Posts Tagged ‘Caregiving’

Caregiving From a Distance

Caring for loved ones from afar has its own set of concerns for long-distance caregivers. The inability to regularly assess a loved one?s needs and monitor his or her care can create emotional and even physical stress for both the older adult and their caregivers.

Often, the older adult feels as if they are a burden on their children who they recognize as having their own families and work responsibilities. As for their adult children, they frequently experience feelings of guilt, frustration, resentment and even anger. There can be the guilt of wanting to do more for their parents which conflicts with the guilt of spending so much time dealing with their parents? concerns that their own children and life partners feel neglected. There may be feelings of frustration in dealing with insurance companies and other public and private firms and agencies, facilities, home care and durable medical equipment companies, physicians and other professionals. Oftentimes caregivers are resentful that they have to spend so much time and effort caring for their aging loved ones, and they feel bitter and angry that other siblings and family members aren?t willing to share the responsibilities.

One solution to helping reduce stress on both the aging adult and his or her long distance caregivers is to consider employing a third party professional to handle the seniors? needs. When family members are not able to regularly travel in order to assess and oversee their loved ones care, these professionals are able to provide regular communication and feedback to the long distance care givers.

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Caregiving – Families Don’t Always Play Fair

In our busy world, caregiving can become a complicated task especially when multiple family members are involved. Who will take responsibility for what tasks? Often the majority of the work is delegated to the family member who has the most available time. Caregivers placed in this position feel that this is not always fair and that their brothers, sisters, or other family members take advantage of them. This resentment creeps into family relationships.

The individual with the majority of the caregiving burden burns out and their health may fail. Statistics report that caregiver stress is at an all time high resulting in physical and emotional declines. Exhausted caregivers are taken to task by family members for not doing more. Or the caregivers themselves feel guilty that they are not doing enough to care for their older adult. Many times this is a no win situation unless other family members will commit to providing support through time or money.

Signs of caregiver exhaustion can be seen in the older adult through poor general appearance or hygiene, poor nutrition, dehydration, lack of socialization or missed medical appointments. At times the primary caregiver is so exhausted that they do not notice weight loss or other changes in the older adult that may be seen by other family members who express concern. It is at this point that family disagreements may occur about the best care for the older adult. Some family members may recommend facility placement or in home care because they feel the primary caregiver is unable to provide the best care.

In this situation a compromise is usually the best course of action for the older adult and the entire family. The primary caregiver may feel unappreciated or victimized because other family members feel he or she is not providing the best care. While neither side may want to be seen as giving in it may be in the best interests of the older adult to compromise. Outside evaluations from physicians or case managers may also prove helpful in deciding on the best course of action. Many older adults would prefer to remain at home if the cost of care is not prohibitive or if the care necessary does not exceed what can be provided. Many times a trained personal care provider can provide the majority of care when skilled nursing is not needed.

Families should know that there are many options available for assistance so that any one family member need not be overwhelmed. These include not only in home care, but day care, family counseling and other services.

Pamela Dombrowski-Wilson is an author and owner of In Home and Family Services, Inc. a counseling and direct care company serving older adults and their family members. Visit htp://www.inhomeandfamily.com or http://www.pameladwilson.com for more informaion
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Overpowering the Demands of Caregiving – Lessons From Madelyn

Madelyn Kubin was a Kansas farm woman who overpowered her own failing health to care for her husband after he suffered a debilitating stroke. She chronicled her experience through writing letters to her daughter. There are many lessons for all caregivers in Madelyn?s experiences. Here are three, illustrated with excerpts from the book Letters from Madelyn, Chronicles of a Caregiver:

Write a Rant

Writing about your anger, fear, and frustrations can get negative feelings out of your head. When you allow yourself to rage on paper you release intense emotional energy.

Writing this rant didn?t change Madelyn’s situation, but she was able to reposition her attitude after blowing off a little steam:

“I had reached a stage where everything about Quentin irritated me.

I hated the way he huffed and puffed when he got in bed. It didn?t start my morning off right to get out of bed and step on a very wet Depend.

I wanted to scream when he would sit and watch me put the orange juice, medication and vitamins, etc. on the table. And then when I would come with the toast, he acted like he was surprised that it was time for breakfast. It made me furious that I would have to wait and wait while he struggled to get his chair located right.

I don?t have time to remember and itemize all the other irritants, but I can tell you that everything he did aggravated me.

I do realize that the stroke has affected him in so many ways that aren?t obvious. I also know he is definitely not this way by choice and that he is not trying to irritate me.

I believe it is important ‘To do unto others as you would have them do unto you.’ That is the reason I don?t want to be cross with him. I also realize that some day I might be in even worse condition than he is. It would be awful to be struggling with every little thing and have your caretaker and others cross with you, so I’ve readjusted my attitude, and today I’m feeling a little better.

Stay Connected to Family, Friends, and Organizations

It is not uncommon for invitations to social functions to stop once a person is diagnosed with a chronic illness. As a caregiver you will need to be proactive and innovative to make sure you don?t become isolated.

In this letter Madelyn tells how she turned a regularly scheduled meeting into a party:

‘Our Fellowship Group has a carry-in luncheon once a month. I decided I would have them come to the farm this time, and I have had more fun getting ready for them. Except for being a little windy, it was a perfect morning. I sprayed the yard with Yard Guard and there wasn?t a fly or mosquito in sight. There were 24 of us.

Quentin was there and he enjoyed himself so much. He was sitting with some especially interesting people. I regret I didn?t get a picture of him with the happy expression he had on his face. It is something that triggers memories of the past, but it is very rare now. The experience is somewhat like the feeling one has playing golf ? one good shot makes a person want to go back and try for it again. I will be trying to think of things for him to do so I can see that expression again.”

Accept that Death is a Part of Life

We all know that death is inevitable, but it can be very difficult to discuss. Talking about it openly can remove some of the mystery and fear and open the door to some meaningful conversations.

Madelyn wrote:

“On the fourth anniversary of Quentin?s stroke he was terribly depressed. He was convinced he was going to die that night, and he wanted to. When we went to bed he told me he didn?t know what was going to happen in the night, but if I woke up and he was having a problem, he wanted me to try to go back to sleep and leave him alone.

He woke up alive and fairly cheerful the next morning.

I never get excited about death premonitions the way my mother did. Dad could make her jump through a hoop when he would cry and say he was dying. I made three trips to Florida one year. She would call me up crying and upset about him. Frankly, it never made much sense to me, as she had kept a nice black dress in the back of her closet to wear to his funeral since 1946.

One time when I went to Florida Dad started the crying with me and saying he was going to die. I said I thought death was one of the nicest things God had planned for us. I told him it would be terrible to think a person would have to go on forever in a body that was hurting and didn?t work right. I still feel that way. He stopped crying while I was there.

Madelyn Kubin survived her caregiving experience by taking care of herself physically, mentally, and spiritually. Although there is nothing that can make the job of caregiving easy, writing a rant, engaging in social interaction, and talking openly about death can help ease some of stress.

Elaine K. Sanchez, author of the tender, gritty, and uproariously funny book, Letters from Madelyn, Chronicles of a Caregiver speaks to audiences across the country about finding hope and humor in aging, illness, and long-term caregiving. For a free Caregiver?s Survival Guide, visit her website at http://www.LaineyPublishing.com

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Caregiving Can Be For Everyone

Don’t be surprised if you see a respectable Vice President of a certain company giving up his position to be a caregiver. Why you may ask? Well for the pay. If a local executive earns X amount of dollars, would he pass up for a job that pays him 4X his present salary? Of course not!

Further, it does not require the stressful acts that most leaders have to deal with today. Add to the fact that they get the opportunity to work abroad complete with housing. With those fortunes on the table, would you not grab it? Most probably you would and that is why most great executives are no longer around their local countries.

Some say that they only become caregivers for the curiosity of being one. They promise to come back and pick up from where they left off. Here is some news. They don’t!

Once they see what the job is all about and the corresponding pay for it, most people who become caregivers would stay on being one. It may be a dirty job for most but the pay is good.

Compensation is something that most people complain about and if you find a certain way to complain lesser, then why should you leave it? By all means people will stay on it. Financial concerns are important now rather than career paths for most.

While some may have attained their primary goal to earn the much praised dollar, some keep going back or better yet, stay in that profession since it pays more than what they earn locally. Imagine a salary that almost triples the one you get home. Why would you go back to an old job where there is insufficient salaries?

Some would not understand what makes caregivers much importance. Outside of the job, it is the compensation that really sticks them to it. It may not be decent for most, but in these days, being decent does not help put food on the table

Most caregivers come from the Philippines. Some may not classify these jobs as blue collar jobs but the fact remains, you have to provide financially to be able to help your family today. Much of this is inclined with the finances that need to be addressed. Ideally this would be a bad way to look at it but considering the times, some people are left with no choice.

Caregiving can be rendered by anyone. Whether you have finished college or not, it is how your personality fits in to the job. With an open mind, anyone can really be a caregiver if you look at it.

We can see some groups offering special courses on how they can be professional caregivers and understand the whole essence of being one. Apparently, what people tend to forget is that you cannot teach caregiving. You can only orient them and that is about it.

It is not something that you have to learn. If you are a parent or have some that are still living, you can just observe how they take care of children or your older relatives. Some would call them minor but they are part of caregiving. Add some professional assistance to be given and you will notice that you caregiving is really nothing out of the ordinary.

Jon Caldwell is a professional content manager. Much of his articles can be found at http://allaboutcaregiver.com
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Senior Caregiving Jobs

In just the last ten years, an entire industry has developed to offer professionally managed in-home care services for seniors.

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Tips On Caregiving To Someone You Love

Caring for a parent or a loved one is a difficult job. Your duties as a caregiver become increasingly difficult as the miles increase between you and your loved one. The following are a few helpful tips in order to plan ahead in the event your loved one needs your help, as well as ideas on how to become a successful caregiver once your caregiving duties begin.

1. Have a discussion with your loved one. Years before the need for caregiving arises, discuss ideas and thoughts with your loved one. Discuss with them their thoughts on possibilities of relocation, assisted living or nursing home care, and end of life arrangements. Make sure all of their legal and financial needs have been met. Talking with your loved one ahead of time will make them more comfortable with the idea of needing help down the road.

2. Design a “Family Plan of Action”. Before the need arises, get the family together and discuss responsibilities and divide them up accordingly. Devise a plan to keep in contact with those members who may be out of state by frequent phone calls, emails or set up a private chat room on the internet for family discussions. Investigate costs for care and travel expenses. Design contingency plans in the event that funds run out, level of care increases, and availability of family is limited.

3. Gather emergency contact information. Make a list of important emergency numbers such as out of town family members, family friends, physicians, attorneys, clergy, etc. To help preserve this list in the event of an emergency, place this list in a zip lock bag and store it in your loved one’s freezer where they keep their ice cubes. Place a magnet on their refrigerator with a note as to the location of this list.

4. Gather important documents. Locate important documents such as social security card, Medicare and/or health insurance cards, legal documents such as living trusts, wills, and powers of attorney, all financial statements including life insurance information and real estate deeds. Inform the family regarding the location of these documents. Keep copies of powers of attorney in the event you need to make health care or financial decisions from a distance.

5. Organize and set up a network. Contact relatives, friends and neighbors who live close by your loved one. Ask them to routinely stop by and visit your loved one, and ask them to contact you if they observe anything out of the ordinary. Find out about community programs that provide services such as meals or transportation, and get them involved. Consider hiring a geriatric care manager to help coordinate the care.

6. Make the most of your visits. Schedule and attend physician appointments with your loved one when you are in town, and keep yourself informed with your loved one’s diagnosis. Meet with members of your network, and ask them detailed questions about their interaction with your loved one.

7. Keep a journal. Take detailed notes of your loved one’s care such as their progress, medications, changes in level of care, recent injuries, personality changes, etc. A journal will help keep the family organized, as well as provide helpful information for the physician or other caregivers who might be involved in your loved one’s care.

8. Be observant. Be aware of changes in your loved one’s personality, their appearance such as lack of grooming or soiled clothing. Verify that the mail is being opened and the bills are being paid. Set up a consistent schedule for communicating with your loved one, and pay attention to what they’re “not” saying. Remember, your loved one doesn’t want to give up their independence, and they may not always tell you the truth.

9. Re-evaluate the situation. Assess your loved one’s situation and don’t be afraid to make adjustments as the circumstances change. Don’t hesitate asking for help from other family members, and investigate the potential for placement in a care facility or hiring a full time live-in caregiver if the family and physician deems necessary.

10. Care for the caregiver. Don’t allow yourself to get to the point that you experience burn-out. Get help from other family members, as well as take time for yourself. Maintain a healthy diet and exercise daily. When caregiving becomes too much for the family, and the level of care is beyond your immediate resources, seek out other options. Don’t let your guilt get in the way of providing the best care for your loved one, even if a care facility or full time caregiver must provide that care instead of you.

Above all, remember to allow your loved one to remain involved in the decision making process for as long as their decisions do not negatively impact their health or safety. Remember to discuss your concerns with their care in a sensitive manner. Your loved one deserves to be treated with dignity and respect. Be realistic about the situation, and in addition to looking out for your loved one’s care, remember to look out for your own as well.

Find tips about ear popping, flea bites on humans and other information at the Health And Nutrition Tips website.

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Over 30 million Baby Boomers provide countless hours of assistance to elderly parents at no charge. It is estimated that, using average hourly wages, the total amount of this uncompensated care is comparable to the entire Medicare budget. For the estimated 7 million Boomers who provide long distance care, actual out of pocket expenses amount to almost $5,000 per month. For caregivers who have, or are considering leaving the workforce to care for an ailing parent, the costs are even greater – over $650,000 in forfeited salaries, benefits and pensions.


This stark economic reality shows only one dimension of the price caregivers pay for this act of love.


Caregivers pay with losses that extend well beyond their bank accounts. They often forego the activities that bring joy and richness to their lives, like meeting friends for dinner, or going out to the movies or taking family vacations. They pay with their time, the loss of professional opportunities and the erosion of personal relationships that result in isolation.


Sometimes, otherwise healthy loved ones need a short dose of care as they recover from an acute medical episode like a broken leg. Usually loved ones are on a path of steady decline with cascading assistance needs. Some caregivers sacrifice large chunks of their own lives as they help their parents and other family members and friends peacefully make their transitions. Caregivers can pay with their own health and well-being. In fact, we have evidence that some caregivers pay for their acts of care with their very lives.


You can decrease the personal and economic costs of caregiving. This means proactive planning rather than reactive responding. Planning saves money. You know this as you reflect upon your experiences of going to the grocery store with and without a shopping list. Planning also minimizes personal wear and tear and decreases stress. You will feel much better when you know your options and develop back-up plans before you jump into a challenging project.


5 Tips to Decrease the Cost of Caregiving:


1. Begin the conversation today. We have tremendous cultural resistance to the recognition of aging, disability and death. Just as the first few steps uphill are the hardest, so, too, you may meet the greatest resistance simply starting the conversation about their possible need for care. Say today, “Mom and Dad, it would be great if you lived forever, but the discovery for the fountain of youth is nowhere on the horizon. What thoughts and plans do you have about enjoying your golden years?”


2. Create a plan. Talk with your parents about their ideal plan if they are no longer able to care for themselves. Then, start to work toward that proactively. Investigate long-term care insurance. Draw up the appropriate legal documents. Find out who would make medical choices if they were not able to make them on their own, along with some guiding principles for the choices. You can anticipate and limit parental resistance by saying, “Mom and Dad, I just got back from the lawyer’s office signing my will and durable medical power of attorney. I’ve asked Mitch to make my medical choices if I cannot make them myself. Just so you know, if I were in vegetative state, I wouldn’t want to be maintained on a machine. You probably already planned ahead too, right?”


3. Use personal and community resources. Make caregiving a family job to which each member contributes. Even children can make grandma’s life special with drawings and phone calls. Identify services that make your job as a caregiver easier. If you and your parents live in the same community, check with friends and neighbors and local organizations to learn about services and resources that will make your job easier. You say, “Mom has just moved in with us, and she wants to ?find a card game with the girls.’ Do you know of any senior centers that have social events? How about transportation?”


We’re a mobile society and millions of caregivers live more than an hour away from their parents. Executive William Gillis learned from his own personal experience how challenging it is to identify community resources from afar. As he was carving the path that ultimately led his on-line portfolio management service, he became the caregiver for his father. Talk about mixed emotions! Professionally, he was introducing a service that let millions manage their investments with one click of a computer mouse. Personally, he was investing untold hours just to find one bit of information to help his dad.”


As with so many innovators, he used his personal and professional experience to launch Parent Care (www.parents-care.com), a service that he wished would have made his life as a caregiver-at-a-distance easier.


4. Gather cost-savings tips. This might mean something as simple as ordering generic medication or regularly inquiring about senior discounts. But, most cost savings opportunities aren’t as obvious. Mr. Gillis found, for example, that some states will pay for phones for hearing, visually or mobility limited seniors or fund home safety improvements. He said, “We’ve invested heavily to locate time and money saving resources that most would have difficulty finding. I made it a personal mission to help other caregivers avoid some of the costs and frustration I encountered.” You don’t have to re-invent the wheel. Tap into the resources others have collected.


5. Take care of yourself. You will be able to provide the best care as a caregiver when you’re at your best. Get good nutrition, enough sleep and regular exercise. Manage your stress and do a little something every day to nurture your soul. Understand that you are at increased risk for anxiety, depression, and weakening your immune system. Talk to your doctor if you see worrisome signs such as problems sleeping, changes in appetite or loss of interest in activities you enjoy.


Despite the costs, most caregivers say that they received much more than they gave. Most say they would do it again, and many do.


Sometimes the question is not the personal cost of caregiving; it’s the value that you bring to the lives of others that matter at the end. What personal cost are you willing to pay for the privilege of helping those who welcomed you into the world to enjoy their golden years and travel the road of illness with love and dignity?

Dr. Vicki is a board-certified surgeon and Clinical Instructor at the University of Washington School of Medicine who left the operating room to help caregivers and patients take the most direct path from illness to optimal health. Want more tips about caregiving? Get your free report “Caring for the Caregiver” by emailing Dr. Vicki Rackner today at DrVicki@DrVicki.org and be sure to check out her regular column with the Johnson & Johnson Consumer Products Group’s new caregiver web site http://www.strengthforcaring.com

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