8 Rules for New Caregivers

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8 Rules for New Caregivers.

Caregiving is one of the hardest jobs any of us will ever undertake. Please take time to read this article that I have added to my Blog that originally came from an AARP posting.

Elder Fraud: a few things you can do to protect your loved one.

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A senior citizen receives mail that promises her the opportunity to receive a $10,000 Sweepstakes check but first she has to send the organization a $25 check or she is told to wire money in order to receive the proffered $10K.  This same lonely person receives CONSTANT phone calls in which many demands are placed upon her to send money or they will come to her residence and cause her bodily harm.

It doesn’t matter how many times you tell your loved one to hang up when she receives one of these calls.  It doesn’t matter how many times you try to convince her that responding to the mail and/or the phone calls will not net her any positive financial results.  She always responds, and because she’s still able to mail a check or drive to Western Union and wire money to these nefarious people, she keeps doing so and finds herself in a heap of financial trouble.

Let’s consider the following mail fraud scenario:  at a long-term care (LTC) facility, the staff, along with the resident’s family members, changed the resident’s phone number numerous times and rerouted her mail to go elsewhere, but because of the persistence and trickery of these unscrupulous people, they always managed to get through the filters set up to eradicate them.  This particular resident’s apartment was finally searched by staff, at the suggestion of local law enforcement and with the permission of the resident, and what they found would make your blood boil.  This resident had shoe boxes full of “Sweepstakes” documents, and once the apartment had been cleaned out, over a dozen large garbage bags filled with documents had been removed.  Once this resident responded to these criminals by sending money, they had a victim upon which they could rely.

I’m not going to address the issue of identity theft per se which is another prevalent type of fraud exacted upon elderly adults.  Let’s concentrate on mail fraud which can certainly lead to identity theft.  With mail fraud, which eventually can lead to  “phone fraud,” the victim in question is oftentimes isolated, lonely, and as most senior citizens will tell you,  is worried about having enough money to get her through her later years.  The promise of a $10,000, or higher, windfall is just too good to resist.  Let’s be honest with ourselves – we can’t resist this type of temptation either.  If you’ve ever purchased a lottery ticket, and I’ve purchased many, you hope beyond all reason that this time the lottery ticket will have the winning numbers, because after all – somebody has to win!  When you’re a senior citizen and money is tight, why not hope beyond all hope that the $10K Sweepstakes could be real, as unlikely as that may seem to us?

 So how does one put safeguards in place to ward off these types of criminals?

My sister-in-law and my father in front of his desk.

If you live close enough to your elderly loved one, have a look-see around their living space.  Do you see any piles of envelopes that look suspiciously like one of these mail fraud schemes?  When my father lived in a one-bedroom apartment in an assisted living facility, as he left the room to use the bathroom and/or to take a nap, I did some Irene-sized investigative work.  I didn’t stop at simply looking at what was on top of his desk, I rummaged through the drawers.  I looked at his checkbook register for suspicious outgoing checks (there were a few.)  I tried to discern if there were any Sweepstakes letters from repeat offenders who thanked him for his previous money submission and asking for more – again, there were a few.  I know that this investigative activity reeks of privacy invasion but if that meant protecting my very generous father who was in the early stages of dementia – I was willing to do so.  And I didn’t stop there.  I cleared his desk of all but one or two Sweepstakes envelopes so he wouldn’t notice that absolutely everything was gone, and I stuffed them in my backpack and took them home to shred.  If you don’t live close enough to visit on an ongoing basis and suspect that your parent who lives in a long-term care facility is succumbing to this type of mail fraud, call a staff department head and ask him/her to have a look at what is visible on top of your loved one’s desk/coffee table.  You shouldn’t ask staff members to open drawers – that’s inappropriate and is actually against most facilities’ resident privacy policies.  Once you are aware of a concerning outcome, then you can take steps to provide personal intervention on your loved one’s behalf.  A phone call to the local Long-Term Care Ombudsman Office located near your loved one will initiate a complaint and that office will attempt to resolve this matter on behalf of the resident – your family member.

Phone fraud harassment – one step closer to elder abuse.

I became aware of a woman who received numerous calls a week from these scammers, threatening her with bodily harm if she didn’t wire the requested funds.  These criminals have no conscience whatsoever so they aren’t shy about yelling at the elderly victim; making fun of them when they cry on the phone because they’re afraid of the threats; calling the elderly person a loser and that they’ll never have enough money to carry them through the remainder of their pitiful lives.  As cumbersome as it may be, I strongly suggest you have your loved one’s phone number changed.  Only those who need to have the number: family, close friends, medical personnel, and facility administration, should be given the new number.  You may have to do this several times before the stream of fraudster phone calls come to an end.

Resources on which you can rely.

The AARP website has links to resources that are very informational regarding elder fraud.  Once you access their website you can link to the chapter that is active in your local area and you’ll find contact numbers for Fraud Fighter reporting.  Additionally, the Attorney General’s Office (Washington State website linked here) is very helpful.  Not only can you report cases of fraud through their website, you will also find a list of scams currently making the rounds.  Let’s not forget the U.S. Postal Service as well.    They have a postal inspection division that walks you through the steps of preventing and/or eliminating mail fraud.  I think once you start typing elder fraud into an internet search engine, you’ll find numerous links, such as The Elder Fraud Project, that will prove helpful.

Whatever you do – don’t sit idle and ignore the signs of mail fraud.  I can guarantee you that the scammers trying to acquire as much of your loved one’s money as possible are not idle – they’re hard at work to enrich themselves at your loved one’s financial expense.

Be an advocate for your aging loved one.

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If your loved one no longer has a voice in which to defend or advocate for herself, who better to do so than you?

In this post I will assume that your loved one, e.g., parent, grandparent, spouse, or sibling, lives in a long-term care (LTC) facility.  Oftentimes by the time our parent has entered a facility, we are so relieved that someone else has taken over the caregiving, we willingly take a back seat and let the professionals do their job.  By all means, reward yourself with the freedom that less active caregiving of your loved one has afforded you, but don’t leave your caregiving role behind.

I know it’s hard to hear what I’m about to say – especially since you finally turned over your parent’s caregiving to someone else – but I want to encourage you to NOT assume that the care being provided (or withheld) is in your loved one’s best interests.  It’s easy to have a perhaps unwarranted laid-back attitude because:

  1. mom is being taken care of by trained professionals who wouldn’t be doing this job if they didn’t love it; and/or
  2. mom is living in a ritzy/expensive place so it must be the best option for her; and/or
  3. this place couldn’t possibly have any problems as witnessed by the waiting list we had to climb to get her accepted.

I wish all of the above points were reason enough to become somewhat removed from the picture but the truth of the matter is that none of the above have any bearing on the quality of care being provided to your mom.  Let’s take each point separately.

  1. Without a doubt, there are caregivers and management staff that truly do love what they do and this attitude is demonstrated in the compassionate way in which they care for your loved one.  However, in 2007, studies showed that staff turnover rates ranged from 50 percent to well over 300 percent a year!  There’s a reason why caregiver turnover is so high.  This job is TOUGH and the pay is unconscionably low.  A 2004 U.S. Dept. of Health and Human Services report addresses the front line long-term care workforce challenges which have only increased in the past several years.  This report is worth your while to read.  Learning is power – right?
  2. Champagne and chandelier facilities are just that – beautiful buildings on their face, but not necessarily representative of the care being provided.  Don’t get me wrong, I’m aware that stellar higher-end senior housing companies exit, but it’s important that we not be lulled into thinking that glitz equals great.   Sometimes what I call “generic” buildings oftentimes provide as good or better care.
  3. The waiting lists that so frequently exist for LTC facilities – especially for dementia care – are representative of the demand for space that, as of 2011, is not adequate for the burgeoning influx of Baby Boomers needing care.  So a waiting list does not necessarily represent quality.

So here are some pointers for you that I hope encourage your continued involvement in your loved one’s care.

SPEAK UP.  You don’t have to be a squeaky wheel to get the grease.

  • Be persistent yet respectful.
  • Take the time to be a part of your loved one’s care meetings/conferences with staff to discern their reasons for the care being provided.
  • Be present: in person if you live nearby or by phone if you are a long distance family caregiver.  Trust me, if the caregivers know that you care and are going to be an active family participant, you’ll get their attention, and so will your loved one.

OBSERVE.  When visiting your loved one, observe her behavior and demeanor; her cleanliness and her appearance.  How does it differ from visit to visit?  Is her room tidy, clean and uncluttered?  One way to observe staff members in action is to accompany your mom on facility outings.  Observe the staff’s interaction with the residents.  Do they speak respectfully to them?  Are they patient with them?  Do the residents enjoy their outings or do you get the impression that these outings are forced upon them?  All of these impressions are important towards discerning what goes on in your absence.

ADVOCACY RESOURCES.  Do your part in acquiring the tools needed to better understand the resident rights guaranteed by law that your loved one should be receiving as a long-term care facility resident.  Each state in this country has a LTC Ombudsman program.  Get acquainted with their mission of advocating on behalf of vulnerable adults and contact your local program to receive help in assuring optimal care for your loved one.

Speaking of Doctors…here’s some medical humor.

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A doctor is talking to his patient one day and he says, “I have some bad news and some terrible news.”

The patient asks, “What’s the bad news?” and the doctor says, “You only have 24 hours to live.”

The patient says, “Oh no!  What news could possibly be worse than that?”

And the doctor says, “I’ve been trying to contact you since yesterday.”

 

Senior Health Specialists? Geriatricians? Where are you?

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The heading from an Associated Press story by Matt Sedensky, “Who’s going to take care of our aging population?” should wake ALL of us up; not just us Baby Boomers, but ALL of us because at this stage of our world’s existence, no one has created a magic elixir that cures old age and dying.

Talk to anybody who is in med school, or considering med school, ask them what specialty they would like to focus on and you’ll hear: orthopedics, pediatrics, heart disease, cancer treatment – all worthy fields but I would venture to guess that not one of whom you ask that question has said, Geriatrics or Senior Health.  “What about geriatrics?” I ask them.  “We’re living longer so you’ll ALWAYS have a job taking care of a civilization that’s fighting to stay alive as long as it can!”  They don’t buy it, especially since Geriatricians are  one of the lowest paid medical specialties amongst the medical community.

Square Dancing class at my town's Senior Center.

Ugh!  Who wants to deal with the wrinkly, saggy, hard-of-hearing, loud complaining geezers among us?  Not very many according to the linked article above.  According to Mr. Sedensky’s research, there is roughly one Geriatrician for every 2,600 people 75 and older.  No wonder people can’t find a doctor who specializes in Senior Health!  I facilitate an Alzheimer’s Caregiver support group in my town wherein these family members expound on their frustrating efforts to locate a doctor who: a) will spend the time needed to have a productive appointment with their aging parent; b) who knows enough about elder health issues to suggest a treatment that will provide quality of life for the patient; and c) who has a medical staff that is sufficiently trained to interact with their elderly patients.   Unfortunately, the General Practitioner or Internist quite frequently provide the same treatment, and the same method of communicating, to their elderly patients – even those with Alzheimer’s or other dementia –  as they do their patients in their 20’s thru 70’s.  That just won’t cut it.

Older patients have more complex conditions – and more of them.  If a medical professional isn’t accurately trained, he or she might discount an elderly patient’s symptoms as those expected during the normal aging process and therefore offer no effective treatment.  “What can you expect at your age Mrs. Jones?  Be glad that you’ve lived this long!”  I know – that sounds really callous – but I dare say too many elderly patients are treated dismissively, and as a result their quality of life decreases greatly.

My wonderful Dad, pre-Alzheimer's, on my wedding day.

Think about it my fellow Baby Boomers.  Are you willing to be dismissed just because your doctor doesn’t know what the heck he’s doing?  I know that all of us have been to doctors who we’ve “fired” because of their lack of understanding and/or their failure to provide proactive treatment.  The vulnerable adults among us might not realize that they have choices.   They might not feel confident enough to challenge the highly educated medical professional to whom they have entrusted their lives.  Who loses in that equation?  We all do.  If our aging relatives don’t have appropriate medical care options at this time in their lives, why do we think that there will suddenly be an influx of Geriatricians to treat us when we’re their age?

Maybe this is a lost cause for us but it doesn’t have to be that way for those coming up in the aging ranks behind us.  What are your thoughts about this glut of Senior Health professionals?  How can we hope to live in a world where quality of life – something we value greatly – is an unreachable, yet much desired goal?

Advocacy starts with the smallest effort to make a difference

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I was touched by the following quote that appeared on Lark Kirkwood’s Elder Advocates site a few years ago:

Do all the good that you can, in all the places you can, in all the ways that you can, at all the times you can, to all the people you can, for as long as you can.  – John Wesley

I want to add the following sentiment which has become a sort of mantra for the way I conduct myself:

We can begin by doing small things at the local level, like planting community gardens or looking out for our neighbors.  That is how change takes place in living systems – not from above – but from within, from many local actions occurring simultaneously.  – Grace Lee Boggs

It only took 3 people to raise $100’s at a garage sale for the local Alzheimer’s Association.

I’m so encouraged by the different types of advocacy that I’ve witnessed across this nation.  Some advocate for the elderly, some the disenfranchised or marginalized, others advocate for the humane treatment of animals.  Whichever the focus – it’s all about advocacy.  The good news is that whether a person lives in Redmond, Washington, like myself, or Washington, DC – we are all making a difference in each of our small corners of the Universe.  Imagine if everyone did just that.

Instead of having the mindset that the only things worth doing are those which are grandiose and news worthy – and therefore believing that you have nothing to offer – do what you can, with what you have, and your impact will be grand.  Many small, positive actions add up to great advances in the betterment of our world.

Regardless of your age, you can make a difference in the lives of others.  If you’re looking for something to do, consider helping an elder or two.  Let’s face it, unless death comes early for us, we’re all going to enter the elder category at some point in the future.  You may someday benefit from someone else’s tender loving respect and care.

Senior Citizens are NOT children!

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An epidemic has taken hold of this Nation.  Adults 70 years or older are being infantalized.  Adult children have decided that their parents can’t do anything without their guidance.  Service employees, e.g. restaurants, retail store clerks and the like, feel compelled to talk down to their Senior customers.  Caregivers in long-term care (LTC) facilities further degrade the residents with baby talk.  These residents downsized their living space; don’t downsize who they are by treating them as anything other than who they are: intelligent adults.

Only you can put an end to this epidemic.  If it is not eradicated by the time you reach the Senior Citizen age, you too will be subjected to its horrors.

Adult children.

Mom moves into your house because of a financial or medical reason, and suddenly Mom has no say in what goes on in her life.  Everywhere she turns, her son and daughter-in-law are bossing her around in the guise of trying to do what is best for her.  Mom wants to stay up late reading or watching TV and she’s told she should go to bed.  Mom wants to do this activity, or that activity with friends outside of the home and she’s told not to leave the house because the son and daughter-in-law want to make sure she doesn’t get into any trouble.

PA-LEEEEEZE!!!!!

Your Mom raised you and somehow you turned out o.k.  She must have been a good parent, teacher, guidance counselor, child supporter, you name it.  Just because she is living under your roof doesn’t mean she’s lost her right to have a say in matters that go on in the household.  Ask her opinion from time to time.  Let her somehow contribute to the functioning of the household, e.g. day-to-day participation in household functions, helping you with decisions you’re making about your own lives.  Doing so will restore her pride and make her feel less superfluous.  It’s quite o.k. to be concerned about her well-being – you should be – but you can do so without suffocating her.

Service employees.

My mother with my daughter Erin, circa 1976.

Why is it that wait-staff, retail sales clerks and the like feel an immediate need to speak super loudly to a Senior citizen customer?  In my work with the elderly, I made this very mistake by talking loudly to a LTC resident I had just met.  She finally interrupted me, put her hand on my knee and said, “Irene, I’m old; not deaf.  Please stop yelling at me.”  So simply lower your voice and don’t call her a pet name such as “Sweetie,” “Hon,” etc.  I’ll never forget my mother’s phone call to me many years ago when she was barely over 70 years old.  She went to the Dept. of Motor Vehicles to renew her driver’s license.  After filling out the paperwork and getting her photo taken, it was time for her to leave with her newly issued license.  The DMV clerk then said quite loudly, “Now Sweetie – before you leave, make sure that you have everything with you that you came with.”  My mother called me that evening, both angered and in tears, bristling at the way in which she was treated.  In my mother’s eyes, the DMV clerk downsized her intelligence and abilities and that thoughtless act forever changed my mother as a result.  Please treat your Senior consumers with respect and with dignity.  They know they are older than you are – you don’t have to remind them of that fact with your ill-placed attitudes and gestures.

An aside:

Here I am, 58 years old, with my hubby. Only HE is allowed to call me Dear.

When I was 58 years old, a couple years ago, I picked up some items at my local grocery store and used the self-checkout counter to purchase my groceries.  As I was leaving the store, the retail clerk said, “Thanks Dear!”  A male customer who was older than me also went through the self-checkout at the same time but that retail clerk didn’t say a cutesy name to him!  Oh Boy – she didn’t know what she had just started.  I didn’t make a scene.  I left the store, wrote a letter to the manager and included this blog entry/article with a suggestion that he update his store training to include my suggestions about how to treat Senior Citizens.  He wrote me back to thank me and stated that he planned to provide updated sensitivity training to his staff.  BRAVO!

Professional LTC caregivers.

Oh boy – I see this a lot.  Caregivers who, God bless them, have a job that not many of us would willingly perform – especially at the low hourly wage at which they are paid.  I admire you and I respect you.  You’re a better person than I because I don’t have what it takes to do what you do.  But please address your patients/residents by their given names.  I would even go so far as to suggest that you call them by their surname until they give you permission to use their first name.  “Good morning Mrs. Smith.  It’s so good to see you today!”  That’s a far more respectful greeting than the following:  “Good morning Sweetie Pie.  Let’s get you ready for breakfast, shall we Hon?”  YUCK!  God help the person who addresses me that way when I reach my Senior years.  I’m a friendly person at heart, but I too would bristle at any condescending treatment directed towards me.  (And considering how I reacted to the cutesy name directed at me in the supermarket a few years ago (above) I may not be quite as civil in my later years.)

BOTTOM LINE FOR EVERYONE CONCERNED.  These Senior Citizens with whom you have contact survived the Great Depression and at least one World War.  Surely they have the ability, and the right, to be treated with respect and given the benefit of the doubt when it comes to making their own personal decisions.  Don’t take away their ability prematurely.  Eventually they may not have the ability to function independently, but it doesn’t do them any good for you to hasten the time in which that may happen.