the family caregivers’ grapevine - nscr › information › caregiver › jan feb...

A bi-monthly newsletter published by the

Supporting Family Caregivers Across the Lifespan Project

T h e Fa m i l y C a r e g i v e r s ’

G r a p e v i n e

January/February 2012

This article originally appeared in The North Shore

News on March 27, 2011. Reprinted with permission.

David and Sharon Moxon are graduates of a

ground-breaking learning program new to the

North Shore. Designed for people with mem-

ory challenges and their partners, North

Shore Memories and More takes the focus off

the condition and places it on the individual.

"When we heard about the program, we

thought, 'This could be really interesting. Here

is something we can do together,'" Sharon

says.

In 2000, the Moxons realized their long-term

plan to retire to the West Coast, choosing

North Vancouver to be close to friends and

family. They were living an active, outdoor

life, taking on new experiences and making

new friends. Then, in 2008, David was diag-

nosed with early-onset Alzheimer's disease.

Often, a diagnosis of Alzheimer's or other

forms of dementia disrupts people's lives. As

they focus increasingly on the condition, so-

cial habits tend to fall away.

Not so for the Moxons. They made it their pri-

ority to maintain their lifestyle, staying con-

nected with family and friends, continuing

with hiking and biking, tennis and travel. In

Mexico last year they found Luna, "a Mexican

rescue dog," says Sharon.

"No, no," David clarifies, "Luna is a rescue dog

from Mexico."

North Shore Memories and More

By Laura Anderson

The Family Caregivers’ Grapevine

Luna is part of the family, her care shared be-

tween the two, with Sharon taking on training

and David in charge of walks.

After David was diagnosed, the couple edu-

cated themselves about resources and com-

munity programs, linking up with the Alz-

heimer Society of BC and the North Shore

Family Caregiver Support Program where they

learned about North Shore Memories and

More. The program, designed for caregivers

and care receivers, or care partners to partici-

pate in together, aligns with the active and in-

volved life David and Sharon have created for

themselves. Information, resources and refer-

rals are provided throughout the program but

memory is not the main focus. Every aspect of

the program is designed to stimulate and en-

courage participation. A sense of humour, for

example, is not lost along with memory,

though it may change.

"That's why the group is so good," says

Sharon. "So much of the person is still there

inside and there is so much they can do.

We're all at different stages in the journey but

everyone is equally engaged and involved in

sharing ideas and opinions. We enjoyed every

moment of the program but the camaraderie

with the other participants was so valuable.

It's hard to explain what it means to sit

around a table with a group of people and

laugh.

"This is a happy story for us," says Sharon.

"Memories and More brought laughter and

lightness to our lives. It brought us new

friends and new experiences to share with

them. Our hope is that by sharing our story, it

will spark an interest in others to try this."

North Shore Memories and More continued from page 1

The next session of North Shore

Memories and More begins on Thurs-

day February 16, 2012, 1:30 to 3:30.

For more information contact Julie

Doresemaine at 604-984-6414,

[email protected]. Registra-

tions is required.

None of us can predict when we might

become incapable of managing our day to day

financial affairs or when we might become

physically disabled to the extent that we

cannot sign documents. A simple fall off a

ladder or a car crash can happen at any age

with devastating legal consequences, let

alone all the physical, mental and emotional

ones.

The most important legal document everyone

should have in place is a Power of Attorney,

no matter what your financial situation is.

Even if all assets are held jointly with your

spouse, you cannot file tax returns, nor can

you sell or remortgage a home. If your spouse

becomes incapacitated and you don’t have

Power of Attorney you cannot fully deal with

other assets without first applying to the

court to become a committee, a costly and

time-consuming legal procedure.

Given that a Power of Attorney is important

to have in place, it should be done as soon as

possible before accident or illness renders you

incapable.

What is the test for capacity?

Many of you will have heard of the Mini

Mental Status Exam often given by doctors. Its

most memorable feature is counting down

from 100 by 7’s. Doctors use this test to

screen for mental impairment and sometimes

tell lawyers that a client/patient is not

mentally capable of giving instructions for

signing a Power of Attorney based on the

exam results. That may indeed be the case.

However, the capacity test for Powers of

Attorney is very specific and is now set out in

the new law that came into effect in

September 2011. It firstly assumes that you

are capable. If there is some doubt, then you

must demonstrate the following to the

satisfaction of the lawyer:

• your knowledge of your assets and their

approximate value

• your knowledge of obligations to

dependants

• your understanding that the person

you’ve appointed can do anything that

you could do with your legal and

financial affairs with some important

exceptions

• your understanding that, unless the

attorney manages your affairs prudently,

the value may decline

• your understanding that the attorney

might abuse the trust placed in him or

her

• your understanding that you may revoke

the Power of Attorney at any time,

unless you become incapable.

Underlying this test is the fact that you must

know who you are, that you are talking to

your lawyer and that you are discussing a

Power of Attorney. No one else may help with

answers or even be present.

continued page 4

Legally Speaking: Planning for Incapacity

by Jackie Morris



When someone is in failing health, there may be good and bad days. There may be times of

the day when the person is more alert. The lawyer need only be satisfied with responses

when taking instructions and in witnessing the person’s signature. Timing may be crucial, but

the better plan is to not delay. Get it done and tuck it away.

Websites of Interest

Alzheimer Society of British Columbia

The Alzheimer Society of British Columbia’s

website, www.alzheimerbc.org, is an excel-

lent starting point for anyone who would like

to find out more about Alzheimer disease,

other dementia’s and where to find re-

sources.

The site offers information for those who

have been diagnosed with a dementia and for

those who are caring for someone affected by

it. Anyone can subscribe to their free quar-

terly bulletin, InSight that offers helpful

strategies.

The Alzheimer Society of BC is active in advo-

cating for people with Alzheimer’s and the

website is a good place to find out about cur-

rent issues in dementia support.

Legally Speaking: Planning for Incapacity

continued from page 3

“None of us can predict when we might become incapable

of managing our day to day financial affairs...”

Keystone Eldercare Solutions

In the Fall, North Shore Community Re-

sources Caregiver Support Project con-

ducted a series of well-attended webinars

that were not only informative but they

also generated meaningful discussion

among participants. Gerontologist Wendy

Johnstone of Keystone Eldercare Solu-

tions, presented two sessions, Coping with

the Transitions to Care and Communicat-

ing with Residential Care staff. She shared

a wealth of information.

On her website Keystone Eldercare Solu-

tions, www.keystoneeldercare.com.

Johnstone explores a range of caregiving

issues on her blog such as grief, respite

and life balance. Also posted on the web-

site under “Resources” are articles she has

written for The Comox Valley Record.

Renewal and rejuvenation – they’re words

that conjure up fluffy bath robes and spa

treatments. Caregivers may regard renewal

and rejuvenation as indulgences that just

don’t have a place in their lives. The best way

for caregivers to ensure their own good health

and that of the person they’re caring for, how-

ever, is to take time to look after themselves.

Respite is an opportunity to get that break.

Turns out it’s not a luxury; it’s an important

practice for staying healthy.

One in five people over the age of 45 are en-

gaged in some form of caregiving, and of

those, most work outside the home. In recent

years, the shift away from institutional care

has meant that even more caregiving than

ever before is being provided at home by fam-

ily or friends.

Caregivers report that looking after their

friend or relative can be a meaningful and sat-

isfying experience.Along with its rewards,

caregiving can take a toll on physical and emo-

tional health and can eventually lead to burn-

out. Early signs of burnout include waning en-

ergy, lowered productivity and loss of motiva-

tion. If unaddressed, burnout may contribute

to back and muscle pain, hypertension, de-

pression and eventually to physical and emo-

tional exhaustion. The goal is to prevent burn-

out by watching for those early signs and tak-

ing regular breaks.

Respite takes a number of forms and can be

different for each individual. A replacement

caregiver may come to the home for a few

hours or stay several days. The person in need

of care may be enrolled in a day program, or

they could stay overnight at a specialized care

centre.

Respite can be informal. Friends, family,

neighbours and acquaintances can be an im-

portant source of support. They often have a

desire to help, but may not know what they

can do. They can be asked to help with a spe-

cific task, such as odd jobs around the house,

once a week, or even once a month.

Caregivers need to take regular breaks even

before the person they’re caring for needs

someone on site to look after them. Taking

time for themselves every day is a good start.

They should choose an activity they enjoy and

that helps them feel in touch with themselves

and the outside world - whether it’s a yoga

class, a walk or some uninterrupted reading.

The key is that caregivers need to stay active

and connected to their social network.

continued on page 6

Rest and Rejuvenation

by Josie Padro


Book Review: Creating Moments of Joy

by Josie Padro


Respite is available through a number of public and private agencies. The Health and Home

Care Society of BC operates the Family Respite Centre (www.carebc.ca, 604-327-9525) where

those in need of care can stay overnight for up to 30 days. Vancouver Coastal Health has res-

pite beds and operates two adult day programs on the North Shore, Margaret Fulton and

West Vancouver Adult Day Centre. For more information on accessing these services contact

Vancouver Coastal Health Home and Community Care Program at 604-986-7111.

North Shore Community Resources has a list of Home Support Agencies on the North Shore—

many of whom offer respite services. For more information on respite, caregiver support and

how to access it, contact Caregiver Support at www.nscr.bc.ca, 604-985-7138.

The reality is rest and rejuvenation play an important role in a person’s ability to cope and

continue providing good care. Taking time to engage in meaningful activities is a way for care-

givers to stay healthy, and it just may include an afternoon at the spa—fluffy robe and all.

Using a gentle and reassuring style, Jolene Brackey offers

insight into the thought processes of those with dementia.

She leads the reader through scenarios that can arise and

offers examples of how to deal with them.

Brackey advises caregivers to take cues from the person

with dementia. For example, if the person was a fisherman,

allow him to show you how to cast. If the person used to set

the table every day, give them an opportunity to do it again.

She reminds readers to take joy in activities such as reading

aloud and listening to music.

Most importantly Brackey offers hope that the person with

dementia can still share meaningful times with those they

love. Not only can those moments be meaningful, but they

can also contain humour and joy.

Rest and Rejuvenation continued from page 5


Keeping Your Heart Healthy

By Josie Padro

February is Heart Month. The Heart and Stroke Foundation www.heartandstroke.com, sug-

gests a number of simple ways to reduce stress and keep your heart strong.

Stretch

Signs of tension often show up as a head-

ache, neck discomfort, or a tightly

clenched jaw.

Find a quiet place to sit

or stand. Close your eyes

and gently move your

head front to back sev-

eral times, as if you’re

nodding “yes.” With

your eyes still closed,

gently move your head

from side to side as if

your nodding “no.” Open

your mouth wide and stretch the muscles

in your jaw. (If any of these movements

cause pain, stop and consult with your

health care provider.)

Breath Deeply

Take three deep, slow breaths. With each

breath think about gently filling your lungs;

hold the breath for a moment, then

breathe out slowly. Taking those three

mindful breaths can dissipate stress and

help you carry on with your day.

Get a good rest

Sleep provides the body with

an opportunity to regenerate and renew

it’s resources.

Some studies have found that lavender has

a calming effect and helps those who have

difficulty sleeping. Place dried lavender

flowers in a satchel and slide it under your

pillow at night or add them to your bath

water. (Dried lavender can be ordered

through health food and craft stores.)

Check with your physician to avoid prob-

lems with allergies or medication

interactions.

Go for a stroll

The health benefits of walking are well docu-

mented. The activity gets your muscles mov-

ing, your blood circulating and your heart

pumping. For even greater health benefits,

invite a friend to go along

with you. You’ll feel more

connected and you might

even share a good cry or a

good laugh.


Medications and the Dementias

by Josie Padro

In recent years improvements have been

made in caring for those who live with de-

mentia. Research has led to new treatment

approaches and a new generation of drugs are

slowing the progression of the disease.

According to Dr. Stephan Kiraly, a geriatric psy-

chiatrist, there are a number of conditions

that cause dementia. Alzheimer’s disease is

only one of those. Many others exist including

frontotemportal dementia and vascular de-

mentia, which may be the result of stroke.

While there is no cure for these types of de-

mentia, there are medications that may delay

progression of mild to moderate dementia.

Studies have found that if medications are

started early, there is a chance the disease

progression can be delayed by up to two

years.

Dementia often begins with vague symptoms.

In his practice, Dr. Kiraly finds the symptoms

that surface first are depression, anxiety or

sleep problems, all of which may be the result

of the person’s increasing distress over their

loss of mental functioning. These problems

are treated in the same way as they would be

in a person without dementia.

It’s no surprise that with all these symptoms,

a person with dementia can end up on a

whole host of medications. In addition, other

medical problems, unrelated to the dementia,

may develop such as diabetes and thyroid dis-

ease, which can also add to the already sub-

stantial pile of daily pills.

Dr. Kiraly points out the goal of treatment is to

use the fewest medications possible at the

lowest doses.

continued on page 9

Overheard at the World Volunteer Conference:

In response to the observation that volunteers are too often seen as

amateurs: "Just remember: Noah's Ark was built by amateurs. The

Titanic was built by professionals."

—www.energizeinc.com

Laugh lines

The important thing, he says, is that medica-

tion should be periodically re-evaluated, and

at times, it may be appropriate to stop a

medication to assess whether it is still neces-

sary.

Keeping track of each medication in addition

to learning about how to care for a family

member with dementia can be an over-

whelming task. Dr. Kiraly advises families to

learn as much as they can about dementia

through sources such as the Alzheimer’s Soci-

ety of BC and by sharing their experiences in

support groups. North Shore Community Re-

sources Society Caregiver Support also offers

support (network) groups. Pharmacists are an

excellent resource as they can explain how

medications work and what side effects or

possible interactions to watch for.

There’s no doubt those with dementia and

their caregivers can be faced with a dizzying

array of medications. Understanding those

medications and ensuring they are achieving

the intended effect requires careful attention

from both the health care provider and the

caregiver. Luckily, advances in the understand-

ing of how to manage dementias has meant a

better quality of life for people with dementia

and those caring for them.


Medications and the Dementias continued

10 Warning Signs of Dementia

1. Memory loss that affects day-to-day

functioning

2. Difficulty performing difficult tasks

3. Problems with language

4. Disoriented to time and place

5. Poor or decreased judgment

6. Problems with abstract thinking

7. Misplacing things – placing everyday

objects in places where they don’t

belong

8. Changes in mood and behaviour

9. Changes in personality

10. Loss of initiative – may need prompt-

ing to perform normal activities.

—The Alzheimer Society of BC

http://alzheimerbc.org

Where to Turn

The Clinic for Alzheimer Disease and Related

Disorders, http://ubc-alzclinic.vch.ca, is lo-

cated at the UBC Hospital. Patients referred

to the clinic by their family doctor clinic are

assessed medically and given a series of neu-

rological tests. They are also seen by a ge-

netic counsellor and social worker. Test re-

sults are reviewed at a family conference and

possible community supports are discussed.

Patients are followed-up yearly. Contact the

clinic by phone at 604-822-7031.

The Family Caregivers’

Grapevine is a bi-monthly

publication intended to

support family caregivers by

promoting the importance of

self-care while providing

practical information and

resources.

If you have any questions or

feedback about the

newsletter, please contact

the editor at:

[email protected]

The Supporting Caregivers

Across the Lifespan Project

is located at:

North Shore Community Resources

201-935 Marine Drive

(Capilano Mall)

North Vancouver, BC

V7P 1S3

Tel: 604-985-7138

Fax: 604-985-0645

This project is funded by the Government of Canada’s Social

Development Partnerships Program. The opinions and

interpretations in this publication are those of the

authors and do not necessarily reflect those of the Government

of Canada.

The Supporting Caregivers Across the Lifespan Project

The Project provides:

● Education sessions for family caregivers

● Social recreation programs

● Expressive arts programming

● Tele-learning education sessions for family caregivers

(educational workshops over the phone)

● Education for professionals working with family caregivers

● Education for employers

Additional activities provided by the Caregiver Support Program:

● Family Caregiver Network groups

● Stress management and relaxation workshops

● Telephone support and individual consultation

● Educational workshops

● Information and referral to community services

● Library with books, videos, and other educational

resources

The Supporting Caregivers Across the Lifespan Project works in

partnership with the North Shore Caregiver Support Program.

Together we provide a wide variety of educational workshops,

caregiver support and resources for family and friends

supporting someone with an illness or disability.

You’re not alone.

We’re here to help.

Are you a family caregiver?

You are if you provide a family member or friend who is

chronically ill, elderly, palliative or living with a disability with

any of the following types of assistance:

● Personal Care: dressing, bathing, eating

● Household Work: house cleaning, shopping/errands,

preparing meals, yard work

● Coordination of Care: transportation, appointments,

arranging services, visiting

● Support: phone check-in, supervision, emotional

support

● Nursing Care: medication, changing dressings

For more information, contact Helen at 604-982-3313 or [email protected].

the family caregivers’ grapevine - nscr › information › caregiver › jan feb...

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