I recently presented a program on caregiver legal issues at the 2nd Annual St. Clair County Family Caregiver Resource Seminar & Open House at The Council on Aging, Inc. which was sponsored by a number of local senior services organizations. Discussions with attendees reinforced what I have found with many of my own clients over the years, which is, caregivers often wait too long to seek assistance.
Are you or a family member caring for a loved one? Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. Caregiver burnout can creep up on you without you or anyone else noticing it. After a prolonged period of time, caregiving can become too difficult to endure any longer. Caregiver burnout symptoms can include:
- depression;
- anxiety, irritability, or anger;
- feelings of exhaustion;
- self-criticism;
- withdrawal from usual activities;
- trouble with handling caregiving responsibilities; and
- substance abuse
In the short-term, a caregiver can usually handle it. But in the long-term, help is needed. A typical pattern with an overloaded caregiver may unfold as follows:
- 1 to 18 months. The caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
- 20 to 36 months. The caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
- 38 to 50 months. Besides needing tranquilizers or antidepressants, the caregiver’s physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.
It is often at this end stage that family or friends finally intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention sooner, the caregiver may become a candidate for long-term care as well.
Have you and your spouse made a promise to each other that you would never put each other in a nursing home? You may want to reconsider such a pact. Caregiving spouses will often sacrifice themselves to care for a disabled partner. The caregiving spouse may not ever place the disabled partner in a nursing home because of the guilt that would arise from breaking such a promise. I have seen more than one instance in which a caregiver spouse’s health deteriorates to the point that he or she dies before the disabled partner.
At that time, the family usually has no choice other than to place the surviving disabled spouse in a nursing home. Oftentimes, the care at the nursing home is better than that previously provided by the deteriorated spouse. It is best to have a plan in place before this occurs. One such plan is to use a service that is highly valuable but very underused, adult day care.
The benefits of adult day care respite are two-fold. It gives caregivers much needed time to themselves and gives their loved ones social and interactive therapy with their peers. Adult day care services may offer such things as:
• social activities; music, movies, crafts and excursions;
• meals;
• fellowship support;
• nursing care;
• help with activities of daily living;
• medication assistance;
• physical therapy; and
• transportation.
Finding an adult day care services provider takes a little investigating on your part. It is important to know what you are getting and that your loved one is comfortable with his or her new surroundings.
First, ask for recommendations. Check with your local senior center, Area Agency on Aging mental health centers, doctor, clinic, family, friends and neighbors. The best recommendation is by someone who has used the adult day care services or is familiar with those who run it.
Second, call and ask the facility to send you information. Ask specifically to be sent the application, eligibility requirements, cost and payment information. Ask for the calendar of activities, menus, hours and days of operation. See if it fits your schedule. Ask about availability of transportation to and from the location and what is the cost. Ask who runs the facility. Is it private, non-profit or a franchise or part of an assisted living facility or a nursing home?
Third, visit the adult day care facility. Go visit the provider location along with the person for whom you are caring. See if the staff is friendly. Check that it is clean and odor free. Ask about the experience of the staff. Request a list of references.
One last word of advice. Don’t feel guilty about taking your loved one to adult day care, even if your loved one says “You are abandoning me,” or “I don’t need a babysitter.” You both will be better off with time off from one another.
If you are the one providing daily care for a loved one, you owe it to yourself to seek help. Take care of yourself and your needs, both physically and mentally. Seek out professional help that will ease your burden and look for community service organizations that offer respite help.
The US Department of Health & Human Services – Administration on Aging offers assistance to family caregivers through its National Family Caregiver Support Program at http://www.aoa.gov/aoaroot/Press_Room/Products_Materials/fact/pdf/Natl_Family_Caregiver_Support.pdf.
The National Care Planning Council also offers tips and advice for caregivers and their families through its website at http://www.longtermcarelink.net/about_adult_day_care.htm.
By: Matthew M. Wallace, CPA, JD
Published edited July 14, 2013 in The Times Herald newspaper, Port Huron, Michigan as: Recognizing the need for outside help in caregiving