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. Caregivers often wait too long to seek assistance.
In the short-term, a caregiver can usually handle it. What I mean by short-term is 12 to 18 months. But in the long-term over 18 months, 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.
- 18 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.
- 36 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.
After a period of time, caregiving may be too difficult to endure. Without intervention sooner, the caregiver may become a candidate for a long-term care facilityas well. 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.
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 many instances in which a caregiver spouse’s health deteriorates to the point that he or she dies before the disabled partner.
When this happens, 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 caregiving spouse. It is best to have a plan in place before this occurs.
The caregivers I regularly see are usually the disabled individuals’ spouses in in their 70’s or 80’s or children in their 60’s or 70’s. These caregivers often comment about how difficult it is to care for their loved ones and that they are exhausted all the time. When they do, I ask them two questions. Firstly, I ask “How old you?” Then I ask, “If you hired a service to care for your loved one, would you hire someone like you?”
In almost every instance, after thinking about it, the caregivers answer “No.” They would not hire someone like themselves to care for their loved ones. Then I discuss with them, options to make their lives easier and less exhausting. All of the options require the caregivers to take a break from their disabled loved ones.
If you want to keep your disabled loved one at home, you generally have two options. Firstly, if your disabled loved one is mobile, you could 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.
I am aware of two adult day care services in St. Clair County, the Council on Aging, Inc. Starpath Adult Day Service and the Visiting Nurse Association and Blue Water Hospice Specialized Adult Day Program. Both of these programs specialize in care for your loved ones with Alzheimer’s /dementia. For more information about these programs, see www.thecouncilonaging.org or www.vnabwh.com.
Visit the adult day care facility along with the person for whom you are caring. Is it a good fit? 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.
The second option for keeping your loved ones at home is using home care services. Home care service agencies typically charge $20-$25 per hour for non-medical home care and often have a minimum service time, such as 3 hours. It has been reported that there are over one hundred home care agencies providing services in St. Clair County. Which one do you choose?
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 home care services or is familiar with those who run it.
Second, call and ask the agency to send you information. Ask specifically to be sent the application, eligibility requirements, cost and payment information. Ask who runs the agency. Is it local? Is it for-profit or non-profit? Is it a franchise?
Third, ask about the experience of the staff. Request a list of references.
Sometimes, your loved one may require 24/7 care by others. With a home care service agency, that could cost over $15,000 per month. A more economical alternative would be to place your loved one in a adult care facility such as an assisted living facility, adult foster care home or nursing home. These facilities typically charge one-half or less than 24/7 coverage in the home by a home care agency.
If you are already spending all day with your loved one, why not spend it with them at a facility. You can be assured of the care your loved one is getting, because are seeing them every day.
I’ve had a number of clients who have done this who have been pleased with their decision. It’s not home, but both the caregiver and the disabled family member are getting the care and breaks they need.
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.
By: Matthew M. Wallace, CPA, JD
Published edited January 10th, 2016 in The Times Herald, Port Huron, Michigan as: Recognizing the Need for Outside Help in Caregiving