January 2022
Caregivers: What you need to know
Caregivers provide necessary support to someone who, due to age, illness, physical or mental, or some other factor, cannot care for himself or herself. Caregiving may involve shopping, housekeeping providing transportation, feeding, bathing, toilet assistance, dressing, walking, coordinating appointments and medical treatments or managing a person’s finances. Becoming a Caregiver is not something that you think about and normally plan for. Chances are that your introduction will be in the form of some emergency. Your husband/wife has a stroke, or your mother fell and is in the hospital, or maybe it’s cancer, or a car accident or a
devastating diagnosis of dementia. Suddenly you are faced with decisions on how your loved one will receive the care that they need and choices about how much change /impact that will cause in your life.
We are facing a caregiving crisis nationally: The forecast for long term care is that 70% of Americans will need nursing home or home health care for three to five years. Private nursing home will cost about $100K per year for a private room. Adult Day Care will cost about $20K per year. Medicare/Medical do not provide support for these expenses. Medicare/Medical nursing facilities are facing unprecedented waiting lists for placement and as a result, force families to provide at home family caregiving. Additionally, Covid has created a shift to a model of out of hospital/nursing home care, that depends on competent home caregivers, but there is little educational support or financial help to support that new caregiving model.
Getting Educated is the first step in providing effective care.
How do I know if my loved one needs a caregiver?
Some signs that an elderly adult may be in need of caregiving include: increased forgetfulness, decreased mobility, weight loss, poor hygiene, inability to drive, difficulty keeping house clean and organized, increased number of accidents or falls, and feelings of isolation or loneliness. A senior may also need a temporary caregiver when recovering from surgery or a health emergency, like a stroke or heart attack.
What Is unpaid caregiving? At least 44 million Americans provide unpaid care for an adult or child, according to a report by the National Alliance for Caregiving and AARP. Women are much more likely to take on the caregiver role, although many men do it as well. Sometimes the patient/loved one stays in their own home and the caregiver checks in both in person and by phone or technology. Others bring the patient/loved one full time into their own home to provide support and assistance. Most often the patient/loved one is a parent, spouse, or child (of any age) with special medical needs. To provide unpaid care is often an act of love and
devotion, but it can also be a tremendous drain on one’s physical and psychological resources. Caregivers frequently feel on call 24 hours a day, 7 days a week, which can cause great stress and anxiety. Caregivers must pay particular attention to their own needs, or they risk burning out and being of no use to their loved ones. One of the most influential factors in a family’s decision to move an ailing relative to a long-term care facility is the caregiver’s own physical health.
There can be an enormous toll to family caregivers: It impacts finances, health and wellbeing. Finances: There is out of pocket expenses associated with home modifications, transportation, lost wages, and daily supplies like shampoo/lotions/speciality diets. Health can be impacted by the added stressor of home caregiving and exacerbate health issues like high blood pressure, heart disease and even cancers. Family caregivers contribute $470 Billion in unpaid labor in the US. This means caregivers are not considered in the workforce, do not receive compensation and are unable to join the paid workforce to help support their families.
Caregiver burnout: Burnout is characterized as chronic stress, according to the World Health Organization. Over time, the caregiver’s sense of self-efficacy, idealism, and pleasure will diminish, and they will find it hard to cope, and can experience symptoms such as exhaustion, disrupted sleep, anxiety, headaches, and stomach upset, as well as irritability, numbness, a decreased sense of purpose, emotional disconnection, and problems with personal relationships. Caregivers are also more likely to be depressed, especially when the person they care for suffers from dementia. Such individuals may secretly self-medicate with alcohol, drugs, gambling, or food. Balancing the needs of the family and the self is key for caregivers. Experts urge family caregivers to create a plan for maintaining their health, including regular medical checkups and scheduled respite from their roles.
What Is Paid Caregiving? In some cases, it makes the most sense to hire an in-home caregiver, either part-time or full-time, to help a loved one. The caregiver helps with nonmedical everyday needs, such as assisting them with moving around and personal grooming, reminding them to take their medications, preparing meals, and even light housework. A paid caregiver can be hired directly or through an agency, which will vet and train them. California has Medicare and Medical that can help pay for some of the paid caregiving if certain requirements are met.
What kind of long-term caregiving services are available? Long-term care is provided at facilities, such as nursing homes, assisted living homes, and adult day cares. The following describes the speciality of each:
-Skilled Nursing Home/Rehab Facility: Whether your loved one is recovering from an illness, injury, stroke, or surgery, rehab can help them regain strength and mobility. It can also improve physical and cognitive function.
• Skilled Nursing Facilities provide short-term, temporary housing, 24-hour skilled nursing services, and medical care to elderly adults who need rehab after hospital
discharge.
• Inpatient Rehab is offered at special hospital units dedicated to rehabilitation services.
The same rehab services offered at skilled nursing facilities are provided at inpatient rehab centers, including nursing care, orthopedic rehabilitation, physical, occupational, and speech therapy, and more. However, programs at inpatient rehab centers focus on acute care for elderly adults who need more intensive treatment and recovery. (Rehab at an inpatient rehab center may be covered by Medicare, but a deductible may be assessed. Medicare coverage may include shared rooms, meals, medications, nursing care, and different therapies.)
-Assisted Living and Nursing Homes:
• Assisted Living facilities were created as an alternative to nursing homes and are typically made up of individual condominiums within a larger community that provides meals, housekeeping, occasional nursing visits and other services. Many of the newer facilities require a large buy-in ($ hundreds of thousands) plus monthly fees that increase as the daily needs of care increase.
• Nursing Homes, also known as skilled nursing facilities, provide a wide range of health and personal care services. They typically offer 24-hour supervision, nursing care, three meals a day, and assistance with everyday activities. Rehabilitation services like physical, speech, and occupational therapy are generally also available. Nursing homes offer a high level of daily care for residents who need it, including helping them dress, get in and out of bed, and go to the restroom. Nursing Homes cost close to $9K per month.
-Adult Day Care: Adult day services, also called adult care, are typically open during normal work hours. Unlike senior centers — which are usually sponsored by recreational departments and targeted at healthy older adults — adult day services are a resource for people with physical limitations or limited functioning due to memory loss.
Tips for when you choose to become the caregiver
1. Get educated from the start. Learn about the diagnosis can better equip caregivers along the way. Resources , such as support groups, such as Open Our Hearts Family Group, advocacy groups, such as NAMI, Family Caregiver Alliance, books and the experiences of others can all help with the learning process.
2. Pay attention to how you react to stress. Stress affects our holistic health. Once you know which situations cause you stress, you will be better prepares to cope with-it when it happens.
3. Maintain your physical health through exercise, eating well and getting enough sleep. Improved physical health corresponds with improved mental health.
4. Gather strength from others and get the support you need. Lack of support may lead caretaker’s to feel isolated and impact his or her own well being. Creating a support system is considered a factor in reducing psychological distress when faced with stressful events. Simply setting aside time to vent with people in your social circle or connecting on topics other than your loved ones illness can aid in your overall mental
well-being.
Caring for a loved one is an act of loving kindness. We want to honor our aging family and dependent loved ones and provide the care and support to live comfortably to the end of their life. We want to be there in every way to provide the love and attention they deserve, but we can’t do it at the expense of our own health and care. Each of us that face this responsibility will struggle with the balance between our own self care and those that we love. We will educate ourselves about the choices and make the best decision we can based on our capability and finances. We will be there for our loved one in the best possible way we can be. And, we will plan for the future, our own future, and make decisions today that will help give us a voice in our own longterm care.
RESOURCES: When your loved one is being discharged from the hospital a Discharge Planner will meet with you to recommend a caregiver plan. They can be a great asset to you to plan what to do and where to go. You have choices and can often pick the facility or choose family caregiving. Do the research and and be prepared for that discussion.
Family Caregiver Alliance
https://www.caregiver.org/resource/top-17-resources-for-family-caregivers/
Home Care Assistance
https://homecareassistance.com/caregiving-services/hourly
P’tach Libeynu Support Group for Family Members
Questions? Contact: .(JavaScript must be enabled to view this email address) or (925) 988-9707.
David Chen, Caring for the Caretaker, Psychology today, 12/29/2021
https://www.psychologytoday.com/intl/basics/caregiving