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Distance Caregiving – Watching for Warning Signs

When you are a long distance caregiver you hope that when your parent says they’re “doing fine” that everything really is just fine. The fact is that seniors usually under report concerns and problems; even serious problems. Why do most aging parents keep the truth under wraps? Thoughts that come to mind are pride, independence, not wanting to feel like a burden. There is also societal pressure to live independently in your home for as long as possible. We’re all familiar with the plea to promise an aging parent that you won’t put them in a nursing home (we may have even asked a spouse for the same promise) or the declaration that the only way they’ll leave their home is “feet first”. If your anxiety level rockets when the phone rings, this is a sure sign that you know things may not be what they seem. There is a tipping point when it’s clear that an elderly parent can no longer live alone or that hired help is needed to fill gaps in self-care. To get a clear picture of where your parent’s risk level is and what changes may be necessary to mitigate those risks, check out the assessments available in the How to Help Aging Parents e-book available on this site (http://howtohelpagingparents.com/). The situations that usually bring everything to the forefront are a crisis hospitalization or a visit home. Hopefully, you can help your parent make changes before a crisis hits and a visit home give you an opportunity to take a good look around at how your parent is functioning. But what exactly are you looking...

Long Distance Caregiving

Caring for aging parents is stressful, but caring long distance adds a new twist. A phone call or even a Skype conversation (if your parent is computer savvy) doesn’t tell the whole story and can keep you up at night with worry. Assurances that everything is okay, and that they are managing and that dad is only a little forgetful are found to be the tip of the iceberg when a visit home reveals that more care is needed. Long distance caregivers cannot be on hand to see changes has they happen and the challenge of gathering information and coordinating care is daunting and frustrating. You are not alone. It is estimated that out of the approximately 34 million caregivers 15% live one or more hours away from the person to whom they provide the care (2004 MetLife/National Alliance for Caregiving report). In many situations a sibling or relative living locally are available to support their aging parent, but this can cause family drama and stress. The people providing the day-to-day support can make the long distance caregiver feel that they are not pulling their weight in caring for mom or dad. Although it is not always easy, it’s best to talk it out and come up with a plan that may make things more equal. One example is contributing money to pay for a caregiver once a week to give local caregivers a break. If money is a concern, researching and coordinating services can save local caregivers time and frustration. For those caregivers who are the primary person providing care, it is even more imperative to hold a...

What is Adult Day Care?

Daytime hours can be the hardest to cope with when you are caring for an elderly parent. Making sure they are safe, getting to the bathroom without falling, that they are eating and that they are not sitting in the same spot all day feeling lonely. Caregivers might think their choices to address this problem are limited to either quitting their job to stay with their parent or placing them in a nursing home or assisted living. The first thing to do is assess the situation. Is your parent safe to stay at home with minimal support? How much supervision do they actually need? If they are able to stay in their home safely but need minimal supervision and engagement consider the option of an adult day care center. Adult day care centers, also known as social day care, provide a comprehensive program of supervision, structured activities, minimal assistance with toileting, and light meals. Adding this option as part of the care plan for your elderly parent can provide you with peace of mind and your parent with social engagement which is vital to the quality of life. There is also a program called Adult Day Health Care program which is Medicare funded program and is appropriate for elders who are more impaired. This level of program is more appropriate for elderly who are need more direction, are incontinent, or wheelchair bound. Nursing, rehabilitative and social services are offered to participants based on an initial assessment. Unlike adult day care centers, these programs are licensed through state agencies. The fee for adult day care centers is private pay. Most...

How to Prevent Readmission to the Hospital

If your elderly parent has been recently discharged from the hospital, they are at a high risk of being readmitted. One in five elderly are readmitted within 30 days of discharge for reasons varying from congestive heart failure, pneumonia, and infection. The elderly are also more likely to experience falls after a hospital stay due to weakness and confusion which often result in readmission. The best prevention against these health conditions is careful monitoring and setting realistic expectations. The elderly take longer to “bounce back” from a hospital stay. The loss of routine, stress of being in a medical setting, change in diet, and fear can take a toll on their overall well-being – physical, mental, spiritual and psychological. The care that is provided during the transition period from hospital to home is important and various models and strategies have been developed and researched. Some strategies include forwarding the discharge summary to your parent’s primary care physician right away to keep them in the loop, scheduling follow-up appointments before the discharge even occurs, inquiring about follow up nursing care through home health services with the hospital discharge planner and arranging for someone (family or home care agency) to be in the home at least for the first 72 hours after discharge (http://news.yale.edu/2013/07/16/six-strategies-reducing-hospital-readmissions-among-elderly). The Affordable Care Act (ACA) has focused on this problem by imposing penalties on hospitals with high readmission rates with the theory that this will prevent the elderly from being discharged prematurely. The ACA also created the Community-based Care Transitions Program in which hospitals partner with community organizations to provide oversight and services to newly discharge patients...

Support for the Caregiver

Becoming a full time caregiver to an elderly parent is taking on a role that can deplete your emotional, physical and mental health. This is especially true when caring for a parent that has dementia as it is very difficult to separate the person from the disease when hurtful things are said or they strike out physically. Old wounds and pain from the parent/child relationship are often revisited as resentment builds over the time and energy depleted by caregiving. Many people go the caregiving journey alone, wondering how they would find the time or energy to join a support group. But one of the most often-repeated pieces of advice heard from caregivers is to make the time to take advantage of the many resources for caregivers that are available. Seek assistance from family, friends, support groups, and community organizations to help you through the difficult times. Build a support system of alternative care options to cut down on stress and provide much needed replenishment of your emotional and mental resources. Research adult day care programs and home care programs in your area to build in hours during the week of free time for you and engagement for your elderly parent. Local churches or high schools may have service clubs specifically for helping the elderly and their caregivers with grocery shopping or other chores. If other family member are not pulling their weight, it may be time to have a family meeting and review the realities of what it takes to care for mom or dad. If time is not available from family members than money to pay for services...