Hi, I’m Samantha Young and I started Practical Care over 9 years ago. I got to Austin as fast as I could and have lived here for over 30 years but who’s counting. I root for the University of Texas football team and spend my days keeping my young boys out of trouble. For over 20 years I have been helping people with elder-care issues. From Nursing home administration to adult day care to home care I have seen it all. For the past 10 years I have been running my own company which helps older adults stay independent and at home with dignity. I love what I do! Especially sharing information that helps families breath easier and older adults live healthier happier lives.

Follow my blog, I promise I’ll always post interesting and relevant information. And please let me know how I am doing. If you have questions or need resources let me know. If I don’t know something I can always find someone who does.

Top News interest: The weather!
Top Sports teams and interests: My kids soccer team and the University of Texas
Top Life and entertainment interests: Travel and Social Media

2010 Faith in Action Caregivers of Round Rock Water to Wine Fundraiser was a HUGE Success!

The event was held at the Water 2 Wine in Round Rock.  We surpassed our goal of $6,000 and raised over $6,400.  Thank you to everyone who attended the event and those that donated prizes for the silent auction.

This years sponsors where:

Practical Care Continuum

ResponseLINK

Central Texas EMS

Accord Home Care

A Special Thanks to our host Sharon Miller and her wonderful team at Water 2 Wine who donated 10% of their sales to the fundraiser.

Mama Lu’s provided all the tasty treats and

Miloz Jewelry brought the glitz and glamor with their hand made jewelry selection and donated 10% of their sales to the fundraiser as well.

Click on the photos below for descriptions and full images!

On April 22, 2010 I was the proud recipient of one of the Women’s Chamber of Commerce’s Texas’s Blazing Star Awards.  I am so honored to have been picked among such a group of fabulous women all across the state of Texas.  What a great Honor!

Here is the introduction as compiled by Iumi Richards-Crow, my nominator, business associate and good friend

When I first met Samantha Young she was presiding over the Women’s Chamber Growth and Innovation Council.  I observed her competence in this position and was taken by her steady professionalism and lighthearted manner.  It would take several months before I realized the breadth of her accomplishments, the hugeness of her heart, and the depth of her commitment to those she serves in her home health care business, Practical Care Continuum (PCC).  The home elder care industry has changed in the last few years, becoming more competitive as many franchises have sprung up.  Some of these franchises are being run by people who see them as little more than a financial opportunity.

On the contrary, for Samantha, home elder care is avocation. Samantha has been in this field for over 20 years. She started PCC 10 years ago and has taken it to a high level.  In her daily work, she displays compassion for the elderly who want to remain independent, and understanding for the sandwich generation of stressed caretakers.  At PCC her every action and program and policy is focused on offering solutions and support.  Because it is the right thing to do for clients, she always has licensed social workers on staff.  This, by the way, is not required, it is expensive, and it is not a common practice.  In fact, PCC is the only home care business in the greater Austin area with social workers on staff.

Samantha’s accomplishments as a business owner and administrator would be impressive enough, but she has done all of this as a single mother of two lively, happy boys. In fact she was pregnant when she started her business, and remembers going around applying for financing in a very obviously pregnant state!  In those first lean and crucial years, she often brought her sons to work.  She understands first hand the conflicts of motherhood and work, and she offers her office staff flex time.  They can bring their kids to work when needed as well.

Samantha is an innovator and if she feels her clients need something that isn’t readily available, she goes about getting it. Sometimes she creates it, sometimes she contracts to have it made, and in the case of The Ashby Memory Method, an innovative program for persons with memory problems, she went to Canada to get it.

Single mom, innovator, successful entrepreneur, community volunteer, champion of the elderly; all this would be enough to make Samantha a blazing star, but in addition, she has added another responsibility to her overflowing schedule.  Samantha has invited her elderly mother to live with her and the boys, not an easy task, and not one that would be taken on by a majority of people.  In order to make this possible, she even had to remodel her home!

Recently Samantha told me that one night she had the boys settled in for bed  and was looking forward to a little time for herself when she heard the front door slam.  She ran downstairs just in time to see her mother going down the front walk in her robe and slippers. Upon catching up with her, she found out her mother was going out for the newspaper!  It was only when Samantha promised that she herself would get the paper that her mother was convinced to go back into the house.  So Samantha got dressed and ran to the store, giving up that short, precious time  to herself. And yet she takes it all in stride.

When asked what she would consider one of her greatest accomplishments, Samantha answered without hesitation, “My son just received 2^nd place in the Regional Fair.”

I admire Samantha.  In my book she is already a blazing star.  I would like to see her get the recognition she deserves.

Parenting your parent(s) can be one of the hardest things to do.  Planning ahead is very important and necessary as a proactive approach to caring for aging parents.  Most children do not want to think about what happens when your parents age but when you look at the fact that 80 to 90% of all chronically ill older adults will need care at one time or another, you can’t ignore the statistics.  To make your job, or as we call it labor of love, easier you should ask your parents questions about their financial and medical status before a crisis occurs.

You never know when they may suddenly become ill and you are the one that has to provide information to a doctor or other health care professional.  While these questions are not easy to ask now, it won’t be any easier months or years from now.  I had to learn this piece of advice the hard way when I had to suddenly care for my ailing father.  It is far easier to talk to parents when they are healthy than when they’re incapacitated or hospitalized.  The object of these conversations is to get the information you need so that you can determine what kind of help your parents may need or wish.  Since their needs will change, you may have to have this conversation more than once or twice.

In addition to finding out about what they can do and what they need help with, you’ll want to understand what they want out of life, what their biggest concerns are, and what they cherish most.

Some general tips to use when talking with a parent are:

• Talk when you won’t be interrupted and when you are both relaxed.

• Don’t tackle everything in one conversation.

• Ask open ended questions such as “When you think about your future, what are you most concerned about” instead of “What about going to a nursing home”, something nobody wants to do.

• Do not be judgmental.  Your parents are competent adults.

• Don’t pepper them with questions.  Finding ways to have a conversation about the future rather than answering a quiz will cause less anger and stress.

• Involve others if it will help.  There are people out there who help manage later life decisions and issues for families.  In some cases, it’s easier to talk about these matters with an outsider than with a family member.  Call your local Area Agency on Aging, attorney, or doctor for assistance.

• Be open and clear about the facts.  Don’t whitewash problems.  Be straightforward about factual medical prognoses, for example.

• Actively listen to their concerns, don’t just convey your own.

26 QUESTIONS TO CONSIDER

1. Do you know the names and phone numbers of their doctors?
2. Do you know these physicians personally?
3. Are your parents enrolled in an HMO?  What do you know about their coverage and the quality of their HMO?
4. Are they covered by Medicare? Do they have supplemental insurance?
5. Do your parents’ have a lawyer? An Accountant? A financial planner? Do you know any of these people personally?
6. Do your parents have a will? (70% of Americans don’t) Do you know where it is kept?
7. Do you have health care power of attorney?  Do you have power of attorney?
8. How familiar are you with the “continuum of care”.  Do you know the difference between a retirement community (Sun City), an assisted living, a nursing home, skilled nursing facility, rehab, Alzheimer’s units, hospice care and home care services such as homemaker, personal attendant care, and skilled home health agencies.
9. Do you know how your parents feel about the possibility of leaving their home?
10. How much do you know about your parent’s finances?
11. Do you know what level of care they can afford?
12. Do you have other family members who might help serve as caregivers?
13. How honestly – and how recently – have you talked with your siblings and other family members about how you plan to care for your parents?
14. Is the family in agreement on what should be done?
15. Do you know who will be the primary caregiver or if it will be a shared responsibility?
16. If you will be the primary caregiver, how do you feel about that?  Are you willing to take on the responsibility?
17. How do your spouse and children feel about your commitment to your parents?
18. What is your current relationship with your parents?  Is it open and honest or are there a number of unresolved issues?
19. What can you do to resolve or ameliorate those issues?
20. Do your parents live nearby or will caring for them require a move?
21. Will they be moving near you or will you be moving near them?
22. How does your immediate family feel about either of those choices?
23. How candidly have you talked to your parents about their future?
24. Is there an “elephant” in your living room?  Are there on-going issues that have not been discussed such as alcoholism, prescription drug abuse, dangerous driving, memory loss, inadequate diet or self-imposed isolation?  Do you have the courage to discuss these issues?
25. Do your parents want extraordinary measures taken in case of medical emergency?  Do they have a living will?  Do they want to be organ donors?
26. Do you know what kind of funeral service they want, if any?  Do they want their service in a funeral home or a church?  Would they prefer an open casket or closed?  Do they want to be cremated?  Do you know a reputable funeral home?

I just finished reading Dr. Barry Jacobs’ book “The Emotional Survival Guide for Caregivers; looking after yourself and your family while helping an aging parent” and found it to be very insightful. It was easy to read which means I could put it down and come back to it without getting lost or having to backtrack. I loved the way the book followed a caregiver and the family through the whole caregiving process and pointed out issues that could occur, or did occur in this case, and then gave suggestions for everyone on both sides of the issue. The suggestions where very pragmatic and I believe helpful to any caregiving situation.

Here’s are a few excerpt I especially liked:
page 62 “Or, as I’ve heard many primary caregivers put it over the years, “No one else knows how to take care of our sick family member as well as I do since I’m the one with her all the time.” But as a long-term plan, concentrating the caregiving in few hands courts disaster. If you do the vast majority of the work, you’ll likely suffer the brunt of the cumulative physical and emotional toll that caregiving usually causes over months and years. If you give up the pursuits of your own life, you probably will grow gradually more resentful of the family members who still have the luxury of pursuing theirs. The danger is, without consistent logistical support, you’ll burn out and then not be able to take care of your ill relative well at all”

page 63 “Information, empathy, and hands-on help are the kinds of support that could bolster you to handle any caregiving situation. But there’s one proviso: You have to be willing to use the available supports. That brings us to the third common problem of many family members caring for loved ones. They don’t take full advantage of the help they’re offered. They say things like “God only give you as much to carry a you can bear” and then tell other family members they don’t need assistance.

Page 70 has several ideas for family members to use to encourage the primary caregiver to accept help. They include gently persuasion, recruiting the doctor, giving permission, asking instead of telling, and enlisting the help of the person receiving care.

The book is a great read for families who are working through the caregiving process. It’s not easy and it’s always helpful to have your thoughts validated. Whether you get validation through a book or in a support group it’s always helpful.  I get frustrated with my mother often but reading through the book let me know that other folks feel the same way and it’s OK.  My mother and I have actually gotten along better since reading the book.

I highly recommend Dr. Jacobs book.  The caregiving process can be a wonderful experience but not at the expense of your own health.  I personally try really hard to keep up with my kids and care for my mother.  She deserves to be well cared for but I need to keep up my relationships with my kids and other family members so that when I get old and need help they will be there for me.  Plus I don’t want the stress to kill me before my grand kids arrive.

In January of 2010 the American College of Physicians (ACP) published a position paper which recognized the pivotal role family caregivers play in the health and welfare of millions of those with chronic illness such as Alzheimer’s.

The National Family Caregivers Association posted the main points and recommendations in their Spring 2010 newsletter  of TAKE CARE!  They are:

“The physician should strive to ensure that the patient, family caregiver and other family members
have a common, accurate understanding of the patient’s condition and prognosis”

“Physicians should routinely validate the family caregiver’s role and be sensitive to specific
commitments the caregiver may have made regarding how her or she will manage the patient’s care.”

“Physicians should develop care plans that are patient-specific and caregiver-specific and provide
information, training and referrals to support those plans.”

“The physician should be alert for signs of distress in the family caregiver and suggest
appropriate referrals.”

“Physicians should recognize that geographically distant caregivers may face unique challenges.”

“The physician should define a palliative care plan that focuses on maximizing patient
and caregiver quality of life.”

Wow is this exciting or what! Family caregivers can be a huge asset for doctors and hospitals who see their patients returning to their offices or hospitals for issues that could have been prevented with a little thought and effort.  We just need to give these family members a little bit of help and understanding to get huge results.

Because I am in the  elder care business I  know what and how to get services for my mother but what do all those millions of caregivers who are totally unprepared do?  I will say that I take charge in my own life and health and have never had a problem talking to or getting what I need from a doctor and if I don’t I keep looking for one that will help.  Most stressed out caregivers won’t.  They don’t have the strength or will to do what it takes to get answers and many of these caregivers are usually elderly women caring for even older husbands.  They need their children or someone they trust to step in a say “hey what does that mean and how will this affect everyone concerned?”

What has been your experience with doctors?  Have you as a family member been treated badly or have you had great experiences with your doctor and his office?

If you are interested in getting a list of resources that where published online at the ACP website Click Here

I struggle everyday with my mothers depression which she has had all her life.  Most of the time she is upbeat and a lot of fun to be around but there are other times when she sleeps for days at a time and just wants to stay in her room.  She says it’s because she doesn’t want to bother the rest of the family but I think she’s hiding out. 

A lot of things I have to deal with at work have similarities with the issues I have at home.  My mothers depression is one of those.  It relates directly to my employees morale of late.  I only just realized the correlation while developing a new employee performance appraisal system.  I, like most people, used to hate doing annual reviews.  They were uncomfortable and to my way of thinking had no real purpose.  But after doing some research and getting some pointers from my TAB Board facilitator I have come to realize that they are powerful tools for myself and the employees.  They now have a sense of purpose!  We evaluated their work performance but more than that we set goals and I had fun setting them.  I can’t wait to see my employees develop there goals and after just a few days I have noticed a huge jump in employee morale!  The future looks very bright for Practical Care now that it’s employees are working on not just in the company.  They have purpose.

My mothers depression, I believe, has the same characteristics of an employee with low morale.  What is her purpose?  At this point she is just hanging out with me waiting to die.  She doesn’t go to work or volunteer, most of her friends have already passed away and the few she does have all live out of town.  Her health also prohibits her from getting out and that includes her depression which just makes it that much harder to get the get up and go to go anywhere.  She can’t drive anymore, well she can but we sold her car, so she couldn’t if she wanted too.  Although she has threatened to rent a car.  Sigh! 

Just as I sat down with my employees I am going to sit down with my mother and set goals for her.  Some of the goals I’d love to see for her are:  Goal #1  Plan and cook a meal for the family once a week, including grocery shopping with the help of her caregiver.  A stretch goal would be to plan and cook two meals a week.  Goal #2  Set up her sewing machine and make clothes for the kids or fix their torn jeans or hem my work pants.  Wow this would be great for me.  Too come home to a meal already planned and cooked,  to have mended clothes without waiting months whereas before I would wait until I had a healthy pile to take to the cleaners for cleaning and repair.  This is sounding more and more like it benefits me more than her but I know that’s not the case.  She will have a purpose in life and not one that includes waiting to die!

Have any of you come across this issue with your parents?  What have you done to help them?

A recent New York Times article, A Graying Population, a Graying Work Force, talks about older workers comprising at least 30% of the elder care workforce by 2018.

At least 20% of Practical Care’s current employees are over the age of 55 and we hope to add more as our new homemaker program grows. In the past we have concentrated on caring for folks who need heavier care such as assistance with personal care but due to recent requests we are restarting our homemaker program to help those who just need a little bit of help to remain independent. This is the perfect job for a retiree as the hours are flexible and short.

And I can tell you from past experience that caregivers over 55 tend to have better work ethics. Not that I all my caregivers aren’t brilliant in their own way, older workers just seem to have more sympathy for elders. They go to work even on days when their joints hurt and they seem to develop friendships with their clients faster.

There are exceptions from the clients mentioned in the article though! My mother loves her younger caregiver. They talk about kids and school and life. The challenge of being a mother doesn’t change all that much over the years and my mother had lots of experience after having seven kids. I have thought of cutting back the caregivers hours but my mother looks forward to her visits so much that I don’t have the heart to cut her off from someone who has become a friend.

The are pluses and minuses to every generation but all elder caregivers tend to be caring and dedicated individuals who always work hard to help their clients remain independent and motivate them to find meaning in life.

Hello my name is Samantha and my 82 year old mother is addicted to pain killers! As I write this I imagine myself in a room full of  caregivers who are going around the room saying the same thing. I know I’m not the only family caregiver out there that has had to handle this issue.

It’s just one of the many issues I’ve had to deal with since my mother moved in with us in February. She tells me she is not addicted and that she knows they are bad but hides them in her room, searches my house for where I hid the rest and tries to get more than one doctor to write her prescriptions for her drug of choice.

Oh and now since I have taken control of those drugs she has developed migraines which require another pain killer! I got so frustrated last week that I told her to handle the bottles herself. Childish I know but dang it I’m tired of being her drug pusher. Well you can guess what happened, she took 6 migraine pills in an 8 hour period. That brought me back to my senses and I have taken those away from her as well. She now has to ask for them, which humiliates her, but I’ll be damned if I’ll let her “accidentally” kill herself.

The really frustrating part of this whole issue, other than having to police my mother, is the reaction of the medical community and her peers.    Every doctor I have talked too about this gives me the same line “She’s 82 let her take whatever she wants”. BULL! I won’t accept that. She has people that love her and her health such as it is. Would they have said the same thing to someone in their 20’s or 30’s. I sure as heck hope not. People are living quality lives into their 90’s now and there’s no reason why she shouldn’t.

I do think she has seen the light somewhat though due to her 11 year old grandson, Michael. He loves spending time with her. She has the most amazing long term memory and the funniest stories to tell. She remembers all of my fathers stories about WWII and Vietnam and loves to talk about her 7 children. Michael is constantly begging for war stories about his grandfather and has now insisted we work on her genealogy on www.ancestory.com. The other day he came to her and asked very quietly if she would come with us to a WWII war reenactment that a nearby Army Base was putting on. She told him not this time as she was too tired. She told me he looked at her with sad eyes and pleaded with her to come. He really wanted her to spend time with us. Ever since then she has been a more engaged person.

While she is still on enough pain meds to kill a horse she isn’t taking the migraine pills (although the caregiver secretly substituted some of them for aspirin). We are all looking forward to wild stories of the 40s and spending more time with our family.  My mother isn’t perfect but she’s the only one I have and I selfishly want to keep her around for as long as possible.

Wouldn’t that be lovely!  Someone you could call to help out on a moments notice.  You could call them to ask “Can you run over and drop off books for my mother”?  or “Can you run to the drug store for candy this afternoon”?  Just helping out with the little things is HUGE.

Well I have that.  I own my own home care company, Practical Care Continuum,  and I have a wonderful nanny for my kids that helps out with my mother too.  I could never be a caregiver without them and still work.  No wonder daughters are leaving the workforce to care for their parent(s).  How in the world can anyone keep down a full time job and cater to their parent(s).  I would go insane trying to keep up with her needs.

The big issues are not the problem because I can get home care help for those issues but the little things such as making sure her medications are set out properly and ordered in a timely manner consume a lot of my time.  The woman is on 12 medications umpteen times a day.  If I have a problem keeping up imagine my 82 year old frail mother keeping up with them.  Not to mention the 4 different doctors she has.  I don’t even have one (pretty typical for a caregiver to have no physician.  It’s not in our plan to get sick)

I think family members take on too much when caring for their parents and don’t think about the little things a home care company can do for them.  I have an advantage in that I own the company but even if I didn’t I would still hire one to handle the little things because my family time is precious to me.  My kids are growing up way to fast.  My 11 year old is graduating to middle school in two months and will no longer want to hang out with mom.  I want to grab all the time I can with him and running errands for my mother (much as I love her) is not my idea of family time.  So I give myself a break and ask (pay) for help.

Corny as it sounds I don’t want to be remembered for all the hard work I did when I go I want to be remembered for all the love and shared time I had with my family.

Bottom Line:  I am so lucky to have the help I do and if you don’t get your own you are missing out on life so get your own Concierge Service any way you can!

I spend a lot of money on management books each year trying to improve my leadership style but just the other day I realized that I had forgotten one of the basics.  Tell someone what a great job they did!

My week started out very hectic as usual.  Between the kids, my mother, her caregivers, and the business I really needed a Calgon moment and I got it from an email sent to me that included a testimonial from a client of mine.  It was wonderful to receive the pat on the back and the acknowledgment of all the hard work I put into my company.  That simple note made me realize that we all should give more kudos and if we do it will make us feel better which will in turn lower our stress level.

I emailed a kudos yesterday for the great service I received while ordering a pizza from CraigO’s.   I noticed that CraigO’s has gluten free pizza so I called to order for both myself and my kids who can eat anything.  The young girl who took my order was cheerful, patient and knowledgeable about her product.  You don’t find that everyday in the food service arena so I dropped a quick email to her boss about how impressed I was with her service.  They sent a note back thanking me but what I noticed was the fact that my email was forwarded on to her boss and the owner.  The whole process only took a minute, made me feel good, and hopefully put a smile on that young woman’s face. Who knows maybe that simple acknowledgment brought her to the attention of the higher ups which in turn will lead to her one day being the CEO.  A simple pat on the back can do wonders.

Which brings me to my point about caregivers.  Don’t forget to acknowledge all the hard work they do. The stress can be overwhelming but well worth it if someone says “Good Job” and Thank You for all you do.  Caregivers put up with a lot from their clients/family members/loved ones and it’s even worse for those caring for someone with dementia.  Those folks become isolated and forgotten all to often so take a moment to send a card or flowers to brighten up their day.  As an added bonus it will make you feel great too!