How to Be the Best Caregiver/Care Coach You Can Be (Part One)

Barb Resnick HeadshotBarbara Resnick, PhD, CRNP
Professor
Sonya Ziporkin Gershowitz Chair in Gerontology
University of Maryland School of Nursing

As someone who is generally the caregiver—professionally and as a woman, mom, wife and daughter—I have had the opportunity to learn recently what is most helpful when being on the receiving end of caregiving. My thoughts combine my professional work as well as the personal experiences I have had with the health care system and with some challenging health care issues.

There is a difference between short-term caregiving events (such as helping someone after a joint replacement, fracture, or cancer treatment), compared to long-term caregiving events (such as caring for someone who has had a major stroke or who has dementia or Parkinson’s disease).  The approaches recommended here can be used for both short- and long-term caregiving.

My most recent thoughts come from going through an extremely aggressive course of radiation and chemotherapy.  In this treatment, the health care team is focused on destroying cancer cells and not necessarily on helping the individual undergoing treatment cope.  Therefore, a caregiver, or what I like to think of as a “care coach” or “care champion,” is essential.  That role generally falls on family, friends, or co-workers.

Based on my experience, here are some ways to be a terrific care coach. Continue reading

National Family Caregivers Month

HealthinAging.org Offers Valuable Support for Caregivers all Year Long

November is National Family Caregivers Month.  Even though it’s now December, it’s still a great opportunity to ensure that caregivers across the country get the recognition and resources they deserve all year long. 43.5 million caregivers—many of whom may be older adults themselves—provide care for someone over the age of 50, and 14.9 million care for someone who has Alzheimer’s or another form of dementia.

Caregiving is a full time job, often performed by family members whose responsibilities may also include a career, maintaining a home, parenting teenagers and sometimes helping to raise grandchildren—all in addition to caring for an older, vulnerable parent or other older family member or loved one who needs help with the daily activities of life.

The job of a caregiver can be extremely stressful, and can take a toll on a caregiver’s health, especially if the person being cared for has Alzheimer’s disease or dementia. In fact, some 50% of people who care for people with cognitive disabilities develop psychological distress.

You can’t be an effective caregiver unless you take care of your own health needs. You’ve probably heard the pre-takeoff speeches flight attendants give, about putting on your own oxygen mask before assisting others? It’s the same with your health. Seeing to your own mental and physical well-being helps you to take on the demanding task of taking care of a vulnerable older adult.

Here’s a place to start: The Caregiver Health Self Assessment Questionnaire, which was originally developed and tested by the American Medical Association. This questionnaire can help you look at your own caregiving behavior and health risks. With your healthcare provider’s help, this questionnaire can help you make decisions that may benefit both you and the person you’re providing care for. It may also improve communication and enhance your partnership with your own health provider.

This questionnaire is meant to serve as a guide only. Be sure to speak to your healthcare provider about any concerns you may have about the questionnaire or your results.

HealthinAging.org has many other tools and tips for family caregivers. These resources offer valuable support and advice when you’re caring for a loved one:

“The Four M’s” of Caring for an Older Adult with Dementia

Cleveland, MaryJo 4x6Maryjo L. Cleveland, MD
Medical Director, Post Acute & Senior Services
Chief, Division of Geriatric Medicine
Summa Health System
Akron, Ohio

Your older relative has just been diagnosed with dementia. Your head is spinning with questions, concerns, fears, and yes, disbelief.  Still, you want to know all you can. If you are going to be a caregiver, you want to be a good one. So, where to start?

Start with the things that, if not managed well, have the greatest chance of getting your relative into trouble! Start with “The Four M’s.”

 

Meals
From planning to shopping to preparing, meal preparation is a very complicated task—for someone with a memory problem. You may notice that the older person is losing weight, that they eat little at home but eat well when they go out to eat, or that there is spoiled food in the refrigerator.

Try: Have simple foods – especially your relative’s favorite ones – around the house, such as sandwiches, soup, and cereal. Bring in ready meals that just need to be microwaved. Consider arranging for home delivered meals. Try to make meal time a social time when possible. Ask friends, church and family members to stop in and stay during meals.

Medicine
Medication management can also be overwhelming and older adults are often taking 10 or more medications, including over-the-counter ones.

Try: Discuss simplifying the regimen with the primary healthcare provider. Are all medications still necessary, and how many can be given just daily? Set up the medicine in a “days of the week” pill box and monitor if they are being taken. Call daily to remind. Consider hiring help for in-person reminders. Take over the refill tasks. Continue reading

Caregiving for an Older Adult: Stressing and a Blessing

Clare WohlgemuthClare M. Wohlgemuth, RN, GCNS-BC
Nursing Director, Geriatric Services
Boston Medical Center
Boston, Massachusetts

 If you are helping a family member or friend over age 50 with things such as dressing, bathing, housework, or taking medicine on a regular basis, then you are a caregiver. You are not alone—there are close to 50 million Americans involved in caregiving. Caregivers spend an average of 20 hours each week caring for one (or more) older adults. About one in four of caregivers have been giving care for more than five years. About three in four caregivers work a paying job and spend up to $5000 out of pocket each year to help with caregiving costs.

Caregiving has been a part of community life for a long time. These days, the amount and types of help provided by family caregivers has increased a great deal. This has also raised the costs of caregiving—both economic and psychological. Now, loved ones often come home from the hospital earlier and with more complicated conditions. This means that caregivers often take on many roles in addition to providing companionship and emotional support. Caregivers may give medications, find and coordinate services, and perform basic nursing. They also communicate with healthcare providers, coordinate care during transitions from hospital to home, and advocate for their loved ones during visits with healthcare providers and hospital stays.

Caregivers are at higher risk for symptoms of anxiety and depression because of the burden of these many roles. Their physical health may also suffer. It is normal for caregivers to feel alone and overwhelmed. Caregivers may also feel unable to communicate well with the person receiving care and/or other family members. They also report needing information on how to keep their loved ones safe at home and to find activities to do with them. And caregivers also need resources to help them manage their own stress and make time for themselves.

In our recent study of geriatrics health providers who are also caregivers, we found all of these challenges. Even those most prepared to handle all the different caregiving tasks found it very difficult. If you are a caregiver AND a healthcare professional, you may face additional burdens—and will also benefit from support. [You can click here to read the full study.]

What You Can Do
In order to cope with the demands of caregiving, all caregivers need to get help. It is good to ask questions, and to ask for help! If you are not happy with the answers you are getting, it’s important to keep asking. Also keep looking for the information and support that you need, perhaps from other resources. There are many places you can look to for help: hospitals, your community, and online resources.

Continue reading

National Family Caregiver Month

When you hear the words “family caregiver” what image comes to mind? Odds are, you envision a woman. We tend to assume that family caregivers are wives, daughters, sisters, nieces, and granddaughters. But here’s a surprise: According to a recent Pew Research Center report, 45 percent of relatives caring for older adults in the U.S. are men.
What accounts for the growing percentage of men caring for older family members? According to a recent Wall Street Journal article, decades-long declines in family size, and increasingly far-flung families, are likely contributors. If your aging mom needs help, and you’re the only nearby, you step up to bat. Period.

So this month—National Family Caregiver Month—and beyond, we at the American Geriatrics Society Foundation for Health in Aging (HIA) hope you’ll show your support for the women and men you know who are caring for their aging relatives. While growing numbers of husbands, sons, brothers, nephews, and grandsons are now playing this role, they may be less likely than women to reach out for help with caregiving when they need it, according to a recent Wall Street Journal article. This means we need to do more to reach out to them.

Organizations and services for family caregivers are already doing this. The Journal story, for example, spotlights a Colorado home care service that created a virtual community just for men—www.malecaregivercommunity.com—thinking it would be more appealing to male caregivers . It has been. “Since it started in June, more than 84 discussions have developed,” the paper reports.

In addition to support, family caregivers also need top-notch information. And that’s where Healthinaging.org comes in. Among other things, it offers comprehensive information about caring for even the most medically complex older adults—those with multiple, chronic health problems. Just as important, it offers information about caring for yourself if you’re a caregiver. We hope you’ll mention the site to the family caregivers you know— men and women alike.