Understanding the Roles of Formal and Informal Caregivers

Formal caregivers are typically paid providers but they may also be volunteers from a government or nonprofit organization. Where care is being provided in the home there is often a mix of formal and informal care provided. And the trend is towards using more formal care since, unlike the past, more informal caregivers are employed. They choose to remain employed but must juggle limited time between caregiving and maintaining a household and a job.

These added responsibilities often make it necessary to hire non-medical home care aides to provide supervision and help when the primary caregiver cannot be present. Or as adult day services become more common, caregivers may pay for this form of formal caregiving to get rest or to allow for maintaining some employment.

When care is no longer possible in the home, then formal caregivers come into play on a full-time basis. This may be in the form of a congregate living arrangement, assisted living, a continuing care retirement community or a nursing home. It is at this point that long term care can have a significant impact on the finances of the care recipient and a healthy spouse living at home.

Care facilities are quite expensive and the cost for maintaining a spouse in such a living arrangement may rob a healthy spouse at home of an adequate standard of living. It's quite possible the healthy spouse may end up with food stamps and subsidized housing where, before the need for a care facility, this may not have been the case.

Or it is more often the case that the couple recognizes this dilemma of splitting living arrangements in two locations and an attempt will be made to keep the spouse needing care at home as long as possible. This may help with the finances but often results in destroying the physical and emotional health of the caregiver by creating a situation where the caregiver has difficulty coping with the responsibilities and physical demands.

Another reality of providing informal care services in the home is the increasing need for physical and emotional support that often goes unrecognized until too late. As care needs increase, both in the number of hours required and in the number or intensity of activities requiring help, there is a greater need for the services of formal caregivers.

Unfortunately, many informal caregivers become so focused on their task they don't realize they are getting in over their heads and they have reached the point where some or complete formal caregiving is necessary. Or the informal caregiver may recognize the need for paid, professional help but does not know where to get the money to pay for it.

Other members of the family should be aware of this burden and be prepared to step in and help their loved one who is providing care recognize the possibility of becoming overloaded. It is also the job of a care manager or a financial adviser or an attorney to recognize this need with the client caregiver and provide the necessary counsel to protect the caregiver from overload. The advisor can also likely find a source for paying for formal care that the caregiver may not be aware of.
An overloaded caregiver is likely to develop depression and/or physical ailments and could end up needing long term care as well. The consequences of not being able to cope with the burden of caregiving might even result in an early death for the caregiver.

Tips To Help Patients With Alzheimers

It is a little known fact that as many as 5.3 million Americans are living with Alzheimers disease and this number is expected to more than double by 2050. Alzheimer's destroys brain cells, causing memory loss and problems with thinking and behavior severe enough to affect work, lifelong hobbies or social life. Today, Alzheimers disease is the seventh-leading cause of death in the United States. Sometimes called Senile Dementia or simply Alzheimer's, Alzheimers disease is the most common form of dementia. Most people diagnosed with Alzheimer's are over age 65, but it can occur in people in their 40s and 50s. Alzheimers gets worse over time, and it is a fatal disease. The time from the beginning of symptoms until death ranges from 3 to 20 years with the average being 8 years.

Alzheimers affects entire families, especially as the disease progresses and affected individuals become more dependent upon their primary caregivers. In treating Alzheimers disease, it is common practice to include a professionally trained caregiver that will work with the patient and the family. According to Angela Graczyk, who is a Registered Nurse and Field Trainer with Always Best Care Senior Services, a solid relationship between the family and caregiver of a patient with Alzheimers disease is an essential component of providing effective treatment and care. Graczyk also says that a person communicating with an Alzheimers patient can find it to be very challenging. She notes, however, that decreased verbal communication does not mean decreased awareness. Most patients are very aware and feel a great deal of distress about their increased loss of ability.

Many homecare providers, like Always Best Care, provide tips to help persons working with an Alzheimers patient. Some of which include using memory aids such as labeling objects (i.e. closet, bathroom) and being aware that as Alzheimer's disease progresses, an individual's ability to name objects and use words decreases. Other tips include simplifying the environment for Alzheimer's patients and eliminating distracting noises such as the radio or television, or loud conversation. Families also should be aware that their loved one's ability to function and cope will steadily decline and may even vary from day to day. Flexibility is crucial. An Alzheimers patient may no longer find their favorite food appealing or may insist on wearing the same outfit every day. When this happens, simply change the menu or consider buying a few identical outfits.
There is also no single test to identify Alzheimer's disease and the causes are not known. Suspected causes, however, include genes and environmental exposure. A complete medical evaluation will provide a correct diagnosis of possible or probable Alzheimer's 90-percent of the time. Although there is no cure for Alzheimer's disease at present, there are FDA-approved drug treatments, designed specifically for memory symptoms occurring in mild to moderate stages of Alzheimer's disease. In addition, groups like the Alzheimers Association work for the advancement of research for this deadly disease. The organization also provides and enhances care and support for all affected as well as helps with programs to reduce the risk of dementia through the promotion of brain health.

For more information on Alzheimers disease, consult your local healthcare provider or visit alz.org.

By: Carolina Moore

Activities For Dementia Sufferers in Santee CA

My Elderly Parent Has Dementia: What Activities Can We Do Together?
by Emilee Seltzer

Caregivers for the elderly with dementia often find that coming up with activities for the elder can require much thought and effort. But they are vital to your parent’s health and well-being. Creating activities can really be quite simple if you follow some general guidelines.

Create meaningful activities

    * Consider their interests
      Depending on how severe your parent’s dementia is or their stage of Alzheimer’s, activities can vary; however, designing activities that involve their past interests are of the utmost importance. For example, if they love to garden, foster that passion with stimulating gardening activities.

      What if your parent does not have either the physical or cognitive capability to engage in activities they once loved? Beth Kallmyer, Director of Family and Information Services for the Alzheimer’s Association, recommends adjusting activities to fit their abilities. If your parent loved gardening but no longer has the mental ability to engage in it independently, consider assisting them or simplifying the activity. You can go outside with them and do planting and gardening together, or you can bring a few pots with seeds inside the house for your parent to water daily.

Continue reading HERE. 

If you need help with a loved one with Dementia in the Santee CA area, please visit www.inhomecaresandiego.com.

 

Credit: Always Best Care Senior Services – San Diego California (CA)

In San Diego CA, Have Family Meetings to Resolve Eldercare Issues

Having Family Meetings to Resolve Eldercare Issues

A crisis can bring a family closer together and illustrate strength and love; or it can drive a wedge of resentment between members.

Whenever a loved one’s heath, safety or wellbeing becomes a concern, it is important to be proactive and address your loved one’s issues. If the issues come to a point of crisis, families – often spread out across several states – need to call themselves together to discuss the changes which are occurring and will occur in the future.

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If your family needs help with the care of a loved one, visit www.inhomecaresandiego.com for more information.

Original: Always Best Care Senior Services – San Diego California (CA)

In San Diego CA, Hear The Voices of Alzheimer’s

The Voices of Alzheimer’s

In the latest Patient Voices segment, producer Karen Barrow explores the frightening and confusing world of Alzheimer’s. She captures the voices of both patients and loved ones who are struggling with issues of independence, long-term care and making the most of the time they have left.

Hear the voices of Alzheimer’s at the HERE.

If you are needing care and assistance for a loved one in San Diego, visit www.inhomecaresandiego.com.

Credit: Always Best Care Senior Services – San Diego California (CA)

Caring For Yourself and Your Spouse In El Cajon CA

Spouses Face Challenges in Caring for Themselves and Their Ailing Partners

They met on a blind date in 1949 and married two years later. They lived in the same Cape Cod-style house in Silver Spring for nearly 50 years. So when Leonard Crierie was diagnosed with Alzheimer’s disease in 2005, there was no question that his wife, Betty, would take care of him at home for as long as she could.

Betty led him into the shower, helped him dress each morning and took him everywhere with her because, once he started wandering, as some dementia patients do, she dared not leave him alone. She learned how to change the colostomy bag he wore since he’d survived rectal cancer years earlier. She slept, fitfully, with a monitor by her bed so that she could respond if he
needed her at night.

“It was difficult, but I was able to take care of him,” says Betty, now 80. “Because it happens slowly, you don’t realize how bad it’s getting.”

She agreed to have Leonard attend an adult day program at nearby Holy Cross Hospital — he enjoyed socializing there — so that she could get a few hours’ break several times a week; she found a Holy Cross caregivers support group very useful. But she refused the pleas from her three adult children to hire an aide to help at home. “I always felt like I had it under control,” she explains, though her children thought the $18-an-hour cost also troubled a frugal woman who shops at dollar stores.

As the months passed, “we could see the stress level affecting her,” recalls her daughter Linda Fenlon. “The frustrating part was, we wanted her to have some independence, some quality of life. But she saw it as her duty in life to take care of him.”

For four years, Betty Crierie rarely asked for or accepted her family’s help, until a Wednesday last June. As she left her support group meeting, she remembers, “I got this funny feeling in my chest.” It worsened on the 10-minute drive home. She called her daughter and said, “I’m calling 911. I think I’m having a heart attack.”

Caring for a sick or disabled elderly relative exacts a toll — physical, emotional, financial — on any family member, but being a spousal caregiver brings particular challenges.

“Spouses are older and dealing with their own age-related health limitations,” says Steven H. Zarit, a Pennsylvania State University gerontologist. The tasks they shoulder have grown more demanding: Family caregivers now administer arsenals of medications and undertake procedures, from wound care to dialysis, that were once the province of medical professionals.

Continue reading…

If you need care and assistance for a loved one in the surrounding San Diego area, visit www.inhomecaresandiego.com.

By: Always Best Care Senior Services – San Diego California (CA)

In Santee CA, Can We Stop Mom Sundowning?

Can We Stop Mom Sundowning?
By Frena Gray-Davidson

It’s called sundowning because, traditionally it tends to begin around sunset. It’s the agitation time, which affects many who have dementia. It typically continues for a couple of hours and then may pass. It is most likely to start in late afternoon, although some people begin earlier and others reported as starting in the morning.

That’s untypical. It’s also untypical that someone begins agitated behavior in late afternoon and then continues all night long, but it happens. Whether that should really be called sundowning is something for a medical expert to decide. If I were a caregiver to someone with dementia whose behavior included agitation all night long, I’d be getting the help of a good psychiatrist.

Families tend to attribute everything to Alzheimer’s dementia, whether it is or not. You have other conditions as well. You could have Post Traumatic Stress Syndrome and Alzheimer’s. You could have flashbacks and Alzheimer’s. So it’s very important not to blame everything on the dementia.

Sundowning needs a multi-faceted approach because we don’t know exactly what causes it. We can make good guesses though.

Five Possible Causes of Sundowning:
1. Fatigue
2. Hunger
3. Dehydration
4. Disorientation
5. Loss of purpose, belonging and sense of security

In my 20 years of working with people with dementia, Alzheimer’s and other dementias, I’ve learned that we can make affective care plans for sundowning. Each plan is particular to each person, but every plan should include some or all of the following.

The Sundowning Care Plan:
1. Study the typical pattern of your person’s sundowning
2. To decrease fatigue overall, encourage sleeping later and having a nap after lunch, if possible
3. Give a nutritious snack of, for example, banana bread and a sliced apple about an hour before normal sundowning time
4. At the same time, give a natural juice drink and plenty of water
5. Listen attentively to the feelings expressed by your person during time of agitation to learn what emotional issues are unresolved
6. Remember that, in sundowning, this person expresses real issues with which we can help
7. Plan for diversion at the expected sundowning time and increase emotional support
8. Use environmental support — music they love, lavender oil diffused into into the air (notably effective in reducing emotional stress responses)
9. Understand that agitation can be contagious and that your best contribution is to stay calm

I have been able to recommend this approach to care units, which have found very positive responses from the plan. I and many other family members have found it very affective at home.

It is definitely possible to reduce sundowning time and intensity and even to eliminate it altogether. While you’re working on those results, remember anyway that sundowning tends to reduce and eventually disappear as dementia progresses.

As a caregiver, not as a doctor, I can assure you that we can do a great deal to help as caregivers. However, not all caregivers can do this and that’s okay too. Caregivers can only do what they can do. We are all human and it is out of our humanity that family caregivers undertake the heavy task of caring for a family member with dementia needs.

One last suggestion: it is not usual that sundowning involves violent acting out or extravagant fear reactions. Such manifestations suggest a deeper psychiatric issue. Please don’t hesitate to see mental health specialists if you have questions.

Frena Gray-Davidson is a longterm Alzheimer’s caregiver and her latest book is “Alzheimer’s 911: Hope, Help and Healing for Caregivers”, available from Amazon. Frena presents dementia seminars nationally and internationally. Go to her website at  www.alzguide.com and sign up for her free monthly online newsletter for caregivers. Email her at frenagd@gmail.com

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For information about care and assistance for a loved one in the Santee CA area, visit www.inhomecaresandiego.com.

Original: Always Best Care Senior Services – San Diego California (CA)