How to Cope with an Elderly Parent Who Rejects Outside Help

How to Cope with an Elderly Parent Who Rejects Outside Help

You love your dad. You want to be there for him. But playing the role of full-time caregiver has you exhausted, feeling hopeless and maybe a little resentful.

Your parent is determined to reject professional support. And it’s stressing you out even more.

You’re not alone. Family caregivers are at risk for high levels of stress, exhaustion, anxiety and depression. According to the National Center on Caregiving, this is a major concern. It can lead to feelings of anger, frustration and even resentment.

If you continue to be the caregiver without enough support, you put your own health at risk. The ramifications of burnout are not just limited to health either. Caregiving full-time can cause absence at work, meaning you could ultimately be at risk of losing income and health benefits.

Your well-being is just as important as your parent’s health, and you can provide the best care when you’re mentally and physically rested.

It is important for both you and your loved one that you’re persistent about getting the right layers of support added to your family.

It’s okay to say: “I need help.”

Here are three steps to coping with your parent who refuses help, including some sample conversation starters:

  1. Understand the Importance of Your Own Health

    When an elderly parent has a chronic condition like dementia or feels lonely, you may think taking a break is selfish and unthinkable.

    The reality is that the role of a family caregiver takes a toll on your emotional, mental and physical health. Anger, depression, exhaustion, guilt and isolation are all common side effects of caregiving stress.

    Do not risk further damage to your own health, because your health decline will negatively impact the quality of care for your parent.

    A burned-out caregiver will not be a very effective or sustainable caregiver. (See our guide on 10 realistic ways to manage caregiver stress.)

    Your parent may not be open to outside help because he or she is not fully aware of the heavy burden you’re shouldering. As you bear more responsibilities for your parent, he or she will become even more dependent on you.

  2. Consult with Professional Caregivers

    Plan to find respite care so you can recharge and avoid dangerous caregiver burnout.

    A caregiver can visit your parent’s home to help with things like dressing and bathing, or they can provide transportation to the doctor’s appointments or the grocery. That same caregiver can be a companion who joins your mom or dad for a cup of coffee on the porch or who accompanies your parent to an art class.

    Even if it’s only a few hours a week, that relief window may be one way to introduce your parent to the idea of more home care.

    If your parent still refuses outside help, consider having ongoing conversations. Remember to stress your need to improve both your parent’s life and your own health. Explain patiently how you cannot do this alone forever.

  3. Start Talking

    Below are sample conversation starters. Each scenario is a chance to make your case for recruiting outside help.

    It’s possible your parent is fearful and unwilling to explore elder care options. Leverage support from people you trust — a spouse or a doctor, a family friend.

    Stay positive when having the conversation. Don’t speak out of anger or frustration. With plenty of patience and tact, you may slowly turn the tide.

SCENARIO: You are missing work too many days to be a caregiver.

SAY: I’ve been out from work too many days and I don’t want to risk losing my job. But I worry too much about being here when you need me. I’m wondering how we can figure out the best of both worlds. I’ve been hearing great things about a professional caregiver who can stop in and help you with a few things. Would you be open to that?

SCENARIO: Your parent just came back after a trip to the hospital.

SAY: I’m so glad you’re home. We will work together to help you recover, so you won’t have to go back to the hospital again. We will also need the support of a professional who knows how to help avoid re-admittance. I want to be confident that you’re taken care of when I cannot be there all the time. Let’s talk to this person together. I think you’ll be pleased.

SCENARIO: Your parent sees you are unhappy and overwhelmed.

SAY: I am tired and sad because I haven’t been able to get much sleep lately. Life is really hectic these days. I will need to get away for a short break. But don’t worry. I’ve made sure you’ll still get help. A friendly professional is available for a few days.  We’ll meet this person together.

After a successful conversation, follow up with a trusted professional. Ask for a consultation and to meet a professional caregiver. Start with respite care, then expand to other services as your parent gets more comfortable.

How to Talk to Your Loved One About Driving, Giving Up the Car Keys

How to Talk to Your Loved One About Driving, Giving Up the Car Keys

It’s an uncomfortable situation, but role reversal usually is. At one time in your life, it was Mom and Dad granting or revoking your driving privileges. But as mom and dad age, we realize we have to revisit those tension-filled talks, only this time as the authority.

Nearly 80 percent of adult children call it the single most uncomfortable conversation they could have with their parents, according to a national poll commissioned by Visiting Angels.

In fact, about 25 percent of the adult children surveyed said they would avoid having this conversation altogether — despite safety concerns. But that’s dangerous, and the danger factor naturally increases for senior drivers as aging impairs a person’s reflexes, vision and hearing.

Now the risk of trauma from even a minor accident is too big a gamble. Crashes are often fatal. In fact, senior drivers have higher rates of fatal crashes than almost any other group.

Nearly one in five fatal crashes in 2015 featured a driver who was 65 years or older, according to the Institute for Insurance Information.

Below, we’ve provided 9 signs that it is time for a senior to give up the car keys and how to begin the conversation.

9 Signs It’s Time to Start Driving the Conversation

For the safety of the elderly and everyone on the road, it is wise to have regular, frank discussions with mom, dad or that special senior in your life.

To start, develop a casual dialogue about the quality of his or her driving. Assess if the senior is losing confidence in his/her driving skills. The full picture may not be revealed in one conversation, so keep the dialogue open.

Your loved one should be aware of the potential dangers of extended driving, and understand there are solutions available. Meanwhile, as family caregiver, you should anticipate a sensitive and emotional time for your loved one. Understand talking about giving up the car keys is not easy. It may feel like a loss of independence.

Your loved one may worry about how that change would impact his or her quality of life.  A trusted spouse, adult child/caregiver or doctor may all be helpful in these talks.

Solutions like in-home care could ease you and your loved one’s mind, too. A professional caregiver could provide transportation for appointments, errands and social outings to help your loved one maintain independence.

Here are some sample conversation starters to break the ice, based on signs that National Highway Traffic Safety Administration advises family caregivers about:

Warning Sign: Senior driver gets lost on familiar routes. 
SAY: I’m worried about you getting lost when driving. Looks like you might have gotten distracted and confused. Tell me what happened. We can discuss some safer ways to get around without you getting behind the wheel.

Warning Sign: Senior driver has a near-miss or a recent crash. Near-miss could involve hitting the curb or drifts between lanes. 
SAY: I’m so glad no one was hurt. I don’t want to think about the possibility of you in an accident. Let’s talk about safer way to travel.

Warning Sign: Notice new dents and scratches in the car driven by the senior.
SAY: I noticed some new dents/scratches on your car. Tell me what happened. Let’s explore some safer ways of running errands without you driving.

Warning Sign: Senior driver gets a ticket for a driving violation.

SAY: I’m sorry you got a ticket. It been awhile since we talked about your driving. You wouldn’t have a ticket if you didn’t need to drive. So let’s find a better way.

Warning Sign: Senior driver has a chronic health issue that’s become worse. 
SAY: Seems like it’s time to check in with the doctor. We’ll get your health checked out. Then we’ll pick a way to get you around without you stressing about driving.

Warning Sign: Senior driver drives too slowly or speeds for no reason.

SAY: I feel scared for you when you’re not following the rules of the road. Driving too slowly or too fast is dangerous. I don’t want you or others hurt. Let’s look into ways to take you places without you driving.

Warning Sign: Senior driver ignores road signs and markings when driving.

SAY: When you ignore the signs of the road, it shows me your driving skills are waning and that’s totally OK and normal. There are ways to get you around without you having to drive yourself.

Warning Sign: Senior driver is taking medication that may affect driving safely.

SAY: How are you feeling after taking the medication? I don’t think it’s safe to drive while you’re feeling the side effects. I’ll show you some other ways of getting to your errands. You’ll be much safer.

Warning Sign: Senior driver suffers from an illness that may affect driving skills.

SAY: The best thing is to focus on your recovery. Let’s not think about putting you in any more danger. I’ll show you some ways to get around town without you driving. It’s much safer. And you can relax and not worry.

A Nationally Uncomfortable Conversation

Visiting Angels commissioned a national survey of 400 adults whose parents are both living, 65 or older and currently driving.

Among the findings:

  • 79% of adult children said telling parents they’re taking away the car keys because Mom or Dad is no longer fit to drive is the most uncomfortable conversation they could have
  • 35% said no one should have the conversations with the parents
  • 61% fear their parents will become depressed if they can’t drive
  • 45% say it will in some way damage their relationship with their parents
  • 42% say they worry they’ll now have to drive their parents around

Signs Your Loved One is At-Risk for a Stroke and What You Can Do

Signs Your Loved One is At-Risk for a Stroke and What You Can Do

Count to 40. Someone in the United States just suffered a str­­­­­­­­oke.

Now do that six times. Someone just died from a stroke.

Over 800,000 people will have a stroke annually in America, making it the fifth-leading cause of death and the leading cause of adult disability.

A stroke is an attack on the brain. It happens when blood flow to an area of the brain is cut off either from a blockage or breakage of a blood vessel in the neck or brain.

When blood can’t get to the brain, millions of cells begin to die. And the longer it’s left untreated, the more severe the damage.

That means that the clock is ticking when a stroke hits. Knowing what to look for and how to act is of the utmost importance.

Who is At Risk?

While stroke can strike anyone, women, African-Americans and Hispanics over 55 are most at risk, according to the Centers for Disease Control and Prevention. In fact, stroke kills twice as many African-Americans than Caucasians.

People with a family history of stroke or those who have suffered smaller blockages and strokes are also at greater risk.

If your loved one has recently had a stroke, or if you’re worried someone is at risk, Visiting Angels doesoffer highly customizable home care services.

Caregivers with years of experience treating at-risk patients will provide peace of mind for the family member tasked with daily care for a loved one.

Act F-A-S-T!

Stroke affects the brain, so it’s hard to realize when someone is having one. Detecting the signs of stroke and getting quick treatment is important because medication must be given within the first three hours of the onset of a stroke.

Think F-A-S-T to help detection:

  • Face drooping. Is a part of the face numb or droopy? Is the smile lopsided?
  • Arm weakness. Is one arm weak or numb? Can the arms be lifted or does one drop down?
  • Speech difficulty. Is the speech slurred? Can a simple sentence be repeated?
  • Time to call 911. If any of these symptoms are present, call 911 and tell the operator you are calling to report a stroke. Make note of the time of the first symptoms. Follow the operator’s instructions.

There may be other symptoms, including severe headaches with no known cause, dizziness or loss of balance and vision trouble from one or both eyes.

Strokes Can Be Prevented

Prevention is the path of least resistance. Managing any chronic condition and making healthy lifestyle choices can drastically reduce the odds of stroke.

To manage chronic conditions:

  • Treat high blood pressure. Doing so is the most important way to avoid stroke.
  • Manage diabetes. Diabetes causes destructive changes in the brain’s blood vessels and increase the risk of stroke.
  • Treat high cholesterol. Too much cholesterol in the blood can build up on artery walls, increasing the risk of stroke.

To live healthier:

  • Quit smoking. Smoking cigarettes can double your risk of stroke because it narrows and thickens blood vessels.
  • Eat fruits and vegetables. A diet low in sodium, processed foods and saturated fats greatly improves health.
  • Move more. Regular exercise helps ward off high blood pressure, high cholesterol and diabetes.

If you’re worried that your loved one is at risk or might have suffered a stroke, seek immediate medical attention.

Then understand the different kinds of senior care available for your elderly loved one here.

Move from Caregiver to Daughter Again with Respite Care

Move from Caregiver to Daughter Again with Respite Care

Becoming the dedicated caregiver for an aging parent often doesn’t just strain your schedule — it can strain your relationship with that parent, too.

As your visits become more about keeping the house in order and less about spending time together, it’s natural for tension to arise. While you’re cleaning, preparing meals, handling yard work, paying bills, keeping Dad on top of his medication, trying to get Mom to get some exercise — all while trying to balance your own life — it can all become mentally exhausting.

Meanwhile, your parent likely feels the pain of losing independence. Oftentimes, the care recipient may respond with resentment rather than gratitude for your help.

If you find yourself feeling overwhelmed by the tasks at hand and the emotional burden accompanying them, know that you’re not alone—and there are ways to improve the situation.

We Must Think Big Picture

It’s important to keep the long-term objective in mind.

It may be difficult to discuss — but it’s important to keep your loved one comfortable, safe and happy, knowing that the situation is only going to get more challenging. As your loved one moves toward increased dependence, you know it’s going to put you in a tough position.

Expectations for a loved one will be higher. After all, who would be expected to provide optimal care, optimal attention to a parent if not their own child? It’s unfair that a person untrained would have to shoulder such lofty expectations, and it can definitely strain the relationship.

Understand: There is a solution.

Respite care provides you some rest from this situation as things progress. It can be the perfect introduction to ongoing professional care too, and a way to ease both you and your loved one into long-term care solutions.

  1. It’s Normal to Need Help

    You are not alone. There are over 34 million unpaid caregivers for a parent or loved one. Many of these people have no training and are uncomfortable in this difficult role reversal.

    The emotional toll of watching a parent age can be taxing, mentally and physically. Becoming the caregiver for that parent can quickly become more than one person can bear. It can feel like every ounce of your energy and emotional capacity is going to your mom or dad, and yet there’s still always more to do.

    For many people who have taken on the role of caregiver, it’s hard to accept that they can’t do it all — and no one wants to let Mom or Dad down. But when responsibilities become unsustainable for one person (or move beyond their expertise and experience), it can damage the relationship.

    You can’t pause your life. Your job will still be just as demanding. Your kids won’t need you any less. And your friends will still want to socially interact. Having to constantly choose between your loved one’s comfort and your own life is mentally taxing.

    A professional caregiver changes everything. This is the power of respite care. Knowing your loved one is provided for will help you overcome your guilt. Knowing you need help and finding it, you’re actually doing the right thing for both you and your loved one.

  2. “The Talk” is Easier With Stories

    Needing to bring in outside help? Ease into the conversation with your loved one about home care.

    You may start with small tasks like hiring a neighbor kid to cut the grass at your parent’s home; to set a precedent that it’s okay to hire someone to help.

    If you have friends who sometimes have meals made for their family or who have hired a personal trainer and love it—tell those stories. Bringing the subject matter up even in these tangential ways can help get you ready for the big conversation, but it also may open their minds to the idea of home care.

    Don’t push too hard at first, but keep it a dialogue and be sure to listen. Really listen to your loved one. When your parent starts to become more used to the idea, talk specifics.

    If your parent completely balks at the idea, you may need to have someone else share a story. Does your mom or dad have a friend who has in-home help? Sharing stories of people like them in their situation can help normalize the idea of in-home help.

  3. What Not to Say

    Exhaustion makes patience quite difficult. But remember that your parent’s moodiness is likely linked to shame and sadness about what’s happening—it’s not a judgment on your care, no matter how often it may feel that way.

    Those acting as caregivers for an aging parent often feel guilty for not being able to fix the situation or do it all. And when responsibilities are not evenly shared between siblings, this can lead to even more tension.

    The best solution: Leave all of that at the door. This conversation should not be an all-out airing of grievances. It should be about calmly coming to an agreement about a solution that will make everyone’s life happier—bringing on an in-home caregiver.

  4. Finding the Right Caregiver

    First and foremost, you need a good listener. Before there’s any care plan or consultation, you need someone who will just listen. A professional will consult with you and ask the right questions to help you understand what you and your loved one are going through.

    This is a great opportunity to find the perfect match. You know your loved one better than anyone, so simply look for a good match. Personalities, hobbies, interests – with these in mind, you can enlist the services of not only a professional caregiver, but also a perfect fit inside the home.

    The first caregiver visit can be overwhelming for your loved one. Go into that day with the promise — and stick to it — that you can try several caregivers before choosing a permanent one, and that your parent’s comfort will be the deciding factor in your final choice.

    But do what you can to reduce that number of trials by asking questions first.

    For example: If your mom were to need help bathing, would she be comfortable with a male caregiver? Even though all caretakers are professionals, this is a generational and personal preference that many have. Does your dad prefer someone energetic and talkative, or does he respond better to calm and soothing?

    Remember that this person will be coming into the home — and keeping company with Mom or Dad at times when you can’t be there—and you want to get as much benefit and happiness out of the arrangement as possible.

  5. Return to Your Role as a Son or Daughter Again

    So how do you restore the relationship you had before you became caregiver?

    Some of it will happen naturally. As the caregiver assumes more responsibility, you’ll feel less responsible for everything and more like a son or daughter again. Consider those happy memories from your pre-caregiver days. Is there anything you can recreate?

    Even though Mom or Dad may now have mobility or dietary restrictions, think of ways to revisit some of those important memories, whether it’s dinner at a certain restaurant, visiting a nearby park or even just watching a favorite movie together. Simple acts like this can help to quickly re-establish a relationship.

    Beyond that, you’ll have the time and energy to take better care of yourself and find more balance in your life that will strengthen you mentally and emotionally and allow you to be more present in conversation with your parent. You might find yourself looking forward to visiting mom or dad more, as it becomes less of a stress or burden and more of a joy and expression of love.

There are challenges ahead, and the more support you have, the better.

What to Expect When You Become Your Loved One’s Caregiver

What to Expect When You Become Your Loved One’s Caregiver

You just left Mom’s house after a trip to the grocery store that has now become a weekly tradition.

While putting the food away, you notice some misplaced items in the cabinets. The countertops are cluttered. A few things you bought on your last trip never made it back into the refrigerator.

As you head back to your car and return to work, you never really leave. You worry. What if she leaves the stove on? What if she falls in the shower? What if I’m not there when she needs me?

Caregiving: The Early Days

You might think of it as just helping Mom here and there, and you’re glad to do it for all the times she helped you.

But here’s a key difference between caring for your child vs. adult: When you care for a child, you know this is temporary and you’re helping your child grow toward greater independence. However, when you begin a care relationship with your parent, you must have the understanding your loved one is moving toward a much more significant level of dependence.

Every day, more than 34 million Americans are adjusting their schedules to fill in the gaps for older loved ones, per a National Alliance for Caregiving report.

Some welcome the new role, and some struggle with the role reversal (especially those with strained parent relationships). And for the sandwich-generation caregivers still raising young children at home, the balancing act can be truly overwhelming.

That’s why even in the earliest stages of caregiving, it’s important to recognize the reality of burnout. Yes, wheelchair-to-bed transfers and midnight emergency room visits are physically exhausting. But the emotional expense of caregiving? Sacrificing your schedule might be manageable, but things like seeing a parent experience memory loss after an Alzheimer’s diagnosis, or watching your father wrestle with depression after your mother’s passing is challenging. These transitions are equally draining and contribute to caregiver burnout.

It’s never too early to enlist caregiving help.

Solicit advice, even a professional consultation. Part of being a caregiver means planning ahead. This could help you understand the landscape of senior care; including what solutions might fit you and your loved one — now or in the future.

If you meet with a professional home care provider, you’ll also begin forming a relationship so you have a ready resource when something might happen — a fall, a hospitalization, a diagnosis.

That person might even provide some relief sooner rather than later.

For the parent living alone, a friendly visitor even twice a week can make a life-changing difference. For the caregiver who can’t leave work early on Mondays or Wednesdays to help Mom make dinner, a professional caregiver who can prep, serve and clean — and offer conversation and good company while dining — may be the ideal solution.

In some cases, a parent may be more receptive to professional caregiver than to an adult child for assistance with intimate personal care. Some parents may feel more comfortable talking to a professional about comfort and safety concerns, not wanting to burden their adult child(ren).

Getting to know a professional caregiver or finding the right fit can take time, so the sooner you start, the better. Remember that seeking help in the beginning stages of caregiving is not a sign of failure. In fact, as caregiving progresses, it will be easier to build on a foundation of support, rather than react to a sudden mishap.

Caregiving: Mounting Needs

Depending on your loved one’s diagnosis or health status, the care support you’re providing may look different from day to day, but in most cases, you’ll find yourself doing more as time goes on.

You may start with driving Dad to the doctor and soon find yourself scheduling his appointments, too. Picking up his prescriptions from the pharmacy, then ordering refills. Organizing his meds to make sure he takes the right pills on the right day, and eventually reminding him why he needs them.

These tasks fall under the category of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs).

Tasks considered ADL are the fundamental basics: bathing, dressing, grooming, eating and using the bathroom. Tasks that fall under IADL are the more complex — yet still necessary — daily tasks, such as balancing a checkbook, scheduling appointments/using the phone, doing laundry and coordinating transportation.

And as caregivers take on more assistance with ADLs/IADLs for a parent or older loved one, the feeling of not being able to do it all — but trying to anyway — can lead to burnout.

Burnout can be when your son or grandson is disappointed because you missed his T-ball game while taking your mother-in-law to physical therapy, you’ll feel disappointed, too. When a work deadline looms and you have zero energy to meet it, the stress compounds. When your siblings refuse to help, frustration and resentment build. These emotions and cycles are normal in caregiving, but over time and if left unchecked will lead to burnout.

Feeling fatigued? Don’t wait for a breaking point, like a health emergency for your parent or when your own health is compromised.

Make a list of all the care to-dos you’re completing and think about how home care can carry some of the weight. Consider twice-a-week support structure on household chores like laundry, light cleaning and food shopping. Consider overnight care so you can sleep at home again without worrying about an overnight fall.

Consider companion care instead of adding an antidepressant to a parent’s already crowded medication regimen or to help relieve you from all that worry, like what if the stove is on or what if Mom falls in the shower.

The investment is well worth your continued well-being. And it’s always really about your parent’s extended independence and ability to stay at home comfortably and safely. But remember, the better your health, the better (and longer) you’re able to provide care.

Caregiving: Around the Clock

Reality check: Transitioning a parent to full-time, 24/7 support. Making end-of-life preparations and enlisting hospice care. Saying goodbye. Facing grief, loss and what’s next. Caregiving’s final stages are often intense, time-consuming and exhausting —both physically and emotionally. And these final days can follow a year, five years, or a decade-plus of daily grind care.

Will there also be unexpected events in caregiving, even if you have adequate support? Of course. But ultimately, preparedness is the caregiver and loved one’s best friend. Are you prepared with a plan B if something happens to you and you’re not able to provide care for an extended period of time? Are you prepared with backup if the family member who said she’d stay overnight can’t do it because her daughter gets sick?

And how can you prevent and avoid burnout if you don’t know its warning signs? Or if you don’t know how to disconnect yourself from certain caregiving duties because you’ve carried the load alone? Having another person like a professional caregiver who knows your loved one as well as you do can lighten that load.

Imagine having someone who can celebrate the moment your dad recognizes you despite his dementia diagnosis.

Imagine having someone who can come stay with your mom and get the house ready while you bring Dad home from an extended hospital stay.

Imagine being able to say yes to a weekend away with your spouse because you have a caregiver you rely on and trust to check in on your stepdad.

Even if you start the journey with the best of intentions, committed to all until your loved one’s passing — caregiving can be a very long journey worth planning for that can unexpectedly lead to burn you out.

Pace yourself, prepare for the unexpected, prevent burnout and maintain a good relationship with your loved one by asking for help sooner than later. Transitioning to a caregiver before the situation turns dire is a lot easier.

How Alzheimer’s Care May Lead to Your Own Decline

How Alzheimer’s Care May Lead to Your Own Decline

If you’re feeling overwhelmed while caring for a loved one with Alzheimer’s, you are not alone.

An estimated 15 million Americans are providing unpaid care for someone with Alzheimer’s disease, or other forms of dementia, according to the Alzheimer’s Association.

And while you may have the best intentions for your loved one, the reality is that it’s just extremely taxing work. Just over one-third of caregivers report that their own health has declined since they began caring for a loved one with Alzheimer’s.

In fact, you are considered the invisible second patient of the irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks.

Acknowledging the stress that comes with caring for someone with Alzheimer’s and its manifestations is the critical first step toward not only helping you maintain your own physical, financial and emotional health, but also providing more robust and meaningful care to your loved one.

What Stress Does to You

Studies show that caregiving can negatively impact your relationships, your ability to effectively toggle work and life demands and can increase your risk of a variety of illnesses.

Consider just some of the statistics:

  • Increased levels of depression: Studies show that 30 to 40 percent of dementia caregivers suffer from depression and emotional stress. And depressed caregivers are more likely to suffer from anxiety disorders, substance abuse and chronic disease. A study in the Canadian Medical Association Journal
  • found the high levels of depression and anxiety remain and can increase when a loved one is put in a nursing home.
  • Increased levels of frustration: More than one-fifth of caregivers are exhausted when they go to bed at night, and many feel they cannot handle all their caregiving responsibilities. Those experiencing chronic stress may be at greater risk of loss in short-term memory and attention.
  • Increased risk of decline in physical health: About 1 in 10 caregivers say their physical health has declined since they started taking care of a loved one, with many neglecting their own health care needs.
  • Caregivers have higher incidences of heart disease and a decreased ability to fight their own colds and flu.

For women, who make up about two-thirds of caregivers, the statistics are even more troubling. In general, they are even more depressed and anxious, and report their physical health and satisfaction with life and their well-being is lower than men who provide care.

Impact on Care

When caregivers are sick, depressed, anxious and angry, their ailments naturally affect their ability to provide care for their loved one, despite their best efforts.

In fact, family caregivers are at higher risk to lose patience than those who don’t provide care.

A National Institutes of Health study even found that spousal caregivers caring for a spouse with significant cognitive impairment and/or physical care needs are more likely to experience feelings of anger and resentment.

Caregiver burnout is normal. Watching your loved one’s health deteriorate as the disease advances is challenging even for the most resilient. Providing care during that time often seems like a thankless task, especially as your loved one’s memory decreases and needs increase.

That is why it is vital to recognize some of the signs of burnout: anger, exhaustion, denial, sleeplessness, anxiety, isolation, withdrawal from social functions and friends, difficulty concentrating and declines in your own health.

Finding Relief: Practice the Three Rs

Making time for your physical and mental health is not only healthy for you, but it is good medicine for your loved one.

Remember to practice the three Rs:

  • Rest
  • Relax
  • Recharge

How to spot your own burnout

Signs and symptoms of caregiver stress or burnout can come in many forms.

Think STOP to assess if you are in the midst of burnout and need to take some time to re-energize yourself. Reach out to your doctor or seek a friend or an in-home professional caregiver for help.

S: Sad — Are you feeling lonely, isolated?  “I just don’t care anymore.”

T: Tired — Are you physically and or emotionally exhausted? “I’m too tired for this.”

O: Over-reacting — Do little things “get to you” and make you lash out? “Leave me alone!”

P: Pain — Don’t ignore stress headaches or a mental and physical fatigue. Sometimes your body will let you know when you need respite.

How to Communicate with Your Loved One Who Has Parkinson’s

How to Communicate with Your Loved One Who Has Parkinson's

If you are caring for a loved one with Parkinson’s disease, you are probably familiar with two of the hallmark physical symptoms: tremors and impaired gait.

Unfortunately, the disease also affects a person’s ability to communicate, which can be frustrating for both caregivers and your loved one with Parkinson’s.

As with many aspects of caregiving, the more you know, the better you can handle challenges. Improving communication with people who have Parkinson’s is possible.

The Physical Effects

Experts in the field of Parkinson’s advise that it is very individualistic, so physical symptoms can vary widely from person to person. In general, Parkinson’s disease often affects speech. People with Parkinson’s may have softer voices that sound hoarse or blurred. Some people with the disease begin to speak rapidly and may stutter.

Another manifestation of the disease is lack of facial expression. This can make it appear as though a person with Parkinson’s isn’t listening or engaged. The nuanced “body language” part of communication can be limited by decreased facial expression and the inability to make hand gestures due to tremors or decreased muscle control.

People with Parkinson’s may often lose their train of thought. Hallucinations can sometimes be symptoms of the disease or a side effect of medication can also impede comprehension and make conversation very difficult.

Strategies for Caregivers

While your approach to communication will need to change as the disease progresses, there are ways to help you maintain a relationship with your loved one:

  • Focus.When talking with a person who has Parkinson’s, try to maintain eye contact. Sit down if necessary to be at eye level. Parkinson’s can make it difficult for someone with the disease to talk while doing something else (like walking), so conversations may require a concentrated effort from both parties. Group communication may be overwhelming for someone who requires a bit more time to form a response. One-on-one conversations are more manageable.
  • Keep it simple. Ask “yes” or “no” questions and avoid complicated sentences. If you are talking about other people, use names instead of pronouns to help clarify the conversation. Make it clear when you change subjects.
  • Time it. Medications used to treat the disease can cause “on” and “off” times for patients. Take advantage of your loved one’s “on” times to talk and let him or her know how much he or she is valued.
  • Be patient. Avoid finishing the other person’s sentences. Finding the words can be difficult for a person with Parkinson’s, but interjecting can add to his or her frustration.
  • Use new tools. Parkinson’s can take a toll on handwriting as well, so written communication may be difficult. Amplification systems are available that use a small, wearable microphone to make a person’s voice louder (this can be especially helpful if you as a caregiver have hearing loss). Some systems include a receiver that the caregiver can wear, making it easier to communicate from separate rooms. Video calling services, like FaceTime or Skype, can help caregivers who aren’t close by monitor their loved one’s overall condition.

Don’t Go In It Alone

Communication challenges can make both caregivers and their loved ones with Parkinson’s feel very isolated. Reach out to professionals to help you manage the responsibilities of care.

  • Professional Caregivers. As a family caregiver, you need to take breaks. Consider a professional caregiver who can visit your loved one in his or her own home, providing safety and social stimulation for your loved one and the opportunity for you to step away and pursue your own interests. This is never easy, but you must remember that your frame of mind is important in communication. Although a person with Parkinson’s may seem disengaged, he or she can still sense your feelings by your tone of voice. Respite can allow you to refocus and avoid dangerous caregiver burnout.
  • Speech-language pathologists. Professional speech or language therapy can help people with Parkinson’s strengthen their voices and improve the pace of speaking. Experts recommend meeting with a speech therapist as soon as possible after a Parkinson’s diagnosis to set baseline measurements and evaluate speech and swallowing ability.
  • Occupational therapists. Therapy in this field can help people with Parkinson’s who would like to use a computer or electronic device to communicate. An occupational therapist may also have recommendations for improving handwriting.

Your Voice Counts

As you work to hear your loved one with Parkinson’s, make sure your voice is heard, too.

Caregiving is stressful. Be sure to discuss your needs, feelings and fears with family, a trusted friend or a mental health counselor. Ask questions about the disease and take advantage of information provided by medical professionals.

A local support group for caregivers can provide additional tried-and-true methods of communicating with people with Parkinson’s. Online, try tapping into information from the Michael J. Fox FoundationPartners in Parkinson’s, the National Parkinson Foundation or the Parkinson’s Disease Foundation.

Avoid Poor Communication with Someone Who Has Dementia

Avoid Poor Communication with Someone Who Has Dementia

Dementia does more than just unravel a person’s memory, ability and personality. For many, it alters their ability to communicate.

In fact, the change in a person’s ability to communicate is based on those very things dementia is unraveling. As one loses short or long-term memory capacity, the ability to find the right word or name becomes increasingly difficult and sometimes impossible, causing frustration and fear where there once was confidence and clarity.

Are repetitive questions frustrating to receive hour after hour, day after day? Of course.

Is it heartbreaking to watch your mother struggle to recall the day of the week when she was once a prolific writer or public speaker? Is it crushing to see no sign of recognition on your father’s face when his grandchildren are in front of him? Yes and yes. Of course!

Now imagine how your loved one feels: over time, or sometimes overnight, she’s unable to express basic needs. She’s unable to recall the names that go with the familiar faces she sees each day. She’s unable to remember her own name. These are some of our own worst fears in life.

But communication is still possible. You and your loved one just need to find new ways to do it.

Here are six strategies for communication without frustration:

  1. Adjust your expectations, not your tone or volume

    Don’t speak louder or talk to your loved one like a child who doesn’t understand.

    Cognition is complex and so is communication. Just because a person doesn’t respond right away doesn’t mean she doesn’t understand. She may just need to hear the question again. It may just take longer to process the question and find its answer. Or she may know the answer in her head, but can’t get the words out — or remember what order to put them in — and decides not to try for fear of failing.

    When you ask questions, don’t expect an answer every time or get frustrated when there isn’t one. Know there is more going on in Mom’s head then there once was several years ago.

  2. Don’t push it

    Rephrasing a question or thought can help. If it doesn’t, move on.

    Sometimes, a question that was answered easily the day before becomes difficult or impossible the next day. Take it all in stride and know this is unfortunately normal.

    Too often, family and friends push people with dementia, repeatedly asking, “Who am I?” or “What’s my name?” and hoping that, one of these times, they’ll remember. Don’t do it! The only thing this accomplishes is heartbreak for you, and frustration, confusion, or even anxiety for your loved ones.

    If your grandma calls you Caroline but your name is Marianne, roll with it. Big picture: It’s not as important that your loved one remembers your name as it is for you to keep your loved one feeling comfortable.

  3. Offer alternate means of communication

    In some cases, the physical act of speaking is what’s most difficult, but language and comprehension are still there. Remember, language is complicated: your mom’s ears may clearly hear and understand the words you’re saying, but her brain might translate it incorrectly, leading her to say “spoon” when she meant to say, “summer.”

    Offer your loved one a pen and paper or a small dry erase board to communicate through writing. It may also help if you write out what you’re saying instead of only speaking.

    Consider tech tools to augment communication as well. Many modern cell phones and devices have text-to-speech apps and other helpful programs that give the individual more control and independence in conversation.

  4. Simplify your language

    Remove extra, unnecessary words. It just makes the translation process more confusing and complicated, and it may overwhelm your loved one.

    Keep your questions simple, and phrase them in a way that only requires a yes or no answer. That way, if the words get stuck on their way out, a nod or a shake of the head is an acceptable answer.

    Remember, simplifying your language doesn’t mean speaking to your loved one like a child. When you ask Dad what he wants for breakfast, don’t rattle off all the options at once. For example, avoid asking: “Would you like cereal, fruit, yogurt, or eggs and toast for breakfast?” Present the options one at a time, requiring a yes or no answer only: “Eggs and toast?” “Cereal?” “OJ?”

  5. Communicate without words

    If your mom has the same thing for breakfast every morning, do you even need to ask? Sometimes, we don’t need to use words at all: body language and nonverbal cues often give us the answer before anyone has to open their mouths.

    Learn to interpret the ways your loved one is communicating with her eyes, her facial expressions, the way she’s moving her body. If she’s pacing and wringing her hands, it’s likely she’s anxious about something. Try to discover the cause and provide relief without launching into a round of questions (maybe turning off the TV or a bright light will help). If he gives you a pained, sad look when you ask him to remember certain things, don’t keep asking him to remember. Just give him a hug or hold his hand.

    Consider the ways you’re communicating without knowing. If you look or sound stressed when you’re speaking, you might be passing on those negative feelings to your loved one.

  6. Give yourself a break, and bring in respite care

    Answering repetitive questions and having to alter your communication day after day is exhausting.

    It’s also emotionally exhausting to witness and experience a loved one’s decline. The sadness of the situation takes its toll, so don’t feel that you’ve failed because you don’t have the patience you’d like to have, or you can’t read your dad’s body language.

    Also, communication will probably get harder as dementia progresses. Keep practicing, but know that frustration may be unavoidable. It’s important that you get help and rest, too.

    Consider bringing in a professional caregiver periodically.

    A professional caregiver can do something as simple as enjoy a cup of coffee and converse with your mom — or even just to sit with her in silence — so you can have a break. The same caregiver can also help take tasks like appointment reminders, medication reminders and light housework off your plate. All while you rejuvenate and resume your regular role as son or daughter.

Now more than ever, you’ll need to have friends you can talk to and enjoy conversations that flow with ease. Make sure to give yourself these opportunities to communicate freely, without having to “remember this, do that, try this.”

The idea of respite can’t be emphasized enough. Caregiver burnout is real, and so are its ramifications. Hear from a family caregiver in Here’s Why I Wish I’d Hired Home Care Sooner.

Caregivers and Codependency

Caregivers and Codependency

The term “codependence” is clearly being overused in all walks of life; from caring for an alcoholic spouse to staying in a job with an abusive boss. It allows us to label ourselves (or others) rather than work at changing a bad situation. Yet, even such a negative term as codependence can be seen as a reason to look at the context in which the term developed. For example, a controlling caregiver may be seen as codependent due to her need to run their care recipient’s life. And, although there may be some truth lying within that statement, it could also be that the caregiver is truly finding it useful to handle most of the needs of her care recipient in order to offer the best possible personalized care.

Co-Dependents Anonymous, Inc. offers this statement,” Codependency is a tendency to behave in ways that negatively impact one’s relationship and quality of life. This behavior may be characterized by denial, low self-esteem, compliance, or control patterns.”

One issue with caregivers and codependency behaviors/labels is their inherent lack of clear boundaries, such as C.L. Whitfield’s definition of codependence: “Any suffering and/or dysfunction that is associated with or results from focusing on the needs and behaviors of others.” That broad perspective leaves nearly nothing that could not fit into the codependence definition. Rather we should be focusing on the situation before caregiver burnout/labeling of codependency is evident. The question is not, “What is wrong within me?” But rather, “What can I do to change the situation I am in?”

There are certainly times when the use of the term codependency fits well, and with those times in mind, below you will find a listing of concerns that may drive a caregiver to seek counseling to help:

Denial Patterns:
•  I have difficulty identifying what I am feeling.
•  I minimize, alter, or deny how I truly feel.
•  I perceive myself as completely unselfish and dedicated to the well-being of others.

Low Self-Esteem Patterns:
•  I have difficulty making decisions.
•  I judge everything I think, say, or do harshly, as never “good enough.”
•  I am embarrassed to receive recognition and praise or gifts.
•  I do not ask others to meet my needs or desires.
•  I value others’ approval of my thinking, feelings, and behaviors over my own.
•  I do not perceive myself as a lovable or worthwhile person.

Compliance Patterns:
•  I compromise my own values and integrity to avoid rejection or others’ anger.
•  I am sensitive to how others are feeling and feel the same.
•  I am extremely loyal, remaining in harmful situations too long.
•  I value others’ opinions and feelings more than my own and am afraid to express differing opinions and feelings of my own.
•  I put aside my own interests and hobbies in order to do what others want.

Control Patterns:
•  I believe most other people are incapable of taking care of themselves.
•  I attempt to convince others of what they “should” think and how they “truly” feel.
•  I become resentful when others will not let me help them.
•  I freely offer others advice and directions without being asked.
•  I lavish gifts and favors on those I care about.
•  I have to be “needed” in order to have a relationship with others.

(Patterns and Characteristics of Codependence, Co-Dependents Anonymous, Inc., www.CoDA.org)

Whether you are of the school that says codependence in caregivers is a personal, internal issue that must be dealt with in counseling, or, you feel that codependence is a situational issue that can be handled by altering the environment from which the issue springs forth, caregivers must find a balance between their needs and the needs of their care recipients.

The fact remains: change must take place if you are to halt the potential burnout of your caregiver from some definition of codependence. Your role is to be aware of the situations your caregivers are in and do what is possible to help your caregivers be the best they can be without losing their loving nature.

Does Medicare Cover Home Care Services?

If your family is considering hiring home care service for a loved one, there may be financial assistance available to help offset the costs.

For many people over 65, Medicare is a key source of funding for medical benefits. It’s common to ask how much of that might apply for in-home care.

Medicare will only pay for medically necessary care, so there are limited areas of care that may be covered.

What Medicare May Cover

People who are homebound and under a doctor’s care may be eligible for certain home health services.

Home health care includes services like skilled nursing care, physical therapy, speech-language pathology services and continued occupational services.

Here are the most frequent scenarios:

    1. Short-term care for conditions that will improve

      Medicare may pay for some short-term home health care or a nursing home stay following medical treatment from which the patient is expected to recover.

      To qualify, the patient must have:

      • recently stayed in hospital for at least three days
      • entered into Medicare-approved care within 30 days of this hospital stay
      • a doctor certified requirement for some kind of skilled care; such as physical therapy or skilled nursing

If the patient meets all three criteria, Medicare will pay for 100 percent of the care for 20 days and a portion of the total amount from day 21 to day 100. After 100 days, the patient is responsible for all expenses.

    1. Doctor-prescribed care for recovery from an injury

Medicare may also cover additional care, provided your doctor says it is medically necessary to recover from an injury. This may include:

      • part-time nursing care
      • physical therapy, occupational therapy or speech/ language therapy for a limited period
      • medical social services to help people cope with social, psychological or medical issues that may arise after an illness
      • some medical supplies such as wheelchairs, other mobility aids, or an in-home oxygen service

There is no limit to how long Medicare may pay towards these treatments, as long as the patient’s doctor still believes it is required and reorders it every 60 days. The doctor must also certify that the patient is homebound to qualify for these services.

    1. Hospice Care

If the patient has a terminal illness and is not expected to live for more than six months, Medicare will cover hospice and respite care in the patient’s own home, in a nursing home or in a hospice care facility.

In addition to doctor services and nursing care, in a hospice care situation, Medicare may also cover other services that may not usually be covered, including:

    • Physical therapy
    • Occupational therapy
    • Medical equipment and supplies
    • Prescription drugs (for pain relief and symptom control)
    • Hospice aide or homemaker services
    • Grief counselling for the patient and his or her family
    • Social work services
    • Short-term in-patient care for pain and symptom management
    • Short-term in-patient or in home respite care, to allow caregivers time away from caring responsibilities

It’s important to note that once Medicare begins to fund hospice or respite care, it will stop funding other areas, including treatment or drugs that are intended to cure the patient’s condition. The patient (or the person’s proxy) must sign a statement confirming the choice of hospice care instead of any other treatment for the illness.

If the patient agrees to this, Medicare will cover all costs, minus a copay for prescription drugs. There may also be a 5 percent copay for inpatient respite care. Medicare will not contribute towards room and board if you receive treatment in your own home or in a nursing home where you live.

Even if your loved one does not meet one of these eligibility criteria for Medicare to meet long-term care costs, there may be other avenues to pursue.

State Medicaid programs, veterans’ affairs benefits, or long-term care insurance may also help you meet the costs of long-term care.

Will My Love One Be Covered?

Medicare covers seniors over 65 years old.

Medicare is available for certain people with disabilities who are under the age of 65. That includes people who have received Social Security Disability Insurance for a total of at least 24 months, have end-stage renal disease or permanent kidney failure, or have Lou Gehrig’s disease (ALS).

If you qualify for Medicare, it’s still not certain that your long-term care will be covered. Medicare concentrates on short-term care for conditions which will eventually improve.

This means Medicare will not pay for most long-term home care services or personal services such as help bathing, dressing, or help going to the bathroom.

To help you understand you or your loved one’s ability to finance respite care or home care services, Visiting Angels offers free consultations over the phone and at your home.

Complete our care inquiry form and we’ll call you within 15 minutes, or call us now: (800) 365-4189.

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