Elder Care

Caring for an Older Family Member

Providing care to an older family member can be a blessing but also cause stress.  More than 60 million people were caregivers during 2009 with an estimated cost of $450 billion (AARP Public Policy Institute, 2011).  For the caregiver, earning potential and income can also be affected. In 2009, caregivers reported that they shifted around their work schedules, took time off from work to provide care, reduced their work hours or actually gave up work entirely in order to care for an older family member.

What is Caregiving?

The definition of caregiving is that sometime within the last 12 months some type of care to persons over the age of fifty occurred and consisted of assistance with Activities of Daily Living (ADLs) and/or Instrumental Activities of Daily Living (IADLs).

ADLs IADLs
Bathing Using Telephone
Dressing Transportation
Grooming Shopping
Toileting Cooking
Transfer Housework
Continence Laundry
Feeding Taking Medications
Managing Finances

Who are Family Caregivers?

Most caregivers are women, wives, daughters and daughters-in-laws. The typical caregiver is female, 48 years old. One third of caregivers provide care to more than two people and spend on average 20 hours per week providing care. The issues of caregiving are complex and involve hands on help and supervision, financial management or support, emotional and social support, medical and legal decision- making and health care. Caregivers often suffer from emotional distress, related to their own work and family responsibilities and health issues including isolation and depression.

What Family Caregivers Do: The New Normal

Caregiving for an older family member is becoming increasingly complex and demanding. This is a snapshot of what today’s caregiver does:

  • Provide companionship and emotional support
  • Help with household tasks
  • Handle bills/insurance claims
  • Carry out personal care
  • Responsible for nursing procedures in the home
  • Administer multiple medications
  • Identify and coordinate services
  • Hire and supervise direct care workers
  • Arrange transportation
  • Communicate with health care professionals
  • Serve as an advocate at medical appointments/hospitalizations
  • Implement care plans
  • Coordinate care during transitions – hospital to home

These are some of the reasons why the health and emotional well being of caregivers are at such great risk Stress and caregiver burnout can quickly become realities. Self-care, asking for, and accepting help can reduce or eliminate caregiver burnout.

What Family Caregivers Say They Need

In the Caregiving in the US 2009 Survey (National Alliance for Caregiving and AARP), caregiviers reported that  they needed more help and/or information on how to keep their loved ones at home safely, how to manage their own stress, learn about easy activities to do with their loved one and ways to find time for themselves.

Where to Family Caregivers Go to Find Help?

In the same survey noted above, caregivers reported, in the following order, where they seek out help:

  • Healthcare providers
  • Internet
  • Family, friends and other caregivers
  • Aging or disease specific organizations
  • Government programs (Medicare, SS, VA)
  • Social or community services
  • Books, magazines, library

How to be an Effective Family Caregiver

  • Be organized.
  • Ask questions.
  • Write down the answers and names of people you spoke with.
  • Do your homework about community-based services and health care providers who are geriatrically sensitive.
  • Have an honest conversation with your older family member about their actual or potential needs before there is a health or social crisis.
  • Inform yourself about aging issues, services and resources.
  • Ask for and accept help from your other family members and friends.
  • Take care of your own health.

Family Caregivers 12 Step Program

  • Take five – minutes for yourself
  • A friend indeed – reach out to friends
  • Shift gears – slow down
  • The worry hour – set time aside if you must worry
  • Love to laugh – keep your sense of humor
  • Get some perspective – step back
  • Take action – plan ahead
  • Avoid the shoulda-coulda-wouldas – should/could/would have done this or that
  • Pursue other interests – hobbies, friends
  • Spiritual support
  • Meditation, massage and other forms of relaxation
  • Indulgent necessities – hairdresser, shopping

Lots of Stressing – Where’s the Blessing?

  • Reciprocation of love and attention
  • A chance to say things you might not have said otherwise
  • Cherishing things said to you like “thank you”
  • A recognizable and notable closeness
  • A feeling of having no regrets

It’s important to take the time to acknowledge these “blessings”.

Resources

BMC:
Employee Assistance Program – confidential counseling via toll-free phone line or in person for BMC employees and eligible dependents.
BMC Human Resources – non-confidential services for BMC employees
BU Geriatric Services at Boston Medical Center – interdisciplinary group of health care professionals whose mission is to address the special needs of the diverse geriatric and homebound populations of the City of Boston.

BU:
Faculty and Staff Assistance Office – free, confidential counseling and referral service for faculty, staff and their families with locations on both Medical and Charles River campuses
Office of the Ombuds – confidential, impartial, problem-solving resource serving faculty, staff, and students on the Charles River and Medical Campus
BU Human Resources – Human Resources on the Medical Campus is available to prospective, current, and retired employees of Boston University. Services are not confidential

Off Campus:

Commonwealth of MA, Executive Office of Elder Affairs – home care programs, meals and nutrition for the elderly, caregivers support resources, and more
Action for Boston Community Development: Elder Services – intergenerational programs and senior services to help empower older citizens to prevent illness and disability and maintain optimum well-being
Jewish Family and Children Service – services include support and education for the transitions of aging as well as short and long-term care, geriatric care management, mental health counseling, and support for people with Parkinson’s and their caregivers
Elder Services and Eliot Community Human Services – Ombudsman Program assists residents of licensed nursing facilities and rest homes
Boston Elder Info/Caregiver Alliance assists elders and their families in accessing a comprehensive range of services that address age-related needs. Call 617-292-6211.
National Family Caregivers Association educates, supports, empowers and speaks up for the more than 65 million Americans who care for their loved ones. Call 800-896-3650.
Alzheimer’s Association of Eastern Mass – the leading, global voluntary health organization in Alzheimer’s care and support, and the largest private, nonprofit funder of Alzheimer’s research. Call 800-548-2111
Aging Care – an online community that connects people caring for elderly parents to other caregivers, personalized information, and local resources.