Holistic HomeCare News
Helpful tips for family caregivers

Care Manager's Corner — Anne Sansevero, RN, MA, CCM, GNP

Thanksgiving Reality Checks — The Untold Stories
of Seniors Living Alone 

Thanksgiving is a time when we gather around the table to give thanks with our families that we may have not seen in a while. If you have an aging loved one in your family, it is also a time to be curious.  During your visit, with heightened observational skills, you have a golden opportunity to take stock and notice cognitive changes or memory issues with loved ones that you may not have noticed before. Indeed, the busiest time of the year for Aging Life Care Managers ® is over the holidays when family members reach out for advice, support and guidance as they realize that their older loved ones are beginning to have difficulties managing their affairs.  Here are some areas for you to consider exploring:

Review Finances – Are bills being paid on time? Is mail piling up unsorted? Are multiple credit cards being ordered because others are lost? Is there any evidence of your loved one being a victim of a financial scam? Are large amounts of cash being left around the home?

Assess Driving – Is the car getting dinged, damaged and not repaired? Is the driver getting lost or missing turns? For the brave of heart, you may want to take a drive with your loved one to further assess their abilities.

Observe Behaviors – Are they storing items in unusual places (e.g., keys in the refrigerator)? Are they having significant difficulty finding the right word or substituting vague words for more specific ones (e.g., “thing” instead of “ book”)? Are they repeating themselves continuously? Are they dressing inappropriately for the weather or showing signs of poor grooming? These activities can be a sign that they are not retaining old information and are having trouble processing new information. This is highly suggestive of cognitive decline.

Look at Their Calendar or Planner – Are they constantly rescheduling or missing appointments? Are there a proliferation of post-it notes and written calendar reminders all over the home?

Check the Medication Supplies – Are prescriptions being renewed appropriately? Are there multiple supplies of pills? Are expired medications clogging up the medicine cabinet? Are there too many or too little pills in the bottles?

Check the Kitchen/Bathroom – Are you noticing any burned pots/pans in the kitchen from the stove being left on? Is the refrigerator being stocked appropriately? Is rotten food being stored there for long periods of time? Have there been any reports of floods from taps not being turned off?

Check pets – Are they looking hungry, disheveled or lethargic because they are not being cared for or exercised?

Check in with Trusted Friends/Neighbors – Has your loved one begun withdrawing from social activities? Do friends or neighbors have any input on how your loved one has recently been managing their affairs? Are they getting lost in the neighborhood?

Is it time to hire a caregiver – If you are seeing evidence that your elderly loved one is no longer coping well living alone, it may be time to consider hiring a caregiver. Even a few hours of care a few days a week can make a big difference in supporting them to stay safe and well in their own homes. For high caliber expertly matched caregivers consider  Holistic HomeCare Associates as a trusted resource  www.holistichomecareassociates.org

As you visit and start to notice things, avoid  being overly intrusive in your efforts as this will put the senior on the defensive and less amenable to accepting support. Instead show interest and curiosity and be  nonjudgmental. Once you have gathered your information, reach out to trusted health care experts – your primary care practitioner, an aging life care professional www.aginglifecare.org or a local non-profit resource like Caring Kind www.CaringKindNYC.org  about next steps.  F

With early targeted intervention, your observations and actions can help stave off more serious trouble for your loved ones down the road and help them lead happier, safer and more fulfilled lives as they age.

Happy Thanksgiving!

Caregiver Spotlight

A caregiver since 2016, Shota Gulbatashvili has proven to be a rising star and valuable asset to those with care needs since that time. Originally from The Republic of Georgia where he earned a Bachelor’s degree in Computer Science, he has served as a caregiver and companion who enjoys assisting his clients with computer-based projects. Friendly, easy going, positive, and a great team player, Shota becomes an integral part of any care team he is on.

Helpful tips for family caregivers

Family caregivers typically spend four to five years caring for an aging relative. It might start with simple tasks such as picking up groceries or raking the leaves. But in the natural cycle of life, more help will be needed, more frequently, and of higher skill level. While gratifying, it can also be overwhelming. Pacing yourself for the long haul is part of the solution.

This issue of our newsletter relays the top support strategies recommended by millions of family caregivers who have come before you. Call it “Family Caregiving 101.”

Information and support

Seek information, training, and support

• Medical information and skills. Get a thorough and accurate diagnosis. Learn from the medical team about treatments. Ask what you can do at home. And explore online at credible websites. Nonprofits specializing in the disease are a good bet. For instance, the COPD Foundation or the Alzheimer’s Association. The National Institutes of Health are a respected source. Also, the Mayo Clinic, Cleveland Clinic, and WebMD.
• Guidance from a professional in the field of aging. Go to Eldercare.acl.gov for free information and referral to services anywhere in the United States. For more robust help, hire a certified care manager. (Go to aginglifecare.org.) They understand the biopsychosocial aspects of aging and also have a deep knowledge of local and national resources, as well as the best providers.
• Practical tips and support from other caregivers. Look to the professionals for medical advice. But join a caregiver support group for emotional support. You’ll also get invaluable tips on coping with daily challenges. Caregiving is very isolating. It helps to know you are not alone.

Find help for physical tasks

• Family and friends. They are the first to help, but they are not always available. Call a family meeting to strategize together.
• Community programs. These deliver specific services for free or a nominal fee. For example, Meals on Wheels delivers free or low-cost meals once a day to homebound persons. Or there may be help with transportation. Look for a volunteer driver program offered by a faith organization or senior center. There are usually eligibility requirements.
• Hired care. Paid help is the most reliable source of assistance. Especially for the time-consuming, hands-on tasks. But Medicare does not pay for this type of care. Home help is generally an out-of-pocket expense.

Financial/legal aspects of caregiving

Look for financial support for caregiving
Medicare doesn’t pay for home care or other nonmedical support. You’ll need to find other options.

• Benefits. Does your loved one have long-term care insurance? Did they serve in the armed forces? (If so, they may be eligible for veteran benefits.) BenefitsCheckup.org may uncover other sources.
• Local programs. Are there state or local programs that help pay for some caregiving time? Or pay for respite? Check for a housing subsidy. Or a government waiver to reduce the cost of care.
• Tax deductions. If you provide more than 50 percent of the financial support for your loved one, you may be eligible for some tax relief. Talk with a tax specialist.
• Family Medical Leave Act. While it does not provide for paid leave, this legislation can protect you from losing your job if you have to take time off work for family caregiving. Talk to the HR department at your place of employment. 

Get paperwork in order

• Medical records. Keep a current list of doctors, medications, current diagnoses, and past medical history. Find out how to access medical providers online. Also, keep records/notes from the hospital, lab, and doctor visits.
• Financial overview. Learn about your relative’s income and expenses. Find all their accounts and account numbers. This will help you with eligibility requirements and deciding what services can be afforded.
• Powers of attorney. Whether due to coma, dementia, or some other condition, your loved one may not always be able to voice their wishes. Have your relative work with an elder law attorney—find one at NAELA.org—to choose a decision maker for finances and one for health care.
• A will and/or trust for disbursing assets. Likely your loved one has thoughts about what they want to have go to whom. Work with an elder law attorney to draft the appropriate documents.

Pacing yourself

If you develop health problems—mental or physical—what happens to your loved one? Their well-being depends on yours. So it’s vital that you keep yourself healthy and in balance, for your sake as well as theirs. Not taking the time to do this is the biggest regret of former caregivers. There is always a way.

Take breaks
No one can be “on” all the time.

• Ask family to relieve you. A little time after work or on the weekend. Or some of their vacation time dedicated to taking care of your relative so you can do something nourishing for yourself.
• Consider an adult day program with activities and social opportunities for your loved one.
• Investigate respite programs for short-term relief.
• Maintain a hobby or social connection that is completely unrelated to caregiving.
• Take a mental break at least 10 minutes a day. Perhaps you talk with a friend who has a good sense of humor, or watch silly videos. Maybe you meditate or pray.

Take care of yourself

• Keep up with regular doctor visits and preventive exams. Take your own health seriously. Do not postpone surgeries or other treatments you need.
• Cultivate healthy habits (seven to eight hours of sleep per day, regular exercise, and a healthy diet). Avoid unhealthy crutches such as alcohol, overeating, or medications.
• Be alert for signs of depression, the number one mental health problem for family caregivers.
• Nurture your other relationships (spouse and kids, especially). They deserve your attention, and you need them. Find a healthy balance.
• Stay connected with friends, even if just by text. Isolation is bad for your mental and physical health.

Periodically step back and acknowledge all that you do. It’s easy to feel you don’t do enough or aren’t doing things perfectly. Instead, recognize the service you provide. Salute your achievements. You are doing noble work!