Saying “NO” to Caregiving


According to a study by the National Alliance for Caregiving and AARP, there are over 44 million unpaid caregivers taking care of elders or someone with disabilities. Statistics show that the majority of care is provided by a family member with the primary caregiver being the youngest unmarried daughter or the oldest son. The closer the child lives to their parent, the more likely they are to become responsible for their parent’s welfare. If there are no local family members, friends often become caregivers. The path to becoming a caregiver can be slow with the caregiver gradually taking on more and more of the responsibility of caring for a parent as they age, or it can be sudden if a parent has a health crisis or suddenly becomes incapacitated. In both cases, neither the parent nor their child realizes there is a caregiver relationship going on. The ongoing care is basically born from a desire to keep a loved one safe and to provide the best care possible.

Very often, it’s not until the caregiver starts developing “symptoms” that they realize they are fully engulfed in their role as caregiver and are in fact dealing with the stress of that role. Some of the symptoms of caregiver stress include anger, fatigue, poor sleep or health, irritability, and depression. The caregiver may feel hopeless, thinking there’s no light at the end of the tunnel and may in fact want to avoid their loved one. If you are losing yourself to the job of caregiving, it may be time to say “no”. Even though you may be overwhelmed, that’s a pretty hard thing to do. After all, you’ve come to believe that only you can do the best for your parent. In fact, that’s not true. You need to realize and accept that you can’t fix everything that is wrong and there are limits to what you can do. Becoming a martyr helps no one. Your role as a primary caregiver is critical enough that your poor health will surely put your elder at risk also. It’s important to decide what’s reasonable for you to do and to assess other aspects of your personal life and see where your role as caregiver fits in. Set boundaries for your role and get help before you reach a breaking point. Getting help doesn’t mean you’ve failed as a caregiver or left a parent to fend for themselves. It just means that something has to change so that you can continue to be useful to the one you love. Have you had to say “no” as a caregiver? Please share your thoughts below and visit us at http://www.trilliumhomecare.com

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Resistance to In-Home Care

If you’re caring for an aging parent or beloved senior, a time may come when you realistically decide that additional help from an agency is needed. The demands on your time and abilities are greater than you can meet but you still want your parent or senior to live comfortably and safely in their own home. The obvious choice is to get some help. So you make a list. How much help do they need? What kinds of services are needed and how often? After assessing your loved one’s needs, you start the selection process. You make sure the agency is reputable with trained and experienced staff. You verify that the staff has had background checks and is properly supervised. The agency develops a care plan with you and continuity of care is assured. If an employee calls in, a replacement is available and a management team member can be reached twenty four hours a day. You make your choice and start thinking about how great it would be to have a whole day to yourself. It sounds pretty good, doesn’t it?

Unfortunately, your greatest challenge may still be ahead. Often, the person needing help can be resistant if not openly hostile to the idea of getting some outside help. Your parent or loved one may not even recognize they need help or may resent what appears to be an intrusion into their private lives. For many seniors change is difficult to handle. They’ve been leading their lives in what for them has become a comfortable routine. As they age, friends pass away, the body develops all kinds of aches and pains and they can no longer keep up with what was once their younger more active lifestyle. The last thing they want to do is make more changes or adjustments to their lives by letting someone new and unfamiliar in. To them it may even suggest a certain loss of control or independence.

The most important thing you can do to deal with your loved one’s resistance to in-home care is to keep them involved in the decision making process and the conversation about their care. Ask them about their thoughts and preferences and keep your plans and explanations simple and clear. Enlist the help of family and friends and try to describe the benefits of care in a positive way. You may need to point out that outside help will also make your life easier and give you time to enjoy just being with them. Point out that the primary goal is to have them remain in their own home for as long as possible. Pick your battles. Suggest a trial run so they can see first hand the benefits of getting help. If these measures don’t work, you may need to enlist the aid of their doctor or a social worker but whatever you do, don’t give up. Have you had to deal with resistance to in-home care? Share your thoughts below and visit us at http://www.trilliumhomecare.com

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Medication Management for Seniors


If you’re caring for a parent or a senior, there will come a time when you will have to become involved in managing their medication. When the opportunity arises, check the medicine cabinet or drawer where they keep their medications. Are there any duplicate bottles of drugs with some missing while other bottles of the same medicine are full? This is a sign that medications are not being taken as prescribed but prescriptions are just being refilled. Do any bottles have a mixture of medications? This is dangerous because some medications may interact with each other before they’re even consumed. Are there any bottles of expired medications? Are there any unlabeled containers or baggies with a jelly bean assortment of drugs in them? These are all warning signs that it’s time for you to become involved in managing your loved one’s medications.

This is a particularly important issue for seniors because seniors over 65 are responsible for the purchase of 30% of all prescription drugs and over 40% of all over the counter drugs. They typically deal with multiple chronic conditions that result in taking several medications often prescribed in multiple doses. Studies have shown that between 40% and 75% of seniors fail to take their medications at the right dosage and on the prescribed schedule.

The first and most important step to take to successfully manage the medications is to make a list of every drug your senior consumes. This includes prescription drugs, over the counter medications, and any vitamins and herbal supplements. This list needs to be taken to the doctor every time the senior goes to the doctor. It needs to be reviewed by the doctor and the pharmacist for any possible interactions or side effects like dizziness or lightheadedness. Check the labels of the medication bottles. Are any of the same drugs found in several medications? For example, many over the counter medications for colds and sinus problems contain acetaminophen which is the drug in Tylenol. If your loved one uses both at the same time, they’re doubling up on medications. That can be dangerous. Check with the doctor whether a prescribed drug continues to be needed and don’t make any changes or adjustments on your own. Be sure to let the doctor know if you notice any medication affecting your senior in some new or unsafe manner.

Use the same pharmacy for all prescriptions so their computer system can check for possible drug interactions and open the bag the prescription comes in right there at the pharmacy before you go home. According to the University of Connecticut School of Pharmacy, up to 5% of filled prescriptions involve some sort of error. Make sure the name on the prescription bottle matches the name on the bag. If the pills look different from what you’re used to, talk to the pharmacist. Don’t pass up the counseling from the pharmacist. You need to be clear on how the drug should be taken, for how long it should be taken, and what side effects may be expected. If your senior has multiple medications, a divided pill box can serve to remind them of what to take and when to take it. Following these steps will help you manage your senior’s medication and make sure they get the right medications at the right time and in the right amount. Share your experiences below and visit us at http://www.trilliumhomecare.com

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Seniors and Falls

According to the Center for Disease Control (CDC), in seniors over the age of 65, falls are to be blamed most often for non-fatal injuries and hospital admissions. Even worse, two thirds of senior accidental deaths result from injuries sustained from a fall. In hard numbers, that’s almost 20,000 deaths and more than two million emergency room visits at a medical cost of over $28 billion dollars a year. Of fall related injuries, hip fractures are the most common and have the most long term effects with only a quarter of seniors who suffer a hip fracture making a full recovery. Almost half of these seniors will lose their ability to walk and 40% of them will require care in a nursing home. This is definitely a major concern for our rapidly increasing senior population that needs to be addressed.

Preventive measures can be taken once you can identify the major risk factors for falls. Medical issues such as poor vision, heart disease, arthritis, dementia, and diabetic neuropathy can cause mobility and sensory problems that can lead to falls. General inactivity on the part of the senior also leads to muscle weakness and inflexibility and increases fall risks also. Certain behaviors, such as alcohol use and interactions of medications pose a fall risk. Perhaps the most controllable risk is the senior’s environment. This includes hazards in the home and improperly sized walkers and canes.

By reducing these risk factors, falls among seniors can be significantly reduced. Several studies have show that an exercise program such as Tai Chi combined with strength training exercises increases mobility and flexibility while increasing muscle strength. Basically, moving more allows you to not only move more but also to do so with increased safety. Having medications reviewed by the senior’s doctor and pharmacist can identify possible side effects and problematic interactions. If necessary, alternative medications may be prescribed. Taking vitamin D3 supplements has been shown to reduce the risk of sustaining a fracture among women. A comprehensive vision exam can detect the presence of glaucoma, macular degeneration, and other vision issues that can increase the risk of falls. The senior’s home can be modified by adding stair railing, increasing lighting, eliminating clutter, and removing scatter rugs. Adding grab bars in the tub/shower area provide stability for getting in and out of the tub. A combination of these strategies can reduce fall risks on many levels and go a long way toward allowing a senior to remain safely at home. Please share your thoughts below and visit us at http://www.trilliumhomecare.com

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When It’s Time for Home Care

There are a lot of guides available to help you decide if someone you care about has reached the point of needing outside help. If you do a web search for “time for home care”, an incredible list of sites appears with all kinds of signs to look for in your aging parent or loved one that will signal their need for help with daily living. These clues include poor personal hygiene, difficulty managing daily living activities such as housework and grocery shopping, missed appointments, and problems taking medications as prescribed. Although these clues are certainly important when deciding if you should look to professional help for your loved one, a consideration that is often overlooked is YOU.

If you’ve been your loved one’s primary caregiver, you need to assess your own condition also. According to the Family Caregiving Alliance there are over 44 million unpaid caregivers in America and they are definitely paying a price. The effects of being a caregiver are both psychological and physical. The strain of caring for a friend or relative who is frail or elderly causes significant clinical symptoms of depression in 40%-70% of all unpaid caregivers. Take some time to think about yourself. Do you feel stressed all the time? Do you feel frustrated, angry or hopelessly drained at the end of the day? Are you no longer in control of your own life? Are you becoming more isolated and do you continue to maintain social contact with friends and relatives … when did you last have some “me time”? Are all the hours of your day filled with obligations to your job, your family, and your loved one?

How are you doing physically? The stress felt caring for someone long term has been linked to elevated blood pressure, a compromised immune system, and heart disease. Is your blood pressure up? Do you seem to catch every cold or bug that comes your way? Caregivers typically don’t have time to take care of their own health needs. Do you get regular checkups with your doctor and your dentist? Do you take the time to prepare nutritious meals for yourself or to get some exercise? Do you have insomnia or stomach complaints? Do you actually feel guilty if on some rare occasion you take the time to enjoy a former hobby or interest?

Be careful not to miss the signs of needing help, both in your loved one and most importantly in yourself. Don’t wait for a crisis to happen with the one you care for or with yourself. After all, the best way to help your loved one is to make sure you are at your best. It may be time to get some help. How did you know it was time to get professional help? Share below and vist us at http://www.trilliumhomecare.com

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Seniors and Scams

According to AARP, over 70% of the wealth in this country is controlled by seniors. That statistic alone is more than enough reason for senior citizens to be targeted by scammers. In fact, while most crime victims fall in the 18-35 year old age bracket, the victims of the scammers are disproportionately senior citizens. Scams targeting senior citizens generally spike during the summer months.

Some of the most common scams include the “grandparent” scam, the “lottery scam”, and the “utility” scam. In the grandparent scam, the con artist typically calls a senior and tricks them into providing personal information by saying something like “Hi Grandma, this is your favorite grandson”. When Grandma responds with “Hi Tony” (freely supplying a grandchild’s name) the con artist then claims to be that grandchild and lets Grandma know he needs cash for some sort of emergency while swearing Grandma to secrecy so his parents won’t find out. Scammers prey on the grandparent’s fear that their grandchild may be in trouble and needs help. In the lottery scam, the scammer informs the senior that they’ve won a foreign lottery. They then request money to be wired to cover taxes and fees. In addition, the scammer may ask for banking information in order to supposedly direct deposit the winnings. Foreign lotteries are illegal and this scam steals a person’s identity and allows access to personal finances. According to the Better Business Bureau, over $100 million dollars is scammed from unsuspecting “winners” on a yearly basis. In the utility scam, a caller pretends to be from one of the local utility companies and claim there’s a past due amount. They demand immediate payment to prevent a service shut off and require the payment be made through a Western Union MoneyGram. These scams and others like them have cost senior citizens over 2.9 billion dollars a year. This figure will certainly rise as more an more baby boomers reach their senior years and the pool of available victims grows.

The best defense against scammers is knowledge. With that in mind, the Better Business Bureau will now be producing a series of videos with reenactments of scams that target seniors. The videos will include alerts and information on how to recognize the signs of a particular scam. The first video reenacts the “lottery” scam and can be viewed on BBB’s Facebook page at Facebook.com/bbb1936. When it comes to senior scams, knowledge definitely is power. Please share your thoughts below and visit us at http://www.trilliumhomecare.com

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Risky Senior Driving

In our culture, getting your driver’s license at 16 is a rite of passage that most teens look forward to. It’s a symbol of independence and represents the freedom to go places and do things. It becomes a major key to social activities, shopping, and even getting a job. This is true throughout our entire adult lives and especially true for aging seniors. That’s why seniors are so reluctant to give up their car keys, even if they suspect they should.

Although there is no specific age at which seniors need to stop driving, statistics by the Hartford Insurance Corporation show that in seniors over the age of 75 there’s a much greater risk of being in a car accident with every mile driven. The risk is about the same as for new drivers between the ages of 16 and 24. This increase in accidents is due primarily to the aging drivers’ decrease in senses, multiple chronic health conditions, and increased medication consumption. There are warning signs to look for that will let you know your loved one needs to give up the keys or to at least decrease the amount of driving they do. It’s a good idea to take a ride with them and see for yourself how they’re doing. Do they drift into other lanes or straddle two lanes? Do they drive particularly slowly or unduly fast for the road conditions? Do they fail to use their turn signal or do they leave it on without changing lanes? Do they ignore or miss traffic signs or traffic signals? Do they make sudden lane changes? Does your senior get disoriented easily, even when in familiar places? Have there been any “warnings” by the police? Are there any unexplained dents or scrapes on the car?

If you see any of these warning signs, it’s time to have that dreaded conversation about giving up the keys or at the very least minimize the amount of driving your senior does. Until that time when your loved one gives up their keys there are things they can do to help minimize the risks. Encourage them to limit their driving time to the daytime and not during rush hours. Get them to drive only during good weather and optimal road conditions. Make the trips short and use the most direct but safe routes. Keep the radio turned off and minimize the number of passengers in order to reduce distractions. Basically, apply the same strategies with your senior driver that you would apply to a novice teenaged driver. It’s also a good idea to have the pharmacist review your senior’s medications to determine if they can affect their driving. Making these gradual changes may allow your senior to ease into giving up driving. Surrendering the car keys is a major life change. It makes good sense to reduce the risks well before a major crisis mandates an immediate change. Please share your thoughts and experiences below. Visit us at www.trilliumhomecare.com

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The Road To Caregiving

According to the US Department of Labor, over half of America’s workforce is involved in some way with caring for an aging parent or relative. Up to eighty percent of this help is unpaid and according to AARP, the average caregiver provides personal care and does household maintenance chores for at least twelve hours per week. The road to becoming a caregiver for a loved one is often winding with a son or daughter occasionally “helping out”. Your parents slowly age and adaptations are made to accommodate gradual changes in their abilities. Perhaps you offer to help with their banking or write out the bills. If they need groceries you offer to drive them to the store or pick up a few things for them yourself. Maybe you go to the doctor with them to make sure they clearly understand what the doctor has to say. At this point, you don’t view yourself as a “caregiver”. You’re just being a helpful child.

As time goes by and your “helping out” becomes a necessity, it will dawn on you that you are in fact a caregiver. You realize one day that if you stop doing all those helpful things, your loved one won’t be able to function on their own. You now feel obligated to do all these things or to make arrangements so that they do get done. Your loved one’s daily functioning is now your personal responsibility. Welcome to the world of caregiving. You will soon realize what a demanding job this is particularly because you’ll also be juggling a job, family, and personal issues of your own. If your parent or loved one suffers a medical crisis, your level of providing care will rise dramatically. Although your desire may be to tackle this job totally on your own, doing that will surely result in stress, exhaustion, and even physical illness. No matter how much you love someone, where will you find all the hours in the day that you and your loved one need? Be careful not to allow yourself to reach the point of total exhaustion. If you use up all your time and energy to be a caregiver, you will no doubt be robbing you and your loved one of quality time that could otherwise be spent with each other. Be aware there will come a time when it makes sense to get some help. Be wary of taking on so much that you lose sight of your well meant goal of providing the best of care which your loved one both needs and deserves. The road to caregiving is long and full of potholes. Don’t let yourself get run over. Please share your thoughts and experiences below. Visit us at http://www.trilliumhomecare.com

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The Caregiver at the Doctor Visit

According to the Census Bureau, there are over 43.1 million persons in the United States that are 65 years of age or older. The elderly population is expected to double to 80 million when all the “baby boomers” have reached their elderly years. Due to advances in medical science these baby boomers will be living longer and that translates into huge numbers of people living with chronic conditions like arthritis, diabetes, osteoporosis, or dementia. A large population of chronically ill older people means that more and more seniors will be dependant on others for help with their activities of daily living – in short, they’ll have a caregiver whether it’s a family member or a professional from an agency.

Caregivers are now and will increasingly in the future be an important component of doctor visits for the elderly. According to a study by Jennifer Wolff, PhD of the Johns Hopkins Bloomberg School of Public Health, doctor visits that include caregivers are an increasing trend that has important benefits. Her study showed that visits that included a caregiver lasted at least 20% longer and resulted in less social conversation between the doctor and the senior and more biomedical information being given to the patient. This is really important because a trip to the doctor is all about communication and the exchange of information. Doctors need information from patients to provide an accurate diagnosis and to provide treatment options. The patient needs to be able to clearly discuss and understand what’s going on. This is where the caregiver’s presence can be very valuable.
A caregiver can help the senior with every aspect of the visit beginning with getting ready for the visit by gathering all the necessary medical history information and making a list of current medications and by preparing a list of symptoms for the doctor along with any questions the senior may have. During the visit, the caregiver can make notes for the senior and can remind them of any symptoms they may have forgotten and can relate to the doctor any changes in the senior’s general health and abilities. In effect, the caregiver is a second set of eyes and ears and can request further clarification about the diagnosis, treatment options, and what can be expected down the line. After the visit, a caregiver can support the senior’s compliance with the doctor’s instructions by encouraging them to follow the prescribed course of treatment along with taking their medications as prescribed and by helping them further understand the doctor’s instructions if necessary. This in turn can help reduce possible hospital readmissions.

According to the study by Dr. Wolff, seniors and loved ones who have been accompanied by a caregiver to a doctor ended up being more satisfied with their overall care and were shown to be more likely to remember important information after their visit to the doctor. Please share your thoughts and experiences below and visit us at http://www.trilliumhomecare.com

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Preventing Dehydration

It’s been slow coming but summer has finally arrived. It won’t be long before we start hearing TV and radio announcements about municipal “cooling centers” being opened. These announcements point to the importance of staying hydrated, particularly in the summer. This is especially critical for the elderly and the frail. Dehydration can quickly lead to heat exhaustion or heat stroke for this group. Older people are at a greater risk of dehydration for several reasons. While a younger person’s body naturally cools itself through the production of perspiration, this mechanism may not work as well in a senior due to natural aging changes and the assortment of medications they may be taking for a variety of chronic conditions. These medications include antihistamines, antidepressants, motion sickness medication, anti asthma drugs, diuretics which are often prescribed for hypertension, and some heart medications. In addition, as we get older our kidneys are less efficient at conserving water and unlike camels, we can’t store it. By the time your aging loved one’s body sends them the “I’m thirsty” signal, they may be well on the way to being dehydrated. Seniors who have dementia may simply forget to drink and those who suffer from neurological disorders may have difficulty swallowing. Those who are frail need assistance to drink. Any combination of these factors can lead to dehydration.

According to the CDC (Center for Disease Control), there are signs of dehydration to look for: dizziness, confusion, constipation, increased fatigue, increased body temperature, dry mouth, reduced sweating, sunken eyes, and low blood pressure. As a caregiver, taking extra measures to keep your loved one hydrated requires vigilance but in this case, an ounce of prevention is definitely worth a pound of cure. Be sure to offer fluids on a regular basis, at least every couple of hours. Although plain, clear water is the best choice, any liquid is better than none so offer your loved one their preferred beverage frequently. Be sure to serve beverages with meals and encourage more than a sip of water to wash down medications. Try serving foods that are naturally “wet” such as soups, yogurt, ice cream, and smoothies. Encourage your loved one to drink small quantities frequently rather than a lot at one time. A frail senior needs at least 6 cups of fluids per day but consult their doctor if they take diuretics, have kidney disease, or have congestive heart failure. How do you make sure your senior gets enough fluids? Please share your thoughts and experiences below. Visit us at http://www.trilliumhomecare.com

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