Caregiver: put on your oxygen mask first.

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passenger-362169_640The airline flight attendant gives pre-flight safety instructions:

“In case of a loss of airplane pressure, oxygen masks will drop from the overhead compartments.  Put mask on yourself first before assisting children or those not able to help themselves.”

Why?  Unless the able-bodied person is fed oxygen, he won’t be able to help any one else.

Whether you are actively providing care to your loved one or you are the point-person managing that care, you are stretched thin.

Your reserves are low.

Your tank is nearing empty.

You’re on the path to caregiver burnout – or you’ve already arrived.

You love to think that you can do it all:

  • have a full-time job, and a full-time family;
  • have numerous duties in your own household that obliterate any “idle” time during your day;
  • you’re on the community board or other volunteer activity; and, oh yah
  • you’re responsible for your aging parent’s, or spouse’s, day-to-day maintenance.

Not only are you burning the midnight oil; you’re burning the candle at both ends and about to self-destruct.

“But I have to do this.  I have a lot of people counting on me to take care of dad.  If I don’t do it, who will?  I won’t be a dutiful son/daughter, if I walk away from all my responsibilities!”

Oftentimes what happens in these situations is a person ends up being of no good to anyone.

  • You’re taking more and more time off from work either due to your own illnesses or to attend to the needs of others;
  • Your spouse and children are suffering from the constant stress that your over-extension of commitments places on the household;
  • The project for which you volunteered at the PTA or Boy Scouts, or FILL IN THE BLANK, is dead in the water because you don’t have the time or energy to devote to the cause; but
  • Your loved one for which you provide care is doing just fine because he/she is receiving all of your attention.

Keep this up and you’ll be no good to anyone because a vehicle doesn’t run on an empty tank and neither can you.  It’s time for you to attend your own “care conference” to come up with a realistic plan of how to direct your own health and well-being.

The “To Do” List vs the “Don’t Do” List:

You weren’t put on this earth to help everyone and despite your well-meaning belief that you can do it all – you can’t, and you’ll never be able to do so.

  • Write a list of everything you currently feel obligated to do each week.  Now cross out a third of that obligation list.  Do what you can to delegate duties and/or designate other willing people to carry a third of your burden.  You should already start feeling better.
  • Now eliminate – or temporarily withdraw from – another third of your obligations. You won’t offend others by doing so if they know you well enough to understand your reasons for stepping back a bit.  I’m certain they know that they will be able to count on you later when your life situation isn’t so acute.  You’re not dropping out, you’re just putting yourself on pause.
  • Reconnect with the family in your household. Don’t risk losing your family.  You need them on your team and they need you.  They will be around long after the loved one for whom you’re providing care passes away.  You want your family with you now, and you’ll want their support later.
  • Assemble a caregiving team. In my blog entries: Caregiving: The Ultimate Team Sport and Solo Caregiving I address the importance of reaching out to others and tapping into resources that will help you stay sane and healthy while on this caregiving path.

You owe it to yourself, and your loved one, to start taking care of yourself.  So place your own well-being at the top of your priority list.  I can pretty much guarantee that you won’t regret it.

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I sang for my Dad today … January 30, 2011

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I sang for my Dad today … January 30, 2011.

I am so pleased that I FINALLY figured out how to post someone else’s blog entry and I do so with this one by Lark Elizabeth Kirkwood.  How wonderful that Lark was able to have that musical connection with her father at that time in his disease.  One of the last songs I sang to my father, a couple hours before he died, was “Aloha Oe” which is a good-bye song in Hawaiian.  I know he heard the song as he rode on the wave of departure from this Earth. Reading Lark’s many posts about the positive effects of music on those with dementia or brain injuries is so timely as I am still reeling from the positiveness of Diane Sawyer’s 20/20 program on ABC that was broadcast earlier this week.  Her story of Gabrielle Giffords and Mark Kelly was  inspirational on so many levels.  Music had, and continues to have, an AMAZING healing effect on Congresswomen Giffords recovery from that horrific gun shot injury on January 8th, 2011.

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?