Finding Balance in Caregiving

According to a 2009 study by the National Alliance of Caregivers and AARP on Caregiving in the US, there are at least 43.5 million caregivers age 18 and over, equivalent to 19% of all adults, who provide unpaid care to an adult family member or friend who is age 50 years or older. About two-thirds of these caregivers also work outside the home. Let’s call them “working caregivers” even though we acknowledge that all caregivers are working. Working caregivers face unique demands of trying to juggle between their job responsibilities, providing care for their elderly family member or friend, maintaining their own household responsibilities, and trying to take care of themselves. Not surprisingly, the study revealed these working caregivers are more likely to seek help in finding a balance between their outside job, the responsibilities of caregiving, and finding personal time to attend to their own needs and desires.

How can working caregivers accomplish so much in one day? Are they forced to cut corners and feel the negative consequences of such choices? Making deliberate choices where you can understand and manage the consequences can help you achieve satisfaction in all of your roles. It is much more demanding than reaching work-life balance. It becomes a three level balancing act between caregiving-working-supporting your personal life.

The first step is to assess the demands you face in your caregiving role. Once you quantify the tasks of caregiving you may be able to find ways to delegate some of the duties to other family members or friends. Don’t lose heart if other family members live far away and friends are not available. There are organizations in our local community such as Golden Umbrella and Mountain Caregiver Resource Center which provide an array of family caregiver support. Take pride in your abilities to enlist support rather than feel guilty that you can’t do it all by yourself.

While you are listing the tasks of caregiving, assign a weight for each task so that you can better understand its priority. High priority items such as medications, keeping appointments with the doctor, preparing nutritional meals and maintaining good hygiene can be systematized by good organization and record keeping. You will actually save time by keeping records and an appointment calendar in a convenient, accessible location. On the other hand, does it really matter if the carpet is not freshly vacuumed and the book shelf is dusty?  

Coping with the demands of the workplace require similar strategies. Assessing, prioritizing and organizing your job tasks are essential to any job. Cultures vary from one company to the next, and employees need to figure out how much they can share the details of their personal life with their boss. Some family friendly workplaces allow flexible schedules, such as starting later, leaving early or taking time off during the day to provide care. In other situations, employees may be discouraged from revealing too much for fear they will lose a promotion opportunity or land on the short list of candidates for lay-offs. Larger employers are likely to have an Employee Assistance Program which provides resources to help situations outside of the work place. Co-workers who have juggled caregiving and work roles may be able to help you with strategies that have worked for them.

Finally, don’t neglect yourself. Just as you have scheduled an appointment with the doctor, or a meeting at work, make a commitment to a time when you can do something that recharges your batteries. It may be just a few minutes in a day where you can catch up on emails from friends, relax with a good book or take a walk. Ask for help to get away for longer stretches of time to go to the movies, shopping or out to a restaurant. If you can afford it, hire a caregiver or use respite services of an assisted living facility to get away for a few days. Finding time to take care of yourself will not only feel good, it will help you better succeed in your caregiving and working roles.

dementiadvice is written by Mary Burger, owner of A Brand New Day, a full-spectrum memory care community located in Redding CA.

 

Watch Out for Unsafe Medications Given to the Elderly

Medications produce effects which can be good or bad. They can be a life-saving friend or a life-threatening enemy. They may complement the use of other medications or interact with each other to create adverse reactions.

Don’t Do the Math
We have seen the effects of taking too many medications on a senior. One doctor says  take 20mg of one medication and another doctor says take 40mg of the same medication. She added up the milligrams and took 60mg. This caused a hospital visit for 4 days.

Elderly Face Different Risks
Since medications can be dangerous and may cause more harmful side effects than benefits, communication with doctors and pharmacists is absolutely necessary. NaturalNews.com highlights a study by Duke University focusing on unsafe drugs for the elderly.

Take Time to Read and Understand the Inserts
How many times have you actually read the information page that comes with your medications? If you have, did you understand it all? The information can be confusing and it seems you have to be a doctor or pharmacist to completely understand what it actually says.

Beware of the Black Box
If you notice a warning on the prescription drug information page that is surrounded by a black border, you are dealing with a Black Box or Black Label Warning. The pharmaceutical company is required to place this particular warning on its labeling by the FDA for the following situations: The medication can cause serious adverse reactions (such as a fatal, life-threatening or permanent disability) compared to its potential benefit. Or the drug can adversely affect certain populations such as the elderly with dementia. Just look at this warning for Haldol, a drug often prescribed for dementia patients. When your doctor prescribes a new medication, it is important to find out if it carries this type of warning. If so, we strongly advise you to have a conversation about the medications risks vs. its benefits. Follow up with a consultation with the pharmacist when you pick up the medication.

How Many Pharmacies and Doctors are Involved?
Medication issues are especially a concern for those who use multiple pharmacies and different doctors. One may be a cardiologist, yet another may specialize in working with diabetes and kidneys. Others may include an internist, a urologist or orthopedic doctor. All of these doctors may prescribe medications for different reasons. Some may have an adverse interaction with another. The doctors may not know what the other has prescribed.

If you use different pharmacies and doctors, make sure you give them a complete list of all your medications. All of your doctors, and dentist for that matter, should know exactly what you are taking including the dose and time of day and the reason you are taking medications. This includes over the counter medications such as aspirin and decongestants, as well as nutritional supplements such as glucosamine and fish oil. Your pharmacist and doctor will be able to review the list and advise you of any potential for adverse reactions.

By paying attention to your medication regimen, and enlisting the support of your doctors and pharmacists, you will stand the best chance of getting the results the drug manufacturer intended and avoid the horror of serious side effects.

Decisions for Parent with Alzheimers

Siblings dealing with decisions for a parent with Alzheimer’s face special challenges. If handled well, these decisions can bring the family closer together. Handled poorly, these same decisions can drive a wedge between family members and at worst, lead to a family divorce. When parents show symptoms of dementia, family members have to tackle some tough issues. These include financial decision making, managing medications (or even agreeing to see a doctor,) finding a caregiver and perhaps the toughest issue – seeking long term care.   

Here are some common problems that families run into regarding facing decisions on behalf of their parents:

• Some family members may be unwilling to accept their parents’ change in abilities to manage their checkbook, drive safely, prepare balanced meals and look after their own health. Others may overestimate their parent’s ability to continue to live independently.
• Not all family members are equally involved in their parents’ lives. Some members may live far away whereas others are actively involved and have frequent contact. Sometimes proximity isn’t a factor – certain siblings are frequently too busy with their own children, work, etc. Those who have remained close may feel they should have more weight in the decision. The post at http://www.psychologytoday.com/blog/singletons/201108/planning-your-parents-or-your-old-ageshows that the responsibility often is shouldered by daughters living in close proximity to their parents.
• Family members can also differ in the level of financial contribution they might have to make for their parents’ care. Those family members who contribute more may feel that they should have more say in the decision.

 A family who forms a Family Council is likely to face tough issues which serve their parents’ best interests and promote harmony among family members. Here are some of our recommendations to make the process go smoother. 

• Don’t wait to the last minute. Be proactive in starting a Family Council. Start the process before you need to make a decision. Avoid having to make a decision under pressure and in a rush. A parent with advancing symptoms of Alzheimer’s may not be fit to appoint a Power of Attorney and may have to be conserved. Conservation is expensive, as well as tedious. You can learn about the issues at http://www.calelderlaw.com/blog/2010/08/10/conservatorship-basics/
• Approach the situation with some formality. Identify who will be involved and when you will meet. It is best to meet on an ongoing basis to talk so that all members can actively participate.
• Share information openly. Make sure that all members have the same information.
• Meet regularly. It often takes several meetings to resolve care-related issues.
• Document your conversations so that you have a record of your discussions.
• Have your parents participate. You want the conversation to be as open as possible. Your parents should have a voice and be able to make their wishes known.  

Most importantly, decide how you will decide. Start by recognizing that everyone has different opinions and there will be disagreement. Decide how you will deal with disagreement by choosing a decision making method. Should majority rule or must everyone agree? Can family members who are more involved or have greater financial responsibility have a bigger weight in their decision? Perhaps the answer is to appoint one family member as the final authority.  

Making decisions for a parent with Alzheimer’s can be focused toward the best interest of the parent, and produce the best outcome, when using the Family Council approach.

Mary Burger writes dementiadvice. She is the owner of A Brand New Day a full-spectrum long term memory care facility in Redding CA.