Caregiving

The Terri Schiavo saga resonated Monday in the hospices and nursing homes of California, where doctors and caregivers said they routinely confront the same painful and complicated end-of-life decisions that have placed the Florida woman at the center of a national drama. Paul DenOuden said he frequently encounters families who struggle with wrenching decisions about when and if to end a loved one's life.

Getting an early diagnosis of dementia could lead to finding ways to cope - and it could mean feeling bereft at what the future holds. So do you want to know? The early diagnosis of and intervention for Alzheimer's and other dementia has become an increasing priority, but that means the patients and their informal caregivers are left facing many issues regarding their futures that need to be considered, researchers said Tuesday. The researchers, from several British universities, reviewed 102 studies from 14 countries to consider the ramifications on patients and caregivers of a dementia diagnosis.

A local nonprofit agency has filed a lawsuit in federal district court accusing four state agencies of setting up a pay scale that makes it nearly impossible to attract and keep workers who care for people with developmental disabilities in small, community-based facilities.

It sounds futuristic, but telemedicine - the use of telecommunications technologies to diagnose and treat patients - has been hotly anticipated at least since 1993, when the American Telemedicine Assn. was established. But in the last two years, it has finally "taken off" thanks to better technology and lower costs, says Jim Linkous, the association's CEO. "Today 20 million Americans get some part of their health care remotely," and that number will grow as telemedicine will expand its reach, he says.

Mothers, not only do you have your own day this Sunday, you also are the primary beneficiaries of a growing body of laws and court rulings that grant workplace protections to caregivers. California is among several states and cities that are passing or considering legislation banning job discrimination against workers with the responsibility of caring for children, aging parents or ill spouses.

David Solie thought he was being a good son and a competent manager. But his strong-willed mother was having none of it. Carol Solie, 72, had been caring for herself, her 28-year-old son, Roger, who has Down syndrome, and the family home in Portland, Ore., since her husband died in 1989. From David Solie's vantage point in Calabasas, it was too much. So once a month, he would travel nearly 1,000 miles north to set things right. This son decreed that his mother should move someplace easier to navigate -- an assisted living complex, perhaps.

The California Senate voted Thursday to bar employers from denying promotions or raises to workers who juggle job duties with the demands of caring for children, sick spouses or aging parents. One of the first such efforts in the country, the measure would add "familial status" to the categories of discrimination banned by the state's Fair Employment and Housing Act.

JOE WOLF still remembers his wife, Joanne, as a healthy 18-year-old with long brown hair and a '61 Chevy. They met through a social group at a Presbyterian church. They got married and had two children. These days, he trims and curls Joanne's hair, because she no longer is able to do it herself. He brushes her teeth. He helps her dress. He cooks, cleans and drives her in a specially equipped van to the gym, where she battles the debilitating effects of two strokes.

On her first regular day with a new volunteer program, Margie Mayhams tied a denim apron over her white AARP T-shirt and went to work chopping onions and potatoes in the immaculate kitchen of a Carson couple who, until recently, had been strangers to her. During her training to participate in the AARP's Caregiving, Assistance, Respite, Education and Service program (CARES for short), Mayhams had learned to ask what help her elderly clients wanted most.

There are days when Doris Parker wants to throw up her hands in frustration and run screaming into the street. Between a full-time job at the Social Security Administration and tending to her elderly parents who need round-the-clock care, Parker, 57, recognized long ago that she needed help during the day if she was going to keep both parents living in her Baltimore home. "My father was diagnosed with Alzheimer's six years ago, and my mother has slight dementia," Parker says.

Many of John Adams' scores pursue the big ideas. His subjects have included the U.S. relationship with China, Middle Eastern terrorism, the L.A. earthquake and riots, caring for the dying, the Nativity, the bomb. On Thursday night at Walt Disney Concert Hall, he tackled perhaps the biggest of all when the Los Angeles Philharmonic premiered Adams' "The Gospel According to the Other Mary. " Taking on the most monumental narrative in Western civilization, Adams' part-opera/part-Passion is - in subject, meaning, emotion, relevance, historical resonance and musical ambition - huge.

Clarence Ayers was baffled. At 73, he was raising his great-granddaughter in rural Fresno County. He relied on $334 a month in public assistance to help cover the teenager's expenses: new shoes when she outgrew her old ones, transportation to the after-school activities she enjoyed. But last summer, county officials said they were slicing his CalWorks payment by 10% and for the most perplexing of reasons: Over the years, they had mistakenly sent $10,000 to the girl's mother and grandfather.

A yoga meditation program could reduce depression symptoms and boost mental health, a study finds, and that's not all - it may also show benefits at the cellular level. The study, published recently in the International Journal of Geriatric Psychiatry , involved 49 caregivers ranging in age from 45 to 91 who were taking care of family members with dementia. Caregivers are at risk for high stress levels, often with no outlet or relief, which can lead to health problems. The participants were randomly assigned to two programs: Kundalini yoga Kirtan Kriya meditation or passive relaxation with instrumental music.

My 82-year-old mother has been accusing family members of spying on her, listening in on her phone conversations and entering her home when she's not there, among other things, off and on for about 10 years. She told her doctor she won't talk with us. Is there anything we can do? Are there resources and/or free counseling services to help us work out issues with our mom so we can talk with her doctor? You can try to contact your mom's doctor to discuss her condition, particularly given that you're concerned she may be suffering from dementia and unable to properly care for herself.

David Solie thought he was being a good son and a competent manager. But his strong-willed mother was having none of it. Carol Solie, 72, had been caring for herself, her 28-year-old son, Roger, who has Down syndrome, and the family home in Portland, Ore., since her husband died in 1989. From David Solie's vantage point in Calabasas, it was too much. So once a month, he would travel nearly 1,000 miles north to set things right. This son decreed that his mother should move someplace easier to navigate -- an assisted living complex, perhaps.

The first sentence in Dean Takahashi's e-mail was a relief. "Those stories were hard for me to read," he wrote, "but I thought you handled them well. " Then he gave me pause. "I wish you had more room to describe my brother. " Dean had a point. He'd just read my recent two-part series that looked at the state's first prison hospice. There, dying killers, rapists and thieves are graced with a profound compassion, much of it coming from a group of murderers who live in other parts of the prison and have been trained as caregivers.

When 86-year-old Eleanor Siegman's health began to fail and she needed personal care at home to stay out of a nursing facility, her daughter thought she had found the perfect person for the job. The live-in care-giver she chose was a certified nursing assistant who seemed trustworthy and compassionate and was recommended by her mother's rabbi. "I don't think you want a better recommendation than that," said Siegman's daughter, a mental health professional who asked not to be identified.

A scarcity of paid caregivers means that, in the future, older people may have to band together to help each other. Older Americans are already pitching in to care for their more frail or even older counterparts as either paid or volunteer workers. That's because finding younger people to work as caregivers is becoming more difficult.

Five disabled residents of a care facility in the Monterey County city of Marina died in a fire late Saturday night, authorities said Sunday. The two caregivers escaped from the single-story house, said Lt. Rick Janicki of the Marina Police Department. They were treated for smoke inhalation, as were three police officers and a firefighter. A sixth disabled resident also got out, but remained hospitalized late Sunday afternoon, Janicki said. It does not appear that anybody else lived there, he said.

State health officials are circulating a plan they say will help keep about 35,000 elderly and disabled Californians out of institutionalized care when Medi-Cal stops offering an adult day healthcare benefit in December. The plan released late Friday relies primarily on Medi-Cal managed care plans to find alternatives for beneficiaries, including additional hours of in-home supportive services, physical and occupational therapy, and social services. But care providers say the approach could fail because appropriate alternatives aren't always available and families would be forced to shuttle patients around town to obtain the services now offered at more than 300 adult day healthcare centers.