Understanding Options for Help: Homecare

There is an arsenal of resources available to Family Caregivers, but it is essential that you know what those resources are, and how to use them when the time comes. This week we will consider Homecare as a resource for supplementing care.

When you are caring for an aging family member, it’s vital to also care for yourself. One of the most common mistakes Family Caregivers make is their failure to involve others so the primary caregiver can take a break from time to time. Many Family Caregivers do not have other family or friends nearby to help bear the burden of care, and that may be where Homecare can help.

Sometimes referred to as Homemaker services, Homecare began to emerge as an industry more than four decades ago, and in the past dozen years, it has burgeoned as a resource for Family Caregivers. Homecare agencies provide individuals who will assist with companionship, preparing and serving meals, doing laundry, housekeeping, and running errands. More technical skills might include assistance with Activities of Daily Living such as bathing, dressing, toileting, mobility, and feeding.  “Personal Care” services require more skills. In some locations, the Homecare Agency offering them must be licensed, and in good standing, with the governing state agency which issues the license.

Currently, Medicare does not cover Homecare services. Options for payment include Long-Term Care Insurance if the policy covers this service; Medicaid may cover Homecare if your loved one qualifies for this benefit, but private pay arrangements are most common. To determine the approximate cost of care where you live, check out this website from Genworth: https://goo.gl/fpNqmK

Whether or not your state requires licensure for Homecare agencies, there are certain things that you need to know when you are choosing a reputable provider. You want to be sure that the individual who comes to your home, and the agency that employs them, is reliable, competent, and caring. Here are a few questions to ask when shopping Homecare agencies:

  • Does the organization run a background check before hiring, and continue to do random background screenings after an employee is on board?
  • Does the agency do drug testing prior to hiring and ongoing on a random basis?
  • Does the agency provide competitive pay and benefits to their caregivers, including paid time off and bonus opportunities so the aides will provide better care to their clients?
  • Does the agency check references for each employee hired; also verify certifications such as C.N.A.?
  • Does the agency provide professional level orientation and training for its employees, and continuing education to keep its employees on the cutting edge of their field?
  • Does the agency have 24/7 phone coverage for both clients and caregivers so that after-hours issues can be handled in a timely fashion?

For a complete list of features to look for in an excellent Homecare company, please leave a comment below and request our document: Homecare: what to look for when you need it.

Finally, we always recommend that you use an agency when looking for care that supplements what you are providing. While private duty caregivers may be less expensive, the burden or organizing care will fall to the Family Caregiver, and if the private duty caregiver becomes ill or needs a day off, you will need to come up with a backup plan. Also, you will need to manage the taxes and other employment withholdings with a household employee, whereas with an agency all of these problems go away.

Last fall we talked about the need to keep yourself healthy so you can give the best care to your loved one. Finding help so you can take a break is one of the most important things you can do to keep yourself healthy. If Homecare is your best option for this, then find a good one and start a relationship. It can make a world of difference to you and those in your care!

 

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Changes in Diet and Nutrition

I’m not sure when my mother’s dietary habits changed. I lived far away and came home every few months. As the years passed, her refrigerator’s contents went through a metamorphosis. Once filled with fresh fruit and veggies, meat and condiments when I was younger, in later years it held mostly dips, yogurt, orange juice, and expired bottles of ketchup and mustard. The freezer contained a few Stouffer’s single-serve meals and ice cream. The pantry had pre-packaged tuna salad, starchy veggies in cans, and bottles of Ensure.

My mother’s dietary routine in her last months looked like this: for breakfast, she ate a single serving of peach pie with a small glass of OJ, a hot cup of coffee, a spoonful of peanut butter and a glass of water with which to take her morning pills. Her lunch was usually a cup of soup with a few crackers, and dinner was a bottle of Ensure. She also had many packages of snacks and cookies on her countertop next to the frig. For me, it is difficult to comprehend eating this type of menu day after day, but I could not argue with her health. She took very few medications and had no chronic diseases, and she lived to the ripe old age of 97.

As we age, changes occur with our taste buds and our caloric needs. Our digestive habits may also shift depending on chronic diseases or maintenance medications. These changes are real, and the successful Family Caregiver must recognize them and make modifications to their loved one’s diet to provide appropriate, adequate nutrition in their later years.

To overcome our failing taste buds as we age, we must find foods with stronger flavors. Use a variety of spices, pungent cheese, or hot sauce to make meals more appealing. Choose fruits and vegetables in different colors to add visual stimulation. Foods must also pack more nutrients in smaller portions to meet decreasing caloric requirements while delivering substantial nutritional value. You will manage these challenging changes through research and education.

Chronic diseases like Type 2 Diabetes or Crohn’s Disease can necessitate significant changes to dietary habits in one’s later years, as can some medications used to manage various conditions. Allergies like lactose or gluten intolerance could develop as well.  Depending on the severity of the situation, or the risk related to medication reactions, significant changes in menus might be necessary. Old habits die hard, so creativity and coaxing might save the day! Again, research and education for you as the Family Caregiver could make the difference between an unsatisfying existence and a thriving lifestyle. Consistency is critical to maintaining the changes you introduce during this time. Good time and resource management will allow you to keep healthy foods in the house and on the table at mealtime.

Finally, research shows that having companionship while eating is crucial for a healthy, happy senior. Try to eat at least one meal every day with your loved one. If you use a home care service to provide companion support, or if you have neighbors who come over and spend time, ask these people to share a meal on occasion. A single cup of soup might become a luncheon or dinner party with the right planning, and laughter makes everyone feel better.

Here are some resources to help you better navigate your caregiving landscape with regards to healthy nutrition for your aging loved ones. We hope they give you innovative insights and ideas for how to pump up healthy eating in your household as well as in that of your loved one.

https://www.caregiverstress.com/fitness-nutrition/senior-cooking/

https://www.caregiverstress.com/fitness-nutrition/senior-cooking/being-prepared/

https://www.caregiverstress.com/fitness-nutrition/elderly-nutrition/4-convenient-steps-healthier-eating-seniors-us/

Share your thoughts below on how you find ways to make your loved one’s mealtime exciting and appealing. And thanks for all you do each day as you care for those you love.

Changes in Mobility

It’s those changes in latitudes,

Changes in attitudes nothing remains quite the same

With all of our running and all of our cunning,

If we couldn’t laugh, we would all go insane.

Jimmy Buffet, Changes in Latitudes

Jimmy Buffet frames today’s blog well: If we couldn’t laugh, we would all go insane.

As we age, nothing ever remains the same, right? When we are infants, one of our earliest milestones is learning to walk. Next, we want to be older so we can gain independence and do the things we want to do. Then, when we are adults, we may not want all the responsibility that comes with that territory. Finally, as we grow older and begin to lose some of our physical stamina or our mental acuity, we start to rely on others to help us again. I know that I can’t imagine what I would do without my 18-year-old son to open jars for me, or to get those blasted plastic cases off of pretty much anything I purchase at Best Buy! And when it comes to today’s technology, I’m completely lost. I need my kids to show me how to turn on the Smart TV in our home!

My 97-year-old mother needs lots of help these days. As I write this, she is still recovering from a fall last November that left her with a broken hip. She can no longer walk, and for the last couple of years, I have warned her that if she were confined to a wheelchair, she would no longer be able to live at home because her house was not built to accommodate a wheelchair.

Of course, my brother (the awesome primary care coordinator!) and I (the long-distance family caregiver) could have implemented a home modification plan. It would widen doors, renovate the bathroom, and make her home livable for someone in a wheelchair, but we both preferred to keep her on her feet and walking. That task became more difficult as time went by.

Arthritis, osteoporosis, congestive heart failure, and any number of other debilitating chronic illnesses or diseases can rob us of our mobility. When walking hurts or leaves us short of breath, we don’t want to do it, but the best way to keep moving independently of wheelchairs, scooters and the like is just to keep walking! If you can walk, even slowly, then you must walk every day. I told my mom this for the last two years, and for the first year, it worked. She would walk to the mailbox and back each day with her Home Instead Caregiver. Then she got sick and lost strength during her illness. When she recovered, she no longer had the stamina for the mailbox walks. Her caregiver still encouraged her to walk throughout the day within her home, but her steps were fewer and more uncertain as time went by.

The fall that broke her hip put an end to her walking days and began her wheelchair season. She is frustrated by the fact that she cannot walk now, and doesn’t fully understand what happened to make her this way. We all make the best of the challenging change in her mobility. Her caregiver is compassionate and patient when helping her from her bed to the wheelchair or her recliner. But she will never again be able to go for a walk, and that saddens me.

If you are providing care for someone who can still walk, please encourage them to go for walks with you. Get them out of the house, and take a stroll around the yard. If they are able, walk around the block. Go to the mall and join the walkers there for a social outing. Park farther from the entrance to the doctor’s office or a favorite restaurant. But know your loved one’s ability or disability. Be prepared if they are having a bad day, or if they need to take a break. Plan for a place to sit, or use a walker with a seat built into it. And remember, this is NOT a wheelchair. It is not designed for the user to sit on it and be pushed, except in the case of an emergency! The longer you, and your loved one, can walk unassisted, the longer you will both be able to walk and enjoy the independence of walking.

We hope you will join the conversation below and share your ideas for how to keep your aging loved one walking, or for how to manage with patience and humor when they can no longer walk on their own.

 

Accepting Change

As we go through life, we experience changes. While some changes are marvelous, other changes are painful; whatever it’s countenance, change is inevitable, and because this is true, we all need coping strategies to deal with change.

 If you have ever raised children, you will remember having to make changes in your home or your lifestyle to meet the changes in your children as they grew. Once the baby began to crawl, everything had to come up off the floor. Once the teenager began to drive, car rules and seating arrangements needed to be modified. The same holds true as we grow older and our ability to do the things we once did, or to live the way we once did, changes.

 These age-related changes can be frightening and even dangerous in some instances. But, with proper knowledge and planning, they can be handled in stride, and you can achieve the best results because of your attention to the issues you are facing.

 Let’s consider dementia first. Alzheimer’s disease and related dementias impact a significant number of older adults in our society today. With no cure on the horizon, Family Caregivers need to be knowledgeable of these diseases and their warning signs, as well as coping strategies for successful outcomes.

 People with Alzheimer’s disease exhibit forgetfulness, anxiety, wandering, and personality changes. Eventually, as the disease progresses, they may not be able to feed themselves or manage essential physical functions. These symptoms may be hidden at first through the use of avoidance or humor, but as time passes the confusion, anger, and frustration with their loss of memory becomes apparent.

 The Family Caregiver who works with someone who has dementia needs to understand strategies for coping with the challenging behaviors these illnesses present because early intervention is crucial to keeping a potentially dangerous situation from developing. The first step is to see the problem coming. The second is to know how to achieve a quick intervention to avoid the crisis. The third is to take swift action to bring about a successful conclusion to the event.

I don’t mean to frighten you, but the reality is, you only have about thirty seconds to engage your loved one, implement your strategy, and successfully achieve your desired outcome.

 Sound complicated? Not really, if you are equipped and know what you are doing. And, as the Family Caregiver, you are uniquely equipped with an arsenal of intimate details that can assist you with implementing your strategy.

 Here are four suggestions for how to avoid a volatile situation with someone who has Alzheimer’s disease:

  1. Offer choices to reduce stress and the potential for upsetting your dad. Having options gives him a sense of control in the midst of his out-of-control illness. Keep these simple; something like, “Would you like to wear the red sweater, or the blue jacket today?” assumes that he will wear one of them. And if instead, he chooses the green sweatshirt, you’ve still gained the victory.
  2. Try to redirect the person from their objective using something you know they like doing. For example, if your dad worries that the neighbors are going to steal his car (and you know this is not the case) but you know your dad likes watching old war movies suggest that you find one to watch together on TV. Reassure him that you will make sure the car is safely locked up, then move him to the other room to watch TV.
  3. Apologize if he accuses you of something you did not do. Don’t try to convince him that you didn’t do what he is accusing you of, simply apologize and offer to help resolve the issue. If he accuses you of having stolen his wallet, for example, tell him you can look together to find his wallet, or suggest that it is lunch time and you will help him search later for his wallet.
  4. As a final resort, remove your loved one from the room, or the object on which s/he is focused. Sometimes a simple change of venue will win the day.

 

Lastly, always remember that what works this time may not work the next, so try three different techniques to have your best success. Choose your fight carefully when you are dealing with Alzheimer’s disease or a related dementia. Don’t argue or correct your loved one if they claim something to be that has never been, or if they tell you they never liked a particular food. You should only intervene if the activity they are focused on could injure them or someone else in some way. “Lose” the car keys if he insists that he needs to drive to work. Modify the door knobs to exterior doors, or attach deadbolt locks to prevent wandering away from home. And enlist the help of family, friends, and neighbors to give yourself a break from time to time.

 As the disease progresses, you may come to a time when facility care is necessary for the safety of your loved one. If this season happens, don’t feel like you have failed. It is but one possible outcome of the disease. Appreciate the time you have spent personally investing in the life of your loved one, and visit often. We will talk more about facility care at another time because there is a place for it in the spectrum of aging care issues. But for now, we hope you will join the conversation below, and share your heart.

 

 

New Beginnings

Did you make any New Year’s resolutions? Whether or not you observe this favorite tradition, it’s always good to take a little time each year to step back and take stock of where you’ve been, where you are now, and where you’re going. Take this opportunity to celebrate your victories over the last few months, consider where you might have done things differently, and then set a course for improvement in the coming weeks and months.

Without this exercise, I frequently feel stuck, like I’m accomplishing nothing with my life. It also helps me to write down my goals. There’s just something about putting them down on paper. When I come back a few months later to check my progress, I’m often surprised by how much I’ve gotten done.

If you are the primary, or only, care provider for your loved one, you might feel like one day blurs into the next, with no real high points to celebrate during your care journey together. My mom’s days were like that in 2017. Day by day, the clock moved slowly forward. Her Home Instead CAREGivers would try to break up the monotony with conversation, activities or getting out to run errands; phone calls and visits from family members and friends were the high points for her each week. I tried my best to focus on these when I would call her, and when I visited, I told her stories about my children’s lives to give her a window into another world.

Take care of yourself and your care recipient in 2018. Here are a few ideas to get you started on your New Beginnings list:

  1. List three things you are grateful for from 2017, and if possible, ask your loved one to do the same. Write these down, maybe in your journal, and make a habit of doing this periodically!
  2. List one to three things you’d like to accomplish in 2018 and do the same with your loved one. These should be attainable, and things that will make you feel good. For example, perhaps you want to learn to paint or play a musical instrument. Maybe your loved one would like to read or listen to a biography of someone they admire, or perhaps they would like to record a message for their grandchildren. Set a deadline and celebrate your accomplishments together!
  3. Be good to yourself. Keep your preventive maintenance appointments throughout the year. Take some “me” time each day to find your balance.
  4. Be social on a regular basis. It helps you stay connected, and it’s also good for your loved one to spend time with others while you are gone.
  5. Keep your spiritual foundation strong. Join a Bible study group, even if it’s online. Attend church services when possible, or ask your minister to drop in for visits if you cannot get out regularly.
  6. Exercise! Your body and your brain need regular workouts to maintain their ability to function at optimal levels. Try for every day, but three to four times weekly is your absolute minimum. Even bending and stretching is a great way to start this discipline.
  7. Don’t forget that your body and your brain also need sleep and healthy nutrition. Give each of these a healthy dose of priority in your New Year’s planning.

Think about what you want 2018 to look like in your role as a Family Caregiver. Pray about it, plan for it, and write it down. Keep it where you can see it, and you’ll be on your way to a great new beginning in 2018!

 

Winning at Caregiving

What does being a Family Caregiver mean to you? This concept means different things to different people. If you are retired, or if you don’t work full-time, you might be able to devote many hours to caring for a loved one. If you live far away or work full-time in a demanding job, you probably need to involve others in your care plan. If your loved one’s needs advanced care beyond your capabilities, or if you are sick or injured yourself, you will need to modify your care plan to supplement or replace the care you have been giving. The key word in all of these scenarios is FLEXIBILITY.

Flexibility is the hallmark of a champion Family Caregiver. When you take each day as it comes, and deal with each challenging situation as it arises, you will find yourself developing strategies that work most of the time. And if the same technique does not work every time, then have a couple of backup ideas. Through practice with what works and what doesn’t, you can hone your skills and refine your playbook.

Just like with any serious athlete, it takes courage for a Family Caregiver to get up day after day and start all over again. Because one day is never like the next, you always have an opportunity to build on the good moments and minimize the hard ones. Your courage to work through good times and bad, to step back when necessary and regroup, to try new ideas when routines fail you, and to accept your failures when they occur establishes a foundation for winning at caregiving.

In addition to your efforts, remember that victorious caregiving is a team sport. While the Family Caregiver’s role can feel terribly isolated, your game plan should include others who care for you and will offer help before you are at the end of your rope! Just like any championship sports team, you probably also have people on your bench who are just waiting for the opportunity to assist. Accept their help when it is offered, and ask for it when you need help. Take breaks to regain some balance in your own life. Utilize a professional caregiving service like Home Instead Senior Care if you need additional resources. It takes a team to support a winning Family Caregiver, and your team can make you a superstar at giving care.

When you are a Family Caregiver, one thing is certain: every day is different, and each one holds its own challenges. Your championship strategy is to remain flexible, practice what works, step into your caregiver role with courage and confidence, and involve others when you need them. Courage, consistent practice, and a great game plan will carry you all the way to win every day at caregiving!

 

 

When Your Christmas is Blue

With all of the holiday cheer during this season, it’s hard for some people to understand how others could feel sad, lonely, or depressed. The media, retailers, and our neighbors all project the perfect holiday season, and everyone’s life looks perfect from the outside. Good cheer seems to permeate the very air we breathe! But for many people, the holidays bring loneliness, isolation, and regrets. These emotions are driven by a number of reasons, but they are valid for those who feel them.

Some people feel depressed around the holidays because they are grieving losses that have occurred during the last year. This may mean the death of loved ones or the loss of ability or even freedom of time and focus. Whatever the cause, loss requires a period of recovery and time to grieve. Others simply feel that their holiday experiences won’t measure up to our culture’s picture-perfect images of smiling families and bright, shiny packages in perfectly decorated homes.

Some people feel a physical impact with the advent of shorter days and longer nights. They are emotionally impacted by reduced light exposure, and if you are one of these people, you should consult your doctor, because there are therapies that can help with this medical condition, known as a seasonal affected disorder or SAD.

Whatever the cause of your depression, if you are one of these people who feel sadness during the holidays, don’t be hard on yourself. Very few people experience perfect holidays. And if you are a Family Caregiver, you are tasked with managing holiday observations and celebrations for others as well as for yourself.

There are things you can do to give yourself an instant mood-lift during the holidays. Bake cookies, or simply sprinkle some cinnamon on a baking sheet and pop it in a warm oven for a few minutes. Your kitchen will smell like a bakery in no time, with no added calories! Light scented candles, or make a flavored tea and sip on it while you relax in some “me” time. For longer-term mood lifters, simplify long-held holiday traditions, or ask for help from others to make everyone’s memories extra-special again this year. Explain to other family members how things have changed, and implement a plan to balance your responsibilities and obligations to those you care for with the expectations of others in your life during this special time of year.

The important thing is to remember why we celebrate this time of year. My family celebrates the birth of Jesus, the Son of God, who came to save the world from its sins. When we are focused on this point of celebration, the joy of our holiday celebrations shines through any difficulties we face.