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Grandparents Raising Grandchildren Series: When Grandma Becomes Mama

 

Being a Grandmother is a wonderful benefit of aging. The experience is truly all that your friends told you it would be. When you didn’t think you could love anyone as much as your own children, your grandchildren come along and prove you wrong. You can spoil them and send them home, feed them junk food and cookies for dinner, snuggle and take time to play like you didn’t have time for when you raised your own kids. And the best part is that all those things that would have made you a bad parent then, make you an awesome, fun Grandma now.

But what happens when, for reasons beyond your own control, your find yourself moving from the role of Grandma to Mom? According to the Profile of Older Americans (2016), “approximately 1 million grandparents age 60 and over were responsible for the basic needs of one or more grandchildren under age 18 living with them in 2015. Of these caregivers, 593,495 were grandmothers and 429,377 were grandfathers” (pg. 15). The role change from Grandma to Mama is a significant one. The little one you have spoiled and coddled is now yours to raise for the next 20 years into adulthood. This can be a shocking transition, but also a tremendous blessing.

This surprise happened to me at the age of 57. My husband had just retired and we had relocated to a more relaxing place in our life. We already had 7 children between us with an age span of 15 – 34 years of age, the last two of whom were adopted from Russia. So, when our teenagers were ready to graduate from high school, we were looking forward to being empty nesters, having raised children for many years.

Then, along came JJ. Substance abuse, which our pediatrician calls “the scourge of our community”, was the culprit that led to our current situation. This is a common problem, although not all children of substance abusers are fortunate enough to be placed in a loving home out of the influence of parents who use drugs. Our journey started when we offered to take our 6 week old grandson for a few hours so his parents could enjoy some free time together. Those hours turned into several days when the parents didn’t show up to get their son and nobody could find them. They didn’t call to check on him and seemed not to mind that they didn’t contact us for days. It wasn’t long before CPS removed little JJ from his birth parents due to their substance abuse and neglect of their infant and placed him with both sets of grandparents sharing temporary kinship care. Unable to break free of the chains of drugs, even with unlimited free resources and counseling provided by the community, JJ’s parents lost custody of him permanently and we became new parents again through adoption of our precious grandson.

The process of adapting to this life-changing event affects everyone differently. If you find yourself in a similar life-altering stage, then you may benefit from this series on Grandparents Raising Grandchildren. Today’s tips are for Grandmas who are now Moms again:

Some things have changed

If you are anything like me, your last biological child may be in his/her 30’s, so raising a little one might be a bit intimidating. Lots has changed in 30 years! There is so much more technology to help children learn and play. But this means we have become more tech savvy and not avoid the latest cellphones, computers, or apps. (Any teenager is happy to help you learn to be more techie). Toys are more fun now. Clothes are cuter. There are great innovations like disposable diapers, better bottles, and on-the-go baby food. Kids go to preschool and all-day kindergarten now. But, there are negatives too, like many more immunizations to keep track of. The world doesn’t seem as safe in the big cities as it did long ago when we let our children play outside without as much fear of gang violence, guns, or being kidnapped. Yet, there are more guidelines for child-rearing, research on how to educate kids, and better job opportunities for when they are grown. While all these changes may be daunting, you can use them to your benefit and to make your life easier when raising children in your later years.

Some things never change

Fortunately for us, some things never change. Babies are babies, kids are kids, and teenagers are still teenagers. Changing diapers, bathing a baby, suctioning a nose with the blue bulb syringe, putting clothes on a wiggly toddler, and rocking a little one to sleep are still the same. Strategies for teaching math have changed, and maybe kids don’t always have books in high school, but the major concepts of the major subjects are ones you will remember. Don’t worry – this will all come back to you and you might be surprised how much better you are at parenting now than when you raised your first set of children. You are more relaxed and comfortable because you have decades of experience to draw on.

Your experience is a plus

One of your best assets as a new Grammy Mama (as I like to call this role) is your experience. For me, I raised or help raise 7 children before JJ, so I am way ahead of the new mother learning curve. We already know what works and doesn’t work in raising kids. We are not novices, but seasoned experts! So, when you are tempted to feel you are not up to this new challenge, remind yourself that this is not your first rodeo.
You are not too old
It is a normal feeling to think you might be too old to raise another child. Let me assure you that you are not, and you are not alone. There are more than a million other grandparents in America just like you who are doing it, and many are older than you are. Your age gives you wisdom and experience. If you were in another job, you would be a Senior Executive, VP, or CEO – that is what you are in this new job. Embrace your Grammy Mama role. There is a reason why this child (or children) has been entrusted to you. You have been chosen for a remarkable task: to nurture a child who will later thank you for not giving up on him. You are never too old to undertake such a legacy as that.

By | 2018-02-13T19:27:01+00:00 February 13th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Grandparents Raising Grandchildren Series: When Grandma Becomes Mama

Alzheimer’s: Signs & Symptoms

 

Alzheimer’s disease (AD) is the most common type of dementia seen in older adults. An estimated 5.4 million Americans of all ages had Alzheimer’s disease in 2012. Nearly half (45%) of people over the age of 85 have AD. By 2050, the number of individuals age 65 and over with Alzheimer’s could range from 11 million to 16 million unless science finds a way to prevent or effectively treat the disease. One in eight older adults has AD, and it is the sixth leading cause of death in the United States (Alzheimer’s Association, 2012). Those affected with AD may live from 3–20 years or more after diagnosis, making the life span with this disease highly variable.

Risk factors

Advanced age is the single most significant risk factor for AD (Alzheimer’s Association, 2012). More women than men have AD, but this is because women live longer than men, not because gender is a risk factor. Family history and heredity are also identified risk factors for AD, as are head trauma and poor cardiac health.

Warning Signs

Alzheimer’s disease is characterized by progressive memory loss. The person affected by AD is gradually less able to remember new information and memory lapses begin to affect daily function. It is a terminal disease that over its course will eventually leave a person completely dependent upon others for care.

Diagnosis

Initially, the clinical progression of the disease is slow with mild decline; however, deterioration increases the longer the person lives, with an average life span of 8 years after diagnosis (Cotter, 2002; Fletcher, Rapp, & Reichman, 2007). The underlying pathology is not clear, but a growth of plaques and fibrillary tangles, loss of synapses, and neuronal cell loss are key hallmarks of AD that interfere with normal cell growth and the ability of the brain to function. Absolutely definitive diagnosis is still through autopsy, although clinical guidelines make diagnosis easier than decades ago when less was known about the disease. Primary care physicians generally make the diagnosis through a thorough history, physical exam, cognitive testing, and labs. New criteria for diagnosis include staging the disorder and biomarkers (beta amyloid and tau in the cerebrospinal fluid and blood) (Alzheimer’s Association, 2012b). An MRI of the brain may be ordered to rule out other causes of symptoms.

The clinical course of AD is divided into several stages, depending on the source consulted. In the early course of AD, the person may demonstrate a loss of short-term memory. This involves more than common memory loss, such as where the keys were put, and may involve safety concerns such as forgetting where one is going while driving. The inability to perform math calculations and to think abstractly may also be evident. In the middle or moderate phase, many bodily systems begin to decline. The person may become confused as to date, time, and place. Communication skills become impaired and personality changes may occur. As cognitive decline worsens, the person may forget the names of loved ones, even their spouse. Wandering behavior as well as emotional changes, screaming, delusions, hallucinations, suspiciousness, and depression are common. The person with AD is less able to care for her- or himself and personal hygiene suffers. In the most severe and final phase, the person becomes completely dependent upon others, experiences a severe decline in physical and functional health, loses communication skills, and is unable to control voluntary functions. Death eventually results from body systems shutting down and may be accompanied by an infectious process. Although there is no single test, and the diagnosis may be one of exclusion, early diagnosis is important to maximize function and quality of life for as long as possible. Persons experiencing recurring and progressing memory problems or difficulties with daily activities should seek professional assistance from their physician.

Treatment

Treatment for AD is difficult. There are several medications (such as Aricept, Namenda, Razadyne, and Exelon) that may help symptoms (such as memory), but they do not slow the course of the disease. There is currently no cure; however, research continues to occur in pharmacology, nonpharmacology, and the use of stem cells to manage symptoms and perhaps one day eradicate the disease.

Treatment will focus on symptom management, particularly in the areas of behavior, safety, nutrition, and hygiene. Behavioral issues such as wandering and outbursts pose a constant challenge. Many long-term care facilities have special “memory care” units to care for Alzheimer’s patients from the early to late stages of the disease. These units provide great benefits such as consistent and educated caregivers with whom the patient or resident will be familiar, a safe and controlled environment, modified surroundings to accommodate wandering behaviors, and nursing care 24 hours a day. Additionally, nurses are present to manage medications and document outcomes of therapies. However, many family members wish to care for their loved ones at home for as long as possible.

Thus, another important aspect of care in AD is care for the caregivers. Howcroft (2004) suggested that “support from carers is a key factor in the community care of people with dementia, but the role of the caregiver can be detrimental to the physical, mental, and financial health of a carer” (p. 31). She goes on to say that the caregivers of persons with AD would benefit from training in how to cope with behaviors that arise in these patients and how to cope with practical and legal issues that may occur.

Research has shown that ongoing skills are needed by family caregivers to deal with the progressive decline caused by AD. In fact, “a 63% greater risk of mortality was found among unpaid caregivers who characterized themselves as being emotionally or mentally strained by their role versus noncaregivers” (National Conference of Gerontological Nursing Practitioners & National Gerontological Nursing Association, 2008b, p. 4). Adapting to stress, working on time management, maximizing resources, and managing changing behavior were all skills caregivers needed to develop in order to successfully manage home care of their loved ones. When interventions and resources were not used by caregivers in the early stages of the care recipient’s AD, the risk of a healthy patient being institutionalized due to caregiver burden was higher (Miller, Rosenheck & Schneider, 2012). Caregivers needed not only to acquire knowledge and skills, but also to make emotional adjustments themselves to the ever-changing situation.

Such findings suggest that nurses should focus a good deal of time on educating caregivers of persons with AD to cope with, as Nancy Reagan put it, “the long good-bye.” Scientists continue to explore the causes of AD and hope in the near future to be able to isolate the gene that causes it. In the meantime, results from a fascinating longitudinal study (called the Nun study) on aging and AD, which used a group of nuns who donated their brains to be examined and autopsied after death, has suggested that there is a connection between early “idea density” and the emergence of AD in later life. That is, essays the nuns wrote upon entry to the convent were analyzed and correlated with those who developed AD. It was found that those with lower idea density (verbal and linguistic skills) in early life had a significantly greater chance of developing AD (Grossi, Buscema, Snowdon, & Antuono, 2007; Snowdon, 2004). The nun study has allowed researchers to examine hundreds of brains so far in nuns who died between 75 and 107 years of age and discover other important facts such as a relationship between stroke and the development of AD in certain individuals, and the role of folic acid in protecting against development of AD (Snowdon, 2004). Scientists from a number of fields continue to research the causes and possible treatments for AD and the Nun study project is continuing at the University of Minnesota. Snowdon’s research suggests that early education, particularly in verbal and cognitive skills, may protect persons from AD in later life.

For more information on Alzheimer’s disease, visit the Alzheimer’s Association website at: http://www.alz.org/

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L.
Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.

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By | 2018-02-12T22:50:15+00:00 February 12th, 2018|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Alzheimer’s: Signs & Symptoms
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