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Talking to a loved one about moving to a community is usually a dreaded and difficult conversation. Ignoring the subject or being afraid of your loved one’s reaction and response is normal. However, if you are noticing cognitive changes in your loved one, it’s important to raise the subject before a crisis occurs. Once a crisis develops, you will find yourself and your family frantically searching for the right community for your loved one within a very short time frame. Thinking and speaking about long-term care needs with your loved one sooner rather than later may lead to a more collaborative discussion and hopefully avoid anger, fear, and accusations.

1. Notice and track the changes.  If you start to see cognitive changes in a loved one, it’s time to pay attention. Consider keeping a journal with specific dates, times, and what happened.  Ask neighbors, family members, and friends if they have noticed anything. Often it’s someone else who will notice a change first but will be hesitant to say anything.
2. Consider other conditions that might be causing dementia symptoms. Many physical conditions mimic dementia but are treatable, including urinary tract infections, diabetes, low blood sugar, vitamin deficiencies, thyroid issues, medication changes, depression, anxiety, and more. Engage your loved one’s primary care physician. Even if they can’t speak with you because of HIPAA, you can always speak with them. A good doctor will listen.
3. Do some research.  What kind of help do you think your loved one needs? Medications? Cooking? Bathing? Do some research into the different types of care possible – independent care, assisted living, memory care, and in-home care. It’s possible with a few hours of in-home care your loved one can function in their own home longer.
4. Step into your loved one’s shoes. Empathy is vital to success. Think about how your loved one is going to feel when you bring this topic up. Sadness, anxiety, fear, and anger are common reactions of a loved one. Remember there may be a feeling of grief for them – they are thinking about giving up their “home”, independence, and way of life.  While they may be in denial, it could also be their dementia getting in the way of understanding what is happening to them. And above all, remember they are not children. They are not only your parent or spouse – they are adults who have lived a very rich life which needs to be honored.
5. Reach out for support. If at all possible, get your family on board. Family tension often rises with a dementia diagnosis of a loved one. Ideally, you want to all be on the same team. At this point, you should think if there is an unbiased third party that your loved one respects and will listen to. Often another person such as a doctor, clergy or close friend can help with the conversation and in some cases may be the best one to have the conversation with your loved one instead of you.
6. Practice your language.  Role-play what you will say – don’t use words such as “nursing home” or “facility”. Instead, say “assisted living” and “community”. Be honest and thoughtful. Pay attention to your tone and body language. Use a calm and pleasant voice, and try to maintain one even though your loved one may become angry.  One of the goals is to discuss the issues and solve them as a team. And remember – it’s critical to validate how they are feeling about this conversation and a potential move.
7. Decide where and when to have the conversation. Think about the day, time, and place that will work best for your loved one. Make sure neither one of you is in a hurry. Have this conversation at a time of day when your loved one is most alert. This should be a one-to-one conversation, or you can include the person you identified in step 5 above.  Too many people may make your loved one even more confused and defensive.
8. Begin the conversation.  Try not to show anxiety – take 10 seconds and breathe deep. Begin by asking how they’ve been feeling. Have they noticed any changes? Are they worried about anything? This is when your log from step one will be useful. While it’s ok to give specific instances, don’t be accusing.
9. Offer to go to the doctor with the person. Tell your loved one:
   • There are physical issues that can cause these symptoms that be treated.
   • Knowing now can help your loved one and you plan.
   • Seeing the doctor would help both of you with peace of mind.
10. Recognize that this will take multiple conversations. Don’t dismiss the cognitive changes because the conversation was difficult or didn’t appear effective. You are asking your loved one to commit to a large disruption in their lives. They will need time to digest it.  Take the time between conversations to think about what went well, what didn’t, and plan for different approaches.

By Lisa Walts, MSW, LICSW – Social Worker at Cadbury Commons

Learn more about Cadbury Commons’ Community.

Boston area senior centers and local teachers have been offering online fitness classes for several months now, and it’s helping those most at risk during the pandemic. Seniors will find plenty of offerings, too: from meditation or yoga to Zumba strength training.

Even those some gyms and community centers may be opening back up, seniors who are still concerned about their vulnerability are opting to exercise from home. Here’s a list of live classes, videos, and resources from local teachers and groups.

NOTE: Schedules and availability subject to change. Be sure to check to verify offerings!

Boston Area Senior Centers

The Newton Senior Center

Virtual Class: Zumba with Ketty Rosenfeld
Time: Virtual Weekday at 11 a.m.
Cost: Donation Suggested
To Participate:
Download the Zoom application and email [email protected] to receive an access link.
Videos: Tai chi, muscle conditioning, and arthritis exercises at www.newtonseniors.org.

Milford Senior Center Weekly Fitness program

Virtual Classes: line dancing, strength and stretch, yoga, and more.
Instructors: Certified local fitness instructors
Time: 10:30 a.m. every weekday
To Participate:
Milford TV streams an exercise class on its channel and at milfordtv.net.

Chelsea Senior Center

Videos: warm-up, some cardiovascular drills, and strength training
Instructor: Karen Brannon
To Participate: Search Chelsea Senior Center on YouTube.

Hopkinton Senior Center

Virtual Classes: Tap, barre, bootcamp, and Zumba, chair yoga (Mon & Thurs)
Instructors: Rebecca Tredeau and Crystal Lee
Time: 2 PM weekdays
To Participate:
Contact assistant director Ashley Shaheen at [email protected] for more details, or connect with Tredeau directly through her Facebook group, Zoom-Fitness Classes LIVE with Rebecca!

Fenway Community Center

Virtual Classes: biweekly meditation, movement, and yoga
To Participate:
Requires a Gmail account. Access links are published on the updated calendar online. Visit fenwaycommunitycenter.org/calendar.

YMCA 360

Videos: series of taped classes on low-impact exercises for active older adults. Each of the six 20-30 minute programs focuses on weights, chair yoga, core strength, and more.
To Participate: visit ymca360.org.

The Malden Senior Center

Videos:  The center uploads a fitness video from local instructor Aimee Borda on its Facebook page each week.
To Participate: visit www.facebook.com/MaldenSeniorCommunityCenter.

Council on Aging

Virtual Classes:  Yoga and Zumba, for senior residents.
To Participate: call the COA at 617-349-6220 for information on how to sign up.

Compassion fatigue is a well known occupational hazard for those in the caring profession. Read more

Let’s be honest, people are terrified of dementia.  We work hard to hide a dementia diagnosis behind a wall of silence built with bricks of fear, shame and stigma, much like we spoke about cancer 40 years ago (you know, the Big “C”, in hushed voices), But with cancer, something changed along the way. We learned to talk openly and acknowledge the human experience of living with and possibly dying from cancer, and eventually having cancer became a “courageous battle” instead of a shameful illness.

As with cancer, society needs to find a new way to talk about dementia. We tend to focus on the end-stage of the disease,  conjuring up the image of a dying person who is now an “empty shell”.  But dementia has a beginning and a middle, and it’s vital to remember that people are LIVING with dementia.  Those with dementia struggle to be present in their lives, to work through the “fog”, to find humor in the scary and ugly moments, and to continue to live life and love to the fullest. It is a brave and serious fight. It is a DIGNIFIED fight.

So like with cancer, we need to change the image of someone with a dementia diagnosis. And as we did with cancer, we have to look dementia in the eye in order to understand empathically how a person lives and loves in the presence of this disease.  It’s a challenge. It’s scary. And it’s what makes us human.

Learn more about Cadbury Commons’ Memory Care Neighborhood.

By Lisa Walts, MSW, LICSW – Social Worker at Cadbury Commons

Surviving COVID, on top of ALZ caregiving, is like surviving the free fall of skydiving. It takes a Senior COVID Survival plan—and practice—to stay steady enough to open our parachutes in these stormy times. Here are half-a-dozen steps, grounded in science and personal experience, that make up my daily action plan.

1. Spotlight self-care

Because it lays the foundation for mentally managing a perilous world
So, I stress physical activity, sleep, exercise, healthy eats, and social contacts

2. Schedule uplifting activities

Because we all need to get out of our heads and into our lives
So, I engage in prized projects, healthy distractions, and enjoyable ventures

3. Take a tranquilizer

Because in-the-moment soothing can calm jittery nerves
So, I turn to the 4-7-8 breathing technique: inhale-hold-exhale—4 times

4. Adopt a broad perspective

Because it lets us be with stress, not be our stress, thus easing its hold on us
So, I mentally step back, observe, and make room for stress

5. Allow my upsets

Because common practice—pushing away upsets—just adds to our misery
So, I open myself to feelings, even when I dislike them, and just let them be

6. Give myself a hug

Because self-compassion takes the edge off feeling crummy
So, I offer kindness to myself just as I would hug a fragile friend

So, how about you? Might you consider a Senior COVID Survival plan? Given your unique values, circumstances, needs, and leanings, what daily steps might you take to maintain your steadiness, open your parachute, and survive in these scary times?

By Jerry Murphy

Jerry Murphy is a member of the Alzheimer’s Association Caregivers Support Group at Cadbury Commons run by our social worker Lisa Walts.