LIVING WELL Assisted Living at Home has been recognized with the Best of Home Care Award from Home Care Pulse as provider of choice. Awarded to only the top ranking home care providers, based on client and employee satisfaction scores gathered by Home Care Pulse, LIVING WELL Assisted Living at Home is now ranked among a select few of the best home care providers in the country. Living Well was recognized for its work ethics, timeliness of caregivers, knowledge, compassion, problem solving attitude, and overall quality service. Moreover, Living Well received the employer of Choice voted by employees.
The Center for Diseases Control and Prevention (CDC) states that more than 34 million unpaid caregivers provide care to someone age 18 and older who is ill or has a disability; an estimated 21% of households in the United States are impacted by caregiving responsibilities; and unpaid caregivers provide an estimated 90% of the long-term care (IOM, 2008).
It is estimated that one in eight people are now official caring for an aging parent. Edward Francis, a Living Well collaborator, at Forest Health Care estimates that this is a result of the baby boom years combining with improved healthcare and an increase in the average life expectancy. This responsibility may come to these caregivers suddenly or it may become a gradual, progressive path of commitment. It requires a change to your mindset, no longer are you the child, you now need to take care of your parents as they have always done for you.
It can be a challenging experience to be a caregiver for a parent dealing with memory loss that eventually materializes in dementia or Alzheimer’s.
Illness can cause a gentle shift in roles but it is a lot moiré difficult when an accident changes the situation dramatically in moments. This is often the case as elder people are more prone to injury and a broken hip can have a serious impact on their ability to care for themselves. The role reversal can be exceptionally difficult for those who were never that close to their parents but do feel the need to care for them.
It can be very difficult to make the right decision in either your own eyes or your parent’s eyes and you may bear the brunt of a parent’s frustration. For your role as caregiver to work you need to accept that you are now responsible for the decisions and care of your parent.
It can be tempting to visit your parent every day or even multiple times during the day. In reality this will make the process far more difficult. You will end up physically and emotionally exhausted whilst emphasizing your parent’s dependence on you. It can be very difficult to find the right balance between being there and making the best decisions whilst providing them some space to be as independent as possible. It is essential for your own survival to maintain a balance between caring, time for yourself and your own family commitments.
From the moment you start caring for your parent you will have to start thinking about the future. If their condition deteriorates will they need additional caregivers, professional homecare, or perhaps assisted living facilities are the way to go; after all one size does not fit all.
The harsh reality of knowing your parents have a finite amount of time left will combine with concerns over the future, this can become a serious burden and it is essential you share the responsibility as much as possible.
Strengths and weaknesses
Like anyone you have areas of expertise and areas which you are not so knowledgeable or good at. You may be more sympathetic than your siblings or more financially orientated and it is important to utilize the skills you have. Knowing your areas of weakness and accepting that someone else can do that part better is a better way of caring for your parent and yourself than attempting to do it all on your own.
Dealing with a parent experiencing memory loss
One of the most challenging and draining aspects of being a caregiver is when your parent starts to lose their memory. It can feel that day by day they are drifting away from you and you are losing one of the people who have always inspired you and have always been there for you. It is essential to focus on the positives; a memory problem is probably more of an issue to you than to them. Encourage them to visualize their past by using photographs and talking to them, cherish the moments you have and the experience will be rewarding instead of challenging.
Both the caregiver and the parent need to have a good network of support. You need to be able to vent your frustrations and gain advice from others to ensure you know you are doing the best possible for your parent. Your parent needs to remain in contact with as many people as possible to avoid loneliness and frustration building up and making the situation worse.
Every situation will be slightly different but it will always be a challenging time and a difficult journey. Your feelings and emotions will be tested to the limit but the ultimate reward will be worth it; knowing that you were there for your parents when needed and did the best you could, after exploring all the alternatives you could have. Look for consultation with the experts in the field, even if it is a long journey, you are not alone.
Many of our elders who had reached the golden years, find difficult to see the golden part of aging and at least, initially, they are aware of the transitions and respond with a myriad of emotions from shame and anger to depression, anxiety, and fear. Let’s remember theirs was the generation that survived the Great Depression and fought the last “good war.” Aging was not on their agenda, not for this long, not with so many medical issues, and with so little resources for retirement; to care for them we need knowledge, skills but overall empathy.
What is Empathy?
The simplest definition is the feeling of understanding you get when you stop and put yourself in someone else’s shoes. For caregivers this can mean imagining what it must be like to be in constant pain, or to be facing your own death. It could even be picturing oneself as constantly dependent on others, without any privacy. Once you understand what this would feel like you are able to relate better to the patient and will be much less likely to be frustrated by their actions.
Understanding their pain is only the first part of the job. You will also need to overlook your own feelings regarding how they may have arrived at their situation. It is imperative to accept people as they are and help them in any way you can. Empathizing with them will make your job easier as you understand why they need the care and the best way of approaching it.
Edward Francis with Foresthc.com shared with us some of the important points about how relevant empathy s when caring for our elders. He says, “…There are an increasing number of care givers in the world. This is a combination of people living longer and the steady increase of people in the world. Many caregivers fall into the role and can be excellent at taking care of someone’s needs; however this does not mean that they emphasize with them; a good caregiver can simply treat others, as they would like to be treated.
Understanding the Patient
Some patients can seem incredibly rude and make it very difficult to either help them or emphasize with them. In fact these are the ones that need your empathy more than any other. The rudeness is generally a result of severe frustration with the situation they find themselves in. Part of the role of a good caregiver is to understand how the family and friends are coping and to emphasize with them as well.
They may need a break or be struggling with dealing with the issue and a supportive shoulder can work wonders. Understanding their needs and fears can also provide you with the opportunity to help a family member deal with their own emotions and offer a better care giving experience to their loved one. Embarrassment is a common feeling in patients, like all of us they have been used to looking after themselves and doing what they like when they want to.
To have this all taken away and be completely dependent on others is difficult for anyone to adapt to. This often shows as rudeness or aggression but once you understand the patient you will be able to see it for what it is and react accordingly. Be patient and whatever you do make sure you don’t lose your temper in front of them; you certainly don’t want to make them worse, not to mention that it is unprofessional.
Listening can help caregivers empathize more with the patient
It can be very difficult when you are in constant pain and dependent on others to assist you. This can become much worse if you are not able to share your fears with anyone. A good caregiver will see these fears and will listen. Talking to someone allows a patient to lighten the load and this will help them to cope with the situation. It will also prevent either the patient or their family from getting wound up when there are so many factors, which are beyond their control.
Level of care
Caregivers who take the time to understand their patient’s personalities, needs and situation can offer a far better service. You will be able to relate to the patient and this will trigger a better response from them as they register your intentions. A caregiver who can emphasize with their patient will automatically look for ways to improve both the level of care and the general care experience. The best caregivers have empathy, sympathy and integrity, a difficult mix to balance.
Empathy is vital when caregiving for someone with dementia, Parkinson’s or Alzheimer’s. You must find a way to control your negative emotions and focus on the positive. This will help you get a better response from the patient, not to mention that you’ll be more relaxed and willing to help them out too.
Making a life-changing decision on a loved one’s long-term care and considering a nursing home or assisted living facility is never easy and there are many hurdles that must be overcome. For many, this may not be necessary as they will receive the care they require in the comfort of their own home, which is certainly the first option for a large percentage of seniors receiving care.
According to an AARP study 89% of those 65 and older would love to age in place for as long as possible, and there are several important benefits of aging at home, like improved health, routine, independence and the familiar setting. If medically and financially possible, there is no place like home. In-home care can be affordable, when limited in services and in number of hours per day.
For low income seniors, there are several programs, like the In-Home Supportive Services (IHSS) program, the Cash and Counsel program, or if you or your family member is a US veteran, the VA administration for veterans may cover a variety of in home care services in your state. Services that are typically covered by these programs include, health care, personal care, homemaker care, adult day care, transportation, medical equipment and some minor home remodeling.
For those that prefer a group setting, or home care is not appropriate and/or affordable, and the family feels that a nursing home or assisted living facility would be the be the best fit, obviously there are many emotional issues that need to be dealt with. Often there are conflicting emotions raging, including, guilt, anger, sadness and helplessness, when they are no longer able to provide the care that their loved ones now require.
Another area that needs to be navigated when considering a nursing home, is how to pay the bill, which for many American families is financially out of reach even after saving up for a considerable number of years. The same situation arises with home care services; unless the person has savings, equity in their home, or Long Term care Insurance, cost can be an issue. The federal and state governments provide Medicaid/Medical help if the individual meets all financial and medical eligibility guidelines. There is often a grueling task, companies like Senior Planning Services could help you with the Medicaid application process, or you can address your local Medicaid office, often, with the risk of failure quite high.
Last but no least, there are considerations as far as choosing the right nursing home or assisted living facility for mom or dad, to the right in-home care agency that will take into account all personal, cultural, religious and location-based preferences. This accumulation of stress is enough to inundate any sane person, but for the nearly 65 million heroic individuals providing care in the US for a loved one, this is often the best care option for the senior.Having worked for many years as a nursing home placement coordinator for a NJ-based Medicaid planning company, I’d like to share the personal saga of one of our clients which touched me deeply.
Several months ago I was contacted by a woman living in northern New Jersey. Her mom, who resided in central NJ in Ocean County, was suffering from severe dementia and the daughter wanted her admitted to a nursing home in her own area, up in northern NJ, in Bergen County. In addition to her dementia, the elderly woman also had severe behavioral issues.
The family was in the Medicaid application process and their application was in the pending status. Because of her unique needs, our options were quite limited. We needed a nursing home with a secure unit where the residents could not wander out of the unit, since a wander guard would not have been sufficient for this woman. Dementia patients tend to become so confused and lost in their surroundings, that they will try to leave the premises even when wheelchair bound.
The woman, as we mentioned earlier, also had violent tendencies and would sometimes act disrespectfully, hit other residents and caregivers, and needed a nursing facility that was equipped for these needs. These issues made finding the right facility a nightmare.
When we did find one or two, we were turned down, since our Medicaid status was still pending and not all nursing homes were willing to work with Medicaid-pending applicants.
In the meantime, we found placement for the woman in a nursing home in the Ocean County area which was able to provide all of her needs. I had a good working relationship with this facility and, after some cajoling, they accepted her, confident that the Medicaid application would be approved. It didn’t satisfy the requests of the daughter, though, who wanted mom close by.
When the Medicaid application was subsequently approved, we were successful in transferring the woman to a facility closer to her daughter in Bergen County. We were all very excited that it had worked out well for everybody, at last. The daughter thanked me profusely for the effort I had expended in making it happen.
It was heartbreaking when, days later, the woman passed away at the facility…
Conclusion: You know, as professionals, we try to maintain a certain degree of detachment in order to be better able to assist our clients, but at the end of the day… it’s painful. We do develop relationships with the wonderful people whose long-term care is entrusted to us and when they go so quickly, it’s like losing a friend or relative, in a sense.
In collaboration with Benjamin Lamm, a senior advocate.
What makes physical care so challenging in advanced ALS is the absence of other indicators of change — the verbal and physical response to care. The physical changes are much more subtle, and the nurse is more likely to detect changes when there is a connection with the patient that allows a rhythm to unfold. Daily inspections included in the assessment are crucial if potential problems are to be avoided. Particular challenges of patients with ALS who are locked-in follow. It is important to provide a blueprint for supplies in establishing and maintaining a safe home care environment.
Our homes fulfill many needs for us. Often, the most basic need is for shelter from the elements and intruders. Once we are protected and secure, other needs can be met. Comfort and a place for self-expression are vital for our well-being. Home gives a feeling of independence. Our home should also be a place in which we can be safe from accidents and injuries.
A Housing Safety Checklist for Older People prepared by Sarah D. Kirby, Extension Housing Specialist, and published by NORTH CAROLINA COOPERATIVE EXTENSION SERVICE. North Carolina State University and North Carolina A&T State University commit themselves to positive action to secure equal opportunity regardless of race,color, creed, national origin, religion, sex, age, or disability. The guide-checklist stresses that “…Home accidents are a major source of injuries and can cause death. Older persons, whose bones are often less dense and more brittle, are especially vulnerable to serious injuries from home accidents. A simple fall that results in a broken bone can become a serious, disabling injury that limits one’s independence…”
On the guide, you will find a series of checklists. Use these lists as you go through your home. Make a check mark next to those items or behaviors that you already have. If there are items that you do not check, then your home is not as safe as it could be. By improving those items not marked, you can make your home a safer and more comfortable place to live. While the suggestions in this publication are for older people, they apply to all age groups as well.
The increasing number of people turning 65, the high number of elders with health constraints, and the sky-rocketing price of health care posits the question of how are we going to care for all the elders who constitute, today the upcoming silver tsunami?
More than 40 percent of adult patients in acute care hospital beds are 65 or older. Seventy million Americans will have turned 65 by 2030. They include the 85-and-older cohort, the nation’s fastest-growing age group. Elderly people often have multiple chronic illnesses, expensive to treat, and they are apt to require costly hospital re-admissions, sometimes as often as 10 times in a single year. Living Well Assisted Living at Home has designed a new model of comprehensive care that will help care for elders at home, including those who are frail, recovering from surgery, accidents or any illness. The model also strives to care for those suffering from dementia, at home.
In an article written by Milt Freudenheim for the Health section of the New York Times, in June 28, 2010, we find how geriatricians and other professionals are lobbying for best practices in the field of aging. In the article it is stressed the fact of how “..to stay independent, the elderly will need to stay healthy. Many of these people could be back on the golf course and enjoying their grandchildren if we did the right thing for them,” said Mary D. Naylor, a longtime geriatric care researcher and professor of gerontology in the School of Nursing at the University of Pennsilvania. Her research showed that even fragile older people could avoid a quick return to the hospital if they are managed by teams of nurses, social workers, physicians and therapists, together with their own family members. Hospital re-admissions, which cost $17 billion a year, could be reduced by 20 percent — $3.5 billion — or more, she said…” Obviously a new approach to care for the elder is imperative if we wnat to promote wellness in this sector of the population and reduce the increasing costs of caring for seniors.
Mr. Freudenheim continues by saying: “…Many internists, family physicians and other primary care doctors are lobbying for payments for a team approach based in the physician’s office. The concept, which they call a patient-centered medical home, will be tried out under the new health care law by Medicare, Medicaid and some private insurers. Secretary Sebelius has called the medical home idea “one of our most promising models for improving the quality of care and bringing down health care costs…”