Ruth is 87 and has macular degeneration.  She has not been able to drive for a few years. All of her children have moved away but her sister, Bette, lives close by and has always taken her to the grocery store and physician’s office making sure her needs were met. Unfortunately, Bette was recently diagnosed with Alzheimer’s. Her family has decided she can no longer drive.  Did Ruth let any of her children know that she was no longer able to get to the grocery store easily? Of course not!

We are now in the process of finding a good non-medical home care company that can provide transportation and support to Ruth. Being a long distance caregiver is challenging. Situations change and can be easily overlooked when you are not physically there to see the impact. Many people are struggling with this so I have decided I will start to blog about my own experiences as a long distance caregiver. I will share all the ups and downs even if it means swallowing my pride and sharing my own mistakes during this process.

Our first step?  Interviewing home care companies.  I always recommend to clients that if they are long distance, they should consider hiring an agency instead of an individual. There are many reasons for this. If the agency is a good one, their caregivers and management team can become your eyes and ears and let you know if they start to notice any changes in your loved one. They also send replacements if the primary caregiver is sick or can’t be there. They also do criminal background checks, driving checks and reference checks before hiring. If something goes wrong, you have a management team you can speak with who can solve the problem. Because none of us live close by, I feel we need that level of support so an agency is the right decision for us.

Because Ruth does not require any medical care, we are only speaking to companies that provide non-medical companionship care. Here are some questions you need to ask a potential non-medical home care company to be sure you are bringing a reputable agency into your home.       

1. What is the background of your company?

Search out the history and ownership of the company. Find out who owns the company and weigh how the ownership affects the company’s service and reliability. Is this agency backed by a nationally strong firm? Is it reputable and in good standing?

2. How long has your company been in business?

The number of years an agency has been in business is not always pertinent to the quality of care given, but it does reflect on the stability and success of the company.

3. What qualifications, certifications, experience and training do you require of your workers?

Find out if caregivers’ credentials are investigated. Plus, determine whether caregivers undergo a thorough, professional testing and screening process.

4. Are your employees insured and bonded?

For your protection, ensure that all caregivers are insured and bonded by the home care agency.

5. How do you supervise your workers to make sure the proper care is given?

Some agencies make scheduled quality assurance calls and visits. To further ensure quality care, see that all caregivers are regularly and closely supervised by a qualified company representative.

6. Will the same employee continue with my case?

It is difficult to receive good care if different people show up every week. A good home care provider will be concerned with continuity of care.

7. Do you conduct a home visit before starting the home care service?

When choosing the home care services that are right for you, it is important that the patient and family members discuss the kind of care needed with a home care representative. This will help you determine whether the home care provider can meet your needs.

9. Can you give me some references from previous and current customers?

Ask for names of people. One good question to ask is “Would you use this company again for yourself or your loved ones?”

10. Do you guarantee customer satisfaction?

Find out if there is a length of time you will be committed to the home care provider even if you are unhappy with the care they are providing. The home care provider should guarantee care and cancel charges for unsatisfactory service.

Thanks to the Area Agency on Aging of Pasco-Pinellas for these questions. More information about non-medical home care companies, including the names of companies in your area, can be found at your local area Agency on Aging.  

1.      Availability of caregivers – Many people count on friends and family to meet their needs as they age. Initially, they might just need a little help around the house with cooking and cleaning. As they progress, their needs will also include more personal care including bathing and transferring them from one location to another or on and off the toilet. Every family caregiver needs to ask themselves if they can be there for their loved ones as their needs grow. Are you comfortable helping a parent bathe or dress? If not, do you have the finances needed to hire professional caregivers?  These are difficult questions that only you can answer. What is most important is ensuring your loved one has support around them for all of their needs. If this isn’t possible, aging in place would not be a safe option.

2.      Accessibility – It is important that the home be as accessible as possible for someone who is aging. Are doorways wide enough for a wheelchair? Are there grab bars in the bathrooms and are they positioned properly? Are all major living areas on one floor? If the answer is no, the home can be modified to fit your needs. It is important to bring in someone who is familiar with “universal design” so they can help you to determine what needs to be changed. Then compare the cost of home modification to the costs of assisted living. This will help you to determine if modifying the home is a realistic option for your family.

3.      Transportation - As people age, there comes a time when it is no longer safe for a person to drive. Many people count on their friends and family to drive them where they need to go. This works well but what happens when you are not available? Are there services in the area (including buses, cabs, etc.) they can use to get to the store or the doctor’s office?  If not, can you create a team of individuals who can take turns with the driving? If a person cannot get out to do their errands or to go to the doctors, and there are no support services in the area, then aging in place would not be a good option for them.

4.      Socialization – Everyone wants to age in place but many people don’t realize that it can be a lonely option. If a person is alone most of the time and counts on weekly visits by family for their socialization, then they might become very lonely and depressed. It is important that people have activities and people to share them with. Having friends their own age to speak with is very important. Setting up times for them to get together and making transportation easy, will go a long way to having a successful aging in place experience.    

I hope that by focusing on these four items, you and your loved ones will have a safe, rewarding aging in place experience.

The Paradox of our Time

The paradox of our time in history is that we have taller buildings, but shorter tempers; wider freeways, but narrower viewpoints. We spend more, but have less; we buy more, but enjoy less. We have bigger houses and smaller families; more conveniences, but less time. We have more degrees, but less sense; more knowledge but less judgement; more experts, yet more problems; more medicine, but less wellness.

We drink too much, smoke too much, spend too recklessly, laugh too little, drive too fast, get too angry, stay up too late, get up too tired, read too little, watch TV too much, and pray too seldom. We have multiplied our possessions, but reduced our values. We talk too much, love too seldom, and hate too often.

We’ve learned how to make a living, but not a life. We’ve added years to life, not life to years. We’ve been all the way to the moon and back, but have trouble crossing the street to meet a new neighbor. We conquered outer space, but not inner space. We’ve done larger things, but not better things. We’ve cleaned up the air, but polluted the soul. We’ve conquered the atom, but not our prejudice.

Remember, spend some time with your loved ones, because they are not going to be around forever.

Remember, say a kind word to someone who looks up to you in awe, because that little person soon will grow up and leave your side.

Remember, give a warm hug to the one next to you, because that is the only treasure you can give with your heart and it doesn’t cost a cent.

Remember, say “I love you” to your partner and your loved ones; but most of all, mean it. A kiss and an embrace will mend hurt when it comes from deep inside of you.

Remember, hold hands and cherish the moment for someday that person will not be there again. Give time to love, give time to speak, and give time to share the precious thoughts in your mind.

Remember, Life is not measured by the number of breaths we take, but by the moments that take our breath away.

Understanding that aging is a continuum requiring some adjustments is the first step in assuring that elders can maintain the independence they so desperately want. In most instances, a decline in their ability to perform small, daily activities is usually the first sign that a person’s needs are changing. Here are some warning signs that an aging loved one may need some help.

• Grocery Shopping and Meal Preparation
  • Is the refrigerator empty? Is food old or moldy? Is basic nutrition being ignored? Are meals being skipped?

• Housework
  • Is there a change in the way the house is being kept? Is the once clean and tidy home showing signs of neglect?

• Transportation
  • Is the individual having “close calls” or accidents? Are people honking? Do they act confused in traffic? Do they drive too slowly?

• Personal Hygiene
  • Is the person wearing the same clothes day after day? Are clothes clean? Does he/she still care about grooming – showering, washing hair, etc.

• Money Management
  • Are bills piling up? Are they being paid on a timely basis?

• Medication
  • Does your loved one remember to take daily medication on schedule and as directed?

These very common signs of aging are, in and of themselves, not cause for alarm. Yet once the number of signs starts to increase, family members should develop a strategy for making sure their loved ones needs are being met. Assistance with any of these tasks is widely available – whether it be from family, friends, neighbors or professional caregivers. It is comforting to know that the majority of people, with just a little bit of help, can retain their independence and continue to age in place.

Being mindful of the first initial signs of aging allows families and loved ones to help the elderly maintain their independence and quality of life at home – right where they want to be.

The International Longevity Center recently released “Caregiving in America: The Health Consequences on Boomer Women”.  The brief provides statistics that show the negative health, financial and social consequences that women caregivers of the baby boom generation face now and will continue to face as the demand for family caregiving increases with the aging of the population. 

The report states:

Reduced savings, reduced employment, earlier retirement, high out-of-pocket expenses of providing care, and increased likelihood of poverty are par for the course among many boomer women providing care to family members.

The stress and pressures resulting from caregiving may result in increased depression and significant health issues as well.

This is a very depressing picture and with the aging of America it is only going to continue to get worse. People who are caregiving need help. They are taking on more responsibilities as more and more aging people are staying in their homes and counting on their families for support. If the government were to pay for the services provided by our nation’s female caregivers, it would cost taxpayers between $207 billion and $263 billion annually.

What can be done? This report recommends 3 key approaches:

1.    Families must do more to plan for their aging and the aging of their loved ones. Families must talk more with their aging relatives about their wishes and plans for the future. Researching options and having a plan agreed to by everyone can greatly reduce the stress from a health care crisis. As women are helping their loved ones through their aging issues, it is critical they also start to put a plan together for their own successful aging.

2.    Employers should establish a clear dialogue with employees about their eldercare needs, and be committed to providing supportive resources that are needed. On-site eldercare programs, referral services, and subsidies for adult day care are among the possibilities. Alternative work arrangements are often very helpful to caregivers.

3.    Policymakers at all levels of government need to do more to fund initiatives to help caregivers.

Boomer women have always had to lead the way to change our culture through the ‘60s and on. They will do so again as more and more begin to accept the caregiver role and see all the needs that exist that aren’t being met. Hopefully, we will see a change for the better for family caregivers. To read the complete study, please click here.    

“Families are best able to care for their loved ones when they can take time away from work without fear of losing their job or their income. We all have roles to play, including employers, by providing paid leave, flexible work arrangements, and other programs when feasible, to help ensure that caregivers are able to successfully meet their work and household responsibilities.”

That is just what I have been saying! Caregiving is a huge responsibility and families cannot do it alone. Employers need to support their employees who are caregiving not only because it is the right thing to do but it also benefits the employer in the long run by contributing to a committed, focused workforce.

Even though I like having a month to bring attention to those individuals who are doing so much to help their aging loved ones, please don’t limit your appreciation for family caregivers to one month. They need our support and appreciation every day. They are the foundation of our long term care system and our country could not do it without them.

To read Obama’s complete proclamation, please go here.

There are many strategies out there for how to keep a brain “young”. How do you separate the fact from the fiction? WebMD asked a panel of experts what the research really shows. The good news? They have found that what is good for the body is also good for the mind.  Keeping yourself healthy physically will also help to keep you healthy mentally. So if you are currently doing these things to stay healthy, keep it up! If not, now is the time to work them into your daily routine. Many of these recommendations are not hard to implement. Have a glass of red wine with dinner and toast to a healthy brain!

Here are the top 7 things you can do as you age to keep your brain sharp as recommended by the experts at WebMD:

1.       Exercise

2.       Eat a rainbow of fruits and vegetables

3.       Mental workouts

4.       Sleep

5.       Red wine

6.       No more multitasking

7.       Learn new memory tricks

To read the complete article on WebMD, please click here.

Elder care and its impact on the workplace is so much larger than a single annual lunch and learn. The sandwich generation is being pulled in so many different directions. They are juggling multiple jobs including their job that helps them earn a living, their caregiving job taking care of their aging relatives and possibly their child raising job. Businesses need to provide more support to get the most from their employed caregivers. Many of these caregivers are baby boomers who are in leadership roles in their organization. No business will want to lose the value of their expertise due to their personal life challenges. Businesses can help.

Services may include flex time, free information and referral services, education, geriatric care management services, and elder mediation services. Just imagine a workplace where a man who wants to move his mother to Maine can make one call and an elder care expert can put a package together of the top facilities that can best meet their needs while he stays focused at work.  Or a woman who thinks she may have to leave her job because her caregiving role has become so great, can speak with an elder care expert who can help her get the resources she needs and develop a plan so she can stay at work knowing her mother is being well cared for. This is possible and it is possible today.

For businesses, offering services is a win/win. They not only help existing employees enabling them to perform at their best, but they also help themselves and their recruiting and retention efforts. Studies have shown for every $1 spent on elder care services, they receive a benefit of $3 to $5 in increased productivity and reduced costs.  

Elder care and its impact on the workplace are only going to grow in the coming years. Top companies are starting to realize they have a role to play. Maureen Corcoran, VP of Diversity at Prudential Financial says it best: “Elder care resources help employees care for their loved ones and continue to care about their companies. A smart organization educates employees about its business needs so they understand the best way to contribute over time. Likewise, it educates itself about its employees’ life needs so it can support and retain them over time. If an employee is forced to choose between caring for a loved one and devoting themselves to work, the company will lose. That loss will most certainly be in work quality and, more deleterious in the long term, in the loss of the hearts and minds of employees in their commitment to the firm.” 

Good companies care about their employees. Let’s hope that more start to see the value in helping their employees do a better job at home so they can do a better job at work.

National Public Radio’s Morning Edition recently had an discussion on elder mediation and how it can help titled “Mediators Help Families With Tough Choices of Aging“. I hope you will take the time to listen. It does a very good job giving examples of families who haved used the process and achieved good results. To listen to this discussion, please click here.

I look forward to hearing your feedback!

This blog is an important aspect of what I do because it will allow me to share with you some of the challenges I see on a regular basis and the steps you can take if you are experiencing some of the same issues. I hope this means of communication will become a forum for discussion as well. Please send me reactions and questions and I will make sure to answer them here so we all can learn from one another. Hopefully this is a place where you will come as a point of reference for all people in southern Maine struggling with caring for an aging loved one while balancing all of their other responsibilities.

Initially you will be hearing from me, but I will also be having guest blogger’s who can answer questions on specific topics. Our LifeStages team consists of Nurse Case Managers, Geriatric Care Managers and Certified Elder Mediators. I also have a network of Occupational Therapists, Physical Therapists, Long Term Care Insurance experts and other experts in the elder care arena. Between all of us, we should be able to get you the answers you are looking for.

So check back regularly.  I look forward to hearing from you!