Saturday, 16 February 2019


Want to laugh at black humor? Read anything by David Sedaris. I’ve just finished his latest ramble-in-a-book-form titled ‘Calypso’.  It’s very funny when it’s not causing me to blush or wince. I loved it.

Sedaris saves his most barbed tongue-lashings for service providers – at airports, restaurants, in taxis and in hotels. “How was your trip in today, sir? Good? Awesome!” or “Hot enough out there for you?”

These kinds of ‘fake-friendly’ conversations drive the author nuts and they have the same effect on me. Here’s what he says about one young woman who repeated a greeting she’d learned in a staff training weekend away:

I just wanted to get a rise out of her to feel some kind of pulse. I knew that the young woman had a life. She’d gone to school somewhere. She had friends. I didn’t need a fifteen-minute conversation, just some interaction. It can be had, and easily: a gesture, a joke, something that says, “I live in this world too.” I think of it as a switch that turns someone from a profession to a person, and it works both ways. “I’m not just a vehicle for my wallet!” I sometimes want to scream.

This passage made me think of all the times I’ve cringed or seethed privately in doctors’ offices, or hospitals or clinics or in the offices of social workers. When conversation is inauthentic or it’s being managed to an end well before anything meaningful is expressed – no one is cared for. The patient and caregiver make their exit without hope of healing because no human connection has been made.

David Sedaris provokes meaningful (or at least unexpected) conversation by being outrageous. But we caregivers don’t have that luxury. We need natural and meaningful conversations with our families, friends, co-workers and our service providers. Because we don’t have the time or energy to waste on any phony platitudes.

So my message to caregivers today is, call them out. Speak up and say something the next time you are met with empty niceties when what you really need is a meaningful exchange. When a service provider asks (while flipping through papers or looking at a computer screen), “How are you?”, answer “Terrible. Last night I slept for 37 minutes. What about you?”

Saturday, 9 February 2019

How Different Countries Care for Seniors: A Look at Caregivers and the Elderly Around the World

Today, guest blogger Roxanne Baker gives us a world tour of eldercare attitudes and practices. I loved learning about how families in different cultures take care of older loved ones and I wonder what differing cultural practices can teach us about looking after our own. Please chime in with comments if your family's culture influences your caregiving. 

There's just no escaping the cultural milieu and cultural forces that mold and shape us, especially when it comes to attitudes toward and treatment of the elderly. With declining birth rates and an aging population in most countries around the world now, those attitudes matter immensely. How a society thinks about aging and the elderly determines in large part the kind of care the elderly get, and it becomes increasingly more important as populations age. We also have to factor in the decreasing numbers of younger people to serve as caregivers for the elderly. So let's look at the situation and take a quick tour.

Elderly Support Ratio and Attitudes in the West

According to the Population Reference Bureau, we now have a rapidly aging world, and many countries are facing challenges in caring for elderly citizens. "[T]he elderly support ratio – the number of working-age people ages 15 to 64 divided by the number of people 65 or older – is declining in many countries, most notably in developed countries. According to PRB estimates, by 2050 Japan will have the lowest ratio of one working-age adult per elderly person, while Niger, a developing country, will still have a ratio of 19. No country will have an elderly support ratio above 20 by 2050."

These are indeed some sobering statistics. They also illustrate the burgeoning need for trained caregivers for the elderly, who serve on the front lines of caregiving.

Further exacerbating this problem in the developed West is the undeniable fact that ours is a youth-oriented, youth-driven culture. If we have enough money, we resort to cosmetic medical measures to keep us young looking as we age. Many families, rather than caring for aging parents and grandparents in the home, shuffle them off to nursing homes. It's not heartlessness – it's just a way for us to avoid facing the inevitable fact that we will someday be old too.

But it's not this way in all cultures and societies around the world and not even within some subcultures here, for example, among Native Americans.

Family Caregivers and the Elderly Around the World

Being old isn't just a matter of biology: it's also a social and cultural construct. So, while aging is a universal human experience, it is not viewed the same everywhere. Here are just a few examples of attitudes toward the elderly around the world, as well as how that translates into care from family caregivers.

In China, respect and care for the elderly are actually ensconced in law, and, in fact, elderly parents can sue their children for both financial and emotional support. In addition, companies and businesses are required by law to give workers time off to tend to aged parents. The idea is to protect the economy and not overburden resources owing the dense population and growing numbers of elderly people. But it's not all about money. Under these laws, many parents have sued because their adult children don't visit them regularly.

"China is projected to have 636 million people over age 50 by 2050, or nearly 49 percent of the population – up from 25 percent in 2010 . . . And somebody needs to care for them, goes the government thinking" (HuffPost). It may be law now, but Chinese culture has always upheld respect for the elderly as a Confucian attitude. It's just standard in China to honor and care for older people.

Japanese culture has always valued and still values the elderly. It has been ingrained in families and children for generations upon generations, which makes Japan one of the best and kindest places on earth for seniors. In fact, many Japanese families live with several generations under the same roof – one of the reasons why the elderly in Japan live longer than those elsewhere. Besides exercise and proper diet, strong community and family bonds are the chief ingredients in longevity.

All of that is a good thing because Japan has more people over 65 than any other age group. Efforts are made to ensure that all the elderly get some attention, with a national holiday for that purpose. The third Monday of every September is Respect for the Aged Day, a holiday that includes paid time off from work. It aims to honor and show respect to the elderly with gifts given to grandparents and a shared festive meal. "Neighborhood volunteers distribute free bento boxed lunches to elderly people. In some small villages, younger people and school children dance and provide entertainment" (HuffPost).

Then there's Scotland. Although it is part of the developed West, older people are still cherished and valued as an asset. There is now a concerted effort underway to ensure older people are heard and that they are supported in family settings for full and positive lives. For the West, this is a paradigm shift – a movement away from hospitals and nursing homes to family caregivers, preventive care, and quality of life.

This shift also means a different use of money and resources. Adjustments are made and homes adapted so that older relatives can live in the homes and age in a family environment. In general, families work hard to care for elderly loved ones, honoring them and respecting them as valued members of society.

Respect for elders is a valued and deeply entrenched sentiment in Vietnam. In Vietnamese culture, elders are viewed as treasured sources of knowledge and wisdom and the transmitters of tradition. Typically, elderly grandparents live with their families so that they receive support and care. And in return, the grandparents retain their usefulness by contributing to the household, doing such things as preparing meals and caring for grandchildren.

In Vietnam, elders are held to be the head of the family. Their opinions and advice are sought and valued, and they are the de facto decision makers in many households. Basically, being old is not a liability, but rather an asset.

Old age is also seen as an asset and advantage in Greece, where it is equated with wisdom and, sometimes, holiness. "'Old man' isn't a slur in Greece; in fact, it is quite the opposite. As Arianna Huffington discussed in her book On Becoming Fearless: 'I visited the monastery of Tharri on the island of Rhodes with my children. There, as in all of Greece, abbots are addressed by everyone as "Geronda," which means "old man." Abbesses are called "Gerondissa." Not exactly terms of endearment in my adopted home. The idea of honoring old age, indeed identifying it with wisdom and closeness to God, is in startling contrast to the way we treat aging in America'" (HuffPost).

Implications . . .

Attitudes toward and care of the elderly around world, then, often present quite a contrast to what they are here. "Other countries appreciate and admire this transition of life and respect and welcome their elders into society as an integral part of existence. As a society in the Western world, if we want to change the attitudes around caring for our elderly, we must first develop a new perspective on aging and caring for our seniors. With the strides in healthcare and medicine that the United States has made, our citizens are living longer . . . [We must ensure] that the needs of our oldest members are being met with respect and admiration" (MIR).

The upshot of all this is that there is a growing need – a desperate need, really – for more and more trained, long term caregivers with valuable skills and knowledge comprising, for example, patient positioning, pulse and respiration monitoring, and range of motion maintenance. But we also need to strive for a shift in thinking and move toward caregiving in domestic family settings provided by skilled family caregivers.

About the Author:
Roxanne Baker has been a writer and producer for 15 years working at national TV stations, magazines, and newspapers. She is the co-founder and editor of, a website specializing in certified nurse assistant education and training.

Sunday, 27 January 2019

One Gold Award Girl Scout's Contribution to Azheimer's Patients and Families

Yesterday, I was delighted to discover this message in my email inbox: 

Hello! My name is Isabelle Richter. I am a Bee Cave, Texas, resident. I'm a junior at my high school and a long-time Girl Scout. I am currently working on my Girl Scout Gold Award, the highest achievement that can be earned (similar to the Eagle Scout award). 
Local Alzheimer's Program
For my Gold Award project, I decided to create a reminisce and sensory stimulation program here in Lakeway in the memory care area of Legacy Oaks right by Baylor, Scott and White Medical Center.  The program is complete with memory kits, multi-sensory activities, and “destination stations” benefitting the Alzheimer’s and dementia residents. I chose this Gold Award Project because my Papa (grandfather) in California was diagnosed three years ago with early-onset Alzheimer’s.  I know first-hand how important it is to help a person with Alzheimer’s remain engaged, and there was a need for improvement in this area in our local community.  My project will benefit those with memory care needs by providing social stimulation, improving their quality of life, replenishing their spirit, encouraging them to try, and will provide an opportunity for them to build relationships with caregivers while boosting cognitive stimulation and delivering boredom relief. 

Website for Caregivers, Family, Friends
In addition to the program at Legacy Oaks, I have created a free website called Memory Lane for Alz ( and I thought it might be something of interest to pass along to caregivers on your wonderful blog.  I created it to help others gain information, support and ideas as caregivers, family and friends of those with memory challenges.  The website includes background on my project, pictures and descriptions of the destination stations, and easy, how-to videos for all the activities so they can be replicated by caregivers.  The site also includes communication tips, links to wonderful information and organizations for seniors, Alzheimer’s patients and families, and information and language translation on the global impact of Alzheimer’s.  Be sure to visit, take a look and refer others to the site!

Thank you, Isabelle, for your hard work and your creative contribution to patients with Alzheimer's and dementia and their families! This is a wonderful project - I encourage everyone to check out THIS WEBSITE for lots of ideas about how to stimulate memory, conversation and engagement amongst the whole family!

Wednesday, 23 January 2019

When Homes for Autonomous Seniors Aren't Safe

Today is the fifth anniversary of a terrible fire in a Quebec seniors' home. On the night of January 23, 2014, The Residence du Havre nursing home in L'Isle-Verte, Quebec, was consumed by fire - one that originated in the residence kitchen, but quickly became an inferno. 32 people died and 15 were injured. There was no sprinkler system in the building because the residents were considered to be 'autonomous'. They might have been 'independent' retirees when they moved in, but years later, many of the victims evolved into users of wheelchairs or other mobility aids. Today, half of Quebec seniors' residences still have no sprinkler systems. 

Fast forward to last Sunday, the 20th of January. 93 year old Helene Rowley Hotte, the mother of a prominent Quebec politician, perished in the freezing cold outside her Montreal seniors' residence. A fire alarm sounded in the early morning hours, so Madame Hotte evacuated through the nearest exit. The door locked behind her. Slightly hearing impaired, she apparently did not hear an announcement informing residents that there was no need to evacuate. Security cameras showed Madame Hotte collapsed and perished of hypothermia in sub-zero temperatures. Her body was discovered more than seven hours after the alarm sounded. 

The residence where Madame Hotte lived advertises itself as ideal for 'independent', autonomous seniors. But what exactly IS an independent, autonomous senior? Possibly, there is no such thing. We all age into infirmity, some slowly. We need support to be independent. We depend on others to keep us safe. My mother lived in such a seniors' home until, near the end of her life, her needs dictated a move to assisted living. I remember Mom saying that she and other residents of her 'autonomous' home frequently resisted the urge to call for help for fear that they might be seen as 'too much trouble' and that could lead to 'being evicted'. The effort it takes to follow rules and be no trouble in autonomous seniors homes is quite literally killing people. 

Of course there will be an inquiry into the tragedy of Madame Hotte's death. Someone will likely ask why one of six staff members on duty that night did not do a outdoor perimeter check of the building after the all-clear. Another will ask why, if there were security cameras, no one on duty looked at them. Still another will wonder why, in a residence for older people, no staff members considered that older adults at night and without their hearing aids in, might have heard the alarm and hurried outside into the cold. 

Government ministers have redoubled efforts to ensure that all Quebec seniors' residences are fitted with sprinkler systems. And no doubt, new safety protocols will be developed from lessons learned in the terrible death of Madame Hotte. But I fear that we will continue to read about tragedies so long as we do not protect vulnerable seniors at the same time as we treat them with dignity and support them in both independence and dependence. 

Wednesday, 16 January 2019

How Our Book Became a Fabulous Short Film

Dr. Zachary White and I have co-written a new book called The Unexpected Journey of Caring: The Transformation From Loved One to Caregiver. It's coming out on June 8th (Amazon, Barnes & Noble, etc.) and we are really excited to begin the public conversation about our ideas!

Eric Schultz and Tyler Funk are two young animation artists who wanted to make a short film for the Telus Fund Stories for Caregivers series. We all met and voila! Here is the wonderful result - our book in an animated short film form! If you love it as much as we do, please share.

Tuesday, 8 January 2019

Five Unexpected Rewards of Becoming a Caregiver

This is a wonderful guest post by caregiver and writer George Shannon, full of truth and wisdom.

George Shannon

It’s true, the life of a caregiver can be demanding, difficult and daunting. I spent seven years of my life in that role, keeping an eye on my wife’s every move. Just about every night, Carol and I awoke from our slumber at least five times to make trips to the bathroom. We spent endless nights in hospitals and long days in doctor’s offices. 

If given the chance to do it all over again, I would. Those years of being a caregiver constitute the best seven of my life. I learned a ton about myself and my family, became a more fulfilled man, and had the incredible chance to fall in love with my wife all over again.

While I could easily list twenty wonderful things about serving in a caregiving role, here are five very important and unexpected rewards:

1. A Better Relationship

When I started being a caregiver, time slowed down. Because the role can be so demanding, you must focus on the person. In the process, you learn what makes them tick – maybe things you hadn’t noticed before. Putting these nuggets of wisdom to use can make that person so happy, which in turns makes you feel good.

For Carol it was pancakes. When she needed a boost, a single pancake could do the trick. Every once in a while, she’d be down in the dumps. The minute I saw this, we were on the way to our local breakfast joint. Carol’s smile would make my day.

2. Precious Moments

Similarly, you get to be a part of some very special moments. Before my wife’s strokes, we’d spend some time together but did our own thing most of the time. After Carol got sick, I spent 90% of my time with her and I got to be a part of so many meaningful moments. 

Her father had come to live with us for a few years during her illness. He was around 90 at the time. Every night the Pittsburgh Pirates played on TV, they stood, held hands and sang Take Me Out to the Ballgame every time. You could just feel the love and joy between them. I’ll never forget those moments.

3. Discovering Humility 

This might be the most hidden of rewards. Before my wife became ill, I was a decent man and generally thoughtful of others, but my world had veered towards self-centeredness. I was set in my ways and had been accustomed to the order in my world. 

At first, out of necessity, I began taking care of her needs. Soon thereafter, I started feeling good when I did things to help her.  Then something tremendous occurred, I began to derive sustained joy when making her life better. By the time she passed away, I’d committed my life to completely serving her and felt total fulfillment. Why? I had become entirely selfless. There may not be a better feeling in the world.

4. A Deeper Relationship

As I gave myself over to her, my wife started to really feel the love. And in turn, she began outwardly show her love and appreciation. A day wouldn’t go by when she would tell me that “You’re too good to me,” or “Thanks for all that you do for me.” I never sought these assurances but when she’d offer them, it would light up my day. It was then I realized that we were falling in love all over again.

It was during this rekindled time that we showed our truest selves. From her, I got to see a hidden sense of humor and sharp tongue that often had me belly-laughing. For her, my wife saw a much more tender side and the softer edges of my soul.

5. A Stronger Family

Only one of my siblings and one of our three sons lived in Pittsburgh when my wife got sick. At first, I felt sort of alone in dealing with her health crisis but that didn’t last very long. The one son who lived the closest moved in for a year. My other two kids came in regularly and showered their mother with love. My siblings came in all the time and called when they couldn’t.

I’ve lived my life abiding by the philosophy that what happens to you isn’t as important as how you responded to it. My entire family respond with love, concern, help and support. Each time, their acts and deeds made Carol and I feel wonderful. I took great pride in seeing my family come together.

Don’t get me wrong, it wasn’t always easy. Yet, at the end of each day of caregiving, I always received a small gift – a sense of fulfillment. And now, when I look back at those seven years, I am reminded that my life had purpose which is the greatest reward of them all.

GEORGE SHANNON is the co-author of The Best Seven Years of My Life: The Story of an Unlikely Caregiver, which he wrote with his son, Chad Patrick Shannon. George was the caregiver for his wife, Carol, for seven years. While George was taking care of Carol's health, Carol was quietly showing the way to a humble and loving relationship. The entire experience transformed George's approach to accepting himself as he is, the circumstances as they are, and those around him as they are. Humility and unconditional love were the result.

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Tuesday, 1 January 2019

I Don't Do New Year's Resolutions... Except For This One

The New Year is a natural time for reflection on what was and what will be. I've been thinking about the changes in my own caregiving over the past year: Mom died on August 16 and I still have to remind myself that I don't need to call or visit her. Last night, Jim and I co-presented a mini-history of our family life with Nicholas at a New Year's Eve charity ball in support of the care home where Nick went for respite 'sleepovers' when he was small and where he lives as an adult now. 

So, I've been reviewing the past and considering the future, especially over the holidays. What will my caregiving look like in 2019? What will the future hold for me and Jim as we age into care receiving? 

A new study reveals that caregivers and care recipients are getting younger. The same survey shows that more men than we previously thought are giving care. And we know that they manage differently from women, but very little research has been done to illuminate the best policies and services that male caregivers find helpful. 

The caregiving landscape is changing for me personally and for all caregivers. As our society responds to our contemporary challenges, the roles of caregivers shift like fog in the wind. We do what needs to be done on an as-needed basis, like some perpetual game of whack-a-mole. Yet, even when the very lives of our loved ones depend on us, our caring roles, performed in the intimate privacy of homes are rarely seen or discussed. 

Here's an idea for something to hope for in 2019: Let's make caregiving visible and valued. Let's make our roles and our advocacy aims intentional and strategic. Let's talk about caregiving just like we talk about cooking or gardening - as a part of life that we plan, we talk about, and we value. Who's in?