Care For the Caregiver

Nearly half (53%) of all informal caregivers reporting a decline of health
affecting their ability to provide care.  In an effort to be there for the health
of a loved one, many caregivers sacrifice their own health

Caring for an aging loved one can be a challenging experience. It can be difficult to
slowly watch a family member lose their independence and often, their mental
capacities. More often than not it is a middle aged family member who takes on
the responsibility of being the primary caregiver for their parents. Without
additional support, this caregiver can quickly find themselves overwhelmed and
depressed. While many caregivers find themselves up for the challenge, others
may find it more difficult to adjust to the constant demand of being a home
care provider.

Stress and depression can come in many forms. Often, caregivers have to take a leave of absence from work, or they have to cut back their hours to be at home more often. As a result, both parties have to sacrifice and do without. The
loss of monthly capital can lead to stress as it becomes harder to pay the
monthly bills. Additionally, the loss of personal interactions with colleagues
in the workplace can leave a caregiver feeling lonely and isolated. Managing
one’s family can also be difficult and being a caregiver can also lead to
stress in the marriage and immediate family. To avoid sacrificing one’s health
and family for the care of a family member, a caregiver must provide care for
themselves first so they may be able to care for another

There are various ways for a caregiver to stay positive during the time they spend caring for someone. Rather than feeling trapped, a caregiver should do their best to encourage social interactions for both themselves and their aging parents or patients. Dinner socials, poker/bridge nights, and birthday parties should all be encouraged to maintain a festive attitude throughout the home, and to avoid it from feeling like a prison. Maintaining a clean home can help keep good spirits and inviting visitors will
give you a good reason to clean and to stay positive. The caregiver should also make an effort to invite their family to these events to help maintain closeness and to promote family interaction during this time of change.

While maintaining social interactions can help a caregiver stay healthy, many others find success by turning inwards and focusing the time on improving themselves. Some may choose to take up a hobby or learn a new skill, while
others may choose to begin an exercise regimen to improve their own health.
This can be light to moderate exercise; just enough to get your blood pumping.
Feel free to invite your aging family member to also get moving as much is
safely possible. Regardless of age, most seniors can benefit from staying
active.

Submitted by Gabriela F. Brown, CSA

Owner, Constant Companions Home Care
Website: http://www.constantcompanions.net
gbrown@constantcompanions.netPhone and Fax: 888.883.8393

Constant Companions on Why Can’t Mom Just ‘Snap Out of It’?

Last year, I received a call from Sharon, the adult daughter of a potential client, Bette. Her father, Burt, had passed away a little over a year ago from an extended battle with cancer and Bette had been his primary caregiver.  Until his passing, Bette was mobile, energetic and rarely sick. Once Burt passed away, Bette became a ‘different person’ rarely leaving the house. Her sunny, upbeat disposition had turned into an apathetic approach to everything and everyone in her life.
 Sharon shared that she admired her mother more than anyone she had ever met for being able to ‘handle anything’. She had always met life’s challenges with strength and optimism, being able to formulate a plan to overcome any obstacle put in her way. Now, she was little more than a shadow of her former self and unable to properly maintain the house, herself or any of her relationships. Sharon was concerned because she was unable to ‘snap out of it’ and Bette was beginning to decline physically.  
Because Sharon’s life was so hectic, she felt terrible that she could only get over to her mother’s house a couple of times a week, and when she got there she was overwhelmed with what needed to be done, grocery shopping, cleaning out the fridge, making sure there was easily accessible meals to be prepared and questioning whether she was taking her medications as prescribed, etc. The house itself was also being neglected severely, with the bare minimum being done to keep things going. 
While both Sharon and Bette would benefit from a home care worker, there were deeper issues that needed to be addressed. Bette had been the primary caregiver to her husband of 60+ years as he lost the battle with cancer. She had focused all of her energy and purpose into his care for several years. When he passed away, Bette faced a dual life transition. She had lost her life status as a caregiver and she was no longer Burt’s wife of 60+ years. With his death she was faced with excruciating loneliness and loss of purpose.  Her family had been there for her right after his death to help but had assumed that she was adjusting well and would be able to handle things. A year later, it was clear that what may have started out as a normal bereavement and grief period had extended beyond a healthy timeframe. At this time, she felt dependent on her family for care and this new dependence pushed her even deeper.
It is not uncommon for the ‘strong and capable’ family member in this situation to experience depression due to their history of being ‘strong and capable’. Often, those around them and they themselves have the expectation that after a ‘normal’ period of time, they will ‘pull themselves up by their boot straps’, as they always have. Paradoxically, this is the person that is least likely to ask for help may be suffering silently. It is as if they are unable to see themselves as needing any help or being unable to ask for it. Additionally, physicians tend to overlook signs of depression with seniors and many assume that depression is a normal part of loss. Old assumptions and patterns are tough to overcome.
After speaking with Sharon, I advised her to make an appointment immediately with Bette’s physician regarding her decline. She also had to have a gentle talk with her mother about the possibility of being able to see a brighter world through possible interventions of medication and counseling.
We did provide a caregiver for Bette for about 4 months. In the meantime, Bette’s doctor found the right medications and she participated in support groups. After a while, Bette turned the corner and was increasingly able to care for herself and her home again. She now does her own grocery shopping enjoys making her meal and even invites others, primarily from her support group, over for meals. Now, when her family visits, they are able to enjoy her company and provide the companionship that only family can provide. They no longer are in the role of caregiver, which is only helping to restore Bette back to her old self.
Every bereavement experience is unique, but if you have a loved one that is not improving after about two months, a visit to their physician may be in order in addition to grief counseling. Counseling and/or medications can make the fog of depression lift, allowing them to slowly begin to feel pleasure and purpose again, the two reasons we ALL need to lead a satisfying life.

 

“Elderspeak” Can Negatively Affect Health of Older People

(NaturalNews) It is quite common that many of us speak to older folks in a different manner and with a different tone. "Elderspeak" bears many traits which are similar to "baby talk", and these include simplified grammar and vocabulary, as well as overly intimate terms of endearment. And recent research has shown that such a communication style may not only be exasperating and insulting to many of the elderly, it can even negatively affect their health.

About Elderspeak

What is elderspeak? Broadly speaking, it is a style which is assumed to accommodate the perceived communication needs of elderly people. It involves speaking slowly, restrictions on vocabulary, simplified syntax, as well as exaggerated prosody.

The fundamental assumption behind elderspeak is that the elderly are cognitively impaired, and thus need some "help". It can be said to be patronizing and disrespectful to the older adult.

Researchers have also defined elderspeak as overly caring, controlling and infantilizing communication.

Findings from Studies

In a study led by Becca Levy, a professor at the Yale School of Public Health, it was found that elderly folks who were exposed to negative stereotypes commonly associated with ageing, enforced by condescending phrases and attitudes, performed significantly worse when tested for memory and balance.

In one particular town in Ohio, her study team found that those who were above 50 and held positive perceptions about ageing went on to live 7.5 years longer than their peers who did not. This was after other health-affecting factors were already accounted for.

Those attitudes were affected even by apparently harmless words and phrases and, profoundly, they supposedly had a greater impact than important factors such as smoking and exercise.

Elsewhere, Kristine Williams, R.N., Ph.D., an associate professor at Kansas University, studied the effect of elderspeak on Alzheimer's patients with dementia. The interaction between staff and 20 residents of a nursing home, aged between 69 and 97 years and having moderate levels of dementia, were videotaped.

The study found that the patients were more likely to resist care after they were spoken to using elderspeak, instead of the usual adult-to-adult form of communication. When resisting care, they would carry out actions such as saying no or crying out, turning away, grabbing onto someone or something, pulling their limbs tightly toward the body, or hitting and kicking.

"There's the suggestion that these people are unable to communicate that their needs aren't being met. And because they can't communicate verbally, they may respond in these other nonverbal ways," Dr Williams said. And, according to her, the need in question could just be the wish to be treated as an adult who is worthy of respect.

And, perhaps somewhat ironically, the biggest culprits of elderspeak are often healthcare workers, including doctors and nursing staff.

The Problem with Elderspeak

The problem with elderspeak, is that it hurts the self-esteem of those to whom it is used on. Worse, it can literally grind them down and send them on a self-fueling downward spiral toward ill health and even premature death. That, after all, is what we get when we communicate to people that they are weak, a liability, incompetent or even useless – they often prove us right!

"Elderspeak is indicative of general negative stereotypes of the elderly. It is another example of how people are treated differently based on their age in healthcare, in the workforce and in everyday life. And we have found a clear connection between how the elderly are treated and their health and functioning," said Dr Levy.

The Bottomline

"Daily we are witness to, or even unwitting participants in, cruel imagery, jokes, languages and attitudes directed at older people," said Dr Robert Butler, president of the International Longevity Centre-USA, who first coined the term "ageism" some 40 years ago.

With populations ageing in the US and in many developed nations, the need to avoid elderspeak becomes all the more significant. In the US, the 85-and-above age group is the fastest-growing one.

Ms Elaine Smith, a 78 year old retired Chicago schoolteacher, who was subject to elderspeak when she was hospitalized for two months after suffering a fall, said that people can become quite indignant when she tells them she is offended by such a communication style. And she has an interesting viewpoint regarding elderspeak.

"But I believe that the people who heap these endearments upon us are reacting to their own fears of ageing in a youth-oriented culture," she said. Her advice? Get over it.

So, the next time we want to use terms such as "dear", "good girl" and "sweetie" on the elderly, or speak very slowly and in overly simplified language to them, we better think again.

Main Source

Talking down to the elderly is bad for their health, medical study finds (http://www.telegraph.co.uk/health/article3256340.ece)

About the author

Reuben Chow has a keen interest in natural health and healing as well as personal growth. His website, All 4 Natural Health, offers a basic guide on natural health information. It details simple, effective and natural ways, such as the use of nutrition, various herbs, herb remedies, supplements and other natural remedies, to deal with various health conditions as well as to attain good health. His other websites also cover topics such as depression help, omega 3 fatty acids, as well as cancer research and information.

 
Located and submitted by Gabriela F. Brown, CSA, Constant Companions Home Care http://www.constantcompanions.net

Hiring a Caregiver – Private vs. Agency

Posted on October 7, 2011 by 

During these tough economic times it is more tempting than ever to hire caregivers privately, bypassing any placement service or home care agency. However, after reviewing the following information, we hope that you will see the benefit in contracting with a home care agency when looking to bring help into your home.

There are TRUE benefits of working with an agency. Agencies can save you and your family long-term consequences, both financial and legal.

When you hire a caregiver, the going rate is approximately $15 per hour. When you hire an agency such as ours the going rate is $20+. For this additional $5 per hour you receive the following benefits and protections.

  • The workers are covered by Worker’s Compensation, paid by the agency
  • The workers are covered by Unemployment Insurance, paid by the agency.
  • Employment taxes are split and submitted each payroll, half by the caregiver and half by the agency.
  • The worker’s taxes are pulled and sent immediately to the IRS and CA Employment Development Department (EDD). These taxes cover State, Federal, Liability, Employment Tax and California State Training Tax.

These taxes and insurances must be paid by ANY and ALL employers. The state of California is currently in desperate need of revenue and is targeting individuals that consider themselves, “self-employed” or “contractors”.

If a worker is cross-referenced with an individual employer, the employer can always be held liable for back taxes. The reason for this is that the state claims that many of these individuals do not pay or file their taxes, so they are placing the burden on the employers to collect it and submit it.

In regards to Worker’s Compensation, consider this; your private caregiver is injured on the job. If the Labor Board determines that they are your direct hire, and they WILL, you will be responsible for the cost of their injuries and will be fined $1,000 per caregiver for not carrying Worker’s Compensation on that employee. Additionally, in order to continue to hire that employee, you will be required to take out a Worker’s Compensation policy for them to the tune of 7-9% or higher (through State Fund) of their gross pay, each pay period. You will be audited and you will have to show documentation that you are in compliance. Additionally, your homeowner’s insurance may require an additional premium for having a domestic worker employed.

Next scenario; the caregiver you hire just isn’t working out for you. You manage to dismiss their services (not always an easy thing to do). 2-3 weeks later, you receive a notice from the EDD, an unemployment claim. If your caregiver chooses this route, to recover unemployment payments, they WILL win. The EDD will consider that in any direct hire arrangements that you are the employer and they are the employee, regardless of any contracts, business licenses, etc.

Aside from the legal/tax benefits discussed above, agencies are simply a better choice for the following reasons.

  • You can switch out a caregiver that isn’t working out for you.
  • The agency carries liability insurance, both professional and general for all workers.
  • The agency can supervise and direct the worker.
  • Of course, all of our caregivers are screened. I would hope all agencies do the same.

This is the down-side of private hire. This is not to say that there are not some wonderful set-ups that work out well for all. However, one must consider the possibility that if a person is left without income for any reason, they have a wide variety of available options from which to recover what they may feel they are entitled to. It isalways important to remember that it is in the best interest of state-run agencies to find in the worker’s favor. Not only will they assure revenue/justification for their agency, but this caregiver will now be in the “system” and they are better able to pursue them and you if the caregiver has not filed/paid taxes.

There will always be those who will continue to hire privately. However, I believe it is because many are not aware of the serious implications of doing so. I hope this article helps those individuals to at least make an informed decision when hiring outside help for the home.

For further information regarding Employment of Domestic workers, please refer to California Civil Code Section 1812.501 and Unemployment Insurance Code Section 687.2.

Submitted by Gabriela F. Brown, Constant Companions Home Care.
Email: gbrown@constantcompanions.net
Phone: 888.883.8393
http://www.constantcompanions.net

This entry was posted in Elder Matters by gabriela. Bookmark the permalink.

Putting It All On The Table - Senior Nutrition

By 2030, Americans over the age of 65 will reach 71 million, approximately 20% of our population. Further, almost 90% of Americans over the age of 65 have one or more degenerative disorders. These conditions were once thought to be a natural consequence of aging but there is now evidence that many conditions like heart disease, cancer, osteoporosis, arthritis, diabetes can be either prevented or lessened by ongoing good nutrition and exercise.

There are increasing obstacles to proper nutrition as we age: Chronic illness, recent hospitalizations, depression, mal absorption, medications, dental problems, diminished taste and smell, restricted diets, limited income, loneliness and isolation. However, it is important to realize that without the proper mix of fuel and nutrients, symptoms of malnutrition can appear and increase the symptoms and debilitation of any of the above listed conditions. In essence it is a vicious cycle that can only be broken by a commitment to learn and apply better eating habits.

Malnutrition can be seen as increased forgetfulness, dehydration, frailty, delayed wound healing and decreased muscle mass that can lead to falls and fractures. Indirectly, malnutrition could be a significant factor in many hospital stays and lengthy rehabilitations. Additionally, it can make worse any chronic conditions.

Some seniors may be at a healthy or even heavy weight, but still experience malnutrition. Because metabolism can decline by as much as 30% in people over 50, it is important to eat fewer calories. With fewer calories, we run the risk of fewer nutrients, so the foods must be packed with nutrients. A good start is to limit overly processed high-carb, high-fat, nutrient deficient foods and increasing nutrient rich foods like vegetables, fruits, whole grains breads and pastas and to add supplement drinks if necessary. A multivitamin will also go a long way to maintain your stores if your nutrient intake varies day to day.

To help a senior that you suspect of being malnourished, approach the situation delicately. As mentioned above there may be many reasons to not eat properly and you don’t want that person to become defensive and clam up. Eat with them, observe. Is there plenty of protein, fiber and healthy fats in each meal? Are vegetables and fruit included in each meal? Are most meals cooked at home, from scratch and healthy sources? If so, then they are on their way to good nutrition. Next, find out if they are supplementing their diet with a multivitamin or nutrition shake. This can be done by placing the items in the home and periodically checking to see if they have been used. See how much they eat at every meal. A good measure for amount is the size of their fist. If it less than that, try to determine if they are eating more frequently. Many seniors cannot eat 3 large meals and choose to eat more often with smaller portions. As long as the smaller portions and snacks equal 5 a day, throughout the day, all is well.

If a senior is malnourished there are several things that you can do with and for them to encourage healthier/sufficient eating:
Enrich! Add healthy proteins and health fats, like cheese, nuts and nutbutters. Cheese can be mixed in to a wide variety of otherwise bland and calorie deficient foods. Nutbutters are great on crackers and a slice of bread, add a little fruit spread if the diet permits, to moisten and make it easier to swallow. Nuts are great for snacks. Over the day these calories can add up and they are providing rich and healthy oils for the body.

Spice it up! Add some herbs, lemon, seasonings, as tolerated and enjoyed to make the food more flavorful and enjoyable. Make sure you check sodium levels. An adult should take in no more than 1500mg per day. 

Socialize! Get them out or invite yourself over. Eating is a social behavior. We all eat much more when we are in the company of others. This has the dual benefit of providing an anticipated event and the eventual company, which can help to alleviate mild depression.

Get Moving! Exercise gets everything in the body working more efficiently. Encourage walking, biking, chair exercises, swimming, WHATEVER that is possible to do safely and comfortably. The idea is to move the body every day. Metabolism will increase, mood will lighten, appetite will increase. Again, if you are at a loss for options, contact your health care provider for resources.

Supplement! Take a daily vitamin to cover any gaps in nutrition. 

Hydrate! As we age we lose the ability to sense thirst. Aim to get 8 glasses of water per day. Other sources of water such soups, water-rich foods like melons and decaffeinated teas and coffees may be a more palatable way of getting enough fluids every day.

Call the Doctor! If you suspect depression or lack of appetite due to medications or ANY other underlying issues, call the doctor. Many times they will be able to do an overview of health and medications to discover or eliminate possible reasons for a lack of appetite.

This article is meant as general advice. It is not medical advice. I encourage anyone who suspects that they or someone they love is malnourished to see their health care practitioner as soon as possible in order to establish an individualized plan that will put you back on track to better health.

 

By: Gabriela F. Brown, CSA

Article Directory: http://www.articledashboard.com

 

Submitted by Gabriela F. Brown, CSA and Owner of Constant Companions Home Care,www.constantcompanions.net in San Diego and S. Riverside, CA. Contact Info: gbrown@constantcompanions.net

My Passion for Seniors – Why the heck I do what I do!

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Most of the seniors that I come into contact with on a daily basis have such rich pasts and continue to be a huge source of inspiration, at least to me. There is great misunderstanding out there about what it is like to ‘get old’, after all ‘getting old’ is very subjective. At the age of 42, my children think I am REALLY old, but my clients think I am still quite young. Both are correct, it is a matter of perspective, isn’t it?

Let’s start with a question recently asked by a friend, “What made you decide to devote your life to seniors and their families”?  The first thing that came to mind was my earliest work experiences and how they have culminated into what is a life devoted to seniors.

At 17 years of age I was (and still am) an eternally optimistic and cheery person who loved spending time with all older people. My first job out of high school was working as a nursing aid at a convalescent center in San Diego County. I would show up for a 7a shift eager to see all of the residents. That shift was over at 3p, but almost daily someone wouldn’t come in for the 3p shift and it would be offered to me. This was great because it paid time and a half, and I was able to spend more time with the residents.  A few times the third shift, at double time, was offered and I would stay. Twenty-four hours later, I would head home feeling exhausted but satisfied that I could make a living spending time with such fascinating people.

The caregiving continued in college, working for a home care agency many weekends over the school year and during the summer months. I loved it and was good at it! After graduation and looking for a job,  I recalled something often said to me,” If you do what you love for a living then it isn’t work at all”. And so began a professional career working with seniors and their families. See Bio.

Fast forward 25 years!  I am the owner of Constant Companions Home Care in San Diego and S. Riverside, still assisting seniors to maximize their quality of life, no matter what their situation.

My passion for working with seniors continues. Why? Because, the seniors that I have met are truly amazing people! Their lives inspire me daily, and I hope to do the same for our readers through this series.

Let’s explore the histories, trials, tribulations, triumphs and current endeavors of seniors all over the world. If you know someone, including yourself, who has a wonderful story, past or present, email me at gbrown@constantcompanions.net . Together let’s celebrate our seniors, one story at a time.

Meet the Founder of Constant Companions Home Care, San Diego

Founder

Gabriela F. Brown, the CEO and Founder of Constant Companions Home Care, has over 20 years of experience working with the elderly and their families, beginning in 1987 working as a nursing aid at Escondido Convalescent Center after graduation from Mt. Carmel H.S. in San Diego, CA.

From 1988-1992 she worked as a home care companion while attending Mary Baldwin College in Staunton, VA.

After graduation from college in 1992 she took an administrative position at a The University of Texas Medical Branch Home Health in Galveston, Texas.

In 1997 she accepted a position in Washington State with Evergreen Hospital in the department of Home Health and Hospice care.

For a brief time in 1998 she worked with a Skilled Nursing Facility, this emphasized for her that her passion was for the delivery of care in the home.

In 1998 a private Medicare home health company recruited her in North Seattle area, where she continued to develop her skill and knowledge base.

In 2001 a national non-medical home care agency asked her to head up the development of their fledgling San Diego branch. After a year and half, she was convinced that she could integrate the systems she learned in Medicare Home Health with the more intensive personal care aspects of non-medical home care.

In 2003, Constant Companions was founded, integrating the years of experience and knowlege she gained working at many levels in the continuum of care.

This experience has formed a comprehensive understanding of the emotional, psychological and clinical aspects that are involved in making a decision to use home care not just for the client but for their entire family.