Finding Your Tonto

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While caring for my mother in her last months, I sometimes felt like nobody really understood what I was dealing with. My brother, who lived right next door, couldn’t see how rapidly she was declining because he saw her every day. I would go a few weeks between visits and when I returned the changes were startling. Even at the very end, close family friends and neighbors couldn’t believe that she was nearing the end, but by that time I was living with her and knew we didn’t have much time left. The intense grief I felt was paired with the hope that she wouldn’t suffer very long. There was also guilt because Christmas was approaching with its complexities of holiday traditions and family expectations, and I couldn’t be with my family because I was with my mother. The professional caregivers that were there to help me were truly a blessing, but there were many days when I felt isolated, abandoned and alone.

When you are a family caregiver, that doesn’t mean you have to go it alone. Even the Lone Ranger had Tonto to show up when the going got tough. We all need one or more people that we can turn to when we need assistance in providing consistent, quality care for aging family members or friends. If you have a large, close-knit family in the area, you are truly blessed! If not, how about neighbors or friends, or your church family? Try to involve them in caring for your loved one if they are willing and available. Don’t expect them to guess where you need their help but be specific in asking for support. Invite them to observe and learn about what you do so they can feel confident in helping out, and also so someone else will know the ropes if you should need to take an unplanned break due to illness or injury.

If you don’t have a trustworthy support network close by, explore options for community-based services or private-pay agencies that could fill in as necessary from time to time. That’s why my brother and I asked the local Home Instead office to help out with my mom. She had been a client for five years, so going from just a few hours a day to around the clock care was a dramatic increase, but the relationship was already established so expanding her care was a breeze, and took a tremendous load off my shoulders for providing help when her needs moved beyond my limited ability. Honestly, I don’t know what I would have done without those wonderful caregivers!

Before you get to the end of your rope as a family caregiver, remember that God called you to this work, and He will provide for your needs and carry you through every situation you face if you lean on Him and let Him guide you in getting the help you need. In addition to possibilities like extended family, friends and neighbors, your church family and professional caregivers, God is also on your side. When you think of it that way, you can move from a position of desperation to one of gratitude and abundance!

Chris and I hope you’ll join us this week at Heart of the Caregiver dot com and share your heart about finding your Tonto.

 

 

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Managing Medications

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Medication management becomes more complex for many people as they age. Chronic diseases, health complications, and even supplements to assist us with maintaining a healthy lifestyle can mean many people take lots of pills throughout the day. As a family caregiver, you have a big job if you are involved in managing the details of each medication your loved one takes. You need to know important details about each medicine, like what time of day it should be taken, whether it should be taken with food, whether there are foods that cannot be eaten while taking it, and when a refill is needed. Furthermore, your loved one’s medical team needs to know every single medication s/he takes, even if it is only taken when needed, like seasonal allergy medications. Click here for more information on how to keep your health team informed of the medications your loved one takes.

When older people experience a hospitalization for an illness or surgical intervention it is critically important to keep their medication schedule on track. This is not easily accomplished in the hospital or a rehab facility and may require not only your input but also your strong insistence that meds are taken according to doctor’s orders. This happened when my brother-in-law was hospitalized after a fall. He has Parkinson’s Disease, and the hospitalist had him on less than a third of the dosage his primary physician had prescribed for the medicine that managed his tremors. He couldn’t even do the required therapy exercises to fully recover until my sister intervened and insisted that his medication be increased dramatically. Don’t be afraid to speak up for those you provide care for. You might be the only voice advocating for them!

If your loved one is on several medications that are taken at various times of the day, a pill organizer system is very helpful to keep these on schedule. Following directions on when and how medicine should be taken can make a world of difference in how your loved one feels and how effective the medicine is in improving his or her quality of life. It can also mean the difference between continuing to recover at home and returning to the hospital or rehab due to a relapse in physical condition. Home Instead did a webinar on this subject. Here’s the link to that resource.

 When you are managing a loved one’s medications, don’t forget to manage your own as well. Keeping you healthy is the best way to help others in your life! We hope you’ll join us this week here at Heart of the Caregiver and share your heart about solving the mystery of medication management.

 

Caring for Fathers

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My father was loud, opinionated, a great storyteller and a fast friend. From the day I was old enough to know it, I was confident that he loved me and would do his best to take care of me and provide for my every need. Of course, he wasn’t perfect, and over the years he said and did a lot of things that were hurtful to me and others. But he taught me to drive, he nurtured my love of horses, and he gave me a passion for fishing! He couldn’t figure out how to relate to me after I grew into womanhood, and so in some ways, we drifted apart. We stopped going fishing together, and whenever I called home he would ask if everything was okay, then hand the phone to my mother, but I always knew he truly loved me and wanted only the best for me.

Daddy died just two years after I married Chris. He never knew my children, and I’m sorry they never met their grandfather. This week he would have been 100, and I still miss him 28 years after his death. While I was never my father’s caregiver, I was always his little girl.

If you provide care for your father, Chris and I hope you know how precious your time with him is. While giving care has its rewards, sometimes being a family caregiver may be embarrassing, awkward, or frustrating. If your dad has dementia, you may feel like you are caring for a stranger. If he has lost the ability to attend to his own intimate needs, you could find yourself helping him with toileting, bathing, dressing, eating, and many other things that he helped you with when you were little. If your father raised you, don’t let yourself forget that this man taught you many of the things that make you who you are today. Maybe he isn’t able to thank you for the care you give; perhaps he doesn’t even know who you are, or is angry or embarrassed when it feels like he is the little child now and you are the parent, but remember what is important here. He is your father, and you are no longer a small child, but an adult who is gifted and equipped to provide the care he needs in this time of his life.

This weekend we celebrate Father’s Day, a Sunday set aside to remember our dads and the ways they influenced us over the years. If you are your father’s caregiver, you honor him every day as you care for his needs with your gentle touch, attentive assistance, and encouraging words. Just as he cared for you when you were little because he loved you, now you have the opportunity to care for him from that same motivation.

If the care you provide is not motivated by love, but by obligation or necessity, pray and ask the Father above to give you a heart overflowing with love and joy. Ask Him to help you find the wellspring of love that only He can provide. We don’t all have great relationships with our dads, and they may fail us many times, but our Heavenly Father never will. His command to honor our parents didn’t stipulate that we do so if they are worthy of our honor.

If you’ve lost your father as I have, or even if you’ve just lost the connection with him, make a list this week of all the ways he positively influenced your life. Reflect with gratitude on your list and try to share it with him if he is still a part of your life. If you provide care for him, take a few walks down memory lane and let him experience the profound joy of sharing with his child again. Let this renewed connection give you both strength for this season of care.

We hope you’ll join us this week at Heart of the Caregiver and share your heart about memories of your father.

Taking a Vacation from Care

 

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Typically, Memorial Day weekend kicks off the summer vacation season for most people. Everyone enjoys getting away for a few days from time to time, and summer’s long, warm days are a perfect invitation to break our routines and do something different. Schools end the academic year and give students a break, and many workplaces even practice the principle of summer shutdown for a week or two rather than managing various employees’ vacation schedules.

But for a family caregiver, the idea of a vacation may seem impossible to consider. If you find yourself feeling this way, you need to remember that we all need a break from time to time and you are no exception to that rule! Take ownership of the reality that in order to be a good family caregiver you need a vacation from time to time.

There are ways to approach taking time off that will benefit both you and the one you care for. Planning is the key. As a family caregiver, you really don’t have the option to simply decide tomorrow morning that you need to take a week off. You owe it to yourself as well as the one you care for and other family members to create a strategy that will work for everyone involved.

Most great plans begin with good conversation. Find a time and sit down with everyone involved in caring for a family member. If you need to, explain why time away would be beneficial for you as the family caregiver. Ask for support in this decision as well as help in making plans to cover the care needed while you are away. If there are no other family members that are able or willing to fill-in for you then check with local professional caregiving services to see if they offer respite care. We have written previously about the benefits of having a respite care back up plan. This might mean professional caregivers come into the home or could even involve your loved one moving into a care facility for a short stay.

Involving others, whether family and friends or a professional service, can give you the break you need and make you a better caregiver when you return.

We hope you’ll join us this week at Heart of the Caregiver and share your heart about taking a vacation from care!

Remembering Sacrifice on Memorial Day

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Memorial Day is a time for us to remember and honor those who have died while serving in our country’s armed forces. The holiday was originally observed on May 30 from 1868 until 1970 and now is held on the last Monday in May. While the memorializing elements of this holiday are largely lost today in the onset of summer vacation season, many in our older generation still hold to the more sacred observance of the holiday. Lesser known as Decoration Day, many people celebrate this holiday by wearing poppies and placing flags on graves in military cemeteries across the country. Parades and special programs are held in many communities to honor those who served and remember the ultimate sacrifice they made while serving our country.

 If your aging family member knows servicemen or women who died in service to our country, perhaps you could visit their graves together to place patriotic flowers or a flag. If your loved one is homebound, ask about the memories of family members who were in the military. Look at photos and talk about those times. You might learn something surprising!

 Even if your mom or dad didn’t lose family members or friends who served during wartime, they will probably have strong memories about pivotal military moments such as Pearl Harbor, D-Day, or even Desert Storm. If it is possible and not painful for them, ask if they would share those memories with you. If they resist or seem uncomfortable about talking of such memories, then change the subject and leave it alone. Not everyone’s memories are pleasant when related to military action.

Betsy’s parents both were in military service during World War II. While her mother joined the Marines and served stateside so another man could go and fight, her father joined the Army and saw action in southern Europe and Northern Africa. He was posted to drive supply trucks for Patton’s army and was always reluctant to discuss what he witnessed while there.

 The important consideration for you as a family caregiver is that Memorial Day is intended to honor and remember sacrificial service. Consider how you can best do this with those you care for. If nothing else works, enjoy the warm weather and promise of summer just around the bend.

Betsy and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about Memorial Day memories.

 

Caregiving’s Seasons of Change

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We all go through seasons of change in our lives. We begin as infants whose entire existence is driven by basic, simple needs like eating and sleeping. We grow to be inquisitive children whose favorite questions are who, what, when, where, and why. We navigate through puberty and finally achieve adulthood, and our needs move from simple survival to self-actualization through finding meaningful work and a sense of driving purpose.

The same is true for your journey as a family caregiver. You may experience several seasons of change if you care for a loved one over an extended period of time. In the beginning, you might mostly serve as a companion to your mom or dad, stopping by for visits, running errands, or just calling periodically to check in. Early caregiving tasks are routine and ordinary for most people. Grocery shopping, making a meal, watering the house plants or picking up and sorting the mail are simple tasks that anyone can do. Being a family caregiver feels like normal family activities, so the stress level has minimal impact on your life.

As the seasons change, so will your role and responsibilities as a family caregiver. You might begin to notice small changes in your parents or their home that will alert you to a change in the season of care. Remember that change always raises your stress level, so be careful to take care of yourself as the care landscape begins to shift. Unexplained weight loss or weight gain, decreased mobility, or unexplained bruises are just a few of the warning signs that might indicate a need for help with nutritional support, walking assistance or even taking measures to prevent falls. Past-due bills in the mail or general clutter and disarray in the home that was once ordered and tidy could suggest a decline in the cognitive ability to sort and organize and manage life’s requirements. A reluctance to engage in conversation or social interactions with family and friends hints at problems ranging from depression or hearing loss to incontinence or dementia.

More complicated care needs require confidence and training. Tasks like helping your mom with a bath or engaging your dad in meaningful activities when he progresses in his Alzheimer’s Disease diagnosis are activities that you can do with assurance if you know what is required. When it is time to find someone who can supplement the care you give, it is critical to choose wisely and within previously agreed-upon parameters like where and how care will be provided, what the cost is and who will provide it. The great news is that with attention to detail and preparation on your part, you can navigate the changing seasons of care like a pro.

We hope you’ll join us this week at Heart of the Caregiver and share your heart about how you handle seasons of change.

When Families Disagree on Care

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When family members are providing or coordinating care for an aging parent or loved one, some families seem to come to an agreement quickly on every issue that arises. When this happens, something beautiful occurs, and the care comes together smoothly. This was the case with Chris’s siblings when their mother could no longer communicate her wishes in her last days. Although no living will or advance medical directives were in evidence, five brothers and sisters were in complete agreement on every decision their mother’s doctors asked them to make. Their beautiful unison voice amazed the doctors and hospital staff alike. It was evident to everyone paying attention that this family loved and trusted each other completely, despite vast differences in age, career, education, and state of residence.

We have all seen families who struggle to talk about difficult issues and seem unable to find agreement on crucial decisions. Adult children quarrel with each other, their parents argue back, extended family members chime in, and even the medical advisors take a turn. They bicker back and forth about everything from who should manage the house, the money or mom’s medication schedule to whether dad needs to move in with one of them or be placed into a care facility. This discord is even more unpleasant when money is prominently featured in the conversation, or when one or two family members are pushing against a unified front made up of the rest of the decision-makers.

When conflict arises within a family dealing with caring decisions, it upsets everyone. This strain spills over onto friends, neighbors, and the one requiring care, even if they do not appear to be engaged in the conversation. In times of crisis such as illness, injury or a frightening diagnosis, the added stress makes tensions run higher for everyone involved in the decision-making process.

There are a few steps you can take to minimize conflict within your family.
1. Everyone needs to talk through possible scenarios ahead of time and try to come to an agreement. Talk to a medical professional and learn as much as you can about the possibility of future developments.
2. Work with a professional care manager who can offer insights and share resources. This person can also clarify expectations and suggest possible scenarios the family should negotiate before they actually occur.
3. Have your parents or loved one consider drawing up a living will or advance medical directive. The Five Wishes are an excellent resource to use when working through this course of action. Another process is called the Final Years Plan. Having this plan in place ahead of time can help discordant families know ahead of time about their loved one’s wishes.
4. Pray together as a family before any decisions are made. Ask your pastor to join you or your loved one’s pastor. Seek spiritual guidance and the Holy Spirit’s presence to sooth any past or present turmoil that could hinder unified consensus in the decisions that must be made.
5. Finally, talk openly about hard things like feelings, regrets, memories, and family history. Practice patience, embrace sorrow, and welcome laughter into the process. It probably won’t come quickly, but when it does the laughter will be well worth the wait.

Chris and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about managing family conflict in decisions about care needs for your aging parent or loved one.