Tag Archive | Caregivers

Seeking a Higher Level of Care

By Cindy Sproles


Courtesy of http://www.pixabay.com and PICNIC_Fotografie

Parents are the foundational support of the family. They are the symbol of strength when we are children, caring and providing for us. Their goal – to assure their children grow to be happy and productive adults.

As we grow and take on families of our own, our parents welcome grandchildren into their arms likewise providing that special love and care a grandparent can only give. But what happens when the reality of an aging parent hits home?

No longer are we comfortable with leaving the grandchildren in their care. No longer are we sure they can care completely for themselves. A time comes when the roles must reverse. Our parents need assistance and it’s hard to accept.

Every situation lends itself to the specific needs of each individual parent. Therefore having a conversation about the future needs of their care is vital while parents are in good health and not in the throes of sudden illness.

It is important to know there are levels of care spanning from simple assistance to fully dependent care in a facility. Rushing to either degree is not something one takes lightly, rather it is one family members assess with great care.

*In-home non-medical caregivers – The first stage of higher care is the introduction of a caregiver who can come into the home for a few hours a week to help with the mundane skills life requires. Non-medical caregivers can prepare meals, assist with light housekeeping, and help with personal care and hygiene. Most aging parents can maintain their home for a number of years with just a few hours weekly from an outside caregiver. It is important to take into consideration the pros and cons of hiring a private caregiver, keeping in mind the need for backgrounds checks, and access to personal finances and properties must remain strictly limited and monitored. When hiring through a caregiver company, children can trust background checks are performed and workmen’s compensation insurance and liability insurance is in place to cover the caregivers. Please note, when hiring a private caregiver, families are responsible to pay taxes, provide a 1099, and assure there is workmen’s compensations available to protect both your parent and the caregiver. Check with your parent’s homeowner’s insurance to see what is covered and what is not via their homeowner’s policy. Families are stunned that coverage does not extend to cover private contracted laborers. Though private caregivers can be safe and dependable, families are best served to cover the bases of safety and security by considering a company’s assistance. Companies must meet strict standards of care and are monitored by their perspective states.

*Assisted living – When in-home care is not enough the next step of care is assisted living. Parents live in an assisted living community. Their independence is 100%, being allowed to come and go as they please, even drive if they are physically and mentally able. Assisted living offers full internal assistance if needs require. Facilities or communities provide meals, transportation if needed, and a physician, nurse practitioner, or RN on staff 24/7. The primary requirement for living in assisted living is to be independent enough to get themselves out of the building in the event of a fire or facility emergency. Otherwise, assisted living can help parents up until memory care or full care becomes necessary. Assisted living is far more affordable than families imagine. It’s important to know that when families close the parent’s home and turn off utilities, cancel insurances, and either rent or sell a home, those same funds can now be diverted to the cost of assisted living. On a personal note, our family rents our parents home through a realtor and all those funds go to defer the costs of assisted living. Between those funds and parental social security, the costs are met easily and there is no drain on our family. Of course, every situation is different, but it is wise for families to delve deeper into this option and have an open mind.

*Nursing home and end-of-life care – The circle of life continues despite our best efforts. Seek the assistance of an attorney early on to protect parent’s assets in a revocable trust, then when the time arises for full-time nursing, families are somewhat prepared. Do your homework. Seek out the facility that can best care for your parent and then take it upon yourself to be proactive. Visit frequently and at unexpected times so the facility staff sees you are actively involved in your parent’s care.

Write down the wishes of your aging parents and when the time comes for additional assistance, there will be no questions. Make the transition to assisted care easier by early preparation.


Photo Courtesy of http://www.pixabay.com and PICNIC_Fotografie

Choose Your Battles – Effects of Dementia on the Family

MP900442315 By Cindy Sproles
Entering the “golden years” of life should be a joyful and exciting time. For most, the years when retirement becomes a reality and life grows less stressful, is a wonderful time. If aging parents have planned well, their homes are paid for, expenses are overall less, and this season of life, by all due rights, should be a time to relax and enjoy. But what happens when the hopes and dreams of a well-planned retirement shifts?

According to the Institute for Dementia Research & Prevention, there over “5 million individuals with age-related dementias.” One in six women, and one in ten men over the age of 55 will be affected by some form of Alzheimer’s or dementia.  Thanks to cutting edge research, new methods of treatment, including medications, cognitive skills tasks, and physical activity are being developed to help manage dementia.

In an article from Helpguide.org, dementia includes a various assortment of symptoms from memory loss, personality changes, to impaired intellectual functions. Along with the decrease in memory, impaired judgment, faulty reasoning, inappropriate behaviors, loss of communication skills, and disorientation accompany the disease. All of these symptoms mean frustration for the affected parent and the family members.

It is still a mystery as to why our affected aging parents become obstinate to those they love the most, but the key to dealing with any form of dementia is learning to pick your battles. Frequently, well-meaning family members find themselves continually correcting facts with  their seniors who deal with memory loss. For example, a senior may say, “Isn’t that yellow couch pillow beautiful?” The pillow is actually blue.  There’s no need to correct the loved one, when the color of the pillow really doesn’t matter. The instinct to help the loved one remember the color blue comes with good intentions. However, correcting a senior over something this simple is frustrating and leads to agitation.

It’s important to understand, depending on the severity of the dementia, your aging parent is aware their memory is not serving them efficiently. They grow frustrated and irritable when they cannot control the thoughts they once managed successfully.  There comes a time when  therapeutic fiblets  are considered not only appropriate, but necessary. Therapeutic fiblets are those necessary lies that allow affected seniors to maintain a high quality of life over a life of anger, frustration, and feelings of disrespect. Our nature pushes us to tell only the truth to our aging seniors. Never lie to your elders. But when the world of reality for your aging parent is thirty years prior and not today, forcing current facts on them sends them into a state of chaos.  Should your parent think they are living with their spouse, who in reality passed away twenty years earlier, is forced into current reality, they are put at risk. One of two things can happen: 1) they will accept the news and begin the mourning process over  2) the parent will adamantly deny the truth. Therapeutic fiblets become a necessary fact in dealing with dementia.

Diagnosis for dementia and Alzheimer’s can be a slow process especially in the early, milder phases.  Memory slips are easily hidden or brushed to the side, but as the disease progresses and loved ones drift forward and back in time, what becomes most important is their quality of life. It is vital family members understand dementia is a progression. Though simple word games, and reading are good ways to help exercise and maintain the brain, they are not fixes. Dementia does not improve, rather it only leads to eventual decline. Learning to choose the important battles are important.  Providing a stress free environment becomes the primary goal so patients are relaxed and comfortable. Debating the day of the week or the color of a couch become less important and allowing a good quality of life takes the lead.

As loved ones slip deeper into themselves, recognition fades, names seem to go to the wayside, but the love that is felt by a caring family never leaves. Dementia is difficult at best, but holding tight to the joys of that wonderful parent are precious.

*Develop good habits and routines early on, i.e. putting the keys in the same bowl by the door every time, using post-it notes for reminders, securing a personal emergency response button.
*Simplify choices by paring down clothing in closets or lessening dishes and kitchen utensils. Rid the home of clutter. The fewer decisions that must be made for your loved one, the better.
*Have an on-the-road driving evaluation made to assure operating a vehicle is still a good choice.
*Chat with family and friends. This keeps the mind alert. Social interaction is vital to help maintain memory skills.
*Emphasize the joy in life.

Visit https://www.alz.org/ (Alzheimer’s Association) for additional information on caring for family members with Alzheimer’s or dementia.

Senior Beware – Ask, Get Informed, then Decide

Photo courtesy microsoft free image gallery

Aging parents will reach a stage in their lives where families begin to question if living at home is best or should their aging senior move into assisted living. It’s a valid question and one that deserves a lot of attention and consideration. But, before families make the decision to move their loved ones into a facility, there are definite questions that need to be sought out and answered.

What is assisted living?  Honestly, there’s not a real definition by industry standard. It varies from state to state. The best explanation for assisted living is a facility with limited care. Most are not licensed for medical care like a nursing home. It’s important to understand assisted living facilities are not medical care facilities. For lack of better words, we can dumb down the explanation to this: Assisted living is group home living where residents can perform all the necessary assisted daily living skills (ADLs) with minimal help. The general rule for assisted living is, that in the event of an emergency, a resident must be able to remove themselves from the facility (without assistance) within a small time frame. If they cannot, they do not qualify to stay.

Assisted living facilities perform levels of care for residents from those who simply need daily monitoring to those who require assistance with personal care. Residents rent a room or small apartment where they can either cook for themselves or join others in a dining room area for meals. There is usually an RN or LPN on staff in the event of an emergency and who, if the service is needed, will regulate and distribute medications to residents. Those who live in assisted living facilities are fairly mobile and are charged according to the needs.

For example, if you require house cleaning, you may be charged. If a resident needs a higher level of care, i.e. assistance with a bath or dressing, they may be charged a higher price. Should they need transportation, this is additional as well (however, it’s fair to say this service will vary from facility to facility. Some provide transportation as part of the basic package while others charge per month or even per ride.)

Independent care living – It’s important to understand the difference between independent care living and assisted living. The best explanation for independent care living is:  A group retirement facility or community – a  place where seniors in good health can retire to be with friends their own age. They generally pay a homeowners association fee so their home maintenance is provided. They are able to maintain their own care in its entirety, able to function and drive without help. Cook, clean, bathe – all the things they would do in their home on Maple Street.

Some “communities” allow seniors to purchase condos, small homes or even build within a gated community (this instance requires in-depth understanding of the rules of habitation). They can sell their dwellings to other seniors should they come to a point where their care moves to the next level. It’s important to read every line on independent care contracts and notice where the line is drawn in the sand as far as qualifications to remain living in the facility/community.

Many pre-built homes, duplexes, condos or apartments revert back to the owners of the facility/community upon the death or the need for the resident to move away. Wording can be misleading and so can the sale of the properties. Potential residents may be told they are “purchasing” an apartment, condo, or duplex when in fact, it’s a glorified way to say leasing or renting. The purchase may even resemble the purchase of a home with a down payment and monthly payments, and a closing). The greatest surprise may come when independent care facilities or communities see residents growing frail and begin to push residents out, informing them there is no refund or resale on the property. Instead it reverts back in its entirety to the facility or community. This happens more in independent living facility complexes with apartments or condos but it’s important to know, it happens all the time. Read the contracts in their entirety. Invest in a visit with an attorney to read and understand the jargon and wording so your aging parent is not surprised when their needs shift and they are asked to leave. If there are HOA fees, verify they are yearly and not an extravagant amount monthly. To live in an independent care facility, residents must be fully able to maintain their own care completely. If that changes, they will be asked to move.

Seniors BEWARE! – Assisted living, independent care living, and nursing home facilities are expensive. Unfortunately, insurance does not cover what families assume it will. There is no coverage for independent care living and often with assisted living, there is little to no coverage. Families cannot depend on receiving financial assistance from resources, i.e. Medicaid. If seniors have Long Term Health insurance purchased early in their lives, they will receive some payment here, but as a rule, most insurance companies will pay limited amounts on assisted living facilities but far more on nursing home facilities when their resident requires full medical assistance and care.

Facilities are beautiful. Their lobbies are adorned with lovely flowers, pretty furniture, and smiling faces but none of that bears any thought to what actually goes on behind closed doors. Pay attention to the staff. Make unscheduled visits. Does the staff know the residents names, are they interactive, kind, and attentive?  Talk to residents. Are they happy with their care? Seek outside references. Ask past resident’s families about hidden charges or unexpected financial surprises. If ever there was a time to be due diligent, this is it.

In fairness to facilities, it’s important to know there is a horror story for them all. There are few businesses who are incident free. However, 98% of these facilities are wonderful and provide great care. There are those residents and family members who are demanding and are simply unable to please.  You, however, can look at the overall picture and get a good feel. Bottom line. If you walk into a facility and your gut says no. Stick with your gut. Instinct follows us for a reason. Listen to the nudge should you feel it.

Elderly Hand Holding Cane

Photo courtesy microsoft free image gallery

In-Home Care – The question that rises within families is this:  “Why pay for an assisted living when we can get someone to stay at home with our folks?”

It’s a valid question and one that deserves an answer. It is a proven statistical fact that seniors thrive in their own homes. Their own home is familiar and it gives them a sense of holding on to some control in their lives when their cognitive and physical abilities begin to slip away. Educating yourself is still important.

Private caregivers are a dime a dozen. Many are wonderful. But few, if any, meet state and federal regulations for in-home care. There are a few pros. Family members, friends, or someone’s best friend may be willing to care for your senior for a reasonable hourly rate.  They will help manage the household chores, take seniors to appointments and provide companionship.

The cons:  Many private duty caregivers take pay without paying income tax. Senior’s families are required to provide a 1099 to the caregiver and to pay Social Security/Medicare taxes to the state. Families can be sued if a caregiver is injured because homeowners insurance does not cover paid employees. This injury falls under workman’s compensation. Caregivers can call out and leave families in a bind with no one to care for their parent when they are required to go to work. Eldercare abuse, elder scam and thievery are at a higher rate because no background checks are done. Medical procedures are performed (i.e. sugar tests, feeding tubes, wound care, or injections) with no supervision and limited training. Important warning: This not acceptable by most states governing authorities and families tread on dangerous ground when they allow these procedures to be performed by non-medical personnel.

In fairness there are many private duty caregivers who provide excellent care for aging parents. Either way, this is a job that is regulated by the State and if your caregiver is not licensed, paying the taxes due the government, and receiving continued training, then families and the caregiver run the risk of being called out by the state.

The truth:  Cheaper is not always better.

In-Home Care Companies – There is security in hiring a caregiver through a company. First and foremost, caregivers are screened with background checks, credit checks, and motor vehicle driving records to provide the safest care possible. Companies are regulated and licensed through the state. This forces the highest level of care possible. Should a caregiver be ill and need to call out, companies can provide a replacement so families are not left in a bind.

In-home companies provide workman’s compensation. They provide W-2’s, assure federal and state income taxes, Social Security and Medicare taxes are withdrawn. Companies have liability insurance, provide full background, credit checks and motor vehicle reports on all caregivers, and caregivers are bonded. When all is said and done, in-home companies allow aging parents to remain in their homes as long as possible with exceptional care provided. Cost comparison on a senior who requires 24/7 care runs slightly less to equal to assisted living.

All things said, when it’s time to consider living situations, be pro-active. Do not hesitate to research every aspect of the facility or company you are considering. Understand the cheapest route may end up costing you the most due to hidden fees and agendas. Do the homework and find the facility or company that best suits the needs and care level of your aging parent.

Care for the Caregiver

More Baby Boomers are caring for their aging parents than ever before.  According to the Family Caregiving Alliance (The National Center on Caregiving) over 48.5 million Americans are caring for aging parents.With a swaying economy and more individuals now out of work, these people are stepping in to help care for their seniors.

The truth to these statistics is both good and bad. It’s wonderful more family members are caring for their aging parents. Americans are in the minority worldwide when it comes to caring for their family members.  Western countries show a priority in parent care by bringing their loved ones into their homes and caring for them until death.  The down side is  the majority of these caregivers are unpaid.

Family trends show when an elder parent needs assistance the task will generally fall solely on one family member. This is due to the logistics of that family member to the simple fact they are the only one to step up– and these individuals will burn out.

Caring for your caregiver is important. Their hearts are open and kind. They are generally very patient and willing people. Taking advantage of their generosity happens frequently. It is vital families band together to offer assistance to these warm-hearted caregivers.

What can you do to care for your caregiver? 

*Offer them a full 24 hours off.

*Occasionally pop by and help with household tasks

*Provide a meal

*Write a thank you note or card

*Call and chat with the caregiver. Make them feel loved

*Recommend hiring a non-medical in-home care company such as Comfort Keepers  to share the load

Many times caregivers feel as forgotten as those they care for. Make time for them. Show your appreciation. Sometimes all that is required is just a simple thank you.

Loving Care for Aging Parents – Part One

Senior woman contemplatingWhen the time arrives to add caregivers into the daily routine of your aging parent questions rise. Who do you hire? Where do we look for reputable help? What attributes do caregivers need? The list continues to lengthen with questions from salary, taxes, transportation, and on and on. Questions quickly become hesitation and hesitation turns to fear when the answers are not easily found.
In this two part series you’ll find ways to help you begin the journey of adding a caregiver into the routine of your parent.

Begin by making a list of the specific needs of your parent. It’s easy to become overwhelmed by the choices verses the true needs. Finances will play into the need as well. However, don’t be stopped by finances, rather make your list of needs as though there are no financial issues. This will allow you to quickly narrow down “wants” verses real needs.
List the answers to these questions to help launch you into finding the needs of your parent:

*Is your parent mobile?
*Are they able to take care of personal hygiene?
*Are they a fall risk?
*Are there memory issues?
*Can they manage dressing alone?
*Is driving still an option?

This list of questions will help gage your thinking process to the important issues. Once you’ve answered the questions then you can begin to look at how to meet the needs of your aging parent with wisdom.

Move Toward Personal Affairs

*List doctors, hospitals and specialty physicians that work with your parents
*Secure a Power of Attorney for both finances and medical care
*Gather Medicare insurance cards or private pay insurance as well any long term health
*Check with the bank and add one reliable person to help with finances (ie paying bills, budgeting funds,
*Locate the house deed and titles to any vehicles
*Locate living wills and wills for the estate, even check to see if pre-funeral arrangements have been

Factor in Finances

*List all savings, regular checking, 401K’s or bank CDs to get a clear financial picture of assets
*Consider a reverse mortgage to provide funds for care
*Make a budget

Once you have all these items in place, call a family meeting and discuss who will manage the process. Include your parent, even though there are times this may not be possible if a parent is unwilling…try.

Finances immediately press the stress button for most families. Relax. This is definitely important but it’s not a reason to panic. It’s simply an obstacle that must be worked around. With this information in place you can now look logically at the future care of your parent.

Narrow the List

Once you are aware of all the needs, necessities and assets, begin to look closely at the exact needs of your parent. Can they manage well enough to remain at home or is their care beyond a home setting. Keep in mind, it’s a proven fact the elderly thrive in their own homes. If at all possible, make “their home” the goal of their place of care.

Taking these steps will help get you on the road to preparing for long term care for your aging parent. In part two of Loving Care for Aging Parents we’ll discuss putting a plan of care into action.

Golden Years, Cherished Memories

MemoriesAging, for most, is a harsh realization. One day you’re in your prime the next you wake up older, a bit gray…a little slower. Time has suddenly slipped past. Somewhere between active and early morning stiffness, the line between middle age and elder blurred.

Albums line  bookshelves and walls  are covered in generations of photos that leave nail holes and dusty shadows on the paint.

I recently installed an emergency alert button for an aging friend’s mother.  Once the unit was installed I pulled the button from the box. My friend’s mom stood staring at her living room wall covered in family photos.

“Here’s your button. Just slip it over your head and wear it 24/7.” Her stare deepened and I could tell she’d not heard me. “You okay?” I asked.

She jerked. “Oh, I’m sorry. I was just looking at my family.”

“And they’re a beautiful family.” For the next half hour the woman pointed to photos sharing the relationship and sweet stories about each one. Before I knew, we were on the coach thumbing through old photos of her husband during World War II. For this woman, her walk through the family albums were bathed in the richness of cherished memories.

There is more to our elderly than creaking bones and sagging skin. In them we find our history. Our connection to what once was…different times, stronger values, ethics that seem to have slipped away from younger generations. Wisdom. Strength. The ability to seek out hope in a time when hope seemed fleeting. These are moments, we as baby boomers need grasp  and hold.

Our world pushes us into an extensive busyiness, that in turn, forces us to allow the valuable moments found in our aging parents to slip past. We are their legacy, their contribution to the world.

Take time and enjoy the richness found in your parents and grandparents. If you are fortunate enough to still have great grandparents, then do not let the opportunity pass to know the little things about them. Your life will be blessed and your appreciation for them and their struggles will become real. In the midst of the dusty photos, you’ll find the deep love and sacrifice our seniors have made so our lives are better.

Our parents and grandparents deserve the best. Care for them as such.

The Joys of Parenthood

Senior woman contemplatingThere is no greater gift than parenthood.  Just to hold our newborn infants close brings a whole new meaning to life.  In our youth we long to have a family and once that gift arrives the future years are spent nurturing, growing and developing these children.  Children depend on their parents for moral support, guidance and even financial aid at times.  There is a certain comfort and peace in knowing our parents are always a phone call away.  For parents – the gift of a strong bond with their children is everlasting.

Then the tide turns. The waters that once rushed forward into the lives of children now recede, and the ability of the parent lessens; not from desire but from physical ailments. Aging. Dementia. Frailness. The realization of aging attacks and children suddenly understand parents are unable to do the things they used to do. It’s a hard realization, but if it’s hard for the children, imagine how difficult it is for the aging parent.

Children will see definite changes in the attitude and disposition of their parents and it is important they understand the steps of acceptance for their parents.

Anger – Anger is one of the first stages of acceptance seniors experience. A tough skin is important. Learning to understand when aging parents lash out, it’s not personal, even when harsh words are hurtful. Nothing can describe the frustration of being unable to do the simplest tasks. Walking, buttoning a shirt, brushing teeth. The simple tasks of daily living begin to slip through their fingers. It’s enough to grasp being over 70 but when fingers won’t bend, legs won’t lift, climbing stairs becomes slow and painful, frustration and anger set in.  Aging parents lash out as they fight for the one thing held most precious to us all – independence.

Depression – Depression is not uncommon for seniors. It’s an adjustment – slowing down, learning to let others help. Watch for signs of depression and attend to them immediately.  A severe decrease in appetite, less conversation, excessive sleeping… are all signs of depression. Depression is not always an easy fix but seeking the help of the primary care physician as well as additional check-up calls and visits from friends and family help. Most importantly, encourage your parent to do what they are able.  It may take longer to walk around the block, but walking is good.  Always check with their physician as to what can be done or not.

Helplessness – There is a sense of helplessness attached to releasing physical care to a child. The ability to be johnny-on-the-spot when a child is in need fades due to illness or frailty. Work with aging parents to maintain their usefulness. Make them a viable and important part of the family. Seek outside caregivers through reputable companies such as Comfort Keepers, to help seniors maintain a good quality of activity and a sense of being needed.

The steps into aging acceptance can be rocky at best, but with patience and love aging parents will come into compliance with reality. Above all else, continue to be an active part of your parent’s lives – develop wonderful lasting memories for the future.



Encouragement and Prayer Make Good Caregivers

When the tables turn and we become the “caregivers” rather than the “cared for” in the lives of our parents, fear can easily take over. Though the years we’ve depended on our parents to be the lifeline and support for us in most every aspect of our lives. They’ve supported us through hard times, loved us when we were un-loveable, and been the solid rock of the family foundation.

Taking the helm in the care of our parents means turning loose of the dependency and becoming the one to be depended upon. What we fail to realize is that not only is this a frightening time for us, but it’s an equally scary time for our parents.

For years, our parents have been strong and able. They were raised in an era when caring for yourself was a necessity. Therefore, handing over the shards of independence cuts deep into their being, and it’s difficult to accept help when the time arises.

The stress which accompanies the care of an elderly parent can be overwhelming. Not only do children deal with the financial issues and the physical needs of their parents, but mentally shifting the thought process toward being the caregiver becomes more difficult. Separating our love for them from their care is tedious.

Many times our parents fight the need for help—they refuse to see their physical needs have increased. Finding a caregiver who can gently aid in this transition is vital. Being a caregiver is a tough profession, and often filled with frustration and hurt. However, being armed with the tools of knowledge can help ease the transition.

Encouragement is a must—reminding seniors that their opinion still counts and then respecting that opinion as well.

Respect and integrity—one of the hardest things to manage is to remain in control of how we treat our seniors both physically and mentally. Even a parent in the deepest stages of dementia recognizes respect and had a need to have their integrity honored. It’s easy to take the care of our parents to extreme and treat them as children rather than adults who simply need assistance. Honor their integrity and respect them fully for they are still our parents.

Pray – Doctors and hospitals nationwide are beginning to recognize the power of prayer. Pray daily for the empathy and gentleness necessary to handle the situations that arise with our elders. Pray for their health, their understanding and pray for the family as a whole. The knowledge of praying friends uplifts those who are in need.

Work with seniors, not against them—Digging in with stubborn heels is not always the appropriate way to handle things. Relax and move slowly into the transitions when ever possible. Allow seniors the opportunity to adjust.

Caregivers hired from outside the immediate family will generally have the upper hand in dealing with aging parents. A caregiver trained in the appropriate manner will come into a home, encourage, assist and gain the trust of the parent, providing  and making inevitable changes for seniors easier.

Choosing a company who has the ability to train and teach the art of good caregiving is important. Comfort Keepers provides caregivers who are trained in unique and loving caregiving skills.

Seek the help of a good company such as Comfort Keepers. Allow them to assist your loved ones into and through the transition of aging.