Caregiving

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    When feeling overwhelmed with grief following someone's death, it is common for personal care and hygiene to be put off or de-prioritized. Remember that taking care of yourself physically is an important way to take care of yourself emotionally. Try to eat healthy food, exercise, spend time outside and get a healthy amount of sleep. If you’re having trouble taking care of your health, consider reaching out to a friend to ask for support. Many people would be happy to cook dinner for you or with you, help with grocery shopping, attend an exercise class with you or take a walk.
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    If you think you may have a need for home-based healthcare services, discuss your needs with your healthcare team. The doctor must prescribe (order) skilled home healthcare services in order for insurance to pay. Tell your doctor about any problems you are having with daily activities. Discuss the types of healthcare services that might be helpful to you at home. 

    Be certain to include the following in your discussion with your doctor:
    • Your concerns about being home alone
    • How often a caregiver might be required
    • Types of assistance that are needed such as cooking, cleaning or help with other activities of daily living (ADLs)
    • The barriers that exist to getting around your home (including stairs and physical challenges such as walking the distance to the bathroom, kitchen or bedroom)
    Write down any concerns and questions before meeting with the doctor to discuss your needs. This discussion will help define how much and what type of home healthcare services might be needed (such as skilled or intermittent care).
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    Hospice provides a compassionate, supportive network of professionals and trained volunteers to help manage the physical, practical and spiritual challenges that can arise during advanced cancer. Better pain management, assistance with getting personal and legal affairs in order, and emotional support are some of the reasons that survivors choose hospice care.

    Hospice services are family-centered and are delivered by a team of specially trained and compassionate health care professionals and volunteers. They work with patients, loved ones and caregivers to help ease the pain and stress that can occur during advanced illness.

    The term palliative care is often used to describe the type of care given in hospice programs. Palliative care emphasizes the total well-being of the survivor as well as that of loved ones and caregivers. The goal is to prevent, treat or eliminate discomfort whenever and however it appears.

    Hospice care allows people with advanced cancer and other illnesses to be surrounded by those they love and to be as comfortable as possible. The care is compassionate and comprehensive. Care planning involves the patient, loved ones and caregivers.

    Hospice care includes services such as:
    • Medical and physical care
    • Best pain-control treatments
    • Emotional and spiritual care
    • Practical care assistance
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    A Neurology, answered on behalf of
    When caring for a person with dementia it's important for the caregiver, the pharmacist, the doctor and the psychiatrist to work as a team to avoid medication-related problems (MRPs). Teamwork is crucial. The caregiver is the eyes and the ears of the doctor and the pharmacist. If the caregiver is not seeing it, it’s very unusual for the doctor to notice or to be able to become aware of medication issues. It’s important because it contributes to better daily functioning for these people.
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    A , Geriatric Medicine, answered
    When a young person is in a nursing home, he can come up against many challenges -- some generational, some psychological, and some practical. When a younger resident is in a nursing home, his schedule and activities differ from those of an older population. Younger people get up later. They don’t like bingo. Heck, they wouldn’t like me coming in and singing Sinatra! They eat at different times and prefer different food. Young people have unique and sometimes acute psychological and social needs. And there are generational tensions to boot.
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    How much money is available for the care of your friend or family member? What are the sources of regular income? Disability insurance? Long-term care insurance? Pensions? Social Security? Veterans' benefits? You may have to do some detective work to discover where the financial documents are kept. Look for bank and brokerage statements, wills, annuity information, insurance policies, pension information and other income-related records.

    Review papers—ideally with a banker, lawyer, accountant, insurance agent or financial planner who knows your family. Even if you opt to handle the finances yourself, it's important to get a professional's advice on the best way to proceed. The documents will paint a clearer picture of your relative's financial situation and determine eligibility for economic assistance. Here are a few tips for handling the financial end:
    • If you don't obtain power of attorney, you (or a trusted relative or friend) should at least become a joint signer of your family member's bank accounts. You may want to talk to the bank about becoming authorized to draw checks on his or her account.
    • If the person you are caring for doesn't live with you, ask creditors to notify you if a payment is missed. Note that eople with dementia are just as likely to overpay. It's best to have automatic withdrawals and online bill payment or have key bills sent to another family member.
    • Ask your insurance provider or financial planner about long-term care insurance. Long-term care insurance, partially and for a limited time, pays for some home care and other alternatives to nursing homes under specific conditions so people can have the care they need, where they want it. Long-term care insurance helps people have more options and choices, because both home care and nursing home care are expensive. By the time the person is over 65, frail or disabled, the premiums are prohibitively expensive, and the benefits won't be available immediately.
    • Use direct deposit whenever possible. Some payments, such as Social Security, may already go directly to the bank.
    • Keep important documents together in a safe and accessible place.
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    Many features of caregiving, like legal matters or housing, operate by a cut-and-dried checklist. The daily life of a caregiver, though it necessitates supreme organization, has no such checklist. Caregivers must constantly adjust to their aging parent's needs while dealing with the unexpected twists their own lives take. The numerous tasks of caregiving equal a full-time job, in addition to a career and normal family commitments.

    • Caregivers may be called upon to undertake varying tasks, including:
    • Cooking meals and feeding them to the aging parent
    • Chauffeuring aging parents to medical appointments, getting prescriptions and managing medications
    • Showering or bathing, grooming and dressing the aging parent
    • Helping the aging person with use of the toilet or changing diapers
    • Handling finances and paying bills

    These tasks are made more complex by the assorted medical conditions that can afflict the elderly, including Parkinson's disease, adult-onset diabetes, arthritis, depression, heart disease, glaucoma, cancer, Alzheimer's disease and dementia, to name just a few. It will get more challenging to care for a person who can't communicate his or her needs if speech is impaired or he or she suffers from hearing or memory loss. Close supervision will become especially critical in the case of impaired sight.

    If you're feeling uninformed as to how to accomplish some of these tasks, consider enrolling in caregiver training offered by the Red Cross or another community group. These classes will teach you specific skills to ho care for the elderly, including how to move a frail adult from a bed to a wheelchair, how to give a bath to someone who isn't able to get out of bed and how to assist someone who's fallen.

    Caregiver training also provides a way for people to connect with other people in similar circumstances. Having a support group can help you manage the stress so you don't lose your mind and your life.

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    A , Geriatric Medicine, answered
    Appetite and weight changes are common early signs of physical, mental, or emotional problems. If you notice that your elderly loved one has unintentionally lost weight, check with a doctor to determine why. If eating poorly is an issue, try to boost flavors with spices and tempt appetite with favorite dishes. Also talk to a nutritionist, who may be able to help you develop meals that not only are appealing but also address health issues and diet restrictions. A nutritionist may also be able to retool old favorite recipes to meet current health concerns.

    Consider whether dental problems may be to blame for changes in eating. Softer foods (scrambled eggs, oatmeal, or even baby foods) and small meals or frequent healthy snacks may make eating easier. A trip to the dentist is in order if ill-fitting dentures or mouth pain might be causing changes in eating habits that lead to weight loss.

    Alzheimer's disease and other dementing illnesses can affect eating habits as well. As these illnesses progress, a person may find it harder to remember to eat and may need prompts to do so.

    A multivitamin may help cover vitamin and mineral deficits. Ask the doctor about the use of nutritional supplements, such as Ensure, for adding calories or to make up for low food intake on days when a person just doesn't want to eat.
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    Tasks that we take for granted may take up a large portion of a caregiver's day. To cope, try some of these strategies from the Alzheimer's Association and the Family Caregiver Alliance:

    If your relative or friend still prepares his or her own meals, take these steps for added safety:
    • Replace knobs with levers for door handles and faucets.
    • Install large, easy-to-grasp handles on cabinet doors.
    • Place frequently used food and utensils within reach.
    • Put the fire extinguisher within easy reach of the stove.
    • Create a work area where he or she can sit to prepare food.
    If you are preparing meals:
    • Ask a healthcare professional or dietitian for nutritional advice. Should your relative or friend avoid certain foods? Does he or she need a multivitamin or a low-salt diet?  
    • When possible, serve favorite foods. You may need to adjust the seasoning; some medications may affect the sense of taste. In other cases, seasoning may cause stomach upset.
    • Make sure your relative or friend gets plenty of water—about eight glasses a day. However, if he or she has problems with fluid retention or heart failure, talk to the healthcare professional about how much water is appropriate.
    • Refusal to eat could stem from mouth problems, such as irritated gums caused by ill-fitting dentures. If you see signs of irritation or abrasion, consult a dentist.
    • If your relative or friend has vision or cognitive problems, use the same place setting at each meal to help him or her find utensils, glasses and napkins. Use contrasting colors and serve or feed one food at a time.
    • If dexterity is a problem, provide two-handled cups and tumblers with textured surfaces.
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    Medicare, Medicaid, and private insurance companies will cover some of the costs of home health care. Other costs you will have to pay for yourself.

    The cost of home care depends on what services you use. Non-medical workers like housekeepers are much less expensive than nurses or physical therapists. Also, some home care agencies are less expensive than others.

    To qualify for Medicaid, you must have a low income and few other assets. To find out if you qualify for Medicaid, call your State Medical Assistance Office.

    Besides Medicare and Medicaid, there is another federal program, called the National Family Caregiver Support Program that helps states provide services for family caregivers. To be eligible for the program, a caregiver must:

    Care for an adult aged 60 years and older, or Care for a person of any age with Alzheimer's disease or a related disorder Be a grandparent or relative 55 years of age or older who is the primary caregiver of a child under the age of 18, or Be a grandparent or relative 55 years of age or older providing care to an adult, aged 18 to 59 years, with a disability

    Each state offers different amounts and types of services. These include:

    Information about available services Help accessing support services Individual counseling and organization of support groups Caregiver training Respite care Supplemental services, supplies, and equipment, such as home modifications, emergency response systems, nutritional supplements, incontinence supplies, etc.

    To access services under the National Family Caregiver Support Program, contact your local Area Agency on Aging.

    This answer is based on source information from the National Women's Health Information Center.