Archive for the ‘Caregiver Stress’ Category

Spring Cleaning….Your Files
Amy Praskac, Professional Organizer, On the Record
Do you have papers piled high on your bookshelves, crammed in your desk drawers, and squashed in your file cabinet? Wouldn’t it be nice to let some fresh air into those spaces?

Spring is an ideal time to clean out your files. You’re already dealing with paperwork to file your tax return. Just keep going. Here are a few guidelines to help you decide what to keep and what you can let go.

Keep monthly or quarterly statements until you receive the year-end statement. Verify the year-end statement is correct and then shred earlier statements. This also applies to paystubs.

Keep tax-related documents for three years. The IRS has three years to audit your return. There are exceptions such as failure to report income and filing a fraudulent return. You need to retain property records that document the basis for computing gain or loss until three years after you dispose of the property and file a tax return on that income (or loss). See IRS Publication 552 for details (Rev. January 2011).

Keep warranties until they expire or you no longer own the appliance. Keep manuals for as long as you own the appliance. This may seem obvious, but when is the last time you purged your file? Many people get rid of the appliance, but forget to get rid of the warranty and manual.

Keep important documents in a safe deposit box. Important documents include birth certificates, marriage certificates, divorce papers, automobile titles, property deeds, military discharge papers, and partnership papers. Keep a list of documents and photocopies at home in case you need the information. It is vital that the safe deposit box be titled in more than one name so that you have access.

Safe disposal of documents: Shred any documents that have your personal information. This is to protect yourself against identity theft. Use a cross-cut shredder for maximum safety. Remember to oil the shredder monthly.

Neglect, financial exploitation and healthcare fraud are important issues that family members of frail seniors should keep an eye on. Seniors may exhibit signs and symptoms of these problems in the same way they would with other types of abuse.

Neglect is a passive form of abuse, wherein the perpetrator fails to provide adequate care to meet the victim’s needs, resulting in harmful or potentially harmful situations. Some signs that an elderly loved one may be experiencing neglect include:
 Unusual weight loss, malnutrition, or dehydration
 Untreated physical problems
 Unsanitary living conditions
 Being left dirty or unbathed
 Unsuitable clothing for the weather
 Unsafe living conditions (ex. no heat or running water, fire hazards, etc.)
 Desertion of the senior in a public place

Financial Exploitation is the improper use of an elder’s funds or assets. This type of abuse may go unnoticed by seniors who do not manage their own funds, so it is extremely important for family members to look out for the following warning signs:
Significant withdrawals from the senior’s accounts
Sudden changes in the senior’s financial condition
Items or cash missing from the home
Suspicious changes in wills, power of attorney, titles and policies
Unpaid bills
Financial activity the senior couldn’t have done (ex. ATM withdrawals when the account holder is bedridden)
Unnecessary services, goods or subscriptions

Healthcare Fraud or Abuse occurs when individuals or institutions target elderly individuals in an attempt to sell illegitimate healthcare treatments or products. Be on the lookout for the following signs that your loved ones may be the victim of healthcare fraud or abuse:
 Multiple billings for the same medical service or device
 Evidence of over- or under-medication
 Evidence of inadequate care when bills have been paid in full
 Problems with the healthcare facility (ex. poorly trained or insufficient staff, crowding, inadequate responses to questions about care)

It is imperative that family members visit their elderly loved ones as often as possible and communicate with their care providers on a regular basis. Be vigilant and address any suspicions about elder abuse immediately. At Practical Care Continuum in Austin, we know that safety and security are primary to a good in-home care situation. Call us today at 512.380.9339 to schedule in-home care you can trust.

For more resources check out our “Monthly Survival Kit”

Studies show that humor is the best medicine for everything that ails you so I’ve decided to list a few creative signs to put a smile on your face….That I pulled from one of my favorite booklets Good Stuff. 

In a podiaterist’s office: “Time wounds all heels.”

At a proctologist’s door: “To expedite your visit please back in.”

On a plumber’s truck: “We repair what your husband fixed.”

On another plumber’s truck: “Don’t sleep with a drip. Call your plumber.”

On a church billboard: “Seven days without God makes one weak.”

At a tire shop in Milwaukee: “Invite us to your next blowout.”

On an electrician’s truck: “Let us remove your shorts.”

In a non-smoking area: “If we see smoke, we will assume you are on fire and take appropriate action.”

On a maternity room door: “Push, Push, Push.”

On a taxidermist’s window: “We really know our stuff.”

At an optometrist’s office: “If you don’t see what you’re looking for, you’ve come to the right place.”

On a fence: “Salesmen welcome! Dog food is expensive.”

At a car dealership: “The best way to get back on your feet – miss a car payment.”

In a veterinarian’s waiting room: “Be back in 5 minutes. Sit! Stay!”

In the front yard of a funeral home: “Drive carefully. We’ll wait.”

At a propane filling station: “Thank heaven for little grills.”

—Bob Haeffner
P.S. If your interested in finding out how to get ”Good Stuff” email me and I’ll give you their info. 

I have exercised all my life, but come from parents who considered breaking a sweat a waist of time.  So when I see my mother in so much pain due to back problems I think to myself (because I don’t want to push her) that it would be so helpful for her to strengthen her back and leg muscles.  She lays in bed all day either watching TV or reading and everyday she is in severe pain.  I know that if I don’t get moving everyday I get stiff and my moods aren’t the best.

Recently, while going through my Twitter account, I came across this blog post from the Alzheimer’s Reading Room, on what I see as getting things done to make you and your elders life easier and more enjoyable.   But a huge part of the article covers getting his mother to exercise even though she is mean to him on the way to the gym.  I’m thinking I need to get my own mother to the gym or have someone come to the house who can start working with her.

Has anyone starting something like this with their elderly parent?  Do you have any suggestions for a trainer or physical therapist in the Austin area?

My mom has always been a loner.  I don’t remember her being around much as I was growing up as she was always either at work or hiding in her room.  She still does those things (other than the work) while living with me.  She says she isolates herself because she doesn’t want to bother the family but it’s hard to know why she does it now when it’s been a life long pattern.

When she does emerge from her room, the kids love to visit with her and the dog absolutely adores her.  She unfortunately feeds him from her plate.  But she also pets him and lets him hide under her chair when the occasional Texas thunderstorm happens by.

Every year our family goes to Garner State Park to camp but this year we decided to visit a private camp ground called 7 bluffs.  We rented a big house so everyone, all 15 of us, could spend time together with Grandma, or Nona as she likes to be called.  Up to the last minute I thought she would change her mind but I kept encouraging her and she went.  I got her books to read and anything else that might keep her busy.  But after the first day she was ready to leave.  I think she missed her television which she leaves on 24/7 at home.  There was only one in the house and the kids had hijacked it for cartoons and tween shows.

She told one of my siblings she would never  come with us again.  She hasn’t told me that.  I guess she doesn’t want to hurt my feelings. I have to wonder though why she complains about not seeing her grandchildren more often and when she gets the opportunity to see all of them at once for 5 days she wants to high tail it out of there.  She did tell me the highlight of the trip was seeing the baby deer outside her window.  Sigh, I guess spending time with family will never be her thing.

Change is hard for anyone but especially older adults who have lived a lifetime doing things a certain way.  I shouldn’t have expected her to change her routines and become more social because I thought she would have a good time.  She knows what she likes and sticks to it.  I felt as though if I didn’t ask her to go her feelings would be hurt and she thought if she said no my feelings would be hurt.  I guess a little better communication would have been in order here but although she has  been living with me for over 6 months now I still can’t shake that mother/daughter role with every aspect of our relationship.

I think the lesson for caregivers is to find ways to socialize their parent(s) that follow their life long patterns.  Or at the very least introduce new activities in small doses.  Maybe 5 days was not such a good idea and maybe I should have brought her her own television.  I can’t help trying and I don’t think it’s right for caregivers to not try something.  Our parents did it for us when we where young and now it’s our time to change roles.

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

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!