Tag Archives: Care options

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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The Danger of Denial


If you care for an aging parent or loved one you need to be careful that you yourself don’t fall into denial. Denial is actually a strong defense mechanism that you may be using unconsciously to help deal with what you know is coming down the road. Perhaps you come to your loved one’s home daily just to make sure everything is okay. Maybe Mom doesn’t like driving so you take her on all her errands. You’re sure to be there the night before the garbage has to be set out so Dad doesn’t have to do it. And you go back the next day to take the cans in. It snowed last night so you get there in the morning so the snow gets shoveled and Dad doesn’t have to risk falling when he goes out to get the paper. Your loved one has a doctor appointment so you go along as a second set of ears and to pick up the prescription. It’s a lot of extra work in your life and takes up much of your time but so far you’re holding up okay. Does any of this sound familiar? Because you are with your loved one so often, you’ve surely seen changes in how your senior moves, how they function, and what their limitations are as they age. If you are taking on more and more of their activities of daily life, you’re probably in denial that they need help. You may not want to believe that and may dread having a conversation about it with them. If you hold off for a bit longer, perhaps they themselves will realize its time to get help. It can be a difficult and uncomfortable topic so you keep waiting. It’s perfectly normal to deny something unpleasant or frightening but it can prevent us from facing the facts and can in reality be dangerous for our loved ones because denial will keep us from preparing for what’s ahead whether its an accident or the worsening of some chronic condition. Not addressing the issue won’t keep it from happening. Take a realistic look at your loved one’s situation and be careful not to fool yourself into complacency. Making plans and decisions about the future care of your loved one is much easier to do when you’re not in the midst of some medical crisis. How did you come to the realization that your loved one needs some extra care? Share below and visit us at http://www.trilliumhomecare.com

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Home for the Holidays

For adult children, going home for the holidays is usually a time filled with family togetherness and remembrances of past times. It’s a chance to reconnect with parents and other family members. It’s also a great opportunity to observe first hand how your parents are doing both physically and mentally and also assess if they need any help. Don’t be shy about checking on them — in fact, be nosey. Look in the refrigerator to see if any of the food is expired and check if the pantry is well stocked with nutritious foods or if there are containers of half eaten fast foods. How’s the housekeeping? Is it at its usual level of cleanliness or is there more visible clutter? Notice if there are piled up dishes or garbage that isn’t being taken out. Trust your gut feelings. Does it look like your parents need a housekeeper? If they’re still driving, get a quick look at the car. Are there any unexplained dents or scratches? Have they ever gotten lost while on their way to a familiar location? Check the medicine cabinet and medication dispenser if they have one. Are medications being taken as prescribed? Ask your parent what their medication schedule is. Verify that they know what it is and check if it actually matches what medications are there. Take a close look at your loved one. Are they well groomed and wearing clean clothes? Do they seem like their usual selves or are they more confused, less energetic, or even depressed? Observe how your loved one moves around. Is it hard for them to get up from a chair or do they seem to wince in pain as they make their way across the room? Take note of how they communicate with you. Are they able to maintain a conversation or do they need you to fill in the names of people or things when they talk to you. These are all red flags that something may be going on and that they may now need some assistance. Take this opportunity to make arrangements with you family members and siblings to have a frank discussion about your loved one’s future. Your family members may note more changes they noticed themselves. Get together after the holiday and share concerns and discuss what your options are and how you can best help your loved ones whether it involves making modification to the home or getting outside help. Don’t miss this opportunity to be proactive versus waiting for a crisis to occur. 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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Time To Hire A Professional Caregiver?

Hindsight is 20/20 but it’s important not to get to that point when it comes to making care decisions for an elderly parent or loved one. Very often, by the time you’ve made the decision to get some help from a professional caregiver, you’re already past the point of burnout. You’re more exhausted than you ever thought could be possible and you wonder why you didn’t get help sooner. Guilt very often plays a part in your delayed decision because you feel it’s something you should have been able to do for your loved one so they could remain comfortably in their homes as they aged. Your role as caregiver slowly and almost imperceptibly increases and perhaps on a deeper level you don’t want to see that your loved one needs more help than you can give. Be careful not to miss the signs that your parent or loved one can’t go it alone.

*How’s their personal hygiene? Do they bathe regularly or is there an odor about them? Is hair combed and are teeth brushed? Are they wearing the same clothes for days on end?
*Is the house clean and being maintained? Is there a lot of clutter or unopened mail? Is the garbage taken out on a regular schedule? Is there an odor of urine when you step inside?
*Are nutritional needs being taken care of? Is there any spoiled food in the refrigerator? Is there food in the cupboard? Have they lost any weight and are they remembering to eat?
*Is your loved one able to drive safely? Are there any unexplained dings or dents in the car? Do they get to where they’re going without incident? Do they get lost in familiar location or when traveling a route they’ve taken many times before?
*Do they miss any doctor or dentist appointments? Are they able to follow the doctor’s directions? Do they take their medications as prescribed? Do they remember to get prescriptions filled?
*Is your loved one maintaining a social life? Do they stay in contact with friends and relatives or have you become their sole source of human interaction? Have old hobbies or interests gone by the wayside?

If you see some of these changes, it may be time to get some help. There is nothing to be gained from ignoring the signs. Getting some help to keep your loved one safely in the home they want to be in, is truly an act of love. Please share your thoughts and experiences below. http://www.trilliumhomecare.com

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Hiring a Caregiver Privately?

According to the National Alliance for Caregiving, more than 65.7 million Americans provide informal care for a family member or loved one. Most of us come by the role of caregiver gradually. We start by “helping out” when we notice a parent or loved one is having some difficulty taking care of some routine tasks they once managed well. In time our list of responsibilities gets longer and our loved one needs much more help. And then it happens….we see there is so much more to do than we have hours in the day for. Perhaps there’s been a medical crisis or an accident. We realize some outside help is needed.

Once you’ve made the decision to get help, it’s easy to believe all you have to do is hire someone. If you choose to hire someone directly to care for your loved one be sure you know what goes with your new role as employer. This means that now you have switched jobs from “caregiver” to “accountant” because you will now have to take care of payroll and tax requirements since the IRS views you as the caregiver’s employer. According to foxbusiness.com, if the caregiver you hire earns more than $1000 a quarter or over $1900 a year, you’ll have to file payroll taxes including Social Security and Medicare taxes, Federal Unemployment Tax, state unemployment and disability insurance taxes levied on the employer, and advance payments of the earned income credit if your employee is eligible. These thresholds and figures may change yearly so you will need to verify them every year. You also have to know what taxes your employee has to pay and will have to provide a Form W2 to your employee by January 31st of every year. In addition, you’ll need to pay for worker’s compensation and disability insurance in case your caregiver gets hurt while caring for your loved one.

If the caregiver you hire claims to be working as an “independent contractor” and no money should be withheld for any taxes, they are wrong. According to the IRS an independent contractor has total control over their work hours, their responsibilities, and schedules. This does not apply to your employee because the caregiver will be providing the services you want on the schedule and terms you set. Failure on your part to fulfill your accounting duties as the employer of a caregiver will alert the IRS, set you up for an audit, and can even result in compromising your own personal taxes. You’ll have to pay back the unpaid taxes along with interest and possible penalties. Be certain you make the correct decision when hiring a caregiver. Are you prepared to be an accountant in addition to dealing with all the work and responsibility of caring for a loved one? Share below and 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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Making the Choice

Once you’ve made the decision to hire an in-home agency to care for your senior or loved one, you’ll realize that it’s easier said than done. How do you begin? Where do you look? What do you need to know? If you know someone who is using an agency, a referral from them is a good place to start. Of course you can check with the Better Business Bureau and local Chamber of Commerce for a list of local agencies. They should also be able to tell you if there are any formal complaints against specific agencies. Simply doing an on-line search will also result in a list of agencies. In addition, your local hospital social worker can make some recommendations too.

So you’ve made all your calls, got your list together, and talked to several agencies. How do you choose between them? On the surface, they seem pretty much alike….they provide similar services at comparable rates. The important issue is “how are they different?” There are some important questions you should ask when you talk with them. Does the agency provide an initial consultation and safety check? If they do, is there a fee involved? What if you decide to go with another agency after their initial assessment? This consultation should be with a Registered Nurse who has years of experience in this type of work.

Double check as to what types of services are actually available. Is the staff comfortable with the more complex levels of care such as dressing changes, catheter tubes and the use of hoyer lifts? Are the caregivers monitored by a Registered Nurse who performs quality assurance checks for the clients and oversees ongoing staff training? How experienced are the caregivers?

An important issue to consider is how accessible is someone if you need an answer to a question or have a problem. Can you actually speak with someone in person or do you have to play phone tag with an answering machine? Along that same vein you need to know how flexible is the agency when it comes to scheduling. If something comes up and you need to cancel an appointment, do you pay a penalty?

Gathering this information from each of the agencies under consideration will help you make your decision. For a handy printable check off list addressing these same questions and more just visit our website at http://www.trilliumhomecare.com and go to the client education tab and click the link to Questions To Ask When Selecting A Home Care Agency.

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A Caregiver Crisis?

There’s been a lot in the news lately about an impending “caregiver crisis”. What is this crisis and why are we going to have it? Basically, the caregiver crisis refers to the fact that in the foreseeable future we’re going to have more people needing caregivers than the number of caregivers that will be available. According to a report by the Paraprofessional Healthcare Institute, there will be a need for 1.6 million more direct-care workers in 2020 than were needed in 2010. That’s a whopping increase of 48 percent. The AARP corroborates this statistic. It estimates that currently there are 7 people aged 45-64 available as caregivers for anyone who is 80 years old or older. By 2030 there will only be 4 people available. There will soon be more of us needing help with fewer family members or “informal” caregivers available to give it.

Why is this happening? The major cause is the change in population demographics. According to AARP, women who were in their early 80’s in 2010 had an average of 3 children. By 2030 that average will be down to 2. There will be fewer younger people to take care of the older ones with more than 8,000 Americans turning 65 every day. With this in mind, the Weinberg Foundation predicts that by 2020, the United States will need more caregivers than either law enforcement professionals or teachers. The demographics of family members now often living long distances from each other also increases the need for paid caregivers. The close knit family with grandma or grandpa living with immediate family no longer is the norm. The days of the “Waltons” are over.

Changes in healthcare have also played a role in this crisis. People are being discharged from hospitals sooner and sooner, often with complicated care needs. As a result, families bear more and more responsibility for caring for family members recovering from serious illnesses or living with chronic health concerns. Advances in health care mean that we are living longer and caregiving is no longer a short-term process but rather something that can last decades. Are you prepared to deal with this impending disaster? Share below and visit us at http://www.trilliumhomecare.com

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