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

Home Care is a very flexible and cost-effective way to provide a safety net in your parents’ home

Great Expectations

Home Care is a very flexible and cost-effective way to provide a safety net in your parents’ home requiring a minimal adjustment for them in the rhythm of their daily lives.

Even though home care creates a minimal change in lifestyle for your parents, it is has a strong undercurrent of emotion and expectations for the entire family. Home care is a life transition. Having a virtual stranger coming into your home to help manage the most basic aspect of living can trigger feelings of loss and deep emotional responses.

For the senior in need of care, loss of autonomy, independence and privacy are very real. This may be piled on top of other recent losses in health and relationships. No one, in my experience, has EVER welcomed the need for home care as it is usually follows some sort of loss or series of losses.

For the family, namely, the adult children, guilt, fear and inadequacy are feelings that are very relevant and real as well. Many, if not most, adult children wish that they had the time or lived close enough to provide the care they feel their parents deserve. Fear enters in with the control and direction they lose when hiring someone to provide the care. Feelings of inadequacy can surface, especially if they had attempted to provide the care themselves and it became overwhelming.

Rest assured that these emotions are all very natural and if your are feeling any of these things it is best to acknowledge the emotions as they come to the surface. Often, it is the act of hiring outside help that brings these feelings to the forefront. If these feelings are left unaddressed they can have detrimental effects on the success of home care assistance.

Often when people are not aware of or do not want to acknowledge these intense emotions, there is a tendency to place great expectations on the caregiver placed in the home to help. No matter how hard the caregiver works, they will never be a replacement for the adult child. The caregiver is an individual with their own history and personality. They will not immediately understand every nuance and preference of your parent.

Clearly defining tasks and reviewing skill is vital to beginning this professional relationship, which most reputable home care agencies will do with an in-home assessment and a plan of care. Once the expectations are established, they should remain constant as the caregiver establishes a rapport with the family. This takes time and can be a source of anxiety for both the adult children and the parents.

The focus of the caregiver should always be on the safety and well-being of the client. Housekeeping duties can be included, but shouldn’t be at the expense of quality care.  Obvious adjustments should be made if they are not appropriate or working out as anticipated. Clearly, if a caregiver is just NOT the right personality, that should be addressed as soon as possible, but not before careful consideration. If the caregiver is competent and professional, it may help to wait a little while rather than rush into a change. Learning the temperament and rhythms of a new client takes some time. After a while, the caregiver will develop a regular routine based on these daily rhythms and will increasingly be able to anticipate situations and changes and how best to deal with them.  

In short, no one can care for your parents like you can. However, if your situation requires outside assistance, do your best to understand the limits of the professional home care relationship and guard against placing unrealistic expectations. If the home care professional provided is caring and competent, provide space and flexibility for the relationship to develop. In the end this will help both the adult child and the parent ease into this life transition with minimal discomfort.

 

“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

A Few Simple Steps to Avoid Senior Financial Abuse

The time has come. You are in need of home care services. Chances are good that this need has been preceded by some sort of crisis; a hospitalization, death of a spouse

or a sudden decline in health. Likely, there are so many things to think about
and arrange. There may be a variety of service groups coming in and out of your
home to assist you in this transition; home health care, home care, hospice,
durable medical equipment, housekeeping services and an increase in friend and
family visits. The last thing on your mind may be the location and security of
your valuables and financial instruments.  This is why it is essential to locate and
secure these items PRIOR to the need for these services.

Most senior home care service companies do their best to assure that the personnel that they are sending into your home are honest by conducting background and reference checks. Here is the problem, background checks are great for weeding out the prior offenders, however, no background check can detect if someone has never been caught or predict if they are going to steal in the future. Simply put, there is no way
to guarantee that you will not be a victim of theft or financial abuse.

There are things that you can do, BEFORE a crisis (right now) to prepare yourself:

  1. Locate all valuable items, i.e., jewelry, checks, credit cards, etc.  Inventory what you have and identify if you are currently missing something. This will prevent confusion after the fact if you go look for something and it isn’t where you thought it was.  Why? We once had a client who insisted that she had left some diamond earrings in her bathroom. She accused her caregiver of stealing them. Of course, we immediately removed the caregiver and reported the worker to Adult Protective Services.  Two months later, we received a call from her daughter, apologizing that her mother had found her earrings in a different spot and hadn’t recalled moving them there.
  2. Once you do need someone caring for you at home, secure all financial instruments and jewelry in a lock box in your home. Put the key where only you would know where it is and give a copy of the key to a trusted individual or in a safety deposit box.
  3. Never give your PIN to anyone in your employ.
  4. Never allow anyone to go to the bank for you to take out cash, via check, etc.
  5. Report all suspicions or missing items as soon as possible to any company coming in and out of your home. If you are working with a home care agency make sure they are responsive to your concerns and act quickly to resolve the issue.
  6. Do not give cash or check bonuses directly to home care workers, make sure that the agency they work for is notified and has an opportunity to copy the bonus check and document the gift to avoid any future misunderstandings or opportunities for financial exploitation.
  7. If a caregiver asks you for money directly for ANYTHING, immediately report it to their agency. As benign as this may seem, it is considered ‘abuse of
    position    ’ and is covered under the law as follows:

Financial Exploitations –Financial exploitation means a situation in which a caretaker or any other person who is in the care or custody of, or who stands in a position of trust
to, a resident, takes, secretes, or appropriates their money or property, to
any use or purposes not in the due and lawful execution of his or her trust. In
the simplest terms, the person who is acting as a caretaker unlawfully takes
money or property of the resident. This also includes a request for transfer of
property by the resident that was not carried out.

Most caregivers are good people interested in your well-being. They are also
hyper-aware that they are most likely to be blamed if something goes missing in
your home. If you follow the above guidelines, it should protect both you AND the
people working for you.

If you find that you are a victim of financial abuse or theft, PLEASE follow through with filing a complaint with Adult Protective Services and any charges against the person suspected of committing the crime. It is up to you or your family to see that charges are filed. This may be very uncomfortable and stressful but it is VITAL. Without convictions and a subsequent record to detect on a future background check, there is nothing to
prevent that same person from moving on to another agency or to hire themselves
out privately and continue their predatory ways.

Submitted by Gabriela F. Brown, CSA, Owner of Constant Companions Home Care, San Diego and S. Riverside. Website http://www.constantcompanions.net email: gbrown@constantcompanions.net

Posted in Elder Matters | Tagged elder abuse, financial abuse, home care agency, home care workers, san diego home care, senior abuse | Leave a reply

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

Dementia Care - Constant Companions 360 approach

Dementia Care

Dementia is a broad term that describes the process of a decline in cognitive abilities that interferes with activities of daily living. The most recognized and prevalent form of dementia is Alzheimer’s
Disease which accounts for 50-70 percent of all dementias. There are, however, other causes of dementia:

  • Depression
  • Vascular disorders, such as multiple strokes in the brain
  • Infections that affect the central nervous system, such as HIV dementia complex and Creutzfeldt-Jakob disease
  • Chronic drug/alcohol use
  • Hydrocephalus – Accumulation of fluid in the brain that can result from developmental abnormalities, infections, injury, or brain tumors
  • Degenerative neurological diseases, such as Alzheimer’s, dementia with Lewy bodies, Parkinson’s, and Huntington’s

See More information on Dementia

Our 360 approach:

By the time our office receives a call to provide dementia care to a senior the family has usually been very involved for an extended period of time, providing most of the daily care. The call comes because the family is in need of support and guidance. Our 360 approach is just that, an all-encompassing circle of support for the entire family. During our extensive intake process, we identify where the home care worker can provide support for family members as well as the senior themselves.

We don’t aim to replace the family, we are there to support and only take over the duties that prevent family members from enjoying their time together, due to caregiver fatigue. If you are in need of a helping hand, call us. At Constant Companions,

“It is our mission to enrich the lives of each of our clients by providing the best in compassionate care, second only to family.”

Hearing Loss – Bringing Seniors Back into the Conversation


 

Nearly one-third of people over the age of 65 are hard-of-hearing while nearly 50% of people over the age of 85 suffer from some form of hearing loss. Because hearing loss is usually a gradual process that begins in one's forties, it is commonly not recognized until it is significant. It is important to be able to recognize signs of hearing loss, have it diagnosed and treated.

Symptoms of hearing loss:

• Have trouble hearing over the telephone

• Find it hard to follow conversations when two or more people are talking,

• Need to turn up the TV volume so loud that others complain,

• Have a problem hearing because of background noise,

• Sense that others seem to mumble, or

• Can't understand when women and children speak to you.

Hearing loss in seniors can lead to others mistakenly thinking that seniors are confused, difficult or apathetic. Additionally, the senior may be embarrassed by the loss and resist seeking out medical help. The inability to fully communicate can lead to frustration and isolation. The key here is communication and enlisting the following strategies to bring these seniors back into the conversation:

• Make sure that you are looking at the listener and you are in a well-lit area.

• Don't shout, this can often create increased sound distortion.

• If there are 2 or more people present, make sure that only one person is speaking at a time.

• Address them directly by saying their name before starting a conversation so they have time to focus.

• Many people with hearing loss rely on lip-reading. Keep your hands away from your mouth and avoid smoking, chewing gum or eating while talking.

• Slow down a little but not too much. A natural and unhurried rate of speech allows the hearing impaired person to capture more words, read lips and facial expressions.

• If one ear is better than the other, make sure you are directing your speech to the better ear.

• Hearing loss can include certain sound distortions. They may hear your voice but not be able to decipher certain words or pitches.


• Minimize extra noise in the environment when have a discussion, like turning the TV or dishwasher off.

• If possible, avoid having discussions in settings that may have sudden loud sounds like busy streets, near construction areas or near airports.

• Depending on the level and type of hearing loss, certain words are almost impossible to understand, try rephrasing the sentence or find a different word. Don't repeat the word or sentence over and over again.

• Avoid sudden changes of topic. When the subject is changed clearly state the new topic and look for acknowledgement before proceeding.

• Write specific information, such as appointments, directions and schedules down, if you are talking over the phone, have them repeat the information back as many words and numbers sound similar.

• Understand that illness or tiredness may affect any person's ability to follow a conversation.

• If the listener looks confused, clarify that they understood what you were saying.

The best course of action to take if you suspect hearing loss is to see a doctor as soon as possible to determine the cause and treatments available. If you suspect hearing loss in a senior that you are caring for or that you care about, remember to be compassionate about discussing the possibility of hearing loss. It is important to be supportive regarding the options and opportunity for treatment. Motivation for the decision to seek treatment should be to increase their quality of life by providing the ability to participate in all social interactions to the best of their ability.