Fresh air vital for living, healing

Bonnie Sandler, BS.W.

July 2012

Montreal has its share of hot and humid days, but most summer days offer enjoyable weather. On those days, residents of care facilities or care floors in residences should have access to the outdoors.

When visiting care residences, you may be shown lovely terraces and garden areas, but it’s sometimes hard to assess how well the areas are used. You must ask questions to determine whether your loved one will enjoy fresh air when the weather permits.

One lady at a local residence decided dancing was called for at a BBQ. Photo: Bonnie Sandler

Ask for a summer activity schedule. If the residence offers different levels of care, such as autonomous, assisted living and full care, you will need to carefully review the schedule to assess whether these activities are offered to all residents. In a “care only” residence, it will be easier to understand the use of outdoor facilities since the activities are not divided among residents on different levels of care.

If shopping for a residence during nice weather, pay attention to the number of residents outdoors and whether they are engaged in an activity with staff. Are there shaded and appealing areas? Are drinks provided? Is there music? Supervision? If there are only a handful of people outdoors, ask why. Is it a staffing issue? If the residence does not have enough staff to provide adequate supervision, access to the outdoors might be limited.

Residents fortunate enough to have loved ones in Montreal may enjoy a walk during visits.

Residents of care facilities or care floors are not always able to express their needs or desires, so staff should have a good understanding of each person and encourage and assist those who would benefit from being outside. It is not always important to have an organized activity; sitting outdoors with music can be an enjoyable activity in itself.

I asked staff at a residence about a walking club for my client, who is in good physical shape but not able to take walks on his own. I was told that it would take up too much of one staff person’s time to accommodate just a few people. But the recreation director might have assumed that there was little interest, instead of asking residents or their families. I advised the family to consider hiring a private companion for walks.

One of the small family residences that I work with has a large swing in the front of the home which, in nice weather, is usually full. The manager has told me that as much as she has tried to use the backyard garden, residents enjoy sitting in the front of the home where they can see the lively street action. The smiling faces of the residents say it all.

Residents enjoyed fresh air, change of scenery, fun food and good music during a facility’s BBQ. One lady decided that dancing was in order. Breathing fresh air is not a luxury. It should be a given.

bonniesandler@gmail.com

Should senior discounts be available to all?

Bonnie Sandler, BS.W.

June 2012

While the age limit varies, seniors are eligible for discounts at some stores, restaurants, hotels and services.

I see children and grandchildren shopping with parents and grandparents in department stores offering discounts on certain days. It could be a great excuse for families to spend more time together, or maybe it is having the senior pay at the cash to obtain savings. I’m not sure I understand these discounts. A wealthy 75-year-old will pay less for the same product as a struggling single parent? Why not have special discount days for mothers, teenagers or pet owners?

I understand early bird specials in restaurants, where savings are offered for early diners. Restaurants are busier later in the evening and want to fill their tables during the slower period. At least this applies to all diners and is not defined by one’s age. The senior discount meals often resemble the children’s-size portions, so are seniors really getting a discount or just paying for a smaller portion? If so, why not just offer two sizes of meals to all diners?

But it’s nice that seniors are offered savings. It could be for such services as moving although ads rarely specify the age that determines who is a senior.

At the other end of the spectrum are those who might be paying more for some services, such as banking and billing, which are increasingly handled over WiFi, not over the counter.

Bankbooks will soon be part of the dinosaur age. If you peek into a bank, you will notice that it looks like a senior’s convention. Many seniors prefer to do their banking through personal interaction with a teller and have the transaction recorded in their bankbook.

There are ways around using soon-to-be-obsolete paper billing. You can pay by automatic debit or credit-card charge and have the bill delivered to the email address a friend or family member who you trust completely.

bonniesandler@gmail.com

Questions and comments may be used in articles.

Dementia complicates parent-child dynamic

Bonnie Sandler, BS.W.

May 2012

When we think of “mother,” we think of someone who loves her children unconditionally, placing their needs above her own.

Alzheimer’s disease complicates the parent-child role, as the parent loses her abilities and needs assistance in her daily life. As the disease progresses, the mother is no longer able to assume her role.

For the child, there is mourning for the loss of the mother, whose behaviour and actions are a constant reminder of this difficult change. Some children distance themselves from the parent, finding it too painful to witness the effects of the disease. Others will adjust and take responsibility for ensuring that their mother is well cared for.

Freedom 50? I don’t think so. This was supposed to be a time where our children are settled with their own families and or careers, where we reached financial stability and our elderly parents still managed well on their own. Our children are settling down later, often dependent on their parents for years beyond what we imagined, and our parents, now living will into their 90s, need our time and assistance with their daily lives. Many adult children are struggling with their own health issues.

There are many ways Mother’s Day can be celebrated: sing an oldies tune together, hold hands, look at old photos and share beautiful memories.

Bringing grandchildren into the scene will delight both mother and grandmother and heighten the joy of the day. Gifts are always welcome but should be thoughtful to the person with the disease. A CD of favourite songs, a cozy shawl in her favourite color, a cuddly stuffed animal to hold, new slippers or a favourite food are good ideas. While a dinner in a busy restaurant may no longer feel good for the person with dementia, a small warm gathering of loved ones will be enjoyed by every mother regardless of her abilities.

Don’t let Alzheimer’s prevent you from celebrating the person who gave you life and so much more.

bonniesandler@gmail.com

Stranger on the phone isn’t a friend

Bonnie Sandler, BS.W.

April 2012

I am unable to keep track of the number of phone calls I receive each week from people who either try to sell me something, ask me to participate in a survey that will only take three minutes (yeah right), or are soliciting money for a charity.

I have also supposedly won some trips and prizes but never stay on the phone long enough to find out exactly what my big win was. I have my name on a “do not call list,” which might protect me from receiving even more calls.

I hope they understand that my lack of patience is not personal. These people are doing their jobs, but they are not my friends.

However, when someone who spent a day alone at home with little or no social contact receives such a call, their reaction might be very different than mine. They hear a friendly, engaging voice and may welcome any kind of conversation. A friend is defined as a person whom one knows, likes, and trusts. The stranger on the phone is an employee with a mandate to perform a task.

Of great concern are scam artists who target our elderly population to turn over large amounts of money. These fraudsters are skilled at using such strategies as befriending their target or pretending to be someone of authority. They may have a vulnerable person believe they won something of great value but must turn over a sum of money to receive this prize. Some of these con artists are based out of the country and hard for officials to locate. Often the most vulnerable are the least educated on this subject.

If you receive a phone call from a stranger, be on guard. Do not offer any information. End the conversation quickly. You can always ask for a telephone number to return the call at your convenience.

If you feel that there is something suspicious, contact the local authorities or call government-run PhoneBusters, 888-495-8501.

bonniesandler@gmail.com

Consider downsizing as a means of simplifying your lifestyle

Bonnie Sandler, BS.W.

March 2012

As I prepare for my second downsize in four years, I look around my condo and am shocked by the amount of stuff that surrounds me.

I thought I did a decent job of decluttering when I moved to a two-bedroom condo from a three-storey townhouse. I made a pact with myself to store memories in my heart without hanging on to items that needed a place to be stored. Lo and behold, I am finding letters and knickknacks that have been hidden away for four years.

Armed with an e-reader and digital camera, I no longer need tons of shelving for books and photo albums. I have kept one miniature shoe to remind me of the full collection. Clothes not worn for two years will be donated. With each box that leaves my life, I feel lighter and freer. My new home will have empty spaces surrounded by possessions that I love but also serve a purpose.

While I love the excitement, the process of moving and packing is overwhelming and exhausting. I have hired someone to conduct a moving sale for me, a decorator to help with planning my new space and someone to assist with heavy packing so I don’t spend my life savings on osteopathy for my fragile back.

I have been accused by clients of failing to understand their refusal to move. Some will admit they feel their quality of life would improve in a residence with social activity, access to care assistance, regular meals and no daily chores.

But they explain that they feel comfortable in their home. I offer the assistance of individuals who specialize in helping seniors downsize, sort through their possessions, sell what they no longer need and help plan their new home.

Sometimes the senior still refuses to make the move. Excuses range from: the task is too great at their age; they don’t want to leave the home they have lived in for decades; they feel their memories are tied with their home; they see what they have collected over their lifetimes and are unable to imagine life without them. I get it, I really do. And as long as someone is able to stay in their home safely, there is no argument.

I tell them to look at their large vase with the blue and yellow butterflies and assure them that neither their children nor their grandchildren will want it. They have heard this message from their loved ones but still refuse to believe it.

I hope my daughter appreciates my downsizing, ridding my life of possessions that will one day become her heavy burden to deal with (hopefully not for a very long time). Maybe one day I will be like George Clooney in the movie Up In the Air, living in a stark apartment with no personal possessions other than what I can carry in a suitcase. Actually, I hope not!

But the idea of fewer possessions and simplifying my lifestyle makes me feel free to travel and engage in other activities. My next article will be written from my smaller condo. Wish me luck!

bonniesandler@gmail.com

100 is the new 80 – move it or lose it

Bonnie Sandler

February 2012

Some newer residences have fitness rooms with exercise machines. Unfortunately, I have yet to see a resident in any of these rooms. The idea is great, but many residents have not seen the inside of a gym for years. They might not know how to operate an elliptical trainer.

However, when exercise classes geared toward residents are offered, eager participants will be found. In these cases, individuals are encouraged to do what they can, whether it be chair exercises or tai chi. The idea is to keep moving. For those who have let go of the “can’t be seen in a bathing suit” mantra, joining an aqua fitness class is a fabulous way of keeping active without placing too much stress on one’s body.

When visiting potential residences, it is as important to study the activity schedule as it is to stay for a meal to evaluate food and service. Fitness activities should be offered regularly. Research the times of the activities—if you are not a morning person, make sure that some activities are offered in the afternoon.

We have harsh winters and many seniors stay indoors for a good part of the season. Check whether the residence has room to walk around, whether fitness is encouraged.

Some residents have physical problems that prevent them from fully participating in certain activities, but if one can get to the dining room, even by wheelchair, one should be able to find part of an exercise program that they can master. For people with mobility issues, rolling their feet in circles or moving their arms to music are important. For residents with cognitive issues, staff should encourage participation. The popular adage “use it or lose it” applies.

Excuses are easy to find. Sitting around playing bingo may keep your mind working and have you enjoying the company of others, but taking care of the whole person includes keeping your body in motion. I am surprised by residences that only offer one morning activity and one afternoon activity, each lasting about an hour, especially when neither includes physical activity.

A Senior Times column on the need for a full activity program convinced the director of one residence to increase his budget for recreation.

We say 60 is the new 50. I say 100 is the new 80.

Many years ago, as a single parent with a young child, I vacationed at the same resort as my parents. Not only did I love their company, but the offer of free babysitting was too sweet to pass up. This plan meant that I stayed at a spa catering to people who were 55 and over. I stood out like a sore thumb with my young daughter.

This did not prevent me from joining the aqua fitness classes, and I remember the energetic leader shouting her daily routine with “one (foot) in front and two in position” as she got everyone moving around and smiling. At the time, I thought I was in a class with seniors.

I don’t know at what age one should be considered a senior, but in my world it starts at 80. I hope these spas exist when I reach my 80s. Maybe by then 120 will be the new 100.

We read the occasional story of a senior taking up a training program and running marathons.

Your body is yours—be good to it and feed it with regular physical activity, whether it is chair exercises or marathon running.

bonniesandler@gmail.com

Tech if necessary, but not necessarily tech

Bonnie Sandler, BSW

December 2011

For whatever reason, my brain will not learn the proper name for what I refer to as “the white square with the black squiggly design.”

I have QR codes on my For Sale signs in my real-estate career and I hope others make use of them. I have equipped myself with enough technical knowledge to function well in today’s world, although there is much more to learn if I were so inclined. My approach is on “a need to know basis,” and I am proud to say that I just learned to Tweet for professional purposes.

There are many seniors who enjoy the computer, either to communicate through email or Skype, or for Googling interesting information. Others refuse to learn to use a computer. While I encourage everyone to keep brains (and bodies) active, it is not necessary to use a computer to do so. There is a comfort level in using familiar products and not having to struggle with new technology. This is especially so for some seniors.

I visit many seniors in their homes and see they have not changed appliances or electronics. Their old ones function fine and they can operate them easily after so many years. While their children may buy newer, high-tech items, the senior will often refuse the change.

The QR code is the design at top left. If a picture is taken with a smartphone, the code will bring users directly to the website assigned to the code. Photo courtesy of Bonnie Sandler

I am unwelcoming of phone and cable companies that hire staff to cold-call homes with their sales pitches. They might find a captive audience in a lonely senior who will keep the conversation going and hear about great discounts if they change their cable or phone plan. Who doesn’t want to save $40 a month and receive better service? Some even will agree to a visit from a technician after one of these calls.

But does the person really need an HD box or PVR? Will their familiar channels change even though they will be receiving more of them? Will they ever watch the new channels or simply continue to watch familiar channels that might have different numbers, depending on the new cable service? Their phone number might stay the same and the savings may be real, but if they add their old channels to the new savings package, are they really saving in the end? Will the stress of having to give up familiar channel numbers and having newfangled machines collecting dust be worth the few dollars one might save?

So, before making any appointments after a phone call from a sales rep, try to get as much detail as you can about what changes will occur and ask yourself whether you are ready to give up your familiar ways. It may not be an easy process to revert back to your old system once a technician has made changes.

While I consider switching my comfortable BlackBerry for a new iPhone, I wonder if learning to type on a touchscreen will be worth the stress. My BlackBerry and I had a falling out when the system went down for a few days recently. It was then that I started thinking about starting a new relationship with an iPhone.

While I happen to be one of those people who easily change residences (I am looking for a new home), cars and other material objects, I look at my familiar BlackBerry with mixed emotions. After all, a house is just a house, a car just a car, but a cellphone is my office, social life, home, and so much more—and it fits into the palm of my hand. But I am still not sure whether the learning curve of a change will be worth it. Besides, as with most fights, I am less angry with my BlackBerry as time passes.

Questions? Comments? b.sandler@sympatico.ca
Answers may be used in future articles.

Smiles are your first positive clue

Bonnie Sandler BS.W.

November 2011

If you have been shopping for a senior’s residence, you probably know that many residences are not full to capacity. Some have waiting lists, but this is not the norm. What makes some residences successful while others struggle to reach capacity?

The bottom line is keeping a loyal and competent staff. I coach clients to speak to staff during visits and inquire about the length of their employment. If there is no long-term stability, it could be a red flag. Are staff easy to engage, do they converse in your language, are they comfortable speaking to you? Are they interacting with residents or focused on their task?

Staff who are dissatisfied because of low pay, poor working conditions or lack of appreciation by management may be frustrated. Rooms might not be cleaned properly, servers might be impatient and activities might not be interesting. Of greater concern is nursing staff who aren’t at their best. Are there enough employees to do the job, have there been staffing cutbacks? Residences in financial difficulty might reduce staff and services, so while they may be offering the best deal in town, be sure you are getting what you pay for.

I encourage clients to report to me the positives and negatives of their residence. Sometimes I am asked to intervene when clients feel they are not being heard or understood by management.

Don’t just meet with the leasing agent: Ask to meet with the head nurse, director and other people in key positions. When you buy a home, you hire a building inspector to study the house in a way that you are not able to. The inspection report may influence your decision to buy or not to buy. While we can’t compare the monetary investment of purchasing a property and leasing in a residence, in both instances you are searching for the right home. A second move is something we all want to avoid.

Don’t be shy, ask all the questions, do your own investigation. You may want to hire a professional who has extensive knowledge of residences and will guide you to ones that best match your lifestyle. Do your best to get a feel for the staff; after all, they will be the ones you will be dealing with on a daily basis. Find out who you would speak to if you had concerns and talk with that person to see whether you have positive chemistry.

Nothing is written in stone. While it doesn’t happen often, seniors who feel unhappy will make the move to another residence, this time wiser about what they want and need and better able to evaluate the match. Unfortunately, a move to another residence does pose a three-month penalty under Régie du logement regulations. These are rules I would love to see changed for residences, and seniors wanting to move out of their apartments and into a senior’s residence.

When you make a move, please remember to look for smiling staff.

Questions and comments can be sent to b.sandler@sympatico.ca

On turning 25, and what the future holds

Bonnie Sandler, B.S.W

October 2011

Who better to write about turning 25 than my favourite (and only) niece, who just celebrated her 25th birthday? Readers, meet my niece Loren: Having just turned 25 a few weeks ago, my aunt, who is a columnist for The Senior Times, thought it might be interesting for me to write an article for the newspaper’s 25th anniversary. I thought she was joking; I didn’t think I had any perspective on senior life. But the more I thought about it, the more I realized how strong my connections are and how so many others my age probably feel the same way.

At 25, I am lucky enough to still have a grandmother who is a. strong presence in my daily life. She is the kindest, most generous, and definitely the most stubborn person I have ever met, and is also the all-seeing and all-knowing matriarch of our family. There is nothing my grandmother wouldn’t do for my brothers, my cousin, or me. I have countless memories of Friday night dinners at her house, followed by sleepovers where Nana would tickle my back no matter how tired her hands were from cooking all afternoon. With two working parents, carpool fell into my grandmother’s hands. She’d ask what time we would need to be picked up, and then arrive at least a half an hour early (complete with a pompom on her antenna to make sure we were able to see her), just to be sure she had the best parking spot.

These days, as we grow older as so does she, it is our turn to repay the infinite favours she lovingly paid us.

My grandmother now comes to our house for Friday night dinners, and begrudgingly lets us drive her around.

Although her pride sometimes stops her from taking joy in these times together she does at least admit her pleasure in having her grandchildren helping out by her side. I so enjoy walking arm in arm with my Nana and would gladly tickle her back, too, if she’d only ask.

At my birthday dinner, when I was asked if I now felt old, I smiled as I looked around the table at the three generations sitting together. At 25, with my whole life ahead of me, I have never felt younger, more alive, or more appreciative of all the wisdom and experience that surrounds me every day.

Although my mother will shoot me for saying that many of my grandmother’s qualities were passed on to her, and I’ll never admit that these same qualities were passed on to me as well, I am so fortunate to have them, and if I turn out to be half the woman my grandmother is, I’ll be one very lucky senior. So, turning 25 is something to celebrate, as is enjoying the blessing of sharing life with a grandmother.

Thanks Loren, with love, Auntie Bonnie. And thank you, Senior Times, for the wonderful opportunity to share my thoughts with so many loyal readers.

Remember, all seven days are created equal

Bonnie Sandler, BS.W.

September 2011

For many of us, Monday to Friday represents our workweek. We look forward to the weekends for relaxing, family time, running errands or perhaps religious activities. Our weeks are fairly well defined with routine.

But for individuals with cognitive impairment who live in care facilities, the seven days of the week are no different from one day to another. Some people affected by Alzheimer’s disease or related disorder (AD/RD) may still find comfort in the familiarity of a church or synagogue activity during the weekend if this was a significant part of their lives.

I am never surprised when loved ones report disappointment in weekend activities in residences. Activity directors might only be hired to work from Monday to Friday. Activity and stimulation should not vary by day of the week. With families paying thousands of dollars every month for private residence care, the expectation of a full activity schedule seems reasonable.

I encourage families to study activity schedules when considering a residence. I will alert them to any noticeable slowdown in activities over the weekend. Weekends are less busy because families often visit or take loved ones out, but many of my clients are not so fortunate to have family living in Montreal or who do weekend visits. What then?

Small residences or personal care homes face more difficulty keeping a busy activity program because of the cost. Activities don’t have to be fancy and expensive. Many schools offer courses encouraging children to volunteer in the community. With a bit of effort and research, free or low-cost activities could be found. A staff person may have a calm, friendly pet to visit the residents. When clean laundry is returned to the room, the individual could be asked to assist in placing items in drawers. Having residents assist with such things as folding towels, placing napkins on the dinner table or sitting in the garden listening to Paul Anka tapes can be more worthwhile than hiring someone to organize an art class. Having residents gather around the television to watch a program that they are unable to follow is a waste of time and will result in chair sleeping. However, if there is a lively musical movie with a leader to encourage singing, then we have an interesting activity.

When visiting a residence, don’t get wooed by activity stations and rooms that will be part of the tour. Instead, take note of the use of these areas: Are residents playing pool, using the computers, in the library, busying themselves with a memory station? Is there a “snoozalen room” (a soothing and stimulating environment adjusted to individual needs) and is it being used? Are staff trained on how to make use of this type of therapy? After bringing a family to tour large residence, the daughter asked me where the 100-plus residents were hiding, since not one person was to be found in any activity room.

Families need to be less judgmental about the activities they find their loved ones engaged in. Tossing around a balloon serves many purposes and should not be looked at as a child’s play. Participants enjoy this game, stay alert and move around trying to hit the balloon. Observers will hear laughter and shouts of joy. Monday, Tuesday, Wednesday, Thursday, Friday, Saturday and Sunday. Every day should include activities for cognitive-impaired individuals.

Send questions or comments to b.sandler@ sympatico.ca and may be used in future articles.

Finding love in all the right residences

Bonnie Sandler, S.W.

July 2011

It seems that the topic of choice in the senior world these days is the closing of residences. It’s summer, the sun is shining (mostly) and it’s time to think positive thoughts.

Some of my clients have reluctantly made the move to a residence, mostly because of the not-so-gentle nudging of their children. They chose their new home with a mixed bag of emotions, including fear, anxiety and relief. The transition period can be rough and thoughts of regret and uncertainty may be present.

After some time passes, I sometimes get follow-up reports from the children. To the surprise of everyone, including the new resident, I sometimes hear of romantic relationships having formed. This is quite common.

People who have been alone for years, never imagining a new partner in their life, find themselves attracted and enjoying the company of a boyfriend or girlfriend. It almost sounds silly to hear these words attached to individuals in their 80s, but why not?

Finding romance is not going to happen to people, no matter what age, if they are isolated in their homes. Many married couples met in school or summer camps. It makes perfect sense that older people living in a camp-like setting may form special relationships. Good for them! Age should not be a barrier to romance. So for those of you so reluctant to consider a move to a residence, maybe you should give it another thought. I see too many seniors insistent on staying in their homes, isolated, lonely and lacking stimulation.

They feel they are successful because they have managed to continue to live at home.

While some are successful at this and doing well, many others are barely managing. Lack of social contact can lead to depression, which can manifest in physical pain.

Some of the “happening” residences offer trial stays, because they are convinced that a permanent move will occur once the person gets a feel for a better quality of life. At least one residence that I know of offers a two-day free trial including meals and activities. Often my clients refuse this offer and I suspect it is mostly because of fear. They think: Whom will I talk to? How will I know where to go?

As someone who is single and finds it difficult to meet men who interest me, I no longer worry about not finding a partner.

All I have to do is wait a few decades, choose the right residence, move while I can enjoy the activities offered and hope that I am one of the lucky women who hooks one of the few men, who are significantly outnumbered by the women. Check back with me in about 25 or 30 years.

Questions, comments: b.sandler@sympatico.ca They may be used in future articles.

Speak to your MP about their plans for the new Alzheimer’s reality

Bonnie Sandler

June 2011

At a recent international conference on Alzheimer’s disease, held in Toronto, I listened to many fascinating and diverse presentations. My main interest is the psychosocial aspect of the disease. Interestingly, many speakers, from various countries, had a strong message for Canadians.

Alzheimer’s disease and dementia is growing at such a rapid pace that it is expected that by 2050, there will be 115 million people affected worldwide. During last month’s election, Canadians were urged to seek out political candidates and ask questions about their strategy, both short term and long term, with regard to this disease.

Canadians with dementia will double in the next generation to 1.3 million people with a cumulative cost of $872 billion, according to Rising Tide, The Impact of Dementia on Canadian Society. The report highlights the fact that many of these people will be diagnosed before they reach 65.

The Canadian Alzheimer Society posted a letter on their website suggesting three questions residents could ask their MPs:

1. Would your party commit to meeting the needs of the 500,000 Canadians with dementia with a national brain strategy?

2. Would your party commit to a comprehensive and universal package of support programs for family caregivers?

3. Would your party support these investments (see letter on Alzheimer’s Society of Canada website) and commit to the $100-million contained in the budget for brain-disease research as a first step toward a comprehensive, permanent federal research program?

I admit to not being very politically aware. While I was fascinated by the charisma of Pierre Elliott Trudeau, I was more interested in the persona than the politics. I sometimes regret not having moved out of Quebec in the ’70s, as many of my friends headed west on the 401. But the strong message at this conference got me interested enough to want to ask my MPs some questions. Coincidentally, I was confronted with a personal issue where I felt my rights as a Canadian were wronged.

I sent off an email requesting a meeting with my MP or with one of his assistants. After a couple of days, I received a reply informing me that I would be contacted by the MP’s assistant. After two more days, I sent a thank-you note saying I was looking forward to hearing from the assistant. Another couple of days passed and I called the office at 10:30 a.m. to hear a recorded message saying the office would be open from 10-12 and 1-4 during election time.

I left a message that included phone where I could be reached. The following day, I dropped in to the office and asked not about dementia, but about their lack of response. The person who was to have contacted me heard my story and invited me to talk with her.

She was bright and charming and spoke well, explaining the lack of response and offering a chance to meet with the MP.

While she was quite sympathetic, there was not much she could offer other than a list of other people to contact. I handed her my card and asked her to email me the information. She promised to so. And? You got it, no message from her, and no vote for that party from me.

Questions and comments can be sent to b.sandler@sympatico.ca and may be used in future articles.

If there’s no need to cook, a kitchen area can be confusing, frustrating

Bonnie Sandler, B.S.W.

April, 2011

I am always intrigued to observe the reactions of loved ones when they visit full care facilities.

A person who needs a high level of care will have all their meals provided. In some residences these rooms have a kitchen area with a sink, a fridge, and a wall full of cupboard space. There are two opposite reactions to the lack of or the presence of a kitchen area.

Some loved ones feel that it uses up living space and makes the room smaller. Others feel that the look of this kitchen area gives the feeling of a studio apartment contributing to a sense of independence even if the person is not able to use it.

It may make a family more comfortable knowing that their mother, who spent most of her days in the kitchen, has a kitchen area. Others think it is confusing to have a kitchen area that will never be used and may cause frustration for their mother who may want to putter around and cook.

Who is this kitchen space really designed for? I rarely see residents using it other than keeping a few cold drinks or snacks in the fridge. If there is no designated kitchen area, the family can bring in a bar fridge.

If there is a private bathroom, a sink already exists there so what’s the point of a second sink?

A small kitchen area may be useful for semi-autonomous residents who can manage to prepare breakfast in their rooms. Not every building was built to be a senior residence. So when an apartment building is converted into a residence the large fully functional kitchens remains.

Kitchen are a questionable asset if meals are included in the monthly rent. The whole point of a meal program is to avoid cooking, which can also be dangerous in some cases. How much space is needed for snacks or simple breakfasts?

I often advise clients to use the spacious kitchen cupboards for clothing and personal belongings.

While it may be a difficult adjustment for family to see their loved one living in a room rather than a full apartment or house, a simple space, uncluttered may be the most comfortable when the loved one is confused.

Simple layouts, hallways without too many twists and turns, or circular layouts for those who need to walk for long periods work best. Some care floors in residences are converted from autonomous floors as the need for them grows.

So when visiting care facilities, think about the set up and what would work best for your loved one. Try not to think about what is most appeal- ing to your taste. No cooking, no kitchen — unless you’re planning to stock the pantry and whip up a few gourmet meals while visiting your loved one.

Questions and comments may be used in articles and can be sent to b.sandler@sympatico.ca

Dignity, kindness along Old Brewery “zipper line”

Bonnie Sandler, S.W.

March, 2011

At Christmas time, my daughter and I tried to sign up to volunteer to serve dinner at the Old Brewery Mission. We weren’t the only ones with this idea; all volunteer positions were taken.

We chose a later date and showed up at 4:30 pm, joining about 10 others also there for the first time. We were all a bit nervous, not knowing what to expect. There were two other mother and daughter duos, and one young man in this all female group—all strangers and yet within minutes we were conversing as if we had known each other for years. One teammate asked for my card when she realized that I worked in geriatrics, because she is involved in the same field.

We were given a quick tour by Luc, a fine man who had used the services of the shelter years before. He explained the different dorm rooms and answered our questions in a knowledgeable and friendly manner. He shared stories, including one of the man who slept in the same bed for 23 years. Luc, like the others working here, clearly enjoys what he does and feels purpose in his life. Our nervous group was escorted to the kitchen where our duties were explained. We were given aprons and gloves (which needed to be changed for each of the three servings). The group had difficulty understanding the “zipper line” for serving the food and this only added to our anxiety.

We were told to report any inappropriate behaviour to a staff person. Although we did not feel prepared, we moved into position as the diners calmly entered the room, filling each seat in the order they entered. There did not seem to be any newcomers, since seating was quick and efficient. Our group was still mumbling about the “zipper line” and worried that we still didn’t know what to do. Dinner was pasta with chicken and an interesting side vegetable dish featuring grape tomatoes. A slice of bread and two mini pastries were set at each place. All went smoothly until a vegetarian meal was requested, but my panic quickly disappeared when I discovered that this was not a problem and promptly served the meal to a very grateful and pleasant man. Everyone was treated with dignity and kindness.

Our group grew stronger as we found our rhythm, as though we had been doing this for years. We are still not sure whether we were in the proper zipper line but we were efficient. Two volunteers were assigned coffee duty, probably the most difficult task. Diners were polite and many expressed gratitude. Just as we leaned back for a moment to observe our good work after the first meal service, we were handed rubber buckets and told to clear the tables. I protested, saying that they just sat down, but quickly noticed that the first people to arrive had eaten their meals and were already leaving. The diners helped clear the table. They smiled and helped stack dirty dishes and place them in the container. Everything moved at a fast pace.

Next thing you know, we were on our second serving. By then our group had bonded like Krazy Glue and we were confident we were the most successful volunteer group ever. We continually congratulated ourselves, seeking confirmation from the staff, who agreed that we were extremely efficient. We joked and wondered whether their job was to tell this to each volunteer group. By the time we finished the third serving we were feeling like pros My daughter named us The Zippers.

We agreed to return in a few weeks as a team. We joined the full-time volunteers and staff while they ate dinner, some of us eating, others wanting to prolong the experience with a cup of coffee. It was then that I noticed beautiful framed photography displayed around the room and was told that the photos were taken by one or two of the men who used the services of the Old Brewery Mission. Although I am no art critic, these pictures seemed worthy of exhibition in an art gallery.

I can only begin to imagine the history of each individual that rendered them homeless. I wonder how many of us could find ourselves in the same situation through bad luck, mental health issues, addiction or financial bankruptcy. Are any of us safe from this lifestyle? Do we even think about how fortunate we are to have homes where we can eat meals and not rely on the charity and goodwill of others? Maybe we all need to volunteer to be grateful for what we have and complain less about what we are lacking.

We returned home exhausted but feeling amazingly good. I did cancel my plans for later that evening since the few-hour stint was more physically tiring than I imagined. It was a wonderfully rewarding experience to share with my daughter and to feel so connected to a group of people who went from being strangers to teammates in a short time.

Our return date falls on Luc’s birthday and the young man, studying to be a pastry chef, will be bringing a birthday cake. The Zippers will return!

Will your true loved ones please stand up

Bonnie Sandler, S.W.

February 2011

A loved one is “a person you love, usually a member of your family,” according to the Word Web Online and the Free Dictionary by Farlex. The MacMillan Dictionary definition is: “someone you care about very much, especially a member of your family.”

I often work with families during times of stress. These families can be caring and loving or members might be in conflict or estranged. Nothing surprises me, except that the term “loved one” seems to be always defined in the context of family.

Who is the person you trust most with your secrets, the person you turn to when you need support or advice, who you would want to advocate for you if you were in the hospital? Who would you trust to care for your children or grandchildren, who you would trust to manage your financial affairs? In good times or bad, who is the first person you share your news with?

This person is not always a blood relation. While we often have special relationships with our family, sometimes our closest person, our “loved one,” is a close friend. I find that women, who have special relationships with their girlfriends, understand this more than men. The young generation refers to such a friend as a BFF, or best friend forever. These friends are in our lives by choice.

If a person dies without a will, there is a formula of how the succession is divided. It distinguishes between whole blood and half-blood relatives. If there are no children, parents or siblings, their possessions might end up with a distant niece rather than their truest loved ones.

In my family, there was a rift when my ancestors arrived here from Europe in the early 1900s. Every so often I will be informed of the birth of a new cousin, names that are unfamiliar to me. Recently I discovered that someone I knew through a close friend is my cousin. We were fascinated by this discovery and became friends. Yet I have some cousins with whom I have no contact—no animosity, just no contact.

My interest in the term “loved one” arose when I had the unfortunate experience of spending much of my time with my closest friend in palliative care. While I was a constant visitor and advocate, the room for loved ones was called the “family room.” While my caring and love for my friend resembled that of love for a close family member, I was not recognized since there was no family relation. When asked to identify myself, I learned not to say best friend but rather relative, and if questioned beyond this, I added cousin. No one seemed anxious to talk to just a friend.

Every so often, I clean out my memory box. Here I find cards from people who were at one time loved ones in my life, never imagining a time when they wouldn’t be. While they bring back many special memories, they are no longer defined as my loved ones.

Some loved ones are constant during our lives, and many of them are our family. But we do have a wider range of loved ones. So, while it is important to have a will and a mandate in the event of incapacity, it is also important to review your instructions periodically to make sure it is in sync with your present situation. Deaths, divorces, and family rifts may be reasons to update your instructions.

Happy Valentine’s Day to all my loved ones. You know who you are, no need to stand up.

Being in the hospital is hard enough without worrying about finances

Bonnie Sandler, S.W.

December, 2010

Sadly, because of a loved one’s illness and subsequent death, I spent much of my time in a hospital during the past few months.

Wanting to be supportive and at the hospital as much as possible is costly. As a near-daily visitor, I found myself feeling close to bankrupt after parking charges of $15 a day in the hospital lot, or taking my chances at the meters and watching the clock to avoid parking tickets (I wasn’t always successful). I am not sure who is charged less than $15, because by the time you park your car and walk to the hospital, pick up the mandatory coffee (another few dollars) and manoeuvre through the hospital, you have just about surpassed the minimum time before reaching the maximum payment. Hospital parking should be affordable and accessible.

For the patient, there is the cost of a private room, about $80 a day. I can get a decent hotel room for this price. Think about the patients who believe they will be hospitalized for a few days and decide to stretch their budget and go for the private room only to be hospitalized for much longer. Moving into a shared room with up to three other people isn’t easy. Neither is going into debt.

Hospital stays, aside from being stressful, are boring. Many patients are confined to their rooms or bedridden. There is not much to do other than read or watch TV. Reading is free, TV is not: It will cost about $66 a week, more if it’s ordered by the day. It’s cheaper to go to Cuba for an all-inclusive week-long vacation.

And what do you get for all this money? There is a button to push should you need assistance. Like a passenger in a plane, when you press the call button, a steward will quickly appear. At the hospital, you will get a voice on the intercom. I am not sure how many patients ring the bell because they don’t need medical assistance – they are not ordering a latte! Why not just send in the nurse?

After explaining that the IV machine was beeping, I was told that someone would come. Five minutes went by, 10. After about 15 minutes I went to the nursing station and was assured that someone would come. I waited another 10 minutes and then stood at the door near the nursing station as a not-so-friendly reminder. More than once I was reminded that a beeping IV is not life-threatening. What about the patient who is too ill to press the button or not strong enough to explain the problem? If there are no visitors to advocate on behalf of the patient, then what?

Eventually someone will pass by with fresh water or other service and hopefully notice that the patient needs assistance. The solution involves fat wallets paying for private attendants when there are no visitors. The last thing any of us want is to be sick. Hospital stays are not something we choose, but can the majority of us afford the related costs? Perhaps we could afford it if we chose a semi-private room, with no TV, and no visitors once they find out what the parking costs. With this knowledge, we have even more reason to try to stay healthy.

If only this were within our control.

Questions and comments can be sent to b.sandler@sympatico.ca and may be used in future articles.

When looking for a residence, ask an expert, not your hairstylist

Bonnie Sandler S.W.

November, 2010

When assessing and understanding the needs of loved ones, knowing the family’s preferences, including their budget, helps direct them them toward residences that may be a good match.

It has taken years to learn how residences work and to understand that there is no such thing as the perfect residence, even if you’re paying thousands a month. My job is to help clients understand the differences between facilities and work with the family to weigh the pros and cons of each. I can only make recommendations. The final decision rests with the family.

Sometimes this process must happen within a short time frame; other cases are never-ending. Just before a decision is made, new advice might come from a friend, a friend’s friend, an old acquaintance, a familiar waitress or bank teller. The list goes on.

The family ends up more and more confused, asking for information about totally inappropriate places.

I might suggest visiting more residences so families can better understand why these well-meaning people are giving useless information.

Everyone knows someone who seems to be an expert on residences. I suggest that, before a family begins working with a private counsellor, they check out the counsellor’s credentials, ask for references, and get a sense of the chemistry they might have with the professional.

Even someone who has taken this journey with a loved one might have limited knowledge of the resources available.

Families may be handed a list of a few private residences by their CLSC or hospital social worker, but it is rarely comprehensive. And sometimes it is the same place, recommended over and over when in fact there are several that should be considered. Going out on your own is an option that can be overwhelming and stressful.

Determine whether the residence is accredited. A positive reply can mislead the family into believing that it is highly recommended. It is good to know that such safety requirements as call bells, security and fire prevention systems have been verified.

These inspections might not include such things as staff background checks or qualifications, staff ratio or even basic things like handrails.

So while your hairstylist may give you the best hairstyle, please understand that she may not be the best person to advise you on which residence is the best for your loved one.

Is there such a thing as a forever home?

Bonnie Sandler, S.W.

October, 2010

Having grown up in a home that afforded little privacy from my bedroom to the main living space, I dreamed of a home where the bedrooms were far from visitors’ eyes.

My first house was a cottage where a stairway led to bedrooms and bathrooms that were not visible from the main floor. For me, this was heaven.

I couldn’t understand why my friend chose to buy a bungalow that offered minimal separation from the sleeping areas and the open living areas. As my career led me to working with the elderly, I soon realized she’d made a wise choice, which would allow her to stay in her home longer should any health issues make climbing stairs difficult. I decided to downsize and bought a condo.

Aging in our own homes might be the preferred choice, but maybe not the ideal choice. Older people can be isolated as their social network shrinks and their abilities diminish. Someone who has few friends or family, is no longer able to drive, and finds familiar activities becoming challenging may end suffer from isolation.

Staying in their home of 50 years may be a choice of habit, fear of change and sometimes pure stubbornness.

A well-thought-out move to a senior residence can increase quality of life. Even a move to an apartment or condo means there are fewer physical challenges such as staircases.

It’s easier to meet people, network, carpool and share coffee with neighbours in this setting rather than a single-dwelling house.

When we are buying our first home, we think of raising children and seek homes that would best suit a growing family. We do not give thought to the possibility of one day living there alone, faced with empty rooms and many stairs. If we did, we would probably buy one-level homes or condos with superintendents to assist with our parcels and provide us with security. We would be free from having to handle home repairs.

Will the boomer generation downsize from their family homes easily after witnessing the struggles of parents too attached to their first homes? Or will this generation move to senior residences and focus on quality of life, fewer responsibilities and more social activities? As a boomer, I made my move to a condo a couple of years ago and couldn’t be happier. Will this be my forever home? Hard to say. Other than my childhood home, I haven’t lived in the same place for more than 10 years.

So check back with me in 10 years.

Send questions and comments to b.sandler@sympatico.ca

Sandler will participate in a seniors’ information day sponsored by the Council on Aging November 4, between 10am and 4pm, at 1444 Union Ave. across from The Bay.

Early birds, night owls need flexible mealtimes

Bonnie Sandler, S.W.

September, 2010

I remember lining up for early-bird specials when vacationing in Florida with my parents. While we were not accustomed to late-night dining, my parents chose to eat still earlier than usual to take advantage of reduced prices offered by restaurants.

In senior residences, these choices are often taken away. Many adult children voice their dismay when learning their parent is served dinner at 5 or 5:30 p.m. When they question this practice, they might be told it is because of staff issues, that residents prefer go to sleep early or that it works best in the overall management of the residence.

For residents who like to stay up late, this can be a difficult adjustment. If dinner is finished by 6 p.m., it makes for a very long evening. If no activities are offered after dinner and if residents prepare for bed at 7, some fall asleep early because they are bored and then rise before the sun. Others might get restless or agitated.

If there is only one breakfast time and it is before the resident normally wakes up, this could also lead to agitation. While we understand the need for scheduling in large and small residences, we want the routines of our loved ones respected. In a person-centered-care approach, the schedules are adjusted to suit individuals as much as possible.

Some terms used for this type of care are “person centered,” “resident focused,” “patient centered” and “individualized care.” This approach focuses on the uniqueness of each person even as their abilities decline. It emphasizes the patient making choices whenever possible in their daily lives.

The information gathered by the residence prior to the move is telling. If there is interest in the history and lifestyle of the person, often there will be attention to individual needs and matching to services to the person. Frequency and time of showering should be investigated.

Many individuals will gradually adapt to the style of living in the residence and sometimes adult children are more upset during this transition phase than their parent. For loved ones, working through the move to a care facility involves adjusting to the stages of the disease. Anger and sadness manifest in different ways, including being upset about new routines that do not allow for choices.

When we are capable of making our own decisions we do so, but when one no longer has the capacity to make these decisions, family members should try to select a care facility that they feel best matches their loved one’s lifestyle. In an ideal world, each resident would be able to continue with their chosen lifelong habits. Questions and comments can be addressed to b.sandler@sympatico.ca and may be used in future articles.

Parents’ finances can be a touchy topic

Bonnie Sandler, S.W.

April, 2010

I am contacted by a daughter whose mother is considering a move to a senior residence.

The daughter gives me details of the parent’s mental and physical functioning and I begin to think about a suitable residence, but I have one more question: What is your mother’s budget?

“I have no idea,” the daughter says. It seems her mother has been very secretive about her finances.

I ask probing questions but get no further information. Perhaps the brother might know more? The daughter laughs and tells me her brother knows less than she does. I am stuck. Without an idea of budget, how can I suggest residences?

I organize a family meeting. The mother is very open in all areas of discussion. I describe different types of residences and explain that I need to have some idea of her monthly budget in order to proceed. The mood in the room shifts.

The mother is vague in her answers and the children are getting upset. I end the meeting and schedule to meet with the mother alone. There is still secrecy, but a number is thrown at me. It is very low and will not cover the type of residence she is interested in. We continue the dance without any resolution.

I work with the children and we guess at monthly expenses, coming up with a reasonable monthly budget we think fits. I arrange a couple of visits to appropriate residences for the family.

The mother really likes one residence, so we sit down with the leasing agent and go over pricing. The mother insists that it is too expensive and that she cannot afford the move.

People often underestimate their monthly budgets. Food, entertainment, heat and electricity are often part of the package at a residence.

When seniors hear the cost of the monthly rent, it sounds very expensive, but families need to realistically look at all expenses to know whether the residence is affordable.

I advise seniors not to max out their income with a move to a residence. There should be a cushion for unforeseen expenses such as future care needs. Children are often willing to help out financially to allow their parent to move into a residence. What parents don’t understand is that many children would prefer their parents live in a safe and comfortable place that allows for socialization. Helping out financially is not just for the parent, but for the peace of mind of the children. It’s a win-win situation.

So before you think that a residence is not affordable, look at the dollars and use common sense.

Comments and questions can be emailed to b.sandler@sympatico.ca and may be used in future articles.