When Is It Time To Hire A Caregiver?

When Is It Time To Hire A Caregiver?

Posted on Friday, August 30th, 2013 at 11:03 am by lifemediamatters

Home Instead

When is the dividing time between when Mom or Dad can make it on their own and when he or she may need a hired caregiver? This question can be difficult and frustrating, but if you keep it simple­ you will know. Part of the answer lies within your gut, and the rest is left to your loved one. If that loved one was able to navigate daily life independently and now cannot­ it is time. If someone could drive and now cannot, if someone could bathe and now the process is too difficult, if someone was able to cook, clean and do laundry and now is unable due to deteriorating health or mental challenges­ it is time. These are all opportunities to seek outside assistance.

A family caregiver is a wonderfully special type of support when used in the right manner. What I hear most often from family members is that once they become the sole physical caregiver, they lose their role of son or daughter, husband or wife. Adult children would like to be just that, and they should be. I also hear from family members that they are doing the physical care out of guilt or due to financial reasons. Helping out with one or two challenges seems reasonable­ if it does not impact the family caregiver’s ability to attend to their own daily tasks. However, even one area of need­ like providing transportation­ may be taking too much of the family caregiver’s time and may become too much to handle. These are strong indications that it is time to seek out assistance for you and your loved one.

Some indicators that hired help and more constant supervision is needed:

  1. Your loved one continues to miss doses of medication or is taking the wrong amount.
  2. You are having difficulty getting your loved one out of bed or out of a chair.
  3. Your loved one is bed­bound, and it is hard for you to turn or position him or her.
  4. Your loved one falls repeatedly.
  5. Your loved one has developed pressure sores or has complex wounds.
  6. You are feeling overly tired and are not getting enough rest.
  7. You are short­tempered, angry or depressed.
  8. You find that you do not have time to complete your other daily tasks.

Whether covertly or overtly stated, guilt seems to be the most frequent feeling that family caregivers describe. If your loved one is being assisted by a hired caregiver and all needs are being met, then why feel guilty? Are you still visiting or calling? Are you now able to be that loved one’s family member? If you still feel such guilt, I invite you to look into the reasons why. Do they include financial concerns, a lack of resources, or not enough emotional support? A definite indication that change is necessary occurs when your own life is impacted to the point in which you are unable to attend to your daily responsibilities.

Where to find local resources for answers:

1. For finding caregivers to hire, nursing facilities, assisted living, supportive living (i.e. financial eligibility requirements) and memory care places, ask your local hospital social workers or senior social services agency. Call them to inquire.

2. For transportation needs, call your city, town or village. Also investigate local taxi companies or public transportation.

3.For additional resources, seek out assistance from your local senior services agency. They have a plethora of answers!

LGBT Seniors Fear Discrimination From Caregivers

Posted on Monday, July 1st, 2013 at 12:00 pm by Life Matters Media

Dozens of seniors and medical providers crowded into the Unitarian Church of Evanston, Illinois Saturday to watch “Gen Silent,” a critically acclaimed 2011 documentary highlighting the fears many seniors in the LGBT community have about end of life care.

Directed by Stu Madduxthe film chronicles the lives of six seniors living near Boston. They go back-and-forth recounting their experiences growing up during the onset of the gay rights movement and sharing their present struggles– ranging from fears of abuse from long-term care providers to judgmental caregivers and family members.

“When someone’s facing the end of life and feeling alone and isolated it’s incredibly sad,” said palliative care physician Catherine Deamant, a member of Chicago’s End of Life Care Coalition. Many in the LGBT community are afraid to show their “true selves” to caregivers for fear of bullying, she said, and long-term care facilities tend to overlook the individual.

“Many who won the first civil rights victories for generations to come are now dying prematurely because they are reluctant to ask for help and have too few friends or family to care for them,” according to the film’s website. Oppression from the years before the Stonewall riots continues to linger with those in the film.

The audience was clearly moved by the hour-long film, with many wiping their eyes or shaking their head with disapproval at some of the film’s more emotional moments. “I find it very frightening what lies ahead of me,” one man shouted out during the discussion. “Is this another reflection of how we handle the elderly? Why should it be different for any other group?” a woman asked.

The film, similar to the 2012 Oscar-winning drama, “Amour,” did not shrink away from showing the hard truths of aging, including scenes of hospitalization and loss of strength. “I think they saw the full humanness of the people in the film– they weren’t one-dimensional,” Deamant said.

Dementia More Costly Than Cancer, Will Become More Common

Posted on Friday, April 5th, 2013 at 9:05 am by Life Matters Media

Image: Pixabay, Gerd Altmann via Creative Commons

Gerd Altmann via Creative Commons

Researchers determined dementia leads to total annual societal costs of more than $40,000 per case in the U.S.

The most comprehensive study on the costs of dementia shows the disease is more expensive than heart disease and cancer, costing society and families around $200 billion a year.

The costs of dementia-related care and the number of people suffering from the disease will more than double by 2040, according to research supported by the RAND Corporation, financed by the government and published in The New England Journal of Medicine.

Key findings

Researchers determined dementia leads to total annual societal costs of $41,000 to $56,000 per case in the U.S., totaling up to $215 billion in 2010. More troubling were calculations that estimate the aging population will lead to an increase of almost 80 percent in total costs by 2040.

Most dementia-related costs stem from long-term institutional and home-based care, not medical care. Nursing home, formal and informal care account for up to 80 percent of the costs. These estimates place dementia among the most costly diseases.  In 2010, almost 15 percent of Americans 70 and older suffered dementia.

By 2040, nine million people will have the disease. “I don’t know of any other disease predicting such a huge increase,” Dr. Richard J. Hodes, director of the National Institute on Aging, told The New York Times. “As we have the baby boomer group maturing, there are going to be more older people with fewer children to be informal caregivers for them, which is going to intensify the problem even more.”

Still, the findings are more conservative than previous calculations from the Alzheimer’s Association, which estimated that in 2010 the monetary costs alone were $170 billion, as compared to $110 billion.

Figuring costs of dementia

It is notoriously difficult to glean accurate data about the costs of dementia over time, which makes the new findings especially important to the medical community and financial institutions.

Dementia is a chronic disease associated with aging and is characterized by progressive cognitive decline, mostly affecting seniors already suffering from other ailments. This makes its financial implications difficult to separate.

Secondly, most of those suffering from dementia are looked after by caregivers, many unpaid, making it difficult to estimate monetary costs for caregivers’ time.

The researchers began with some 11,000 people from a long-running government health survey called the Health and Retirement Study, which began in 1992. They surveyed more than 800 of the people aged 51 years or older. To get a strong representation of dementia, those respondents underwent a three-hour in-home clinical assessment. Those results were then reflected upon the larger group.

Researchers then analyzed Medicare records and patients’ out-of-pocket expenses. Foregone wages from family caregivers who gave up work to care were tabulated, as were estimates of what the care may have cost if bought from formal providers. Spending on all other ailments, such as diabetes and high blood pressure was subtracted.

Dr. Kenneth Langa, a University of Michigan researcher who helped with the research, told ABC News, “This is an important difference” from other studies that did not determine how much health care cost was attributable to just dementia.

President Barack Obama signed the National Alzheimer’s Project Act into law in January 2011; it aims to track costs of dementia and improve the health outcomes of those living with the disease.

More Male Caregivers Emerge As Demographics Shift

Posted on Wednesday, March 27th, 2013 at 8:30 am by Life Matters Media

As millions of baby boomers enter retirement and as medical technology allows seniors to live longer than ever, more men are becoming caregivers for their loved ones, upending stigmas that caregiving is the work of women. As a 2012 Pew Research analysis on family caregiving shows, 45 percent of U.S. caregivers are now men.

Couple by George Hodan

Couple by George Hodan

The increase has been swift and substantial. Just about fifteen years ago, only some 19 percent of those looking after older or disabled family members were men, according to ABC News and the National Alliance for Caregiving.

“[I]ncreasingly men are being thrust into (or welcoming) the role of caregiver- for their children and/or aging parents- while working full-time jobs,” writes caregiving expert Alexis Abramson for The Huffington Post.

Cultural changes about what constitutes masculine and feminine work also seem to be contributing to the rise in male caregivers.

According to analysis from Leann Reynolds, a contributor to the Good Men Project, “Such an increase in the proportion of male caregivers can be explained by a combination of social and demographic changes,” such as the greater geographic separation of family members, smaller families and shifting gender roles.

As Richard Nix, executive vice president of Aging Care, told ABC News, “It’s OK for men to cry now.”

Workplace discrimination

Still, some male caregivers face discrimination from the workplace for their time spent caregiving. According to Abramson, male caregivers may “unfortunately face a tougher time than women from employers who are used to caregivers being, well, women!”

She writes how male caregivers are more likely to be victims of “caregiver stigma,” as caregiving is associated with feminine traits, that she insists, are not yet valued in the workplace. “Sadly a man who requests time off to take his elderly mother to a doctor’s appointment might just as well be announcing plans to attend a retreat ‘to get in touch with his feminine side,’ ” Abramson writes.

Similarly, Fortune and CNN Money report that the growing number of men taking on caregiving roles has contributed to the overall spike in employee discrimination claims, analysis confirmed by the Equal Employment Opportunity Commission.

“Employers are often more relaxed in applying blatant sexual discrimination against male caregivers,” Elizabeth Grossman, an attorney in the EEOC New York district, told Fortune. “When invoking parental leave, some supervisors might say ‘Oh no, that’s for women.’ There are some pretty entrenched stereotypes.”

The Center for WorkLife Law reports how one man was told by supervisors he would be “cutting his own throat” if he took time off to care for his sick father.

From 2006 to 2010, 147 family responsibility discrimination cases brought by male plaintiffs were decided in court, according to data from WorkLife. Fortune estimates this data reflects a 300 percent increase compared to the number of such decisions from 2001 to 2005.

Dying At Home More Difficult Than Expected

Posted on Monday, January 28th, 2013 at 7:49 am by Life Matters Media

Extensive planning is necessary for those determined to help their loved ones die peacefully at home, health care reporter Susan Seliger writes for The New York Times’ blog on aging. Most Americans say they want to die say “at home” when asked,  but both the patient and caregiver’s well being must be considered.

Investing in the right equipment and preparing documents may overwhelm some caregivers, and although professional help is available, each patient’s circumstances are different.  Seliger has prepared a list of 12 tips to help them fulfill their final wishes.

Perhaps the most important consideration is making room for the bed. “A lot of people put the patient in a family room where there is more space, or the dining room if it’s closer to a bathroom,” said Dr. Stacie K. Levine, a geriatrician and palliative care physician at the University of Chicago. She also recommends putting the bed on the first floor of the home to prevent strenuous movements.

The pros and cons of using a hospital bed, Seliger says, should be carefully considered due to the emotional impact that sleeping apart from a spouse can bring. She advises patients with dementia or  cancer who are not that mobile to choose a bed with an air compression mattress in order to to prevent bedsores.

Other suggestions are simple comfort adjustments, such as cushioning the patient’s favorite chair or buying earphones for the hearing impaired. Spring pressure adjustable curtains provide privacy.

Caregivers may also make use of hospice during the last stages of care. “A good hospice team not only helps the caregiver figure out a plan for care but arranges for Medicare approval and payment,” Seliger writes.

“The larger the hospice, usually the more services for the patient and caregiver,” said Dr. R. Sean Morrison, director of the National Palliative Care Research Center at the Mount Sinai School of Medicine. “Ask for their daily patient census – several hundred patients per day is a good size.”

“What I see that prevents people from being able to stay at home [to die] is not their medical needs but the needs of their caregiver — can the caregiver really help, are there resources to help, or is that person going to be overwhelmed?” Morrison told Seliger.

Respite care” for the caregiver may help with overwhelming stress. Respite care pays for up to five days of patient care in a nearby medical facility so the caregiver can take a break or even go on a vacation, said Lori Mulligan, senior director of development marketing and community services at Gilchrist Hospice.

Still, hospice care remains underutilized. As LMM previously reported, 36 percent of hospice patients die or are discharged within seven days of treatment.  Many others suffer more than they need to due to hospice enrollment policies. Hospice is most often used when curative treatment is no longer effective, and a terminal patient is expected to live about six months or less.

Despite the work, home deaths may be less traumatic than hospital deaths, according to a 2010 study published in the Journal of Clinical OncologySome 300 adults with terminal cancer and the same number of caregivers were studied. Among the caregivers, those whose loved ones did not die at home were about five times more likely to have post-traumatic stress disorder after six months than those whose loved ones died at home.