Family Caregivers: Caring for Yourself & Others

Family Caregivers: Caring for Yourself & Others

According to the National Alliance for Caregiving, approximately 66 million Americans (35% of the US adult population) serve as family caregivers for adult or disabled relatives. With the population aging and living longer, more caregiving is being provided by spouses, children, grandchildren, siblings and other family members.

Taking care of loved ones as they age is important and rewarding work, yet it’s no secret that family caregiving can be extremely stressful and demanding. As caregiving responsibilities grow, family caregivers experience significant challenges in their own lives.  Finding the balance between your needs and the needs of your loved one is the key to keeping your personal health and well-being a top priority.

A few tips to help family caregivers find balance include:

  1. Take care of your own health – It’s essential to take care of yourself so you can continue to be there for your loved one. Make sure to see your own medical doctor when needed, eat healthy, get good sleep, and stay active.
  2. Practice self-care – Find time to do activities that you love. Take small breaks throughout the day to unwind, even if it’s 30 minutes.
  3. Give yourself credit – Practice self-compassion and acknowledge everything you are doing for your loved one. You weren’t trained to be a caregiver, so cut yourself some slack if you’re feeling overwhelmed or trying to be too perfect.
  4. Set boundaries – Healthy boundaries are important for you and your loved one. If able, have a discussion around what your role will be now and as their needs progress. Encourage your loved one to stay as independent and as involved in their care as they are able.
  5. Take respite breaks – There are many community programs and services that offer short term (hourly or daily) care to caregivers. Take advantage of these programs.
  6. Ask for help – Caregiver burnout is real and nothing to be ashamed of. Seek support from other family members, friends or support groups with caregivers who are in the same situation as you are. Our professional caregivers at Hallmark Homecare are available to provide personalized care as well.

Need some additional support caring for your loved one?
Hallmark Homecare offers personalized in-home care to help people remain at home. Our caregivers are specifically matched to each client and their unique needs. This offers clients and families peace of mind and provides family caregivers with a much-deserved break, so they can focus on spending quality time together with their loved one instead of on caregiving or household tasks. There’s help available when you need it, and we’re happy to assist!

Advice from a Caregiver on Stress Reduction

Advice from a Caregiver on Stress Reduction

Lisa Bailey is a kindergarten teacher and caregiver to children and her husband who is undergoing cancer treatment. She shares her top coping strategies in this article for living a balanced life as a caregiver. You may find some of these strategies helpful in your own journey.

      • Make all choices from a solid base of integrity. I try to make medical and personal choices from the base of my Christian faith, which helps free me from second-guessing myself.
      • Be clear about today’s reality. Don’t imagine things are worse than they are. Enjoy the good parts of today and don’t let worries for tomorrow take over your emotions and thoughts.
      • Talk honestly to family and friends. Honest, frequent communication with close family and friends about caregiving concerns is much easier than trying to play catch-up later.
      • Learn the medical lingo. It will help you as a caregiver and a medical advocate to learn as much as you can about your loved one’s medical situation. The Internet is a helpful resource, but be cautious about which websites can be trusted. Ask questions of the doctors and nurses. Check the accuracy of your information if you are at all troubled or in doubt.
      • Be aware that pain, stress and medications may release the patient from their social “filter” and they may say some difficult things at times. Listen and be compassionate as best you can.
      • Control what you can control. Lots of articles about stress-management advise letting go of control; I have found that being in control of some areas of my life has greatly reduced my stress.
      • Let go of what you cannot control. For me this means leaning on my faith; for others it may be working with meditation or other techniques that will focus and center you.
      • Get help with house work and yard work—paid or unpaid. Help with household chores has helped me prioritize my most important tasks.
      • Prepare meals in advance and freeze them. I do bulk cooking and freeze pre-prepared meals.
      • Plan your work; then work your plan. Keep bills and insurance paperwork organized and pay bills on time. Be proactive about taking care of tasks and errands. Don’t let things pile up.
      • Nest. Everyone needs a comfy place to relax and rest. Make a comfortable nest for your loved one and for yourself by having a comfy chair with afghans, pillows, fresh flowers, candles, books and great music to your nest.
      • Journal for yourself. There are so many ways to re-center yourself, but none works as well for me as journaling. Even if you have never kept a journal, try starting one to help you clarify feelings, manage your stress and plan the work you need to do as caregiver.
      • Find joy in living life, whatever the circumstances. Whether illness or infirmity limit the scope of you and your charge’s activities—remember to bring meaning to your lives through activities you both enjoy: a good meal, movies and shows, music, reading aloud, playing card or board games, and trying new activities that may be creative and enriching.
      • Keep a vision for the future. None of us comes here to stay; we know that. But we also know that we can “grow until we go,” and we should. We make plans for our future.
      • Give. While I have learned through my husband’s illness to receive the gifts of help, encouragement, prayer and love from other people, giving to others in return keeps us feeling emotionally and spiritually full and is always worth the effort.
      • Release yourself from expectations for perfection. As humans, we all experience “feet of clay” when we do not have infinite energy, wisdom or capabilities to manage our lives. This is normal. Get through each day as best you can, and don’t dwell on mistakes.
      • Take good care of yourself. Eat good food, remember to exercise, rest and learn to say no to outside demands. See your doctor and dentist for checkups. Get away from the house regularly—and not just to run errands, but to do an activity you enjoy to renew your spirit.
How to Create Fun for Frail Seniors

How to Create Fun for Frail Seniors

As a caregiver, you are focused on your loved one’s safety, finances, medical treatment, nutrition and therapy. You busy yourself with doing everything in your power to keep them comfortable. You worry about their reduced energy level, increasing fatigue, physical weakness and variable mental status. But do you know how important it is for them to just have fun? To laugh deeply, live in the moment, to briefly not be defined by age and frailty and to forget pain?

Below are some ideas on how to add fun and stimulation to their lives:

Mini-Field Trips
Seniors look forward to having a day out, but as they age, they don’t have the stamina or mobility for trips to fascinating museums, monster malls, wooded parks, loud modern restaurants, etc. But they may be able to go out for an hour or two. My mom adored a simple trip to the supermarket—colorful flowers, fanciful balloons, acres of fresh, bright produce, bakery smells, energetic families with huge carts. It was an hour that she talked about for days. Another day we drove one short mile to a local antique shop. “I had those gold Fostoria glasses,” she pointed out. “Your dad and I would stop at the Fostoria factory store on trips to see my brother in Washington, DC.”. Talk about the glassware led to reminiscing about her deceased brother, until she interrupted herself; “Look at the quilts—just like my Grandmother’s.”. And so on, pushing her walker forward toward the next memory. The first trip to a small local department store just before Christmas involved a little arm-twisting. But once there, lights, perfume, soft velvety fashions and just ahead a decorated Christmas tree, worked their magic. She relived it all week. Recently she had favorite rings that needed resizing, I invited her to come to the jewelry store with me. She appreciated being the “customer,” the center of attention. Other ideas might be a quilt shop for a former quilter, a hardware store for the ardent handyman, the library, bakery, family style restaurant, plant store or flower shop.

Fun at home
You don’t have to go out to have fun of course. Opportunities are right there in their home to have fun and fight boredom:
• Stage a sing-along to their favorite music. Play the music loud and clear. Get all dressed up and take some photo portraits—use them for family gifts.
• Rent/borrow movies—old ones, funny ones, scary ones.
• Have a deck of cards on hand and play the old familiar games—gin rummy, hearts, war.
• Scrabble is great fun with grandkids, and good for the brain too.
• Keep a puzzle going if you have a spare tabletop—people coming in always get engaged and stay to talk.
• Pull out a family album—get them to identify the older ones you may have forgotten and take notes or audiotape the stories you hear. Family photos trigger floods of memories.
• Rearrange furniture and pictures—just for stimulation.
• Order in or cook some favorite foods that aren’t usually indulged in as a treat.
• Manicures and pedicures are a special treat too.
• Have candy for drop-in guests and gifts for visitors—think about birthday and holiday gifts and “shop” online.
• Make up a holiday or birthday wish list from the web—send it to family members.

Think about what your loved one has always enjoyed, listen to what they talk about, look around your neighborhood and give it a try!

Tips for Organizing Health Information

Tips for Organizing Health Information

A trip to the emergency room made me realize why caregivers are advised to organize heath information. When Mom broke her hip, I called an ambulance. When it arrived, I confidently recited Mom’s Medicare number. When asked what medications she took, I pulled out our basket of pill bottles. At the hospital, the questions got more complicated. Still, I knew enough to fill out the forms.
However, while I did not know it then, I would be joining Mom in the hospital the next day with an emergency of my own that kept me in the hospital for six weeks. As we both recovered, I looked for the best way to store her health information. I especially wanted an easy way to share it with others in case I am not around.

I now have a folder for paperwork that is portable and easy to maintain. It isn’t just for emergencies. We take it to every doctor visit. Now anyone who has the folder can see when Mom had her last flu shot, what medications she takes and that she had a malignant mole removed in 1981. We can all see when all medical appointments are scheduled. Even my brother, who lives at a distance, could answer medical questions if he had to take Mom to the doctor while visiting.

Information to collect

You probably have most of this information readily available. If not, begin with what you have and add information as you can. Useful information to collect includes: A medical history; health insurance and Medicare cards; a list of medications including dosages, frequency, date started and reason; a list of emergency contacts, relationship, addresses and all phone numbers; any special logs such as blood pressure readings, blood sugar levels or symptoms; a copy of a health care proxy, advanced directives or living will; and a power-of-attorney, if one is used.

What should you keep in a medical history?

Names of all physicians; known allergies or reactions to medications; all medications, including over-the-counter medicines, vitamins and herbs; health conditions and date of diagnosis; dates of most recent exams, tests and immunizations; dates and reasons for hospitalizations; dates and details of surgeries; dates and length of major illnesses; history of smoking and use of alcohol; location of living will or medical directives; history of exposure to dangerous conditions or hazards; family history including illnesses or conditions of parents and siblings; cause of death of parents and siblings and their age at death.

Recording and storing the information

While the primary copy of the health information is more practical to keep in physical form due to various cards, forms and original documents that are part of the medical record, it is highly recommended that at least the medical history also be recorded digitally so that a “backup” copy is available in case of emergencies, disasters, or as the need arises to provide other family members or doctors with the information if needed remotely.

  • For the primary copy, use a pocket folder or small three-ring binder that will hold several pages. We purchased a multi-page presentation folder with clear pockets from an office supply store.
  • Use a bold color for the cover, such as red or yellow, so that it is easy to distinguish from other papers. Label the front clearly: EMERGENCY MEDICAL INFORMATION.
  • Keep the folder in a handy location, such as a desk drawer near the entry. Make sure every potential caregiver knows where it is kept.
  • Use top loading, clear sheet protectors to hold papers. These make it easy to remove papers for photocopying or for handing to a healthcare worker.
  • Pick up a business card from each healthcare provider you see. Cards usually contain the name, specialty, address, phone and fax number. There are vinyl business card holders available at office supply stores that are the most practical way to store business cards.
  • Each time you have an appointment, take the reminder card or jot the appointment details on a 3X5 card. Slip these cards into a page protector just as you did the business cards to keep a record of the visit.
  • When you add any information to a document, put the date at the top of the page to show how current the data is.

With a Medical History in hand,  I will never again have to phone a doctor’s office to relay information I didn’t have with me at the appointment, and I’m confident that if I’m not around, someone else can tell the emergency room doctors what they need to know about my loved one.

Siblings & Caregiving

Siblings & Caregiving

The doctor has informed you that your mother can no longer live independently. You feel that assisted living would be the best solution, but your sister strongly disagrees. It seemed that at one time you were able to communicate with her, but not any longer.

Ideally, providing care for an elderly parent would be a time of family unity and mutual support among siblings. Although this might be the case for some adult siblings, for many others, eldercare brings about painful conflict. Although each family is unique, there are common underlying causes that can lead to friction between adult children.

Old wounds and past rivalries will undoubtedly come into play during this time, making compromise about care decisions especially challenging. It is not uncommon for adult children to regress to childhood roles, where suddenly siblings are competing for mom’s affection or tallying up how many chores each has completed.

Elderly parents can unintentionally contribute to this regression by favoring one sibling over the other; many times focusing their attention on the child who is actually the least involved in their care. Often, the anger and frustration that they are feeling towards their own dependency will cause them to lash out at the child who is providing the day-to-day care and representative of their lost independence.

Most often, the spark that will trigger sibling feuding is the unequal distribution of responsibility. Even in large families with multiple siblings, there is almost always one adult child who will take on the majority of the care-giving duties. Whether this role is taken on because of geographic proximity, age, or emotional ties, it is certain that the primary caregiver will feel some resentment for doing so much and other siblings will feel shut out.

Many adult children will unknowingly place themselves in the role of primary caregiver by slowly taking on more and more tasks for an elderly parent. Soon, a pattern is set in which the primary caregiver is responsible for all aspects of a parent’s care. Changing this pattern can be difficult and it is best to get siblings involved early on. A primary caregiver who is trying to encourage sibling participation should remember these tips:

  • Keep siblings informed about an elderly parent’s condition and care plan.
  • Listen to siblings’ opinions concerning care decisions and be willing to compromise.
  • Let siblings know that their help really is wanted and needed.
  • Ask siblings to take care of specific tasks. Even siblings that live across the country can help by making check-in phone calls or locating services.

Family meetings are an effective way for siblings to work out conflict and set up a care plan. It is best to involve a facilitator such as a social worker, counselor, or trusted outside party who will ensure that all participants have a chance to be heard. Although emotions may run high, it is possible to conduct a productive meeting by following a few guidelines:

  • Set an agenda for the meeting and keep to it.
  • Focus on the “here and now.” Try not to bring up past or unrelated issues.
  • Share your feelings with siblings instead of making accusations.
  • Listen and respect the opinions of all participants.

Case management may also be a viable resource for siblings who are unable to agree on care decisions. Leslie Camozzi, M.S.W., a case manager with the ElderPlan Program, part of the Institute on Aging, says, “It is useful for siblings to have an objective third party’s observations and opinions. A case manager can set up a tangible, working care plan. Dividing and compartmentalizing care tasks can help reduce sibling conflict.”

Funeral Arrangements: Decisions to Make Now

Funeral Arrangements: Decisions to Make Now

No one wants to think about dying, but it’s going to happen to each of us sooner or later. While approaching the topic of death and dying may be difficult for caregivers, family members as well as the elderly should try to organize and prepare for the end ahead of time, to reduce the stress, confusion and the necessity of making serious and sometimes confusing decisions regarding the care and disposition of a loved one.

A variety of checklists for seniors or their caregivers may help to organize funeral arrangements and decisions regarding funeral services, contacting relatives, selling a home, shutting off utilities, down to where lists of insurance policies and bank account information are kept, right on down to who will deliver the eulogy at the funeral service.

Pre-Death Planning Checklist

While this list is by no means all-inclusive, it should give you an idea or help guide you to determining what type of arrangements need to be made prior to the death of a loved one.

  1. Prepare a phone list or address list of individuals you want to be notified in the event of a terminal illness or death.
  2. Designate a trusted family member, child, or friend to serve as your executor. This person needs to have information and locations for your insurance policies, bank accounts, safety deposit boxes, and bills, so that accounts may be canceled, closed, or paid off.
  3. Place a reminder in your file to contact the Social Security Administration or the Veterans Administration of the death along with any relevant Social Security or identification numbers.
  4. Create a contact list of utility service providers, newspaper delivery, and postal service delivery for easy cancellation of services.
  5. If your parent or loved one has pets, make arrangements ahead of time about who will take on the care of those pets.
  6. Designate a Durable Power of Attorney to make health care decisions in the event your parent or yourself is unable to make rational medical decisions regarding health care. At this time, make sure any Advance Directives or DNR (Do Not Resuscitate) documents are placed in an easy-to-access file and that a copy of such documents is/are made available to your parent’s physicians.
  7. As part of the funeral arrangements, ask your parent what information he or she would like provided in an obituary, or whether or not they even want one. At the same time, ask your parent to determine what type of funeral or memorial service they would prefer.
  8. Purchase burial plots or make arrangements for cremation or burial ahead of time. Discuss such arrangements with your parents or with spouses.
  9. Organize your finances ahead of time and make sure records are up-to-date and easily accessible to whomever is designated to take care of closing accounts or paying off balances. Documents should be together in one location and include bank details, life insurance policies, birth certificates, wills, deeds to the house, or any other pertinent information that may be necessary for the executor to close accounts, make payment disbursements, access funds and so forth.
  10. Talk about any special needs or requirements of your parent in regard to their burial or cremation. Do they want their ashes scattered? Do they want to be buried in a traditional casket or in the increasingly popular ” green burial” method?

Funeral Arrangements – Putting It All Together

Talking about the death of a loved one is difficult, but don’t leave things to chance.

Whether or not your parent has been diagnosed with a terminal illness, it always pays to talk about such concerns ahead of time. Don’t leave anything to chance.

Seniors and adult caregivers over 40 years of age should have some type of death planning arranged or at least in the discussion phase. Write it down, keep track of it, and designate someone to organize the information and put it together into an easily accessible format for family members.