Supportive Care Bulletin
Helpful tips for family caregivers
Did you know that financial abuse is on the rise? It’s becoming the most common form of elder exploitation. June is National Elder Abuse Awareness Month and a good time to acquaint yourself with the signs of a problem. In our middle article we look at the importance of periodically taking in the awesomeness of life. It’s not hard to do and it’s measurably good for the body and spirit. Last, we look at the option of managing advanced kidney disease without dialysis. While not for everyone, it is a liberating strategy for those who value quality of life.
Signs of financial abuse
Older adults are frequently targeted for financial abuse. They typically have more funds than their younger counterparts do. They tend to be generous and naïve, not understanding all the ways they can be scammed. Some have memory and thinking problems. And even if they do realize they’ve been “taken,” they may be too ashamed or scared to admit it.
Indeed, studies suggest financial abuse is on the rise. It is likely now the dominant form of elder abuse.
Perhaps the saddest of all facts is that 50% to 65% of the time, the abuser is a member of the family or someone known to the victim. Maybe an adult child at loose ends or grandchild with a drug problem. Even spouses are perpetrators.
Common signs of trouble
- A “new best friend.” Fraudsters prey upon loneliness to become deeply involved in an elder’s life. They can be strangers or relatives who literally or figuratively move in to “help.”
- Isolation. Can you still connect with your loved one easily and privately? Abusers may hide the phone, hide glasses and hearing aids, or listen in on every contact. Another strategy is to emotionally manipulate the older adult into mistrusting everyone but the abuser.
- Unusual financial activity. Watch for sharp reductions in assets, bounced checks, unpaid bills, or collection notices. A new check signer or additional credit card may spell trouble. Also, a recent change in the will or trust. A report of forged checks is definitely a red alert.
- Frightened or secretive behavior. Some abusers threaten repercussions for any disclosure or complaint. Shame may cause your relative to retreat and comply.
If you suspect abuse: Contact the Elder Abuse Hotline in the state where your loved one lives or AARP’s ElderWatch program (1-800-222-4444). Or consult with an elderlaw attorney.Return to top
Giving "awesome" new meaning
Can you recall taking in a majestic view or the miracle of dewdrops on a spiderweb? That sense of awe—the magnificence of it all. In the presence of amazement and wonder, we feel connected with something much greater than ourselves. Our problems seem to shrink.
It turns out that these moments of awe have measurable physical and emotional benefits. Research shows they boost the immune system and arouse kindness and generosity. An “awe-some” life is good for us.
What makes an experience awe inspiring?
- Vastness. Seeing, hearing, or perceiving something that takes you beyond your normal sense of what’s possible.
- Transcendence. Fully understanding and accepting this new perspective that you are both very small and part of something very grand.
Do you have to go to the Grand Canyon to experience awe?
Not at all! Wonder and amazement can be found at home. What is necessary is that you take the time to unplug and see things anew. (Leave the phone behind!) Give yourself uninterrupted time to immerse in the full experience of what you see, hear, smell, touch, feel, or even taste.
- Take an “awe walk.” Try a local park, or even your backyard. Don’t go for a walk. Go for the experience. Slow down. Tune into your senses. Take in the setting each time as if it were brand new.
- Listen to music that transports you. It’s not just visuals that can inspire awe.
- Expose yourself to art. Instead of trying to see everything in a museum or on a tour, linger with what moves you. Savor a few pieces.
- Awe journal. Recall past events when you were awestruck. Sights, sounds, smells, feelings. Relive the experience as you write.
According to the research, measurable benefits can be found by consciously opening yourself to awe twice a week.Return to top
Medical management without dialysis
Dialysis typically buys a person some time. But it rules their life—and possibly yours. It requires strict adherence to the schedule. Also, severe food restrictions. Your relative’s energy level will fluctuate. That makes planning for other activities difficult. There is an increased chance of infection because of the access port for dialysis. And there are side effects: Itchy skin, trouble sleeping, headaches, and dizziness. Cramps, nausea, weight loss, and fragile bones are not uncommon.
Unless your relative is doing home dialysis, they will need transportation to and from the center. A typical schedule involves two to three sessions a week. A session lasts about four hours.
One option to consider is managing the disease without dialysis. Admittedly, this may shorten length of life. But even patients on dialysis often decide to stop the treatment when the difficulties outweigh the benefits.
People who say “no” to dialysis from the beginning place a high value on quality of life. They prefer the thought of living on their own terms for eight months to living fifteen to twenty-four months with the rigors of dialysis.
People who receive the least benefits from dialysis are
- persons age 80 or older. Only 1:3 is alive two years into dialysis.
- persons with other serious conditions, such as heart disease or diabetes. Two years into dialysis, only 2:3 are still living. This goes down to 1:3 if they have two serious illnesses.
- persons with dementia. They have trouble following the restrictions. The procedure can also be confusing or scary to them.
Deciding against dialysis does not mean no treatment. Your relative’s doctor will prescribe medications for blood pressure and fluid buildup. And to address fatigue. All of these treatments support easier walking and breathing. A better daily experience.
Deciding against dialysis is very personal. Ask the doctor to talk about your relative’s best- and worst-case scenarios with and without dialysis.Return to top