Managing relationships Archives - Better Health While Aging

Sex When Caregiving:
Navigating Your Changing Relationship (Even if There’s Dementia)

(This article is part 2 of a special guest series by geriatrician Dr. Nicole Didyk, founder of the blog and YouTube channel The Wrinkle. Like me, Dr. Didyk has a particular interest in informing and empowering older adults and families. So I’ve been very glad to have her contributing to the site these past few months — you may have noticed she’s been helping me answer comments — and I’m thrilled to say she’ll be covering some topics that I haven’t yet had the time to address. Enjoy! — L. Kernisan)

Let me begin by sharing a true story:

One of the most unforgettable couples I ever worked with was Grace and David. Grace developed Alzheimer’s at the age of 63, and within 2 years of diagnosis, her symptoms were such that she moved into a long-term care home and used a wheelchair to get around.

She and David had been married for 42 years, had 4 kids, a dairy farm, and a warm and affectionate marriage. David continued to visit Grace 3 times a week, until her death (after a bout of pneumonia) at the age of 69, and in the last two years, his girlfriend, Linda, accompanied him almost every time.

I remember being so touched by the way that David and his new partner lovingly advocated for Grace when she needed it, with both stepping in to provide hands-on care when staff at the home were overwhelmed. There were some who judged David for so boldly “having an affair”, but most saw his involvement in a new relationship as a much-needed respite for him, and a way to expand the circle of love for Grace.

Have you ever met a couple like Grace and David? Keep their story in mind, as I share more about Sex and Caregiving, and Sex and the Changing Brain.

How does sex and intimacy change when one partner becomes a caregiver?

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5 Easy Ways to Connect with a Different Generation (& Why it Matters)

by Leslie Kernisan, MD MPH 3 Comments

When is the last time you had a really meaningful conversation with someone from a different generation? And who was it with?

Was it with a grandchild? A niece? Your own parent? A neighbor? Or maybe even the person standing next to you in line at the store?

While these types of connections happen every day across the United States, they probably aren’t happening enough.

And that’s a shame, given that research suggests these intergenerational connections are actually really valuable to people of all ages.

For instance, in 2018, the AARP conducted a national survey of grandparents to learn more about this intergenerational relationship and what it means to older adults. Almost 90% of grandparents reported their relationship with their grandchildren is good for their mental well-being.

However, the survey also found that distance was the number one barrier to seeing grandchildren more often, with over half of grandparents reporting they have at least one grandchild who lives more than 200 miles away. Sixty-one percent of grandparents reported wanting more information about connecting with their grandchildren and staying relevant in their lives.

I first heard about these findings at a conference last summer, when I met Kerry Byrne, PhD, a fellow aging and family caregiving expert who has developed a special interest in intergenerational connections, and in the grandparent-grandchild relationship in particular.

Partly due to her own experience living abroad and trying to keep her children close to their grandparents, in 2019 she founded The Long Distance Grandparent, a website dedicated to helping grandparents and grandchildren connected, even if they live far from each other.

I find this topic of intergenerational connections fascinating. Among other things, it has a role in countering ageism!

So I invited Kerry to join me on the podcast, to talk about how older adults can stay more connected to people of different generations, whether that’s with grandchildren or with people outside their family.

If you are a grandparent yourself, or just want to learn more about why intergeneration connections matter and how you can foster them in your own life, I hope you’ll take a listen to the podcast, or read through the transcript.

Both are available on the show notes page, which you can find here: 102 – Interview: The Importance of Grandparents & Intergenerational Connections

5 Practical Ways to Have More Intergenerational Connections

Here are five specific things Kerry suggests that older adults can do, to foster more intergenerational connections: [Read more…]

Incompetence & Losing Capacity:
Answers to 7 FAQs

by Leslie Kernisan, MD MPH 79 Comments

Have you ever been concerned about an older relative who seems to be making bad decisions?

Perhaps your elderly father insists he has no difficulties driving, even though he’s gotten into some fender benders and you find yourself a bit uncomfortable when you ride in the car with him.

Or you’ve worried about your aging aunt giving an alarming amount of money to people who call her on the phone.

Or maybe it’s your older spouse, who has started refusing to take his medication, claiming that it’s poisoned because the neighbor is out to get him.

These situations are certainly concerning, and they often prompt families to ask me if they should be worried about an older adult becoming “incompetent.”

In response, I usually answer that we need to do at least two things: [Read more…]

6 Causes of Paranoia in Aging & What to Do

by Leslie Kernisan, MD MPH 70 Comments

Q: My mother is 80. She is very active (despite breaking her hip 2 years ago), she still attends water therapy 3 times a week at the YMCA, she drives to the base (which is 20 miles away) and pays her bills on time. She is a retired Psych nurse and has shown signs in the past of paranoia.

Lately, she has “heard” voices of her grandchildren in her home and called my sister. She also has difficulty with getting the right words to say out and has her sleep pattern out of whack and will call people at odd times of the night. With her independence comes the fact she won’t share any medical information because she thinks we are out to get her committed.

How can I test her/question her to find out the level of decline she may be in to make sure she is safe? — K

A: Great question. As you may know, it’s fairly common for aging parents to develop problems like the ones you are describing. Understandably, these problems are frustrating and worrying for adult children.

You are absolutely right to be concerned about your mom’s safety. I do have some ideas for how you can get started assessing her, which I share below.

But first I want to explain the most common causes of this type of behavior in older adults. That’s because one of the things you must do is help your mother and the doctors figure out why she’s developed these behavior changes and other symptoms.

A fair number of people don’t get around to the medical evaluation because they assume that these crazy behaviors are either normal aging (definitely false) or dementia such as Alzheimer’s (true about 40% of the time).

Furthermore, it’s often hard to get a resistant older parent medically evaluated.

Still, it’s worth persisting in this, because many causes of paranoia or other odd behavior in older people can be treated.

6 common causes of paranoid symptoms in the elderly

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Q&A: What You Can Do if You’re Worried About “Incompetence”

by Leslie Kernisan, MD MPH 42 Comments

Q: My 87 year old father lives alone. His house has become increasingly dirty, but he refuses to get help, even though I’m sure he needs it. I’m worried that he’s becoming incompetent, but he doesn’t want to go see the doctor. What can I do?

A: This situation does come up a fair bit with aging parents and relatives. I’m sorry to say there usually are no easy solutions. But there are definitely things you can and should do, and it’s better to act sooner rather than later.

Let’s review what you can do. I’ll also explain what I’ve learned about “incompetence” over the years, and how doctors usually play a role in the evaluation of such older adults.

Then, I’ll share some thoughts on how older people and families can plan ahead, to avoid facing this kind of dilemma. And then last but not least, I share a few thoughts on taking care of yourself as you go through this.

What’s probably going on with your father

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How does sex and intimacy change when one partner becomes a caregiver?

5 Practical Ways to Have More Intergenerational Connections

6 common causes of paranoid symptoms in the elderly

What’s probably going on with your father

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