May 2018 - Green Tree Home Care

Few things are more synonymous with the finer things in life than a delicious meal. If you grew up in a household where home cooked meals were a cornerstone of comfort, it can feel jarring when elderly people lose their appetite altogether.

Often changes in appetite set in slowly. Family members may not notice eating changes until there is a health consequence or drastic weight change. Changes in appetite occur throughout life as we age. Some changes are good like moving away from hotdogs and instead choosing broccoli. But, when elderly people rapidly lose weight, there may be underlying health issues that affect nutrition. Malnutrition is the elderly population is a problem. There are things you can do to help your loved one who has lost her appetite.

Visit Your Doctor

When you notice your loved one is not eating or has lost weight, it is time to schedule an appointment with your loved one’s primary care doctor. Changes in cognition or acute illness can suppress appetite and cause drastic weight loss. You doctor may be able to address these physical illnesses and get to the root of what is causing your loved one’s loss of appetite. Your loved one’s doctor may also be able to make nutrition suggestions. Your doctor can also order medical services like home health which may include the support of a nutritionist. You may also want to schedule an appointment with your loved one’s dentist. Poor fitting dentures can cause discomfort and can lead to a decrease in nutritional uptake.

Contract with a Meal Service or Home Care Provider

There are many meal services that cater specifically to the homebound senior community. Some of the meal services have free or reduced meals depending on the financial needs of your loved one. Meals are delivered regularly. Senior centers often have meal programs. These programs meet an important need because they offer nutritious meals and socialization. Some of these senior centers offer transportation services as well. So, even people who have limited transportation can participate. Home care companies like Green Tree Home Care send caregivers into the homes of clients to help with tasks like meal preparation. Depending on the wishes of the client and family caregivers can prepare home cooked meals to the clients task. Caregivers can also dine with clients to encourage eating and socialization.

Plan to Eat Together

Eating is a social event! Sometimes elderly people lose their appetite when they feel lonely or depressed. Sometimes, the simple act of sharing a meal will perk your loved one right up and bring a lackluster appetite back to normal. Arrange family and friend visits around meal times and offer to bring favorite foods. If you aren’t close by skype or call your loved one. Set a virtual lunch date or offer a gentle reminder to eat. Help get your loved one involved in groups and organizations who regularly get together to socialize and eat.

Simplify the Plate

If your loved one is suffering from dementia or cognitive decline. One noticeable symptom is a decline in appetite. According to the Alzheimer’s Association, people who have dementia may experience perception changes. These changes include difficulty recognizing food and distinguishing between food and non-food items. Keep the plate orderly and limit the number of foods on a plate to reduce confusion. Do not clutter the table and give plenty time for your loved one to eat.

Make Food Easily Accessible

As people face reductions in mobility and stamina they may struggle to prepare food for consumption. This can lead to a cycle of decline. Put nutritious food within easy reach. Make sure your loved one can open bottles and heat meal. Sometimes pride and embarrassment keep people from asking for help. Instead they turn to more convenient foods that may have poor nutritional value. Grocery delivery services can ease the burden of shopping. You can help your loved one set up regular deliveries. There are also online services that deliver entire meals to the door in cooled boxes.

Wrap Up

A wide variety of physical and environmental circumstances can cause elderly people lose their appetite. Without addressing the root cause of changes in appetite elderly people are at increased risk for decline and malnutrition. You can follow these five suggestions to help your loved one get her appetite back.

Is there a difference between agency caregivers and private caregivers?

Learn the bottom line facts when it comes to private caregivers vs agency caregivers.

Private Caregivers Vs Agency Caregivers

When it comes to providing home care for our senior loved ones, we all want the best value for our financial situation.

Thus, it is easy to pick one kind of caregiver over the other because of personal stories we have heard.

It is important however, to consider if private caregivers are better for your specific situation or not.

This is not a post against private caregivers as they are some gifted caregivers out there who don’t work with agencies.

However, the points we raise below will help you think through your decision when the time comes to either go with a private caregiver or an agency caregiver.

Private Caregivers May Not Have an Insurance Policy

Depending on which state or local vicinity a private caregiver is operating from, they may or may not have an insurance policy.

If an injury occurs on their watch, you are left vulnerable.

You could be paying for unexpected hospital bills out of pocket.

In order for any senior care home care agency to exist, they have a legal obligation to register and insure their company.

This insurance plan does not exist to protect the agency alone; it is meant to protect your senior loved one as well.

Do They Have Proper Training?

A private caregiver may not have the necessary training to provide the highest quality of care to your senior loved one.

While hiring a private caregiver may help cut the corners on cost, the life of your senior loved one is arguably more valuable than that.

If you’re going to go this route, at the very least make sure they have basic life support training that covers first aid and CPR.

You will also have to make sure that they are familiar with medical conditions your loved one has so they provide the most appropriate care.

Do They Have Reliable Recommendations?

Does your private caregiver have reliable recommendations or did you find them through a Craigslist ad with no evidence that they have done this before?

At Green Tree Home Care for instance, we have an eight-step interview process for our caregivers to make sure we choose the best.

As a company we want to give the kind of home care that helps your senior loved one live a productive life.

Thus, making sure your caregiver has recommendations is important.

Coverage When Something Happens

Life happens.

If your private caregiver does not show up for work one day, do you have a back-up plan?

When a caregiver does not show up, it throws a wrench into your daily plans.

When you work with an agency, they provide coverage when a caregiver calls out sick or does not show up for some reason.

Your plans should not be interrupted just because a caregiver didn’t show up.

Supervision

Private caregivers typically work for themselves. This usually means that they answer to nobody about the care they provide your loved one.

Caregivers working for a home care agency on the other hand, work as employees or independent contractors.

There is supervision that is provided through the home agency office.

This supervision ensures that plans of care specific to your loved one are executed.

Depending on the agency, supervision may require that a caregiver clocks in and out through company-monitored software.

Caregivers may be required to check specific tasks within that software during their session.

Their session may require that somebody in the home signs off on their reporting.

At Green Tree Home Care, we use a use a tool called Family Room that allows anyone who cares about your senior loved one, (example, your siblings who live across the country) to log in and follow along with the care we provide.

This type of care transparency may not be provided by a private caregiver.

All these checks and balances are important to make sure the highest quality of care is provided and ultimately to protect your interests as a paying client.

Closing Thoughts

Working with an agency may require that you jump through a few processes.

You may even view these processes as “hoops”.

These processes exist however to protect you as a paying client.

Most importantly, they are there to protect your senior loved one from preventable untoward events.

Please take all the essential steps to make sure you protect your interests when you’re choosing a private caregiver.

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Living with elderly parents is about providing care for their changing needs.

But, have you considered how living together might create tension?

Practice these 5 rules to keep the peace.

5 Rules Every Adult Child Should Consider While Living With Elderly Parents

Understand that Your Experiences are Different

People who grew up in the days of the Great Depression have different views on money than say a millennial.

These views extend to a number of things.

Everything from how children should be raised, how a home should be run down to how spouses talk to one another is heavily influenced by the era a person grew up in.

Conflicts easily arise because of these generation gaps and it is important to know that as you move your parent in, you will run into these types of problems.

Being ready for it will reduce the number of things you disagree on that are based on the different eras you both have experienced.

Consider Your Own Code of Behavior

We all deal with people we would rather not interact with everyday.

It could be at your local grocery store or it could be at your workplace.

In these instances, we always have a code of conduct we adhere.

Remembering your own code of conduct when you have to deal with difficult people will help you keep the peace with parents who have difficult personalities.

Yes, it is possible to co-exist peacefully with people you don’t like. Even if those people are your own parents.

Communicate Clear and Reasonable Boundaries

Set clear but reasonable boundaries that accommodates both of your needs.

It’s a well-researched fact that when boundaries are not clearly stated in a relationship it leads to conflict.

Since your elderly parent is moving into your house, it is important to communicate respectfully exactly what the rules are at your house and what the consequences are of breaking those are.

Perhaps you have a family and you like to get your children into bed by 8 pm.

This requires that the house is nice and quiet by a certain time.

If your parent is a night owl who has the television blaring into the wee hours of the night, it is important for you to communicate to them that you would appreciate it if they lowered volume of the TV after a certain time to allow your children to receive enough rest.

They may break the rules a few times, but staying firm with what you want and doing so in a manner that appeals to the sensibilities of your elderly parent goes a long way to keeping the peace.

Face the Reality: You Cannot do it all on Your Own

While a lot of us like to masquerade the world like we are superheroes, the truth is that nobody accomplishes great things on their own.

Taking care of your elderly parent is tough.

Moving them in with you is yet another bold move.

If your elderly parent has dementia, Alzheimer’s, urinary tract infections or any other health conditions, it throws an extra wrench into the whole situation.

It is understandable that you get burned out in these situations.

And it is almost inevitable that you will lose your cool and become very annoyed with your parent.

You’re not alone.

Caregiver burnout and stress is more common than you realize.

As a matter of fact, according to this study published by the American Psychological Association, there is a correlation between caregiver stress and elder abuse.

On top of that, being stressed out as a caregiver is not good for your own health.

Stress is related to problems like high blood pressure and heart disease.

One of the ways to reduce your stress as a caregiver is to get help.

This could involve enlisting the help of siblings or other family members to help with caring for your parent

Alternatively, you could source help from a home care agency like Green Tree Home Care.

Have the “Money Conversation”

Money is a common cause of contention for many families.

It is important to have the “money conversation” at the very beginning of living with elderly parents.

Your parent may still be collecting pension payments each month or may have financial investments they are benefiting from currently.

Having the money conversation with parents is not an exact science.

However, what you do want to avoid at all costs is the accusation that you are mismanaging your parent’s funds.

In the case where your parent has money that needs to be handled, getting the help of a licensed fiduciary can ease conflicts about money.

(Read more about fiduciaries and how they can help your parents with finances here.)

If your parents have no funds and all financial responsibility of taking care of them relies on you, it is also important that you settle this fact within yourself and where applicable, with your spouse and children.

It is not fair to remind your parent constantly that you are paying their bills and taking care of them financially.

Closing Thoughts

Living with elderly parents can be a pleasant experience with the right rules in place.

In this post, I’ve shared 5 rules you should consider while living with your elderly parents.

Implementing these rules especially at the beginning of cohabitation will ensure peace prevails in your home.

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During my fourth pregnancy, I got the unhappy news I needed to go on bed rest. I reluctantly put my regular life on hold and vowed to leave the chores and daily tasks to someone else for a short while. This was not an easy promise to keep. I felt resistant to home care. I hated losing my solitude and independence and I wasn’t comfortable relying on someone else for basic needs. As a home care owner, I knew how to arrange care.

Learning to Receive Care

But, learning to receive care was a whole new beast. The lovely caregiver came to my home pressed and polished. Now, as the client, I saw this experience through new eyes. She stood ready and willing to do whatever I asked. She was friendly and helpful. I couldn’t have asked for a nicer person. But, nice didn’t do it for me. Generally, I am a naturally quiet person. I am efficient and prize self motivation in myself and others and I don’t like telling people what to do. I want them to give me ideas of things they are willing to do. For me, talking was not a necessary exercise. I like it very quiet. This is just who I am and this lovely lady was not the right for my personality. She did NOTHING wrong. But, when it comes to sharing your personal space with a caregiver personality fit is super important. She was placed with a different client and someone new was sent to me.

Finding Caregiver Success

This time I was very specific about the qualities I knew I wanted and I communicated those with the staffing team. They hit it out of the park with Lacey. Lacey arrived and introduced herself. I gave her some introductory directions and she set to work. She worked her way around the house and looked for opportunities to take work off my plate. She asked me before tackling big projects. But, with my quick approval she completed her chosen task with detail and speed. I loved her vibe and we became friendly. I looked forward to seeing her and she got to know what I liked and how I liked it. When the baby came and I was off bedrest, I felt a sense of loss that Lacey would not continue our routine. I had gotten used to the help and enjoyed the camaraderie.

I learned from the client perspective how important the personal connection is. And, how difficult it feels to adjust to a new person sharing personal space. If you or your loved one feel resistant to home care, here are a few tips that helped me adjust to receiving help.

Make a List of Tasks You Need Help With

Before anyone ever came to the house. My family and I sat down to prioritize what tasks we needed help with. My husband hates to cook but enjoys laundry. Our older daughters agreed to keep up with pet care. No one wanted to take on meal prep. So, cooking went to the top of the list. After our family pow wow we had a solid list of must have duties and a few nice to have tasks sprinkled in. But, more than the task list, talking together about the coming caregiver gave us time to emotionally adjust to receiving outside care support. Discussing how someone might help us made the situation seem more positive than scary.

If you are helping a loved one arrange home care, I recommend you meet with your loved one to discuss where the added help will be most effective. If your loved one is resistant to care the caregiver task list can end up a bit short. It is important to tease out places your loved one might accept help. Forcing people to accept care often creates conflict. So, list building and family discussions play an important role in early acceptance.

Clearly Communicate Your Care Needs to Your Chosen Home Care Agency

You know your loved one and what he or she needs. Make sure you share all care requirements. Sometimes family members are embarrassed by a loved one’s personal biases or desires. But, it helps create a smoother transition if a client isn’t immediately put on the defense.

Give Feedback

Caregivers can’t improve if you don’t communicate with them. Your chosen agency is the actual employer of your caregiver. Great agencies use your feedback to provide caregiver coaching. Sometimes creating client specific cleaning schedules or offering gentle feed back is all it takes to move a caregiver from good to great. Weather you offer coaching directly to your caregiver or share your feedback with the agency so they can encourage improvements you must get used to offering constructive criticism. I recommend you share concerns quickly before irritation becomes frustration. If your loved one is resistant to care asking her to accept a caregiver may feel frustrating. Make sure caregivers are properly trained before starting work with a resistant individual. Once a client moves from open to frustrated, it is harder for the caregiver to create a professional bond.

Be Patient

It takes time to adjust to change. Be prepared for your loved one to feel resistant to home care for some time. Even when the caregiver is a great fit, it can take weeks to get used to having a caregiver come in. This is especially true for people who have some level of cognitive impairment. They may need to spend many days with a caregiver before they feel comfortable with a new face.

Wrap Up

If you or your loved one feel resistant to home care, you are not alone. It takes time to feel comfortable with someone in you personal space. Preplan and make lists so you know exactly what you want a caregiver to help with. Usually the list evolves as client and caregiver become more comfortable with each other. Let your caregiver know how you feel he or she is doing whether it is good or bad. And, be patient with yourself, your loved one, and the caregiver. This is new for all of you and sometimes it takes time to settle into comfort!

Are you thinking about moving your parent in with you? Here are 5 cohabitation realities you may not have considered yet!

This post is in no way written to scare you or dissuade you from allowing your parents to move in with you.

There are simply serious points to consider as you take this very important decision.

Let’s dive in.

5 things to consider before moving your parent in

1-You have changed. So has your parent.

It is important to realized that since you moved out from your parent’s home in your late teens or early twenties, both you and your parent have changed.

Your personalities may have remained the same but perhaps they way you like to eat or the way you like to keep your home has changed drastically.

They are set in their ways. And you are set in yours.

This may cause some friction between you and them.

It is important to realize that personal conflicts will arise because of this.

2- The time/money investment

Moving your parent in with you is a time and money investment.

If you have to move your parents by yourself, you will have to take time off work, go over to their home, help them pack, get rid of stuff they don’t need and then finally load everything into a vehicle to move them.

You can spread the time you do this over a period of weeks or months.

There will be a time investment regardless of the approach you take.

Let’s also not forget that a time investment goes beyond moving day.

In the initial phases of moving your parent in, if they need home care and you have not engaged the services of a home care agency, you will have to take up that responsibility.

You will also have to plan to spend quality time with your aging parent.

When it comes to money, the financial investment involved in moving your parent in will show up in different forms:

Moving day will cost money
Any renovations and adjustments you have to make to your home will cost money
Your bills may increase with an additional family member living with you

If you’re deciding now to move your parent in, it is important to understand that your parent may not be able to work to help you pay the bills around the house.

Settling this thought within yourself will keep fights about money to a minimum.

3- Equip your home properly for your parent

This is especially important if your parent has health and/or mobility issues.

Your bathroom will need supports to help your parent take safe showers independently.

Walkways around your home will need to be well-lit to avoid falls.

You will need to upgrade Fire and carbon monoxide detectors.

For parents who have dementia or suffer with Alzheimer’s disease, you may have to make sure that their bedroom is set up in a safe way so they don’t hurt themselves in an unfamiliar environment.

For more on how to equip your home safely for senior adults, please read this post.

4- Unresolved conflicts may flare up

Having to care for your parent you have had conflicts with in the past may be unavoidable.

Living in close proximity with them could cause unresolved personal conflicts to flare up.

In this case, it is important to remember a few things.

You have a personal moral code. This code dictates how you treat people whether you like them or not. You employ this code when you have to work with people everyday who rub you the wrong way. Use this code with your parent.
Discuss and enforce boundaries. Most of our conflicts come down to the fact that we have not set boundaries for the people we interact with. When boundaries are clear and the rules are set, trespassing is kept to a minimum.
Clear up the confusion and forgive them…even if the forgiveness only comes from your end. It is always better to be the bigger person and as Elsa sings in the movie Frozen “Let it go”.

5- Making a decision to move your parent may not be a singular decision

Unless you are a single person, making the decision to move your parent into your home is not a singular decision.

You will have to discuss the decision with your spouse and children and get them on board.

Neglecting to do so can be another cause of conflicts in your home.

Closing Thoughts

Moving your parent in with you is a noble thing.

In your case, it may be the best decision for you and your parent.

However, like any important in life, it is important to consider all angles of it before you make a decision.

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I have the honor of sharing a home with my father. In fact, I share a home with my husband, two teen girls, two cats, two pigs, two milk cows, 20 something chickens, and my father. We have a busy life. And, inviting my dad to join our world added chaos and joy. There were a few moments of rockiness, but all-in-all our blended, busy family is humming along nicely. We learned lessons along the way. And, I have many years of experince helping adult children living with an ageing parent. These lessons come from my own experience and the experiences of hundreds of other successful family caregivers.

Make Sure the Buyin is There

One of the biggest mistakes I see people make is creating lots of plans before getting their ageing loved one involved. I completely understand the appeal of reaching out to providers, compiling information, talking with siblings, visiting with contractors, and fully formulating a plan before presenting it to your loved one. Here is the problem – unless your loved one is unable to make decisions – the planning activity is part of the acceptance process. In an effort to ease the decision making process for your loved one, you want to present all the options in a clear well thought out way. But, you take the control out of the hands of your loved one and skip straight to check yes or no. Where is the courtship? Living with an ageing parent is often a matter of necessity, but that doesn’t mean it should feel plug and play to your loved one.

Family Buyin

The second biggest buyin block I see is with siblings. You know your loved one needs much more care than she is currently getting. She has firmly said she doesn’t want to move to an assisted living community. It only makes sense to move her in with you! Well, maybe your siblings have other ideas. Even if your siblings can’t possibly care for your mom the way you can, your siblings may still insist on implementing their own care ideas. While not every family has a long history of open communication, working together to create a move-in plan often saves drama and hurt feelings later. Try to get siblings and other important family members into the conversation early. One great way to create buyin is to assign every member a job. For instance, since you plan to host your loved one in your home, maybe a sibling who is out of the area can interview and locate a moving company to help. Or an out of area sibling can offer to manage bill pay and document signing. Work together to make living with an ageing parent easier for everyone!

Don’t Hide Important Information

Usually living with an ageing parent is the most cost effective, comprehensive option a family can choose. Make sure you have a very clear understanding of your loved ones financial situation and what if any financial contribution you expect. Consider this information a family topic so no one feels slighted or cheated. Make sure to discuss future plans that might affect the living situation of your loved one like a home sell. When you lay your cards on the table, fewer opportunities for miscommunication exist.

Take a Realistic Look at Your Set Up

You will need to look at the current and future needs of your loved one. While she may be able to get up stairs now, will she be able to handle them in 6 months or a year? What kinds of home modifications will you need to make to properly care for your loved one? Can you afford the emotional and physical output your loved one may require? Have you realistically considered how hard it is to care for someone 24 hours a day? You want to consider long term plans before you make important life changes. You can always relocate your loved one to an assisted living facility later. But, moving can be hard on senior adults, especially those with memory impairment.

Create a Plan of Care

As the owner of a home care agency, Green Tree Home Care I have seen the positive impact of great care planning. We always create a plan of care for every client. We do this to make sure support systems are in place, current and anticipated needs are met, and everyone is on the same page. When you are living with an ageing parent, it is import to write down all the care needs. If your loved one needs 24 hour care or cannot be left alone, you will want to include a plan for respite care. Often adult children living with an ageing parent will call us for care support while they work. Or, they will request a caregiver on the weekends so they can go out with friends and other family. The most successful family caregivers plan for personal time, and make it part of the plan of care. If your loved one has trouble walking, you may want to include a physical therapist or personal trainer into your care plan. You can also utilize services like meals on wheels, home visit doctors, and mobile dentists. Speak with medical professionals about what resources you might want to include.

Host Family Meetings

As the condition of your loved one changes you will want to keep family members in the loop. With your loved one’s permission, invite family members to weigh in on concerns and decisions on a regular basis. These meetings will give you a focused time to share your hands on experiences. Family meetings are great for assigning new jobs, planning for upcoming care needs, and asking for more help. I often notice family caregivers are like frogs in hot water. They will continue to provide care alone as the needs increase. They keep going until, nearly exhausted, they realize the world is boiling around them. Family meetings allow siblings outside the gradual day-to-day changes to offer support when you might not know you need it!

Wrap Up

When you are living with an ageing parent there are lots of responsibilities you assume. By getting everyone’s buyin, communicating honestly, assessing your setup, creating a care plan, and hosting family meetings you will create a collaborative environment for everyone!

You might expect a loved one with dementia to repeat herself or experience forgetfulness. But, sometimes people with dementia experience hallucinations. Hallucinations in elderly people may occur or become worse for a variety of different reasons. Hallucinations can feel jaring or scary to both you and your loved one. Learn why your loved one may experience hallucinations and how you can help manage those episodes.

Causes of Hallucinations in Elderly People

Hallucinations may occur for many reasons. People with dementia do sometimes experience hallucinations. Hallucinations may be intermittent and varied or might include a recurring theme. Charles Bonnet Syndrome causes visual hallucinations in elderly patients who have experienced vision loss or impairment. Medications sometimes have side effects that include hallucinations. If your loved one’s hallucinations started at the same time as a new medication, you may want to reach out to her primary care for a consultation.

My grandfather experienced delirium related hallucinations after a major surgery and anesthesia. It took him a few weeks to completely return to his normal cognitive baseline. People with urinary tract infections can also show increased confusion and may experience hallucinations.

Certain illnesses that affect the brain like cancer or illnesses that affect the kidney or liver have been shown to cause hallucinations.

Acknowledge that Hallucinations May Cause Uncomfortable Feelings

The first time my grandfather tried to pick my mother’s red fingernails thinking they were cherries, I felt my stomach fall. I had never seen this kind of dementia and couldn’t even process his behavior. I felt helpless! He continued to see and speak with people long gone, and pointed out shadows and shapes that he identified as people and objects that weren’t really there.

The hallucinations felt extremely real to him. No amount of reason could convince him my mother was not a cherry tree, or shadows were not puppies. The more we tried to convince him the angrier he got. I realized he was as scared as we were.

It is important to give yourself and your loved one space to feel unsettled and scared. These are normal responses. You will develop ways to cope with your loved one’s hallucinations. But, acknowledging and respecting emotional reactions helps you mourn and cope as you journey with your loved one.

How to Help a Loved One Cope with Hallucinations

Seek medical attention if your loved one experiences hallucinations for the first time. Once the cause of the hallucinations has been identified your doctor may be able to reduce or alleviate hallucinations altogether. If hallucinations persist you can help provide support by practicing the following:

Create and Stick to a Routine

Hallucinations are often a response to stress or confusion. It is important to create a reliable routine your loved one can count on. Routines help teather people with dementia and reduce anxiety. You may notice your loved one’s hallucinations increasing when normal routines get missed. This is a good indication you may need to pay special attention to managing and respecting routines.

Do Not Fight Against Hallucinations

Your instinct might lead you to reassure your loved one that her hallucinations aren’t real. But, the hallucinations feel real to her! You want to show empathy and support when a loved one has a hallucination. If the hallucination is not causing emotional stress, you may want to engage and ask questions. Traveling down memory lane, even if it involves conversations with a long gone parent, might bring comfort to your loved one.

Sometimes hallucinations cause stress and anxiety. In those cases, you may want to offer a solution for your loved one. I have seen caregivers successfully defuse a client’s fear by killing imaginary spiders with a shoe or putting an invisible dog outside. Practice empathy and creative problem solving!

Avoid Triggers

For some, hallucinations may arise when certain triggers are present. Triggers might include the mention of a dear loved one, certain locations, or tasks. What ever your loved one’s trigger. Once identified, try to avoid these situations if they bring on anxiety and confusion.

Practice Redirection

I once cared for a woman who insisted people in the room were staring at her in a mean way. We could be the only two present. But, she would insist that she couldn’t stand the mean stares. I could do nothing to take her mind off the angry crowd. One day during a particularly difficult hallucination I suddenly broke out into joyous chorus of “Oklahoma – where the wind comes sweeping down the plains”. In an instant she started tapping her knee and singing along – Eureeka! From that moment on, my repertoire of classic showtunes expanded and I could help her escape the angry stares of the crowd. I redirected her attention and focused her mind on a positive experience. Redirection looks different from person to person. Try different techniques to engage your loved one.

Wrap Up

Hallucinations in elderly people vary from person to person. If you provide care and support for a loved one experiencing hallucinations, you will need to exercise empathy and creativity. Try creating routines, going along with hallucinations, avoiding triggers, and redirecting emotionally negative hallucinations.

Caring for another person requires patience and consideration. You can use Great caregiver strategies to help manage difficult caregiving situations and improve your charges state. Caregiver strategies are not complicated. But, using some tricks from the pros will help you stand out and bring joy to your loved one or client.

Make a Plan Before Starting Care

Great caregivers know that bathing and transfers can be difficult for those they care for. They want to minimize stress and create an environment of comfort and support. A great way to make care tasks more enjoyable is to have all supplies set up and on hand. Showering is a great example of a task that requires planning. You instinctively prepare your own shower but you want to plan for the comfort of your charge:

Do you have towels ready

Is the room warmed and comfortable

Have you checked the water temperature to ensure it isn’t too hot

Do you have mild soaps and washcloths ready

Have you set out clothing, so you don’t have to leave your charge unattended in a towel

Do you have shower chairs, walkers, or wheelchairs handy and in reach.

Is the room safe for transfers and do you feel comfortable supporting you charge at the level she needs

As you can see from the above list there are lots of factors to consider when caring for another person’s personal needs. When you initiate a care task with someone who has compromised physical or cognitive function, you must consider how the task will affect her safety. You need to make a plan that engages your charge while still allowing you to accomplish the care task in a safe comfortable manner.

Dementia – Live in Their World

Dementia care requires a special touch! New caregivers sometimes try to repeatedly explain their rational reasoning to a person with dementia. It can escalate into a frustrating mess with the caregiver baffled and the person with dementia scared and anxious – not a good outcome! As a person providing care you must remember that dementia is a disease. It is not simply old age or “forgetfulness”. It is a medical condition that causes physical changes in the brain and interrupts normal processing. As a caregiver your job is not to remind that person of “reality”(unless that brings peace and comfort to your charge). You role is to keep your charge safe, carefor, and comfortable. As you continue your journey into caregiving, you will learn how to be an expert dementia caregiver.

I once met a woman who had significant memory loss. She would ask her daughter several times a day where her husband of 50 years was. Each time the daughter would reply, “Dad died last year mom, remember?” And, each time, the mother would break down into hysterical sobs that would last until she forgot the conversation. The daughter realized quickly that this pattern was causing intense stress for her mother. She began answering her mother’s question with, “Dad went to the store. He should be back soon.” With that, her mother would continue whatever task they were engaged in.

Redirecting a person with dementia takes the focus off emotionally stressful situations. It allows you to meet the needs of your charge. Trying to bring a person with dementia to your present creates frustration. Live in the world they have created for themselves as long as it doesn’t compromise their health and safety. Redirection is one of the pro caregiver strategies.

Communication is King

In-home caregiving usually takes place in a personal residence where only you and your charge or charges dwell. While the act of caregiving is very one-on-one there is usually a support network of family, friends, and professionals who have an interest in your charge. Your role is to make sure all care team members are aware of changes and on board with the care plan execution. Great communication channels include written notes in the home, company provided online portals, texts, calls, and email. The channels you use depend on the needs of your charge and the supporting care team.

On the flipside over communication of every minor incident may water down the urgency of important communications. Make sure to read the level of communication each authorized person wishes to receive. For instance, nurse case managers may want regular health updates while a financial power of attorney only wants the numbers. Make sure your communications are timely, appropriate, and important.

Use Great Body Mechanics

Proper lifting and support protects you and your charge. Youtube abounds with how to videos and professional organizations offer training and support for proper lifting. You can’t provide great care if your back is out. And, your transfers will not go smoothly if you are not using proper technique. Often people believe size matters when it comes to transfers and hands-on care. While it is a factor, I have seen petite 4’11” women gracefully transfer clients a man with poor technique could not easily move – technique matters.

Know Your Charges Nutritional Needs

Unintended weight loss and malnutrition is a problem in the elderly community. When you care for someone else, nutrition should be a big consideration. Plan for your charges nutritional health. Take note of foods that she favors and create a consistent well received menu. People with dementia sometimes experience changes in hunger awareness and processing. You will want to place foods in front of you charge rather than asking if she is hungry. I have seen clients with dementia decline food when offered then dig immediately dig into a plate of food placed in front of them. If it is your charge’s normal meal time, prepare food. You don’t want your charge to skip meals because she has forgotten she is hungry or embarrassed to put you out.

Wrap UP

Great caregiver strategies often come down to pre-planning. Know your charge and practice anticipating her needs. Your role is to provide care and engagement. You want to avoid stress and anxiety. So consider the needs of your charge and focus on providing consistent, considerate care.

There are many home care companies in the San Diego area. You need to pick one, but what should you look for? Not all licensed San Diego home care companies are equal. Owning and operating a home care company became a state licensed category a mere two years ago. Licensing requires all companies to carry insurance, ensure caregivers complete background checks, and act as the caregiver employer. All licensed San Diego home care organizations are expected to offer these basic services. But, this is where similarities end. Each company has a unique vibe. And, policies around hiring, customer service, and follow-up vary and mean distinctly different client experiences. Below are the questions you should ask any home care you are considering.

Are you a licensed San Diego home care company?

This may sound like a simple question but there are several different types of companies. Not all agencies currently offering services in San Diego county are licensed or in good standing. You can check the license status of a License San Diego home care company by checking the license status online. If the company is not current on licensing or has infractions, the site will show that information.

Some companies operate under a different model called a domestic referral agency. These organizations are not licensed home care agencies. There are a few key differences between a Licensed San Diego home care organizations and domestic referral agencies:

Insurance – Licensed companies carry workman’s comp and contribute to unemployment insurance. They also take out bonds. Domestic referral agencies do not provide insurance for in home caregivers.

Employment – Licensed San Diego home care agencies officially employ caregivers. This means licensed agencies manage all employment aspects. Domestic referral agencies simply facilitate the connection between caregiver and prospective client.

Ongoing Management – great licensed home care agencies offer ongoing client management and remain important in the continued relationship between caregiver and client. Domestic referral agencies cannot have continued contact with the caregiver after placement. They may answer client questions but do not offer continued client management.

Domestic referral agencies offer do-it-yourself solutions for home care. But, if you desire comprehensive legal, employment, and insurance protection, you want the support of a licensed San Diego home care organization.

You can find more resources and information about San Diego home care here.

What Ongoing Support Do You Offer?

You don’t want a set-it-and-forget-it home care organization. Not all agencies are created equal. Great agencies offer field support and training. The team at Green Tree Home Care has a dedicated field manager who does monthly or bimonthly quality visits. The benefit of a field manager is the global perspective. Because our field manager develops long term relationships with clients she can spot changes and offer support. This is especially important for family members who are not local. We have helped clients get new refrigerators, locate a dog groomer, and flag emerging urinary tract infections. Great licensed San Diego home care agencies are partners in the care landscape.

How Do You Find Your Caregivers and How Do You Know They are Good?

Essentially all home care organizations find caregivers from the same sources: online, schools, networks, and word-of-mouth. Great companies create and enforce systems that ensure the caregivers they hire are the best. Ask what qualities the company looks for in caregivers that join the team. The representative you speak with should have a clear idea of the values the company looks to attract. Some companies hire anyone who meets the minimum requirements and then see who sticks with the organization. Others – like Green Tree Home Care – believe in only bringing on people who have genuine compassion, experience, and dependability.

What Do You Charge For?

Most companies don’t charge for in home assessments. But a few may try to charge for the initial meeting. Most companies charge for mileage if the caregiver uses his or her own car.

Home care organizations observe wage and hour laws. They have to pay overtime for longer shifts. Some companies charge time and a half when the hours go over 8 or 9 while other don’t. Make sure you understand how the perspective company charges and how this might affect you now and in the future.

What Happens if I Need Help After Hours or Weekends?

Nothing is worse than sitting on call center hold on a Sunday morning when you need to quickly cancel a caregiving shift and take your loved one to urgent care. Some companies use call centers to handle after hours and weekend calls while others keep all call handling in house. Our team at Green Tree Home Care handles all phone calls in house. We believe it is important that someone who knows your loved one answer questions or support emergency situations no matter the time or day. Home care is pretty quiet until it isn’t. Great home care agencies realize accidents, emergencies, and changes can happen any time and want to provide support any time.

What Does Your Company Do to Retain Great Caregivers?

You want to make sure the company you choose has programs designed to keep caregivers happy and onboard. You don’t want your favorite caregiver jumping ship for better pay or opportunity because the company hawks the bottom line. Great companies are generous with PTO and flexibility. A very small handful – like Green Tree Home Care offer medical insurance for caregivers.

Wrap Up

You have choices when it comes to licensed San Diego home care companies. It is important to ask questions before you agree to services with any company. Make sure their operations are designed to care for you and your loved one above all else. Any company can do the minimums but you want to look for organizations that go the extra mile.

While you may have wanted June Cleaver to tuck you in at night, you didn’t get to pick your parents. For those who got the short end of the parental stick, caring for a family member you don’t like can feel like salt in a wound. Creating and executing a care plan for a family member is difficult and stressful. Add in years of mistreatment and neglect, and you have a hot bed of emotional stress.

I have had MANY conversations with adult children and relatives who suddenly find themselves unwilling caretakers. A guy friend of mine suffered severe abuse at the hands of a father he later cared for over 15 years. I asked him how he managed to put years of abuse aside to take care of his father after a massive stroke. Here were his words of wisdom.

Make Choices that Align with Your Personal Beliefs

You may not be able to pull from years of parental modeling of love and nurturing. But, as an adult you live a life of purpose and compassion. You may remember the old wounds and still have scars from mistreatment but you must act in a way that exemplifies your own moral code.

“I was angry at my father for the years of abuse and neglect. But, at the end of the day he was still a human that needed help and compassion. Sure, I was angry at the past. But, I could either follow in his footsteps and practice cruelty and hate. Or, I had the power to care and forgive. I chose to forgive, not for him, but for me”.

Most adult children who agree to care for a family member they don’t like find some peace in the situation. Not everyone chooses the path of caregiving. It is truly a personal decision that must feel right to the individual. Don’t feel pressured to accept a role you fundamentally do not want. Caring for a family member you don’t like requires a lot of emotional and physical work. You need to do what is right for your life.

Create Boundaries

Boundaries help keep the mission clear. If your role is to talk to medical professionals and manage funds, keep to the business. You may have signed up to help. But, that doesn’t mean you have to fall into old patterns – especially toxic ones. As an adult child, you are incontrol of how deep the relationship goes. Open communication with your family member and service providers helps create healthy expectations for the relationship.

Be honest about the extent of your involvement. If you feel uncomfortable spending lots of time with your family member, avoid taking on the direct care role. Remember, you do not HAVE to do anything. Your decision to get involved should be for your own reasons like setting the example for your children, or sharing human kindness.

Take Care of Yourself

It is important to maintain your health and mental wellbeing. You don’t want to burn out or lose focus and that can happen to any caregiver. It is especially important when you don’t want to care for a family member since burn out can come much faster.

Make sure you have emotional outlets you can connect with. You may want to secure the emotional support of a trusted friend. Or seek out the support of a social worker or therapist. While you may have made peace with the injuries of the past, renewal of intimacy and care may bring back old wounds.

Create a Support System

Caregiving is an important and sometimes intense role. Don’t feel like you have to handle every aspect of caring for your family member alone. There are professionals who can help with roles you prefer not to handle:

Fiduciaries – help with financial management and sometimes support clients by arranging medical resources.

Home Health and Hospice – these services are covered by medicare. Your loved one may receive regular visits from medical professionals. The visits are episodic but may give you needed respite and support.

Home Care Organizations – These organizations employ and manage caregivers. If you do not wish to provide daily care, you can find great caregivers to see to the needs of your family member.

Other Family Members – This resource is often overlooked. If you and your siblings share the same history, they may not share a willingness to care for a disliked family member, but might want to support you. By sharing your journey with other family members you may find support you didn’t know existed.

You can find out more about San Diego home care resources in this article:

San Diego Home Care – Everything You Need to Know

Wrap Up

When it comes to caring for a family member you don’t like, you set the rules. Don’t be afraid to honestly consider your motivations for providing care. Armed with that honest information you can set boundaries and create support systems that meet your emotional and life needs.