The Endocrine Society estimates that roughly 33% of adults 65 and older have type 2 diabetes. The good news is that with the right proactive care and management, many adults can reverse their diabetes. 

When that isn’t possible, commitment to managing diabetes through healthy lifestyle choices – particularly with diet and exercise – can significantly lower the medication doses required to keep blood sugar levels in check.

Managing Diabetes For A Long & Healthy Life

Diabetes management is a multi-faceted process. Here are five steps to helping your parent or loved one manage diabetes so they can enjoy a long, active, and satisfying senior lifestyle.

Connect with your loved one’s healthcare team

If your parent or grandparent has diabetes, we recommend going with them for a visit – or scheduling a telehealth consult – so you can connect with their physician or diabetes management team. It’s important that you have all of the information as your loved one does so that you can create a consistent and supportive care plan.

Speak to their doctor about whether reversing or lowering medications is possible. In many cases, the answer is yes, but it requires a clear plan that must be adhered to without fail. 

A diabetes-specific diet is essential

Diet is one of the essential players when managing diabetes. The internet is an incredible resource for learning about and implementing a diabetes diet. In most cases, these diets look like modified Adkins or South Beach diets. They prioritize healthy proteins, fats, and high-fiber foods while minimizing and eliminating processed starches and sugars. 

There is no need to feel disappointed about a diabetes diet. With the right planning and access to fresh foods, ingredients, herbs, and spices, your loved one can eat delicious, nutritious, and satisfying foods – including sugar-free treats replicating their favorite snacks, sweets, and desserts.

Your conversation with their doctor should include lots of diabetes diet information. We recommend learning about antiinflammatory diets and modifying them for diabetes management. In addition to supporting senior nutrition and health, antiinflammatory diets reduce or eliminate side effects from other common senior ailments, like heart disease and arthritis. 

If your senior loved one isn’t likely to adhere to a diet on their own, enlist the help of a senior caregiving agency that offers grocery shopping, meal planning, and meal prep. We can prepare healthy easy-to-reheat meals and snacks that keep their diabetes plan on track.

Most people with type 2 diabetes fare best when they migrate away from the “three square meals a day” model. Blood sugar levels stay more consistent – and people tend to feel better – when they eat six to seven smaller meals and snacks throughout the day and evening.

Exercise at least once per day

Physical activity is another essential step in balancing blood sugar. There’s no need to go crazy here. The goal is to get the body moving as regularly and comfortably as possible. There are so many ways for seniors to get the exercise they need, even when they’re averse to joining a gym or taking an exercise class.

• Taking a morning and/or evening walk
• Going on an accessible hike once or twice a week
• Gardening
• Riding a bicycle
• Swimming at the local pool
• Following along with an exercise or yoga video on YouTube

Is your loved one chair- or bed-bound? That’s okay. There are plenty of ways to move their body in the chair or bed that support weight management and blood sugar balance.

Medication management

For most seniors, oral or injectible medicine is required to keep blood sugar levels in check. This requires regular blood sugar monitoring and administering the right amount of insulin accordingly. There is little room for error here, as severe reactions occur when blood sugar levels get too high – or too low – for any length of time.

If your loved one has trouble managing blood sugar levels, or they have dementia, caregivers are essential to the medication management part of the diabetes equation.

Proactively preventing – or noticing – diabetes complications

A type 2 diabetes diagnosis automatically elevates a person’s risk of additional health complications. For example, people with type 2 diabetes are more likely to develop:

• Vision loss as a result of diabetic retinopathy and faster cataract growth
• Chronic kidney disease
• Heart disease
• Vascular (circulation) complications
• High blood pressure
• Gum disease
• Atherosclerosis
• Alzheimer’s
• And the list continues

That last one is worth emphasizing because in addition to increasing the risk of developing Alzheimer’s, adults with Alzheimer’s and diabetes experience a faster progression of the disease without proper diabetes care.

Caregivers Provide Senior Diabetes Management & Care

Does your aging loved one with diabetes want to remain at home, aging independently in place? Are you afraid they aren’t able to manage diabetes at home on their own? In-home caregivers are an ideal solution.

There are several ways we can support your loved one’s healthy lifestyle requirements:

Meal planning and preparation

As we mentioned in the section on diabetes-specific diets, access to fresh ingredients and meal planning/preparation is critical for adults with diabetes. If your loved one is unable to keep up with this task, caregivers can do that for you. Depending on the client and family’s needs, caregivers can come once a week – or multiple times per week – to make sure fresh diabetes-friendly foods and snacks available at all times.

Encouragement and companionship during exercise time

Caregivers can also provide encouragement and companionship during exercise time. Whether that means driving clients to/from senior-specific exercise classes, accompanying them on walks or outings that get them moving, or gardening in the backyard – we’ll make sure physical movement is incorporated into every shift. 

We’re happy to work with your occupational therapists or physician to create a specific exercise routine to focus on balance, strength training, or whatever is needed to optimize physical fitness, stamina, and weight management.

Managing diabetes medication

In-home caregivers can ensure your parents take their medicines as prescribed and on time. We can also help clients chart blood sugar levels and doses (we cannot legally administer the medications but provide them to the client at the right time and in the correct dose). 

Respite care

If a spouse or family caregivers are already at the helm, caregiver agencies can provide invaluable respite care services. This gives primary caregivers much-deserved breaks on a regular basis. We can also step in for longer shifts so that family caregivers can take a decent vacation.

We’re Here To Help

Schedule an in-home assessment with HomeAide Home Care. Our caregivers are available for respite care, part-time or full-time shifts, and are educated and trained in diabetes management for seniors and those with Alzheimer’s or dementia. We’ll help you create a plan that honors your loved one’s independence, safety, and well-being.

Vision loss is a natural part of aging; by the time most adults reach 65, they wear corrective lenses. However, there is a difference between age-related vision loss and blindness associated with eye diseases like glaucoma.

Glaucoma describes a group of conditions rooted in fluid build-up inside the eye (the aqueous humor). Over time, accumulated pressure damages the optic nerve, leading to vision loss and – potentially – blindness. There are several different types of glaucoma, but the most common type is called open-angle glaucoma. 

Glaucoma Is A Leading Cause Of Senior Blindness

Glaucoma is one of the most common causes of blindness in seniors. The American Academy of Family Physicians (AAFP) states, “An estimated 1 million Americans over 65 years of age have experienced loss of vision associated with glaucoma, and approximately 75 percent of persons who are legally blind because of glaucoma are over the age of 65.”

Here is what seniors and their caregivers need to know about glaucoma and the importance of vision care as we age.

Open-angle glaucoma develops slowly

Glaucoma is commonly referred to as a “sneak thief of sight” because it develops over time. Also, very few people experience symptoms of glaucoma until it is far into its development. As a result, vision loss may seem to occur rather suddenly when, in fact, it’s diminished little by little, proportional to optic nerve damage.

This doesn’t mean that glaucoma diagnosis means you’re going blind, but it means you’ve already lost some of your vision, and treatment is essential to slow down future progressive vision loss.

Lifestyle plays a part in glaucoma

There are several risk factors associated with glaucoma. The first is genetics, which is out of a person’s control. However, two of the major risk factors – high blood pressure and diabetes – are controllable via healthy lifestyle choices. 

Eating well, and focusing on an anti-inflammatory diet, are one of the best things adults and seniors can do to live a healthy, active, and independent life. Anti-inflammatory diets prevent, manage, and reverse some of the most common senior health issues – like type 2 diabetes, heart disease, high cholesterol, high blood pressure, arthritis, and more. 

Other risk factors for developing glaucoma are:

• Being African American or Latino
• A history of eye trauma or thin corneas
• Using corticosteroids (especially in eye drops)
• Extreme near/farsightedness

Observing annual eye exams is one of the best ways to catch glaucoma early. Optometrists and their screening/diagnostic equipment notice changes in the field of vision faster than you will. The good news is that almost all healthcare insurance plans – including Medicare/Medical – cover glaucoma tests every 12 months for adults 50 years and older. 

Speak to your parent or loved one’s healthcare provider or optometrist to ensure they’re observing their annual or bi-annual wellness visits.

It causes changes in the field of vision

The most common causes of compromised vision cause general blurred vision (nearsightedness, farsightedness, astigmatism, or age-related presbyopia). Glaucoma is different. Seniors with glaucoma typically experience changes in certain areas of their field of vision – so they might lose peripheral vision first while retaining center vision. Others occasionally lose various spots throughout their field of vision or describe it as if they’re constantly looking through a very dirty pair of glasses.

If your loved one has glaucoma, know they need access to well-lit areas, so this is a good time to ensure their home has sufficient task and safety lighting. Depending on what they do and don’t see, it’s also time to speak to their optometrist and physician about driving restrictions and create an agreement about when it’s time to exchange the car keys for transportation services. 

Glaucoma can be treated but not reversed

There is no way to turn back time and restore glaucoma-related optic nerve damage or vision loss. Instead, optometrists refer patients to ophthalmologists who treat and manage the condition. Treating glaucoma focuses on relieving pressure inside the eye, which reduces damage to the optic nerve. 

This may involve one or a combination of the following:

• Special eye drops 
• Oral medication
• Laser surgery
• Optic surgery

In most cases, seniors with glaucoma visit their optometrist or ophthalmologist twice per year. Patients may get check-ups every three months in more serious cases or those that are more challenging to control.

Vision loss decreases senior independence

Over time, progressive vision loss impacts seniors’ ability to live at home independently. In best-case scenarios, glaucoma is caught early, and a combination of medication and glaucoma treatments maintains healthy vision for many years to come. However, late-stage glaucoma diagnosis or the diagnosis of glaucoma on top of existing vision loss may mean it’s time to bring in outside support.

The loss of one’s vision can mean the loss or diminishment of the ability to perform daily tasks. For example, seniors with notable vision loss, especially if combined with other medical diagnoses or age-related decline may find it harder to:

• Drive safely – especially outside of daylight hours.
• Shop for groceries.
• Cook their favorite meals.
• Maintain a clean home.
• Read prescription labels and other fine print
• Balance or navigate areas like stairs, elevation changes, or uneven walkways that require adequate depth perception.

If your senior loved one lives alone, it’s time to discuss a long-term care plan that increases care levels as glaucoma and vision-related changes make it harder to live safely on their own.

Is Glaucoma Or Vision Loss Affecting A Loved One’s Ability To Age-In-Place?

Is glaucoma or advanced vision loss negatively impacting a senior loved one’s daily life? Studies show that more than 90% of seniors prefer to age in their own homes whenever possible. In cases where healthy seniors with vision loss need extra support, that might look like once-a-week visits and errand running. Over time, our licensed caregivers increase care to meet the age- and ability-related needs of our clients. 

Contact HomeAide Home Care to schedule a free, in-home assessment and learn more about which of our services make it safer and easier for your loved one to remain safe, independent, and engaged in the community.

Our culture suffers from common “hospice care myths” that block loved ones and families from getting the well-rounded support and comfort care they need. Studies published in the Journal of The American Geriatric Society found that most people wait far too long to start hospice care, prolonging the pain and suffering of their loved ones and blocking their ability to enjoy a higher quality of life. 

These findings agree with other hospice studies that enlisting palliative and hospice care sooner rather than later extends and improves the quality of life for patients, caregivers, and families. As professional in-home caregivers, we see over and over again how much clients benefit when they have access to the full spectrum of hospice support services as soon as they can receive them.

Hospice Services Improve Quality Of Life For Patients & Families

If your loved one is diagnosed with a terminal or chronic prognosis, or age-related declines make them increasingly frail, it’s time to connect with hospice services in your area to learn more about them, their services, and how they can support you.

Hospice Care 101

For a more comprehensive description of palliative care vs. hospice care, Click Here. The quick version is that palliative care is comfort care provided for patients pursuing curative treatments. It may be partially or fully covered by insurance but typically requires out-of-pocket payment. Hospice care is 100% free to all, but patients must cease curative treatments (medications to support and manage existing health conditions are fine). 

Once you begin hospice care, clients and families have access to:

• Regular visits from hospice nurses
• Aides that come to help with bathing and hygiene care once a week
• Free delivery of all necessary durable medical equipment and medications
• Social worker visits
• Spiritual advisors
• Support creating comprehensive end-of-life plans
• Grief counselors
• Education and information about what happens when we die
• Volunteers provide a range of services, from weekly respite care and grocery shopping trips to gardening and pet care.

The combination of family caregivers (if available), in-home caregivers for longer-term shifts, and hospice care providers support daily life for those who require increasing levels of physical care. 

So, while hospice is certainly considered an essential component of heart-centered end-of-life care, it by no means equates with giving up or dying. It’s about acknowledging “what is” and creating the most supportive, comfortable, and high-quality environment to support patients and families.

You’re Ready For Hospice Care When…

Here are five of the biggest signs you’re ready for hospice. Or, at the very least, these signs should inspire you to connect with hospice care providers in your area to learn more about what they offer.

Treatments are no longer working, or treatment/appointment rigor diminishes quality of life

The modern medical system isn’t very good at telling patients, “we can’t do anything to fix you.” When you have a terminal diagnosis, there are rare cases where a “complete cure” is possible. Most of the time, you’re offered treatment regimes that extend life and help you live with the disease or condition, but at what expense? In many cases, the treatments cause side effects that make it difficult or impossible to enjoy life. Financial costs often override any physical/emotional benefits, and they become exhausting. If this is the case, it’s time to consider hospice.

Then, there is the normal ebbing of life due to old age. In that case, there might not be an ‘official’ diagnosis, but a loved one’s appetite wanes, daily life becomes more challenging, and they begin to turn more inward and lose interest in the outside world (entirely unrelated to depression).

Both of these scenarios are a cue to look at sooner-rather-than-later end-of-life plans – and hospice helps with that. 

Symptoms are more difficult to manage

In the beginning of a loved one’s diagnosis or decline, appointments, treatments, and medication for symptom management may have been straightforward. Then, there is a tipping point. Suddenly, symptoms increase, your loved one is almost perpetually unhappy or uncomfortable, and family or hired caregivers are being run ragged trying to hold it all together. 

This is a major red flag that something needs to give. Contacting hospice is a wise next step.

A loved one needs hospice care when they can no longer manage daily tasks

There is a certain point in almost every aging adult’s life when they need help with day-to-day living in order to retain vibrancy, energy, a healthy diet, social engagement, etc. As long as they are generally healthy and content, and their health issues are manageable, in-home care support is all that’s needed.

However, if your loved one is ailing as the result of a chronic or terminal medical condition or is in mid-stage dementia, the combination of hospice care and family or professional caregivers helps them with all the daily tasks that they’re no longer capable of, like:

• Mobility transfers
• Bathing, changing, and other hygiene needs
• Toileting and incontinence care
• Meal planning and preparation (hospice volunteers often do grocery shopping, but family or hired caregivers need to provide meal prep and feeding)

This level of decline requires the comprehensive support provided by hospice.

They are showing signs of consistent decline

Those with a terminal diagnosis should remain relatively healthy, alert, and able to enjoy daily life and the things that bring them joy. By the time they’re showing the following signs of decline, patients typically need hospice because their current plan isn’t serving the business of “living life to its fullest:”

• A physician acknowledges they probably have around six months or less to live if the disease follows its general course OR that they feel the patient’s quality of life is not worth the invasive or exhausting treatment protocols. 
• Palliative (comfort care) is more of a focus on getting through the day than “living”
• Loss of 10% or more body weight in the past four to six months
• Three or more ER or urgent care visits in the last few months
• Mental alertness is waning
• They’re spending more time resting or sleeping than actively interacting
• Daily tasks are impossible to maintain without help

Slow declines are difficult to see from the inside because you’re witnessing the progression. An objective hospice team or caregiver is often the best judge of when it’s time to contact hospice.

You Suspect they’re “hanging on” for others’ sake OR you’re waiting for “the miracle”

Many people know they’re dying and want to talk about the fact they’re dying, but they can’t because spouses and loved ones don’t let them. These individuals suffer for months and years to make others happy. However, in the end, the outcome is the same, and life can be much richer when everyone is honest and present with what’s happening.

If you suspect your loved one is dying, but everyone’s waiting for “the miracle,” it’s time to contact hospice. Miracles happen, but why not take advantage of all that hospice has to offer in the meantime, prioritizing the care and comfort of your loved one? They’ll provide all of the support and resources you need to have real conversations. Yes, it’s very sad and may even feel unthinkable. But the last thing you want is for someone you love to suffer unnecessarily when they’re ready – and needing – to make their way forward into the inevitable.

We Can Support The Transition When A Loved One Needs Hospice Care

The team at HomeAide Home Care works collaboratively with hospice teams throughout the bay area to support the well-being of clients and their families. Our caregivers can fill the gaps between family care and hospice support, including everything from companionship, overnight stays, and meal preparation to respite care and errand running. Contact us to schedule a FREE assessment and learn more about how we can help.

Has your aging parent or grandparent shown signs of a waning appetite or refused to eat altogether? The waning of appetite is a natural part of aging and – eventually – dying. However, lack of appetite, changes in taste, or food resistance may signal an undiagnosed or unmanaged health issue. 

Is It Normal For A Senior To Stop Eating?

There are multiple reasons a parent or grandparent won’t eat. This could be physical discomfort, medication side effects, or an undiagnosed medical issue. Inactivity or depression can also play a part. Finally, less energy spent during the day means fewer calories required, so inactive or minimally active seniors may also experience a naturally diminished appetite.

After noticing an aging loved one won’t eat, the first step is to assess the underlying cause. Here are places to start:

An aging loved one won’t eat if they need dentures or dental work

Sometimes, seniors are reluctant to acknowledge painful or sore teeth. They may worry about inconveniencing you or have financial concerns and fret about how much serious dental work or new dentures will cost. However, malnutrition affects seniors quickly, so time is of the essence.

It may be time to schedule an appointment with your loved one’s dentist to get a professional opinion about whether dental issues may be part (or all) of the problem. 

When was their last physical?

Sometimes, seniors have so many routine appointments on the calendar for things like optometry, podiatry, or specialists, that they don’t realize how long it’s been since they visited their general physician. A noticeable decrease in appetite is worth scheduling an appointment.

Sometimes medication side effects or a new/exacerbated health condition affects energy and appetite levels. Medications or their side effects may also affect how food tastes. Cover all the bases to see if something physical is going on. If your parent is reluctant to share time in the physician’s office with you, speak to them and the physician about the best way for you to remain in the health/wellness communication loop without violating your loved one’s privacy.

What is the status of their mood, social engagement, or daily activity levels?

Physical, mental, and social engagement are all essential for senior health and well-being. If your parent or grandparent lacks movement in these areas, appetites may wane. Make sure your senior loved one has regular access to the following:

• Physical movement
• Companionship/social engagement
• Transportation to their favorite places, activities, or events
• Fresh, healthy meals and snacks
• Connection with friends and social networks (use senior-friendly technology if friends have moved away or transitioned into senior housing). 

This might be a good time to look into in-home support options, which can help with the above.

Is It The Beginning (Or Middle) Of The End?

It’s hard to accept when the end of someone’s life is on the horizon. However, waning appetite – and then food refusal – is a natural part of the dying process. If your loved one has a terminal or chronic diagnosis, their lack of appetite or food resistance might signal their life force is waning. Similarly, seniors who are winding down – even without an evident health problem – often eat less and less.

Their physician may shed some insight. This might also be a good time to speak to various hospice care providers in your area. Their staff can help to assess whether your loved one has six months or less to live, in which case loss of appetite is very common. If your parent or grandparent meets hospice qualifications, you’ll benefit from an incredible support network and expert information on what to expect from month to month, week to week, and day to day.

Do They Have Access To Fresh, Healthy Meals And Snacks?

Sometimes, the very act of shopping, planning, preparing, and cleaning up around meals is too much for seniors to handle. Their refusal to eat or waning appetite may have something to do with their diminished energy levels or interest in preparing food for themselves. In this case, we recommend using a home care agency that provides meal planning, shopping, and preparation services – along with other in-home services. 

This gives seniors a break from the rigors of daily chores, refills their energy coffers, and ensures they have delicious and ready-made meals and snacks on hand.

Tips To Support Senior Nutrition When An Aging Loved One Won’t Eat

First and foremost, we advocate honoring your loved one’s feelings and intuitions. We know it’s not easy, especially when food is such a large part of nurturing the ones we love. However, if internal systems aren’t working as they should, a lack of appetite supports a senior’s well-being. 

Forcing aging adults to eat can result in severe abdominal discomfort or serious constipation, leading to painful and embarrassing treatments. Sometimes, as hard as it is, offering food but respecting their “no thank you” is the kindest way forward.

Here are ways to support senior nutrition when loved ones don’t want to eat:

• More small, less large. Instead of three meals per day, make up healthy, balanced snacks, and small meal portions served five to six times per day.
• Make every calorie count. Skip processed and refined foods, opting for nutrient-rich foods instead. Smoothies, homemade popsicles (made from leftover healthy smoothie ingredients), soups/stews, rice or beans with added veggies, or small salads of various kinds, avocados with lime juice/salt/pepper, cheese and whole-grain crackers, and mixed nuts with fruit are all ways to do that. Use the foundations of an anti-inflammatory diet, which can reduce symptoms associated with certain health conditions.
• Get seniors active and moving. The more seniors are out and about, moving their bodies, and interacting with the world at large, the better their appetites tend to be. Spending more time outdoors is another way to spark the appetite, and you can pack a picnic while you’re at it.
• Provide company during meals. Studies show that seniors who eat with companions tend to eat more than those who dine alone. So do what you can to ensure your loved one has company for at least one meal per day. If that’s not possible in person, how about during a FaceTime or video chat with you or their grandchildren?

Let HomeAide Home Care Support Your Loved One’s Healthy Diet

If your aging loved one won’t eat then let the licensed home care aides at HomeAide Home Care work our magic. We’ll ensure your loved one has regular access to delicious and healthy snacks and meals while providing companionship, transportation, or light housekeeping duties. We’re here to support aging seniors’ quality of life however we can.

Contact us to schedule your free, in-home assessment and to discuss how our sporadic, part-time, or full-time services can support you.

Most people die a slow death. By slow, we mean that there is no sudden heart attack or stroke, nor is there a traumatic accident. Instead, most of us die of a terminal or chronic medical condition or from old age, and the body’s inevitable fade into death. Understanding that death is a longer-term experience and what each stage of the dying process entails helps families and caregivers provide a more attuned and personalized care plan whether the age-in-place at home or in a facility.

When We Die: Months, Weeks, And Days Before

For this post, we’ll describe the most common things your loved one may experience as they get closer to their death date. Many of these may even start one or two years before when they die, but in most cases, families and caregivers notice these signs months and weeks ahead of time.

Again, we want to emphasize that this post describes what happens to the body when we die from natural causes – or slow death. This is not the same as it is for someone who has an acute health episode or fatal accident.

The Months (Or Years) Before

There are two things you’ll notice in a person who is a year – or months – away from death. The first is that they will have less and less interest in the outside world; the other is a decline in their appetite or interest in food.

The movement from outward to inward

In the months and weeks before death, most people go through their own life review and emotional processing – whether they vocalize it or not. This process is an inward experience, so it’s natural that seniors or those declining from diagnosed medical conditions begin to retreat from the outside world. While they may still be interested in family traditions and holidays, or major milestones, they may show declining interest in attending meetings or social groups. 

It’s true that social engagement is essential to senior health and well-being. However, we also want to consider the reasons behind any social “retreat.” If you suspect depression is part of the picture, that’s worth addressing with your loved one and their healthcare providers. However, the retreat may actually be a sign that your loved one is turning inward and participating in a natural retreat from the world at large. 

This may be a perfect opportunity to begin reviewing boxed photos and listening to the stories your loved one has to tell. Children, siblings, and grandchildren may appreciate helping your loved one to officially preserve these memories that, in turn, support their life accounting process.

A waning appetite

This is challenging for those of us who feel very much alive because food is associated with health, well-being, and comfort. However, it is not uncommon for a person’s appetite to wane significantly in the year and months preceding their death. For one, most aren’t expending as much energy as they used to, and their body requires fewer calories.

The other reason appetite wanes, and dramatically so in the weeks and days before death, is that the digestive system slows down. It doesn’t process food like it used to and so instinctually, those who are dying have less appetite and typically only want to eat foods that are easy to digest, like broths, soups, softer foods, smoothies, and hot soothing beverages. Eventually, even the ability to swallow and process liquids fade, at which point we provide moist sponges to wet the mouth without risking choking or digestive upsets.

Work with healthcare providers to determine if lack of appetite is something to be concerned about or whether it’s just a normal part of the death process. If it’s the latter, support your loved one by honoring their food refusals. If they eat to make others happy, they can wind up in extreme discomfort or even experience a medical event that diminishes their quality of life. Offer food but respectfully honor their wishes if they’d rather not eat.

Support loved ones in creating end-of-life plans

If they haven’t done so already, now is the time to gently support your loved one as they begin to make end-of-life plans. This includes things like:

• Creating an estate plan, will, and/or trust.
• Enlisting support from a local hospice care agency gives you access to all of the FREE benefits that come along with those services.
• Asking if there are any last requests regarding people they need to speak with or visit, places they’d like to go, etc. – all of which support the emotional and spiritual “life accounting” process we’ve mentioned above.
• Verifying their after-death wishes (what to do with the body, funeral/celebration of life plans, etc.)

Our culture is death phobic, and it doesn’t serve the dying well. They need people who can help them look at death head-on so they can speak about it, work with it, and process what they need to process without feeling responsible for others’ feelings. If that is challenging for you, contact home care services providers, spiritual counselors/ministers, or hospice/palliative care professionals who can fill that role.

The Weeks Before Death

In the weeks before death, people spend more time asleep than they are awake. If they aren’t already home- or bedbound, they will be around this time. It’s essential that primary spouse and family caregivers take advantage of respite care if they haven’t already, as caregiving is likely to be an around-the-clock event at this point. 

The goal at this point is to keep your loved one as comfortable as possible. Make sure they:

• Are being turned regularly to avoid bedsores
• Are kept clean and in fresh clothes each day
• Have access to fluids and easy-to-digest foods that appeal to them (if there are any)
• Have plenty of time to sleep or be alone in between the stream of visitors that tend to arrive during this point in the dying process.
• Are in soft ambient light.
• Aren’t in an environment that is overstimulating or too loud (pay attention to their body language and cues).
• Have the ability to sit in comfortable silence with the ones they love, resisting the urge to fill the silence with talk or activity. 
• Are supported if they begin speaking in metaphors, saying they see or hear their ancestors/loved ones who’ve passed or seem to see or interact with things you can’t see. Resist the urge to blame it on medication and open yourself to the mystery of the death and dying experience.

Never underestimate the power of “being there,” without any need to do or fix anything. This is one of the best gifts you can give to someone who is dying.

The Last Days And Hours

In the last days and hours before death, the body’s organs and systems begin to shut down. This has several marked effects on the body’s physical appearance and processes. Dying is not painful. 

The only physical discomfort associated with death is the physical discomfort caused by any medical diagnosis leading to death. Use pain medications as a means of monitoring medical condition-related pain. However, the goal here should be to keep your loved one as lucid as possible so they are awake to their own process.

• They sleep far more than they are awake.
• Speech or interaction may stop completely as they become non-responsive.
• Eating and drinking may stop altogether, which is fine (just keep the lips moist using stick sponges in freshwater or a favorite lip balm).
• Breathing may be erratic, very slow, or very fast. They may not take breaths for a minute or more and then start breathing normally again for a bit. 
• They may develop a “death rattle,” which is a very congested sound but is completely normal and doesn’t make them uncomfortable.
• Heart rate may also be erratic, and there is no need to take the pulse or blood pressure at this point.
• Disorientation is common, and there’s no need to be alarmed. The goal is to ensure they feel safe and as comfortable as possible.
• Skin color may change to very pale or grey in color as circulation slows down.
• Extremities may be cooler to the touch.

When they die, all movement and sound stop. There will be no pulse and no more breaths. Their eyes may be open, or they may be partially closed. They will not stay shut as they do in the movies unless they die with their eyes shut. Don’t let that alarm you. You are welcome to gently cover the eyes with a cloth if it’s hard for you to witness. 

Take as much time as you need to sit quietly and be present with the sacred act that has happened. There is no need to rush around or do anything for a while. If there is a hospice nurse or other caregiver present, they can support whatever “needs to happen” so you can have the chance to be present with your loved one.

HomeAide Home Care Offers End-Of-Life Care Support

Is your aging loved one showing signs that the end may be near? HomeAide Home Care offers licensed, experienced respite and home care services to families around the Bay Area. 

Contact us to schedule an in-home assessment, and let us know if you could benefit from extra support, allowing you to focus on more quality time with your loved one who is dying. In addition to providing respite care or companionship, our caregivers also support families with light housekeeping, meal planning and preparations, grocery shopping and errand running, laundry and linen changes, and more.

Adults receiving an official Alzheimer’s diagnosis experience a wide range of emotions. Anger, sadness, and grief are certainly in the mix. However, we’ve also heard clients (or their loved ones) experience a surprising sense of relief because the diagnosis is the final answer to all of the signs and symptoms indicating “something was wrong.” 

In many cases, an Alzheimer’s diagnosis explains why a person was experiencing one or more of what healthcare providers and caregivers call the Four A’s of Alzheimer’s.

Four A’s Of Alzheimer’s Diagnosis: Amnesia, Aphasia, Apraxia & Agnosia

Here is a summary of the four A’s of Alzheimer’s (and dementia), all of which can show up at any point along the disease’s progression.

Amnesia (memory loss)

In almost all cases, bouts of regular or worsening amnesia brought you to the physician or neurologist in the first place. Amnesia refers to memory loss, which becomes worse over time. It’s important to note that while some level of memory loss is considered a normal part of the aging process, Alzheimer’s and dementia are not normal or inevitable. Both are neurologic disorders that cause brain cells to shrink and die over time.

Most people with Alzheimer’s struggle with short-term memory loss far more than long-term. This is why they forget to turn off the stove, can’t remember friends’ names, or don’t remember what they did yesterday – but can remember detailed stories from their past.

Aphasia (loss of words)

Aphasia, the inability to recall words, is linked hand in hand with amnesia. In the mid-stages of Alzheimer’s, individuals can become lost mid-sentence. It can take them upwards of a minute or more to recall common words or immediate thoughts. This first phase is called expressive aphasia. 

Over time, aphasia increasingly worsens. By the later stages of Alzheimer’s and dementia, a person may talk completely nonsensically and will eventually lose the ability to speak altogether. They are also unable to follow or participate in conversations, which is referred to as receptive aphasia.

Apraxia (loss of motor skills)

The culture tends to think of Alzheimer’s as a loss of memory, but the decline progresses to all of the body’s systems and functions. The more brain cells die, the more signs and symptoms emerge, including those affecting the physical body. One of the tell-tale signs of dementia’s progression is when it moves from amnesia and aphasia to a decline in voluntary motor control. 

People with Alzheimer’s often develop a shuffling gait and are more prone to tripping and falling. As time moves on, fine motor skills diminish. By the latest stages, a person is typically char or bed-bound, and most of the body’s movements are involuntary (breathing, digesting, blinking, etc.)

Agnosia (failure of the five senses)

Agnosia is the final stage of Alzheimer’s. At this point, the brain no longer processes or accurately interprets information available to the five senses. By this stage of the game, patients require 24/7 care. People with Agnosia are typically 100% bedbound and are often on hospice to increase comfort care while providing support to the client’s spouse or family caregivers.

What To Do After An Alzheimer’s Diagnosis

Once the shock of an Alzheimer’s diagnosis wears off, it’s time to have meaningful conversations about long-term care plans. We all have the right to explore and create end-of-life plans that align with our values and preferences. Because the initial stages of Alzheimer’s include the first two A’s – amnesia and aphasia – time is of the essence.

Start conversations around long-term care planning

These conversations aren’t always easy, but getting things down on paper about a person’s preferences and requests provides invaluable peace of mind. A thoughtful long-term care plan allows spouse and family caregivers to be proactive and eliminate stressful or emotionally challenging complications that take place when there isn’t a plan, and everyone is in crisis mode/

Things to think about include:

• Creating a will or trust
• Completing advanced medical directives
• Talking about home care vs. assisted living options

The financial plan: paying for Alzheimer’s care

If you don’t have a financial planner, now’s the time to schedule a consultation with a fee-based financial expert who can assess your current financial situation and help you plan for the costs of progressive caregiving needs. Our post, The Cost of Senior Care… is a good place to anchor as you and your loved ones create a long-term plan. 

Most people draw from multiple wells of financial and community-based resources, so there is no “one way fits all” answer to questions about how to pay for Alzheimer’s care. A consultation with a financial planner provides a comprehensive look at your options so you can begin preparing for the months and years ahead. 

Also, did you know spouses and immediate family members can get paid for taking care of family members with Alzheimer’s? A meeting is the local social security office can establish whether or not you qualify.

Focus on healthy lifestyle habits after an Alzheimer’s diagnosis

There is absolutely no doubt that healthy nutrition, lifestyle habits, sleep patterns, and early treatment are vital for slowing down the Four As of Alzheimer’s and its progression. Immediately focus on the lifestyle habits that nourish the body and spirit. 

• Anti-inflammatory diet
• Ample access to social engagement and activities
• Cutting out unhealthy habits (check out these Mocktail recipes for alcohol-free “Happy Hour” alternatives)
• Focusing on healthy sleep habits and regulation of circadian rhythm

Begin researching senior care resources in your community

The more senior care resources you have at your disposal, the higher quality of life you and your aging loved one can enjoy. We touched on the need to begin planning for long-term care (in-home, assisted living, memory care, etc.) in #1. Within two to three months after receiving an Alzheimer’s diagnosis, begin meeting with home care agencies and assisted living communities to determine which makes the most sense when Alzheimer’s progresses beyond what you can manage on your own.

Even if you feel you aren’t ready for in-home care services (yet), making connections and getting a feel for what’s available makes a big difference when caregiving needs progress. Plus, even in the early stages, spouse and family caregivers should have a professional respite care plan to get the breaks required to support their mental and emotional well-being.

HomeAide Home Care Is Fluent In The Four A’s

As a longtime Bay Area home care agency, HomeAide Home Care specializes in Alzheimer’s and dementia care. We provide everything from respite and part-time care to overnight and live-in care options. We also work to provide attentive caregiving services to clients who live in assisted living or nursing home facilities.

Contact us to schedule a consultation and learn more about how we can support you and your loved ones.