Everyone wants long term success. But it is elusive for most.

Long term success is dependent on knowing where you are now and where you are headed. Then closing the gap. Frequently. Continuously.  Whether it’s your business, your career or your life at home., it’s easy to get off track, lose touch or get buried under. Without a true sense of where you are in the moment, it is impossible to realize your dreams or be a leader in your field.

Re-calibrate your profound knowledge

The only way we can take 100% responsibility for sustaining our success is to keep re-calibrating-in every aspect of our lives and organizations.

Key to successful recalibration is to acquire what my dear departed mentor, Dr. W. Edwards Deming, coined as Profound Knowledge. This umbrella phrase emphasizes understanding change and how to measure it, being aware of emerging trends and shifts, and learning how to apply this knowledge to leading and sustaining long term success.

Bottom line: If we don’t acquire Profound Knowledge we cannot know how to prepare for and leverage coming change, thus how to sustain our success long term.

Understanding change means understanding shifts in our personal world as well as tracking trends that capsize us, overtake us, or cause us to flounder.

Learning the Hard Way

Unfortunately one of my Gen X male clients learned this the hard way. A rising star in his field and recently married, he was planning far a great future for his kids, tons of time for fun and all the trappings of success. As if out of the blue, the rug got pulled out from under him. His “Happy Homemaker” wife fled, saying I’m out of here!

Somewhere along the way there was a breakdown or perhaps many small fissures below the surface. Had they been recalibrating an checking in with each other, communicating the truth of what was so for each of them…perhaps they could have saved their marriage…or at least ended it with love, grace, and forgiveness.

Even in the most secure relationships, unexpected change happens to ruffle our plans. A recently returned to work mother of teenage kids reported that her new career is now going gangbusters and she no longer worries about the empty-nest . But, the new ripple in her life is that her once very successful husband, in his late 40’s, now faces an unknown future. Surprised by the shifts in his industry, “suddenly” he and his business partner are facing the probability of closing their doors. What once appeared to be the sure path to their dreams, is no crumbling beneath them.

Change is inevitable. If you can learn what Profound Knowledge is and apply it you can avoid these same pitfalls and NOT LEARN THE HARD WAY!

What steps are you going to take to future cast your long term success?

Finding the Best Long-term Care for an Aging or Disabled Loved One

By Dawn Waddell Elledge RN, CCM Board Certified Aging Life Care Professional, Owner @ Elledge Geriatric Care Management

Whether or not you have thought about long term care for an aging or disabled loved one, the reality is that human life expectancy has increased steadily over the past few decades. The number of people living past 70 has dramatically increased, and because of higher standards of living, by the year 2040 the percentage of nursing home residents will jump from 50% to 130%. In the United States, more than 70% of nursing home residents are 75 years of age or older. 92% of those are Caucasian, 6% are African-American, 1% are Spanish, and the remainder are Asian, Hispanic mix or of other Native American descent. Another important contributing factor to the ever increasing need for long term care is the decline of the extended family in our culture. American households consists mainly of what sociologists refer to as the “nuclear family.” This is where the home is downsized to a single unit family replacing the former agricultural and extended family group.

Because we live in a very mobile society, more families are moving miles apart as the children become adults. Siblings are far removed from one another, and parents are very likely to have to care for themselves when they grow older.

The bottom line is that long-term care issues are here to stay. Also very important is the awareness that long-term care insurance premiums are usually less if you buy them when you are younger; this is not a preparation that should be postponed until one is nearing the possibility of needing long-term care facility placement.

Here’s a rundown of some of the types of long-term care settings most commonly found in communities throughout the United States today…

Adult Daycare alternative

Accessory Dwelling Units alternative

Subsidized Senior Housing

Board and Care Homes

Assisted Living Facilities

Continuing Retirement Communities

Certified (Medicare) Home Health Care option to facility based alternative

Hospice Care alternative

Respite Care alternative

Home and Community-Based Waiver Programs for the Medicaid & V.A. Eligible

Programs of All-inclusive Care for the Elderly who are Medicare/Medicaid

Nursing Homes (custodial-non-skilled-non-Medicare-long-term care)

Retirement Centers/Apartments

Multi-level of Care Complexes

Personal residential or facility based private pay sitter

For senior citizens and their loved ones there is a vast number of resources within every community, these are just a few examples:

Local Community Senior Citizens Centers for Supportive Services

Transportation Programs

Non-Medical Care Agencies

Certified Home Health Care Agencies

Geriatric Care Management (Aging Life Care Professional)

State Ombudsman

State Dept. of Health

Council on Aging

Veterans Services

Mental Health

Dementia & Aging Care-Giver Support Groups

Admin. On Aging at www.aoa.gov (1-202-619-0724)

Centers for Medicare & Medicaid Services at www.medicare.gov

ELDERCARE LOCATOR www.eldercare.gov

Long-Term Care Ombudsman (1-202-332-2275 FOR MORE INFO)

State Health Insurance counseling & Assist. Through St. Dept. of Health

Area Agencies on Aging at www.eldercare.gov

Aging & Disability Resource Center at www.adrc-tae.org

For more information on dementia care go to Alz.org or contact Vanderbilt Memory and Alzheimer’s Cntr.

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Dawn Waddell Elledge RN, CCM Board Certified Aging Life Care Professional, Owner @ Elledge Geriatric Care Management

I’m currently transitioning from professional board certified geriatric care management to becoming a hospice nurse manager in the home health sector. I write books that outline how “it will dawn on ya, life’s a journey….” Life has certainly been an interesting journey for me as a nurse person who has keen insights on living, aging and accepting the natural process of it all, like you mean it. Intentional living is what the journey is all about!!

However, from the vibrating heart of our dissipating structures comes the promise of our true greatness: a greatness of awareness and action that will change the world. From the midst of the evolving Great Transition, we leave the Great Recession and the uplifting Obama era behind us as we enter an unknown, unchartered new cycle of populism and extreme radicalism ripping our valued democratic tenets to shreds and putting each of us on the line.  This Great Shift demands that we each unlock our potential for greatness which lives in each of us, and we are being called to make a difference. That is the premise of The Greatness Challenge, in which I offer a template for embracing and embodying our unique Signature Greatness DNA^SM to unleash our personal and collective greatness.

The Greatness Challenge is a manifesto for the growing wave of us who want to add value in all we do and who are being called to personal and collective evolution—from dentists to doctors, executives to engineers, artists to teachers and visionary leaders and futurists who are looking to redesign their lives so that every moment counts . . . for those of you who seek work that not only fills your bank accounts but your “values” bank as you yearn to do well doing good . . . for leaders who seek a pathway to visionary leadership, so the impact you have is of the greatest benefit for all.

To be one of the first to hear about The Greatness Challenge when it releases join us in the Secret Facebook Group here.

Photo Credit: geralt, Pixabay

Losing a spouse, especially one who was the primary caregiver, is one of the hardest experiences in life. When the person suffering the loss has Alzheimer’s or dementia, it can make the experience even more challenging. While the needs of a grieving individual are the same regardless of the presence of Alzheimer’s, people with dementia experience bereavement in a range of ways that depend on the person’s personality and cognitive difficulties, which can present unique challenges.

Sharing the Information

When someone with dementia loses a loved one, you must decide whether or not to share the information and how many details to provide. The best solution depends on the individual and his or her distinctive circumstances. Consider discussing the situation with professionals, including the primary care provider, dementia expert, and a mental health professional. Regardless of the decision, it’s crucial to acknowledge and support the person’s emotional responses.

Not telling the person prevents the grieving process from occurring and may lead to feelings of fear or lack of support when the spouse stops visiting without explanation. On the other hand, some individuals may not be able to fully process the information and can become distressed. Keep in mind that the individual is likely to still feel the intense emotions of grief, including loneliness, shock, guilt, anger, and more.

When telling the individual about the spouse’s passing, provide the information clearly and simply. Avoid euphemisms like “passed away,” and don’t give too much information at once. Provide ample time for the conversation and remain supportive. Having support for yourself is also important. Try a different approach if the person becomes too distressed.

Providing Support During Bereavement

Acknowledge feelings, which can range from profound shock and a sense of bewilderment to an inability to understand the loss despite a strong emotional impact. Encourage self-expression and allow the person to talk about the spouse. Reminiscence can be helpful for those with dementia. If the spouse was the main caregiver, the significance of the loss is amplified. The person with Alzheimer’s is likely to need extra support, guidance, and assistance.

Like many other grieving individuals, someone with Alzheimer’s may find comfort in spiritual beliefs, such as prayer, meditation, or other faith practices. Consider creative outlets, such as art and music, which are often used for self-expression and engagement in Alzheimer’s patients.

Providing an object that reminds him or her of the spouse can help with feelings of connectedness and reminiscence, which is why it’s important to carefully sort through the deceased spouse’s belongings to decide what to keep, give to other family members, or donate. You don’t want to toss something that could help in the grieving process. Starting with the kitchen and working your way through the home room by room is the best approach, but sorting personal items in each room will be difficult. It’s best to go with your gut instinct when sorting.

Reminding Your Loved One about the Spouse’s Death

At times, the person with dementia may forget that the spouse has died, which can be difficult for family and friends who are coming to terms with the death. The individual may react as though he or she is hearing it for the first time and may experience the emotions all over again. He or she may also confuse the recent loss of a spouse with a previous loss of a parent or other loved one.

How to handle reminders will depend on the individual. For some people, a gentle reminder is helpful, but for others, any reminder can be very upsetting. Remain patient and responsive. “Recognizing and focusing on the person’s emotional state can make knowing what to say easier,” suggests Alzheimer’s Society. For those in the later stages of dementia, reminders that the spouse has died are unlikely to work and can cause high levels of distress. Avoiding reminders may be advisable in these circumstances.

Supporting a person with Alzheimer’s who has lost a spouse can present many challenges, especially if the spouse was the main caregiver. However, there are ways that family, friends, and new caregivers can help the person to feel safe and supported. From the way that the information is shared to handling reminders of the death, support should be provided in a patient and caring way that’s also unique to the person’s individual situation.

No one wants to move to a nursing home or put an aging parent in one. Yet, families may not have a choice when Dad loses a lot of weight because he lives alone and doesn’t eat well, or when he becomes depressed and forgetful. The nursing home may be the only place to care for him.

It happened to my family. We knew Dad didn’t want to go, but his dementia severely affected his ability to care for himself. It first started with problems dressing himself, followed by incontinence and, lastly, problems with his mobility, making transferring him even from his bed to a chair nearly impossible. Watching a parent slip slowly down the rabbit hole is frightening, and there’s nothing anyone can do about it.

The doctors told us that Alzheimer’s disease can cause deterioration in his capacity to do day-to-day living activities (ADLs), as well as the loss of cognitive function and behavioral changes. My Dad’s decline in everyday functioning increasingly became a burden on the family which led to a nursing home placement.

ADLs, activities involving health and hygiene, are the things we do on a regular basis to safeguard our health and well-being, and many of us take them for granted until we can no longer accomplish them. These instrumental activities are the ones that allow a person to perform complex skills to live independently. Here are some examples:

Primary activities of living

• Eating
• Bathing
• Dressing
• Toileting
• Continence
• Transferring – the ability to get out of bed or a chair
• Walking (even with the aid of a cane or walker)

Instrumental activities of living

• Food preparation
• Housekeeping and laundry
• Managing finances
• Shopping
• Use of the telephone
• Taking medication
• Using public transit or driving a car

The medical team measured Dad’s ability to perform these activities to assess his functional ability. They used tools called the Katz ADL Scale and the Lawton IADL Scale to determine the level of care he needed.

As his dementia progressed, there was a continual decline of abilities until the performance deteriorated to the point of ill-health. His body, not just the mind, was affected by the disease. He lost motor control. It was hard to watch him lose the independence he treasured, and it was very frustrating and depressing for him to realize that this was happening.

That’s when irritability, anger, aggression, and withdrawal set in. The family believed these behaviors were the result of his recognition that he couldn’t take care of himself. We tried everything to help him regain some skills but, unfortunately, the deterioration did not reverse. The doctor assured us that it was the nature of dementia, but we continued to encourage him to attend the therapies (brain cognition and memory training, for example) in hopes of delaying the effects. They did help make daily activities a bit easier, or at least do-able, for a short time. Our goal for Dad was to improve his functioning and independence that made him feel more productive in the end.

For families, safety should be the first concern when caring for a relative with a disability. Don’t take for granted that a loved one can perform everyday tasks like you. Remember that a knife can cut fingers as well as vegetables, and Alzheimer’s-proofing is similar to child-proofing a home.

Keep a watchful eye for a sign that points to their need for more care. Look out for unkempt hair and grooming, loss of weight, incontinence issues, and issues with paying bills. It’s hard to admit that a parent can decline so rapidly, but your awareness will keep a parent safe and healthy. Don’t jump to conclusions, and always consult with the parent’s physician for appropriate steps to take on their behalf.

Carol Marak contributes researched articles for the senior living and healthcare market. She advocates for older adults and family caregivers by writing on tough topics like chronic health issues, senior care, and housing. Find Carol’s work at AssistedLivingFacilities.org and SeniorCare.com. Find her on LinkedIn and at Carol@SeniorCare.com.

“Human beings have a very limited ability to accurately predict or even imagine the needs of their future self. It is especially true when that future contains scary possibilities.”  ~ Dr. Bill Thomas

I lost my mom before she died. I could no longer deny that her Alzheimer’s was full-blown. She had early onset of the disease when I was a teen. Now suddenly, at 28 and a young mom myself, I had to face that she was really gone. There was no retrieving her. She was only 59!

Mom went from living alone independently to needing constant supervision and professional care in a nursing home that specialized in Alzheimer patient care.

As a family, we’d never talked about how we would care for our parents or what provisions were to be made for their eventual passing. My older siblings, far more astute on these matters than I (having faced Long Term Care — “LTC” — needs of other family members), sprang into action and garnered the help from an array of trusted advisors we needed to sort out the best care for Mom.

Let’s face it, it’s never easy to work out complex logistics and quality of care concerns. But I guarantee you it is far more overwhelming and devastating when done in crisis mode intervention, which only exacerbates stress and intolerable grief. However difficult, it’s wise to plan for LTC sooner rather than later.

I assumed this waiting till it’s too late modus operandi was attributable to my family’s dynamics. Over time, however, I learned that this is more prototypical than not. In fact, when I asked Activist-Philanthropist Elly Guggenheimer, then age 86, during our interview for my book, Visionaries Have Wrinkles, “Do you talk to your children or do they ask you about your plans for your end of life?” she responded, “No, absolutely not. I never sit down and say to my children, ‘Let’s talk about my end-of-life planning.’ ”

What a pity that so many of us don’t have these conversations with our kids (much less our spouses or partners) long before we reach a crisis point. Instead, we wait until it’s too late.

This has all hit home for me this spring as I am recuperating from an old injury thrown out of whack by an unrelated surgery at the beginning of 2015. Albeit temporarily, this has put me out of commission physically for several months. I’m an independent woman and my freedom is paramount to me. Yet, during my recovery I have had to rely on others to drive me anywhere and everywhere, prepare my meals, and much more. I even had to move my “office” from a room requiring staircase access to my main floor living room. All of these “inconveniences” have caused me to wonder how this would be if it happened when I was a lot older. Or, what if my adoring husband of almost 40 years wasn’t able to care for me or wasn’t with me any longer … how would I manage?

While machinating on LTC, I received a report from Senior Care entitled, “America Has a Major Misconception on Aging.” I highly recommend you take a moment and download it for yourself, your health care providers and your family. I’m pretty savvy on aging and the adult life course, but the stats reported are a wake-up call I can’t ignore, nor should you. For instance (this was a shocker for me!) — what would you guess is the percentage of Americans who will need LTC (e.g.: nursing homes, assisted living, home health care, informal caregiving)? Apparently only 37 percent of us think we will need LTC. In actuality, that number is closer to 69 percent (approximately 2/3 of us).

But the royal Holy Cow for me was discovering that 75 percent of Americans have not had LTC discussions with family members! This lack of pre-planning can result in greater emotional and financial strain, as well as less control over and/or fewer choices regarding preferred care.

So I ask you, have you had a serious conversation with your loved ones? It will never be a “good time,” but I assure you now is a better time than later.

(Note: June is Alzheimer’s & Brain Awareness Month. Find out more at: Brain Awareness Month)

(Image Credit: Langholz by Wolfgang Staudt, flickr.com)