Adding Life To Years

Eldercare: A Family Caregiver Role

I have written a lot about eldercare, but it is so prevalent today, where the estimates are that about 50 million care for elders in the US and this number is growing phenomenally. We need to know what it entails, plan for it, and balance it with our other roles, while maintaining our own health.

According to AARP and the National Alliance on Caregiving, the state of Nevada has more than one-half million informal caregivers, and the value of informal caregiving in Nevada is said to be roughly $4 billion annually. In addition, nearly half of family caregivers are caring for someone who lives in his or her own home, while an additional one-third are sharing a home with the loved one. Some are caring for a spouse or partner, many for a parent — all working to help that person stay at home for as long and as comfortably as possible. The caregiving role may be simply checking in on the elder to assisting them with everything from bathing and meal prep to medication management.

It’s important to think both short term tasks and needs and long term issues that require planning. You can not anticipate everything, but being forward-thinking now will help you respond more quickly and effectively in an emergency. We cannot do this caregiving role alone. Reach out to form a team of family, friends and others who can help you and the care recipient.

So, in forming a team what needs to be done. First, identify who can participate. Second, be open and honest with yourself. If you are uncomfortable with hands-on caregiving tasks, such as helping a loved one bathe, ask if another team member can step in. Or discuss whether there is money available to hire assistance. Really think about what you can and cannot do. Talk to the team members about tasks and find consensus. Third, communicate with the team members and determine what they’re willing to do to contribute to the care. Even if they live out of town, they can handle jobs like paying bills, ordering prescriptions and scheduling medical appointments. Fourth, work with the team on a plan, and if possible always include the care recipient. The plan needs to be agreed upon by all parties and if valuable, put in writing. Be aware that it will constantly change, so review the plan regularly.

Caregivers may need help with basic care.  The areas in which caregivers most frequently seek information include keeping their loved one safe at home, managing their own stress, identifying easy activities to do with care recipients, finding time for themselves, balancing work and family, talking to doctors and other healthcare professionals, making end-of life decisions, and managing challenging behaviors among many other areas. Many services in the community can help with obtaining information. For example, the Center for Healthy Aging collaborated with the Reno Senior Citizens Advisory Committee, Washoe County, Truckee Meadows Parks Foundation, AmeriCorps VISTA, and No NV Building and Construction Trades Department to create the 2017 Reno, Sparks, Washoe County Elder Services Guides and Resources. This is one of many guides available. The important thing is to ask the questions and seek information, because there are many resources out there that can help with the care. One invaluable new resource available to Washoe County created by the Community Foundation of Western Nevada is the Washoe Caregivers Guidebook. Go to www.WashoeCaregivers.org or call the Foundation for a printed copy.

In addition to becoming aware of the information and resources in the community to help with caregiving, there are specific fixes that can help with maintaining a safe home environment. Some basic, low-cost changes for home safety and fall prevention include removing trip hazards such as throw rugs, making sure the home is well lit (use automatic night-lights) and installing things like handrails, grab bars and adjustable shower seats. Lifeline has amazing technology to provide notice of falls, in the house or community, to provide peace of mind to the caregiver.

Those caregivers who have a loved one with dementia or Alzheimer’s brings with it particular worries about safety and self-injury. Some preventive measures include installing remote door locks, using GPS devices, disabling the stove and lowering the water heater temperature to 120 F or less. Cognitive confusion can occur due to a variety of reasons. One such area is mis-management of medications. One preventive technique is to create and maintain an updated medication list, with the name, dosage, prescribing doctor and other relevant information to bring to medical appointments and hospitals. Lifeline also has a Personal Medication Dispenser that handles the complication of taking many medications. In addition, when I was at UNR’s Sanford Center for Aging, we established a medication review program that is staffed by a Certified Geriatric Pharmacist. Note that mis-management of medications account for many elder hospitalizations and deaths. Take advantage of this low to no cost medication therapy management program.

Historically hospitals have discharged Medicare patients more abruptly to cut costs, tasks once reserved for nurses are now often handed off to caregivers, who sometimes get little or no training or instruction. However, since 2015 NV legislative session, the CARE Act was passed mandating the hospital educates the caregiver on the discharge plan. Make sure you identify yourself as the caregiver and then demand that you be educated by the hospital when your loved one is being discharged. It is the law!

There are many more areas to cover with caregiving of elders that I will cover in future articles, but please be aware that caregiving can become all-consuming. You may find yourself playing nurse, coach, nutritionist and social director. All of these roles are important for maintaining your loved ones mental and physical health. Just don’t neglect your own well-being and other roles you play in your life. Make sure you establish boundaries. Especially if you and your spouse/partner are living with the person you’re caring for; it’s important that everyone has a level of privacy. Ideally there is some separation between living areas and you can manage some time together as a couple. Clearly caregiving can be all inclusive, but very rewarding. So make sure you take care of yourself so you can “add life to years”.

Lawrence J. Weiss, Ph.D. is CEO of the Center for Healthy Aging. Dr. Weiss welcomes your comments on this column. Write to him at larry@addinglifetoyears.com or c/o Center for Healthy Aging, 11 Fillmore Way, Reno, NV 89519.

On August 16th, 2017, posted in: Adding Life To Years by
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