Options: Continuing Care Retirement Communities

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Every month Chris and I explore another option in your Care Arsenal, and this month we will help you understand what Continuing Care Retirement Communities are. For short, we call these types of care communities “CCRC’s.”

Sometimes CCRC’s are called Life-Care Communities. A CCRC is a retirement community that covers a full range of aging services and levels of care, from independent living cottages or apartments to assisted living housing, to full-blown skilled nursing services. In most cases, each change in care-level requires a move to new living quarters. The different levels of care may all be housed on different floors of a high-rise building or in different wings or buildings across a single campus.

Independent living is usually the entry-level for most residents. The idea is that residents enjoy a higher quality of life in a community of peers with similar life experiences. Independent living residents experience maintenance-free housing and landscaping, housekeeping services, and sometimes even congregational meals in a restaurant-style dining room. A variety of activities and opportunities abound for those who enjoy hobbies, concerts, games, dances, and even excursions.

As the resident begins to need assistance with personal care needs like bathing, toileting or walking, they must move into the Assisted Living section of the CCRC. This area has more of a nursing presence and closer supervision of the residents. CNA’s, Home Health Aides, or Nurse Aides will assist with those personal care items that need help. With this transition usually comes a higher monthly cost.

Skilled Nursing Assistance is the highest level of care provided in CCRC’s. You would probably think of this as a Nursing Home, but still on the campus. It will have the highest monthly cost for the resident, but it provides constant nursing supervision of the resident. Frequently when a couple resides in a CCRC, and one spouse needs Skilled Nursing Services, the other spouse will need to remain at their current level of care unless both require the same level of care. It is sad when a couple married 60+ years must live separately because of the declining health of one.

Payment options for CCRC’s vary greatly. There are many models that may apply. Some require a large sum of money for an entry fee, but remain fairly consistent with the monthly residential fee, even when levels of care increase. Others require a minimal entry fee, but the resident is in a “pay as you go” program where every level of care costs significantly more than the one before.

You might want to check out Genworth’s Cost of Care resource: https://www.genworth.com/aging-and-you/finances/cost-of-care.html

So that’s more or less the rundown on CCRC’s. They can be very expensive but can also be very enjoyable for the socially active retiree. Be sure to ask lots of questions and understand the contract and its requirements. If your loved one has dementia, or if you suspect they might, be sure to ask if the CCRC has a Memory Care facility. That’s also critically important to know. Finally, ask if they allow private duty caregivers in their facilities, and how they screen and track those individuals. Arm yourself with knowledge and visit several times throughout the year before you decide to commit, so you can experience lots of different seasons and conditions within the community. The more you know, the better the decision you can make.

Planning to Win

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Being a family caregiver is a big job, and every task worth undertaking needs to be carefully planned. You know what they say: Failing to plan is planning to fail! So, what does your plan look like? Chris and I talk a lot about having a plan, because we have learned from owning our own business that a great plan can set you up for success. Likewise, just managing the day-to-day chaos with no real goal in sight can leave anyone feeling exhausted, frustrated, and like a dismal failure. Even worse, burnout comes on quickly if you just make up things as each day progresses.

If you’ve followed us here for any time at all you have seen information about having a plan. Family caregivers need to think through many different aspects of their responsibilities in order to have a sound working plan. Does your plan involve other family members, and do they know what they need to do should they get a quick call and need to go into action? What about neighbors or friends? Is their information kept current so, as needs change, they are still able to cover for you at a moment’s notice? Are all the medical documents, like Powers of Attorney, Living Wills, and insurance cards readily available should they be needed quickly? How will financial matters be handled if something happens to you? While this type of situation is not something we relish considering, it is vital that your loved one’s care can continue seamlessly if you suddenly cannot provide the care yourself.

If you haven’t already done so, begin to have some open-ended conversations with others who might be a part of your plan, or at least join with you in the planning process. Thinking partners might help you see or consider things you otherwise might miss. This isn’t something you can accomplish over lunch on a Wednesday; it might take months to fully construct a solid strategy that covers all your bases. Bathe this process in prayer and ask others to also pray for God to reveal resources, helpers, respite options and advisors to assist you with building your plan.

Next, it’s important to remember that any good plan is always open for revision. Your care plan is a living, breathing, working framework that helps you stay organized and get everything done, but it’s also flexible and forgiving. It’s never concrete, never set in stone. At best it’s rubber or plastic, able to give when and where flexibility is needed.

Finally, how do you measure and celebrate the success of your plan? When implemented, does your plan work effectively? Where does it consistently fall short? How often do you evaluate your plan and make adjustments? You should ask yourself all these questions regularly to know whether your plan is working.

Chris and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about planning your work and working your plan.

Sharing the Care

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Sometimes things fall apart, and as the family caregiver, you find yourself in need of someone who can share the care for a little while. This can happen when you or the one you care for has an unexpected situation that arises that makes care at home difficult or impossible for a time. Nothing is embarrassing or awkward about this situation; it’s just reality, and you need to be prepared when it happens.

Maybe you have an accident or illness that needs a period of rehabilitation. This type of thing happens to everyone eventually. What’s your plan? Do you have family members or friends who can step in and become a temporary caregiver while you recover? If not, what will you do?

It also might be that you need a break, a vacation from being a caregiver. There’s nothing wrong with acknowledging that you need a little time off. Remember, you must take care of yourself regularly when you are caring for another. Regularly taking time for your personal restoration will make you a better caregiver in the long run. But, again, who steps in to provide care while you are away? You must work this out BEFORE something happens that leaves everybody scrambling for a quick fix!

A temporary stay at a local Assisted Living Facility (ALF) could be your best solution. The right ALF is an excellent resource for your loved one who can do a lot for themselves but needs a little assistance to stay healthy and mostly independent. Some facilities even offer temporary respite stays to give family caregivers a short break. These senior communities provide your loved one their own space while also being a part of a broader community. There are usually group activities, communal meals in a dining room, and even trips for shopping or sight-seeing in the local area. There are medical services available, but your loved one is mostly independent within their own small efficiency apartment or room. Nobody will come and get them for group activities or meals unless you arrange for these services if they are not joiners. Medication reminders can also be set. An ALF offers some limited assistance, like help with bathing or dressing, and regulations for these facilities differ from state to state. The important thing for you to know is that you need to check out your local ALF options to ask about respite care stays and how much notice they would require should the need arise. The cost might also be a consideration.

At times a loved one’s care may move beyond what the family caregiver can offer. The declining ability could be caused by an infection or illness, a sudden fall, or a progressive chronic disease. When you can’t provide adequate care, there are several ways you can include others to safely and effectively meet your loved one’s care needs both now and in the future.

First, make an appointment with the doctor to determine if the issue can be resolved with medical intervention. Dehydration or a UTI can cause a rapid decline that reverses quickly with proper intervention. Loss of walking ability can be regained to some extent, with a referral to the right Home Health agency for gait training and leg-strengthening exercises.

Other loss of capacity is more lasting and can force you to move to a professional caregiver service. Home care organizations like Home Instead offer dependable, reliable, trained professional CAREGiversR that supplement or replace the care you provide. This may allow you to move back more into your original role as a family member who coordinates care.

Your loved one may require skilled care provided by the nursing staff in a more clinical setting in extreme cases. Wherever the care is given, and by whom, you are still the family caregiver. Your role becomes even more critical when you must take on a more administrative function to ensure that your loved one receives the best possible care.

Sharing the care takes on a whole new meaning when it grows from one person to an entire caregiver army. Wherever you are on the spectrum, we want to help you plan the best pathway to achieving your best life as a family caregiver!

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

Caregiving: A Labor of Love

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Often, family caregivers find themselves caring for aging family members who helped raise them through their most formative years. This is Grandparents’ Week, and throughout history, grandparents have played an invaluable role in raising their grandchildren. This was not my experience since my grandparents lived far away, and I saw them infrequently. Chris’s grandmothers were both very involved in his early years. In fact, his entire extended family was very close and gathered together as often as possible. All the adults helped, in some part, to raise the children. Our three children have a wealth of knowledge and instruction gleaned from time spent with older aunts, uncles, cousins, and grandmothers alike.

Our families shape us in many ways as we grow from childhood into being an adult. How many of your values, morals, and spiritual beliefs have their foundations in lessons learned on your parents’ or grandparents’ knees? What life principles were discovered around the dining room table, or while you played in the yard while older family members sat in the shade and swapped stories? Whether or not you embraced all those wise nuggets, they helped mold you into the person you are today. Face it, you are made up of all those memories, experiences, wet kisses, and bear hugs.

Family caregivers are usually caring for people they love. Some provide care because they have no other choice; others step cheerfully into the role and greet each day with courage and hope. Whichever of these descriptions best fits your particular circumstance, one thing is true for both. There will be days when the family caregiver and the aging family member who needs care simply don’t like each other very much.

The pain point might arise over resistance to care or disagreement about how things should be done. Irritation can spark over the simplest of differences when pain, discomfort, fatigue, or even boredom are present. Being a family caregiver can feel lonely, unappreciated, and overwhelming. Add to that an uncooperative or defensive aging loved one, and the situation can quickly get out of hand. Words spoken in anger can leave invisible wounds not easily healed.

This is when caregiving becomes a labor of love because love overcomes all things!

As the Apostle Paul reminded us in 1 Cor. 13:7, “Love bears all things, believes all things, hopes all things, and endures all things.” Being a great family caregiver is, above all, dependent on love! And our God IS LOVE. When things get tense, take a deep breath and cling to Him. Maybe you need to step away for a moment (if it is safe to do so) and pray for patience, calm, and healing. Try to change the subject if possible; we call this redirecting when dealing with dementia. Most of all, regain your balance and help your loved one do the same. The moment will pass, and tomorrow is a new day. Love will win out over angry words when given a chance.

Chris and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about caregiving as a labor of love.

Caregiving as Hard Labor

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Being a family caregiver sure isn’t easy! Depending on what kind of caregiver you are, this is a job that is not for the faint of heart. Sometimes care means a weekly call to check-in or stopping by for a quick visit from time to time. More involved care usually involves several hours each day of in-person assistance. It requires a much deeper level of commitment from the family caregiver. Occasionally being a family caregiver may be a job that feels like it will never end.

Are you a born caregiver? If so, you probably started providing care at a very early age and have continued throughout your life. The child that diligently feeds the family pet or waters the house plants and flower garden is probably a natural caregiver. As he or she grows older, a caring profession like nursing, teaching, and customer service positions is a natural fit for a gifted caregiver. These caring individuals quickly become family caregivers when the time is right. Does that come close to describing you? If so, then caregiving probably comes relatively easy for you.

But what if you aren’t naturally gifted to care for others? This isn’t a weakness or a fault; it’s just a fact. You do other really important things, but maybe you shouldn’t be expected to water the house plants or feed the dog except on occasion as a special favor. So, what happens when you find yourself needing to step up and become a family caregiver? It’s not that you are incapable of taking on the role, but you probably need to approach it differently. Maybe you are gifted as a manager and organize a team of family and friends to provide the necessary care. Perhaps you hire an agency and hand over the responsibility of daily care but oversee how payments are delivered because you are good with money. Possibly you are just comfortable enough in your own skin to call a family meeting and ask for help with ideas and solutions. All of these pathways will achieve the desired results: an aging family member receives the care s/he needs and knows that s/he is loved and cherished by you and others.

Which type of family caregiver are you? Are you great at taking care of others, approaching each new day brimming with creative thoughts and boundless energy? Or are you good at other essential life skills, and do you now find yourself in need of ideas to manage care for an aging loved one? Whichever description best fits your current situation, Betsy and I are here to lend a hand. We hope you’ll join us this week here at Heart of the Caregiver and share your heart about how you approach caregiving as hard labor.

Lonely Caregivers Need Friends!

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God created us in His image, and He is a relational being. When we read the creation story in the book of Genesis, we learn that Adam was created to be in fellowship with God. Still, Adam wasn’t complete until God created Eve to be Adam’s human companion. From this perspective

God reveals that He wants us to be in a relationship first with Him and then with other people. We can never be our best selves alone, so we need to build friendships with those around us to fully thrive and become all that God intended for us to be.

For many family caregivers, relationships with family and friends are hard to hold together on a caregiving schedule. Taking time to meet a friend for coffee, lunch, or a movie can feel like a futile effort when you spend all day caring for an aging family member. Nurturing relationships requires time, focus, and energy. If you can’t step away for a quick hour here or there, how can you strengthen friendships or deepen family ties with anyone other than your aging loved one? When all of your energy is spent caring for someone, you have nothing left for friends or family members at the end of the day.

This relationship desert leaves most family caregivers feeling lonely and forgotten by those who shared their lives before they entered this season of caregiving. Many family caregivers struggle to overcome depression because of their isolation and lack of a social support system. If you feel like you are suffering from depression, the Alzheimer’s Association has some useful resources. One of their suggestions involves tapping into your friendship network, but if you don’t have this, then it’s not there when you need it!

I think you know what you have to do next…make time to nurture your supportive relationships. How do you go about this? Begin by listing all the reasons why you don’t have time; then attack your list with the mission of eliminating some of your obstacles. If you get stuck, ask a friend, your spouse, or another family member to give you a hand. Or reach out below and ask a question. There’s a whole world of experience all around you that would be eager to help you find time to nurture relationships with others who can share your burden and expand your capacity to care. It’s just up to you to resolve to make it happen.

Chris and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about nurturing relationships even when you are a family caregiver.

Nurture Your Mind for Better Care

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Did you know that you feed your mind every day? Beyond the nutrients found in the foods we eat, our minds need to be fed with information to stay sharp and focused. To be at their healthiest our minds crave variety in the types of information and experiences we take in.

Think about it this way: when we are young, our minds are like blank pages just waiting to be written on. In the beginning we are taught everything we need to know through life lessons, classroom experiences, independent study, and on-the-job training. Robert Fulghum’s book “All I Really Need to Know I Learned in Kindergarten” isn’t wrong…as a starting point.

1. Share everything.
2. Play fair.
3. Don’t hit people.
4. Put things back where you found them.
6. Don’t take things that aren’t yours.
7. Say you’re SORRY when you HURT somebody.
8. Wash your hands before you eat.
9. Flush.
10. Warm cookies and cold milk are good for you.
11. Live a balanced life – learn some and drink some and draw some and paint some and sing and dance and play and work everyday some.
12. Take a nap every afternoon.
13. When you go out into the world, watch out for traffic, hold hands, and stick together.
14. Be aware of wonder. Remember the little seed in the Styrofoam cup: The roots go down and the plant goes up and nobody really knows how or why, but we are all like that.
15. Goldfish and hamster and white mice and even the little seed in the Styrofoam cup – they all die. So do we.
16. And then remember the Dick-and-Jane books and the first word you learned – the biggest word of all – LOOK.”
― Robert Fulghum, All I Really Need to Know I Learned in Kindergarten

You just don’t stop there. The beautiful thing about your mind is that it never stops learning! From the day you are born until the moment you die your mind is engaged with capturing and processing new information. The more you do to nurture your mind with new learning opportunities, the better it will work. Whether you are learning new caregiving techniques or reading a best-seller, you are giving your mind a workout! Here is a list from Harvard of things to do to nurture your mind. Not surprisingly, many of them are physical or nutritional! We all know that we feel better mentally after we exercise. We also know now that what we eat has a huge impact on how well our brains work. Your mind is an integral part of your entire being. You must take care of the whole package to maximize your potential as a family caregiver!

Even games can exercise your mind. Some, like crossword puzzles, Scrabble, or Sudoku, work the brain muscle in thought processes. Learning a new language or taking an online course will make your mind work to store new information. Painting, sculpting, or drawing can open up the creative pathways. Scripture study, meditation and prayer even tap into your mind differently. Every new experience or adventure will strengthen your thought processes and make you a better caregiver in the long run.

Betsy and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about things you do to nurture your mind.

Caring for Your Health

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Here at Heart of the Caregiver, we talk a lot about family caregiver self-care. That’s because caring for yourself, in large part, enables you to take better care of aging family members! Too many family caregivers develop ailments and disabilities that impair or prevent them from being able to care for aging loved ones. Often this happens because they did not take the time to care for themselves first.

Managing your health is critically essential for taking care of yourself. Eating right, exercising regularly, and getting enough sleep is just part of the solution for becoming or maintaining your best and strongest self. It would be best to keep up with routine check-ups, screening tests, and other recommended evaluations based on your age and current health. These activities and appointments all take time you might think you don’t have, but you can’t afford not to take the time needed to keep yourself in good physical shape.

It would be great if we could wave a magic wand and give ourselves a perfect health baseline from which to start, but let’s be honest. Where you are today is where you begin when it comes to nurturing your health. The good news is that it’s not where you have to end! You can make changes today that will yield improvements in the coming weeks and months. You could feel healthier, happier, and more energetic for years to come.

So, where will you start? The best path to making healthy lifestyle changes begins with one small step. Decide to make one healthy change this week and tell someone what you are doing so they can cheer you on. Maybe you can walk around the block every morning or drink more water. The change doesn’t need to be a big one. Being accountable to someone else is the secret recipe for your success. What change will you make this week, and who can you tell about it?

Chris and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about how your health impacts your ability to care for others.


Growing a Strong Faith

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Fitness is essential in every part of your life. Betsy and I exercise every day to build our physical strength. Please don’t get me wrong …we’re not trying to win any bodybuilder competitions! But we both know that by keeping ourselves in shape, we can continue to do the things we need to for our family and our business. Biking, walking, practicing yoga, and strength training are just a few ways to build stronger muscles and better endurance to maintain and expand our physical ability.

Occasionally my schedule forces me to miss or lighten my workout regimen for a few days or a couple of weeks. I feel the difference when I return to a more strenuous circuit. It’s incredible how muscles that aren’t kept in condition will weaken over time. That’s why it’s crucial as we age to keep on moving and doing things to keep our muscles conditioned to do the things we enjoy as we grow older.

Your faith is kind of like your muscles; without exercise, our muscles grow weaker over time. The same goes for our faith. But how do you exercise your faith? While it’s not as simple as picking up hand weights or walking in your neighborhood, there are several great ways to use your faith. We build up our faith through prayer, Bible study, devotional readings, corporate and individual worship, and fellowship with other believers. We also strengthen our faith by listening to worship music, engaging in mission work through personal involvement and financial support, and evangelism. Our faith grows when we look for ways to practice our spiritual gifts to advance God’s Kingdom. If you don’t know your spiritual gifts, click here for one example of a free spiritual gifts test

As you engage in these activities, you might feel like your faith is being tested. If this happens, seek God’s guidance through prayer, Scripture study, and sharing your situation with other believers. As you continue to seek His face, God will reveal Himself to you in surprising ways that will profoundly strengthen your faith.

Strong faith is part of what enables you to be a great family caregiver. It strengthens you to do things you never thought possible! It is an essential part of your caregiver’s survival kit, so don’t neglect this vital component of who you are.

How do you exercise your faith? Betsy and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about how you work at building up your faith.

Balancing Church with Caregiving

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During the COVID-19 pandemic, I have greatly missed corporate worship and Bible study with my church family. The opportunity to come together for fellowship, worship, Bible study, and sharing is one that I’m afraid I took too much for granted until nobody could gather together because of the virus. Sunday after Sunday, Chris and I “attended” streaming services over the internet. We sang the hymns, prayed when the worship leader led in prayer and opened our Bibles when someone read Scripture, but it wasn’t the same as physically sitting next to others on the same pew.

This inability to participate in corporate worship or group Bible study is an everyday reality for many family caregivers whose aging family members cannot be left alone or leave home to attend services. If neither of you can go, then you both must stay at home. There is a void that grows a little every day we go without some level of connectedness to our church family. Newsletters, emails, and phone calls may have to suffice for now to protect you and those you care for from being exposed to the virus, but even before this risk emerged, you were probably struggling with the need for a spiritual recharge.

As Christians, we have a scriptural mandate to worship God with other believers. In Psalm 122 we find David extolling the virtues of coming into God’s House when he writes, “I was glad when they said unto me, ‘Let us go into the house of the Lord.’” Going to church is more than attending a meeting; it is supposed to be a family gathering where we find encouragement, support, and accountability as we worship, sing, pray, study God’s Word, and share together.

Your church family can be a precious resource for family caregivers, but you have to humble yourself and be vulnerable to share your needs. So many family caregivers pretend to be the Lone Ranger and try to handle everything by themselves. You shouldn’t hide your struggles as a caregiver; share your prayer requests, and ask for help. God already knows your struggles, and He wants you to come into His house with rejoicing.

Of course, to attend weekly services, your church needs to have returned to safely meeting in person. If they are not doing so at this time, you could reach out to the pastor, your Sunday School teacher or small group leader, share your needs and ask for help. If you can safely attend church, can someone take turns with you weekly to enable you to attend worship services, or could you hire a home care service to give you that opportunity? The investment you make here could be life-changing in terms of reconnecting with your source of encouragement, hope, and endurance. Don’t shortchange your spiritual wellspring during your season of caring for an aging family member. God is always there for you, and He desires to help you through His power and your fellowship with other believers. If you find the time and make a way, He will provide exactly the right resources to meet your needs.

Chris and I hope you’ll join us this week here at Heart of the Caregiver and share your heart about finding ways to balance church with caregiving.