Are your aging loved ones safe at home?

A recent article from AARP* told the story of a 70 year old woman, who had a medical emergency while out of town. According to the article, it required an “array of often-confusing calls and wide outreach to friends and neighbors that left her feeling vulnerable and terrified.” The article continues by outlining important steps to take if this should happen to you.

It is very helpful advice if you are physically and mentally capable of advocating for yourself, or if you have a concerns about an aging loved one who wants to remain in their home. Whether or not you are, the Secure@Home program can be an invaluable resource. Secure@Home is an aging-in-place program staffed by clinical social workers/geriatric care managers.

As a member of the program, if you do not have family or friends who could intervene on your behalf, you can list a Secure@Home care manager as your primary emergency contact. Though we do not make medical decisions for you, as a member, we would know who your medical care proxy is and how to reach them. We would have a list of your medications, physicians and additional emergency contacts. We would also have your advance directive on file and could transmit it to wherever you were hospitalized, and coordinate your follow up care with the hospital social worker. The Secure@Home program will follow you wherever you are.

We have received calls from people who are traveling and find themselves in a hospital. Sometimes their travel buddy or spouse calls us to find out what medications they are taking. And of course, when you are home, we will step in and manage your care locally. One of the AARP article recommendations was to “find a geriatric care manager” – and here we are! 

Andrea Gaynor, LCSW Geriatric Care Manager

Grieving in the Time of COVID-19

I went to a funeral last month for a 98 year-old mainstay of my synagogue who died of COVID. The immediate family, rabbi and cantor stood at graveside. I sat in my car, parked on the perimeter of the burial site, along with people in at least 25 other cars. We could not hear what was being said but we could say our own prayers and access our own memories. My husband played the Jewish memorial prayer—El Molei Rahamim—on his phone, and it set the appropriate somber tone. We reminisced about the deceased and said how pleased we were to see so many present under these very strange circumstances.

At the end of the service, we were allowed to go up to the grave, one at a time, to place shovels-full of dirt on the casket in accordance with tradition—if we wanted to do so. We were masked, standing 6 feet apart. We acknowledged each other with nods but did not speak. We hoped that the family would gain strength from our show of support. We gained strength from being together in this new, strange way because we shared our love, respect, and sense of rightness in being in the cemetery together.  Over the weekend, the synagogue held a Zoom memorial service that was attended by at least 100 people where stories were told and reminiscences shared.

This is grieving in the time of COVID.

We are already grieving the loss of a normal life. The loss of a loved one hits us even harder because the normal rituals of grieving are not available. As illustrated above, these difficult times call forth creativity and a search for new ways to come together to show respect, to grieve, and to share memories.

In these unusual and unprecedented times, I will share some of the wisdom I have gained as a chaplain leading bereavement groups for more than a decade and as a human being living with the grief of many in this time of COVID.  While my focus is on those who are grieving, I hope relatives and friends of the bereaved may also gain insight.

FEEL YOUR FEELINGS & BE KIND TO YOURSELF: Remember that there is no time limit on grief. Mourning the loss of a loved one is forever, but it also changes with time. There is no “right way” to grieve or “right timeline” for grief. Grieving does not happen in a straight line, it is experienced as waves that come and go.

In these surreal times of social isolation, it may be harder to accept the reality of the death of a loved one—that is normal. It also may not be possible to take time out for the mourning you want to do at this time, there are young children at home, or a job that demands all your energy and attention (this is particularly true for all front line responders, though everyone going out into the COVID world is living in a time of incredible stress), or you must attend to your own health or that of others.  Do what you have to do and do not be afraid that you are not grieving “properly.

HONOR THE MEMORY OF YOUR LOVED ONE: There are many ways to find the comfort that usually come from traditional funeral practices (shiva, viewings, etc.). Use Facetime, Skype and Zoom to connect with loved ones singly or in groups. Create memorials or electronic collages on Facebook or other platforms, these can continue indefinitely into the future. Plan a memorial for your loved one for the time when it will be possible to be together again. Pick up the telephone to call each other.  Send emails with pictures and stories. You don’t have to be technologically advanced to make the connections—just do whatever you can. A friend’s father died this past week of COVID. I did not know his father well but I would have attended the funeral, instead, I asked my friend if he would tell me stories about his father on the telephone.  He eagerly agreed. I plan to continue our phone conversations over the coming weeks and months.

CURRENT GRIEF BRINGS UP PAST GRIEF, REMEMBER YOUR PAST STRENGTHS: It is also normal to revisit many past losses while experiencing a fresh grief. This can be very painful, but it also can give you an opportunity to remember how you dealt with grief in the past—what helped you get through the unimaginable. One of my cousins is having flashbacks to her father’s death many years ago, she is using her COVID social isolation time to reach out to family members, share stories, and document family connections. The pain of loss is very fresh to her, but she also is finding new coping mechanisms that give her love and support.

STAY IN TOUCH: For the mourner, it may be hard to reach out and even harder to know what is wanted or needed. Friends and relatives may need to be more proactive than usual in making calls, sending cards, bringing or sending food, or offering any kind of comfort that is possible. It’s important to take action without being asked. This is another opportunity for creativity

SEEK PROFESSIONAL SUPPORT IF YOU ARE STRUGGLING: Connect one-on-one with a JFCS counselor for individualized support and tips during “Drop-In” Hours, Mondays, Wednesdays and Fridays 10AM-12PM, Tuesday and Thursday 5 PM-7 PM. Call JFCS at 609-987-8100 and dial 0.

Beverly Rubman, Chaplain & Support Group Facilitator

Sheltering in Place: How older adults can stay connected and active

The phrase “social distancing,” the action needed to reduce the risk of exposure to an illness or virus, has now become part of our vernacular. We’re advised to maintain a distance of 6 feet from others, avoid being in crowded areas (i.e., avoid shopping when stores are busy or use “senior” hours to shop), wash our hands for 20 seconds or longer both before and after an array of activities, and use online grocery service. While all this is meant to safeguard us as best as possible, we have become isolated out of necessity and safety.

One of the keys to remaining healthy during this crisis, both physically and mentally, is to find alternative outlets for socialization and stimulation. We need to follow a “normal” routine with regards to sleep/wake times, exercise, eating, etc. Limit the amount of news exposure and consider the source of where you are obtaining your news from, as some may be more sensational rather than factual. Constant exposure to the news can also increase one’s anxiety. 

Here are 12 activities that might be of interest, while remaining in the safety of your home:

Chair Yoga

“Visit” a Museum

De-stress by listening to a 20 minutes relaxation exercise  

Sign up for a free online class…one option is Covia: Well Connected

Here is one option: https://covia.org/wp-content/uploads/2019/12/Well-Connected-Winter2020-FINAL.pdf   

Join a chat room such as Bridge Club Live or Mah Jongg

“View” historic sites or take a walking tour of NYC

Learn a new skill or craft

Use this time to declutter your home (pick a room) or switch over your wardrobe for the spring season.

Try a new recipe that uses the ingredients and spices already in your home

Socialize with friends and family through Skype, Google Duo,of Facebook Messenger

Set up a regular time for a call with family or a friend daily

Beth Hammer, LCSW (Geriatric Care Manager)

Handling the Holidays in Time of Crisis When You Are Grieving

We are all dealing with grief now—loss of normalcy; loss of connection; fear of economic toll, nervous anticipation of the future. For those in our community who are mourning the loss of a loved one, the grief is intense and even more isolating because we do not have the traditional community supports to provide some sense of stability. As holiday times approach, the Empty Chair has become the Empty Table and the Empty Room. What are some tools that can give you the support you need?

A VERY IMPORTANT REMINDER:  Everyone experiences grief in his/her own way. There is no right or wrong. Give yourself permission to do whatever feels right, and please be gentle with yourself.

Suggestions for Handling the Holidays:

  • Nothing is normal for anyone this year. Think about what has helped you since the loss of your loved one; don’t do what you think you should but what feels right to you.
  •  Connect, connect, connect—to your friends, your family, your community (of faith or otherwise).  Take advantage of technology old and new:  telephone calls, email, text, Facetime, Skype or Zoom.  JFCS will provide resources for virtual Passover seders, as well as other services and celebrations, in a future post.
  • Tell your family and friends what you need, whether or not they ask. Don’t be shy—this is not a time for false reticence, you ARE strong but you still need others for support and help.
  • Think of rituals that have meaning for you and turn to them as often as necessary—these can relate to the holiday or not. There won’t be a big family meal this year (that would have raised other issues for you as you grieve), but you can make dishes that you love or that bring back happy memories. You can share recipes, perhaps using technology as you go about your preparations, or sing songs together or tell stories of holidays past. Or you can do none of the above.
  • Turn to prayers or readings from the holiday that have special meaning for you. Repeat them as often as needed for consolation.
  • Sing special songs relating to the holiday as you wash your hands (for 20 seconds). In fact, listen to or make music as much as you can. Music leads to activity in multiple parts of the brain where we process emotion, memory, awareness, and attention. It can help short-circuit sadness by using these brain areas to bring up happy emotions and joyful memories as we tune our attention to the song. We also know that music can bring strong emotions and heartfelt tears to the surface, which can help us process the complex emotions we are experiencing at this time.

NOTE:  Memories, with their sweetness and their pain, are important tools for healing. You know that your loved one will never be forgotten. Relationships don’t end with death but, with time, they will become transformed. And there is nothing wrong with crying.

  • Breathe.  Focus on all five of your senses, perhaps with particular reference to the upcoming holiday.  The sweet smell of a favorite food, the texture of special clothing, tablecloths or a reclining pillow, the sight or feeling of one small item related to the holiday that warms your heart, the clink of glasses of wine. Memories of holidays past will, of course, be painful without your loved one.   Try to access the positive ones.
  • This is the time for spring holidays, with their connection to nature. Go outside as much as possible, if you can. Savor the sights of flowering trees or plants. Smell the smell of fresh green grass. Move your weary muscles. Remember that we are all part of the cycle of life.

Beverly Rubman, Chaplain

Daily Webinar Alert: Impact of COVID-19 on Medical Decision Making

JFCS continues to gather important resources for dealing with the impact of COVID-19. We are sharing the below information for an outside resource:

Daily 30-minute Webinar available at 1 PM EST Monday-Friday (through April 24)

“Impact of COVID-19 on Medical Decision Making: POLST and Other Important Considerations for High-Risk People” Hosted by Dr. David Barile, Palliative and Geriatric Physician, Founder & Chief Medical Officer Goals of Care Coalition of New Jersey

The purpose of the webinar is to help educate people and address their questions regarding POLST (Physician Orders for Life-Sustaining Treatment) and advance directives for the populations at high-risk for complications of COVID-19 (e.g., nursing home residents, frail elders, people with compromised immune systems and underlying medical concerns) and their surrogate decision makers or healthcare proxies.  Dr. David Barile will explain what a POLST is, why it is an important document, how to complete the form, and under what circumstances someone should have one.  Each session is followed by a Q & A period. Once registered, you can submit your questions.

 To register, go to goalsofcare.org 

What We’re Doing, What’s in the Works, and How to Help

It is impossible to look around you – even from within your own home – and not be inundated with information about the COVID-19 outbreak. These are uncharted waters for our local, national and global communities, but, there is an oddly comforting unity to know that this outbreak has an impact of everyone in our community, we are in this together.

We do not know how long our lives will be upended by restrictions and quarantines, but we do know the impact will last even longer. Right now and through the uncertain future, JFCS will be here ensuring help, hope and healing. In this phase of social distancing and disconnection, we intend to keep you, our community, well informed on JFCS actions.

What are we doing right now?

We are utilizing all available resources to ensure the most vulnerable and most in need have food:

  • We provided 50 families at Better Beginnings with packaged groceries
  • We plan to maintain our Mobile Food Pantry distribution schedule, including a stop at for 50 Redding Circle residents this week
  • April pantry hours for our on-site Yvette Sarah Clayman Kosher Food Pantry will be kept for our scheduled clients. For the health & safety of all, clients will be provided prepacked bags of grocery items, delivered to them in their cars, limiting outside access to our site.
  • Kosher Meals on Wheels continue to be delivered to homebound seniors. Meals are delivered by staff at the door with no direct contact with the recipient.
  • We are packing to-go boxes for Kosher Café seniors and have seen an increased attendance given the limited resources available for this low-income population. Last week we also provided the Kosher Café guests with a supplemental bag of grocery items to help them during this time.
  • We have frozen prepared meals available to supplement any of our seniors existing deliveries on an as-needed basis.
  • We are exploring all possible resources for packaged, pantry items and prepared meals to keep in stock as we anticipate growing need for food among our seniors and the food-insecure.
  • We are ordering Kosher for Passover meals to be distributed to our homebound senior clients.

Counseling is being provided by phone to our existing clients. Our team of counselors is available to take new calls for anyone who needs immediate assistance to cope with the heightened stress, anxiety or fear and for those with ongoing mental health concerns.

JFCS Geriatric Care Managers are making regular check-in calls and providing support by phone to our Secure@Home members, low-income seniors, Holocaust Survivors and support group members.

Volunteers have stepped up to provide check-in calls to our Kosher Meals on Wheels clients as well as seniors who were enrolled in Cooking Companions and Friendly Visitor programs.

We have launched a comprehensive resource page on our website as a one-stop source of agency information, helpful blogs from our staff on topical issues, and links to outside resources.

What is in the works?

  • Our staff is working with all community partners to make connections and ensure any available food is reaching those who need it most.
  • We are planning to launch teen engagement programs over Zoom (video conferencing) to keep our youth connected and supported during this challenging time.
  • We are creating plans to host Community Calls with one of our counselors to provide topical information on the challenges being faced by many.
  • We are working to offer free “call-in” hours during the week where callers can be connected to one of our counselors for coping skills and support.
  • We are exploring the capabilities of Zoom and other conference-calling programs to deliver supportive workshops to our constituents.

What can you do?

  • If you know of any counseling needs in the community, recommend JFCS.
  • If you know of families or seniors in need of food, recommend JFCS.
  • If you know of resources that will help us continue to deliver our programs whether it is through food, funding, or technology, we welcome your help and support.
  • LAST BUT NOT LEAST… check in on your children, your parents, your elderly neighbors, your coworkers, your friends, and yourself.

Administrative staff will be available by phone to answer any questions Monday – Thursday 9 AM – 5 PM and Friday 9 AM – 4 PM. Please note effective March 23, the restrictions noted in our original posting remain in place indefinitely in accordance with local, state and national health and safety guidelines. 

JFCS is stretching our resources as far as possible at this time to ensure our current clients have the support they need, be it counseling, senior resources and food. We know this is just the beginning of a rise in need for our services. Help us be equipped to provide for as many as possible here in our community.

Consider a contribution today.

NOTICE ON PROGRAMS DURING COMMUNITY HEALTH CONCERNS

 

UPDATED MONDAY MARCH 16, 2020

JFCS is here for the health of our community. In line with directives from the Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO) as well as local leadership for the state of New Jersey and County of Mercer, we are moving our programs and staff to remote schedules effective March 16 – 27. We understand this situation is evolving day by day and will continue to assess our remote service delivery during these two weeks and beyond as prudent and safe for our staff, our clients, and all constituents. 

 Please note the following changes to programs & services:  

  • No clients or visitors will be allowed inside JFCS offices through March 27. 

  • Counseling services will be provided through tele-therapy. We are continuing to take new calls for clients interested in services. If interested in counseling services, call us at 609-987-8100 Ext 102.

  • Seniors enrolled in our programs will receive regular check-ins and phone support to connect them with needed resources. There will be no in-home visits and/or geriatric assessments provided by Senior Services. 

  • Food delivery programs will continue to the extent our resources are available.

  • Gesher LeKesher and Jewish Community Youth Foundation (JCYF) recruitment and programmatic gatherings are canceled through April 1.

  • J-Serve, International Day of Jewish Youth Service is canceled.
  • All community events and days of service are canceled through April 1.
  • All volunteer activities are canceled through April including Shop & Stocks, Chore Corps, Cooking Companions, Friendly Visitors and all individual and group opportunities
  • All on and off-site support and therapeutic groups are canceled through April 1 including Bereavement groups, Caregiver Support group, and Youth Mindfulness group.

Administrative staff will be available by phone to answer any questions Monday – Thursday 9 AM – 5 PM and Friday 9 AM – 4 PM.  

The Truth About Long Distance Caregiving

About 1 in 8 family caregivers live more than an hour’s drive from the recipient of the care. Whether you are in a different city, a different state, across the country, or across the globe, as caregiver you want to be there without always being there.

According to AARP, these are five steps to staying informed and effective as a long-distance caregiver.

  1. Establish Access

Caregiving often involves having the legal authority to make financial and healthcare related decisions. Having good information channels to accessing this information is crucial to a long distance caregiver. Try to arrange as much as possible during an in-person visit, when you can work with your loved one to locate, organize and fill out necessary paperwork such as a will, power of attorney and medical care plan.

  1. Create a Team

In the digital age, you can handle many important tasks remotely, such as paying bills and ordering prescriptions; however, you will need others to be your eyes, ears and sometimes hands on the ground. It is natural for long distance caregivers to feel guilty about delegating certain jobs to others, but do not try and do it all. Delegating regular check-ins and more hands-on care to nearby family, friends or professionals can be in the best interest of your loved one, especially in cased of serious or complicated health issues.

  1. Find a Local Coordinator

A local care manager can supply local knowledge and help with caregiving logistics. One option is to hire a reputable caregiving professional, also known as geriatric care manager, aging life care manager or eldercare navigator or coordinator. These professionals are often licensed nurses or social workers and can be valuable mediators or sounding boards when family members disagree on care decisions. A care manager can help make tough choices easier on the caregiver and care recipient – such as knowing when it is no longer safe for a loved one to live at home – by presenting an array of options from a knowledgeable, outside perspective.

  1. Stay in the Loop

Establish ways to communicate regularly with your local team and loved one, whether through organization apps, group emails or social tools like FaceTime and Skype.

  1. Make the Most of Visits

Nothing replaces an in-person visit. When you can manage one, come with a list of things you need to know or discuss.

How can JFCS help you to navigate these challenges?

If your loved one resides in Princeton, NJ or the surrounding Mercer County area, consider a membership in the award-winning Secure@Home program offerings through JFCS. Our Secure@Home team of highly skilled Senior Care Consultants provides a comprehensive umbrella of care management services to help older adults age comfortably, independently and safely in their own homes.

Membership includes a complete home assessment, care plan, 24-hour emergency telephone availability, “Chore Corps” volunteers and regular check-ins, preferred provider list and wellness lectures.

If you are concerned about your loved one, please call JFCS at 609-987-8100 and ask to speak to a Secure@Home representative.

How do I Talk to a Family Member about Senior Care Options?

The holidays are a wonderful time for families to gather and share in memories and traditions. However, meals around the table can also spur on questions about the health of our aging family members.

“Did Dad almost trip coming up his own front step?”

“Did Nanna look this frail last year?”

“Does Uncle Stu seem more forgetful?”

Family gatherings can shine a light on deteriorating health in our loved ones and be an opportunity to discuss senior care options from in-home care to assisted living.

What are signs your loved one needs help?

Some of the most common signs of concern include*:

  • Changes in mood or extreme mood swings
  • Cluttered, dirty and/or disorganized house
  • Disheveled clothing / poor personal hygiene
  • Expired/spoiled groceries
  • Confusion and uncertainty when performing once-familiar tasks
  • Forgetfulness
  • Loss of interest in activities
  • Trouble getting up from seated position
  • Unexplained bruises

How to start the conversation?

As with many difficult topics, beginning the discussion is often the hardest part. Open-ended questions are the best way to encourage them to talk. Sit back and really listen to their answers.

These conversation starters may help:

  • How is it living at home alone? Do you still feel safe? (OR give specific examples i.e. Are you concerned about the stairs? Do you have trouble getting into the bath?)
  • Do you feel lonely sometimes? Would you like to spend more time with people your own age?
  • How do you feel about driving? Would you be interested in other options for transportation, so you don’t have to worry about getting where you need to go, car maintenance costs, traffic, parking, etc.?
  • Is it ever hard to manage your finances and keep up with paying your bills?
  • Ever wonder about getting a helping hand with housekeeping and laundry?
  • Would you feel less stress if you didn’t have to worry about the house?

Speaking to your aging loved ones about care options can be difficult, starting the conversation is the first step. Multiple conversations may be needed to understand your loved one’s needs and wishes AND balance those with the best options for a safe, comfortable and fulfilling lifestyle. Remember these tips to have a helpful conversation each time:

  • Talk in person. This isn’t a conversation to have by telephone if you can avoid it. Instead, pick a day when you and your parent are well-rested and relaxed. Block out a time and a location where you can talk without interruption.
  • Empathy, not sympathy. No older adult wants their child to feel sorry for them. But empathy is another matter. Your kind, calm voice and demeanor will show you care – and that you’re trying to understand the fears and frustrations they may feel. The idea of accepting in-home care or moving to a senior living community is tough. You begin to help as soon as you really begin to listen.
  • Don’t rush. Once you’re armed with knowledge, you may feel ready to make a decision. But your parent may need more time. Allow them the time they need to find the words to express how they’re feeling. Coming to an unpressured mutual agreement now will continue to pay dividends as you move forward together.
  • Plan to talk again. And again. As much as you might want to wrap things up in one conversation, the reality is this will likely be a series of talks. Unless your aging family member is in eminent danger, that’s okay. It’s a process, not a once-and-done discussion.

*Signs Loved One May Need Help sourced by A Place For Mom. (link https://www.aplaceformom.com/planning-and-advice)

November is National Caregivers Month and JFCS Has Answers!

November is National Family Caregivers Month. But for those of you who are caregivers, you know that EVERY DAY is a family caregiver day. Whether or not you live with your loved one, your responsibility for their care is 24/7, filling your heart, mind and time.

Caregiving can be a very isolating existence. You are so busy taking care of your loved one that you may not have time for yourself—to address your own health needs; to have some “down” time for relaxation, hobbies (hobby—what’s a hobby?) or visits with other family and friends; to talk about the difficulties that you encounter and the normal frustrations that you feel. But the stark reality is that, if you do not take care of yourself, you may not be around to care for your loved one!

Support groups can provide a critical shoulder to caregivers, diminishing the isolation and allowing the caregiver to know that he/she is not alone. At JFCS, we have extensive experience with caregiver support and facilitate a wide number of support groups throughout the year.

Many of our participants attest to the value they experience in being together as a group member:

“I am not alone, other people feel the same things I do. I actually have a lot to contribute.”

“Most helpful has been simply sharing stories, worries, concerns, laughter with each other. The caring community itself is a stress reducer.”

“Camaraderie!”

“One doesn’t have to go through ‘trauma’ alone.”

“We identified with each other and really came to care for each other.”

I learned to “honor my feelings.”

“Honesty, directions, aid in resources…people, caring, support.”

“Hugs.”

We also understand how difficult it can be for caregivers to leave their homes and loved ones to attend a group. JFCS is excited to announce the launching of a new program to create an online video support group, employing 21st century technology to address the time-old need for connection, support and validation. All you need is a laptop with video capability and you can interact with a group on your screen in your own home with complete confidentiality and privacy.

If you are interested in the online video group or any of our other support group programs, please contact Beverly Rubman at beverlyr@jfcsonline.org or call 609-987-8100.