WELLNESS

Advocates for Health in Minnesota try to save lives — one outdoor AED at a time

Leo Pomerenke — Tue, 16 Jul 2024 22:22:00 GMT

WILLMAR — Rich Feneis has a litany of stories about someone’s life being saved by an automated external defibrillator.

One such story involved his brother, Bob Feneis, and his friend, Marv Erickson, in 2016. Both were volunteering at Hazeltine National Golf Club in Chaska, Minnesota, during the Ryder Cup.

As the two were walking down a trail, Erickson stopped talking and fell over, going into sudden cardiac arrest.

“It’s like somebody turns off an electric switch,” said Rich Feneis.

Thankfully, paramedics were there just in time with an AED.

“It ended up saving his life,” said Feneis. “Now he’s back golfing, and he got to see his daughter have their grandchild. I mean, what a change.”

There’s a reason why Rich Feneis has stories like this. They’re common ever since he and his longtime friend Joel Vogel started Advocates for Health, a nonprofit organization whose mission is to make AEDs accessible in as many communities as possible.

Vogel started volunteering for heart health organizations after he suffered a heart attack in 2004. He started a golf tournament in 2010 to raise money for AEDs, which inspired Feneis to approach Vogel to start the nonprofit.

What is an AED?

An automated external defibrillator shocks a heart back to normal rhythm for those experiencing cardiac arrest.

They’re important, lifesaving and very expensive.

Most paramedics have AEDs on hand, but in some communities, waiting for paramedics isn’t a viable option.

“Where I live in Pine Point (Minnesota), EMS response time is 30 minutes,” Feneis said. “If somebody goes into sudden cardiac arrest, you’ve got to do something within the first 10 minutes or they just won’t survive.”

Sudden cardiac arrests can be much more lethal than something like a heart attack, according to Feneis.

"A heart attack is a plumbing problem, a sudden cardiac arrest is an electrical problem," he said. "The survival rate from a heart attack is 90%. Sudden cardiac arrest, if you don't have an AED, your chance of survival is less than 5%. And yet, if you have an AED, it's 75% to 85%. That's why they're so important."

Feneis added that sudden cardiac arrests aren't just for old people.

“(About) 370,000 people a year die of sudden cardiac arrest just in the United States, and 23,000 of them are kids 18 and under,” he said. "We've seen every age group. Sudden cardiac arrests doesn't discriminate."

That’s why having AEDs in public places is so important in the eyes of Vogel and Feneis.

Storing outdoor AEDs

Vogel and Feneis both started their work in 2018 with the Pilot Program, which supplied AED cabinets in local parks around Stearns County. After the program, the two officially founded the organization in 2019.

An AED can’t be stored in areas where temperatures get below freezing, a problem in Minnesota winters. According to Advocates for Health, for an AED to be available outdoors, it costs $6,605 for the outdoor cabinet, $895 for the AED itself and $600 a year for annual maintenance costs plus electricity.

For such an important life-saving device, the cost can be covered by donations from the public, local businesses, service clubs and more.

Their work doesn’t stop there. Four years ago, Stearns County became the first county in the state to map AEDs for 911 callers with help from Advocates for Health. This provides 911 operators rapid information they can relay to the callers about the closest AED to them.

“It’s been a phenomenal success,” said Bob Knutson of Advocates for Health.

Since then, the project has expanded into Kandiyohi and Meeker counties, with more on the way.

Yet Feneis emphasized that the education to use an AED “is just as important as getting the product out there.”

Spreading the word

Knutson, from Spicer, knows people who buy an AED but aren’t curious enough to know how to use it. It can be frustrating, he says.

“I know people that don’t want to come to the (AED) meeting. They don’t care,” he said. “‘Oh, we bought the machine, that’s good enough.’ No, it’s not. You gotta know how to use it.”

AED training is done across Minnesota high schools. Students are required to have CPR and AED education before graduating, one of 41 states to do so.

Advocates for Health also holds classes for those who need AED education across the state.

Social media has been great for getting the word out, according to Feneis, but spokespeople have been an enormous help to the organization.

Caitlin Gilk won a gold award for the Girl Scouts thanks to her efforts helping Advocates for Health, raising $22,000 for the devices in the Paynesville area.

"She installed over 160 AEDs in Stearns County alone," Knutson said. "She's just incredible."

2024 Miss Minnesota Emily Schumacher has also been helpful to the organization as well, raising money for the organization and is set to make an appearance at this year’s golf tournament.

“She wants to be an open heart surgeon,” Feneis said. “She teaches CPR and AED classes in Rochester, so this is very important to her.”

Saving lives

On July 11, Bob Knutson oversaw another outdoor AED installed, this time at Robbins Island Park in Willmar, a week before the start of the Rockin' Robbins concert series.

Members of the Rotary Club of Willmar, Willmar city staff, Advocates for Health volunteers and other members of the community helped or witnessed the installation.

"It's very important to me because it saved my life," said Tim Rehn of Willmar.

Rehn was playing in an adult hockey league in December 2023 when he went into cardiac arrest on the ice at the Willmar Civic Center. Quick-thinking retired emergency medical technician Heather Coleman grabbed an AED at the rink and used it on him, which ended up saving his life.

Stories like that are inspiring, but in Rehn's case, Coleman knew what the AED was and how to use it.

For Knutson, Feneis and the rest of Advocates for Health, educating the public is just as important as getting AEDs out there.

“We’re just trying to make people aware,” said Knutson. “From 10 years old to 100 years old.”

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Northlanders seek renewal with midwinter dips in Lake Superior

Melinda Lavine — Fri, 12 Jan 2024 13:00:00 GMT

DULUTH — Cold air nipped at noses and infiltrated threads, as waves rolled onto the shore.

A snowsuited child attempted a sand angel as a group of about 25 people stripped to swimsuits, leaving parkas, hoodies and sweaters behind to step slowly into Lake Superior.

With gloved hands and covered heads, they whooped, cheered and chatted, their voices mixing with the music of the waves.

“Right now, I just feel my toes. Really tingly,” said Ellie Korwin, of Duluth.

It was her first December dip in Lake Superior, and she stayed in for about a minute. She said she wants to build her cold tolerance to change “the winter chill from being painful to feeling pleasant.”

After she got out of the water, Madeline Fisher, of Poplar, said she went in as far as her knees and she had to remind herself to breathe.

“This is harder than the Polar Plunge because you're not jumping in. You have to get yourself all the way in. There's a lot more willpower in that,” she said.

I felt my real personality bubbling up again from under the pain. I had minutes of, ‘Oh, I remember who I am.'

The practice of cold water immersion, or CWI, isn’t new. It’s happening around the country and the globe, from Ukraine to New Zealand. And, there’s a local group dedicated to it.

Loralee Pasley launched the Duluth Cold Water Dolphins Facebook group for folks who want to experience or learn more about the benefits of cold water immersion.

Pasley started cold plunging consistently in 2022, which led to less joint inflammation in her hips and fewer seasonal affective disorder symptoms.

“I would go in on a Monday and by the end of the week, I’d have a change in mindset: ‘I need the water because I’m getting sad again,” she recalled.

The online group fostered safety, accountability and motivation to keep it up. It now has more than 800 members. People want to be part of this growing method of health and wellness, Pasley said.

CWI is the most common form of cold therapy. There’s a cold water contrast bath, such as a sauna and an ice bath; whole body cryotherapy, with a large tank and extremely cold air; and the Wim Hof Method, committed CWI paired with breathwork.

Those who struggle with cardiovascular or circulatory issues should avoid CWI, said Cristina Nistler, Essentia Health athletic trainer and Grandma’s Marathon medical liaison.

CWI can take place in a lake or an ice bath. To reach the optimal benefits, aim for temperatures around 40-45 degrees and a duration of 10-15 minutes, said Nistler.

The cold water forces blood out of the body’s extremities and the inflammatory byproducts of exercise are moved back into circulation, alleviating soreness, she said.

Submerging the body in cold water also creates hydrostatic pressure, which pushes metabolic waste created by inflammation back into the bloodstream, disposing of it more quickly.

CWI can increase blood concentrations of dopamine, a neurotransmitter behind pleasure and motivation, by 250%, according to the National Library of Medicine.

And, folks who aren’t fans of the cold can achieve a significant amount of the same benefits from a 10- to 15-minute cool-down after exercise, said Nistler.

Studies show that cold water therapy reduces soreness, people report improved well-being and increased energy, but the research is “pretty anecdotal and subjective,” Nistler said.

"If people say they experienced that, I believe they do," she said.

“My knee is numb, and it’s a blessing,” said Jocelyn Pihlaja.

She suffers chronic pain from a meniscus tear and arthritis in her knee. The pain drove her to tears after a yoga class, when a classmate asked if she’d consider dipping in Lake Superior.

Two days later, Pihlaja felt exquisite numbness in the icy waters.

“The first time in the lake, and I felt my real personality bubbling up again from under the pain. I had minutes of, ‘Oh, I remember who I am,’” she recalled.

Since then, Pihlaja has been dipping a minimum of twice a week, sometimes daily, since January 2023, and always with family or members of the Cold Water Dolphins.

They have their favorite spots to dip, and they always adjust to avoid large waves and undercurrents.

“I’m intimidated every single time I do it, but the group energy catches me, and it changes everything,” she said.

Unlike the Polar Plunge, a series of cold water jumps, Pihlaja said she enters the lake slowly and intentionally with a focus on deep breaths. By the time the water reaches her shoulders, she’s calm and settled, and she tends to stay in a minimum of 10 minutes, longer than most.

“To be perfectly honest, I think it’s because I have more body fat. Jokingly, I told my doctor that I found my sport. I could do this competitively. … I think I was born for it,” she said.

After a dip, Pihlaja lets her body warm up naturally, opting for layers of warm clothing and blankets over a hot shower.

“Food tastes better. I sleep really well. I’m generally pretty upbeat and happy, but I feel like I’m flying,” she said.

The practice has changed her relationship with Lake Superior.

“I’ve gone from being an observer of something beautiful and amazing to a participant and a collaborator with it," Pihlaja said. "It is very powerful.

“I may be walking stairs sideways and living with a brace on my knee, cortisone shots, gel shots, trying not to do surgery, and I at least know that when I get in that lake, I’m going to feel great," she said. "I’m not going to feel the pain, and I’m going to have a nice conversation I never would’ve had otherwise."

For Sarah Ina'amii, cold water dives have helped more than her physical recovery.

As a teen, Ina'amii endured a near-drowning experience. She said joining the Cold Water Dolphins in the lake helped her process the trauma.

During her first group dip, Ina'amii lost her footing due to an unexpected drop-off in the lakebed. Panicked, she said she started hyperventilating, when a plunging partner held her arms, reassured and encouraged her to breathe.

“I felt like I just drowned again but … I had somebody walking and talking me through it. After that experience, I have been kind of fearless about it,” she recalled.

Ina'amii committed to dipping at least once a month for a year, but she ended up going two to three times per week. And she feels this practice has validated her cultural beliefs. “The water has its own spirit. Water can heal.”

A year later, Ina'amii said she hasn't been sick, she feels healthy and strong, and setting a CWI routine has helped her achieve other goals. “Once you have a practice of that level, it makes everything else a little bit easier," she said.

For those who want to start, Pasley recommends building up to it with cold showers for 10 seconds and increasing increments.

“It’s a mind-over-matter thing, and once you’re in the water, it feels so amazing that all the fear and nervousness goes away," Pasley said. “The benefits outweigh the fear and the discomfort, and it’s coming back to nature, connection with others and connection to ourselves."

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Mayo Clinic expert explains why a change is needed when talking about dementia

DeeDee Stiepan / Mayo Clinic News Network — Mon, 06 Nov 2023 18:12:03 GMT

One of the challenges in addressing Alzheimer's disease, dementia, cognitive impairment and aging is not related to the conditions themselves but rather the terminology. That's according to Dr. Ronald Petersen, director of the Mayo Clinic Alzheimer's Disease Research Center, who suggests a new framework for dementia nomenclature is needed.

Inconsistent use of terms such as Alzheimer's disease and dementia has compromised progress in clinical care, research and development of therapeutics. Dementia-associated stigma further contributes to inconsistent and imprecise language.

"We sometimes use these terms inconsistently. That confuses us as scientists, and clinicians. It confuses our patients and our families. So we decided to take a look at that whole issue and see if we could understand the problem, and then make some recommendations," Dr. Petersen said.

In a recently published paper authored by Dr. Petersen, the Advisory Council on Alzheimer's Research, Care, and Services of the National Plan to Address Alzheimer's Disease authorized a committee to help bring consistency to the use of the terms.

What's the difference between Alzheimer's disease and dementia?

"Dementia is a clinical syndrome, which means that it has a set of clinical features of the disease. Alzheimer's disease, though, implies that there's an underlying biological cause of the dementia. Often we get these two terms confused," says Dr. Petersen.

Clearing up the confusion

The initiative is organized into three groups: researchers and scientists, clinicians and public stakeholders. Focus groups, which included people from underrepresented groups, also were asked to look at the various cultural issues surrounding this language.

"How the term dementia is used in one group might be quite different from how it's used in another group. We put all of these inputs together and came up with a framework that we hope is going to help sort out how these terms should be used so that everybody is using them consistently."

Dr. Petersen says the goal is not to change any definitions of any disease, but rather to clarify how different expert groups are defining the diseases.

"Is it clinically? Is it biologically? Or is it a combination of clinical and biologic features? So the framework is meant to characterize those distinctions," says Dr. Petersen.

"We hope by clarifying how people are using these terms, we'll be better able to communicate with patients and families when we discuss a disease like Alzheimer's disease."

The next steps

Dr. Petersen says the next step is going to be a beta test of the new framework.

"In the next phase of this exercise, we're going to ask clinicians, primary care physicians and specialty clinicians to actually use this framework to see if it helps them explain the underlying diseases to the patients and to the families. We're going to ask patients and families, 'What did you understand going in? What do you understand going out?' Same thing with the clinicians themselves," says Dr. Petersen.

©2023 Mayo Clinic News Network. Distributed by Tribune Content Agency, LLC.
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Answering the common questions I get from caregivers and family members

Carol Bradley Bursack — Sat, 24 Sep 2022 13:00:00 GMT

Dear readers: This morning, as I answered another email asking how I choose questions for the column, I realized that even readers who don’t ask might be curious. So, today I’ll address questions about how the "Minding Our Elders" column works.

Are these real questions from real people?

Short answer: Yes.

Longer answer: While some people prepare a concise, well-written question that I use verbatim, the average email question is longer than my full column word count. I understand why this is so and am honored that people trust me enough to let it all out. However, these questions must be heavily edited to make sense to readers as well as leave room for a response.

My first step is to answer the writer’s email providing whatever comfort and resources I can. Then, depending on their question, I’ll consider the topic in view of the column to decide if it would be of interest to readers. If so, I’ll create an edited version for print.

Can people call or meet with me?

Short answer: No.

Longer answer: While I realize that not everyone is comfortable writing, email allows me to schedule my time efficiently and work with more people overall. My contact information is available at www.mindingourelders.com.

Do I protect privacy?

Short answer: Yes.

Longer answer: Occasionally, someone will tell me that I can print their names, but even then, I decline. People who write to me don’t need more trauma. Therefore, I use random initials as a signature and change identifying details. This may or may not include gender.

Do you advise people on insurance and legal questions?

Short answer: No.

Longer answer: Both insurance and legal issues can be dependent on an individual’s location, and for insurance, their coverage. These considerations aside, these are highly specialized fields. What I can do is direct people to possible resources for more information.

Do you repeat topics?

Short answer: Sometimes.

Longer answer: Since caregiving questions are unique in detail yet nearly universal in nature, I do occasionally readdress a common topic. This only happens if I’ve received numerous people asking what happens in a specific situation, or if there are important new resources to share. I try not to repeat a topic in a calendar year, though if there were an important medical breakthrough, I would consider it.

Why don’t you tell more stories and provide more detailed answers?

While I believe that storytelling is a powerful way to communicate, columnists’ space is necessarily limited. I do my best to provide readers with both comfort and information within the confines of a necessary word count. Those who want more information can follow up by subscribing to my blog at www.mindingoureldersblogs.com, or sending me a question via email.

Note: A reader’s question may not appear in the column for several months, but I’m deeply tuned into caregiving, so I personally answer their emailed questions ASAP.

As always, thank you for your questions, your comments, and your heartwarming notes. Back to your real concerns next week!

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Are family caregivers 'mad as hell?' Many are, and for good reason

Carol Bradley Bursack — Sat, 17 Sep 2022 13:00:00 GMT

Dear Carol: My dad, 83, has received bladder cancer treatments for years, but now his cancer has become aggressive. Unfortunately, so has his oncologist. Dad has rarely questioned his doctors, so even though he’s in agony, he’s accepting each new treatment without asking for alternatives. He’s always been emphatic that when treatments don’t work, he wanted hospice care, so we’re now determined to transfer him. It’s a process, but we’re getting there so I’m not writing for advice. I just want to know why alternatives to last-ditch treatments that simply “buy time" aren’t better explained to patients. — GM.

Dear GM: Doctors are trained to cure, which is admirable if a cure is feasible. In many instances, though, giving a patient, particularly an older patient, “more time” at the expense of comfort and family time extends suffering rather than life. This trade-off should be clearly explained to patients as well as their families and discussed in view of overall end-of-life wishes.

Your note reminded me of my neighbor who, like your dad, had lived with bladder cancer for years. Following his death, I expressed my sympathy to his widow. After thanking me for my words, this normally gentle woman launched into a livid rant over her husband’s care. The doctor had routinely ordered excruciating treatments right up to the day her husband died. The alternative of comfort care was not even discussed.

Your note spurred me to share information about “Caregivers Are Mad as Hell: Rants from the Wife of the Very Sick Man in Room 5029,” by Ann Brenoff.

Brenoff cared for her not-so-elderly husband who suffered from kidney disease — and yes, she’s on a rant. That said, she’s a professional writer with a Pulitzer, no less, making her passion-packed rant relatable as well as informative.

Her story expands on some well-documented concepts:

Family caregivers, whether spouses or adult children, are often ignored by medical teams. Family caregivers are routinely required to perform medical duties far beyond their experience with little or no training in this area. In Brenoff’s husband’s case, increasingly disabling, painful and useless treatments were continued to give her husband in their words “more time.”

While “Mad as Hell” is a personal book, it’s broadly useful. Readers will relate to Brenoff’s fury over her husband’s care. They’ll also root for her as she struggles through the daunting aftermath of his death such as bills that she can’t cancel without his approval. They’ll also cheer as she struggles to establish her identity as a widow, and eventually remarries.

I encourage caregivers of terminally ill people who feel dismissed, ignored and angry to read “Mad as Hell.” You’ll feel a connection with other caregivers while you gain from Brenoff's passionate energy.

To you, GM, I’ll assure you that most of us who have been long-term caregivers for older adults learn that when it comes to treatments in the last stages of life, less is often more. My heart is with you as you stand with your dad during this painful time.

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In-home care agency's high turnover is upsetting to older adult

Carol Bradley Bursack — Sat, 10 Sep 2022 13:00:00 GMT

Dear Carol: My mom needs help while bathing and with some daily tasks, so we hired an agency to provide four hours of in-home care per day. Our problem is constant staff turnover. Most of the new people are fine, but each new caregiver needs to be trained for Mom’s preferences and needs. From Mom's perspective, another stranger in her home is upsetting. Are some agencies more likely to retain caregivers than others? How about hiring privately? This turnover is hard on both of us since I need to take time away from work to cover missing caregivers. — CE.

Dear CE: Lack of consistency is understandably hard for older adults. Who wants strangers to come into their home to help them shower? Unfortunately, low staffing has been an issue for years, and of course, after our intense COVID challenges this problem has intensified.

You could, as you suggested, change agencies, and that might be a good option. Do consider this carefully, though, if you are otherwise happy with them. Since most agencies are struggling to stay staffed, you could find it difficult to get started with another one, and you don’t want to be left stranded.

It’s true, though, that if an agency pays well or provides better training, they retain more employees. For that reason, I’m not discouraging you from changing agencies, but, if possible, contract with a new agency before discontinuing your mom’s current care.

Regarding hiring privately: Understand that you’d be taking on extra work, as well as risk. You’d need to do your own background checks, screening and interviewing. Also, depending on where you live, you’d most likely have to pay the employer’s part of the caregivers’ taxes as well as issue tax forms. Even if the person you hire is an independent contractor which could change how you handle taxes, you’d be smart to buy liability insurance. This would protect you in case they are injured in your home, or while caring for your mom.

My last thought on this is to remind you that since bona fide agencies are having a tough time hiring, hiring independently won’t be an easy task. I’m not trying to discourage you from hiring on your own since, with the right caregiver, this option can be a dream come true. However, if you consider a private hire, do it with your eyes open. Begin the process by conducting research into the state laws of your mom’s residence.

You could also use this opportunity to discuss with your mom the pros and cons of an assisted living facility (ALF). Since either choice means changing caregivers, you might at least plant the seed, and even schedule some tours if she’s willing to look around. If your mom enjoys socializing, highlight that aspect of an ALF.

Assure your mom that you'll do everything you can to honor her preferences. Gently remind her, though, that reliable care is what will help her live as independently as she realistically can, and options are limited.

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Palliative care and hospice can enhance quality of life at different stages

Carol Bradley Bursack — Sat, 03 Sep 2022 13:00:00 GMT

Dear Carol: My mom has advanced lung disease and is also in the middle stages of dementia. While we understand that neither of her diseases can be cured, we’re told they can be managed. I think that management should be about making her quality of life the best it can be, but Mom’s miserable. When I asked her doctor about options, he said they are doing all they can for now. I suggested hospice care, but he says that he doubts that she’s “ready.” I feel so helpless. What else is there? — VL.

Dear VL: A holding pattern like your mom's is confusing and emotional even with proper support. Yet, I’m sorry to say that many doctors aren’t prepared to help you beyond their specialty.

For that reason, I’d suggest that if her primary care physician isn’t someone who has a background in caring for older adults, you find a doctor who is. A geriatrician is ideal. However, since there aren’t enough geriatricians to go around, someone in internal medicine who works with a significant percentage of older patients can be a good alternative.

If you’re a longtime reader, you’ll know that I’m a fan of hospice. Both my parents received care from Hospice of the Red River Valley, and HRRV’s help was invaluable for pain management and support. You could clarify the requirements for hospice care by directly contacting your local agency. If your mom is not yet meeting the necessary criteria, consider palliative care.

Palliative care is a service that provides comfort care while patients are still at a stage where they may benefit from treating their current diseases. This type of care is delivered by a specially trained team of health specialists who provide quality of life for the patient as well as the patient’s family.

Palliative care can be offered alongside curative treatments in a clinic, hospital or home setting. Smaller community hospitals may not offer the in-depth services of larger hospitals, but most will work hard to offer the best support that they can deliver.

Ideally, your mom’s palliative care team would include both a doctor and a nurse trained in palliative care. Additionally, a specially trained social worker would likely be involved, as well as a non-denominational chaplain or someone who can offer spiritual support. In most cases, Medicare or other health insurance should cover much if not all of the additional cost.

Even as you investigate palliative care, I’d encourage you to stay informed about hospice qualifications because the rules can change. The usual criteria would include that the person is unlikely to live past a six-month window. However, many people live longer than that once they receive the support that they need from hospice. In that case, some will go off the care, but many others will be reinstated for a time.

Best wishes, VL. You’ll feel like you’re jumping through hoops to get your mom the care she needs. This takes determination and at times, courage, but you obviously have both in spades.

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Suicide of caregiver leaves spouse adrift and friend devastated

Carol Bradley Bursack — Sat, 27 Aug 2022 13:00:00 GMT

Dear Carol: After years of caring for his wife who has advanced dementia, my lifelong friend reached his limit and killed himself. He had the financial resources to place her in a care home, yet when I suggested this, he said that he couldn’t live with the guilt. Had he viewed outside help differently, he could have returned to his role as a loving husband rather than a stressed-out caregiver. Now, his wife has been moved to a care facility without him to support her transition, and his friends and family are heartbroken.

Keep doing what you’re doing by telling caregivers that practicing their own self-care is also the best choice for all involved. My friend’s determination to give his wife what he considered the best care cost both of them everything. From my perspective, I thought I was doing everything that I could to support him. Now, I’m doubting myself as a friend, and it’s devastating. — SP.

Dear SP: My heart goes out to you. Your private note to me was exceptionally detailed and I can assure you that you did everything you could to support your friend.

Tragic situations like the one you describe are more common than most people know. Sometimes, the caregivers lose their health, if not their lives, to disease. Even worse, though, are those who die by suicide because they’ve reached the end of their emotional resources.

Of course, we don’t know exactly what pushed your friend to his limit, but we’ve learned from people who have come close. For some caregivers, it seems to be the strain of making difficult decisions for someone who can’t make their own. For others, it may be that they can no longer live without sleep or a break from their duties. Others may feel that they can no longer stand watching someone they love suffer. Most often, it’s a combination of challenges. The caregiver simply reaches a point where there is nothing left to give.

Now, of course, the very person for whom your friend sacrificed so much is left to be physically cared for by strangers without having him nearby to support her. Even if she could no longer find the words to reassure him, she would have known that he was there for her. Now, he’s not.

I want to be clear that I’m not blaming your friend. The decision to die by suicide out of desperation is not logical. All he knew was that he could no longer handle the pain. No one should judge him for that. We all must remember that no matter what we witness from even an intimate connection, we can’t really know what it’s like to live another person's life.

You have my deepest sympathies, SP. You did all that anyone could have done, yet you’re taking it one step further. What you are doing to spread awareness of such tragedies is invaluable. I’m certain that your courage in sharing your story will lead some overwhelmed caregivers to seek support for their own mental health.

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Tips for restarting our lives after caregiving responsibilities end

Carol Bradley Bursack — Sat, 20 Aug 2022 13:00:00 GMT

Dear Carol: I’m a single woman and an only child. Several years back, I stepped up to help my mom care for Dad, but as Mom grew frailer, I took over his care as the primary. Dad died a year ago, and Mom followed less than three months later. Neither of them wanted to linger, so I’ve made peace with their deaths.

I work online and really enjoy what I do, but I’ve let friendships go due to caregiving duties. It’s obvious to me now that I need to restart my life, but I’m not sure how to begin. Any suggestions? — CL.

Dear CL: I'm sorry about the recent deaths of both of your parents. Under these circumstances, mixed feelings are inevitable since we grieve their loss as we also celebrate that they are no longer suffering. Our family went through this as well, so I do understand.

I’m proud of you for recognizing that it’s time for you to restart a life for yourself. Take your time doing this, reevaluating each step to see if it feels right. This is your chance to concentrate on your own needs.

Most caregivers have experienced a diminished circle of friends, if for no other reason than there is no time to devote to nurturing these relationships. That doesn’t mean that the people you felt close to in the past won’t welcome your return. Initiate contact one by one knowing that some may have felt neglected and simply moved on. Don’t allow anyone to make you feel guilty about that. We all have limited resources while caregiving.

Resurrecting old friendships may prove satisfying — or not. Either way, you can always build new ones, as well. I’ll list some starting points:

Join a religious community such as a church or temple. Join political or environmental groups, volunteer for your local hospice or hospital, deliver Meals on Wheels, or join an auxiliary involved with an assisted living facility or nursing home. There are also disease-specific groups, so if Alzheimer’s, cancer, Parkinson’s, or some other disease has affected friends or family in the past, you may feel inspired to work for awareness. Tired of health-related topics? I get that. How about supporting a local children’s or teen’s theater group, or joining your local adult theater group in some capacity? Or you could join a painting or craft class which could lead to new friends and provide you with a refreshed focus on life.

As with many things, finding your new normal is about balance, CL. If you immediately jump into several activities, you may feel smothered with responsibility, which you don't need.

This time is for you. Renew some old friendships, expand into new ones, and consider joining a group that reflects what you believe in. Take each step in its turn, then check your comfort level before expanding any further. Try one thing and then another. No rush.

Gradually, you’ll find your life becoming more open, yet you’ll retain control of how social you want to become.

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Adult child with snowbird parents worries about their long-distance care

Carol Bradley Bursack — Sat, 13 Aug 2022 13:00:00 GMT

Dear Carol: After my parents retired, they moved south to enjoy the year-round heat. Dad’s since had a heart bypass and Mom had a hip replacement, but otherwise, they seem well enough. Still, these are red flags. We’ve tried to convince them to move back home, but they say they are home. They take care of each other now, but with worsening health, or when one of them passes, things will need to change. How do we prepare for that time? — PF.

Dear PF: Distance makes keeping track of your parents’ health harder, but barring dementia, they get to choose where they live. Remember that they likely understand that eventually, they’ll need assistance.

Before discussing your worries with them, put yourself in their place. They have friends, activities, a whole lifestyle based on where they live. They care for themselves and each other. So, consider their present satisfaction before resurrecting your request that they move back to your community.

The first step: Your parents may already have power of attorney documents for health and finances, but check with them to see who is assigned responsibility if neither of them is well.

Something to offer your parents: Leslie Kernisan is a geriatrician with a free website that I recommend to adults over 60. This website could help your parents stay healthier longer, something that’s in everyone’s interest. The site is www.betterhealthwhileaging.net.

For you: I nearly always recommend two books that are packed with information about how to approach your parents about legal documents, as well as what to watch for as health challenges arise.

The first book is by Dr. Kernisan and is titled, “When Your Aging Parent Needs Help: A Geriatrician's Step-by-Step Guide to Memory Loss, Resistance, Safety Worries, & More.” I reviewed the book in my column, “Book offers a practical roadmap for helping older parents.” This book is packed with cheat lists for ease of use and offers downloadable checklists and worksheets. (Full disclosure: I moderate a support group for Dr. Kernisan).

The second book is by Linda Fodrini-Johnson and is titled “The Empowered Caregiver: Practical Advice and Emotional Support for Adult Children of Aging Parents.” This book will give you a window into the services a geriatric care manager (GCM) can provide. Read my review in “Geriatric care manager shares decades of experience in new book.”

Free resources for the future

The Eldercare Locator: You can educate yourself and your parents if all of you learn to use this government site. After typing in your parents’ ZIP code, a list of services available in their state will unfold. Check it out now and bookmark it since you will want to use it later; https://eldercare.acl.gov

Your proactive mindset will pay off, PF. The difference between what you could do for them if you just stopped over versus having to fly down in an emergency is obvious. Yet, most of what you need to do now is not that different from what you’d be doing if they lived locally.

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