Ask the Experts: Moving to Memory Care; Heart Transplantation in Seniors; Bloating from Fiber
I’ve been caring for my elderly mother for a couple of years, but her dementia is getting worse. I have my own health problems, and am beginning to feel very isolated because I need to spend most of my time at home with her. With these factors in mind, I have reluctantly decided she may be better off in a memory-care facility. We are fortunate to have a highly rated nursing home nearby, but how can I make her transition easier?
I’m sure this has been a difficult decision for you, but caring for an older adult living with dementia is not easy. While you likely feel guilty about your decision, your mother may do better in an environment with round-the-clock care, interaction with people other than you, and plenty of things to do. It sounds as if your emotional wellbeing also will benefit.
Find out if it is possible to familiarize your mother with the facility before she moves there—perhaps she could spend a few mornings or afternoons there getting to know the staff and residents, and taking part in activities. When it comes to the actual move, schedule it for whatever time of day she is most calm. It’s important to let her take with her some of her treasured items and possessions, such as family photographs, a favorite chair, and bedding. But keep in mind that her room likely will be small, and cluttering it with too much furniture may create tripping hazards.
Since you have access to a proper memory-care facility, the staff will be used to interacting with older adults who have similar issues to your mother. Work with them on helping her settle—tell them about her: what she likes and dislikes, what calms her when she is agitated or upset. Knowing more about her will help them when it comes to engaging her in conversations and activities, and easing her through any confusion she feels in her new home. Accept that it may take time for your mother to fully settle in (when you visit, she may ask you when she can go home). It may be easier if you schedule visits during activities or her lunchtime, since she will be distracted.
Also take care of yourself during this transition. Stress and depression are real problems for people who are caring for older relatives, particularly when cognitive decline is an issue. You may find that these feelings persist after your mother moves into her new home. I suggest you reach out to others who are experiencing the same issues—the Alzheimer’s Association (www.alz.org) has an online community that offers support and advice to caregivers.
Rosanne M. Leipzig, MD, PhD
Geriatric Medicine
Is it possible for older adults to have a heart transplant? I say yes, but my friend says no.
There is no official upper age cut-off for people undergoing heart transplant, and in 2019, nearly 600 Americans age 65 and older underwent transplantation. All potential heart transplant recipients are evaluated to determine whether the procedure is appropriate and whether they are likely to survive. They also must commit to making lifestyle changes that will protect their future cardiovascular health, and need to be able to follow a complex drug regimen to prevent organ rejection. Heart transplants are performed by a limited number of hospitals and they have their own criteria governing who is eligible for consideration. Fortunately there is an alternative to transplantation in the form of implanted devices that can help a failing heart pump blood to the body and vital organs.
Bruce Darrow, MD, PhD
Cardiology
I’d like to increase my fiber intake by switching to whole-grain bread and pasta, but I’ve heard that these can cause bloating. Is this true?
It isn’t so much that whole grains cause bloating— it’s more that rapidly boosting your fiber intake after previously eating a low-fiber diet can cause it. Whole-grain bread and pasta are much better for you that refined (white) options, so I recommend you do make the switch. But do it gradually so that your digestive system has time to adjust, and be sure to also drink more water, since this helps fiber move through your digestive tract. These precautions should help prevent bloating.
Fran Grossman, RD, MS, CDE, CDN
Nutrition
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