“There are far, far better things ahead than any we leave behind.”
— The eternal optimist
Hope is a roof over your head
The 3:11 Youth Housing Program is for youth ages 18 to 24, to transition from homelessness to stability. They focus on that age range because it’s when people are entering adulthood. It now consists of eight rehabbed duplex-style homes in Grand Rapids, each with room for three to four youths and a mentor or mentor couple. More info here.
Still time
David Wiesner (American, b. 1956), Art & Max, 2010. (Supplied)
If you haven’t taken your kids to the Grand Rapids Art Museum yet during winter break, you’re still in luck. The GRAM will waive admission fees for visitors age 17 and under through Jan. 5.
Grieving the loss of a loved one?
The holidays can often serve as a stumbling block on the journey from grief to healing. The topic of grief is not often something anyone wants to talk about, especially at a time of year that, for most, is a time of great joy and happiness. Here are some tips on how to cope.
Fun fact:
It’s nothing new
Mesopotamia (modern day Iraq) began the concept of celebrating the new year in 2000 BC. Back then, people observed new year in mid-March, around the time of the vernal equinox. See? We’re not so special.
As it was mentioned in part one of this series about the importance and value of informal family caregiving, caregivers often experience depression as well as physical health challenges. In a Family Caregiver Alliance 2006 report, Caregiver Assessment: Voices and Views from the Field Caring, it says that caring for persons with dementia can impact a person’s immune system for up to three years after their caregiving experience ends, increasing their chances of developing a chronic illness themselves.
In the National Alliance for Caregiving and AARP 2009 report, Caregiving in the U.S., it states that 17 percent of caregivers feel their health in general has gotten worse as a result of their caregiving responsibilities. The report also says that studies have found that 23 percent of family caregivers who have been providing care for five years or more report their health is fair or poor.
Michigan State University Extension says that caregivers need to make their own care their first priority. It isn’t possible to be an effective caregiver for others without taking responsibility to keep their own well-being in mind. But, because of the constant demands of family caregiving, it is often difficult to include self-care in the daily list of responsibilities.
It is important to keep self-care simple. Stick with the basics. According to the National Center of Caregiving at the San Francisco-based Family Caregiver Alliance, it is vital to focus on the following basic self-care practices:
Learn and use stress-reduction techniques.
Attend to your own healthcare needs.
Get proper rest and nutrition.
Exercise regularly.
Take time off without feeling guilty.
Participate in pleasant, nurturing activities.
Seek and accept the support of others.
Seek supportive counseling when you need it, or talk to a trusted counselor or friend.
Identify and acknowledge your feelings.
Change the negative ways you view situations.
Set goals.
All of these activities are easier to accomplish with the support of family, friends and community resources. Reaching out to others to gather support for your family caregiving efforts can mean the difference between the normal caregiver burden and disastrous caregiver burnout. Contact your local MSU Extension office, your county commission on aging or the regional Area Agency on Aging to locate community resources to support your valiant efforts at family caregiving and self-care.
Being a full-time caregiver for your loved one is a taxing job. It takes a lot of energy and time to give good care, not to mention the emotional toll it takes. Caregiving is a difficult journey, and it takes a lot out of you. Because of that, many caregivers can suddenly find themselves burned out.
Caregiver burnout is a state of emotional, physical, and mental exhaustion brought on by the stress of full-time caregiving. Avoiding caregiver burnout should be a top priority for you as a caregiver. After all, how can you give your best effort to caregiving if you aren’t in good health yourself?
Here are some ways to take care of your health and avoid burning out.
Find Other Caregivers in Your Area
Building a support network of other caregivers can be a big asset in avoiding burnout. Meeting with people who can understand and sympathize with your situation is a great outlet for your stress, and talking with people who experience similar feelings as you can help you feel less alone and isolated during your time as a caregiver.
You can meet other caregivers through online groups, Facebook pages, support meetings, or by asking medical professionals if they are aware of any type of caregiving support groups in the area. Social media and technology allows you to stay connected to your support group when you need them.
Take Respite Breaks
There aren’t regular breaks from caregiving like there are for other jobs. You don’t get weekends off, and your hours aren’t from 9am-5pm. You are constantly on the clock and need to be prepared at all hours of the day, every day. One way to regain some energy is to use a respite care service. Respite care is temporary, professional care of a dependent person that provides relief for usual caregivers.
Taking advantage of respite care helps you avoid isolating yourself, lets you stay healthy and avoid exhaustion, and allows you to stay focused and remain positive. You also don’t have to worry about the quality of care your loved one is receiving when they are at an assisted living community or other senior care center that offers respite care.
Keep an Eye on Your Health
Another important step in avoiding caregiver burnout is to keep a close eye on your own health. Remember, you can’t take care of your loved one if you aren’t doing well yourself. Staying active, exercising, and eating right are all ways to keep your health in check.
You also need to watch out for signs of stress and depression, which can signal caregiver burnout. Signs to look out for include:
Feeling sad, hopeless, or empty.
Losing interest in things that used to bring you joy
Outbursts and sudden changes in emotion
Changes in appetite
Changes in regular sleep patterns
Increased anxiety and restlessness
Trouble thinking clearly
Feeling extremely guilty and constantly blaming yourself
Frequent thoughts of death or suicide
If you experience these symptoms, seek medical help. There are services dedicated to helping caregivers maintain their mental health, and you can take advantage of those services.
Stay Organized
It’s easy to get overwhelmed with the stress of caregiving and burnout, so help yourself by keeping organized where you can. By staying organized, you don’t have to worry about where your loved one’s insurance papers or appointment schedules are.
Set up calendars either online, on your phone, or in paper form to organize appointments and meetings. File away paperwork in an orderly fashion that you can remember later on. You can also create daily checklists and task lists so you don’t have to worry about what you need to get done in a single day.
Organizing your life can help you feel more relaxed and confident in your role as a caregiver. It doesn’t take a lot to organize, but it can go a long way in reducing your overall stress and your likelihood of burning out.
Find Caregiving Services Near You
There are services and companies that provide caregiving assistance to people who need extra help. The National Eldercare Locator can help you find caregiving services around you. Examples of caregiving services include:
Meal deliveries
At-home nurses or physical therapists
Housekeeping services
Doing “elder-proofing” in your home with ramps and handrails
Legal aid
Financial counseling
Taking advantage of these services doesn’t mean you are incapable of
doing these things on your own— it just means that you don’t have to do it alone. Using these services can help you avoid feeling isolated and burning out.
Accept Help from Family and Friends
Along with accepting help from caregiving services, you should also use the help offered to you by family and friends. It can be hard to admit that you can’t do everything on your own, but everyone will be better off when you do. Not only does this greatly reduce your odds of burnout, but it will make your family feel better to be able to help you as well, even in small ways. Family and friends can help with:
Cleaning
Cooking
Doing house and yard work
Grocery shopping
Driving you and your loved one to appointments
Running errands
The last thing you want to do as a caregiver is burn out. By using these tips as a guide, you can avoid burning out and relieve some of your stress so you can be a better caregiver to your loved one.
As a caregiver, you have many responsibilities that can leave you physically and mentally drained. While getting your loved one dressed sounds like it should be the least of your worries, nothing is more frustrating than struggling to get arms up and into a shirt or needing to remove clothes in time for toilet needs. Adaptive clothing could be the solution that makes your day run a whole lot smoother.
What is Adaptive Clothing?
Adaptive clothing is designed to make getting dressed a painless and straightforward process. A lot of thought is put into how the clothing falls and is secured on the body. What makes them an attractive option is their ability to prevent injury by being more maneuverable and easier to work with. And, they aren’t just for the convenience of the caregiver.
Seniors with physical limitations or mobility issues often find them to be more comfortable than their regular clothes. Some are even able to live more independently because it allows them to get dressed freely without conflict.
You might be thinking that adaptive clothing is a style cramper, and your loved one wouldn’t be caught wearing them in public. While it’s true that options were limited in the past, today, adaptive clothing has evolved to be more than hospital gowns and stretchy pants. Many of the designs are modeled after popular styles and can address a variety of needs. In other words, seniors can feel good while looking great.
What to Look For
If you’re new to adaptive clothing, knowing what to look for can be mystifying. After all, adaptive clothing takes many shapes and has a variety of functions. They come in pants, tops, skirts, robes, capes, undergarments, and footwear. Not to mention, you may need to keep an eye out for specialized functionalities, such as for dementia patients who may have a tendency to disrobe or for people with diabetes who need compression wear. Here are some adaptive clothing features to keep in mind:
Shirts
Opens up completely (arms can slide in rather than be lifted overhead)
Magnetic, snap, overlapping, or hook and loop closures
Fabrics that won’t irritate sensitive skin, such as 100 percent cotton
Shoulder snap closures on pajamas
Full zipper backs to keep clothes on without worry of disrobing
Pants
Back of pants are able to be completely open
Legs can be inserted into pants while in a seated position
Able to open at the sides
Option for additional nylon handles that allow a caregiver to complete safe transfers
Elastic waistbands
Footwear
Use of hook and loop closure
Closure is adjustable in order to accommodate wide feet and other concerns
Suitable support
Slip-resistant soles
Non-constrictive diabetic socks to relieve issues with swollen feet and ankles
Anti-skid socks
Most people don’t give a second thought as to how they put on their clothing, but when you’re a caregiver, the challenges of dressing someone become obvious. Adaptive clothing is a gentle solution that gives the person in your care more comfort and independence. If you’re considering adaptive clothing for a loved one, explore the options and find the styles that fit their needs
With the aging of baby boomers, chances are there will also be an increase in the number of informal caregivers. Michigan State University Extension recognizes that caring for an aging parent may seem like a natural progression of life; however, many are ill prepared to deal with the social, emotional, physical and financial decisions that will arise. If you’re caring for a loved one, a family caregiver meeting can help you navigate the many decisions that need to be made.
If you are making these decisions on your own (for example, if you are an only child), then your scope of consulting would mostly fall between you and your parent. It may be helpful to include a social worker, your care receiver’s medical care providers and perhaps their religious advisor. The final decisions, however, are up to you and your parent.
If you have siblings, your decision-making circle is much larger and has the potential to be highly emotional. It may include a variety of opinions and be loaded with family relationship baggage. Siblings can be a major source of support and a major source of stress. Not everyone thinks alike or has the same amount of time or talent to devote to caregiving. For these reasons, you may want to consider having a family caregiver meeting. A family caregiver meeting can help you work on specific problems, give people a chance to share thoughts, make a list the needs of your loved one and opens discussion about who can best fill those needs and how.
Whom you invite depends on your own family dynamics. You may want to consider being more inclusive rather than being exclusive. You may assume someone is not interested or involved enough; however, that person may end up being someone who really has the time and would love to pitch in. More hands tend to make less work. If possible, be sure to include your loved one, as they are the expert on their thoughts, wishes and needs. If relationships with your siblings are typically contentious, you may want to invite a social worker or religious leader to help mediate.
A caregiver family meeting should not be much different from staff meetings at work to address tough issues or lawyers meeting to discuss a plea bargain. Both situations have the potential to be emotionally charged. However, the difference is in the planning. Imagine a lawyer going into a plea bargain meeting unprepared, with no notes, no facts, and just relying on raw emotion. You could be almost sure their client would not be getting the best representation that they need or deserve. A lawyer or a boss goes into a meeting at a set date, time, place with certain people invited. There is an agenda, rules of communication to follow, there is productive discussion, notes are taken, decisions are made, and subsequent meetings may be scheduled. Caregiver family meetings can be run the same way.
Whether you have no siblings or many, a planned and organized caregiver family meeting can help you all make the best decisions possible for your loved one. For more information about caregiving, you may wish to consider signing up for a Powerful Tools for Caregiver class. During six lessons, groups of caregivers explore and share tools for focusing on self-care in order to be able to provide the best care possible to a loved one. To find a class near you visit www.msue.msu.edu and search for Powerful Tools for Caregivers. You can also call your local Michigan State University Extension Office to inquire about starting a class in your area.
Research conducted by the National Alliance for Caregiving estimates over 1.4 million youth ages 8–18 are taking care of ill, injured, elderly or disabled family members. They are taking care of parents, grandparents and siblings as well as dealing with the most prevalent conditions: Alzheimer’s disease, dementia, heart, lung or kidney diseases, arthritis and diabetes.
What kind of care are they providing?
Kids are not just performing day-to-day household chores such as laundry, dishes, vacuuming and fixing simple meals, they are handing out medications, bathing, dressing, toileting and feeding family members. Some are even responsible for communicating with health care providers.
While it may seem inappropriate for kids to take on caregiving duties, changes in family structures, such as kids being raised in single parent homes or by their grandparents, increase the number of older people and multi-generations in households. Healthcare delivery has also changed so that home visits have decreased and an increase of care is becoming the responsibility of families instead of hospitals and doctor offices.
Why are kids in the role of caregiver?
Not everyone agrees that a child should be in the role of a family caregiver, however, changes in family structure and how healthcare is delivered impacts children. Economic hardships also play a part in multi-generation households, with married adults returning home with children. Regarding healthcare, medical facilities are no longer providing complex care, instead, it is being done at home by family members. Adults may be identified as the primary caregiver, however due to job obligations, children end up providing care.
How do caregiving responsibilities affect these kids?
Roger Olson, a clinical child psychologist at St. Luke’s Children’s Center for Neurobehavioral Medicine in Boise, Idaho, states that low level caregiving (helping with chores, running errands or spending time together) helps youth with character development. This type of caregiving fosters kindness, generosity, compassion and nurturance. The other, more personal side to caregiving including feeding, bathing or changing adult diapers, can take a toll and may be traumatizing to a child. Children have the coping skills of children and are not equipped to handle these stressful roles.
What can we do to help youth caregivers?
We can help young caregivers by knowing behaviors that may be signals of concern:
School: tardiness, missed days, incomplete assignments, lower participation in after-school programming, poor behavior and dropping-out
Emotionally: anxiety, depression, grief and feelings of being overwhelmed
Socially: difficulties getting along with others, loss of social activities and friendships
Physically: exhausted, lethargic and lack of interest in appearance
We can also bring awareness to our communities that kids are in this role. We can help by providing resource information for kids in our local schools, religious organizations and public libraries. Starting a local coalition can bring more attention and support for these families. Every caregiver needs and deserves support.
For information on youth caregivers visit the American Association of Caregiving Youth (AACY) at www.aacy.org or call 800-508-9618 or 561-391-7401 for direct assistance. The AACY website has suggestions and links that can help families, professionals and school-based staff to assist caregiving kids. Visit the Michigan State University Extension website for additional information related to caregiving.
Over 40 million people provide unpaid caregiving for a family member in the United States. The daily routine of caring for another often means caregivers are not taking care of themselves. The holidays can be a particularly stressful time for caregivers due to the break in daily routines, the additional planning necessary to join in celebrations, travel or to receive visitors. Some caregivers may choose to isolate rather than to burden themselves with making these plans.
The holidays are a wonderful time for other family members to express their gratitude and appreciation for their family member’s caregiving and help them enjoy the holiday season. Caregivers often put their needs second, third or last to other people in their lives. Offering the caregiver some relief would be a marvelous gift for the holidays.
Sarah Sobel, AAAWM Caregiver Services & Contract Administrator says, “Caregiving is stressful and the holidays can add to that stress. It is important for caregivers to do self-care.”
How can family help with this? Having a friend or family member stay with a loved one would offer the caregiver the freedom to get away for some rest and time for themselves. Stepping into the caregiver’s shoes for a weekend or a day can be eye-opening as to what the caregiver experiences regularly.
Julie Alicki, Certified Dementia Practitioner, points out, “This clues the rest of the family in on what the caregiver is going through — it keeps them in the loop.” If family members providing relief isn’t feasible, arranging for professional in-home care or respite services would be a great way to provide relief for a caregiver.
Relieving some of the daily tasks of a caregiver can also make a thoughtful gift. A membership to a grocery delivery service like Shipt or a meal delivery service like Hello Fresh would offer the caregiver one less task to manage. With winter coming on, arranging for a snow clearing service would provide some stress relief as well as additional safety for the caregiver.
Gifts they can use during some precious time off, like a spa day, tickets to a sporting event or the theatre, gift certificates to favorite restaurants, a round of golf, movie tickets or a weekend get-away make wonderful stocking stuffers for caregivers. If you’re a little more on the creative side, putting together a book of IOU coupons to be used throughout the year would not only help provide support, but would also assist the caregiver in being able to ask for much needed help more easily.
The greatest gift a caregiver can receive is time — time for themselves. Being given the ability to be worry-free and able to choose how they want to spend a few hours, a day, a weekend or even a week to themselves is a precious gift to a caregiver. It is also a tremendous acknowledgement on the behalf of family members of the gift the caregiver gives to another all year around.
Whatever we can do to though to demonstrate our gratitude and appreciation during this holiday season to the caregivers in our lives will reverberate throughout their year.
If you need help making in-home care or respite arrangements, contact Area Agency on Aging of Western Michigan at (888) 456-5664 or aaainfo@aaawm.org.
It’s easy to gravitate towards the idea that more is better. But when it comes to your loved one’s care, having more people around doesn’t always translate into better quality of care. The impact of one skilled nurse over several personal aides can be the difference.
One of the many misconceptions about assisted living is that it only offers long-term custodial care. However, some assisted living communities are beginning to offer skilled nursing care services to their residents. Here’s what that means.
What is Skilled Nursing Care?
When starting the search for a viable care option you’ll come across different terminology used in the care industry, and it’s important to understand the differences. There is a spectrum of care options ranging from basic needs assistance to medically licensed help. Making the wrong choice could lead to unintended consequences for a loved one. The two main players in the care industry are custodial and skilled nursing care.
Custodial care consists of any non-medical care that can be reasonably and safely provided by non-licensed caregivers. It involves help with daily activities like bathing and dressing. However, custodial care can also include assistance with household duties such as cooking and laundry.
Skilled nursing care is a whole different level of care. Professionals providing skilled care are always licensed health professionals like nurses and physical therapists. In addition to routine medical care, like tracking and administering medication, they have the ability to provide advanced medical services like physical therapy, wound care, intravenous injections, catheter care, and more. Usually, when skilled nursing care is employed, it’s medically necessary or ordered by a doctor.
When is it Needed
Many families ask the question if skilled nursing care is right for their loved one. After all, it’s not only more expensive, but also it may not be covered by Medicaid. Unfortunately, the decision is not always black or white. It’s still best to talk to their primary health provider for a professional opinion. But, here are a few life situations where a loved one could benefit from skilled nursing:
Rehabilitation care due to fractures or joint replacements
General rehabilitation due to weakness or physical decline
Diabetic rehabilitation
What Are the Benefits?
While assisted living communities are often perceived as senior housing designed for those who don’t need around the clock care, communities with on-site skilled nursing care can be a great option whether your loved one is looking for an independent lifestyle or requires near-constant assistance. Some of the benefits include:
Immediate medical attention. We become more prone to sickness with age. It’s not uncommon to experience a sudden change in health. A skilled care provider can be available for 24-hour care. You can rest easy knowing loved ones have rapid access to health care services.
Guidance on diet and nutrition. As we age, nutrition becomes even more important. Our bodies require different levels of vitamins and minerals to stay strong. Making sure our loved ones are getting the right kinds and quantities of food is essential for staying happy and healthy. Skilled providers can also give guidance on diet and nutrition for specifically for seniors.
There isn’t a one size fits all solution to long-term care. At times the best option can seem obvious, but often it can be confusing. Finding the most effective care solutions for a loved one starts with understanding their needs. There is a wide range of benefits seniors can experience from skilled care nursing, which can make this type of care the perfect fit for your loved one.
Being a caregiver is one of the most difficult roles to fulfill, yet with the population of people age 60+ continuing to grow, it is a role that 1 in 3 people find themselves taking on. Some of us are thrust into caregiving due to an illness or an accident. Oftentimes though, we discover that the caregiving role has crept in and slowly taken over our lives.
It might start out simple — taking a loved one to the grocery store on occasion. Then occasionally turns into every Wednesday at 3:00 p.m. along with doctors’ appointments several times a month. On these trips you notice difficulties with money or paperwork, so you double-check their bills, discover they are overpaying, and now you’re a shopper, bill payer, and health advocate. Sarah Sobel, LMSW, Caregiver Resource Coordinator at Area Agency on Aging of Western Michigan said, “When I talk with caregivers, often times I go through some daily living tasks and I ask them about how much assistance they are providing to their loved one with these activities. Many caregivers don’t realize how much they are providing assistance on a daily basis until it is reflected back to them.”
We discover we’ve become a caregiver and didn’t even know it.
What starts out as lending a hand gradually grows into another job. The National Alliance for Caregiving estimates that caregivers spend at least 20 hours per week caring for a loved one. Yet, many people in this position still don’t consider themselves caregivers, especially if their loved one continues to reside in their own home. We regard these tasks as the duties or responsibilities that a spouse, a child, a parent or even a friend undertakes for a person they love, so we juggle the caregiver role with other parts of our lives, like our career, family and social life.
Fulfilling the duties of caregiver without recognizing that we are a caregiver can result in stress, anger and ultimately burnout, putting our own health and well-being at risk.
Sobel said, “This is why I encourage caregivers to build a village — whether formal or informal — for the times when caregiving becomes hard to handle. Do they have a friend they can call to sit with their loved one, while they take a walk? Maybe their loved one is a good candidate for an adult day program — where they might receive some attention and the caregiver can have some time off to take care of themselves.”
When we recognize ourselves as caregivers, we embrace that we are going above and beyond typical expectations, and we also then come to understand that taking care of ourselves is paramount to our being able to take care of others.
This realization also opens doors to resources that can help support us in our new role.
“An important part of my work at Area Agency on Aging of Western Michigan,” Sobel shared, “is to provide the caregivers with education. These classes are a great way for caregivers to come together and learn about some of the issues they are facing.”
Taking advantage of the resources available in our communities helps caregivers build that “village” Sobel said is important, “In these classes, caregivers can come together — to share with each other about their experiences” and begin building a support network. Getting connected to resources early can also help us assess the growing needs of the person we’re caring for and, if necessary, get connected to professional caregiving services.
If you’re interested in understanding more about caregiving and the resources available, contact Area Agency on Aging of Western Michigan at 888.456.5664 or email aaainfo@aaawm.org. You can also visit the Caregiver Resource Network website. Caregiver Resource Network and Area Agency on Aging of Western Michigan can be found on Facebook.
According to a 2015 report on caregiving by the AARP, 16.6% of adults act as an unpaid caregiver of another adult age 50 or over. This may be a spouse caring for their husband/wife, a family caring for their mother/father, or even a friend caring for another who doesn’t have family available. As our aging population continues to grow, so will the number of people who find themselves in position of caring for a loved one.
Often when we begin having discussions about those we are caring for, with them or other family members, we often assume that the decisions are “Who is mom going to live with?” or “Should we start looking at nursing homes for dad?” A person caring for their spouse may be reluctant to ask for help, believing that it means they are incapable of providing for their loved one, and fear losing them as a result. Many people are unaware that there are options available for older adults that may not require a move or loss of independence at all.
The MI Choice Medicaid WaiverProgram is one of these options. Created in 1992, MI Choice is an income-eligible program providing in-home services to older adults in order to help them remain in their own homes rather than a nursing home or to move in with a relative. With assistance, many older adults are able to live independently for the remainder of their lives.
Individuals in the MI Choice program can receive help with all sorts of daily living tasks, like in-home cleaning services, bathing and dressing, nursing, and meal delivery. Individuals may qualify for services like home modifications, personal emergency response systems, and transportation. For those families who already made the choice to have a loved one move in with them, these services are available to help care for a loved one in your home, as well as respite services for those times when family caregivers need a break. In addition, MI Choice Medicaid Waiver saves Michigan tax-payers money.
Providing in-home services costs far less than a move into a nursing home. Applying for the MI Choice program begins with a phone call to Area Agency on Aging of Western Michigan. Applicants to the program are pre-screened for income eligibility, so it is important to have financial information on hand. Once an applicant’s income is verified, a Care Management team, comprised of a Social Worker and an R.N., is sent to the home to do an assessment. This assessment determines what supports are necessary to help an older adult remain at home.
Throughout this process, the individual and anyone else they choose to have involved has a say in what services they want and how they want them delivered. There are supports we may be qualified to have, but we do not want them, or we want less of them. The Care Management team will work to insure you have a say in decisions made about your care every step of the way.
If you are interested in learning more about the services that may be available to you or your loved ones or you would like to begin the application process, contact Area Agency on Aging of Western Michigan at 888.456.5664 or email at aaainfo@aaawm.org. Even if the MI Choice Medicaid Waiver program isn’t for you, there are a number of other services available through Area Agency on Aging of Western Michigan and their partners for older adults, people with disabilities, and their caregivers. Visit our website: www.aaawm.org or find us on Facebook.
