All About Care Giver

Communication goes on in many ways: exchange of thoughts, messages, or information, as by speech, signals, writing or behavior. It is no surprise that most families develop a special and unique communications style. When we talk to our family members, not only do we search for signs of love, but we also look for signs of disapproval. When families come together for making decisions about the care of their parent, they may need to develop or reframe their communication skills.

Here are five ways to improve family communications:

1. Realize the family is a hierarchical institution. There is power of a parent over a child, of an older brother or sister over a younger one. There are shifting alliances between siblings.
As the parent ages, there is a reversal of the roles of helper and helped, and this can be disconcerting. Strive to find the balance so that the needs of one person do not impinge on the actions of the other.

2. Understand the power of being a good listener. Whether you are the caregiver or care-receiver, in most families we want someone to listen to us and to really understand what we are thinking, understanding, and saying. It is not unusual for family members to realize they have never really known very much about real feelings and values of each other. When we concentrate more on listening attentively, our relationships improve, and so do our communications.

3. Learn to be a good speaker who can clearly express ideas and feelings AND help the listener to hear the message. You can improve your odds of getting your message across if you use I statements rather than You statements. A family member is more likely to continue conversation if you say, I feel upset when you _________ instead of You make me upset when you _____________.

4. Become a problem solver. This does not mean just coming up with the answer, it also means finding a solution. Be realistic in your expectations. Allow siblings to help in ways they are able. Keep them informed and included in the caregiving process.

5. Show appreciation and gratitude. Human nature tells us that people respond favorably to those who show them genuine appreciation and gratitude. Just a simple thank you or apology can go a long way. Make a decision to make a positive impact on those around you.

If poor family communication is hindering your decision making process, it may be a good idea to hold a family meeting with a formal decision making process. You may have to enlist the help of an outside facilitator.

Posted on March 28th, 2010 by Peter
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When the time comes for a senior to need additional care services in their home or in an assisted living community, you will have the option of hiring a senior home care agency to provide the services or finding an independent caregiver to hire directly.

Which is the right choice?It is far better to hire a quality senior home care agency to provide care services unless you are the rare individual who has adequate insurance coverage along with a care support team of family and friends to help direct and support the independent caregiver and provide back-up care when they need a day off.

Senior care is far different from child care. A family can successfully hire a nanny as an independent contractor to care for their children. This is because the parents are there every morning and every evening to supervise and monitor the care. In addition, the parents make sure the children understand the nanny is in charge. It isn’t the same with senior care. There is usually no one else supervising the care. Seniors are older than their caregivers and because of this, sometimes do not choose to easily cooperate. When memory loss and other illnesses are present, the senior can become extremely difficult. They may know they need care but still be emotionally resistant. This creates a problem for the caregiver and for the family.

A senior home care agency solves this issue by providing a supervisor or case manager to manage the care and support the caregiver. They also provide a substitute caregiver when the regular caregiver needs a day off. And even more vital, the senior care agency is available for the caregiver to call when difficult situations arise (the senior won’t take their medications, the senior won’t take a shower, the senior won’t let the caregiver in) or when they have survived a trying day (especially important when caring for seniors with Alzheimer’s Disease).

This additional team support manages caregiver burnout and stress. It also prevents the negative situations which can develop when care issues are not addressed by a third party. Unlike child care, senior care involves managing many life issues such as dealing with the death of loved ones, adapting to new medical conditions and coming to terms with the aging process. And just as special training in children’s education makes for a better nanny, special training in caring for specific age-related diseases makes for a better caregiver.

Senior home care agencies provide training and supervision for their caregivers. They also create a Care Plan for the daily routine to make sure the correct needs are being addressed. The care manager can also address changes in medical conditions to the family members to make sure the senior has appropriate doctors, medical equipment and other services to make their situation as comfortable as possible.

Another challenge with a direct-hire independent contractor is insurance and tax issues. Most home owner policies are limited in covering employees in the home. There are people who seek out work with seniors who know the opportunities that exist. One senior client my agency began care services for had previously hired an independent contractor caregiver who had been with her for more than a year. The senior was a widow with no family living nearby. Over the course of the year, the caregiver took out credit cards in the seniors name and used them for their own purchases. The invoices went to the financial manager who did not question them. The caregiver took many liberties with the petty cash purchases and the client’s care was not their main concern. I have many more stories of starting care after a hire-direct had first been hired. Some families believe they will save money by negotiating a lower hourly fee, but this is rarely the case. Another client my thought they were paying their independent caregiver less than the agency fee but it turned out the caregiver would take $20 every time they ran a grocery store errand and charge the senior an extra fee for laundry and transportation. Many opportunities exist when no active management is involved.

Many people who hire nannies as independent contractors use a nanny agency for some of the same protections a senior home care agency offers. Maria Katris, owner of Nanny Boutique, says “Many clients repeatedly told me the value of using a nanny agency was in the background check, screening of the nanny candidate and access to additional resources such as our tax information. There is simply one more layer of assurance before allowing someone to work in your home with your loved ones. Furthermore, our clients were very aware of the tax liability involved in hiring a domestic employee and did not want to risk their careers by not paying taxes. We aided them in achieving this goal through education and partnership with a domestic employee tax company.”

It is important to be cautious of “free” background checks. Usually such checks are just a name and address match to a social security number. If a website is advertising a free background check, be sure there is another fee they are charging to pay for this service as a solid criminal background check will cost at least $15 and a thorough background check will be closer to $100. Caregiverlist.com explains background check laws by state and what is typically included in a check.

A senior home care agency, as an employer of the caregiver, provides insurance protection and takes care of all the payroll taxes, as required by law. Worker’s Compensation Insurance will cover on-the-job injuries (they do happen – dog bites, falls, back injuries). As an employee, the caregiver also has added benefits, including being able to collect unemployment benefits if they are laid off, collecting social security benefits when they retire and other agency benefits such as health insurance, training, team support and bonuses. The agency will also carry professional liability insurance and a fidelity bond to cover theft or financial loss.

Posted on March 12th, 2010 by Peter
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The position of caregiver entails a responsibility for giving companionship, support and care to generally an elderly patient. Common responsibilities tied with the position are preparation and presentation of meals, support not only for physical but hygienic needs as well with other expected support depending on the caregiver position.

The caregiver position is not an easy task and generally requires a genuine desire to dedicating themselves to making a difference in the lives of other people requiring their attention and care. Salary of the caregiver position ranges from $7 to $15 an hour based on the attached responsibility, experience and extent of patient care required.

Posted on March 10th, 2010 by Peter
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Finding the right caregiver to take care of your loved is not always an easy task. Here are some key interview questions to help you get started. Be sure to take notes during the interview. Always check the references of at least two final applicants. Do not wait too long to make the offer, as good applicants may find another job. If the offer is accepted, the caregiver and the in-home helper should set a date to sign the contract and begin work. Both employer and employee should keep a copy of the contract.

1. Name, address, home phone number, cell phone number, and the best time to call.
2. Do you smoke?
3. Do you have a driver’s license? If yes, do you have reliable transportation and insurance? How far from here do you live?
4. Do you have any CPR or first-aid training? Do you have any formal caregiving training?
5. Do I have your permission to run a background check?
6. What type of position are you looking for? After reviewing our job description, is this the type of position you are looking for?
7. Can you perform the duties required for this position?
8. Are you comfortable with pets?
9. Are you able to work the hours needed?
10. When are you available to start working?
11. Do you have any medical conditions to prevent you from heavy lifting? Would you be able to transfer someone from a wheelchair into a car or onto a bed?
12. If we are delayed, go out of town, or go on vacation would you be able and willing to adjust your schedule?
13. Where was your last job? How long were you there? Why did you leave? May we contact your past employer? Please provide contact name, phone number, and email address.
14. If meal preparation is needed, what kind of food do you cook? Have you had experience cooking for other people
15. How do you feel about caring for an elderly/disabled person? Or a person with memory problems?
16. How do you handle people who are angry, stubborn, or fearful?
17. What type of diagnoses have you cared for?
18. Is there anything in the job description that you are uncomfortable doing?
19. Give an example of a difficult situation you handled with a client. For instance, how did you handle refusing to take a shower?
20. What time commitment are you willing to make to stay on the job?
21. Will you keep daily records? Do you know how to use a computer?
22. Why should I hire you?
23. Are you willing to sign a contract saying you will not accept money or gifts from my parents?
24. How will you keep the family informed?
25. Can you give me two work related and one personal reference?

When you hire a caregiver be sure to provide an employment application, W-4 tax Form, job description, and summary of the care-receiver’s condition. Ask the caregiver to provide written references, completed employment application, completed W-4 Form, and signed copy of job description, copy of driver’s license, car registration, and insurance.

Posted on March 5th, 2010 by Peter
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Depression in caregivers is very common. The complex role of many caregivers comes with several responsibilities that could create stress to them. They may have to give up their jobs, may experience social isolation, and have trouble coping with the diagnosis or experience psychological problems themselves. Their time to relax and time for their interests have decreased or lost. No matter how caregivers love their job or care for the people they look after, it is still possible that you experience low moods.

Low moods often develop into depression. Depression can be caused by many reasons. It could be a result of life situation, like stress or disease. Most of the times, depression is caused by uncontrollable stress. To get the clearer picture, let me give you an example. Anyone who is going through an unpleasant event, in which they think their efforts will not affect the result, can definitely stress you out. Caregivers are the ones most affected by situation like this. Caregiver depression is associated with the demand of their jobs. In the case of disease, such as Alzheimer’s, a patient may need constant attention from family members for a long period of time, resulting to an intrusion to a caregiver’s life.

You may regard caregiver depression as an extension of low moods that most caregivers experience at some points of their career. Depression has great effects to our lives in so many ways. It is important that you know what the symptoms for caregiver depression in order to get immediate attention before the condition worsen and lead to more interference in caregiver’s life or life-threatening situation. Here are the symptoms of caregiver depression:

* Feeling of intense sadness, anxiety, insensibility, guilt or a combination of all of them

* Recurring negative thoughts

* Inability to focus

* Loss of interest in people and the things around you

* Constant mood swings

* Experiencing thoughts of causing harm to yourself or to others

* Chronic fatigue

* Loss of interest in appearance

* Tend to get very agitated

* Loss of interest you once loved and enjoyed

* Experiencing changes of your sleep pattern

* Loss of appetite

* Gain or loss of weight

* Constipation

Because caregiver depression is associated with uncontrollable stress and is common that means you are not the only one suffering from this condition. And since, most types of depression is treatable, you have a great chance of regaining control of your life. So, don’t waste your life over anything and don’t let depression get into you. There are other people who need your care and attention, which is reason enough for you to get on your feet and overcome depression.

If you feel that no matter how you care about your patient and your efforts do not pay off in making your patients get better, and you feel sad, guilty, disappointed, or helpless, it only means one thing – you are under uncontrollable stress. It is what you call caregiver depression and it should be taken care of immediately in order for you to continue the job you love and enjoy doing. How can you offer and provide care if you, yourself, have an issue to resolve to. Not everything that happens within the scope of your job is your responsibility. I can’t stress this out as too much for you. A doctor who knows about depression is the one who can really help you with your problem in addition to your willingness to recover.

Posted on February 14th, 2010 by Peter
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First thing to do to understand the behavioral symptoms of people with AD is to try rationalizing the person’s behavior, which may be the result of the environmental factors of extreme weather conditions. Loud noises also affect the behavior of people afflicted with AD that may overwhelm them due to the excessive stimulation from the noisy environment.

A common reason for the display of behavioral symptoms is that they cannot express a need that like hunger, thirst, pain or the need to go to the bathroom. Sometimes people with AD get easily irritated when they cannot get nor do things that they want which results in a behavioral display that can be misinterpreted.

Posted on February 10th, 2010 by Peter
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One of the greatest fears of older adults is the loss in independence. That loss is felt acutely when it translates into the need for institutional living. Even the most luxurious congregant living facility isn’t the same as your own home. “Aging in place” is the chief desire of our aging parents, but for some, it just may not be possible without assistance. It is not uncommon for an ailing, frail adult to be cared for by their aging frail spouse, who will soon become ailing as well from the stress and demands of caregiving. Frail seniors who will be facing old age alone may have a poor outcome if living independently.

It is an especially frightening prospect for those of us who have an aging parent in a different city. Imagine having a parent who doesn’t always hear the phone when it rings. How many alarm bells go off in your head when the phone rings off the hook? Are they taking a nap, or lying unconscious on the bathroom floor? Do they have groceries? Did they remember to take their blood pressure medication? When was the last time they took a shower?

Professional help in the home can take many forms, but custodial care (assistance with bathing, dressing, meal preparation, errands, companionship, light housekeeping, etc.) is the type of care most frequently needed by the aging population. This type of care is not covered by Medicare or senior HMO. Long term care insurance is the only third party payer designed for this need and different policies have different allowances.

When arranging for care, realize that care might not have to start out all day, everyday. Examine what the actual current level of need truly is. Which of the tasks necessary for safe and healthy home living are no longer able to done independently? It might just be assistance with meals, trips to the doctor’s office, or the occasional outing for exercise and mental stimulation. On the other end of the spectrum, however, it might be that an individual is so frail they are no longer able to safely bathe and dress themselves. Perhaps knowing that someone is awake in the house at night for assistance with trips to the bathroom offers a sense of security. Care can be provided in a shift-work, live-out arrangement from 4 to 24 hours per day, or live-in. Costs vary according to the level of care (e.g., simple companionship vs. providing personal care). These needs can change over time and caregiving can be flexibly arranged to match the need.

Another consideration is whether to use an agency or hire privately. There are obvious advantages to dealing with an agency. The staff are pre-screened for you. Additionally, if an agency caregiver is ill or on vacation, another caregiver can easily be substituted. An agency handles the payroll taxes and workers’ compensation coverage for its employees. Inquire if the agency utilizes employees, or are their caregivers “Form 1099″ independent contractors. Be aware that for the latter, the client will be responsible for the payroll taxes and must be certain that their home owner’s insurance will cover workers who may get injured while in their employ. This will also be true if the caregiver is hired privately.

Another advantage to working with an agency is they will help the client adjust during the initial phase of having a caregiver in the home. To some fiercely independent seniors, having a caregiver is seen as an affront and they will work very hard to sabotage the relationship. They will find fault with everyone. (“You sent me someone with blue eyes! I can’t be cared for by someone with blue eyes!” Yes, it’s happened.) That can mean a revolving door of caregivers until they become accustomed to having someone in their home. Ultimately, regardless of the route taken to hire a help in the home, to quote a popular commercial, “Finding the right caregiver – priceless.”

Posted on February 3rd, 2010 by Peter
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Caring for one’s loved ones is a tough job that requires a lot of responsibility. As a family caregiver, not only do you have to manage your loved one’s health and medical needs, you also have to manage their daily living needs, including legal, financial, and social concerns. Judging from the important issues listed above, it is not hard to see that caregiving is often difficult, exhausting, and emotionally upsetting. Many times it feels like the care-receiver makes too many demands on the caregiver. At the same time, the caregiver still has to deal with her/his own responsibilities of work, marriage, and child rearing/parenting. In addition, the care-receiver and the caregiver may not see eye-to-eye regarding how caregiving situations should be handled.

Stress can be exhibited in a number of ways: physical symptoms such as muscle tension or increased blood pressure, behavioral symptoms such as depression or verbal or physical abuse, emotional symptoms such as the inability to concentrate, or loss of self-esteem, or participate in escape activities, such as excessive alcohol or drug use. To better manage stress it may be necessary to modify the source of stress and/or change your reaction to it.

To combat any stress that comes with being a caregiver it may be advantageous to keep a stress journal, noting events and issues that triggered a feeling of stress. Laughter, exercise, breathing techniques, meditation; guided imagery or visualization, yoga, music, a long, hot bath and other simple remedies are available to relieve stress. The main thing is that caregivers need to realize they must take care of themselves as well, to not let stress get to them. Otherwise, you’ll fail as a caregiver and be left with your own physical or emotional pains.

To avoid the stress of caregiving and, what I like to call, “caregiver burnout” it is important to share your feelings about your caregiving experience. Find someone you can talk to about this. Support groups are a sure-fire method of finding someone with whom you can talk.

Ultimately, there are eight steps a caregiver must focus on to control those things that cause stress:

1. Become aware of your stressors and your reactions. Don’t gloss over your problems.

2. Recognize what you can change and change what you can.

3. Reduce the intensity of your emotional reactions to stress. Are your expectations accurate?

4. Learn to moderate your physical reactions to stress. Take deep, slow breaths.

5. Build your physical reserves. Exercise.

6. Maintain your emotional reserves. Be kind to yourself.

7. Find someone to talk to about what you’re feeling. Join a support group.

8. If you cannot change the situation and cannot change the way you view the situation, you can still manage stress by mastering other skills. You can learn to “turn off” your stress.

Achieving the ability to turn one’s stress off is an important component to being the best caregiver possible. This is a difficult task to undertake with immediacy, however, it is something that can be achieved by following the steps and passages listed above.

Posted on January 31st, 2010 by Peter
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What is a “caregiver“? Someone who is involved in helping someone else manage to carry out the tasks of living. It sounds so simple, doesn’t it? For the caregiver, it is anything but easy or simple.

Let’s be honest. Being a caregiver is a tough job. Being a caregiver to aging parents is even tougher. Not that we don’t love our parents. Of course we do, or trust me, we would not undertake the caregiver role.

It’s stressful because of a lifetime of family dynamics. The emotions and memories, happy or sad, have a way of coming to the surface when least expected.

Who knew that providing TLC to loved ones could be this stressful? How stressful is it? Well, caregivers are at an increased risk of depression and burnout.

Symptoms of both tend to mimic each other. One contributes to the other. Sort of the age-old puzzle…”Which comes first? The chicken or the egg?”

~~~Signs of Caregiver Burnout~~~

anxiety irritability anger exhaustion self criticism trouble at work trouble in relationships substance abuse feeling overwhelmed apathy for usual activities depression
~~~Things To Do For You~~~ always talk with your doctor vent to support network speak with therapist call local senior service organizations utilize programs to assist caregivers join support groups arrange “home care” visitors get respite care do not neglect nutrition try to get at least 7 hours of sleep a night take time to do something you enjoy you must find humor in everyday events Of course, each caregiver’s situation is unique. Some may be handling the responsibilities from thousands of miles away. Coordinating and managing elder care over the phone and making visits. Some live near enough to try to run two households. And, others have one or both aging parents residing with them. Whichever caregiver role you are in charge of, you have to take care of yourself. And I know it’s way easier for someone to offer well-meaning advice than it is to carry out.

But you have to try. Depression and burnout are serious conditions. How sad and unfair to have this happen to you when you are trying to make the last years of an aging parent as pleasant as possible.

(c) 2007 Karen Cook

Posted on January 31st, 2010 by Peter
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To care for yourself is easier said than done when you are the caregiver of a seriously ill child. Add to that other children, a spouse, cooking,cleaning,laundry,appointments, pets, church, other family members or an outside job and taking care of you goes to the bottom of the list. Here are a few tips to put you at the top again without feeling guilty.

1. Delegate…. There is no rule that says you must do it all, whether you are the mom or the dad. Let others help, delegate smaller age appropriate jobs to the other siblings, and divide chores with your spouse. And that includes the care for the sick child. No one person can do it all.

2. During times of acute illness, have prepared or prepackaged meals on hand in the freezer. There is nothing wrong with a frozen pizza on occasion. Or make simple meals like scrambled eggs and bacon or pancakes. Have fresh fruit on hand too, for a quick pick me up and an easy snack for you.

3. Do household bills on the same day each month instead of several times a month. When your child has been ill, the days and weeks run together so it is easier to plan on one day for bill paying. You are less likely to miss a bill and it is less stressful.

4. Plan to handle emails, phone calls, and other household business the same way… on one day each month or one day each week. Assign a spokesperson for the family for the other times during the month saving your time for your child or for rest for yourself.

5. Utilize the social service department of your child’s hospital and don’t let pride get in the way if your family needs something extra. Social workers are trained to help families deal with the stress of a chronically ill child and they can meet with siblings, help find financial solutions, and liaison between family and friends.

6. Leave the guilt behind when you have a few minutes to yourself. Enjoy a hot bubble bath, savor a meal prepared by someone else, or just be content when another has cleaned or done laundry, even if it is not up to your standards.

Give yourself permission to relax or read or just sit quietly listening to the birds a few minutes everyday. It will go a long way to keeping you sane and refreshed.

Posted on January 25th, 2010 by Peter
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