Having the Talk about Home Care

HomecareProfessional in-home care agencies report an uptick in information calls after holidays. The reason? The holidays are the time when out-of-town relatives are most likely to visit their elderly loved ones—and to realize that these seniors need help!

The lights, the special delicacies, beautifully wrapped gifts and traditional music—these are things we love about the holidays. We participate in our family’s treasured traditions and reminisce about holidays of the past. And for the many Americans who live far from loved ones, the most meaningful aspect of the holidays is to reunite with family who live at a distance, whom they may not have seen since the previous holiday season or even longer.

These holiday visits can be the time when family realize that elderly parents or grandparents aren’t coping with getting older as well as they had hoped. There may be red flags like stacks of unopened mail piling up, including unpaid bills. Their loved one may have lost a lot of weight. The home may be dirty and the refrigerator almost empty. It may be apparent that hygiene and grooming are becoming a challenge. When the holidays are over, family members may return home filled with anxiety that their parents are no longer living safely.

This often is the time when families conclude that it’s time for Mom and Dad to get some help. They might suggest a move to an assisted living or other supportive senior living environment, but most seniors resist, wishing to stay in the comfort and familiar surroundings of their own home. For these seniors, in-home care is a perfect support resource, providing a variety of services that help ensure elders can continue to live safely at home.

These services include:

  • Personal Care. Caregivers assist with various activities of daily living including bathing, dressing and using the bathroom.
  • Medication Management. Caregivers can monitor a senior’s compliance with the doctor’s care instructions and provide reminders for medications, as well as watch for and report side effects.
  • Nutrition Support. This can include assistance with meal planning, grocery shopping and cooking, and help with special diets.
  • Transportation. Whether it’s a trip to the doctor or to a social event, in-home caregivers can ensure your loved one makes it to their destination safely.
  • Light Housekeeping. Arthritis and osteoporosis, visual impairment, memory loss and other health conditions make it hard to perform the usual household tasks. In-home caregivers can vacuum, dust, clean floors, organize drawers and closets, sort mail, and remove hazards that could cause a fall.
  • Companionship. Isolation is a major trigger for depression and mental decline. Having a companion around helps seniors stayed engaged with life, increasing their overall well-being.

But What If Your Loved One Says “No” To In-Home Care?

Seniors may be reluctant to let a “stranger” into their homes. They may be embarrassed that they need this kind of assistance and fear that home care is the first step in losing their independence. Rest assured that if you receive some pushback from your loved one, you are not alone! Home care experts tell us that during “the talk,” many seniors initially express some resistance.

Starting a conversation about including home care in the lives of older loved ones can be awkward. According to a recent Caring Right at Home poll, the need for care is the No. 1 subject families find difficult to discuss! It’s an ironic role reversal—you want the parents whose advice you often ignored to listen to you now. Before you bring up the topic, take a look at tips from seasoned caregivers that might ensure your conversation yields the outcome you’re looking for:

  • Come from a place of compassion. Put yourself in your loved one’s shoes and empathize with their feelings surrounding change. Listen to their concerns and validate them as normal.
  • Choose the right time. Many seniors are calmer and have more energy in the morning. A good time to broach the subject may be after you’ve all had a good breakfast and everyone’s feeling comfortable.
  • Watch for natural conversational starting points. If your mom discusses a neighbor who fell while cleaning and is recuperating, ask her what she would do if she fell and ask, “Wouldn’t it be nice to have someone come in and clean?”
  • Share your own feelings. Let your loved one know that having someone looking out for them would ease your stress level and enhance your well-being, knowing they are safe.
  • Include your loved one in the decision-making process. If you reach a point where your loved one acknowledges they could use some help, reassure them that they are still in control. If they have any concerns about a specific caregiver, a replacement can be made in very little time.
  • Use independence as motivation. Remind your loved one that with the help of a professional in-home caregiver, they will be able to go out and about, and spend more time doing the things they enjoy—in short, they will enjoy more freedom. And in-home care promotes the best possible future health outcome, another big factor in independence.

If you’ve reached the point where your loved one is willing to consider in-home care, a good place to start is to have an agency provide a needs assessment. During this meeting, everyone can discuss the services that would be of most benefit. It’s best to have your loved one participate in this step if possible. After the assessment, discuss with your loved one how they would like to move forward. You can start small—perhaps just having a caregiver come in once a week to clean, to ensure your loved one is eating properly, and to help with medication reminders.

Finally, it is best to start these conversations early on, before your loved one experiences a health crisis or their condition has deteriorated too far. Thinking about home support services is an important part of healthcare planning! While they’re still healthy, ask your parents what their plans are, should they ever become unable to manage on their own. A series of smaller conversations is always preferable to being forced into having the “big talk.”

When Someone You Love Has Dementia

When Someone You Love Has Dementia

As an experienced geriatrician with many years of seeing dementia patients and their families, I thought I understood not only dementia but of the impact of the disease on family caregivers. So, I was taken aback when the daughter of one of my patients asked me to read the manuscript of a book she had written about her journey with her mother who had Alzheimer’s disease. I realized that, although I knew the medicine, I didn’t understand how difficult caring for someone who had Alzheimer’s disease really was.Later, this same daughter, Anne P. Hill, was diagnosed and treated for breast cancer. After her mother died, we met for coffee and she asked me why she never received any kind of resource book to guide her as a caregiver through her mother’s 10-year dementia journey.

“When I was diagnosed with breast cancer,” she said, “I was given a notebook by every doctor that treated me about what to expect and how to cope.” She went on, “But you never gave me anything to help me with my mom who had Alzheimer’s disease.” I was embarrassed, because she was right. But I didn’t have a resource that I liked well enough to give to family caregivers. So, Anne and I decided to write the notebook that I wish I could have given her. We co-authored Help Is Here: When someone you love has dementia.

According to the Alzheimer’s Association, more than five million Americans have been diagnosed with Alzheimer’s disease or another dementia illness like vascular dementia or Lewy body dementia. In 2013, 15.5 million family caregivers and friends provided an estimated 17.7 billion hours of unpaid care.

Marian Hodges, MD

Eight Tips for New Caregivers

New CaregiversMom just had a stroke and Dad is having a hard time caring for Mom, his own diabetes, and household chores. This may put you in the position of having to take on new caregiving responsibilities. Being a new caregiver is a demanding role requiring an abundance of patience, compassion and self-care. Here is some advice people who’ve had some experience with caregiving offer to those who are starting in the role:

  • Educate Yourself. Learn as much as you can about your loved one’s diagnosis and what you can expect in both the immediate and not-so-near future. Learning about the changes that are likely to follow will provide you with the information you need to ensure both you and your loved one are well taken care of.
  • Be Gentle With Yourself. You will likely go through a range of emotions—grief, anger, resentment and guilt, to name a few. Recognize that these are a normal part of dealing with your new situation and allow yourself to experience each emotion freely as it arises.
  • Maintain Your Regular Health Routine. Continue to exercise, eat well, get enough sleep and keep all medical appointments. Consider learning a stress-management technique such as yoga or tai chi. Keeping yourself healthy is an important part of being the best possible caregiver for your loved one.
  • Meditate. Find some time to be simply still. Quiet your mind as much as possible whenever things feel like they are moving too fast or you are feeling overwhelmed. One thing most caregivers share is that it’s a great challenge to find time for themselves—yet this should be a top priority to allow you to rest and refresh yourself in body, mind and spirit.
  • Ask For Help. Family members and friends often are more than willing to help caregivers with their duties. But they may hesitate to ask. Speak up!
  • Bring In A Professional. Family and friends can be a great help, but this is just the start. Take the time to find out about resources available in your community, such as senior centers and other senior services organizations. Many families find the help of a geriatric care manager to be well worth the fees these experts charge. And to help keep your loved one safe at home while providing respite for you, professional in-home care is an important part of the care plan. In-home caregivers can provide a variety of services, including personal care, medication reminders, meal planning and cooking, transportation, light housekeeping, and companionship.
  • Take Some Time Off. Getting away, whether it’s a week-long trip, a weekend escape, or even a single day indulging in something you love, can make all the difference in maintaining your health and sanity. Ask another family member or friend to stay with your loved one. Or take advantage of respite care provided by a reputable in-home care agency. Knowing your loved one is well cared for will allow you to relax all the more during your time off.
  • Socialize. Continue spending time with your circle of friends. This will help you maintain a sense of self. But if you sense that you’re spending too much of the conversation discussing your loved one and your caregiving challenges, consider joining a support group! Just knowing that you’re not alone can provide a real morale boost. Support groups are also a great place to get practical advice and discover the variety of resources available to you. And you’ll most likely make some new friends.