stay with her mother so that she could do other things from time to time - like go on dates with her husband, or trips out of town. When her daughter lived closer, she would watch her daughter's baby so that her daughter could get away, and then her daughter would watch my friend's mother so that my friend could get away. Now that her daughter has moved far away, my friend relies on her list of other people she can call. She also investigated community resources for respite care.

4. Find ways of making the elderly person feel useful. My friend's mother helps with the laundry. She can sort and fold clothes.

5. Be patient. My friend lets her mother do for herself whatever she can, even if it takes longer to accomplish the task. The more the person with dementia can do for themselves, the better they will feel about themselves and be easier to live with. It is also important for the caregiver to accept the quality of work the person is able to do with patience and understanding.

Often the person with dementia will make unkind comments and say things they would never say before they had dementia. That can be very difficult for a daughter. I asked my friend if she has learned to let those kind of comments roll off and not be so hurtful. She said that most of the time she can, but there are times that it isn't so easy and that is when she must constantly be taking it before the Lord in prayer and asking Him to protect her heart and mind and give her the ability to respond in love.

More suggestions can be found in Can You Carry the Burden.

I would love to hear from others who could offer words of encouragement.

A little vent

When my mother went to be with the Lord April 19, 2001, she had supplemental health insurance through AARP. At the time, I informed AARP of mother's death and cancelled her health insurance, along with her AARP membership.

However, about once a year correspondence from AARP arrives in the mail, addressed to my mother, as it did yesterday. It begins.....

"Dear.......

Since your membership ended, AARP added many new and improved member benefits and services.

We would very much like to welcome you back to AARP, so you can enjoy those benefits and services...."

Argh!!!! The first few times I received the letter, I returned it - reminding them of mother's death.

Obviously they just don't get it!

Now I just throw the letters in the trash. It's their money!

A missionary at home

Ann Flory Soden shares her caregiving story "What About Mom?" at Comfort Cafe.

I love what Ann says here:

"In her smile I could see that she now agreed with me: my staying home with her was just as important to the Lord as being a missionary in the Philippines."

Visit Comfort Cafe and read Ann's caregiving "Life Story" here.

"Trading Places"

Last evening NBC Nightly News began a series entitled "Trading Places - Caring for Your Parents". Video from last night featured Bryan Williams and his father who lives in an upscale assisted living facility. Tonight's segment featured Tim Russert and his father who lives alone in his home.

NBC is urging their viewers/readers to submit their own stories and photos of caring for their parents.

You can access these stories and videos here.

Bed sores and a testimony

Earlier today I received this email from Jennifer:

I wrote you several months ago as we were building an addition so my father-in-law could move in w/us. He moved in the beginning of Nov. After just a week & a half, he was in the hospital with pneumonia. After 9 days, he came home...1 day before Thanksgiving. Things went downhill fast and I found myself checking his blood sugar (which my 8 year old son taught me how to do!! He had been watching his grandpa and was able to help me), giving him his medicines 4 times a day, filling his syringes with insulin (until the day came that I had to actually inject him!), and monitoring his breathing treatments. As the days progressed and my fil weakened, the day arrived when I had to clean him and care for him. God gives such grace for exactly what we need to do!

He was only home for 2 and a half weeks and then had to be admitted for internal bleeding. The high doses of prednisone he has been on for over a year have done their work.

He has been in a nursing home for several weeks now. We want to bring him back home. He is not alone. He does not need to be there. We can care for him, help him exercise, and do all that they have or have not been doing at the home. He also has MRSA and so the attendants don't go in unless they are gowned, masked, & gloved. He is very isolated there.

He is also one of the sweetest, politest, and uncomplaining persons I know. He does have a sore on his backside that we will have to care for. They also have him on a different steroid that is through an IV. I've been encouraging my husband that we need to be very proactive in asking questions and seeing what we can actually do here...more than what they are telling us right now, I am sure.

We are already getting questions from nurses and other people about why we would want to do this. Why not leave him in the nursing home where others can care for him? We tell them that WE are his family and he is NOT alone and we WANT to do this!! This was why we put on the addition! Granted we didn't expect it to come so soon, but it has and it is what God is calling us to do!

We believe that my fil has decided to come to Jesus for salvation during this time! I'm sorry I wrote so much. Wanted to share... I appreciate knowing some of what we
can do to help with the bed sores! Thank you!

Jennifer, please do not apologize for writing "so much". The testimony of your love for your father in law, and your family's desire to care for him at home is a beautiful one. Thank you so much for sharing your story with me. God does indeed give us grace for exactly what we need at the moment.

Don't be surprised if you continue to receive questions from those in the medical profession, and even family and friends, about why you would want to assume responsibility for your father in law's care, rather than relinquish that responsibility to the nursing home staff. There are many possible reasons why they would like for you to keep your father in law in the nursing home. Doctors like it because they can turn the day to day care of that patient over to the nursing home staff doctor and not have to be concerned about middle of the night phone calls from family. Nurses love caring for patients like your father in law who are kind and not demanding. The nursing staff is also threatened by family who question the care their loved one is receiving.

My advice to you would be to remain proactive in your questioning, but with gentleness. Avoid putting the nursing home staff on the defensive. It will only make it more difficult for you to get the information you need to bring your father in law home.

When I removed my mother from the nursing home, she had bedsores on both heels that the nursing home had neither acknowledged or treated, but Medicare provided several weeks of home health care that was initially very helpful. A home health nurse performed an initial assessment of mother's needs and then obtained the doctor's orders I needed for the treatment of those bedsores. Eventually they also helped me get an order for an alternating pressure air mattress to prevent the development of future bedsores. The nurses instructed me in how to care for mother's bedsores and provided the dressings until her bedsores were healed.

Bedsores are treated according to their classification. They are not all treated in the same way. You will need to ask your father in law's doctor to order initial home health care when he leaves the nursing home so that the home health nurses can instruct you in the particular care needed for your father in law's bedsores.

After mother's heels healed, I was very diligent in my care of her skin. I kept her clean and dry, and repositioned her often. I gently massaged her skin after her morning bath, and again before she went to sleep at night to stimulate the circulation to her skin. The alternating pressure air mattress was the best. It allowed me to sleep at night without having to wake up and turn her during the night. Mother never developed another bedsore.

You might be interested in reading what I wrote about how I cared for her skin here.

Jennifer, please stay in touch and let me know how you and your father in law are doing. He is so blessed to have you for a daughter in law.

"The Sandwich Generation"

Please take 11 minutes and watch this excellent documentary - "The Sandwich Generation" - about 83 year old Herbie and his daughter and her family who care for him. As someone who has walked in their shoes, I find their story comforting and encouraging as they articulate many of the feelings I experienced. (HT - Pat at Sometimes I Feel Like a Piece of Bologna)

Heart hunger for intimacy

In her book Dear Abba, Finding the Father's Heart through Prayer, Claire Cloninger tells the story of Mother Teresa's 1979 Nobel prize acceptance speech in which Mother Teresa spoke of visiting a nursing home - "where elderly people had been placed by their adult children."

When Mother Teresa entered the nursing home, she was initially impressed by the well-furnished and attractive decor until she noticed the expressions on the faces of the nursing home's residents.

"I saw in that home they had everything, beautiful things, but everybody was looking toward the door. And I did not see a single one with a smile on their face. And I turned to the sister (in charge) and I asked:...'How is it that these people who have everything here, why are they all looking toward the door? Why are they not smiling?'"

The sister in charge told Mother Teresa that the residents were not smiling, but looking toward the door in the hope and expectation that their son or daughter would enter. The sister added, "They are hurt because they are forgotten."

Claire Cloninger wrote:

"Mother Teresa was reminded that day of something she had often observed in her work: that 'the poorest of the poor' are not the only ones who know poverty. There is poverty in the midst of great wealth. There is loneliness in the middle of crowded rooms. And all of us are hungry. Even the well fed have a hunger of the heart."

"Do you have any idea what you would have gotten yourself into?"

On the way to my brother's house Thanksgiving morning, we stopped to visit with Louis' aunt and her sister - both widows in their 80's who look absolutely fantastic for their age. Some how the conversation became focused on nursing homes. Louis informed his aunt, as he has done numerous times in the past, that she doesn't even need to consider living in a nursing home because should she need the assistance, we would be delighted to have her live with us.

Louis' Aunt V had lived in a nearby nursing home and developed severe bed sores that eventually led to her death from infection. It was horrible, and totally preventable. Louis reminded his aunt and her sister that we had wanted Aunt V to come live us.

"Do you have any idea what you would have gotten yourself into?" Louis' aunt's sister quizzed us.

Turning to me Louis said, "We did it for two years for Pat's mom!"

"It was like caring for a 140 pound baby," I explained, "but I did it. I had to figure out many things for myself, but eventually I was able to get a hoyer lift to get mother in and out of bed and an alternating pressure mattress so I did not have to get up during the night to turn her."

"I bathed her, turned her, fed her, changed her, read to her, talked to her, and loved her," I added.

I miss her so very much. I would be so honored to still be caring for her if the Lord had let her stay here longer.

I really would.

Even without our conversation, I had been thinking about my mother a lot lately. She had been discharged from the hospital to the rehab center where daddy was in a nursing home because she had been having difficulty walking and couldn't be at home by herself, and it was on a Thanksgiving morning that the center called to tell me that they had sent mother to the hospital in an ambulance after finding her slumped over in her wheelchair and unresponsive.

For the first time, we had decided not to cook a big meal that Thanksgiving, but to help serve at a meal being provided by a local church. Instead, we headed three hours north to the hospital where mother had been taken and the nursing home where my daddy was living.

Memories of many of the details of the next week and a half are sketchy, but my mother's health continued to decline, and my father died after a brief hospitalization just 10 days after Thanksgiving.

A few days before Christmas, my bedridden mother was moved into our home.

The truth is that I really didn't have any idea what I had gotten myself into, but I knew that I could love on my mother and provide much better care for her than she was receiving in an institution.

I won't lie. It was hard - very hard, and even though I did not know what I had gotten myself into - I really would do it again.