Newsletter For Family Members and Friends Who Help or Care For Older Adults Volume 8 Issue 4 2009

FAMILY CAREGIVERSUPPORT NETWORK

NONPROFITORGU.S.POSTAGE

PAIDMILWAUKEE,WIPERMITNO.4400

FamilyCaregiverSupportNetworkInterfaithOlderAdultPrograms,Inc.600W.Virginia,Suite300Milwaukee,WI53204-1551

ADDRESSSERVICEREQUESTED

Call the Family Caregiver Support Network at (414) 220-8600 or (800) 449-4481, a free resource center offeringfamily caregiver support & older adult care information for family caregivers and professionals who assist them.

Visit us online at www.caregiversupportnetwork.org and www.living-options.org

In Part 1 of “Dealing with Difficult People,”we reviewed the reasons that people aresometimes considered “difficult.” These mayinclude: personality, cognitive impairment,difficulty managing emotions, and externalstressors. Part 2 will look at approaches totracking and managing these difficulties.

Identifying and Tracking Patterns:The first step is to develop an under-

standing of the difficult behaviors, andunderlying circumstances and dynamics.It is helpful to identify and track thebehaviors, their causes and triggers, howfamily members and professional caregiversdeal with those, and the factors that con-tribute to positive or negative outcomes.The creation of a behavior log, or note-

book, is recommended; a spiral notebookcan be used to record the following:

(a) record of activities, mood, andbehaviors; circumstances underwhich these occur (time of day;event or cares involved;family/caregiver approaches used;and impact on behavior);

(b) other information, including: sleeppatterns, appetite, toileting patterns,other symptoms or health issues,and medication use.

This log can then be reviewed and ana-lyzed: Are the behaviors occurring withregularity, or is there a variable pattern?Are they becoming more or less frequent,or changing in intensity or duration? Dothese occur under specific circumstances?For example, do they react negativelywhen someone is trying to provide per-

sonal care (toileting, bathing)? Are theirbehaviors related to who is caring forthem, what the approach is, or the time ofday? It may be that the behaviors occur incircumstances that are overwhelming oroverstimulating, as in a large family gath-ering, or public place. It is common forproblems to occur when people are feel-ing rushed or pressured – possibly to getto an appointment or event at a specifictime. There are times when cycles of calmor agitated behavior are related to weather,changes in light, or even the full moon.

Approaches to managingdifficult behaviors:Once the pattern can be reviewed, it is

possible to gain a better understanding ofthe issues, and develop an interventionplan.

Understanding: “Difficult behaviors”may be an expression of physical or emo-tional discomfort. Try to see the worldfrom their point of view. Are they frustrat-ed at their inability to communicate howthey feel, or what they want? Are they inphysical pain, hungry, or tired? Are theybeing asked to choose between too manyoptions? Are they angry that someone istelling them what to do, or at the changesin their health, or abilities? Once you are

able to gain an understanding of what iscausing the “difficult behaviors,” it iseasier to respond effectively to thatunderlying emotion.

Communication: The ability to processverbal communication can be affected bycognitive changes, sensory impairments,depression, or illness. Factors which con-tribute to successful communicationinclude: creating a quiet environment;getting the person’s attention; speaking ina calm, quiet voice; using simple, straight-forward words and sentences; and provid-ing sufficient time to process and respond.Arguing may not be productive; it can behelpful to back down, withdraw, and tryagain later. Limiting choices can be help-ful: instead of asking someone what theywant for dinner, give them the option ofchoosing between two familiar items, orserve something you know they like.

Environment: It may be that a changein environment is needed. Do they needquiet time; to be around fewer people,listen to calming music, or engage in asolitary activity? Or, if they are restless,do they need a walk around the block?

Caregiver Stress: Caregiving is stressful;even the most loving, caring person, canbecome overwhelmed, frustrated, orangry. When that occurs, it can be a signthat help is needed, and that allowingsomeone else to become involved willprovide an important break, or respite.

Expectations: Sometimes it is necessaryto modify expectations of the person youare caring for, and to learn to “pick your

Dealing with Difficult People (Part 2)

Continued on back

A Two-Part Article by MiriamOliensis-Torres, MSW, LCSW, C-ASWCM,a professional geriatric care manager

She can be reached at 414-964-5030 ext.114; motorres@geriatricsupport.com

Caregiver Contacts

If you have a change of address or wish to be removed from the mailing list please call us at 414-220-8600. Thank you!

RespiteWould it be nice to pause,get reprieve, relief or take a break?That is respite and caregivers use it manydifferent ways. Some caregivers need helpin order to attend a family event, go outas a couple, watch a movie or footballgame, look for work or go to the doctorthemselves. Supplemental services canprovide some of the daily cares or homechores a loved one needs and directly orindirectly provides respite to the caregiver.There is often a piece of equipment (life linetelephone system) a certain technique(washing hair or giving a bath) that canmake caregiving easier or safer. Call and talkto us here at FCSN at 414-220-8600. Learnabout the various types of respite care, howit can be tailored to meet your needs, theservices and places that may be available totake care of your loved one and the goodpossibility of assistance with funding.Currently there are no incomerequirements. It never hurts to inquire.

Visit uson the Web

Family Caregiver Support Networkwww.caregiversupportnetwork.org

Living Options Servicewww.living-options.org

Interfaith Older Adult Programswww.interfaithmilw.org

Wisconsin Caregiverwww.wisconsincaregiver.org

GreaterMilwaukee Area

Caregiver Support GroupsGeneral caregiver support groupsWheaton St. FrancisCaregiver's Support Group3237 S. 16th St., first Sat., 10:30 AM.Ask for Louise at 645-9095.

Catholic Charities —2 locations & respite is available13700 W. National Ave., New Berlin,3rd Wed. of the month, 3:00 PM;1755 N. Calhoun Rd., Brookfield,3rd Tues., 12:45 PM;Contact Susan Yee 262-782-0740.

Cedarburg – Ozaukee Co.N69 W5289 Columbia Rd.,Harris Bank, Community Room; 3rd Tues.,6:30 PM. Contact Jan 262-238-8120 or262-284-8120

Waukesha CountyCommunity Memorial Hospital,Menomonee Falls; 3rd Thurs., 6:30-8 PM;Call 262-251-1001 or 1-800-246-8332for info.

Specific support groupsThe Caregiver Contacts column has only asample of places to seek help. Contact FCSNfor complete information at 220-8600.

Caregiver Resource LibraryFree resource library – Call 414-220-8600;100+ Videos, DVDs and Books. We mailthe materials to you free of charge.

C A R E G I V E R N E W S

The Family Caregiver Support Network is a program of Interfaith Older AdultPrograms and is primarily funded through the Milwaukee County Department on Aging

with additional funding through United Way of Greater Milwaukee.Donations are greatly appreciated.

“I would like to thank you for understanding that caregiving is a difficult thing to do.When you hear it over & over again you realize that it is alright being a caregiver, it

raises your self esteem. When you feel better about yourself it is easier to dismiss the badthings that bother or hurt you. Someone appreciates you and what you are doing.”

— A former Powerful Tools participant.

Taking Care of You:Powerful Tools for Caregivers

Feeling stressed? Looking for ways to interact with your family members orcarereceiver? Wish that others understood how you feel or not sure how to express

your feelings? Do you wonder how you can meet your own needs? Do you have sometough caregiver or family situations? Looking for good local resources and help?

This six part series is designed to help family caregivers provide better self care andways to meet the challenges involved with caregiving.

Call FCSN at 414-220-8600 for upcoming class information.

Call the Alzheimer’s Association, Southeastern Wisconsin Chapterat 414-479-8800 for more information in your county on:• Vacation Tips and Hints • Holiday Tips and Hints• Partnering With Your Doctor • Early Stage Programs• Dementia Basics • Savvy Caregiver• Brain Health Classes

UPCOMING PROGRAMS FOR FAMILY CAREGIVERS

battles.” Does the behavior put the indi-vidual or those surrounding them, at risk?If so, then it is important to intervene.However, if there is no danger, it may behelpful to all involved to accept ratherthan try to change the behavior.

Medications: Medications which affectmood or behavior can be useful toolswhen used in conjunction with the other

approaches described above. These canbe used very effectively, when managedby physicians who are knowledgeableregarding these drugs, as well as howthey impact on older adults.

For more information or assistance indealing with difficult people or situa-tions call us at FCSN, 414-220-8600.

“Dealing with Difficult People” continued from front

The twinkle in their eyes is betterthan all the twinkling lights, it brings a

smile to my face and breaks theseriousness of our days.

— Trish

The simple rare “thank you” travelsthrough me. This appreciation meant

more than anyone could know.

— Veronica

The long, heartfelt hugs that warm mysoul and need to last until the next

holiday gathering.

— Jan

Conversations and laughter that fill everyroom and will remain long after

everyone has gone home.

— Jan

The smell of once a year treats,shared in good company of people

who don't forget.

— Pat

Remember and share the small things ofthe holidays: a turkey undercooked,

beautiful frosted cookies, the best treeever, your favorite song, a wrapped giftunder the tree that the dog found andopened by accident, Aunt Mary’s fruitcake... the memories are so precious.

— Eddy

Caregivers give all year long and often at great expense. The most precious giftsfrom those we care for this holiday season may just be simple things .... watch for

yours and write your own medley from the heart, to keep forever.

A Medley of Caregiver Holiday Joys