Games on the Go

Remember the agonizing whine of "Are we there yet?" coming from the back seat of the car from your two wonderful, bored children on the last family vacation you took? Here are some game ideas that you and your family can try for your upcoming vacation.

1. Geography
Geography is a great way to get your family in an upbeat mood for the journey ahead. How to play: The first person thinks of a place (city, state, country, etc...) then the next person has to think of a place that starts with the last letter of previous place. Remember that you can't use the same place twice and the place has to be real.

Example:	Dad starts with: North Carolina
	Jill (daughter): Alabama
	Mom: Arlington
	Jack (son): New Mexico

2. Twenty Questions
How to play: One person thinks of a person, place or thing and each person in the family has 20 questions to figure out what it is. Remember that "yes" or "no" can only answer the questions.

Example:

Dad: Thinks of a person, place, or thing

Jill: Is it a person?

Dad: Yes

Mom: Is the person still alive?

Dad: No

Jack: Was this person a former President?

3. License Plates
Are you ready to try to find all fifty license plates from around the county? Be on the look for states that have more than 1 type of license plate. A map is included to help you keep track of what states you should be on the look for.

4. Buzz Here's a game that will test your math skills.
How to play: Take turns counting to 100. Whenever a 7, multiple of 7, or 7 in the number comes up, say "Buzz". Remember if one person makes a mistake, you have to start the whole game over again.

Example:

Jack:	1
Jill:	2
Mom:	3
Dad:	4
Jack:	5
Jill:	6
Mom:	Buzz
Dad:	8

5. Scavenger Hunts
Scavenger Hunts are a great game to play in the car. Before you leave the house, prepare a list of things that you can see easily from the car. Remember to bring a couple of lists with on the trip so your family can play against each other. Also, remind your family that the first one to spot all the items on the list gets a surprise!

Here are some ideas that can get you started on your list:

• Stop sign
• United States of America Flag
• Motor home
• Swimming pool
• Welcoming sign
• California license plate
• McDonald's Restaurant
• Mountain
• Bridge
• Boat
• Convertible car with the top down (weather permitting)

6. Alphabet Words
This is a great game for children beginning to read.
How to play: The object of the game is to find words on the road starting the letter of alphabet in order.

Example:

Jill:	A- sees AT on bill-board
Mom:	B- spots a Best Western sign

7. I Spy
I spy is a classic favorite for family car rides.
Remember that you can limit what you see to the interior of the car or you can include things that you have already passed. And the first one to answer correctly goes next.
How to play: One person spies an object and the rest of the family has to guess what it is.
Example:

Jack: I spy with my brown eyes something large.

8. Bingo
This version is a little different from what your family might be use to, but it's a lot of fun. Prepare equal size grids for several colors of cars and X out a square every time one is spotted. The first one that Xs out all the squares wins! Remember to make each grid different so your kids can compete against each other.

Example of the grid:

Red	Yellow	Blue	Green
Black	White	Red	Maroon
Blue	Black	Beige	Silver
Yellow	Green	Brown	Black

Painless Pointers for Packing

So you have your suitcases laid out for everyone in the family, now the question is what to bring? You already know that your whole house won't fit in the car. But no need to worry, follow these helpful hints and packing should be a breeze.

Stay organized, lists are a perfect way to keep control. Keep lists for each member of the family, this will prevent any confusions in what you have packed and what you need to pack

For the Kids:
• Diapers
• Diaper Bag- preferably waterproof
  • Diaper rash ointment
  • Pacifier
  • Tissues
  • Premoistened wipes
  • Travel size of powder and lotion
  • Bib
  • Food: formula, water, juice, snacks, bottle, sippycup and utensils
  • Toys and books
• Vinyl diaper wraps to prevent leaks
• 2 blankets
• one to lay on and the other to be covered with
• Stuffed animal
• Plastic bags to put dirty clothes in
• Clothes: bring at least 1-2 outfits per child a day
  • Two suggestions: bring mix and match clothes or preplan the outfits
  • Easy to clean
  • Comfortable
  • 2 bathing suits, weather permitting and if you kids like to swim
  • Comfortable shoes (sneakers) and water shoes
• Towels
• Pillows, if desired
• Travel size night light
• Stroller, car seat
• Portable crib, if hotel does not meet specifications
• Camera and film
• Disposable camera for your children to use
• Empty back-pack for day trips and outings
• Toiletries
  • Travel size to take up less space
  • Keep in a plastic bag to prevent leakage on clothes
• Soccer ball, Frisbee, and/or jump rope to play with during rest stops

You may think that you need everything but if you are really crunched for space, don't pack anything that you can buy at your destination. Maybe you really don't need that 100 pack of diapers, 24 might suffice for the beginning of your travel.

Hotel/Motel Safety Tips

Here are some safety tips to make you and family feel more secure away from home.

1. When booking your hotel room, make sure that the room comes equipped with deadbolts and peepholes.
2. Ask for rooms that open into the interior of the hotel, compared to the outside of hotel. Interior of rooms provides more safety because thieves can not monitor your coming and goings.
3. Make sure that all windows and doors are securely locked. And if your room has a balcony, make sure there is a net around it so your kids are unable to slip through.
4. Try to get a hotel that utilizes electronic keys instead of regular keys. Electronic keys are reprogrammed after each stay of a guest.
5. If your room comes with a safe, lock up your valuables. Don't leave valuables in plane site; more people have access to your room than you think.
6. Locate the emergency exits in case of a fire.
7. Teach your children how to call the front desk and 911 in case of an emergency.
8. Do not mention your room number in public, you never know who is listening.
9. Just to be on the safe side, make sure your family has ID on them, especially your kids. Let your children help make there own ID. The essential information that should be on their ID are:

• Name
• Address
• Telephone Number
• Hotel of where you are staying
• Phone number of the Hotel
• Parents Names
• Allergies of the child (if any)
• Age/ birth date
• Emergency Contact (family or friend from home)
• Recent picture (keep a copy of the recent picture in your wallet just in case you do get separated from your children, the police would like to get the most recent picture for their records)

Safety First: First Aid Kit and Emergency Phone Numbers

So you've decided to take the family on a trip, now it's time to pack. Don't forget to pack the first-aid kit. Use this checklist to help you form your own first-aid kit (you probably have most the supplies at your finger-tips)

• Container
  • choose a container that has plenty of room, easy to carry and able to with stand your family
• First-aid manual
• Adhesive bandages- varying sizes
• Antiseptic wipes
• Gauze bandage
• Tape
• Soap
• Hydrogen peroxide
• Hydrocortisone cream
• Diaper rash ointment
• Ibuprofen/ Extra strength Tylenol
• Benadryl (antihistamine)
• Extra prescription medications
• Instant cold packs
• Calamine lotion
• Sunscreen
• Insect repellant
• Lip balm
• Tweezers
• Scissors
• Safety pins
• Q-Tips
• Thermometer
• Flashlight (with batteries)
• Emergency phone list
• Blanket

Your Emergency Phone list should contain:

• Child's Name
• Address
• Telephone Number
• Social Security #
• Doctor's Name and Phone number
• Health Insurance name, policy number, and phone number
• Emergency contacts
• Medical History: preexisting conditions, allergies, and immunization history

Happy Travels!

Conquering the Car Ride

So the games only lasted for 2 � hours of the 12-hour car trip, how else can you keep your kids occupied for another 9 � hours? These no fail travel tips will make the time fly:

• If your body can handle it, leave late at night or really early in the morning. The object is to travel when your kids are most likely to be asleep.
• If money is not an issue, the portable TV/VCR is a great way to keep kids entertained. Make sure you bring movies that the whole family likes.
• Hand held video games (with the sound turned down, so as not to frighten the driver)
• Numerous tapes
  • Books on tape
  • Sing-along tapes
  • Movies on tape
• Kids Pack - Each child gets his/her own backpack that they can take whatever they want. As long as it fits in the bag and isn't breathing it should pass. Some suggestions could be:
  • Their favorite book
  • Coloring books
  • Crayons
  • Legos
  • Washable markers
  • Stickers
  Remember not to pack anything in the car that could get too messy such as PlayDough or games that have small pieces that could get easily lost like Monopoly. Also, if you really want to be a great parent in your kids eyes, pack each of them a present and surprise them along the way.
  

Childproofing Your Hotel Room

Before you leave for the long awaited vacation you've been dreaming about, be prepared for childproofing your hotel room. Just because you're going on a vacation doesn't mean that your responsibilities are on a vacation too. Just use your common sense when planning to childproof your hotel room. Think of the room as a smaller version of your home, taking the same precautions. But before you leave, call your hotel to see if childproofing equipment is available at your hotel. If not, be equipped for all the essentials to do it yourself.
When you arrive at the hotel give the room a good inspection taking notice of the all the dangers for a child. If it is necessary get down on your hands and knees and view the room from your child's point of view. Look carefully at the floor, are there any staples or tacks lingering around?

Once you have inspected the room take some time to make your adjustments. Here are some helpful hints:

• Move furniture away from the windows
• Furniture needs to be stable and sturdy to avoid tipping over
• Knobs should be tight so your children will not remove them and pop them into their mouths
• Make sure that doors and windows are securely locked
• Tie up any loose cords to prevent strangulation
• Unused outlets should be properly covered
• Tables with sharp edges should either be removed or edges should be covered, washrags are a perfect solution
• Remove any table cloths;

The Crib

• Make sure that it is up to standards with the Consumer Product Safety Commission: slats should not be more than 23/8 inches apart
• Remove any pillows or blankets that causes suffocation
• If your hotel is not up to standards, pack along your own portable crib Bathroom
• Never leave your child alone in the bathroom
• When giving your child a bath, the water should not reach more than 120 degrees F, try to keep it between 96-100 degrees.
• Unplug any electrical appliances, i.e. hairdryer, and store them in a locked drawer
• Make sure there are decals or a non-slip mat on the bathtub
• Check to see if the bathroom mat has a stable backing to prevent slips.
• Any hazardous products should be put away: mouthwash, shampoo, cosmetics

Please take extra precautions when you are traveling. Your family is in a new, unfamiliar environment and may need even more supervision.

Babysitters on Vacation

So you and your spouse would like a quite dinner together and the hotel provides a babysitter, easy right? Double-check the hours of babysitting services. Make sure that they are available during the time you need. If not, see if they can recommend anybody. Ask the same questions as you would at home. If there is an organized program ask questions.

• Do they have planned activities?
• Are meals provided?
• How much does it cost?
• Are they trained in CPR or emergency procedures?
• What is the ratio between babysitter and children?

Remember that this is a family vacation. Try to do as much as you can with the family and your children, the memories can never be replaced.

Care Home Complaints

Occasionally your relative has something they cannot cope with any longer. For instance, it may be loud music from somebody's television. Ask one of the nurses if they could persuade the resident to turn down the volume to a more acceptable level. If there is no change you or your relative might like to make an official complaint. Start by speaking to the nurse in charge or the matron. If nothing is done speak to your relative's care manager if they have one, or to the manager or proprietor.

If nothing is done about the complaint write a letter to the manager or proprietor telling them no action has been taken. Suggest that they might like to visit the room and hear the noise for themselves.

Should your letter be ignored send a reminder. If you do not get a satisfactory solution to the problem write to the inspector of the home who will investigate the problem.

To make a complaint about a care home take the following course of action:

1. Make your complaint to the nurse in charge.

2. If no change complain to the matron.

3. Still no change: speak to the Care Manager.

4. No response: speak to the manager or proprietor.

5. Complaint ignored: put it in writing to the manager or proprietor.

6. Complaint still ignored: send a reminder to the proprietor.

7. Still no response: write to the Nursing Home Inspector.

8. The Inspector will:

• Investigate the complaint.
• Discuss it with the matron.
• Discuss it with the proprietor.
• Problem solved.

Checklist when Moving to a Elderly Care Home

Television Licence

If your relative takes their own television into the home, they will be required to buy their own television licence unless they are over the age of 75 years. However, their current licence is transferable when they move to another home. Please verify this with the matron or the manager.

Car Insurance

Make sure your car insurance covers any passengers from the home you choose to take on an outing.

Special Occasions

Don't forget to inform the matron in writing if you intend to take your relative out or prepare something special for their birthday or Christmas. Ensure you have their permission before you finalise your plans.

Reading Matter

If there are no library services within the home, go to your local library and borrow books or tapes for your relative. The borrower (yourself) will be responsible for the borrowed book or tapes and for them being returned on time in good condition.

Check Clothing

Check your relative's clothing at the beginning of each season to ensure they have a suitable range of clothing to match the weather. A shawl is useful for chilly evenings. Gloves, scarves, a hat and warm shoes will be needed for outings during winter weather.

Calendar

Buy a large calendar to hang on the wall. Note special events, birthdays, etc on the appropriate date as a reminder. Help them buy and write cards and undertake to post them.

Post

Ask the matron what the postal arrangements are. Most homes have a letter box for the residents' outgoing mail, it will then be taken by a member of staff and posted.

Residents' mail is delivered to the home, provided it's addressed properly. It will then be delivered to the residents by a member of staff.

Phone Numbers

Give your relative an address book with the address and phone numbers of all her friends.

Lockable Safe, Cupboard or Drawer

Residents should be provided with a facility for keeping private papers, small amounts of money, etc either in a lockable top drawer or cupboard. If none are provided, ask the matron if they can get a lockable facility fitted.

If your relative has a lot of cash with them, it must be handed over to the matron or nurse in charge to be kept in the home's safe. Make sure you get a receipt for the cash.

Comparing Care Home Costs

All homes have their own fee structure. Most homes charge different rates for single rooms, double rooms and for en suite facilities. Some homes will only admit residents who are self-funding, others will also admit those who are being helped by Social Services; some homes only admit residents who rely on Social Services for their funding.

It is sensible to contact your local Social Services offices and ask for a financial assessment before making any final decisions regarding your relative's transfer to a care home.

Your relative's care manager will assess the needs of your relative and decide the type of care which is most appropriate for them. This may be a residential care home, a nursing home or another type of care. If you disagree with their decision you may ask for a second opinion.

They will give you a list of homes in the area and guidance regarding the listed homes which may be suitable for your relative. However, care managers are not allowed to recommend any particular home. Before you visit the various homes jot down a list of financial issues you need to know about, for instance.

• Will a monthly account be sent to me?
• Do the fees cover everything?
• Are there any extra charges for anything?
• When are fees due?
• Can fees be paid by direct debit?
• Who are the direct debit or cheques made payable to?
• Do Social Services send their contribution to the home?

Your care manager will arrange for your relative to have a financial assessment. This is mandatory if they hope to have financial help from Social Services. Even those people who expect to be self-funding may benefit from such an assessment because the assessor will ensure your relative is getting all the allowances to which they are entitled.

Care Home Finance

Whilst it is not obligatory to involve Social Services, particularly if your relative is going to be self-funding (being totally responsible for their own fees) it is best to inform them and ask for advice as soon as you or your doctor realise your relative needs full-time care. A care manager will be appointed to help and advise. They will:

• Make an assessment regarding the most appropriate type of care required.
• Arrange a financial assessment if required.
• Give you a comprehensive list of homes in the area.
• Inform you which homes will give the type of care your relative needs.
• Arrange respite care during the waiting period if necessary.
• Reassess the placement of your relative during the first few weeks.
• Advise you if the placement is unsuitable and help find a more appropriate home for your relative.

If Social Services is involved four assessments will be made:

1. Assessment by a care manager to establish the type of care required.
2. A financial assessment to determine your relative's contribution towards care.
3. An assessment by the matron of the care home to establish whether the chosen home is the best possible home for your relative.
4. An assessment by the health authority to determine if your relative requires nursing care. If they do it will be decided how much nursing care need.

If Social Services are not involved only assessments 3 and 4 will apply.

The reason for the last assessment to determine the amount of nursing care a resident will need is because the National Health Service now pays for nursing services within nursing homes. This means that the resident no longer has to pay for this component of their care.

Finding a Care Home: Essential Facilities

Laundry services

Almost all homes have an in-house laundry where residents' clothing is washed and ironed and taken back to the person's room and put away. Unfortunately if clothing is not marked with the resident's name it can get mislaid.

Laundry services do not generally include articles that need to be dry-cleaned and it is usually the responsibility of the resident's relatives to take the clothes to the dry cleaners and pay for this service themselves.

GP services

Your relative's current doctor may be willing to continue to visit, monitor their progress, advise, and prescribe for them if and when they succumb to illness, on condition the surgery is near the home.

However, if it is not practical for your relative's own doctor to continue caring for them, they will have the opportunity to change to a more local practice. The matron will advise in this case.

Activities

Many care establishments have an activities programme. Some employ a person to draw up a daily activities list and put it into operation. It is difficult to suit all the residents all the time. They may enjoy some activities more than others but if they join in they will make new friends and enrich their lives.

Library services

There is generally a library within the homes for those residents who like to read. Sometimes the books are donated but in some areas the local library is able to bring a selection of books initially and change them at regular intervals. If there is no such facility, books can be borrowed by friends or relatives on a resident's behalf from the local library. However, the person borrowing the books is generally responsible for their safe return at the proper time.

Trolley shop

There are always a few residents who are too disabled or who have no inclination to go out. In nursing homes the residents are often too sick or frail to even think of leaving the home. With this in mind some matrons organise a weekly shopping trolley with things such as writing paper, envelopes, stamps and other useful items that the residents can purchase.

Gardens

Many homes have lovely gardens for the residents to rest or walk in. Sometimes the home's gardener or handyman will help residents to plant hanging baskets or tubs or even bulbs for them to have in their rooms or communal areas. It may even be possible to have raised flower beds to enable keen gardeners, if they are fit and well enough, to enjoy gardening again.

Religious services

The matron may already have arranged to have church services held within the home by the local clergy or pastors. If there is no religious service suitable for your relative, bring the matter up with the matron. They may be able to contact the appropriate minister and ask them to visit your relative when admitted. Alternatively, depending on distance, you could ask their own minister to visit.

Car parking

Many of the residents' visitors will have their own transport. One of their biggest worries is where they can park the car.

Most homes outside a city or town have car parking facilities both for staff and visitors. It is sometimes more difficult if the home is situated on a busy road with little or no space to park a car. The matron or the staff will know where the nearest parking places are. If the home is fortunate enough to have a car park it may prove difficult to find. When you phone to make an appointment to view the home, ask how to find it.

Sheltered Housing

Sheltered Housing or warden controlled flats are not classed as care homes but they deserve a mention here.

A warden is employed to ensure that residents who live in these flats are well enough and able to care for themselves on a daily basis, and to answer any emergency calls when they are on duty.

Each flat has a call bell or intercom which rings in the warden's office if they are in need of help during office hours. In order that the residents can call for help when the warden is off duty the residents are usually advised to hire a 'press-button-gadget' (sometimes called 'life line').

This is a call bell, usually in the form of a pendant, which residents can wear round their neck. When the bell is pressed it rings in an office in another building often miles away in another town or city. The person who answers will call the resident's next of kin and advise them of the problem.

Nursing Homes

Nursing homes have a higher ratio of staff to residents than residential care homes because the residents are less able than clients living in a residential care home. They need more help with their 'activities of daily living' such as personal hygiene, going to the toilet, bathing, etc. Some will need to be assisted with their feeding and drinking.

Clients who are admitted to nursing homes need nursing care. In all nursing homes the residents will be suffering from different illnesses and conditions.

Some people enjoy being in a home caring for a large number of residents. Others prefer to live and be cared for, in smaller ones. There are advantages and disadvantages in both cases.

The Larger Nursing Homes

Larger homes have 50 beds or more. It would be difficult and unusual to have this number of beds plus dining rooms, lounges, toilets and bathrooms, etc all on the ground floor. In view of this there may be two, three or possibly more floors depending on the number of elderly residents they care for.

The residents would be taken to their floor by lift. The largest homes may have two lifts. Access to each floor is also provided by stairways.

In some homes, particularly the more modern ones, the floors are complete with a small kitchen area, lounge and dining area, bathrooms, toilets, nurses' station and treatment room in addition to the bedrooms.

All nursing homes, whether large or small, have communal rooms for the use of residents and their visitors.

Smaller Nursing Homes

Some homes are designed to be a single storey building, depending on the number of residents they have been built to accommodate.

Residential Care Homes

Men and women are admitted to residential care homes for care such as bathing, meals, washing, etc. However, residential care homes are not usually allowed to admit anybody who needs nursing care. Most of these homes employ care assistants who work under the direction of the matron or manager. Usually a suitable weekly activities programme is arranged and even trips to the shops or various places of interest, for those residents who are interested.

The ratio of staff to residents may be lower than in a nursing home because the residents are usually able to do more for themselves. They are not expected to make their beds, do any housework or cooking but they should be able to carry out most of their own personal care when they are admitted.

The snag is that if any resident becomes ill and needs nursing care they may have to be transferred to a nursing home. Initially such a move often upsets the resident and they will need a lot of comforting and help until they learn the routine and make new friends in their new abode.

Care Options for Patients with Alzheimer's and Dementia

In England people diagnosed with Alzheimer's disease are usually cared for by the family in their own home in the early stages. There comes a time however, as the disease progresses and the behavioural pattern becomes more difficult to cope with, when carers find they can no longer cope with their relative's forgetfulness, odd behaviour and possible aggressiveness.

If you are a carer in this situation contact your relative's care manager and seek advice. They will be able to tell you which kind of home would be most suitable for them and give you a list of appropriate homes.

An EMI Home (Elderly Mentally Infirm)

An EMI home is usually the home where residents with dementia or Alzheimer's disease are cared for. A person suffering in this way will be happier in this type of home than in a nursing home. There are Registered Mental Nurses (RMNs) who are specially trained to care for residents with this kind of illness on duty at all times. They know how best to help and care for the residents.

Residential Care Homes for Elderly Folk with a Mental Disorder

These homes cater for elderly residents who suffer from such illnesses as depression or schizophrenia.

Some of the residents need to have regular medication administered by injection, usually fortnightly or monthly. The Community Psychiatric Nurse (CPN) visits frequently to monitor the residents, to give advice if necessary and to give the injections as they become due.

Causes and Symptoms of Alzheimer's Disease

This disease involves the parts of the brain which control thought, memory and language. Research is ongoing and although much has already been done neither the medical profession nor the scientists know the cause of this disease. So far, no cure has been found.

Signs and Symptoms

• Slow onset.
• Mild forgetfulness, patients may have difficulty in remembering recent events, the names of people they know - even their family members.
• Patients may not be able to solve simple problems or do simple sums which may cause minor difficulties. However, it's not usually serious enough to cause alarm.
• Most people will not suspect anything is wrong at this stage.
• The person may begin to forget how to do simple tasks such as combing their hair or cleaning their teeth.
• They can't seem to think clearly.
• They may ask the same question repeatedly, or repeat an activity, such as washing their hands, because they have forgotten they have asked the question or washed their hands already.
• Problems arise with speaking, reading, writing and understanding.
• As the disease develops the changes are more pronounced and more easily noticed. At this stage either the person or a family member, on their behalf, will seek medical advice.
• As time passes the person may become anxious, agitated, aggressive, suffer with insomnia and depression.
• They may become wanderers - going out and getting lost.
• Eventually they will need total care.

What Causes Alzheimer's Disease?

The cause is unknown at present but there are several factors which may be contributory.

Age

• The risk factor increases in people over 65.
• As people reach their seventies and eighties the risk factor increases. This is known as 'late onset Alzheimer's disease'.

Family History

There is a rare form of Alzheimer's which is familial. It usually occurs between the ages of 30 and 60 years of age and is inherited. This has led scientists to believe genetics may play a role in some cases. However, the more common form which occurs later in life shows no sign of being inherited.

Symptoms of Dementia and Care Options

Dementia is a brain disorder that seriously affects a person's ability to carry out the activities of daily living. Dementia is progressive and incapacitating if it occurs in the earlier years the mental deterioration advances more rapidly and is more severe than if it starts in later years. In people over 65 years old early symptoms resemble the forgetfulness of ageing. Many people worry they are becoming demented.

The earliest symptoms

A close relative may notice failing memory and initiative. The person may become irritable. The loss of memory is a gradual process, patients can often remember incidents in their past but cannot remember recent happenings. This is called short-term memory loss.

After a time the relatives may notice the person does not understand what is said to them and they appear to have lost interest in their former activities and hobbies. Not all signs of confusion or impaired capacity in the elderly are due to senile dementia. There may be another cause which when treated can reverse the condition. If your relative has this problem persuade them to see their doctor who will probably refer them to a geriatrician (a consultant who specialises in the care of elderly people). They will give advice on the patient's management and/or may refer them to a clinic, sometimes known as a memory clinic. The patient will be seen by a consultant, who not only specialises in the care of the elderly person but also in memory loss, its cause and management.

The most common form of dementia in elderly people is caused by Alzheimer's disease.

Assessing a Relative's Care Needs

It is helpful if you make notes of all the various pieces of information you learn about your relative. Thus new knowledge will help you find the right care home for them.

Try to establish how your relative copes with daily living, and whether they have any help from social services such as a home help.

Try to find out in which way they are incapacitated. Are they mobile at all, or do they have any appliances such as a walking aid to help them? Some people have trolleys so they can transport their food and drink or other things and use it to help support themselves at the same time.

Is your relative able to prepare their own meals, take their food and drink to the table, sit down, eat and drink without help?

Do they suffer from any illness that requires a special diet, such as diabetes? Food allergies also have to be considered so alternative foods or special diets can be prepared for them. The matron needs to know in order to instruct the chef and ask them to visit the new resident.

Can your relative get to and from the toilet by themselves? Sometimes it takes too long for this to be accomplished and elimination takes place before the toilet is reached. If the matron knows about this problem arrangements can be made for a resident to be taken to the toilet at regular intervals before they are desperate to eliminate. Hopefully this will solve the problem.

Take notes about the amount of pain, if any, your relative suffers from. It would be useful to find out what medication they take to keep them relatively pain free. Severe pain is sometimes treated at a pain clinic, to which their doctor would refer them if it was thought necessary.

A few people who are not really able to care for themselves any longer develop pressure sores on their sacrum, elbows, heels and other places, in fact anywhere where there is constant unrelieved pressure on the body. Sacral sores can be made worse by incontinence. The matron will want to know if your relative is suffering from any skin condition including pressure sores so the problem can be assessed by the doctor and treated.

Building Confidence via Anchoring

Anchoring is a way of drawing on past experiences in which you felt confident to help you cope better in the present. It's another powerful weapon in your confidence armoury.

An anchor is any stimulus that consistently triggers an emotion. To use an anchor you have to:

• Generate in yourself the particular set of feelings you wish to recreate.
• Programme your subconscious to associate those feelings with specific words and gestures.
• Use those words and gestures to trigger the desired feelings when required.

Sportsmen and women use anchors continually. For example, tennis players bounce the ball repeatedly before serving to calm themselves; most runners go through an elaborate routine to centre themselves, much of which is not strictly necessary to the actual performance; and the mighty All Black rugby team go through a series of rituals before each match to intimidate the opposition and fire themselves up.

You constantly anchor feelings in the nervous system whether you like it or not, so why not learn to use this to your advantage? Using anchors you can feel calm and confident, or energised and confident whenever you wish.

• Choose an event you shortly have to face, when you need to remain calm, but you fear could bring on nervousness. Start working on your anchor a few weeks before the event. Get into the relaxed state and recall a time when you felt really calm and confident. Relive it in as much detail as possible. If you can't think of a suitable time just pretend to be confident. If you have a good imagination, your subconscious won't know the difference. When the feeling is strong, put your thumb and fingers together and gently whisper, 'Cool, calm and confident'. The stronger the feeling, the more successful will be your anchor. Affirm that every time you make this gesture and repeat these words, these same calm, confident feelings will return. This is called 'installing the anchor'.
• Just before the actual event you were rehearsing, and if necessary during it, take a deep breath, put your thumb and fingers together and repeat your chosen phrase silently or aloud. Say it with conviction. Allow the confident feelings to flow through you. This is called 'firing' the anchor.
• Alternatively, install an anchor when you experience good feelings as you go about your activities. This is effectively what athletes do when they raise their hands above their heads as they break the winning tape. If they were to do this repeatedly they would find that simply raising their hands above their heads would trigger those winning feelings.
• Practise anchoring every day until it comes easily to you. The more practice, the better.