Chapter 1
Providing Eldercare for a Loved One
Aging—it happens to all of us. It’s a natural part of life, and for anyone who has made it to his or her golden years, there will be changes and challenges to body, mind, and spirit. Bit by bit, you may notice a new wobble in your loved one’s walk, an increase in those senior moments, or perhaps your older person just seems more fragile and vulnerable overall.
Providing care for a loved one will touch your life in many different ways. It might affect you personally as you care for your spouse who is recovering from a heart attack. Perhaps your best friend is a long distance caregiver for her parents living across the country. Or maybe your neighbors’ elderly mother has moved in with them because she has fallen so many times, and it’s not safe for her to live on her own. It would be nearly impossible to go through life and never face the aging process and some form of caregiving yourself or through someone you know.
Taking care of another person can be a tremendous responsibility, and chances are that the majority of care will fall on your shoulders. If you’re lucky, you may have family members willing to help with certain issues, but it’s likely that one person will be providing most of the guidance and advice to the others. Usually, there’s been no special training to teach you how to manage the welfare of your loved ones before you realize it’s needed, and that can be very unsettling. How do you know what you should be most concerned about? Where can you get the guidance needed to make these decisions? When will you know it’s time to ask for outside help?
It’s important to remember that you aren’t the only one in this situation. According to research conducted by the Alzheimer’s Association in 2011, there are over 43.5 million people providing care for someone over fifty years of age. But the good news is that there’s a great deal of information and many resources available to assist you through the process of providing care for the aged or infirm.
It’s Not Just about You
If you’re a caregiver, not only are you significant to the person you provide care for, but you most likely also have a spouse, children, other family members, and friends who rely on you as well. Your day-to-day responsibilities and decisions affect more people than just yourself and the person for whom you are caring. They also have an impact on nearly every other person in your life. This stress can add to the normal pressures of managing your family and professional responsibilities. So who is it that may be feeling the pressure and effects of eldercare along with you?
Spouse
Providing care for another person can simply be overwhelming. It’s only natural that you require a great deal of support and understanding from your significant other to manage it all. However, it’s critical to remember that your significant other also has needs and that your relationship needs regular maintenance. Some suggestions for nurturing your connection are given here.
• Talk about everything. Couples need to be able to communicate openly and honestly. It’s a must, and no subject should be off limits. Both parties need to feel that they have the right to speak about whatever is on their mind and that it will be received without judgment.
• Listen. It’s hard to realize what your spouse is saying if you are already trying to solve the problem or form an answer in your head. Ask if your spouse is done before commenting, and it can be helpful to repeat what you heard to make sure you understood correctly.
• Don’t blame. Blaming one another never solves the problem. Focus on what the issue is and how to solve it rather than who created it. Try to take the emotion out of the discussion and stick with the facts. Seek out ways to work as a team moving forward.
• Don’t wait too long. Holding on to your anger, resentment, or whatever feeling is causing the stress will only delay things until a time when you can’t handle it any longer and you blow up. There is always an excuse as to why you can’t talk about it today, and that won’t change tomorrow, next week, or next month. You need to address the issue as soon as possible and clear the air.
Children
It is not unusual for children to act out or suffer quietly when their parents are caregivers. They might be angry or anxious about what is happening within the family, sad about the changes they see in someone they love, or maybe they just feel as if they are being ignored. Here are some actions you can take to help them feel included and more secure.
• Ask them to help. Don’t push your children aside because they are too young and you want to spare them the realities of aging. You can include them in ways that will help empower them and teach valuable life lessons and skills without exposing them to any details they are too young to understand. Explain that sharing their company, hugs, and affection is the greatest gift of all and will make anyone feel better. Also, you might prepare some topics they can talk with their loved one about. They may find that they need to initiate the conversation, but then they can sit back and simply listen to the stories. Feeling as though they are part of the process will inspire them greatly.
• Beware of the constant crisis. Stop and think before you react to situations. Make sure that you don’t create a crisis every time something unexpected or difficult happens. Take a deep breath and ask yourself if anyone is in immediate or imminent danger. If the answer is no, then slow down, clear your head, and take time to address the situation calmly. Your children will learn from you and will develop a beneficial life skill.
• Make time. No matter how many different scenarios are screaming for our attention, there is always time to take a few moments, a couple of hours, or maybe even a whole day every now and then to create personal time with your children. Recognize times when your children are away from home and might be missing you, such as spending the night with friends or attending summer camp, and call them on the phone, leaving a message that tells them how much you love them and that you are proud of them. Pick a night each week and make it a mandatory family meal. Plan special dates with one child at a time, even if it’s just to get an ice cream or play a game. Whatever you do, make sure that you focus on the child and create optimal quality time.
• Invent a special nickname or habit just for them. The comedian Carol Burnett used to sign off her variety show by tugging on her ear in honor of her grandmother to let her know how much she loved her. By giving someone a unique nickname or inventing a special action or gesture such as an ear tug, you are telling them how special they are each time you use it.
Siblings
Providing care for an aging parent or relative can bring out the best or the worst in family members. But few relationships are more emotional than those among siblings. Ideally, everyone would come together and support one another, but for various reasons, it can also end with strained relationships or conflicts. Why? The demands of caring for an aging loved one will invariably give rise to old family dynamics and patterns. Adult children may find themselves replaying old hurts and resentments and reopening those wounds, making it difficult to work together. There may be a sibling who is in denial over the condition of the parent and who refuses to be involved because he or she doesn’t want to face the truth. Another sibling may feel responsible for the majority of or all the caregiving duties due to close geographical proximity or fewer outside responsibilities than the others. Whatever the case, there are ways in which families can come together in the best interests of all concerned.
• Ask for open and honest communication. Let everyone know that their feelings and opinions matter.
• Keep everyone informed of a loved one’s condition. Use e-mail and group settings to make it easy to send one e-mail with all the information rather than to make time-consuming personal calls to each family member.
• Have realistic expectations. People have different skills and abilities. One person may be quite good at hands-on care such as showering and dressing a loved one, while another may balk at such intimate assistance but will excel at managing money. Accept them for who they are and what they can provide.
• Respect differences of opinions. You may not always carry out another’s wishes, but you can show respect and acknowledge each other’s feelings. Find ways to compromise whenever possible. Remember, there is usually more than one way to do something.
• Utilize other professional services. If discussions are too heated, find a mediator such as a social worker, religious leader, or counselor to facilitate family meetings. If siblings are unable to help with care, find outside agencies to come in and provide respite, help with meals, or offer companion services. There are many resources available if you are willing to move beyond the idea that you should only rely on family support.
Friends
Friendships are often a lifeline for a caregiver. It’s not uncommon for a friend to provide more comfort and support than family members. But caregiving can also take a toll on these bonds, and it takes effort from both sides to make it work. You can ensure your friendships will last while your focus increases on an aging loved one by taking certain steps.
• Share openly and honestly. While you don’t want to dominate every conversation with the details of providing care, do let your friends know that your time is limited because of care-related appointments or that you’re feeling run down and need to nap instead of having coffee. If you are straightforward about how you’re feeling or what challenges you have right now, your friends will understand.
• Be a good friend back. Remember that just because you are struggling with your own situation, your friends still have lives they are living as well. Make sure you ask how they are, what their kids have been up to, or if anything new happened in their lives. Show an interest in them and then listen!
• Ask for specific help. Your friends want to be there for you, but it can be extremely frustrating if you won’t tell them what they can do. Many have no clear idea of what would be helpful. If you need someone to spend an hour with your mother so you can take a bubble bath, say so. Maybe you’d like for someone to fix a meal or pick up a meal from a restaurant to give you a break from cooking and cleaning, so ask for that. The key is to be specific, and you may find that you get exactly what you want or need.
• Identify friends from acquaintances. It can be heartbreaking when you realize that someone you thought was a friend is not acting like one, especially when you are in need. It can be extremely helpful to take account of your relationships and identify whom you believe you can truly turn to in a time of need. Don’t waste precious time and energy investing in a person who doesn’t fall into that category, and you will free up more time for those who do.
Professional Relationships
Maintaining your work responsibilities and relationships can be one of the biggest challenges while providing care. You can take the following steps to care for your loved one without jeopardizing your career.
• Understand your rights at work. Your first step in maintaining your professional relationship is to learn what your rights and protections are at work with regard to caring for parents or other loved ones. The Federal Family and Medical Leave Act of 1993 (FMLA) allows employees to take 12 weeks unpaid, job protected leave for the purpose of providing care for a spouse, parent, or child with a serious health condition.
• Inform your employer of your needs. Contact your supervisor or the human resources department at your place of work and let them know about your situation. Discuss any possible changes to work hours, work environment, or time off you may need. It may be possible that you can work more flexible hours or telecommute in lieu of taking leave.
• Always be professional. While our employer and fellow employees may be kind, supportive, and understanding of your situation, you must remember to always behave as a professional during business hours. Don’t use your employer’s time to make personal phone calls or waste another employee’s time by sharing your troubles during working hours. Focus on continuing to perform your duties at your highest level, even though you may be feeling emotional. The bottom line is that you need to maintain and honor your business relationships to protect your income and future.
Being a caregiver for a loved one is a rewarding experience. However, being thoughtful about your other relationships can also promote a sense of normalcy and peace for you, your family, and everyone else included in your daily life.
Your Biggest Concerns Regarding Eldercare
Decisions about providing care for another individual are not easy. There are many worries that can overwhelm and confuse those in charge of managing that care. The good news is that you can and should prioritize these concerns. You don’t need to spend a great deal of effort and thought on every need or desire your loved one may have. Give yourself some breathing room. Start with the major areas you should be focusing on and then, when you are confident these are being managed appropriately, you can begin concentrating on the smaller needs.
Safety
Ask those who are providing care for an elderly person what they most worry about, and certain images will likely come to mind: their loved one falling with no help close by; becoming confused while driving and turning in front of oncoming traffic; or, one of the most dangerous, growing forgetful and taking a medication in the morning and then again later, resulting in an overdose. The best factor for determining what one should worry most about is whether it pertains to the safety or essential health and well-being of an individual. This takes priority over those that deal with personal preferences or desires. Some of the major issues that should be watched for and addressed in a timely manner include the following items.
• Home environment. For most, safety begins at home. Conduct a thorough inspection of the living environment and assess any hazards that might cause a fall or injury, such as throw rugs and out of place furniture. Can there be a fire risk because of piles of magazines or newspapers? Are the air conditioning and heating units working properly? Do the windows and doors lock and unlock easily? Is the lighting adequate inside and out? If you aren’t sure you are catching all the potential hazards, there are home safety assessment tools available online, or you can hire someone to conduct the assessment in person and make recommendations to make the property safe.
• Abuse or neglect. Every person has the basic human right to be free and safe from all forms of abuse or neglect. Physical abuse results in pain, injury, or impairment. Symptoms will include bruising, swelling, cuts or scratches, or even broken bones. Emotional abuse causes emotional pain or distress. It is caused by intimidation through yelling and threats, humiliation or ridicule, ignoring the person, isolation, and other forms of menacing behaviors. Sexual abuse involves physical sexual acts, but may also include exposing a person to pornographic material.
• Neglect or abandonment. This may or may not be intentional, but neglect or abandonment is a failure to support the physical, emotional, and social needs of the person in your care. Neglect is usually the result of caregivers feeling overwhelmed or overloaded and might be identified as not providing enough food, withholding medications, physically restraining a person, or confining a person in his or her room or home with no stimulation. Abandonment is when a person is completely deserted with no support.
• Financial exploitation. This involves unauthorized use of a person’s funds or property. It can include the misuse of a person’s checks, credit cards, cash, or household goods. Forging a person’s signature or committing identity theft is also classified as exploitation.
Functional Decline
Functional decline is the loss of the ability to do certain things. For a loved one who is aging or already elderly, it will become more prominent over time. The following are some of the signs of functional decline.
• Physical symptoms. This includes changes to or loss of vision, hearing problems, balance issues or falls, decreased mobility, trouble sleeping or eating, incontinence or lack of hygiene, and skin problems, including pressure sores.
• Mental or emotional symptoms. This includes changes in personality, memory loss, depression, and behavioral problems.
Every human being experiences some functional decline with age. However, there are some things you can do to ensure that you and your loved ones remain as healthy and independent as possible.
• Get enough sleep. Six to nine hours each night should be the goal.
• Watch your diet. Make sure your meals are full of healthy and nutritious foods. Avoid sugar and processed foods.
• Stay hydrated. This is especially critical for our elderly loved ones who can develop conditions such as urinary tract infections that can land them in the hospital.
• Exercise. Keeping our bodies moving is necessary to maintain muscle mass and flexibility and to reduce falls. As they say, “A body in motion tends to stay in motion.”
• Keep your brain healthy. All of the above will assist in keeping your brain healthy but also make sure your loved one is receiving as much social stimulation as possible and participating in activities such as reading; watching television programs that require thought, like game shows where the viewer can answer questions or play along with contestants; and engaging in hobbies or taking courses on subjects that are of interest. One of the most important things you can do to keep your brain healthy is to keep stress under control. Find ways to manage stress through meditation, deep breathing, or visualization.
Falls
Falling can happen at any age, but it can be particularly serious for the elderly, who are at higher risk for serious complications from brittle bones or other medical conditions. A younger person may recover quickly, but a fall for an older person may result in an emergency trip to the hospital. In some cases, it can lead to a loss of mobility and independence, traumatic brain injury, or possibly death. The good news is that there are easy ways to help prevent falls from happening.
• Keep your environment clear. A cluttered living space will invite accidents. Make sure throw rugs are tossed out, remove unnecessary furniture such as low-lying coffee tables or stools, secure loose cords or wires, and pick up shoes or clothing strewn about on the floor. Anything you can remove from pathways will help reduce the risk of falling.
• Build muscle strength. Exercise will develop muscle strength and thereby increase a loved one’s balance and ability to recover at the beginning of a fall.
• Check your medications and supplements. Many medications such as sedatives or antidepressants may cause fatigue, dizziness, or other side effects that might make your loved one more susceptible to falling. Make a list of all medications and supplements, take it to your doctor or your pharmacist, and ask if they might increase your loved one’s risk of falling. If the answer is yes, then discuss what might be eliminated to help promote safety.
• Get a checkup. Many health issues can contribute to your loved one being unsteady on his or her feet—like eye or ear problems. Take your loved one to visit your doctor or specialists to ensure there aren’t any conditions that might need treatment.
Medication Management
It’s been estimated that over 50 percent of seniors will mismanage their medications and that over 10 percent of all hospital admissions are a direct result of that mismanagement. This is one of the most serious concerns for seniors and their families. Not taking medications properly can result in hospitalization or worse—death. There are many reasons why people may not take their meds properly. Here are some of the more common excuses and suggestions on how to resolve them.
• I forgot to take my pills. While it can be true that they simply forgot, neglecting to take pills may also be caused by memory issues or the side effects of medications. The family may want to consider pill organizers, services that provide reminder phone calls, or watch alarms that sound when it’s time to take their medications.
• I can’t read the prescription labels. If they can’t read the label to know how much to take or what pills they are taking, seniors may simply choose not to take their medications at all. The solution is quite easy. Ask the pharmacist to use large print on the labels. Make sure loved ones have a magnifying glass nearby to help read smaller print. Or, once again, have a family member fill up a pill organizer.
• I can’t afford the medication. Financial difficulty leads many seniors to either stop taking their medications, purchase larger pills and split them, or take them at irregular intervals to make them last longer. This can be disastrous. It can lead to health complications, overdoses, or even death. For lower income families, there can be relief by requesting generic brand drugs, asking your pharmacist if they offer any discount drug programs, and researching prescription assistance programs through online organizations such as BenefitsCheckup.org.
Dementia
Dementia is not a disease in itself. It’s a collection of symptoms caused by a number of disorders that affect the brain. In general, it’s a decline in mental function that is severe enough to interfere with daily life. Dementia can cause many issues for your loved one and family members. The symptoms can include the following:
• becoming lost in familiar places or wandering away from home
• being unable to follow directions
• losing orientation about times, places, and people
• asking the same questions or making the same statements over and over
• lacking the ability to make sound judgments, especially about money
• losing the ability to communicate
• neglecting personal hygiene, nutrition, and safety
These symptoms can place tremendous stress on caregivers, especially if they are accompanied by severe changes in behavior.
The symptoms of dementia vary greatly, but a diagnosis of dementia requires that two of the following core mental functions must be significantly impaired:
• memory
• communication and language
• ability to focus and pay attention
• reasoning and judgment
• visual perception
It is important to remember that many people may develop memory issues that are classified as dementia. Medications, infections, and acute illness are some of the causes of memory loss that could possibly be reversed with treatment.
To date, dementia is not curable, but there are great strides being made in the efforts to find cures or treatments such as gene therapy, stem cell therapy, and dementia vaccines. There is also the positive news that some of the symptoms may be treatable, at least for a period of time, to provide relief to both the patient and the caregivers.
If you suspect that your loved one has dementia, it is critical to schedule a doctor’s visit as soon as possible for a thorough evaluation. Here are some things to help prepare for the appointment.
• Make a list of mental and physical complaints and any unusual behaviors.
• Make a list of all medications and supplements, including both prescription and over-the-counter.
• Consider scheduling an appointment with the doctor for yourself to provide essential information and address your concerns before meeting together with your loved one. This will allow you to provide helpful information without causing discomfort, embarrassment, or fear for your loved one.
Finally, if there is a diagnosis of dementia, surround yourself with as much support as possible. Seek out support groups, educate yourself about the condition causing the dementia, and when things get really difficult, remember that it’s OK to love the person you’re caring for, but you don’t have to love the disease.
Isolation
Mental and social stimulation are tremendously important to a person’s overall well-being. When people are isolated, they will decline physically and mentally much faster than if they are in an environment that will provide much-needed interaction. Isolation can cause the following:
• aches and pains, headaches, illness, or other medical conditions
• anxiety, panic attacks, depression, or paranoia
• tiredness
• lack of motivation
• difficulty sleeping
• weight gain or loss
• loss of appetite
• substance abuse
• low self-esteem, hopelessness, and thoughts of suicide
If you’re worried about your loved one feeling isolated, there are things you can do to help.
• Help them to connect or reconnect with family and friends. Reach out to let family and friends know your loved one wants a relationship and would love to see them in person, talk on the phone, read letters and cards, or even use the computer to stay in touch.
• Yes, use the computer. While many seniors feel that Skyping and social media are not proper ways to interact with family and friends, it is more likely that they are uncomfortable using a computer. Invest some time helping them learn how and you may have a hard time getting them off at the end of the day! As their confidence grows, not only will they be able to communicate with others, but they may even learn how to play games, use brain fitness programs, and engage in other positive activities that will take their mind off of their loneliness or depression.
• Suggest a pet if they don’t have one. Pets make excellent companions and provide a sense of purpose.
• Help them get out and about. Investigate means of transportation so they can get out on their own, if possible. Being able to run errands, going out to eat, or seeing a movie will give them more independence and help with self-esteem and happiness.
Depression
Significant life events or the changes in your loved one’s body can cause depression. The death of a spouse and friends, medical problems, a reduced sense of purpose, or the loss of independence can all lead to moodiness, sadness, or worse. Depression is common in older adults or those who are debilitated, but it doesn’t have to be a part of your loved one’s life. Depression can be easily treated with medication, therapy, or a change in lifestyle. The key is to recognize it and seek help. Here are some of the clues that a person is depressed:
• feelings of hopelessness or helplessness
• anxiety and excessive worries
• irritability
• loss of interest in things that use to give pleasure
• memory problems
• lack of motivation or energy
• neglect of personal care, such as showering or eating
• unexplained aches and pains
• thoughts of suicide or death
Depression is a serious medical condition and needs to be addressed as soon as possible. In addition to seeking treatment, there are some things you can do to help your loved ones.
• Accompany them to doctor appointments and offer support.
• Listen to what they say and don’t judge; give them feedback based on reality and hope.
• Encourage them to interact with others and to take care of themselves.
• Make sure they are taking their medications.
Managing Life Transitions
Life is simply a series of transitions. From the time we’re small children stepping into school for the first time and then graduating from college, getting married, and having children, it’s expected that we will learn, grow, and adjust. But certain changes in life are overwhelming to us all and more so for the elderly, who may have health problems, suffer from memory loss, be more fragile because of age, or be set in their ways and simply stubborn. It’s possible that they’ll need a little more support and assistance to get through these moments than a younger person will in order to make it less stressful.
Retirement
One of the first major transitions an older person will have to navigate is leaving the workforce. For many people, their profession is their entire identity. “I’ve been a doctor for 40 years. What will I do with myself if I quit working?” Retirement can have a different effect on each person, but for most it will mean reduced income, changing roles or relationships, and having nowhere to go and nothing to do. While some look forward to quitting work and spending more time on hobbies, family, and self, for others it may mean hours of feeling bored and unproductive.
Loss of income is often the culprit for much of the anxiety retirement causes. Without money, seniors may not be able to afford to take the trips they dreamed of, may have to downsize because their home is now too big and too expensive, and may no longer have enough money coming in to pay for rent, food, and medications. Budgeting beforehand and preparing for retirement would be ideal, but it’s equally important afterward. You may have to sit down with your loved ones and insist on going over the finances together in order to help them find ways to manage.
Along with the loss of income also comes the loss of the relationships with the coworkers they interacted with daily. This can be as depressing as losing a good friend. In fact, they may have just lost all their friends, especially if they were a workaholic. They’ve also lost their ability to control and manage others, which is why you often hear of the cliché where the husband is now micro managing his wife’s daily chores and activities.
Finding interests and activities to replace the daily routine of work is necessary to maintain mental and emotional health. If your loved one is really struggling with retirement, perhaps volunteering with charitable organizations or groups, joining a club, or taking classes on engaging subjects will help ease the transition.
Relocation
By the age of retirement, many people find themselves living in a house much larger than they need or more expensive than they can now afford. Children have grown and don’t visit as often as was planned; two people don’t need four bedrooms and three baths or the yard with the swimming pool, basketball hoop, and playhouse. These big homes often require too much work and money to maintain. Perhaps your loved one would simply like to focus on other things. Unfortunately, declining health may dictate the need for new living arrangements. No matter what the driving force is, the thought of downsizing, selling a home, and moving can be very unsettling. It can be so overwhelming that some people will simply refuse to even think about it and remain in a situation that isn’t in their best interest. Depending on the reason for the move, you can assist them by listening to their thoughts and feelings on the matter and then providing resources to assist them. Maybe a little counseling is needed, or the assistance of agencies that specialize in downsizing and that can help them sort through their possessions, decide what to do with them, and then make the arrangements so that the process is not so overwhelming. Doing your homework and having the support identified and available will help make an overwhelming project much more bearable.
Taking the Car Keys Away
At some point in time, it will be inevitable. It will no longer be safe for your loved one to drive. This may be the most traumatic transition he or she faces. It means a loss of independence and, for many, the end of the road. No pun intended. While giving up the keys may mean more of an inconvenience to getting around, it doesn’t mean that your loved one will become a prisoner. There are plenty of options to help her maintain that independence if she is willing to meet you halfway.
• Be realistic and prepared to have a series of discussions. It is highly unlikely one discussion will resolve the issue. Don’t be surprised if emotions run high and your loved one becomes very angry and refuses to talk further. Avoid coming on too strong in the beginning. Ask some questions that will force her to reflect on her driving skills, such as “Are you aware that you drive with the passenger side in the bike lane?” or “What do you think about the fact that you’ve been in two fender benders this month?” She is probably already aware of the difficulties, and this will allow her to acknowledge her own concerns. If she becomes defensive, be willing to back off, but firmly set the expectation that there will be another conversation when she has calmed down.
• Listen and reflect. Give her time to talk about her feelings and fears. You may find her reminiscing about the past and giving you reasons why she can’t give up driving. Talking through her driving life may make it easier to reach the conclusion that it may be time to give it up. Ask why she thinks it might be time to stop, and then offer your reasons, such as the amount of money she will save on gas, insurance, parking, and perhaps car payments. Remind her that there are plenty of ways to get around without owning a car. Be prepared to tell her exactly what those options are—such as using Dial-a-Ride, calling a cab, or utilizing the senior center’s bus—and how much they may cost. Reassure her that you will help until she is comfortable making arrangements on her own.
• Seek out a second or third opinion. Sometimes our opinions don’t carry much weight. It might be necessary to bring in an expert to convince your loved one it is time. Our seniors respect certain authority figures such as their doctors, religious leaders, or police officers. Bring the subject up with someone you know your loved one respects and ask that person for help. That may be all it takes: to have someone else whom she trusts and listens to tell her that she shouldn’t be driving. Or you can insist on a driving test and then let that be the deciding factor, at least for the time being.
• Disable the car. If all else fails and you believe that your loved one is highly likely to hurt herself or another, then you may need to take extreme measures such as disabling the car. If the car won’t run, then she can’t drive.
Death and Dying
Perhaps the most difficult transition to cope with is when seniors begin losing their friends and are facing their own mortality. Coping with death can be difficult for anyone, but when compounded with issues such as declining health and memory loss, it can be an even greater struggle. While there is no right way to help someone deal with grief, there are some things you can do.
• Acknowledge the loss. Tell him you understand it must be difficult, and ask him to share stories with you about the person who has died.
• Listen attentively. Don’t be too eager to share your feelings or to make comments. He may need to tell the same story over and over until he comes to terms with the death. If he doesn’t want to talk, be willing to sit quietly with him if he would like.
• Be understanding. Not everyone grieves in the same manner. Don’t tell him how he should handle it. Be respectful of the process, but let him know that you are there for support.
Providing care for a loved one is often a long, complicated journey. You can drive yourself crazy thinking about every concern or issue that might arise. My advice is to remember that not every concern is critical or needs to be addressed as a crisis. One fire at a time . . . slow down, breathe deep, and think carefully about where you need or want to spend your energy and time. You’ll want to acknowledge the situation in its entirety, but you’ll also find it much easier to handle if you prioritize regularly—maybe even daily.
Recognizing Your Role as a Family Caregiver
“I’m not a caregiver. He’s my husband, and it’s my job to take care of him.” I can’t tell you how many times I’ve heard a similar version of this statement. Family members in particular tend to view the role of caregiver more along the lines of an extended version of their relationship with the person receiving care or providing care. Why is it so important to identify yourself as a family caregiver? Mostly because if you don’t call yourself a caregiver, you will never reach out for support, resources, or solutions that might be available to you. You, and perhaps others, tend to see it as a role that requires you to do it all. And that’s not true at all!
You might think to yourself that it doesn’t really matter what you’re called, but it does. Sometimes the role of caregiver sneaks up on you. Over time, you begin to assume more and more responsibilities while taking care of yourself and others that you don’t even realize you are a caregiver. You’re just doing it, and by the time you realize it, you’re overwhelmed, exhausted, and sometimes desperate. Caregiving can cause stress, emotional and physical problems, financial struggles, and much more, so being able to identify yourself as a caregiver may prompt you to claim your right to also care for yourself. This will then enable you to provide better care for your loved one.
Did you know the following facts?
• Family caregivers who live with their loved one spend an average of 39.3 hours per week providing care.
• Caregivers show higher levels of depression, as well as exhibiting other mental health problems such as anxiety, stress, frustration, and feelings of loneliness or isolation.
• They are also more susceptible to substance abuse or dependence, smoking, and consuming more saturated fat.
• Caregivers suffer from more physical ailments such as headaches, pain/aching, diabetes, arthritis, cancer, obesity, slower wound healing, high blood pressure, higher levels of cholesterol, and an increased risk of heart disease.
• They report lower levels of self-care such as engaging in preventive health behaviors, visiting their own doctors, exercising, and eating healthy.
• Approximately 60 percent of caregivers die before their care receivers.
The good news is that being a family caregiver also has a positive side. Caregivers often report positive feelings of being useful, having a sense of self-worth, a greater confidence in their abilities, and an increased family closeness. Some even say that they have gone through spiritual growth that may not have happened otherwise. Lastly, caregiving often requires complex thought that can ward off cognitive decline.
How Do You Know If You Are a Caregiver?
A few simple questions may give you clear insight on whether or not you should accept the title of “caregiver.”
• Who does your loved one depend on the most?
• Who would your loved one call in the case of an emergency?
• Who handles medications and doctor’s appointments?
Caregiving is hard work. Take vacations, also known as respite, just like you would for any other job.
Accept help. When people offer, be specific, let them know what you need, and then let them do it.
Learn as much as you can about your loved one’s condition. Knowledge is power, especially when dealing with medical personnel and insurance companies.
Trust your instincts. You know your loved one better than anyone.
• Who knows the most about your loved one’s condition and care needs?
• Who does the hard, intimate work, such as helping with showers and toileting?
Owning your role as caregiver will allow you to acknowledge how much you do for your loved one. It will give you a sense of responsibility to the person you are caring for and to yourself, giving you permission to take care of yourself so you can continue to take care of your loved one.
You Have Choices in Managing Care
You have now identified the main concerns regarding aging and eldercare. You’ve also realized and acknowledged that you are a caregiver. Right about this time, you may be scared to death over what this means. Don’t be. There are many choices and resources available for every type and every level of need. Taking a realistic look at what your loved one needs, what you are truly capable of providing, and who to turn to for help when it becomes more than you can deliver will be the first steps in making sure that there is as high of a quality of life for all involved. Whether you choose to provide care through the family, bring on professional caregivers, or move your loved one to a care community, you will do it knowing that you’ve educated yourself and are making informed decisions.