Walking the Tightwire: Balancing Caregiving with Career

Every day family caregivers face the challenges of balancing many areas of responsibility in their lives. For some, the problem comes in managing the needs of raising children with those of caring for aging family members. Others strive to find time for nurturing a marriage as well as caring for children as well as parents or grandparents. Many family caregivers also have jobs or careers that place additional demands on their time and energy. Add to any or all of these commitments things like church or community involvement, time with friends, exercise, and sleep, and you might feel like 24 hours just isn’t nearly enough to get everything done!

This week, let’s consider the plight of caregivers in the workplace. If you are balancing a career or full-time job with caring for aging parents or family members, you are walking a tightwire every day, but you shouldn’t feel alone in your struggles. Over 60% of today’s family caregivers work in addition to caring for aging family members. Some share their situation with co-workers or supervisors, but others keep things to themselves and silently strive to manage their overwhelming responsibilities.

When my mother developed a blood clot in her leg in December of 2016, I knew that I needed to be with her more than a few times a year. I stepped up my visit schedule to spend about a week every month down in Georgia. Visiting with that frequency from our home in Virginia necessitated air travel to maximize my time with my mother while minimizing the travel time it took to accomplish my mission. During those visits, I still kept up with emails, returned phone calls, and worked on projects for my company, but I did all of this early in the morning or late in the evening so that my work would not intrude on quality time spent caring for my mother. Since Chris and I own our company, I didn’t have to negotiate this time away with an employer, and my wonderful staff kept things going in my absence. But most family caregivers don’t have the luxury to come and go from work as I did during that last year with my mom.

Amy Goyer writes of her experiences as a working family caregiver in this article posted for AARP. She shares invaluable insights about her experiences and the progression of her career decisions as her parents’ health conditions worsened. If your workplace offers options like flex time or remote work, usually referred to as telecommuting, these options might be beneficial to help you during this time. You could also look into whether your situation is qualified under the Family Medical Leave Act, which will allow you to miss up to 12 weeks of work while still having job security, but there are specific employer qualifications, and this is unpaid time off.

You need to schedule a time to talk with your employer as soon as possible. It’s your responsibility to speak up and make your needs known to the right people to discover your best options. Web MD gives lots of useful tips about the importance of having this conversation. Most employers would prefer to offer some flexibility and retain a great worker rather than losing you to rigid policies and having to train a new person to take over your job.

If you find yourself in a situation where you just cannot continue at your current job, you could look at picking up a more flexible work option. Flex Jobs shares helpful information about how family caregivers can find balance, and they also post flex job options on their site.

The important things to keep in mind are twofold: first, you must take care of yourself first so you can care for others in your life. Chris and I will continue to reinforce this truth because it is the first commandment for a family caregiver! Second, if you don’t let others know what you need, they won’t know how to help. You must share, share, share! Let others know where you are struggling. Family members, friends, and neighbors, your church and work-family all need to know how to help so they can become part of your solution. Also, many of these relational resources may become an essential part of your backup plan in the case of an emergency that comes out of the blue.

Chris and I hope you will join our conversation this week here at Heart of the Caregiver and share your heart about balancing caregiving with your career.

Making Room for Mom

Caregiving from far away is challenging at best, as Betsy learned when her career took her 400 miles away from her aging mother. When we married, I moved almost as far from my mother. It’s one of the reasons we started our homecare business; we saw how hard it was to know your parents are aging well when you live at a distance.

When Betsy and I moved to Roanoke, we found a house that would have enough room for one of our mothers to move in and have her own space if that became necessary. Removing the distance is one option that might make care more manageable. But if you are contemplating moving an aging parent or relative into your home, there are several factors you should consider before making a commitment that might be larger than anticipated.

First, think about whether you might need to make some modifications to address your loved one’s aging needs now and in the future. Is your home age-friendly for both younger and older inhabitants? When Betsy’s mother would come for a visit, her bedroom (our guest room) was upstairs on the same level as our children’s rooms. While in her late 80’s, she could still negotiate the stairs and said upon leaving that her legs were stronger for having climbed stairs every day. Had she ever come to live with us, she would have needed a downstairs apartment with no stairs at all, because she could no longer climb stairs in her 90’s. Other decisions might involve bathroom modifications to add grab bars or a walk-in shower, or wider doors to accommodate a walker, wheelchair, or second kitchen so that your parent can make their own meals to feel more independent. Here’s a link from Agingcare.com that illustrates more about home modifications.

Multigenerational living has both its benefits and its challenges. You need to consider and respect your family’s feelings when deciding to move an aging relative into your home. Also, if you have siblings, listen to their thoughts and feelings as well. Remember, it takes a healthy community to balance care for the best outcomes. Invite lots of input, and don’t forget to ask your mom or dad what they think about how moving in might work. Click here to find out more about multigenerational living.

Then there is the cost of having your mother or father move in to live with you, and the question of their care needs assessment. If they need care, do you have the time to provide that care in addition to your current responsibilities? Will you be balancing the new responsibility of caring for an aging parent or relative with managing a job or career and nurturing a family? If you have a spouse, kids, work, pets, church, and community involvement, it’s easy to lose things in the whirlwind of activity, and you certainly don’t want one of those things to be your aging parent OR your family!

Caring.com gives an excellent summation of things to consider when Mom might be moving in.

Betsy and I hope you will join our conversation this week here at Heart of the Caregiver and share your heart about finding balance when mom moves in.

Checking In

When we launched Heart of the Caregiver almost a year ago, we opened with a series of blogs focused on family caregiver wellness. After a year, I think it is time for a check-up, so how are you doing?

Are you taking time for yourself on a regular basis?

Are you finding ways to nurture your spiritual health?

How about your social life? Do you get together with friends from time to time and take a break from caregiving?

Are you making healthy choices in what you eat, and getting regular exercise of some kind?

Do you have a support network that can back you up when you need a break?

Click here for tips from the National Institutes of Health on taking care of yourself.

Check out these ideas for more suggestions.

Remember to give yourself regular check-ups to maintain your health in all these areas.

When you take care of yourself, you will do a better job of caring for others. We hope you will join the conversation this week at Heart of the Caregiver and share your heart about the things you do regularly to care for yourself that enable you to care for others.

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This week I am thinking about my mother, who would have been 98 years old on August 21. This picture was taken in 2017, her last birthday with my brother and me. Chris and I drew our inspiration for Heart of the Caregiver from my experiences with my mother over the last decade of her life. I’d like to take a moment here to thank you for joining us on this journey and sharing our stories and insights with others who need the support of this community. We pray the information and wisdom you find here provides strength and inspiration that empowers you to face each day with renewed hope and determination. You are someone’s hero, whether you know it or not!

Caregiving From a Man’s Point of View

Historically, caring professions have primarily been populated by women of all ages. As children, girls are encouraged to take on responsibilities like caring for younger siblings, or as teens finding jobs as babysitters, while boys are directed toward traditional gender roles like lawn care and household maintenance. From our earliest origins, young mothers have borne the primary responsibility for raising their infants and children while men provided food, shelter and other life necessities. In the shifting cultural norms of today’s world, however, much has changed and recent surveys indicate that men exceed 40% of the family caregiver population. Men co-parent, do the cooking and housekeeping and enter caring professions like nursing and senior care at a higher rate than ever before.

For those men who choose a caring career path, the choice allows for the development of skill sets that were perhaps not previously honed, but for men who find themselves unexpectedly thrust into the role of family caregiver, the transition can be awkward, uncomfortable, or even terrifying!

My brother was my mother’s caregiver for several years. He checked up on her almost daily, making sure she was eating, staying healthy, and well provided for. He helped with her car maintenance, took care of her yard work, and tackled household maintenance whenever necessary. While he never bathed her (and I did on numerous occasions during her last year), my brother took great care of my mother during the last decade of her life. He arranged for professional CAREGivers through Home Instead’s local office when she began to need more companionship than he could provide. Gradually these wonderful individuals took over her household cleaning, laundry, and finally driving for shopping and errands. She grew to depend on Laverne and others to keep her as independent as possible. Whenever I came to visit, however, she told Home Instead she wouldn’t need anyone during the days I was there. I understood intimately how much care she needed during those times, but my brother used the resources he had available to him to fulfill his caregiver role when I wasn’t present.

Male family caregivers are often overlooked mostly because they care quietly, and don’t talk about their wants or needs. They internalize and suppress their stress and anxiety about providing the most intimate of care for their loved ones, going stoically about the tasks that might be embarrassing or difficult for themselves and their aging parents or others. Men may have the advantage when it comes to size and strength, so these attributes may be assets to their new role as a family caregiver, but these physical attributes might be offset by the emotional burden of caring for their loved one. AARP offers videos that can encourage men who find themselves caring for others.

Seth Goldsmith found himself caring for his wife of 20 years following her diagnosis of ovarian cancer. Here are his ten steps for effective caregiving, gleaned from his experience and observations of others in his shoes.

Simply asking for help, finding peers who can offer support and encouragement, or even talk about your experiences and feelings with others who are going through similar circumstances can change how it feels to be a male caregiver.

Here are observations on how spousal caregiving differs from caring for an older family member, offered by Caring.com.

Chris and I hope you will join our conversation this week here at Heart of the Caregiver and share your heart about the men who care in your world.

Hoarding: What’s the Big Deal??

Hoarding and hoarders are not new to our society, but in 2009 the issue took the spotlight with a show produced by A&E titled “Hoarders.” People all over the country tuned in to watch the lives of those dwelling in beautiful homes stuffed to the rafters on the inside with so much junk, trash, and even dead animals or human waste that the residents wouldn’t even open the door to allow visitors to enter.

In the course of providing homecare in my community, I have been in the homes of hoarders many times. In some of these homes, I found rooms stacked with high piles of newspapers, magazines, boxes and various items, leaving narrow walkways to move about and creating a dangerous environment that invited vermin and insects as well as a risk of fire. Usually, the homeowner wouldn’t admit that their living environment was unsafe or even unusual, although they were fiercely protective of their possessions and their privacy.

Even my mother had some minor hoarding tendencies. I realized this when I found many small plastic cookie containers while cleaning out her kitchen. She must have two hundred when I discovered her “hoard.” I quickly discarded all but ten, thinking that if she came up with a purpose, she would still have a few. She also kept every card anyone ever sent her. I sorted through hundreds of these after her death and found Mother’s Day cards drawn by my own 6-year old hands. These habits did not endanger my mother in her later years, but they did create quite a mess to sort through after her death.

Hobbies that involve collecting specific items are activities that include family members and enhance relationships. Hoarding tendencies can tear families apart because, for the person that hoards, the hoarded items are their relationships, and the hoarding behavior inhibits healthy social relationships. Hoarding disorder can destroy families, friendships, health and quality of life if left untreated, but as with any mental illness, there are right ways and wrong ways to address the subject.

If you have a loved one that you feel might be exhibiting hoarding behaviors that could endanger them or others, here’s a list of symptoms.

Here are some do’s and don’ts for helping someone with Hoarding Disorder.

Matt Paxton, one of the hosts of A&E’s “Hoarders,” shares tips for how to declutter a Hoarder’s home here.

Finally, remember that prayer, patience, and love are your most valuable tools when helping a hoarding loved one. True hoarding is a mental illness frequently associated with Obsessive-Compulsive Disorder and is not simply or quickly treated. Ask your local Area Agency on Aging for resources or check with your church or local social service agencies for help with your loved one’s situation.

Chris and I hope you will join the conversation and share your stories about finding a light at the end of the hoarding tunnel.

Options: Skilled Nursing Facilities

My mother used to tell me that when she got old and couldn’t live at home anymore, she planned to go to a nursing home. She was adamant that she didn’t want to be a burden on my brother or me by needing to move in with one of us. I bought a house with an “in-law suite” just in case. As she grew older and visited more friends who lived in such places, her eyes were opened to new facets of nursing home residency. One day she called me and said, “I never want to live in a nursing home!”

Today nursing or convalescent homes are more appropriately called Skilled Nursing Facilities, or “SNF’s” (pronounced “sniff”). These facilities offer onsite 24/7 medical services, medication administration and management, and a range of therapies as well as social activities, personal care services, and meals. While the need for skilled nursing services should not dictate placement in a SNF (because in-home options are also available), sometimes a referral to a SNF is an appropriate option. SNF placement is generally reserved for those who need a significant amount of care or total care.

Private pay skilled care in a SNF is costly. Medicare Part A may cover a period of time in a SNF under certain circumstances. Click here to learn more about the details on what Medicare will cover. Medicaid SNF’s are also available, but if your loved one qualifies for Medicaid benefits and needs to be placed in a SNF, they may need to wait for a bed to open up or be placed in a facility many miles from where they currently reside because bed space is available in another location.

Most people don’t just decide to move into a SNF. Unlike most other residential care options, SNF’s usually offer semi-private rooms, meals, medications and skilled nursing services. A hospitalization precedes most admissions. If you have the luxury of choosing a SNF for your loved one, you need to visit and get a feel for the facility. Here’s a link to 10 tips for selecting a SNF.

If your loved one is in a SNF, Chris and I always recommend that you visit often and get to know the professional caregivers on staff there. Stay involved in your loved one’s life as much as possible. This involvement will ensure that you are still seen as a part of the care team, and your loved one will receive better care because of it. No one should ever aspire to move into a SNF, but these facilities do have an essential role in the aging care continuum. A SNF placement can be hugely beneficial to the care recipient and their family as well.

We hope you will join our conversation this week and share your heart about Skilled Nursing Facilities.

Click here to learn more.

Self-Neglect and Failure to Thrive

At the age of 90, my mother planned to step down from teaching Sunday School and coordinating her church’s homebound ministry. Then, unexpectedly, her church underwent a split, and she felt she had to remain actively involved to keep those ministries going. She continued teaching and visiting for several more years.

When she finally did “retire” from these activities in her mid-90’s she underwent a transformation that greatly concerned me. Suddenly my mother was no longer active socially, and she was always a very social person. She mostly sat at home in her recliner and watched TV or the hummingbirds at the feeder in her yard. Over time she stopped going to lunch with friends. She began to wear the same clothes day after day, and she never ate a real meal except with my brother or me. She bathed infrequently, slept later in the mornings, and had little energy. She lost weight and was thrilled by this, although her doctor told her she should not be losing weight at her advanced age.

Sometimes family caregivers find themselves caring for a family member who doesn’t want to take care of themselves. When someone stops caring for their health or their environment and refuses help from others, their situation may be described as self-neglect. Possible causes for this condition include mental illness, chronic diseases or even a side-effect of some medications. It might also be caused by a loss of motivation due to impaired physical ability.

Failure to thrive is similar to self-neglect but is a medical diagnosis usually indicated by depression, impaired physical abilities, malnutrition, and mental decline. Symptoms may include weight loss, lack of appetite, and inactivity. These symptoms described my mother to a “T,” but her doctor never applied a diagnosis because of my mother’s very social nature. She perked up whenever she went for a doctor’s appointment, smiling and laughing while chatting with the doctor, so nobody ever saw her symptoms.

If your loved one is exhibiting signs of self-neglect or failure to thrive, you probably feel great concern and frustration when he or she refuses to eat, bathe, or otherwise care for themselves; but there are ways to enhance their quality of life.

First, you should talk frankly with your loved one. Ask your father to talk about how he is feeling or what he wishes he could do now. Encourage your mother to stay as active as possible. If she played bridge, invite friends over and ask her to teach you all the game. If your dad enjoyed the coffee club at a local fast food restaurant, why not suggest you both go one morning and see if you can help him to rejoin that group.

If possible, go with your loved one to a doctor’s appointment and ask questions. Ask your mother to tell the doctor about how she sleeps, or what she eats for meals. If your father is depressed, ask the doctor to prescribe a mild anti-depressant. Review a current medication list and ask if any of these medicines could be causing your loved one’s decline. Also, check for organic causes such as a UTI or a blood clot.

If a physical disability has curtailed your loved one’s engagement, ask the doctor if physical or occupational therapy might help improve things like mobility or hand-eye coordination. If incontinence is a problem, encourage your loved one to start wearing protective undergarments. This one thing might give him or her the confidence to venture out and re-engage in life. Fear of bathroom accidents is a significant deterrent to social engagement among the older population.

Finally, click here for more suggestions on how to help with failure to thrive or here for ideas on managing self-neglect.

Also, don’t let yourself fall into self-neglect as a family caregiver! Remember that self-care is one of the things that will help you give great care to your loved ones. Click here for ideas on how to take great care of yourself as a family caregiver!

Chris and I hope you will join our conversation here and share your heart about dealing with self-neglect or failure to thrive in a loved one or yourself. Who knows, your words can make a difference in someone else’s care world!