Consumers need to become better educated about the process of finding a Good Therapist. However the last thirty-five years as a therapist has taught me that a Good therapist is often about the fit. What research has demonstrated is that a Good therapist FIT is based on whether the consumer feels more comfortable with a man or a woman therapist. The race and or religion can play an important part in the fit. Also the socio-economic level of the therapist can sometimes play a part in the fit. Here is what I think is the most important factor that contributes to the very best fit and successful outcome of therapy, does the therapist engage in asking meaningful questions, offer unsolicited feedback, keep you honest, encourage being accountable for your behavior, and push you to become the person you truly want to be.
Thank you for listening.
Dr. Mikol Davis – Family Conflict Specialist and Elder Care Psychologist with AgingParents.com
The Boomer’s Guide to Aging Parents (Video)
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Lots of us are providing some kind of help to aging parents. Some are working at their regular jobs, handling responsibilities for their own families, and doing caregiving chores for their parents, all at the same time.
Maybe it’s a cultural thing: “yankee independence”. Maybe we’ve been socialized to be self-reliant. Maybe it never occurs to us to get help with our elderly parents. Whatever it is, caregivers aren’t rushing out to ask everyone they know to pitch in.
Even within families, the caregiver burden seems to fall more squarely on one person, often as not, even if there are multiple siblings or other relatives who could pitch in. At AgingParents.com, we often speak with caregivers, in our role as consultants, and in mediating family conflicts. I’m a nurse-attorney, and I work with my husband, Dr. Mikol Davis. A recurring theme in the conversation with clients we meet is the resentment of one person feeling overburdened, and not getting enough help. But does the resentful one ask for the help she needs? (It’s often a “she”).
In my past work as a nurse, I was often in the role of teaching family caregivers how to manage the tasks of the job. In my role as a lawyer, I have been an advocate for individual rights. Now I’m in the role of teaching caregivers of aging relatives how to manage their complicated duties as well as teaching them how to advocate for themselves.
Speaking directly and asking for what we need calmly is not a skill everyone possesses. Even if it seems obvious that one member of the family is doing the lion’s share of the caregiving, that person often seems to say little, even while expecting and not getting assistance from others. Anger builds, sometimes boiling over into outbursts, sarcasm, and aggressive behavior.
We urge clients who are in the role of the “burdened one” to speak up. Although other family may live at a distance, or are less capable than the burdened one, you’ll never find out who is willing to help unless you ask.
If asking family doesn’t do it, it’s certainly possible to recruit volunteers from community agencies, church and synagogue groups, and other organizations. If the budget allows, paid assistance through agencies is available to take some weight off the primary caregiver. The point is to ask for the relief every caregiver needs. This is particularly true if the parent who needs the caregiving is a difficult or unpleasant person. Some parents are.
Despite our culture’s emphasis on self-reliance, we have to recognize our own limits. No one can take care of elders 24/7, or even part time, without relief unless the caregiver risks her own health breakdown.
We hope all family caregivers will take care of themselves by asking for some assistance with the work. It’s entirely reasonable to ask for help, besides being necessary for the caregiver’s own mental health.
Let’s consider “yankee independence” to be an unwise
attitude when it comes to caring for aging parents. We need all the help we can get.
Alzheimer’s is indeed a devastating diagnosis for anyone. Much fear is associated with it, as there is, unfortunately no cure as yet. You can encourage your father to talk about how it feels among your family members. You can offer to accompany him to an Alzheimer’s support group. You can offer your reassurance to him that you’ll be with him on this journey in his life, and that you will see to it that he is safe.
I suggest that you encourage him to have all legal documents he needs updated and available to the family, for his peace of mind and yours. It can also be helpful for everyone in the family to educate yourselves about Alzheimer’s Disease, using your local community resources and the Alzheimer’s Association, which is a very good source of information for all of you.
Finally, it is wise to spend as much time together as you can, enjoying the things that your father and your family like to do. This disease will cause a progressive loss of memory. It is important for the family to enjoy the moment, and to have as many positive experiences as you can with your father for as long as he is able to participate. Even if he forgets what happened a short time later, one needs to practice living for right now when you are with him. Remember that now is the time to plan for the future needs of your father with your family, don’t wait for a medical crisis.
Grieving over the loss of a spouse is one of the most difficult things we go through in life. It is very individual, and can take a year, or longer, before a grieving person feels a lessening of the sadness and devastation. We don’t really get over such a loss, we learn to better cope with and accept reality. However, we can do things for ourselves that restore a sense of purpose and provide structure and meaning to our lives, creating better mental health, even while the grieving process is going on. Being present for your mother is one of the important things you can do. Invite her to activities, or just spend time together doing things she would normally like to do. Include her in your life to the extent that she is willing. Offer to visit, cook a meal together, see a movie or play cards, for example, if those are things she would usually like. Keep trying. Ask her if she would like to talk. Sometimes, grieving can lead to depression that doesn’t let up. Rule of thumb, if it has been over one year since the death of a spouse without some progress forward, then it is time to consult the doctor. In those instances, encourage her to see her doctor to be evaluated for anti-depressant medication on a temporary basis. This can often help get a person get unstuck. Grieving is not a mental illness, but the sometimes accompanying depression can be very hard to overcome without medication. Encourage her to see her doctor if she seems to be “lost” in the process, and find out if medication and or counseling can help.
Irritability and loss of interest in activities a person used to enjoy are two symptoms of depression, but there could be other causes for these two problems. The symptoms are a cause for concern. Encourage your father to see his regular doctor and describe the symptoms. You can tell you father that you are concerned because he doesn’t seem to be having much fun lately, and offer your support in going to the doctor with him if he wants, but especially in following up if he doesn’t make the appointment. If Dad wants to go to the doctor by himself, suggest that he briefly write down some of your specific concerns while still on the phone with you. If depression is the reason for these problems, the good news is that it is successfully treated quite often in seniors.
What are the treatments for depression in older adults?
Older adults generally respond very well to medication for depression. The newer drugs, called “SSRI’s” help with brain chemicals that can be out of balance with depression. Older medications for depression also work very well for some people. Often, a combination of talk therapy and medication is a good solution to the problem, with a 80% success rate in older adults.
You were just having a very average day before your cell phone rang, you answer it. You identify the caller as your mother, however it is a mans voice, the local Emergency Medic on the scene. He tell you your mother fainted, fell to the ground, got scraped up, has many cuts to her neck and face, and needs to be transported to the local hospital for evaluation. Now what do you do? Is this a call for immediate action? If so how will you deal with the emergency after all you live 500 miles away from Mom. Oh yes weren’t you the one Dad told on his death bed, “Please promise me you will always take care of your Mother after I have gone.” Yes my friend you were the one that your father expected would take care of Mom. But that is really unfair, since you have other siblings who can do the job. Actually the reality is your other siblings are FLAKES. You never were able to trust them as kids, they never were responsible as adults, and they never were able to handle their own affairs and money well. Yet now is the time you need them to help carry the Aging Parents Care Burden (APCB)!
So what do you do now that you got the emergency call, take the next airplane out and cancel the rest of your day or week? This experience is not a unique one, and in fact is quite common to now Baby Boomers. However this crisis forces you to re-evaluate your family resources. Are you really totally alone on this one, or is there a way to take leadership from a far and coordinate the local response team? The answer is that this emergency probably does require your immediate advocacy in the hospital. However this crisis situation your serve you as a “wake up call” to do some proactive planning. Once at the local hospital go see the discharge nurse. Ask her to refer you to a private Geriatric Care Manager. This nurse or social work professional can serve as your local coordinator of all the medical and emotional needs of your mother. The professional can evaluate if it is safe for Mom to return from the hospital to the family home, or if she needs additional services to care for her needs including the safety ones. The Geriatric Care Manager can take Mom to doctors appointments and or be there if Mom is admitted to the hospital again in the future. This professional can serve as the “non-emotional” point person to coordinate care with your siblings if they care to help out with Mom.
Remember the best thing you can do for yourself and your Aging Parent is hire a Geriatric Care Manager.
