If you would like to have a FREE 1/2 hour consultation to discuss how I may be of service to you or a family member, email me at 4u2mend@gmail.com. The services I can provide can be located on the service page. My goal is to help you sort out and put in place the best plan tailored for you and your loved one specifically. There is no "one size fits all"when it comes to the safety and optimal care for those we love.
Even if you are not ready for services, check back often as I will be adding resources to hopefully make the path a little less bumpy.
INDEPENDENT LIVING
Complicating this challenge is the fact that people are more
mobile, careers and other life events have created a different family picture
that once existed. Family members who at one time were in close proximity to
one another now have many miles creating distance between them.
With distance there comes the additional challenge to figure
out how to best manage care which will be done between the miles. This will
include making the best of the time when you are actually in the presence of
your family member/s. Learning how to
make keen observations (how much food is in the refrigerator, what is the
condition of the home, what seems odd or out of place, etc.) working towards
viable solutions, figuring out what resources are available and developing a
local network (dependable/trustworthy friends, neighbors, church affiliates,
professional organizations, etc.) for them, is key to long distance care-giving.
The initially invest of adequate time to develop a plan, you
will find, can pay off big over time. Take time to accompany your family member
to medical appointments so you can gain a clear understanding of their health
status, medications and projected prognosis; and make a journal to write down
everything. As more is required it is best not to rely on your memory, even if
you have previously prided yourself in that area.
A final piece to long distance care-giving is having a good security/
health monitoring system installed. For my mom’s added piece of mind because
she has to go to her garage and walk a distance to retrieve her paper, we
choose a two way pendant which allows her to be able to speak directly to the
monitoring station via the pendant. Should she be in her garage, which is some
distance from the base unit, and needed to summon help, someone could talk to her
while she waited for help to arrive.
I recently came across another device that I am going to add
to our care-giving package, Lively activity
sensor. This is just another layer to enable long distance caregivers to track
of their loved ones daily routines without the intrusion of cameras which often
are considered offensive.
THE SEARCH FOR A PAID CAREGIVER
Often until you or a family member has the need for in home care, how to begin the search for a well rounded and trained caregiver is something you probably have never given much thought to. There are many factors to consider and knowing what to look for is vital to help ensure that you get someone who is qualified to do the job they are being hired to do. You may find the following article helpful for the interview..."15 Questions to Ask When Interviewing a Home Care Worker On Your Own"
WHAT'S AVAILABLE AND WHO DO I CALL
The task at hand for someone taking care of a loved one who is aging or disabled is complex and knowing what is available and who to contact will be a big help during the navigating process. The Family Caregiver's Alliance website offers a great resource "State by State Help for Caregivers"
IS IT TIME TO TAKE THE KEYS?
PATIENT DISCHARGE A VITAL PART OF THE PROCESS
After the experience of having several family members hospitalized over the past couple years, one thing that I came to understand that should be part of the process was DISCHARGE PLANNING. Unfortunately what I found was that too often the idea of discharge planning was a phone call the evening before the planned discharge day to inform the caregiver. In the case where a nursing home or rehabilitation placement was needed you are given a list of facilities and told you need to choose one by the end of the day so the social worker could begin to make call to inquire of bed availability. Now if you are the average caregiver this adds to the heightened stress level that already exist from having an ill family member.This inadequate planning process can often lead to re-hospitalization and caregiver burn out.
What is important to know is that YOU the caregiver have a voice and being assertive will help ensure that things are done in a manner that will be beneficial both for you and your loved one. I have always told individuals "FRIDAY home discharges should be outlawed", especially in the cases of someone with a chronic health condition or recent major surgery. If you leave the hospital on a Friday and something goes wrong after 5:00PM, you the caregiver are stuck and often find yourself on a Friday night in the emergency room. I know this first hand to be true; so after several incidents of having a family member discharged on a Friday afternoon, only to have to bring them to the emergency room that night, I flatly refuse Friday discharges.
It is important that from DAY ONE, and every day until you are talking face to face with a social worker, you let a staff person, preferably the charge nurse, know that you need to speak with someone to begin discussing DISCHARGE PLANNING. If you suspect that your family member will need placement, either temporary or permanent, in a nursing or rehabilitation facility, begin to ask question regarding what options are open for your family member based on their insurance. You will need to do your homework once you have been provided with a list of facilities based on your loved ones insurance so you can be sure the facility you choose will be one that you would want them to stay in. Sadly, there are still some facilities that you would not even consider so you need to know which those are. "Stressful but Vital: Picking a Nursing Home" is a great article with links that could assist you as you begin the process.
If your family member will be coming home with you, you will want to be sure that if any medical equipment will be needed that you ask the social worker to assist you in obtaining what will be needed. Because some insurance do not pay for such equipment, you will want to check around to see if there are local organizations that have a loaner program. The local office on aging would be a good starting point for this information.
Bottom line, you, the caregiver, must become a key player in the discharge process. DO NOT plan on someone from the hospital making it happen, YOU WANT TO BE IN THE DRIVERS SEAT so that YOU along with their help can map out the best plan to ensure the continued care and safety of both you and your loved one. Take time to review the A Family Caregiver's Guide to Hospital Discharge Planning to begin the process.
If all this is just more than you feel you can handle, the assistance of a private patient navigator who can assist you through the discharge planning process. You want to be sure when they say "it is time to go home", that everything is in place for both their care and comfort as YOU have determined is best.
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CLOSED CAPTION VIA TELEPHONE
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KINSHIP NAVIGATOR PROGRAMS
THERE'S AN APP FOR THAT
The ability to utilize technology to make the job of caregiving easier is a reality if you know where to find and which smart phone applications will help you accomplish your task. Check out the Best Caregiving Apps for 2017.The Challenge of Medication Management
One of the most challenging duties a new caregiver finds
themselves in is the management of medications.
According to AARP…. 78% of caregivers are managing multiple medications.
31% are managing 1-5 medication, 46% 5-9 medications and 18% over 10 medications.
This does not even take into consideration supplements and over the counter (OTC)
medications. Thankfully with the use of
some innovative applications
along with some guidance this challenging task can be made easier.
There are some general tips for managing medications that
will be helpful for almost anyone.
First rule is to keep an
updated list of all medications (supplements and OTC) along with the dosage,
who prescribed the medication, the dosage and why the medication was prescribed
(certain medications have multiple reasons for being prescribed so it is
important to document why the medication was prescribed for yourself or your
family member).
Pillboxes are a must…even if you are managing one medication. This allows you
to always know if a dose has been taken or not. You can setup a pill box for a
one week or two week time period. Just find something that works for you and be
consistent…you will find life is a lot easier.
Become familiar with
prescribed medications, their side effects, possible interactions with other
medications (supplements and OTC) and how they should be stored and taken
(morning, night, with food, without food, are there certain foods or beverages
to avoid). This is where the most valuable member in relations to medications of
your healthcare team comes into play, the pharmacist. Get to know your
pharmacist (develop a RELATIONSHIP with him/her). It is advisable to have your
prescriptions filled at the same location and if you use a different pharmacy,
inform the pharmacist of your current medications if you are filing a
prescription for something new.
Do not be afraid to
ask your prescribing practitioner questions regarding medications. Some good
questions would be - “why is the medication needed, how long it will need to be
taken, will any diagnostic test be required while taking the medication (an
example would be certain medications to thin the blood or to control seizures
may require blood test monitoring), and the ballpark cost of medication along
with a suggestion of an alternative that may be less costly (no sense in
getting a prescription for a medication that cannot be afforded). Are there any known assistance programs for
the medication? Physicians may be reluctant to become involved in this aspect
of care due to time constraints but as a partner in your care, they must begin
to take a holistic approach to their patient’s wellbeing.
If you are
struggling with medication management…one of the services I offer is to assist
caregivers create a medication management plan. If you have some innovative
applications or tips…please email me so I can share them.
Working to speak the same language
We live in a world where the uses of abbreviations are
commonplace and that which seem to have meaning to some are totally foreign to
another. One thing is certain, to provide effective caregiving, one of the most
important things you can do for yourself and your loved ones is to learn how to
speak and understand the language you may hear during the course of caregiving.
You will probably hear reference to
terms such as PRN (as needed) or NPO (nothing by mouth) and your familiarity
with the lingo will become a vital component of care. The site Senior Resource
Guide provides an article containing “67 common
medical abbreviations/acronyms” which is a good place to start. You always want to
be sure if a term is used that you are not familiar with that you ask the
individual using it to explain what it means. Invest the time and effort to
learn what you can and remember; when it comes to the caregiving, no question
is a wrong question to ask.
The Medication Game
Answer this question; do you always take medication as
prescribed by your practitioner? If I am honest, I would have to answer that I
have not always been vigilant about it. For me, it was often that I got busy and
missed a dose and did not consider that it really made that much of a
difference. The reality is whether you take one pill a day or ten, medication
non-adherence (not taking medications as prescribed) can become the reason for reoccurring
infections, confusion or something more life threatening.
As a caregiver you may find yourself becoming extremely
frustrated with your loved ones attitude concerning medication, skipping pills
or their re-arrangement of the pill box. From a personal experience, for the
life of me I couldn’t understand why my loved one constantly was taking
whatever day of the week he opened first. To me, how difficult could it be to
take Monday on Monday, Tuesday on Tuesday, etc.? To him what difference did it
make? For me it was my way of keeping track of whether he had taken his medication
and it really mattered when a medication was being phased out and the dosages
changed each day.
What I have learned over the years, the worst thing one
could do is to get into a heated debate over the issue. Success at this
requires developing strategies where it becomes a win/win. Work at engaging
your loved one in a two way conversation about things that do not seem to be
working for them. For my loved one it simple, he could not see the days of the
week on the pill box. We switched to a box with large print and color coded day
and night. I explained why it was important for me that we work together and
things are much better.
There are various reasons why a loved one will refuse to
take a medication or “forget” to take them. It could be the medication makes
them feel different, the pills are too big, I have heard about all of side
effects or they cost too much. Whatever the reason, for them the reason/s are
valid and they deserve to have their feelings heard and addressed. What may be
helpful for them is to have a clear understanding of why the medication is
important will as well as the assurance that everyone does not experience
adverse reactions but if a side effect arises it will be promptly discussed
with their physician. If the pills are too large, checking with the pharmacist
to see if they can be safely cut or do they come in a liquid form is an option.
Checking to see if there are any pharmaceutical assistance programs to assist
with cost or if there is a less expensive comparable medication may address
their high cost opposition. The memory issue can definitely be assisted with
various alarm reminder systems or applications.
I found there were things I needed to change about myself in
this equation as the designated medication manager. This is a vital role in caregiving
that comes with much responsibility. The most important change I needed to make
was to be consistent about pill box monitoring. The pill box is not the Ronko Rotisserie
“just set it and forget it”. I could not
deduct that because the pills are in the box they will always be taken. I must
monitor it daily and be open to making changes that will best suit the needs of
the individual I am caring for and not mine.
You can always reach out to me for a free 30 minute consultation
on developing workable strategies at 4u2mend@gmail.com.
Confusion - Pills That Look, Sound and Are Spelled Similar
Novice caregivers are often thrust into the challenge of doing OJT when it comes to the how to of taking care of a loved one. For a first time caregiver it can truly feel like “baptism by fire”, being introduced to learning skills generally reserved for medical professionals.
You can bet one of the areas that can be the most confusing
is when a caregiver becomes the medication manager for their loved one. Even
for skilled professionals having a grasp of the names of medications and what
they are prescribed for can be confusing especially in the case where two
medications look, sound or are spelled similar. According to the New York Times
article “CASES;
Do Spelling and Penmanship Count? In Medicine, You Bet”, a panel of experts
identified 600 sound-alike or look-alike pair of drugs that could be cause of
medication errors.
One helpful tool caregivers can utilize to help eliminate
errors is an online site that you can search a medication by name. I like one
hosted by Medco
Health. You always want to inquire from the physician what each medication
is being prescribed for. This information will be helpful when you look up a
medication.
Another possible challenge a caregiver may encounter is the
color or shape of a pill changing from the previous time the prescription was
filled. This is often due to a change in the manufacturer who the pharmacy now
uses and previously used. In the instance where the color or shape of a pill haschanged, always check with the pharmacy before you give the medication to your
loved on. I personally have had a different color pill and it turned out to be
a pharmacy error. You never can be too careful. Being the dedicated medication
manager for a loved one is a caregiving responsibility that has to be taken
seriously. So each time you set up your loved ones pill box be sure you are in
a space with minimal distractions and always check and recheck yourself before
administering.
I read a touching article in the Health section of my local paper which I believe would be the humane thing for physician's to do - when their patient has entered into that revolving cycle, take a step back and instead of them deciding what to do, ask their patient what can he/she do for them. What are their goals at that point of their life and how can he/she assist them in reaching their goal. In the article when that question was posed to the physician, he said he desired to live the remainder of his life without falling and remain at home until his death. His doctor told him that he would order physical therapy and hospice care, being honest that he wasn't sure if physical therapy would prevent his falling but they could give it a try. For that patient's last few months of life he was at peace...no more hospitalizations, no more test, no more falls and dying in his home. To me this is medicine at it's best. Read a touching article "A Doctor Discovers an Important Question Patients Should Be Asked"
FINANCIAL RESOURCES
Caring for a love one can often have an impact on finances...below are some suggestions which can be helpful.Financial Aid for Caregivers - AgingCare.com
When Treatment Ends and Final Wishes Begin
Far too often it seems that as an individual ages and their body begins to be a series of diagnosis, the normal course is to prescribe a medication that will help one condition but be antagonistic to another. Doctors are trained to treat diseases but what happens when in reality continued treatment see futile and somewhat cruel. How many times can a patient's treatment course become a cycle of hospitalizations, test, medication, discharge, emergency room visits back to hospitalization? I am certain many loved ones ask themselves this same question with often no resolve.I read a touching article in the Health section of my local paper which I believe would be the humane thing for physician's to do - when their patient has entered into that revolving cycle, take a step back and instead of them deciding what to do, ask their patient what can he/she do for them. What are their goals at that point of their life and how can he/she assist them in reaching their goal. In the article when that question was posed to the physician, he said he desired to live the remainder of his life without falling and remain at home until his death. His doctor told him that he would order physical therapy and hospice care, being honest that he wasn't sure if physical therapy would prevent his falling but they could give it a try. For that patient's last few months of life he was at peace...no more hospitalizations, no more test, no more falls and dying in his home. To me this is medicine at it's best. Read a touching article "A Doctor Discovers an Important Question Patients Should Be Asked"
Be Sure to Ask For Your Discounts
It wasn't until recently after receiving a message from a dear friend that I even gave any thought to "hey you"...you've finally joined the club where you've earned the right to say "SENIOR DISCOUNT PLEASE". Now it depends on the establishment the age at which this request is honored but you never know unless you ask for it. By all means if you've invested in the AARP membership always be ready to flip that card. Just recently I took my mom to Denny's for breakfast and they not only have a "SENIOR MENU" which is discounted but when I went to pay the bill and asked if they honor an AARP discount...indeed they did..15% off the bill. Check out "For People Over 50 Might Be The Best Thing You Learn All Day" for an extensive list of discounts.CAREGIVERS AWARENESS 2016
“Take Care to Give Care”
The first rule of taking care of others: take care of yourself first. Caregiving can be a rewarding experience, but it is also physically and emotionally demanding. The stress of dealing with caregiving responsibilities leads to a higher risk of health issues among the Nation’s 90 million family caregivers. So as a family caregiver, remember to pay attention to your own physical and mental wellness, and get proper rest and nutrition. Only by taking care of yourself can you be strong enough to take care of your loved one. You really do need to “take care to give care!”-
Caregiving can be a stressful job. Most family
caregivers say they feel stressed providing care for a loved one. With
all of their caregiving responsibilities – from managing medications to
arranging doctor appointments to planning meals – caregivers too often
put themselves last.
-
The stress of caregiving impacts your own health.
One out of five caregivers admit they have sacrificed their own physical
health while caring for a loved one. Due to stress, family caregivers
have a disproportionate number of health and emotional problems. They
are twice as likely to suffer depression and are at increased risk for
many other chronic conditions.
-
Proper nutrition helps promote good health.
Ensuring that you are getting proper nutrition is key to help maintain
your strength, energy and stamina, as well as strengthening your immune
system. Maintaining a healthy diet is one of the most powerful things
you can do to take care of yourself and keep a positive attitude
overall.
-
Ensuring good nutrition for your loved one helps make care easier. As
many as half of all older adults are at risk for malnutrition. Good
nutrition can help maintain muscle health, support recovery, and reduce
risk for re-hospitalization – which may help make your care of a loved
one easier.
-
Remember: “Rest. Recharge. Respite.” People think
of respite as a luxury, but considering caregivers’ higher risk for
health issues from chronic stress, those risks can be a lot costlier
than some time away to recharge. The chance to take a breather, the
opportunity to re-energize, is vital in order for you to be as good a
caregiver tomorrow as you were today.
During National Family Caregivers Month,
we remind family caregivers that to be strong enough to care for your loved one, you must
Take Care to Give Care!
we remind family caregivers that to be strong enough to care for your loved one, you must
Take Care to Give Care!
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