Minimizing Caregiver Stress while maximizing Elder Independence

Welcome to ElderCare Advice, the monthly musings of eldercareadviser, Irving Hellman, PhD, regarding topics of interest to the eldercare community.  Advocating for the best interests of elders became my top priority over 2 years ago, when I entered the middle stage of my career as a caregiver to my 84 year old mother.  An early morning phone call from the Los Angeles Kaiser Hospital informing me that she was going into surgery  for a broken hip, is still vivid.  Thus began a process of caregiving from a distance as I took many weekend flights to comfort and advocate for my mother in her recovery.  After rescuing her from her rehabilitation hospital, it became clear that she could not return to independent apartment living.   She would require the assistance of a full time caregiver to monitor her at night, her most vulnerable time .   .   .

My personal example illustrates how elders and their families are forced to adapt to progressive functional challenges.  Ideally, elders and their families can plan for such challenges by gathering information, talking with others who have had similar experiences, and determining potential service options based on the best interests of the elder and available family resources.  Family meetings including siblings and their elders are helpful at this stage in assisting family members in defining the level to which they will be involved in caregiving, and the role that they will play over time.  The following is a  helpful tool, published in 2006, which summarizes a variety of typical concerns that need to be addressed in developing an action plan for caregiving at the early to middle stages of the caregiving career :

Minimizing Caregiver Stress while Maximizing Elder Independence
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Getting Organized/ Assessing Your Loved One’s Needs
   Psychology: Decision making capacity; delirium/depression/dementia
   Health:  Health providers/medications/disease specific prognosis
   Financial:  Assets, income, liabilities, insurance, and tax planning
   Legal:  Estate planning/durable powers of attorney
   Social:  Activities/services/resources/housing options
Defining One’s Role as Caregiver
  Family meetings with parents and siblings to negotiate specialized roles
  Distribute specialized roles among family and extended social network
Developing an Extended Care Plan
  Caregiving from a distance:   Frequent visiting, care manager, relocating
  Use Formal Support:   Consultants/care coordinators/in home services
  Housing Options: Relocating to a continuum of higher levels of care
Surviving the Stresses of Caregiving
  Balancing Work /Family:   Competing demands/ changing roles, routines
  Refining Your Caregiving Skills:    Education/hands on training/practice
  Preventing Physical, Social, and Emotional Burnout
Death and Dying
  Preparing for Death:    Emotional/financial/logistics/spiritual/hospice
  Grief and Bereavement of the Elder and the Survivors
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Hellman, I. (2006).  From Home to Nursing Home:  A continuum of care for dementia patients. LoboPrabu,  S.H., Lomac, J.W., & Molinari, V. (Eds.) Caregiving in Dementia.  Johns Hopkins Press, Baltimore, MD.

In the coming months, I hope that my musings on a range of subjects will provide helpful eldercare advice to visitors and will inspire some of you to share your own stories.  Some offerings will be of professional interest, some will be practical, while others will be personal.   The focus of these offerings will not be limited to care for the elders in your life but also for yourselves as you age.  Future topics will include personal reflections on my own career as a caregiver for my mother, my career as an advocate for elders, my internal journey through my mother’s death; political reflections on the marginalization of elders in our youth oriented culture, diversity of our aging population, the switch from acute medical care to comfort care; professional reflections on dementia care, developments in guardianship law, functional capacity, successful aging.

So feel free to visit monthly.  I welcome your input . . .