Be a Balanced Caregiver

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By Jody Gastfriend, LICSW

Caring for a parent, grandparent, spouse or loved one has its challenges and rewards. It can be gratifying as well as frustrating, with no clear roadmap on how to proceed. More than 65 million people in the United States care for a parent or disabled adult, and of those caregivers, more than a third still have minor children living at home. Middle-aged adults may find themselves sandwiched between limit testing teenagers, pushing for more independence, and aging parents, who want to hold onto the independence they still have. Is there a way for caregivers, whether you are a daughter, son, spouse or partner, to juggle it all without feeling depleted and guilt-ridden? The answer is yes, but it takes time, patience, forethought and compassion – for yourself as well as everyone else.

Sometimes, the best thing a caregiver can do is to take a step back, breathe deeply and evaluate their routine. Consider how caregiving rituals can be handled more effectively, without abandoning career, family and other aspects of life. Here are few things to consider:

1. Have conversations early and often. Unless your loved ones are completely incapacitated, you must include them in discussions about their care and accommodations. Approach decision-making from a place of love and respect. Many caregivers get frustrated by their parent or grandparent’s resistance to help. But that resistance may be a need to exert some control, especially at a time when things feel out of control. If you can help them understand why you feel they need a home health aide, a certain medical specialist, a safety-related home renovation or even a new domicile, you o_ en get better participation in making the change. Rarely are plans made in just one conversation. It may be a series of conversations, lasting months or even years. Be patient and recognize that your loved one has the right to make decisions, even if you think they are bad ones.

2. Talk about money. Nobody likes to talk about money, but it simply must be done. When it comes to eldercare, finances determine options. Do your parents or grandparents have long-term care insurance? Do they have savings to liquidate or assets they’re willing to sell? (The family home may be non-negotiable, but what about the car your senior relatives no longer drive?) What kind of care and services can they afford? Keep in mind that home care costs around $20/hour and Medicare doesn’t pay for long-term care in a nursing home—which averages over $80,000 a year. If you’ve been operating on the assumption that long-term decisions can be made “when the time comes,” you may be in for a harsh dose of reality. There’s no point in spinning your wheels, going over choices that just aren’t viable for your family.

3. Don’t try to do it all. In many cases, a nearby family member, perhaps you, will take on caretaking duties, thinking you can or should be able to handle it all. Plus, Mom really trusts and relies on you and wouldn’t feel comfortable with a stranger in the home. Things may go along _ne for a while, but as the picture turns more complicated, you may quickly become overwhelmed and ineffective. Go ahead and step up if you’re the one who lives closest or has the most time or financial wherewithal to deal with an initial crisis. But then, assess the situation and quickly marshal your resources. Call a family meeting—via Skype, if need be—and find out what other family members are willing and able to do. A brother or sister who lives across the country may not be able to make daily visits, but perhaps he or she could pay for or a cleaning service to help with laundry and housekeeping. And what about those teenagers striving for more independence? If they have a driver’s license, they can be tasked with making a daily wellness check, running errands or tending to Grandma’s pets.

4. Manage medications and therapies. Develop a simple system to track medication, prescribed exercises, nutritional supplements and other health related needs. There are websites that allow for information-sharing among family caregivers, which can be great. But a simple calendar or spreadsheet along with pre-filled pill boxes can also work. Make sure the system is user-friendly for all who will rely on it. Leave a spot for notes to indicate when medications must be refilled or supplies replenished. Keep in mind that most paid caregivers, unless they are nurses, are not allowed to administer medication—in other words, hand out pills. But caregivers can remind people to take their medication and this is often all that is needed.

5. Explore community resources. Finding a handicap-accessible transportation service to take your mom to the hairdresser or to visit friends can go a long way toward maintaining her mental and emotional well-being. If Mom can’t leave the house, look into religious organizations, senior centers and local agencies on aging that other home supports or social calls. If your senior feels isolated and needs more company, sometimes variety can spice up life. Many colleges and schools of social work have volunteer programs for students interested in aging studies.

6. Reassess your routine every two weeks. Or more often if conditions are changing rapidly. See what’s working and what isn’t. Talk to your parents and grandparents, spouse or partner—find out if they’re happy with the care they’re getting, or if they’d prefer more, less or different. Consider whether your loved one is still safe living at home and whether you feel their mental or physical condition warrants a change. And don’t be discouraged by setbacks, along with an occasional crisis or two. If you keep yourself grounded, tend to your own needs, and are open to support, you will be able to withstand the ups and downs of caregiving. And hopefully enjoy the journey as well.

Jody Gastfriend, LICSW, is the VP of Senior Care for Care.com.

Published: July 2014

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