Freedom Eldercare Blog

"Tips for Caregivers"

8 Unselfish Ways to Put Yourself First

1) Eat a well-balanced diet

When you’re stressed out, you may tend to overeat. When you’re exhausted, it’s easy to resort to whatever is handy; quick snack foods, tea and toast, cheese doodles and pop. You need high quality food to perform well.

2) Get regular exercise

Exercise is the original “feel good” tonic. It helps you sleep better and wake up refreshed and ready to face another arduous day. Regular exercise improves both your mental and physical wellbeing, keeping your mind alert and body fine-tuned and energetic.

3) Get enough rest

This may be easier said than done, especially if you’re caring for someone who tends to wander at night. Still, most people need six to eight hours of sleep a night to maintain good health. Catch up with cat naps if necessary, early in the day.

4) Look after your own health

When you’re preoccupied with someone else’s health, it’s all too easy to neglect your own. Caregiving can be physically and emotionally exhausting, leaving you at risk for serious illness.

5) Get organized

It is very important to get an early diagnosis of your loved one’s illness, and then learn everything you can about it. That way you’ll know what to expect, and you can plan for it.

6)  Plan for emergencies

Who will take over if you do get sick? How will you cope if your loved one has a medical emergency? Be prepared. Keep a file or notebook with names and phone numbers of people you might need. In a crisis, you’ll be less likely to panic if you’re organized down to the last detail.

7) Take time out for yourself

Whether you’re caring for a parent, spouse, or other relative or friend, you need time for yourself. You need outside interests, other people, and a way to escape from the constant pressure of caregiving. You need to get away from time to time. Keep up your friendships. It’s easy to let friendships lag when you have “more important” things to do. But friends can get you through some tough times, just by being there.

8) Consider joining a support group

If you feel alone and isolated in your role as caregiver, talk to other caregivers. They’ll know what you’re up against; they’ll understand where you’re coming from. Think of it as therapeutic socializing—while you’re not actually escaping from your role as caregiver.

     

"Funding for Home Care: Tips to Better Access and Allocate Private Funds"

When looking to fund home care from personal resources, the following steps are suggested:

Assess the situation realistically, including all possible options for paying for care. Consider how best to utilize assets.

• Potentially seek the advice of a financial planner for guidance on which investments should be liquidated first.
• Homes, businesses, rental property or commercial leases, land owned, or farms may all provide potential funding sources.

Consider the value of personal property like antiques, old coins, jewelry, art, or other collectibles.

• If there’s fine jewelry to sell, a jewelry store may offer a better price than a pawnshop.
• Selling treasured collectibles typically brings higher prices if they are sold individually rather than selling an entire collection together in one sale, particularly if there are rare pieces.
• Have some of the better pieces appraised beforehand.

 Look into pensions, annuities, or life insurance policies, which could provide cash flow.

• Before delving into savings set aside for retirement, the situation should be discussed with the insurance agent.
• Many life insurance policies now offer an option that gives the policyholder the right to sell his or her policy for more than its cash value.

A tax adviser can offer insight into how much gain would be realized when selling a home or other personal assets.

• Work with him/her to get the maximum benefit from financial resources.
• Applying for an equity line of credit on the home might be another possible solution.

Discuss with other family members the option of sharing both the costs and caregiving duties involved in keeping elderly parents at home.

• When family members work together to take on some of the caregiving tasks themselves, the expenses associated with providing care can be reduced.
• Moving an elderly parent into a family member’s home or moving into a parent’s home could be a practical alternative for some situations.

Additional Possible Options for Paying for Home Care

Disease-Specific Debilitation. Most major diseases such as Alzheimer’s, Multiple Sclerosis, and Cancer offer programs to assist individuals with these particular illnesses. Agencies supporting specific illnesses can be checked to determine local community resources. Additionally, many religious organizations have some funds available for their members.

Office on Aging. This local agency is an excellent resource that can assist with finding information on available funds through county and state programs. The information provided is available to the public and free of charge. To search for local agencies, go to Senior Advice: www.senioradvice.com/index.php.

Home Care Allowance. Some states offer a home care allowance through their Department of Social Services. Applicants must usually be eligible for assistance from the Department such as Aid to the Needy and Disabled or Old Age Pension. In addition, recipients are typically evaluated for medical need. Income guidelines vary depending on age and severity of disability.

      

"5 Ways to Being a Better Caregiver" By, Dawn Perdon, Client Relations Director of Freedom Eldercare

Few would dispute that caregiving is physically and emotionally draining. Whether one is caring for a disabled child or a senior parent, the responsibilities seem endless. Sheer exhaustion can lead to heightened levels of emotions. What can a caregiver do when those emotions turn negative and counter productive? Here are 5 ways that helped me nurture my emotional health making me a better caregiver:

1. Friends – Most often friends are not directly connected to the caregiving situation which allows them to be more objective. Friends will listen with a sympathetic ear but also let you know when you need to regroup. If they haven’t experienced being a caregiver themselves, they may not completely understand your emotional meltdowns but they allow you an environment to vent without judgment.
2. Family-Now some may argue family is part of the problem. This is true in many cases. However, if you can find just one family member that truly understands the intensity of being a caregiver then you’ll know you have someone in your corner rooting for you. For me, my sister and brother-in-law were my saving grace.
3. Support Groups-A support group can either be formal or informal. There are many wonderful coalitions that can connect you with other caregivers. If you’re in the Morris County, NJ area I highly recommend contacting the Morris County Caregiver’s Coalition at (www.unitedway.org).
4. Education-Concentrate your efforts on finding out all available resources to you. There are many respite programs available to provide you some time to yourself. A good place to start is to contact your local Division on Aging. If finances permit, a geriatric care manager is a professional expert who can assist with recommendations and options.  This is often a long term situation. Knowing how to move the caregiving process can be daunting.  A geriatric care manager can make it less so. Visit www.njgcm.org to see a full list of New Jersey providers of the National Association of Professional Geriatric Care Managers.
5. Solitude-Having 15 minutes alone everyday is not impossible. At the time that I was a caregiver, I had a challenging 2 year old, a new house, and a full time job. You need time to just breathe. This shouldn’t be time spent washing dishes, doing laundry, or updating your Facebook page. Sit in silence for 15 minutes and you’ll be amazed how much you’ll be rejuvenated. Trust me, 15 minutes can offer some clarity. You’ll be a better caregiver as a result.

     

"Adult Daughters and the Loss of their Fathers" By, Janet Pincu, MSW, LCSW, CALA of Freedom Eldercare

It has been 15 years ago this month since my father died.  The grief over this loss is as palpable today as it was that Super Bowl Sunday in 1996.  Why so surprising?   I’ve discussed this often with other women – friends, daughters of our clients, my sisters - who have lost their fathers as adults.  What is it about this father/ daughter relationship?  Why this terrible sense of emptiness so many years later, this chaos of emotions?  Freudian references or Erickson’s stages of psychosocial development are not explanations for what this is about for some of us.

There seems to be so much more thrown into this mix. Whether the loss comes from a death, a divorce or an abandonment our fathers have held many roles in our lives.  Sometimes the father has been absent.  Those of us who have been fortunate to have had a positive relationship with our fathers travel on a very different journey.  We have had fathers who have been our male role models, our protectors, our guides through an uncertain world, our supporters, our cheerleaders, our breadwinners.  Whichever the role(s), these men have had profound influences on their daughters’ lives. 

When we are 50, and our parent of 75 dies, it is expected.  Not any easier to bear whether due to an illness or to aging.  No matter how one is prepared for the loss when a parent dies it is truly a unique experience.  It is a rite of passage that hurls us forward into our futures.  We are suddenly aware that it is we who are the remaining generation of our family tree still living.  And another realization becomes clear – even if we have been the caregiver to our parents before their deaths it is the parent of our youth and childhood we bury. 

Our culture often treats grief as a luxury that one cannot dwell on rather than a normal and necessary part of life.   We allow a spouse the opportunity to grieve but somehow diminish or dismiss the feelings of sorrow that adult children want/need to express at the loss of a parent.  And the world becomes a very different place for some when left without our anchors.

Every year around my father’s Yartzheit I revisit Auden’s  poem “Funeral Blues.”  

“He was my North, my South, my East and West

My working week and my Sunday rest”

      

"Women Caring for Ex-Husbands" By, Janet Pincu, MSW, LCSW, CALA of Freedom Eldercare

Sitting in the hair salon recently I was drawn into a conversation with a woman (I’ll call her “Nancy”) sitting in the chair next to me.  Nancy had travelled back to New Jersey from her home out of state in order to assist her husband who was dying of a highly aggressive form of cancer. 

While they shared two children in their twenties Nancy had taken on the role of caregiver.  She seemed conflicted around this role particularly since it appeared as though it had been a contentious divorce and ongoing relationship.  During the course of our discussion what I heard her say was that her motivation came from the children she and her ex shared and the desire to be perceived by them as a “good person.”

I was struck by this woman’s experience and wondered if it was a common one.  Aware that many more men and women are entering their senior years divorced, and sometimes without a partner, I believe that we will be seeing more of this phenomenon.

In fact, the US Census Bureau reports that of the aging population over 65 there are close to 3.8 million divorced men and women.  We know that illness and end of life issues will clearly impact singles without spouses or caregivers. 

A study form the University of Missouri has provided some insight into this experience and the need to offer support, assistance with medical needs, health needs and daily living needs.  The research speaks to the unique characteristics of these relationships and the women who provide care.  Those with positive post-divorce relationships are more likely to take on these caregiving relationships.  Certainly, if there are shared children, the emotional attachment is facilitated.

A surprising outcome of the study was the report by some women that caregiving was seen as a turning point in relationships with their exes, which buffered the challenges of caregiving.  Women reported the “softening” of their ex-husbands during illness and therefore there was less conflict.

The researchers will continue to explore this phenomenon while determining the support needed for all caregivers.

 

“My Grandma Has a Facebook?!?!” By, Nicole Brierty of Freedom Eldercare

Imagine waking up, logging onto Facebook and seeing a friend request from your Grandmother!  My first reaction was to call my mother and ask “Since when does Nana have a Facebook???”  My grandmother who I once unsuccessfully tried to teach how to use an iPod now “likes” my statuses and comments on my pictures on a daily basis.  It cracks me up, and I love it, since I don’t see her very often because she and my grandfather live in South Jersey.  It’s a fun way to communicate.  Granted, I had to set up her profile picture for her during my last visit because for weeks all I saw was that grey box with the white silhouette of a woman, so I INSISTED that I change it; but I must say, I am impressed!  Now I look at my Facebook and to my surprise not only does my grandmother have a page, but so does my grandmother’s longtime friend, my Great Aunt and GASP…my mother in law! Who’s next and what’s next? 

When you study the statistics, the younger generations were the ones responsible for the growth of the internet.  However, senior citizens now signify the fastest growing portion of internet users.  The numbers are quite interesting.  In January 2009, Facebook users 55 and up were at 954,680.  As of March 2011, 10,459,580 Facebook users are senior citizens.  The numbers are shocking and they are on the rise, but think about it…what better way to keep in touch with family, especially those who live in different states? 

We now have the technology to use webcams with programs like iChat and websites like Skype which allows seniors to see what their loved ones are up to. This is so important for the sometimes isolated senior.  My grandparents are about an hour or so away from their children and grandchildren, but fortunately, they have made a lot of friends in their senior village.  Nevertheless, at the end of the day when my grandmother sits down at her computer while my grandfather watches his Yankee games, it must be nice to log on and view the photographs her grandchildren have taken, or check to see how her children’s days were. Now, when she calls her family she knows whether or not to keep it short, based on their “IS IT FRIDAY YET” statuses; or by logging on to see pictures of her new great-granddaughter…yes my 4 month old Black Labrador.  It makes her happy to be in the loop and I can only imagine that it’s refreshing for most seniors who are in my grandparent’s shoes.

Sources say that senior citizens are not on Twitter… yet.  BUT… I beg to differ!  At 67 years old, Danny Devito has a Twitter and yes….I “follow” him. 

"The Basics of Medicaid" with Special Guest, Barbra London, MSW, LCSW, LNHA of Freedom Eldercare

 

In this segment of Elder Law Today, Elder Law Attorney, Yale Hauptman discusses the basics of Medicaid. Special Guest, Barbra London, MSW, LCSW, LNHA of Freedom Eldercare, a licensed home health care agency, talks about the types of services a home health care agency provides and common misconceptions people have about this resource. Also discussed are the new Medicaid laws and the risks of hiring a non-licensed agency, which can cause an ineligibility period for Medicaid.

 

"10 Tips to Help Prevent Wandering with Dementia" By, Janet Pincu, MSW, LCSW, CALA of Freedom Eldercare

Often we receive panicked phone calls at our office from family members asking for respite and assistance inc caring for their loved one with dementia.  One of the issues that often overwhelms a caregiver is the person who has the potential to wander and the risks associated with this behavior. 

Wandering is the most common behavior of agitation among people with dementia.  Health care statistics show that 6 in 10 dementia victims will wander at least once.  Cities and communities are retraining their EMT and police in how to conduct searches for victims of dementia who may wander.  At Freedom Eldercare training our caregivers about this potential risk and helping to alleviate the worries of the families is important to the services we provide.

Why does someone with dementia wander?

• They may be disoriented
• They may be bored or hungry
• They may feel pain or discomfort
• They may feel frightened or frustrated
• They may be searching - for the toilet, food, drink, a remedy for their pain, a bed, a familiar face
• They may be playing out an old routine – going home to make dinner for family, going to work, catching a bus
• They may be trying to escape a task, activity, noise or tension

The challenge is to find out some of the commonalities in the timing or occurrence of the behavior and this can only come through trial and error. 

So, what are some tips:

• Simplify the environment -  minimize confusion, distraction
• Cover door ways - hang drapes, curtains or posters (i.e. Pictures of bookshelves)
• Avoid the use of child-gates – clients can climb over them or kick them down
• Put coats or hats away in closets
• Walk with the client - when possible, gently redirect them back home or to a task
• Schedule regular daily walks -  in or outside of the home
• Install alarms - notify when a door has opened
• Assess – what is going on at that moment? 
• Label rooms – Use photos or signs to help eliminate confusion (bathroom, kitchen, bed.)
• “Safe Return” – register with the Alzheimer’s Organization

Freedom Eldercare can help care for your loved one with dementia.  We provide skilled caregivers and support to families.  Please call us at Freedom Eldercare 1.866.7.Freedom or go to www.freedomeldercare.com.

"'Too Old' to Drive" By, Janet Pincu, MSW, LCSW, CALA of Freedom Eldercare

A recent spot on ABC’s Good Morning America highlighted the question of how old is too old to drive.  The piece reported the horrific results of a truck driven down the wrong side of a California interstate.  At the wheel was an 83 year old gentleman.  Thankfully no one in the crash was seriously injured.

This event and others like it speak to the risk that continues to grow as Baby Boomers age.  How can communities prepare for the problem as many more drivers remain on the road when they probably shouldn’t?   How do families approach their parents when it becomes apparent that they may no longer be safe on the road?

Some tips to consider when the time comes for a family to make a determination on their parent’s ability to drive,

• Follow your gut instincts!  Have you noticed a change in your parent’s driving ability?  Are they more hesitant, slower to react or more reluctant to drive on busy streets?  Inquire about changes they may notice but remember subtlety is key!
• Rule out medical causes.  You may need to go to a doctor’s appointment with them.  Make sure that any changes in abilities aren’t a result of a medical issue. What you are observing may be the outcome of a loss in vision or hearing, or the slowing down of reaction time.  Some of these issues come with reasonable solutions
• Observe first hand what’s going on.  Take a trip with your parent to the grocery store or to church and let them drive.  This is good time to watch for any changes in their skills.
• Is it time for a “family meeting?”  If alarming changes are present it’s probably time for the family to meet.  For families separated by distance a phone or on-line conference call works.
• Develop a plan.  Every family works differently.  There is not “one size fits all” solution.   How will the family address this situation and who is best suited to this task?  Does the family need an outside facilitator? 
• Remember – Offer your observations without accusation.  Be empathic, gentle, supportive.  One of the greatest losses one is confronted with as they age is the loss of independence.  How do you react when your car is in the shop for repairs???  Try to imagine what this would be like for the rest of your life!
• Now what?  Having a plan in place moving forward is paramount.  The less drastic the change to their life and routines the more accepting they may be.  Be able to put a plan in place that will assist them to get to medical appointments, grocery shopping , the hair salon,  church.  Create a team of family, neighbors, friends, volunteers who can pitch in.  Research the community senior shuttles or transport systems.
• You may not succeed.  No one wants to be dependent.  Part of the plan must include ways in which your parents can stay active and not become house bound.  Again, the community is a good place to look for senior programs and activities that may include transportation availability.

Seniors’ ability to continue driving may be evaluated by rehab specialists:

• AAA has a Roadwise Review including a CD for review
• Kessler Institute provides a driving Rehab Program on all of their campuses in NJ
• JFK Johnson Rehabilitation Institute in Edison provides a course as well

"My Mother Started Receiving Home Care Services This Week" By, Nick Kirby of Freedom Eldercare

My Mother is a piece of work! She will soon be 83 and has lived alone for nearly 35 years since my Father died. During that time she went back to school, became an LPN, worked for the State of Illinois in a mental health hospital for over 15 years, built a house which she subsequently paid for, was an excellent Grandmother to 8 grandkids, and supported herself through nearly 20 years of retirement. And of course the best testimonial of her quality as a person is that all 3 of her children, who themselves are nearing retirement, built strong careers where they made meaningful contributions to society while raising families of normal, American kids. That’s quite a lot. Oh, and by the way, each of us kids have massive respect for our Mother and who she is and what she has done with her life.

Now it is becoming more difficult for Mother to stay on top of everything involved in maintaining a household. Keeping the house up, eating well, keeping track of medications, staying somewhat active in various senior activities in her community – she can still do these things. But they are getting harder. She makes more mistakes with chores and medications. She is a bit more forgetful.

My brother and sister and I talk with her or see her a lot. It’s been increasingly clear over the last 6 months that things were not working quite as well as they have in the past. We’ve been unclear as to what we should do, and how to think through and make decisions, especially since they will impact our Mother and her quality of life.

Thank goodness I now work with very experienced geriatric care managers. A few late afternoon informal discussions with my co-workers, whom I GREATLY respect, helped me clarify – and helped me clarify for my brother and sister – our situation. So, this week my Mother, who lives half the country away from me, started receiving home care services. We are starting with a few hours a week of care. As my Mother gets accustomed to this new person in her life, and as my Mother’s situation changes, our home care system will change to address the needs at the time.

What a relief for me, my brother, and my sister!!!! We didn’t have to figure all this out in a vacuum!