Home Safety, A Look At The Bathroom

This is part two in our four part series on creating a safe environment for an aging love one. Most people are familiar with the concept of childproofing a home when a new baby arrives. There are several steps you can take to “elder-proof” your home and ensure a safe and comfortable environment for your parents in their later years. One of the key rooms of concern is the bathroom. The bathroom can be the most dangerous room in the house, with slippery surfaces that are easy to fall on and sharp or hard corners where someone can hit their head. Making the bathroom safe is an important step in helping your aging loved one to maintain their independence.

Here’s a few simple steps:

- Add an elevated toilet seat with handgrips on both sides. Ensuring that the toilet tissue is within easy reach can ease the strain on an aging parent’s back and legs, thus reducing the risk of falling.

- Equip the tub with a  grab bars or a handrail placed at both sitting and standing levels. When using a bath chair or shower chair make sure that there are rubber grippers on the chair’s feet. Also make sure the chair is at the correct height so your loved one’s feet rest on the floor.

- If using a bedside commode, place it as close to the bed as possible.

- Use secure non-slip mats in the tub or shower, along with a wall-mounted liquid soap dispenser to keep your parent from having to bend down to retrieve a dropped bar of soap.

- Consider changing to hand-held shower devices. They are much easier to use when mobility is limited.

- If your parent does happen to slip in the tub, a shower curtain securely mounted into the wall will offer more support than a pressure-hung curtain that will pull away easily.

With the right bath safety cautions and aids in place, one of the most dangerous rooms in the house can become one of the safest.

How to Shoot a Photo to Remember

Editor's Note: Here is a great post we'd like to share by Susan Seliger via The New York Times.

Sometimes the realization comes almost too late — you sense that your parents or other loved ones may soon be gone, and it dawns on you that you don’t have any recent photos to remember them by.

Sure, you might have a few photos of them in their youth, before you even knew them. But what about a photo of them now, so you can remember the person you have come to know so intimately over these years of caring for them?

Those photos are harder to come by. As readers of this blog know, those of our parents’ generation did not grow up with a camera in their pockets to record every moment with friends on Facebook.

A lot of people who are now elderly “only have a high school senior photo – they don’t ever visit a photographer again,” said Steve Bedell, a professional photographer in Dover, N.H. “That’s why it’s so important to document these people at an older age.”

Mr. Bedell began doing just that several years ago, when his mother-in-law moved into a nursing home. He found the process so moving that he eventually took photos of 30 of the other residents, too, at no charge — to the delight of the residents and their families.

You don’t have to be a professional to take a memorable photo, of course. But snapping the elderly involves some unique challenges. So I consulted several experts in this area for their tips.


One thing they all agreed on: It’s never too late. Even if your relatives are frail or suffering from dementia or in the hospital or a nursing home, there are still ways to capture the essence of who they were and, beneath the lines and curving spines, still are.

Here’s how to take your best shot.

1. Help your loved one get dressed for the occasion.

“Hospital gowns depersonalize a human being,” said Dr. Jeffrey M. Levine, a geriatrician at Beth Israel Medical Center in New York who has been taking photos of the elderly across the country for decades. (See his Web site and many of the pictures in the slide show at the top of this post.) If dressing is not an option, at least help cover the person with a favorite shawl or quilt to add a personal touch.

“My father loved to put on hats and scarves and have his picture taken all bundled up,” said Susan Sermoneta, an English teacher at the Fashion Institute of Technology who spent six years photographing her father (some of the results are posted on her blog) until he died in February. Women, especially, may feel more relaxed in front of the camera if you’ve helped them apply some makeup or they have had their hair done (many nursing homes have salons).

2. Shoot in a cozy room, or at least in a comfortable position.

If your relatives are at home, find the room that makes them feel relaxed, like the kitchen. If they’re in a hospital, try to catch them when the hospital staff is changing the bed linens; they often move the patient to a nearby chair. Lying in a bed makes anyone feel weak and exposed.

3. Be sensitive to quirks and vulnerabilities.

If they have injuries or scars or IV tubes that make them self-conscious, reassure them that you’ll try to keep those things out of the photo.

“My father thought profiles were his best angle, so he would pose that way — always with his hands crossed over his chest,” recalled Ms. Sermoneta. “I asked him why, and he said, ‘If I don’t hug me, who will?’”

4. Bring in friends or other family members to engage with the person.

Never say “cheese!” Interacting with others will help animate their features and make them look — and feel — more cheerful and lively. Grandchildren and babies can be especially handy for eliciting natural smiles, said Mr. Bedell, “as long as you can control the grandkids” and send them home before everybody is exhausted.

5. Put on some music.

Music is relaxing (for the photographer, too), but for those with dementia, it also can sometimes spark unusual focus and clarity. (See “Revived by Music”, a blog post by my colleague Paula Span.)

“One elderly nun I photographed had lost her ability to speak because of dementia — but if you brought her to Mass, she could sing the hymns,” recalled Dr. Levine. “It connects dots in their brain and gives them a sense of well-being.”

6. Hand them a memory prop to get them talking.

Sometimes all it takes to get even elders with dementia talking happily about their lives is to have them hold an object that stirs up memories.

“I had a patient who was a fireman who kept a toy fire truck and the awards and medals that he had gotten,” said Dr. Levine. You should be careful with war memorabilia, though, Dr. Levine warned, as it may agitate some veterans.

7. Ask simple questions that play to their strengths.

Sometimes just asking about what games they played as children can trigger some great conversations. Questions that remind older people of who they used to be when they felt strong and independent can produce lively responses.

Dr. Levine recalled visiting an uncle with severe dementia who had been a doctor. “He still loved playing doctor,” said Dr. Levine, “so I asked him about a blood clot I had under the nail from slamming it in a door, and he grabbed my hand to examine it as he had done when I was a child.”

8. Forget the flash.

“You don’t want to have a big flash popping off in their faces,” said Mr. Bedell. It’s distressing, and the harsh light makes everybody look worse.

To use natural light, have your subject sit near a window or take her outside in the shade of a tree to get soft, even lighting. Remember, your subject should be facing the source of the light while you, the photographer, keep your back to it.

9. Don’t take pictures of people eating.

Resist that temptation, even though it may be one of the few times in the day when a very sick person is awake and alert. “They look really weird,” said Ms. Sermoneta. Not surprising – who does look their best when chewing?

10. Get close.

One of the big mistakes amateur photographers make, according to several of the pros, is that they are reluctant to get close enough.

That doesn’t mean you should stick the camera in your subject’s face. “I use a Telephoto lens so I can zoom in tight with just the head and shoulders filling the frame,” said Mr. Bedell. Even most standard point-and-shoot digital cameras have a zoom feature.

11. Know when to eliminate or include the background.

If your loved one is in a hospital or institutional setting, all those dangling wires and flashing machines can be just plain sad. Obscure that background by focusing closely on the person’s face (see Tip No. 13).

But sometimes people’s environment can provide the critical details you’re looking for to reveal their character and capture their spirit. “I photographed one nursing home patient who made herself a little shrine with angels, and a couple in Santa Fe who surrounded themselves with objects in their home that they loved,” said Dr. Levine.

12. Focus on body parts for variety.

After you’ve done the more traditional portrait, zero in on the parts. (Yes, sometime the sum of the parts is actually more than the whole.) “I like to zoom in on the hands, the eyes, maybe even shoot from behind or at other odd angles,” said Ms. Sermoneta.

13. Take lots and lots of shots.

“People always say to me, ‘Oh, I wish I had taken photos of my mother or father.’ Just take them!” said Ms. Sermoneta. Hundreds of them. “If you take enough, you’ll get one that feels true.”

14. Keep the sessions brief.

“I used to schedule 20 minutes for each person, but I found that the first 10 minutes is usually enough,” said Mr. Bedell — that is, unless you have friends and relatives around interacting with them.

In that case, you’re as good as invisible, so you can keep on shooting discreetly for as long as the subject’s energy — and yours — lasts.

15. Use these photo sessions as a chance to connect.
When you ask questions about your loved ones’ past, you’re not just getting them to look lively. You’re opening up an opportunity to discover things you may have never known.

For those whose relationship with a parent may have been awkward or troubled, examining the parent through a camera lens — instead of through the eyes of a vulnerable child — can provide the distance that, paradoxically, can bring you closer.

“My father was always hard to talk to — he was a drunk and sarcastic. Then he had dementia,” Ms. Sermoneta said, which made communication even harder. But she found that taking pictures of him gave her a way to see him more sympathetically and connect with him, without words getting in the way.

Caregiving and Insomnia

As we grow into adulthood, the amount of sleep that we require diminishes.  As newborns, we can require up to 18 hours of sleep per day. At age 5,we need around 10 hours of sleep and at adulthood 7 hours is acceptable. Unfortunately, meeting these requirements is not always easy and with the added responsibility of being a full time caregiver, sleep may not seem like a top priority.

Caring for a loved one is a full time job, and the added effects of insomnia can hamper your ability give. While there are many varied factors that cause sleep disorders, there are several steps that you can take to ensure that you’re getting the best possible chance at a good night’s rest.

• Establish a regular sleeping schedule. Going to bed at the same time each night and waking in the morning at the same hour can add consistency to your sleeping pattern and curb erratic sleep behavior.

• Limit caffeine intake, especially after mid-day.  After consuming caffeine, effects can last from 8 to 14 hours.  Consider switching to decaf coffee or tea.

• Watching TV, and looking at other devices such as cellphones, computer screens immediately before bed can hamper your ability to fall asleep.

• Regular exercise can work wonders for maintaining a healthy sleep schedule. Not only does exercise promote physical and mental health, it also increases the need for the restoration that occurs during sleep. Exercise does not need to be strenuous to be effective, walking and water aerobics are great low impact activities that should be considered.

• Check your medications to see if side effects include difficulty falling asleep or inability to stay asleep. If so, you may want to consider changing medications to one that does not include these side effects.

• Turn cellphones (and other electronic devices) to silent mode while you are  sleeping. Disturbances can upset the circadian rhythm and affect future sleep cycles for days to come.

• Remember to remain positive if you are struggling with a consistent sleep schedule. Being negative or pushing to hard can cause regression and possibly make matters worse.

The best way to care for your loved one is to start by caring for yourself and ensure that you get proper amounts of sleep each night. We hope these tips may be of service in helping you to assist your loved one and make your caregiving journey a bit easier. We want you to know we are here to assist you and your loved one with any of the challenges that you may be facing in your caregiving journey.

Looking at Grief from Both Sides

By Linda Donovan, Grief Support Volunteer

In 2006, shortly after my husband died of cancer, I began a personal exploration into understanding grief and how to work through it. I turned to Hospice of Santa Cruz County for the healing, compassionate individual and group support that I needed to heal from through my loss. Two years later, armed with new insight based on my own journey, I decided to move over to the “other side” and become a grief support volunteer. I completed a series of training sessions and began to provide individual and group grief support to the community. It has been one of the most rewarding experiences in my life.

As a recipient of grief support services, I learned that the grief journey is a process. The one-on-one sessions gave me a chance to express my concerns, ask questions, and learn how to adapt to a “new normal” way of life. These individual meetings helped address my unique circumstances and issues. In the group workshops, I experienced the power of group healing and compassion. I even met a really good friend through the group. We have built a friendship that has helped us get through the challenges of our loss.

I cannot stress enough the value of grief support services. These programs provide a place where you can feel safe enough to express your fears, discuss your struggles, and learn how to pick up the pieces and move forward with a life without your loved one. Without grief support, it’s all too easy to put your feelings of loss aside and try to “get over it.” But that approach doesn’t help you heal. It only postpones the loss that needs to be addressed at some point.

As a grief support volunteer, I get to see firsthand the power of helping people give themselves permission to feel their loss and work through it at their own pace – not anyone’s else’s. I’ve witnessed the transformative nature of grief groups. When people first begin a group, they are often quiet, lost, and bewildered. As each week progresses, many find an inner strength to not only learn ways to cope with their own loss, but also to reach out to others in the group in a caring, healing manner.

Hospice of Santa Cruz County provides up to eight one-on-one sessions for adults and children facing the loss of a loved one. There are also focused groups for those losing a partner, child, or parent, as well as for children and teens and adults who prefer a drop-in group. And the support isn’t just for families who had Hospice care. Anyone in our community who has lost someone close to them can access these services.

Hospice’s grief support programs are completely funded by community support. Contributions to Hospice of Santa Cruz County make these valuable services available for the entire community. If you are interested in making a donation to support this and HSCC’s other community programs Click Here or call 831-430-3000.

Looking Back at a Successful Year

by Ann Carney Pomper, Executive Director

From time to time, a responsible organization must review and revise its mission, vision, and values to accurately represent its services and the needs of its constituents. During this past year, Hospice of Santa Cruz County’s Board of Directors and executive staff undertook this important task. The resulting intentions, shown on the cover of our newly-released 2009-10 Annual Report, emphasize a long-held ideal—that patients and families are the driving force behind their end-of-life decisions. This concept has been, and will continue to be, foundational to every aspect of HSCC’s programming as we strive to honor the wishes of our community members with the utmost integrity and professionalism.


HSCC’s dedicated staff and volunteers provided a record breaking 46,726 days of hospice care during 2009/10 all the while maintaining performance standards that have surpassed state and national benchmarks. Stringent MediCare guidelines for participation were met, thereby securing 90% of our annual budget through this essential revenue stream.

The impact of our Transitions program has also been more profoundly felt in the community with HSCC’s medical social workers easing the path from the hospital to home for more than 350 individuals annually. Grief support and educational programs are thriving, and we continue to focus on expanding bilingual access to these vital services.

While challenging economic times persist, I am happy to report that Hospice of Santa Cruz County continued to serve every eligible patient regardless of their ability to pay. Charity care for the uninsured in the amount of $90,000 was generously underwritten entirely by community members during the year. HSCC also realized a $273,240 savings as a result of the more than 13,000 hours of program support provided by volunteers.

Our successes in 2009/10 bring to mind Helen Keller’s words, “Alone you can do so little; together we can do so much.” I am deeply indebted to the broad family of supporters, philanthropic foundations, Legacy Circle members, Friends of Hospice, Hospice Angels, and volunteers who have made our work possible in the past, who continue to do so today, and who hold the vision of compassionate end-of-life care for our future.

Top Ten Ways to Manage Grief During the Holidays

The holidays can be a very difficult time for people who are grieving. You miss your loved one, especially during times of celebration and sharing. There is no easy way to make the grief go away, but there are certain strategies that can help you cope. Over time you will heal, but what can you do now? Here are some recommendations:

1. Take good care of yourself. Holidays are a busy time and it may be more challenging for you to accomplish all the different tasks you’ve done in holidays past. Don’t try to do more than you can handle. Take care of your basic daily needs – eating three meals a day, getting enough sleep, and exercising. If you don’t feel like writing holiday cards this year, people will understand. Maybe you’ll send them out next year.

2. Express your emotions. Don’t be afraid to cry if you need to, or tell people when you want extra space to be alone. If you feel like talking about your loved one, share your feelings with people who care. But if you’re not ready to do that, then let them know your wishes as well. Some people find comfort in keeping a journal to help them deal with their emotions. People grieve in different ways. Some express their emotions; others keep them inside. There is no right or wrong way to grieve, but the more you share your story and the more often you can put these outside of your head, the greater the chance that your grief journey will be less difficult.

3. Seek help. Perhaps you used to cook the family holiday dinners and now you don’t even feel much like making just dessert. That’s okay. Ask for help from your friends and family. Maybe next year you will want to do more, but this year you may not be ready. Or, you may just need a shoulder to cry on. That’s where friends and counselors can make a difference.

4. Do something different. Some people find comfort in changing their routines. This may mean going out of town for the holidays. If you cooked at home, maybe going to a restaurant might be a good option. Or, just start a new tradition, such as seeing a movie after the holiday meal.

5. Celebrate in the same way. The opposite of the previous strategy is to stick with your traditional holiday routines with the same people and find comfort in them. How you react to this situation depends on your unique perspective. Not having your loved one there may trigger some sad moments. With time, however, these moments could transform into fond memories.

6. Help someone else. One way to feel more connected during the holiday is to volunteer. If you are at a point in your grief where you do can this, it’s very rewarding helping others.

7. Make a tribute to your loved one. Set aside some time to organize pictures and mementos. Talk about that person to your family, partner, spouse, and friends. Share the special holiday memories if that brings you comfort. You may not be able to do this the first year after your loss, but over time this ritual may become easier and healing.

8. Appreciate the people in your life. Your other loved ones need you and they can help you heal. The death of someone you love can make you realize just how precious life is and why it’s important to make the most out of blessings – even when you are struggling and with dealing with a loss.

9. Do something spiritual. This may involve visiting the cemetery of your loved one or attending a religious or non-denominational memorial service. You may also find a comfort in reading a poem or book or walking by the beach.

10. Don’t feel guilty about not being able to share the holidays in the same way as in the past. You may decide that you need extra time alone. Maybe you’re not ready to be immersed in the holiday spirit. Accept only the invitations that you think you can handle and try not to feel guilty about saying "no” to activities.

Hospice of Santa Cruz Country provides a variety of support to help people deal with grief during the holidays. Call 430-3000 and let us share the ways we can help.

Helping a Friend Who Is a Caregiver to a Hospice Patient

By Linda Donovan, Grief Support Volunteer, Hospice of Santa Cruz County

Someone you know may suddenly be thrust into the role of a caregiver to a loved one who has become a hospice patient. You may be asking these questions: How do you help your friend at this critical time? How can you provide the best assistance without being intrusive? What can you do to assist your friend in coping with her added responsibilities? Here are some strategies to consider:

1. Make it known that you are available to provide assistance and recommend specific ways you can help. Don’t expect the caregiver to have a long list of things for you to do, or even to know what could be delegated. She may be so overwhelmed that it’s too much effort to even think about the ways people can provide assistance to her. If that’s the case, make a few suggestions to her. Perhaps you could pick up groceries, cook a meal, watch her loved one while she leaves to do an errand, do laundry, or walk her dog.

2. Offer to contact other people for her to keep them updated on the patient’s condition. Caregivers are often inundated with calls from people wanting to know how the patient is doing and desiring to express their sympathy and support. While it may be comforting for the caregiver to talk with people, it’s also emotionally draining. She may have to repeat the same sad story to various people, when she’d prefer to spend that time taking care of her loved one. If you are close friends, offer to communicate messages to a group of people by phone or email to keep them updated on the patient’s progress.

3. Assist out-of-town relatives who may be visiting the patient. Your friend may have family members from out of town who want to visit. They may need to picked up from the airport or taken to a hotel. While their visits may be comforting and welcome, it still involves a level of coordination that the caregiver may not have the time or energy to manage. Volunteer to help with their transportation or find another friend who might assist as well.

4. Bring over a treat to share with the caregiver. Depending on the stage of a patient’s illness, the caregiver may want to leave the house. There may be many times where she could be eating alone, or be so preoccupied that she’s tempted to skip meals. Offer to stop by and bring some coffee, cake, or a meal that you can share with her at a time that is convenient.

5. Enlist other people to help. Some efforts can make such a difference. Cooking meals can become a challenge for the caregiver, who may not have the time or energy to cook or shop. Find out if the family has special dietary restrictions. Then offer to organize a group of friends who can deliver meals to the caregiver. By doing this you are able to take care of an important need for the family and give others a chance to help show they care.

Each hospice patient’s experience is unique and people have various levels of help that they are comfortable accepting. Talk with your friend to find out what would be most helpful and appropriate. By making it known that you care, and offering specific assistance, you can make a real difference in helping people during this challenging time.