Category Archives: Uncategorized

Caring For The Caregiver

According to a report by Emblem Health, there are close to sixty six million caregivers in the United States. That means almost one in every three people provides personal care to a loved one or family member. Typically a caregiver’s job includes helping with transportation, grocery shopping, preparing meals, helping with medication, and doing housework. Personal care often includes helping their loved one get dressed, helping with a bath or shower, or help with getting to and from the toilet. The burden of providing all this care usually falls to family members who also have jobs to go to, their own homes and families to take care of, and often their own personal health issues to deal with. The stresses of dealing with all of these responsibilities can in fact turn a caregiver into a patient in need of help. It’s important for caregivers to realize that they must care for themselves and take steps to maintain their own health and well being if they want to be effective in caring for their loved one.

The most effective things a caregiver can do to help their own well-being is first, to accept the fact that they are human and cannot fix everything and second, take a break. A caregiver is not a miracle worker and needs to be realistic about what can be accomplished. Taking a break from caregiving responsibilities relieves caregiver stress and improves the ability to provide care. A break can be something as simple as taking some time to read a book or take a walk or getting some extra scheduled down time. Scheduling down time can be a few hours off or even better, getting regularly scheduled respite care. The respite care may involve using adult day care services for your loved one or regularly scheduling a home health care aide to take care of some of the responsibilities. The bottom line is that its important that the caregiver attends to their own personal health and well being without feeling guilty about getting some much needed help. What steps have you taken to care for the caregiver? Share below and visit us at http://www.trilliumhomecare.com

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Getting Family On Board

Being a caregiver for an aging friend or relative can often be a time consuming and daunting job. At least forty two percent of family caregivers spend more than thirty hours a week providing care and seventy six percent of family caregivers say they don’t receive help from other family members. This can make an already tiring job even more stressful not to mention the natural resentment that builds when you feel your siblings are leaving you alone to handle everything. Family dynamics can often play a part in determining who the primary caregiver is. According to the National Association of Geriatric Case Managers, in 99.9% of families, only one sibling takes on the responsibilities of providing care and it’s usually based on geography….the closer you live to mom and dad, the more likely you’ll be the one filling the role of caregiver. Other factors include your work and family situations, your own finances, and your marital status. Very often the problem of getting help from uninvolved siblings can be traced to an issue with communication. Once you take on the role of caregiver, the natural progression of things results in you taking on more and more work as your loved one ages and their health declines. If you just go about your daily tasks and don’t let your siblings know of any changes in your loved one’s condition over time, your siblings may just assume everything is fine and you don’t need any help. So they don’t offer any. It’s best to have a family meeting early in your journey to caregiving….before you are burned out and resentful. It would allow you to openly discuss what the future may hold and would allow family members to identify what their contributions to caregiving would be. Different family members have different talents and different ideas of what “help” means. It would also allow siblings the chance to indicate if there are any personal issues no one is aware of that may limit how much they can help. It’s important to be specific when talking about what would be helpful to you — general pleas for help are just too vague. If you need someone to drive your loved one to appointments or help with the grocery shopping, be clear about it. Don’t assume anyone instinctively knows what needs to be done. It’s important to be honest and try to understand differing points of view while keeping lines of communication open with your siblings. If you get to the point where you aren’t communicating with each other, your loved one is the person who will end up suffering the most. If siblings remain unresponsive or unhelpful, despite your best efforts to communicate with them, consider other options for getting help. Check into getting some in-home services and arranging some respite care. If you allow yourself to get burned out, you won’t be able to help your loved one. How have you gotten siblings on board with caring for your loved one? Share 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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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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Older Adults and Medication – Part 2

As you get older or someone you care for enters their “senior” years, you have to be very careful about which medications are used. Older adults usually have several chronic medical conditions they are dealing with at any given time so that means they’re probably using a variety of drugs. The more medication you take, the greater are the odds that you can end up dealing with the effects of drug interactions. In addition, seniors are more sensitive to some drugs due to the natural changes in their bodies as they age.

Among the most commonly used and abused drugs are non-steroidal anti-inflammatory drugs (NSAIDS). Long lasting versions include Feldene and Indocin which are available by prescription while shorter acting ones include Motrin, Advil, and Aleve. Because the shorter acting NSAIDS are available over the counter, there’s a misconception that they must be totally safe but keep in mind that they’re mean for short term use only. In fact, all NSAIDS carry a risk of indigestion and ulcers and in the over 75 age group there is a possibility of bleeding in the stomach or colon especially if your senior is taking aspirin or a blood thinner like Coumadin for their heart. In addition, NSAIDS can increase your blood pressure so if you’re taking medication for hypertension which is very common in seniors and you take an NSAID for your arthritis, the medications are fighting each other.

Other medications to use with caution include muscle relaxants and over the counter allergy and cold medications. Muscle relaxants such as Flexeril and diphenhydramine , which is the active ingredient in Benadryl and over the counter sleep aids like Tylenol PM, can cause confusion and grogginess along with blurred vision. This can be particularly troublesome for seniors since it can increase the risk of falling. If your senior takes something to help them sleep and something else because their allergies are bothering them, you can see how easily they could be double-dosing without realizing it!

In light of the fact that there is an endless list of possible drug combinations you or your loved one may be taking, it’s important to keep a CURRENT list of all drugs being used, including any over-the-counter medications and herbal supplements. Take this list with you to every doctor visit and ask lots of questions. If your doctor prescribes a drug, be sure you are clear about what it’s for and how to properly take it. Ask if it will interfere with anything on your list and if any adjustments need to be made. Be sure to get all your prescriptions filled at the same pharmacy so the pharmacist can also keep track of any possible interactions. Using a pill organizer at home can help you keep track of whether you’ve taken the medication as prescribed. If you start noticing a possible side effect to a medication, don’t just stop taking it without contacting your doctor. Follow his advice and be safe. Do you have any tips for managing your senior’s medications? Share below and visit us at http://www.trilliumhomecare.com

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Give the Gift of You

It’s that time of year when we wrack our brains trying to select that perfect something to give the special people in our lives. If there is a caregiver who helps us or who cares for a family member or loved one, this is an especially difficult decision to make. What can we possibly get them that would be both meaningful and helpful? What could the caregiver in your life use the most? It seems to me that all caregivers are short of one special thing — time. There just aren’t enough hours in the day to go to work, care for one’s own family, and care for a loved one. Don’t even mention having a social life or time for simple personal interests. If you think about it, anything you can do to free up some time for the caregiver would be appreciated. You can volunteer to do some grocery shopping or you can provide some meals. Better yet, you can stay with the loved one for a while to free up some time for the caregiver to do something for themselves. Volunteer to do some household task like doing the laundry or cleaning house. If you personally don’t have time to do these things, perhaps you could arrange to pay for some of these services to be provided.

It’s important for caregivers to know they are not alone. Providing an opportunity to vent without being judged or criticized can be an invaluable gift. Caregivers often have to deal with family members who provide little help but lots of ideas on how things should be done. Just lending an ear can help relieve the constant stress they are under. In that same vein, a gift certificate for a day at a spa or for a relaxing massage while you take over the caregiver duties would allow for some much needed “me time”.

If you’re more inclined to giving tangible things as gifts, you might consider gift cards for restaurants, grocery stores, or services. Anything that would help defray the costs of living would surely be appreciated. Caregiver reference materials like books or caregiver magazine subscription can help provide tips and advice on how to ease the burden of their duties. Paying for a personal emergency reporting system for their loved one can provide some piece of mind for the caregiver when they are not there. The bottom line is, give the gift of YOU. They surely don’t need another knickknack. Do you have any other caregiver gift ideas? Share below and visit us at http://www.trilliumhomecare.com

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A Caregiver’s Holiday

Well, we’ve reached that wonderful time of year fondly known as the “holiday season”. This year it began on October 31st. I know….that was Halloween, but all the stores had their Thanksgiving and Christmas decorations up already. Of course, these will be followed by Kwanza and then New Year’s Day will mark the end of the season. If you are a caregiver, this can be a time of very mixed emotions. We all have in the back of our minds a Norman Rockwell memory of holiday seasons past. We remember huge family gatherings, laughter, a table covered with wonderful family favorite dishes, and gifts galore. There were days filled with cooking and baking, shopping for gifts, and decorating our homes. But things are different now. Now a great portion of your time is taken up with all the duties of caring for a senior or loved one. Add to that the time your job and caring for your family takes and you quickly find yourself feeling overwhelmed and resenting the holidays. The memories stirred up by holidays make us realize how much life has changed.

Perhaps the only way to get through this time is with a spirit of acceptance. Accept that life is different. There is no right way or wrong way to celebrate a holiday and every holiday season doesn’t have to be the same. Don’t let yourself become overwhelmed while you try to keep up old family traditions. Think about what’s really important to you and your family and try to just do those things. Set limits on what you’re willing to do and don’t make too many social commitments.

There are some practical things you can do to make the season run more smoothly. Simplify things. You can cut back on how much decorating you’ve traditionally done. You don’t have to spend days baking every type of cookie under the sun….there are a lot of wonderful bakeries out there and some deliver right to your door. Ask family members for help….maybe they’d like to do some of the holiday cooking or baking. Keep family gatherings at a smaller more manageable scale and suggest a potluck dinner with everyone bringing something. Most importantly, don’t neglect yourself. Do something for yourself to lower the holiday stress level. Use the resources that are out there whether you call on family and friends or enlist an in-home agency and give yourself a much needed break. After all, caregivers deserve a holiday too. As a caregiver, how have you adjusted your holidays? Share below and visit us at http://www.trilliumhomecare.com

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Is It Reversible?

As our parents or someone we care for age, we may notice some behaviors and symptoms often associated with Alzheimer’s. Perhaps our loved one has gotten a bit forgetful or just can’t think of someone’s name or the correct word during a conversation. Maybe they seem to be getting a lot of “senior moments”.  It’s very easy to panic and assume they may be getting Alzheimer’s.  Actually, that panic is a good thing.  It may motivate us to get our loved one in to see their doctor.  If Alzheimer’s is the cause of their symptoms, early treatment may slow the progression of this disease.  Even more importantly, if it isn’t Alzheimer’s, it may be totally reversible.  Yes…….reversible.  That’s why it’s important to get the right diagnosis quickly. 

Early diagnosis is necessary so treatment can begin before any permanent damage to the brain occurs.  The most common cause of reversible dementia is medication.  The aging body reacts differently to medications.  The liver doesn’t work as well in terms of metabolizing the drugs and the kidneys are slow to eliminate them from the body.  This combination makes the amount of drugs in the body accumulate quite quickly.  Multiply this retention by the higher number of drugs consumed for a variety of medical problems and you end up with a lot of medication in your system at any given time.  The drugs that can cause dementia like symptoms include: corticosteroids, sedatives, antihistamines, heart medications, and antidepressants.

A low level of Vitamin B12 is another culprit.  A very low level of this vitamin causes pernicious anemia.  The first symptoms of this type of anemia are slowness, confusion, and apathy.  Sound a lot like Alzheimer’s, doesn’t it? B12 injections can eliminate the deficiency and get rid of those symptoms.

Another common disorder, a thyroid hormone imbalance, causes dementia like symptoms.  Hyperthyroidism, which is an overproduction of thyroid hormones, as well as hypothyroidism, which is an underproduction of thyroid hormone, both cause what looks like dementia.  Removing the thyroid or a thyroid replacement medication can often reverse the dementia.

So you see, panicking about what looks like Alzheimer’s can be a good thing.  If your loved one is diagnosed with Alzheimer’s, early treatment will help slow its progression.  If the symptoms are caused by some other underlying condition, the cognitive problems may be reversible or well managed.  In either case, the sooner you know, the better the results will be.  What’s your experience been?  Share below and visit us at http://www.trilliumhomecare.com

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The Real Work Begins

Once you’ve made the decision that you or a loved one is going to need some help to remain independently at home, the real work begins. Selecting an agency for yourself or your loved one is not an easy job. There are a lot of options out there but be aware they are not all the same. Before you make your choice, be sure to get the answers to some very important questions.

Are the caregivers who come to your home employees of the agency or are they merely referred by the agency and employed by you? If they are employed by the agency, their employer will take care of collecting all taxes and remitting them to the government. The caregivers will be covered under Workers Compensation insurance if they are hurt on the job. If they are simply referred by the agency, all of these bookkeeping and payroll responsibilities will be yours to handle.

Are the caregivers bonded and insured? Do they have background checks performed on them? Are they screened for drug use? What if you don’t want a smoker in your home?
It’s very important to feel safe when you have someone come into your home. After all, you letting someone into your personal life and you need to feel secure in the knowledge that safety isn’t an issue with them.

How experienced are the caregivers? Do they have any ongoing training? Who does the training? Is there any oversight while they are in your home? Are they supervised by a trained medical professional such as a Registered Nurse? When a caregiver comes into your home you’ll surely want some things done to your own specifications but do you really want to or have time to train someone? If there’s a problem, can you reach management or do you have to wait for regular office hours? Does the agency provide continuity of care by regularly scheduling the same caregiver to your home? What if your caregiver can’t come due to illness or vacation time off? How flexible is the agency with scheduling? If your needs change, will scheduling someone to come to your home be a problem?

When you’ve decided it’s time to get some help, don’t settle on simply checking prices and rates. Go the extra step and do the real work of asking specific questions. The more information you have, the more comfortable you’ll be while making your decision. You won’t regret going the extra mile. What method did you use to select your in-home care? Share below and visit us at http://www.trilliumhomecare.com

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The Long Term Care Commission – Part 2

As promised, the Long Term Care Commission has finally made its recommendations. As the members of the baby boomer generation approach retirement age and the number of informal caregivers decreases, this bipartisan commission was charged with coming up with a plan to ensure the availability of long term services and support for people with disabilities and for seniors needing care. According to the commission’s statistics, 70% of seniors over the age of 65 will need some long term care. That’s pretty much most of us.

Although the commission did come up with a list of recommendations, it failed to agree on how to pay for long term care. Among the recommendations was the elimination of the required three day hospital stay that is now needed to make patients eligible for 100 days of skilled nursing care paid for by Medicare. Other recommendations focused on increasing community based care and home care. This included increasing the pay and improving working conditions for paid caregivers who will be in much greater demand as the ranks of informal caregivers decrease. It was also recommended that direct care workers need to have criminal background checks — something that a reputable home care agency does as a part of good business practices anyway.

Despite its recommendations, there was a split along party lines as to how family members would pay for the care. Generally, the Democrats would like to see an expansion of Medicare. With the looming increase in the number of baby boomers, that’s an unsustainable option. In addition, the Republicans tend to see this option as an increase in entitlements. Their solution is the idea of financing long term care through private options such as long term care insurance. This would also include tax advantages for those who purchase long term care insurance policies. That would require an expansion of the long term insurance market which over the last decade has seen a major drop in the number of policy providers.

The bottom line is that for the foreseeable future, nothing much will change. If you are an informal (ie. unpaid) caregiver, don’t hold your breath waiting for relief. The family is and will remain the first line of care as family members struggle with the expenses of caring for their loved ones. The next affordable option for care is the use of a home care agency, followed by assisted living residences and then the most costly, a nursing home. How are you dealing with the financial crisis of providing long term care for a loved one?
Share below and visit us at http://www.trilliumhomecare.com

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