senior care services

Medicare Doesn’t Cover WHAT?!
Gregory Peebles is a Certified Senior Advisor (CSA), Certified Dementia Practitioner (CDP) and trained Medicare Counselor, whose work focuses...
Read more
June 18, 2018
0
0

In the Caregiver's Words

Recent Client Praise

There is no doubt that being a caregiver to an older loved one can be a positive and rewarding experience and it may be a way to give back. But the caregiving demands can become onerous, and the caregiver can feel stretched between their obligations to their own children and their partners. Or the day job can be demanding in and of itself without the "extra shift" that caregiving heaps on a person. As a certified geriatric care manager, I have seen caregivers who are stressed, but not nearly as often do I see a caregiver who talks about this burden. It brings up too much guilt, or they feel they just need to "get through" the next week or month, but the weight of the added responsibilities can be huge to the point of breaking. It is important to find relief before the caregiver reaches that point, and there is a way to measure caregiver burden before one reaches a breaking point. Consider the following and rate each on a scale where 0=never, 1=rarely, 2=sometimes, 3=quite frequently and 4=nearly always - be honest:
1. He/she needs my help to perform many daily tasks.
2. He/she is dependent on me.
3. I have to watch him/her constantly.
4. I have to help him/her with many basic functions.
5. I don’t have a minute’s break from his/her chores.
6. I feel that I am missing out on life.
7. I wish I could escape from this situation.
8. My social life has suffered.
9. I feel emotionally drained due to caring for him/her.
10. I expected that things would be different at this point in my life.
11. I’m not getting enough sleep.
12. My health has suffered.
13. Caregiving has made me physically sick.
14. I’m physically tired.
15. I don’t get along with other family members as well as I used to.
16. My caregiving efforts aren’t appreciated by others in my family.
17. I’ve had problems with my marriage (or other significant relationship).
18. I don’t get along as well as I used to with others.
19. I feel resentful of other relatives who could but do not help.
20. I feel embarrassed over his/her behavior.
21. I feel ashamed of him/her.
22. I resent him/her.
23. I feel uncomfortable when I have friends over.
24. I feel angry about my interactions with him/her.
Add up your score, and if you are close to or above a 36, it is time to consider help. At least consider help with some of the supportive activities you do for your loved one. You will find senior residential communities or centers who provide respite care to give you the break you may need. Also, look to what you rated "quite frequently" or "nearly always." If you have a cleric, a counselor or therapist, these may be good points for your conversation. Also, do a search of my blog here using the keyword, "caregiver." One of the topics I have addressed a lot is Caring for the Caregiver. Take care of you! For more on this scale (and there are others as well) go to: http://www.fullcirclecare.org/caregiverissues/health/burden.html Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.
For a what, you may ask? I have either talked about or invited elder law attorneys to talk about advanced directives like Do Not Resuscitate (DNR) orders, living wills, powers of attorney and other documents that will help to assure that an older adult's end of life wishes are honored. And that is where POLST comes in. It is a standardized (by state) document that walks through a patient's wishes for end of life care that falls short of a DNR. POLST is Physician Orders for Life-Sustaining Treatment. The majority of states have enacted such legislation following the lead of Oregon in 1991. It is standardized for the state and is typically a brightly colored single sheet so that it will stand out in a patient's file. (Illinois' form is two pages.) Not only doctors, but first responders and other clinicians will understand the instructions of the POLST. It is not for everyone, but if your older loved one is frail or suffers from a life-limiting illness, you should consider having a talk with your loved one's physician along with your loved one. If your older loved one's physician can honestly say they would not be surprised if that person died in the following year you would be well-advised to start the conversation in order to have the POLST on file. What would that look like in a standardized form? In Illinois, the form asks for all the usual patient-identifying details, contact information for your older loved one's preferred contact, physician contact information and the physician's signature. The rest is pretty much a check list. Check yes or no if your loved one agrees to having CPR in the event their heart stops. If your loved is still breathing and there is a pulse, check yes or no for comfort measures only, for limited added interventions or for intubation for ventilation. To these the physician can add other measures. Finally, check yes or no for what kind of nutritional supplements are desired if your loved one cannot be fed by mouth. The rest is referred to as documentation that this discussion occurred between competent adults. To see the Illinois form, please go to this link (http://www.idph.state.il.us/public/books/dnrform.pdf) As you can imagine, life or end of life decisions are not so cut and dried. There are some potential ethical issues to be addressed here. Clear and sensitive discussion needs to occur among you as the caregiver, your older loved one and the rest of the family. And then there is the real question of whether your older loved one can really understand all the medical speak. It may prove helpful to bring in a professional counselor to talk this through with the family unit so that all voices are heard and all questions or objections are raised. Most important, however, is that your older loved one feels that it is they who are in charge. This ultimately is not about the doctors or the family; it is about the care receiver.
If you will be heading home for any of these seasonal holidays you will find that it can be a wonderful trip back in time as you revisit your own family history in the context of your mom’s or dad’s house. But when you visit, take a closer look at how safe that house may still be for your older parent living there. Some parts of the home interior landscape may be just like you remember them, but they may now pose hazards to your older parents.

    Start with electrical fixtures. Check for where the cords to lamps or telephones and other household appliances are. If they are in the flow of traffic, consider arranging furniture differently. Also, remember that extension cords are really only meant for temporary use, so it is a good idea to move fixtures to be closer to outlets. If you must use an extension cord, place it against a wall to reduce the trip hazard. If there are electrical cords under furniture, check for wear on the insulation to avoid fire risks. Cords under carpeting or rugs also can wear to the point that the floor covering becomes a fire hazard. And, of course, frayed or cracked cords should be replaced. Finally, check to see that all outlets have secure cover plates so that no wires are exposed. Do the hands-on test as well to be certain no outlet is unusually warm to the touch, a sign of potential overloads and therefore a fire risk.

    The Consumer Product Safety Commission has estimated that thousands of people 65 years and older each year are treated in hospital emergency rooms for falls associated with rugs or floor runners. Older adults have less agility and some shuffle as they walk making the trip hazard even greater, so remove rugs that cannot be securely attached to the floor. It is easy to use double-sided adhesive tape to secure rugs or use rubber matting under the rug cut to size is an alternative.

    In addition to replacing batteries in smoke detectors, make sure there are enough detectors placed throughout the house. Especially if one of your older parents has any difficulties with hearing, you will want to have multiple detectors, and they typically come with instructions on where they optimally should be placed in the house. Adding a carbon monoxide detector also is important if there are any fuel-burning appliances in the home. Even homes with electric kitchen appliances may have gas-burning heating units or water heaters.

Because accidents can still happen despite all these preventive measures, make sure emergency numbers are close to every telephone in the house. Include the local Poison Control Center along with a trusted neighbor’s number and your own family ICE (in case of emergency) contact. Write these telephone numbers in large print and tape conspicuously near each land line. Check also that phones and contact numbers are accessible to your parent in the event that an accident leaves them unable to stand.

    Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to Charlotte Bishop.
In the meantime, we invite you to download the below featured FREE white paper - offering both personal and professional advice for those who care for the elderly or people with special needs. Make sure to come back and visit us for more great FREE resources.

Caregiver Counsel on Senior Living OptionsFinding the best living options for your loved one can be tough. Whether it is picking the right senior living community or making your current family home safer, we help you to prepare for a productive conversation with your loved one about these transitions.Download
Who thinks it’s a good idea to just blow off Valentine’s Day? I am guessing not many hands will go up for that idea…some might even say that their spouse will kill them if they don’t bring forth at least a sentimental thought. Never mind the flowers, candy or sparkler. Just forget about the day later this week. Well, that probably is what some of us do every day … with our hearts…we just forget about our hearts. And that is why heart attack and stroke are the top two causes of mortality in the United States. So, what do you do to remember of your hearts? Earlier this decade the American Heart Association came up with seven habits to embrace to help avoid heart attack and stroke. You don’t have to wait until February 14^th to start:
1. Exercise - there is a new exercise program recommended almost every week, it seems, but the simple fact is that getting your body moving regularly and vigorously supports a healthy heart…and the rest of the body with it.
2. Eat right - we all know what the good foods are and what the bad foods are; make a healthy diet your Valentine’s Day resolution.
3. Lower blood pressure - you will need a medical provider to give you your actual numbers (not to exceed 12/80), and if your numbers are high stick to the prescription you will be given and follow #1 and #2 along with losing weight and cutting your salt or sugar intake.
4. Lower your cholesterol - focus your diet on fruits and vegetables along with fish, nuts and soy; your doctor can tell you if a statin is indicated.
5. Manage your blood sugar - sugar is not your friend, so limit its visits to your body in order to keep down your weight and not beat up your pancreas…your heart will thank you.
6. Maintain a healthy weight - losing weight should be an outcome of the first 5 instead of a goal in itself, but keeping your weight down lightens the workload for your heart.
7. Don’t smoke - smokers have double the risk of a heart attack and triple the risk of a stroke over nonsmokers; it is not just your lungs that suffer if you smoke.
So this list is the short version of a lot of material I have covered in other posts. If you have questions, you can use key words to search the blog for a related post or you can go to the American Heart Association web site. Make February your heart-healthy month! Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.
I've talked about being on the lookout for signs of early onset dementia as we all begin our holiday gatherings. Dementia may be difficult to detect for a number of reasons. First, early onset can be evidenced in very subtle or small changes in behavior or recall, so it may be the accumulation of a number of tells that begin to tell us there is some slippage. Second, most of us are so fearful of losing our faculties that we tend to deny it or try to hide it from others, and after all who doesn't forget someone's name at some point? Third, loving couples tend to compensate or cover for one another. One partner may see the lapses in the other, but work to help their partner feel as empowered as they were before this decline. For all of these reasons, it underscores how we all should work to be empathetic and sensitive to the special needs of a loved one who may experience some form of dementia, because they can still function very well with some accommodation.

            So, once you do notice something or perhaps any number of things that are just not quite right in your older loved one, be sensitive about how you broach the issue...if you bring it up at all. As dementia sets in, it may cause a great deal of anxiety in the person with the symptoms. The anxiety understandably comes from a feeling of helplessness, and it is important to not provoke the anxiety into full blown defensiveness or angry outbursts. Here are three suggestions for friends, families, and caregivers on how to soothe an older adult with some form of dementia while maintaining a meaningful line of communication.

1.    As you plan the holiday gathering, think about the way these events have always been hosted in the past. Keep the surroundings and the routine familiar, and avoid noisy restaurants, especially places where the older person may be unfamiliar. If there has always been a certain way you prepared the pie, do it that way again, and you may be amazed how the tastes and the smells bring a wonderful memory back even to someone with memory loss.

2.    It may be appropriate to downsize the gathering a bit. In the past you may have invited a whole host of friends and family, but a smaller gathering of familiar faces will prove much easier for a person with dementia to navigate. While not every face will have a name for a person with dementia, familiar faces will put them more at ease.

3.    Appreciate that it is short term memory that is the most common casualty in dementia, but you can still talk about the early memories which everyone can replay and enjoy together. And it does not hurt to hear a wonderful memory repeated more than once at a family gathering.

            Finally, it is really all about family and sharing a positive moment, so be sensitive. If a story is repeated more than once you can indulge that. The most important thing to remember is to just enjoy the family moment. Follow your instincts about what has always been special in the past, and it likely will be pleasant for everyone again this year.

            Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to ccbishop@creativecasemanagement.com.

See all Testimonials »

Creative Care Management, Inc.

1740 Ridge Avenue • Suite 111
Evanston, IL 60201

847.869.5118 x511 tel
847.869.0410 fax

info@creativecaremanagement.com

Evanston • Chicago • Skokie • Park Ridge • Glenview • Niles • Northbrook • Deerfield • Wilmette • Winnetka • Glencoe • Highland Park • Lake Forest • Naperville • Hinsdale • Wheaton • Oak Brook • Lombard • Glen Ellyn • Bloomington/Normal • Springfield • Decatur • Champaign/Urbana • Kankakee

Gay Friendly

senior care services

Medicare Doesn’t Cover WHAT?!

Contact

Newsletter Sign Up

Areas We Serve

Accreditations

Connect

Careers