Transitions: making the move

You’ve finally reached the point and the decision: you’re going to help your mom, dad or other family member move from home to a care community. What should you expect? What can you do to make the transition better for both of you?

Make the move easy. When you’re planning moving day, make sure you consider how to make the move as quick and easy as possible.
* Enlist the help of every family member possible.
* Offer your loved one an option – their choice – of staying while you move their belongings or going to lunch or for a ride, while other members of the family make the move.
* Minimize the amount of things moved. Many older people enjoy the process, once the decision has been made, of gifting their items to various family members, reflecting on the items heritage or meaning during the process. Ask your loved one to select just those things he needs for basic comfort and then either store or get rid of the rest. Most moves entail downsizing significantly, so start that process off right by not bringing too much in the first place. Besides, a less crowded space feels bigger.
* Move as quickly as possible, and then relax a bit with your loved one. Allow time in your moving day schedule for a dinner together, a drink or light meal at the end of the moving day. This is a chance to focus on the relationship, not just the task of moving. That’s important on moving day.
* Leave. There will come that moment when the work’s essentially done, you’ve relaxed and chatted a few minutes, and there’s not much more to be done. You may have that feeling like you’re leaving your child at daycare for the first time in the pit of your stomach, but you need to make your exit. You need to give your loved one time and space to begin his own journey of adjustment.

Visit. Some care communities may advise you not to visit for the first few days or even weeks. Unless this is a firm requirement, smile, nod, and plan your next visit. It’s important to your loved one to know that you haven’t done the much feared “dumped at a nursing home” maneuver. Your regular visits will reassure your loved one that you’re still going to be involved, even though his physical residence has moved. Make an effort to make your visits about the relationship, too, not just tasks. Moving your loved one to a care community can relieve you of many tasks; it will never take the place of your relationship, however. Focus on your relationship by:
* Bringing in picture of your children or other family members
* Sharing meals together when you visit
* Taking walks together or taking your loved one for a drive in the countryside
* Talking about your regular daily life and routine
* Encouraging other family members, especially youngsters, to visit regularly, too.


Get acquainted. On your visits, try to get acquainted with the staff at the new community. Meet the front desk people and the manager, the dining room staff and the housekeepers. Introduce yourself, smile and thank them for their work. You’ll gain the trust and respect of important people involved in the welfare of your loved one; you’ll also know who to turn to if something goes wrong. You may want to get acquainted with other residents and their families as well, a step that frequently speeds the settling in process.

Be patient. It takes time for a person to adjust to a move. Some people will adjust quickly; others will still be adjusting several years after the move. Be patient, and let your loved one adjust at his own pace. Complaints may be frequent initially, especially about food. Listen, sympathize, but don’t rush to the manager demanding changes unless you witness the problems yourself, too. Be patient with staff, too, especially in new communities. It takes time for everyone to learn their jobs and to do them flawlessly. Expect some level of human error - housekeeping that miss a garbage can, for example, or soup served a little cool, but expect excellence in any personal care or services that are delivered. If the community laundry is cleaning your loved one’s clothes, expect that some items will go missing, and other items might get shrunk or bleached. Keep your loved one’s irreplaceable clothes or jewelry at your house, or launder them yourself (be sure to let the staff know).

Tune in to your own reactions. Be aware of those moments when you feel a wave of sadness wash over you for the losses your loved one has experienced. Feelings of sadness and guilt are normal, common reactions. You might think, “I should have cared for her myself,” but don’t let these feeling drive you to actions that make matters worse. Often, family members who are racked with guilt turn their feeling toward those providing the care, relentlessly finding fault, blame or error. If you find yourself complaining on every single visit, check in with your own feelings to see if you may be turning your own feelings of guilt or anxiety toward the people caring for your loved one. If you think you might be feeling more than the usual level of sadness or guilt, get help. Find a counselor, pastor or good, patient friend to listen and help you work through your emotions.

Many people find moving to a care community one of the most difficult tasks they do as caring family members. But most find that they’re happier, healthier and better off because of the choice, often sooner than they would ever have expected. It just takes a little effort on your part to make the transition.

Caregiving takes an emotional toll on the whole family

My friend Vickie came into my office today for a meeting. We had a chance to catch up after the meeting and I asked Vickie about her current work/family situation.

“I’m working as a caregiver for my father-in-law these days,” Vickie said. “He has late stage Parkinson’s disease and requires help with everything. We have a lift to get him in and out of bed; I’ve got to care for his catheter; it’s just a lot of work.”

I asked her how many hours each week she spent helping her mother-in-law, assuming that she traveled to their home for a few hours each day.

“That’s the hard part,” she said. “They live with us. The caregiving never ends – I can’t begin to count how many hours each week I work.”

She was excited to be out of the house for the meeting as it was just about the only break she could see on the horizon.

As I listened to Vickie I heard what I hear so often from family caregivers: the work is not only physically challenging, but emotionally draining as well.

It’s hard to be the “rock” that your family relies on. It’s exhausting, no matter how much help you get from other members of the family.

Vickie’s husband, mother-in-law, son and grandchildren are all involved in Grandpa’s care. But at the end of the day, the person they all turn to is the one with the experience and training as a caregiver – Vickie. And of course, Vickie being the person that she is, worries about them all even when she’s not there.

I don’t really have an answer or a solution. What I know is that family caregivers need our emotional support, maybe even more than they need help with actual caregiving tasks.

They need us to thank them for their work, to honor and validate their importance in our families’ lives, and the contribution they make to society as a whole.

It’s not much, but it might make a difference for Vickie and all those other caregiving family members just getting through another challenging week.

Families need caregiver training to add skills to loving care

Caregiver training is the number one topic of conversation in our office lately. We initially developed our Caregiver Certification course for people working for in-home care agencies. In-home care is one of the fastest growing segments of all senior care, and our own division of in-home care is growing at a phenomenal pace.

We’ve also been hearing stories from individuals all over the world, seeking training to become experts in caregiving.

One school in Fiji is now using our online course to train students to become caregivers throughout the islands.

Today, I responded to a woman in Mumbai, India regarding this training. She cared for her own mother through the stages of Alzheimer’s disease, and realized that she didn’t have the knowledge and skills to provide good care. At one point, she says, “I could not take it anymore.”

As she searched for answers, she says, “It then dawned on me that I was basically giving in to the situation and giving up on her.” She determined to learn as much as she could about caregiving, and found approaches that have really helped her mom. Now she wants to help others with similar diseases, but knows that she is not fully prepared for this.

We hear stories nearly every day from family members who are realizing the same thing: they want to provide care, but they’re not trained or prepared to do it well.

Family members provide somewhere between 70 and 80 percent of all care to seniors in this country. Most are caring with their hearts; many realize they need more skills training, too.

For families – and professionals – training can add essential knowledge and skills to a caring, compassionate heart.

Family caregivers are heroes, worthy of their own stamp, and a whole lot more

Family caregivers are heroes, worthy of their own stamp, and a whole lot more A U.S. postage stamp honoring the more than 50 million family caregivers may be released by 2011, according to a news report last week.

“The objective of the campaign is to bring awareness of the issues facing family caregivers to the general public, healthcare professionals and public policy officials. A family caregiver is a relative or friend caring for a loved one who is chronically ill, disabled, or living with the frailties of old age and needs assistance. Family caregivers provide nearly 90 percent of the services needed by their loved ones. These services were conservatively valued at more than $375 billion in 2007,” according to the report.

The commemorative stamp is currently under consideration by the U.S. Citizens' Stamp advisory Committee, and you can sign a petition for support of the idea at: www.thefamilycaregiver.org/.

While the honor and recognition that a commemorative postage stamp brings is a wonderful thing, I must admit to thinking, “Most family caregivers could use a lot more than just a stamp!’ Caregivers need some practical help as well.

That thought led me to a new website I’d like to share with you: www.agingcare.com. It’s about as packed full of helpful information as anything else I’ve found, from care and housing suggestions to advice about money, legal issues, and care products. It also has a great community forum, offering family caregivers the chance to exchange ideas, tips, and frustrations with each other and with experts. Check it out!

It’s not easy being green

For some reason – maybe the fact that yesterday was St. Patrick’s day - that refrain from Kermit the Frog came to my mind.

In fact, it’s not easy being anything when we’re talking about family caregiving - except maybe "blue."

It’s not easy being patient – when you’re tired and simply want to get through the tasks to the end of the day.

It’s not easy being compassionate – when you have to wonder if the person in your care is really, truly doing his best.

It’s not easy being cheerful and fun-loving – did I mention being tired all the time?

A new email friend of mine shared with me that she has slept on the couch for the past 2 years so her mother can have her bedroom. Did I mention being tired all the time?

Yesterday was St. Patrick’s day. St. Patrick is the patron saint of Ireland, but we don’t really know much else about him.

Perhaps, like a caregiver, he worked in quiet solitude, helping others gain quality of life to the end of their lives.

Perhaps, like a caregiver, he was tireless in his efforts to bring comfort to those who were troubled, physically or spiritually.

Perhaps, like a caregiver, he sacrificed so that he could do what he believed, in his heart, was his God-given mission on earth.

The weary, devoted family caregiver today will probably never become thought of as a saint.

But then, I’ll bet Patrick never thought that would happen to him, either. I'll bet he never even considered that one day, people would wear green and celebrate his day.

Who knows? Maybe someday we'll all celebrate the true saints that are today's family caregivers.

Need a caregiver? Do's and don’ts of hiring unemployed family members to be caregivers for a loved one.

Most of our clients are in the business of providing care to seniors in assisted living or other community based care settings.

We’re hearing recently that the current high level of unemployment is causing some of our clients to lose their residents to family members needing work – and pay.

It makes sense, certainly, to pay a loved one who desperately needs the work and income to care for mom, rather than paying strangers.

It makes sense, at least, only if the unemployed family member is prepared, capable and ready to provide care.

If I were considering hiring an unemployed cousin to care for my mother, here are some of the questions I’d be asking:

1. Does she have the temperament to be a good caregiver? Is she patient, compassionate, and caring by nature? I might consider how she handles pets, children, friends and neighbors. People who are by nature good caregivers tend to be that way with everyone in their sphere of contact. You can tell the good caregiver in your family – she’s the one who remembers that you hate chocolate, and buys vanilla cake for the party. She’s the one who will rush to pick up the fussing baby, and gently rock it back to sleep. If you think about your relatives, you’ll know who would make the best caregiver, and who probably wouldn’t. That’s question #1.

2. Does she have the time to be a good caregiver? Just because a loved one is unemployed doesn’t mean that she will devote the time to your relative you need. Caregiving means making a commitment to the person receiving care, and to you. Just being present (and spending most of the day job-seeking online) isn’t caregiving. Neither is adding an elderly loved one to a family with children, no longer going to daycare to save money.

3. Does she have the training to be a good caregiver? Fortunately, this doesn’t have to be a make-or-break item on the list. Good caregiver training is available in many places in almost every community. Great books, guides and workbooks are available; there are even online courses for comprehensive caregiver training available and affordable.

These are the first three questions I’d ask myself if I was considering hiring a family member to care for my mom. It’s a good starting point for a very important decision.

When the "Pro" becomes the family caregiver

Wendy Finch is our Vice President of Business Development. She’s been with the company for over 12 years.

But two years ago, she became a family caregiver.

Her mom’s mother, Wendy’s grandmother, became ill and needed a little help with her daily activities. She wanted to stay at home – no, she insisted that she was absolutely, positively going to remain in her home.

Less than a year later, she fell and broke her hip. Against all of Wendy’s professional experience and advice, she was determined to go home.

Wendy’s mom quit her job to become her caregiver, but grandma needed 24 hour care, around the clock.

So the family began the challenge of finding and hiring personal caregivers.

They chose to hire caregivers directly, since they had an “expert” in the family. They’d save money that way, and be able to afford better care, longer, with the resources grandma had at her disposal.

What followed was a scene that family caregivers everywhere can relate to. The daily phone calls (“what do we do when she refuses her medicine?”). The no-show caregivers. The need to find qualified individuals to hire to replace caregivers who could no longer cover all the care needs.

Most of all, the exhaustion and the continual sense that caregiving is a job more challenging than raising a child. If, in fact, raising a child takes a village, caring for a beloved elder takes a full city of people, resources and energy.

Today, Wendy is the staunchest support of our newest online course, the Caregiver/Personal Care Aide Certification Course. She knows what caregivers need to know to provide high quality care, whether they’re related to the person or not. She knows that often – in the middle of the night, or the middle of the afternoon, caregivers are alone with the person in their care, and need all the help in caring and coping they can possibly get.

Wendy’s family, supported by paid, trained caregivers, cared for her grandmother right to the end of her life. She stayed in her home, just like she wanted. She was lucky, too, to be surrounded by family members who not only wanted to do the right thing, but who also had the training and experience to know what that right thing was.

The experience has helped Wendy better understand what other family caregivers are going through too. It’s no longer just a professional awareness; it’s personal, too.