see the show where we talk about eating issues and their solutions my name is sam callahan and i'm a senior living in elder care coach consultant and crisis manager when we talk about aging issues we often think of just the seniors themselves whether they're facing a broken hip dementia or were no other ailment the other people that are affected by this are actually there don't show up for you now find themselves facing a lot of issues pertaining to their parents aging issues my gues today is alan axelrod licensed clinical social worker local to lawrenceville area ellen welcome to only seniors thank you very much let's get right to it what is one of the biggest issues facing the adult children today well one of the biggest issues is being on call twenty four seven when you have an elderly relative and people don't understand  k being called for all sorts of reasons all times of the day and the night and because once a person loses a certain amount of independence they do rely on others and even when someone is innocent and an assisted living there is still things that the family needs to do and people will make the false assumption that all of the person's needs will be taken care of at the assisted living and that's not the case that there still needs to be a responsible person there to do what needs to be done and in a timely manner true there are a lot of decisions people don't realize  that they think when they move mom and dad into an assisted living or skilled nursing home that they're kind of done but as you said there needs to be a decision maker case mom or dad does have to mention somebody needs to be able to make those big decisions have to call even if there's just a small incident they have to let you know by law yes it's an interesting thing that they don't face there's a social logical term for the adult children what they what they're called and that's the sandwich generation and that is the fact that the adult children are getting older and have become seniors themselves and they in turn are taking care of the senior and so that ends up being a bit of the stressor on the adult child as well and i had the funny incident of when i turned sixty two my mother who was it was an assisted living said to me isn't this ironic you can start collecting social security and i said yes very ironic but that sort of tells the story you know why they call the sandwich generation well because usually they've got to take care of their children who are starting later and later because of economic situations so they've got their own children then they've got their parents and then they got themselves and their spouse and so they're kind of like crunched in the middle needing to take care of everything and they become the nucleus for care yet much everybody guess what happens distressed and manifest itself what are some things that you're seeing i think it manifests itself  for yourself and any relief that you need from that stress of being on call all the time and also there are ups and downs there you know again we're doing it depends on how old the person is what the condition is i mean you have older adults who are quite healthy way into you know into their eighty's you know and then you have other adults who are quite compromised in earlier age in a late sixty's seventy's so it really depends on who you're dealing with at that point and so the responsibilities are different depending on the age of the person you're caring for but the caregiver needs to step away the caregiver needs to refresh themselves they need to emotionally recharge and a lot of caregivers find it very difficult to step away and to allow themselves that space and they you know will say who who will do it if i don't do it who's going to step in but if you don't create that vacuum no one's going to step in because everybody's going to assume hey he's doing it she's doing it you know nobody's going to step up unless you step away  y there's a term for which you describe and that's called compassion fatigue yes and we've been hearing a lot about this in the aging industry because of the it's just more than burnout it's a complete lack of feeling you expand on that one as well i don't know in terms of a complete lack of feeling that i can actually address but from my personal experience what i had found was that the time i took to refresh myself like a long weekend and are getting away doing something pleasant the aftereffects the carryover would lessen more and more and more so that you know if i went away for a long weekend when i started doing things like that i would last a month or so and i would feel ok i feel refreshed i feel fine towards the end of my experience when my mother was very very close to dying i had gone away for a long weekend and i came back and by thursday of that week i was totally burnt out i just i felt like i could not handle anything and it's a it's a very strange feeling and unless you've been there i'm not sure you can understand it i mean it feels like you don't have the emotional energy at all to do what you need to do and yet you have to do it i guess it's kind of like if somebody takes a painkiller once in a while you know the mountain time that he takes care of the pain lessens over a period of time in situations like that would be best thing that person can do i think the best thing a person can do is make sure that they have some support and take it because you know they always give this illustration on an airplane that if the oxygen masks fall put yours on for sed and don't respond to the initial impulse let's say you're traveling with a child of putting it on the child because you have to be conscious in order to take care of the child so you have to take care of yourself first in order to take care of the other person and that becomes a very difficult thing to maneuver a motion only and that's why you need support either friends relatives or therapist who you can speak to about these things and i would actually say and this is not to to my own horn that speaking to a therapist is probably better because everyone wants to help everybody wants to give the suggestion people don't understand that just listening compassionately is so important for the caregiver and so they end up getting frustrated by talking about it people not understanding making lots of suggestions which they feel they can respond to and instead talk to someone who's not going to have the answer for you someone who will be able to hear you who will be able to empathically engage with you and that is incredibly healing and also to be able to discuss your frustrations and the things that you feel you can't talk about with other people you have can you say to somebody i can't stand this anymore this is too much for me if i just don't know what to do people don't feel comfortable saying that in a safe confidential environment it's much easier to do that and so again the other thing is that the adult children caregivers won't take time to go to support groups because they say well who's going to watch my relative if i do that and it's them and that's important to talk to people who understand and that's one of the things that as a therapist and as a person who has been through it i understand that if you talk to someone who doesn't have a similar experience or cannot relate to it all the support from all of the suggestions come off as platitudes when you talk to someone who has been through it and you know they've been through it what they say resonates so differently it's really i mean it's almost palpable and so i would really suggest and i know there is so much resistance to this that caregivers go to a support group and you know you'll get well they don't have the same problem i do their relatives the mind is that this is that it's all of the same problem th particularities are particularities the umbrella is the same and i would really highly recommend that and i know groups have such a difficult time recruiting and that you know you need to find someone who can stay with your relative for those two hours to let you get away i have a number of takeaways from everything you said the first thing is there is no shame in asking for help there's no shame in it all what you're faced with as you don't child taking care of your parents is so monumental that you should be ashamed if you don't ask for help really what might you really should be reaching on asking for help even when your parents  raising you every now and then they hired a babysitters to get a night out right it's kind of the same thing to support groups very important want to add to there are so many support groups out there for different there are a lot of support groups out there it's just a matter of finding one that meets your needs is it beneficial to people to go and try and several to can support groups certainly but i would you know try to get a recommendation from someone you trust i think that's very important because you know you do have limited time especially if you're the caregiver i would say if you are if your relatives that in assisted living the staff there you know ask the director as the director of patient services if you have home care for the person you're caring for ask the nurse or social worker if you are hiring help from a private agency ask the agency who they recommend and what they recommend so i would do some targeted looking and also if you know someone who is caring for elderly person ask them if they have ever attended a support group and you know which one did they find helpful so again i would try to get a recommendation from someone who knows the field and knows what's out there rather  when somebody keeps denying a problem with mom and dad would what are some of the results of that oh well the results of that can be quite aside i mean you know if you are not accepting the fact that your relative is not really ambulatory and you don't accept that i mean they run the risk of falls severely hurting themselves if you don't accept the fact that they may be having some dementia that can cause terrible problems in terms of finances paying bills and actually being exploited by people who take advantage of elderly people who are starting to show signs of dementia so and also getting the proper kater that's you know if you're if you're denying that you're the person you're taking care of some going to get the proper care so so that's probably the biggest biggest issue with denial i've seen families who have health care professionals in the family themselves who there's been the problem with the parent it's obvious just obviously dementia but they you know they cobble together care and unfortunately what disast case the person actually fell down a flight of steps in arkansas was because the family jus gets and it's a topic i want to get into this why do we have this hang up that nothing can be wrong with mom or dad think i'm motional you about the fact that the person who you felt was your caregiver  is deteriorating and look let's face it there's a real i mean we all have relationships with our parents some good some bad you know and the thing is if it's bad that's going to present problems of its own and if it's good it's going to present problems of its own including that the whole issue of loss to admit deterioration and severe deterioration is to have to come to grips with your own sense of loss which is incredibly painful and can be and especially with something like dementia because you're losing the person twice you're losing them mentally in the body that they are in and then at the end you're losing them physically as well so there are these two losses that are going on for you and it's incredibly difficult i mean and it is much as we may and understand dementia you know that it exists you know and what it does to be in a relationship with someone who is becoming increasingly demented is incredibly difficult and you know just our normal human nature which you know is not bad not good you  is we get frustrated when you tell someone the same thing three four five times and they don't listen it's just you know it's just the way we respond it's very hard to get into ahead of pure compassion and again there are those frustrations that that you have and how do you deal with that also sometimes if you have a relative who is having impairment and they don't listen it can be dangerous and so you're worried about them but they're not listening to you and so the level of frustration and the sense of loss is a very big  n that kind of situation and people just don't know what to do and that that may be one of the worst predicaments in caring for an elderly relative one thing that we see a lot is  arguing with a loved one who has dementia you know mom gets a slight facts wrong and people correct yes and one things i tell mom like stop correcting yes mom or dad yes you know i'm like you know it just confuses mom or dad more what i'd like to talk about then is what's that doing to the adult child and the fact that they're always correcting them is i don't like just stop go on their journey with them right ok but i think it's funny while we're talking about it thoughts occur to me and that is you were asking someone to totally change their reflexive way of interacting you know if somebody gets a fact wrong it if somebody forget something it's element then you know assuming they're not but it does not work in a situation like this so you have to approach it in a in a very different way as you say don't argue because it's not going to work it's not going to help it will make things worse and it may make the senior agitated and you don't want that and so again you're working against what you want and yet it's very hard to to absorb that because again what i'm saying is a natural response is to correct someone to take care of them to tell them what's right to tell them what's wrong don't touch a hot stove you know and you expect so but if someone has no memories are going to start such hot stove and you have to realize that then they're not doing that to be defiant and they're not doing that to be bad they're doing that because they're not functioning the way that we normally function and that is so hard to adjust to is i often use the adage it's an old adage of the man who keeps banging his head against the wall and somebody says why are you doing that he says yes you want mom or dad to have the facts but the problem is like a child a child as they progress they learn not to touch the dementia you're actually kind of going backwards and say no not to touch  but the names forgetting and that's i think a lot of people don't realize yes and they become very frustrated with us let me say something i think what's difficult about this is that requires a totally new way of thinking and a certain amount of creativity and that is really difficult because if you are working with someone with dementia and they are talking about well i you know i have to get ready to go to the doctor i have to get dressed and there is no appointment you know you can't argue have to be creative and that can be very difficult like we don't have to get dressed now you won't be l time i promise you i will i will help you dress and we'll get ready to go and i just want you to relax and maybe distract them in some way and like before we go why don't we listen to music together why don't we watch on television but you have to be very creative and it's often very difficult to do with the spur of the moment and you know so those are the things that i think are are hard but are the most successful and the it's very hard for an adult child to take to take that step  back and just look at the situation as a whole because being in the middle of it can be so difficult and i think that's a lot of what goes into creating the stress facing the same a generation is the fact that people aren't stepping outside of and saying wave of everything this isn't a normal situation normal as we know it but maybe a new way of thinking is important what are some of the things you take people through to help them readjust that way of thinking well one of the things is i think the root of all of this is the pain of accepting it and that is what gets people caught in these loops of  trying keep trying to because as long as you keep trying you don't have to accept it in a way and the real answer is to accept it and it's very hard to do and it's very painful and to be able to get in touch with that loss with the morning of parts of that person that you have lost who is occupying a body you recognize but the content of the mind has changed so severely and that's an incredibly difficult thing to do and you know even need to really help people and in a supportive way except that not that you want them to stay there forever and just be miserable but to be able to accept so that then they can in a sense move on and integrate that and then be freed up from this tug that they have not to accept to try to do something that'll change it  know and to get them off of that that treadmill so it's almost like you have to go through the as dr cooper ross put together it's the five steps of dying where the five steps of except invites a lot of times it's like you kind of need to jump to step five total acceptance in order to be able to work through the other four steps yeah i want people need to understand two is that i it's funny i'm old enough to have remembered when that book was written and when everybody was accepting it as as castle those are not stages those are phenomena those are things that everyone goes through and they don't go through them one two three four five one three five three two you can feel you're in a state of total acceptance and at that moment you are and then you can go back and be in denial and it's is shocking to you is it it's to anybody and realize that those stages or fluid and again part of this is accept your own feelings and don't label them good or bad just label them as they are and i think that's where we get into a lot of trouble i'm bad i'm not to to admit to including i can't deal with this anymore i mean it's like i feel so guilty it'll be peaceful for me and for then if they die if they are in a hospice situation and people feel so guilty about that and but these are things that everyone feels it doesn't mean you don't love the person it doesn't mean you're not dedicated and devoted we're humans we have irrational feelings that come up all the time and we have to learn how to accept them and then move on and to not condemn ourselves for having these feelings alan with the last minute that we have here where's your practice my practice is on princeton pica lawrenceville very easy to get to in an office park where frank would corner route and princeton  together ok and how can somebody get in touch with you they can call me a six zero nine nine two four zero three five eight they can send me an email that is then shrink dot here if you are an adult child there is no shame in admitting that you need help in dealing with your parents aging issues be sure that someday you may face the same issues and you're going to want your children to be reaching out for help for you  axelrod appreciate you being here and once again how can somebody get in touch with him just give me a phone call six zero nine nine two four zero three five eight thank you thank you for being on only seniors i'm tom  look forward to joining you against