Preventing Eldercare Burnout: Setting Boundaries

 

It’s hard for caregivers to learn to say no.

We want to provide the bet care possible while balancing multiple roles, the demands of illness, our communities, and the countless responsibilities of life. We are often fatigued, overworked, and unrecognized. But it is important that early on we become experts in setting boundaries as caregivers. We will always have limitations and be faced with the trap of false guilt.

So what can we do? The following tips are recommended by caregiving experts.

Set boundaries early.

  • Make a realistic list. What do you think you can do, and what do you think can’t do–both now and in the longterm. Believe it or not, you can’t do everything, and you’re not good at everything. For instance, if you’re not good at your own finances, it wouldn’t be wise to try to manage your aging parent’s money. Delegate, and talk to a lawyer who handles eldercare issues. Assist Guide Information Services (AGIS) provides comprehensive guides for caregivers.
  • Assess what will you need.This will change as time goes on. You may not need in-home care services right now, but you likely will at some point in the future. Know what types of tasks will be beyond your ability physically, financially, and in other ways. Make sure your assessment is realistic and provides a plan for the future. AARP offers a free Prepare to Care: Caregiving Planning Guide.
  • Be realistic about what you can and cannot do. Assess your health, your finances, your living situation, the distance from your loved one’s home, their health needs and longterm prognosis. What challenges lie ahead? For instance, you may desire to have your loved one in your home, your home design may make it difficult for them to live with you

 

Commit to taking care of yourself.

  • Assess your current health needs. Do you have a chronic illness that requires attention? Are you working a full-time job? What other roles and responsibilities do you need to protect?
  • Be aware of depression and signs of burnout. According to the Cleveland Clinic, caregiver burnout is a state of physical, emotional, and mental exhaustion. Caregivers who are burned out may experience fatigue, stress, anxiety, and depression. Be aware of symptoms: withdrawing from friends, loss of interest in activities, irritability, fatigue, insomnia, weight loss or loss of appetite. Be aware that caregivers often try to meet unrealistic expectations and struggle to distinguish between their role as caregiver and spouse/child/parent, etc.
  • Be prepared to scale back if your needs begin to suffer.

 

Gather a support team.

  • If possible, find an advocate. This person assists in making connections for things you need and for gathering and distributing information on your behalf when necessary. It’s sometimes easier to have others ask on our behalf than to ask ourselves. And in times of crisis, it can be helpful to have someone serve as our contact person.
  • Ask for help. Consider family, neighbors, community services, church support, and other available assistance. Call the Area Agency on Aging in the county where you parent resides and ask for an in-home assessment and information on available resources.
  • Find a support group—online or face to face. If your loved one has been diagnosed with a chronic illness, disease-specific support groups can be helpful. Two respected general groups are the Caregivers Action Network (CAN) and the Caregiver Alliance.

For inspirational and practical reading, check out Precious Lord, Take My Hand: Meditations for Caregivers and Ambushed by Grace: Help and Hope on the Caregiving Journey.

 

When It’s Time to Take Away the Keys

CarThruWindowWe knew we had a problem when we discovered Mom was accelerating through red lights.

And forgetting how to get to church and the grocery store.

And not realizing that her reaction time had slowed a few seconds…or a dozen.

Other tell-tale signs include not recognizing appropriate speed limits, ignoring traffic lights and stop signs, getting lost in familiar places and fender-bender accidents or near-misses.

But the big problem was that Mom didn’t recognize the big problem.

She thought her driving skills were fine. And the simple truth was that our family’s greatest concern wasn’t for Mom. To be honest, she’d been diagnosed with a terminal illness–Alzheimer’s–and faced years of diminishment. We had a strong faith that if she died, she’d go to heaven and see Jesus and finally be healed of her suffering.

The bigger problem was that if Mom had an accident while driving, a very real chance existed that she could be responsible for the death or impairment of an innocent person. Some child’s mother. Some mother’s child. A young man’s fiancee. A beloved friend. The grandmother who was raising her child’s children.

No difficult conversation or display of hurt feelings was worth the risk of someone else’s life, much less my mother’s life.

So what does a family member do when it’s time to take the keys away from a loved one?

Especially if they don’t understand, become angry, or refuse to cooperate?

  1. Assure them that you’re on their side. Reassure them that you support their independence and driving as long as they are safe and not jeopardizing the safety of others.
  2. Speak their language. What resonates with your parent? My parents had worked and saved all their lives so they could give an inheritance to their children. When we told my dad that risking an accident could put their assets (as well as their children’s assets) at risk for a possible lawsuit, he quickly understood the gravity of driving if his skills had eroded.
  3. Make a third party the judge. Physicians and driving assessment centers can play a key role on taking pressure off family members. Write a brief letter to your family member’s physician and explain your concerns about their driving. Follow up with a call and ask if they can make a recommendation for a driving evaluation with a local agency or the Secretary of State in your area. For help finding a Driver Rehabilitation Specialist, click HERE.  Explain to your parent that if the agency determines that they are fit to drive, you will support their decision. However, if they are found to be lacking necessary driving skills, their license might be revoked or limited, or they may need to work to improve their skills.
  4. Offer options. Losing the independence of driving is an enormous transition. Discuss alternate means of transportation with your loved one. Research options in the area where they live. You may find many options available. Have them talk to friends about options they’ve found that have worked. My father moved to an assisted facility that was within walking distance to stores and restaurants and provided transportation to a large shopping facility to residents several times a week. The home was also within several miles of family members who took Dad out several times a week. A dedicated bus also took residents to a fabulous senior recreation center each week.
Discovery House Publishers, 2008

Discovery House Publishers, 2008

How have you navigated taking the keys away from a member of your family? What was their response? What would you recommend to others?

For more practical advice on tough caregiving topics, check out Ambushed by Grace: Help and Hope on the Caregiving Journey.

Tips When You Suspect Your Loved One Has Dementia

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Like most people, my family was unprepared for my mother’s Alzheimer’s diagnosis. We saw the signs, but we didn’t want to admit that such an awful thing could happen to our mom.

And so we didn’t talk about the hard things for too long. By the time we were ready to make a plan, we’d already hit crisis stage.

Many of my friends are now in a similar position, and you may be, too. Here are my top recommendations for how to best care for your loved one if you suspect they may have or be heading toward dementia.

1. Get them under the care of a gerontologist. 

A gerontologist is a doctor trained in illnesses in the elderly. My mother had heart problems, a seizure disorder, diabetes, was a stroke risk, and was sensitive to a number of Alzheimer’s-related medications. We needed ONE doctor who understood dementia and could best advise us regarding her medications and long-term care. Gerontologists understand with the various forms of dementia and what medications can best help your loved one, as well as drug interactions and how best care for those with dementia-related needs.

2. Have your loved one assessed by the Area Agency on Aging in the area where they live to find available services.

For a number of years, my mom and dad lived with my husband and me. We found an amazing adult day care program for my mother that offered me respite three mornings a week. A bus came to our home and picked up my mom (and dad) at our doorstep free of charge. The day care program offered programming specific to my mother’s needs, and they also bathed her. This was hugely helpful to me, since Mom was terrified of water, and bath time was a battleground. I’m convinced that this program (one of several that we accessed) extended my mother’s cognitive abilities, as well as the time we were able to care for her (and my dad) in our home.

3. Consult an elder care lawyer.

Our family has never regretted this decision, even though it meant an initial financial “investment,” which was returned over and over again. This decision saved my mother and father tens of thousands of dollars. It preserved funds that are still available for my 93-year-old father’s care. Elder care lawyers can help you and your family make the best possible decisions regarding your loved one’s, your parent, or your parents’ estate. If you live in Michigan or West Michigan, I recommend Tim Alles, who practices in the Grand Rapids area.

4. Begin talking and planning ASAP. 

I recommend Jolene Philo’s Caregiver’s Notebook (published by Discovery House Publishers) to help you begin the discussion and make appropriate preparations. It’s a great tools. Of course, my books are also helpful, especially Ambushed by Grace: Help and Hope on the Caregiving Journey. This book is packed with valuable websites and resources for caregivers who may feel caught off-guard.

5. Don’t be afraid to ask for help.

Bring your loved one’s physician, pastor, or trusted friends into the discussion. Work to put together a long-term plan with flexible options. What works today may not work tomorrow. And above all, turn to God as your ultimate resource. We can never be enough to meet the needs of our loved one. God is with us. He will supply the wisdom and strength that we need every step of the way.

What about YOU? If you’ve been a caregiver for someone with dementia, what would you recommend to others?

Caregiving: Seeking Abundance in Desert Places

 

My caregiving has taken many forms over the past ten years or so.

God-mother, companion, and “foggy brain buddy” to a sweet child who endured forty brain surgeries before the age of eight.

In-home caregiver to my father-in-law, who died of Parkinson’s disease and my mother, who died of Alzheimer’s.

Advocate for an “adopted daughter” and young mother who lost her husband to cancer.

Close friend to a mom who lost her eight-year-old son to brain cancer.

Most recently, I’ve been a caregiving supporter to my brother, his wife, and his children and their spouses who are caring for my aging father. Each time my phone rings and I see my brother’s number of my nephew Brian’s number, I steel myself for the possible news that my dad is gone. Each time I talk to Dad on the phone, I remind myself that we could be talking for the last time. He’s ninety-one, and he’s already exhausted his options for heart surgery.

“I’m wearing out,” he tells me every time we talk. He doesn’t have to say it. I can hear it in his voice.

I know it’s coming, but still I struggle to prepare for life without parents. Even though my mother died four years ago, her pink robe still hangs on a hook inside my closet. Not a day passes that I ache to see her and hear her laugh.

DESERT PLACES

Caregiving can feel like a wilderness experience. Many of us are walking our loved ones to the gates of death, and we’re not given a guidebook for the journey. Some of us wake up one morning to find ourselves navigating unfamiliar territory without supplies or sign of an oasis in sight. And like the cast on the Survivor television series, people around us can suddenly become motivated by self-protective instincts.

Apart from the grace of God, I could easily have spiritually perished in the desert of caregiving. But my dad helped teach me how to find abundance in desert places. For the past twenty years, I’ve watched him relinquish his freedom and give up what he could have claimed as his “rights.” Instead, he chose to release his past in order to embrace his future. The future my father embraced was a vision for the best possible good of his wife. He chose to live with my mom in a home for residents with Alzheimer’s, even though he was capable of living independently elsewhere and enjoying a lifestyle of relative freedom. I watched as my dad chose contentment out of devotion to my mother. His attitude gave him the ability to enjoy the time he spent serving my mother, rather than enduring it.

I’m grateful for a father who showed me how to seek something better than my own way. Through my caregiving experiences, I was ambushed by God’s grace and changed.

Thank you, Dad, for living a truth I could see.

 

Shelly on Blogtalk Monday, February 22, 2010

Listen in Monday, February 22, 2010, from 3:30-4:30ET to Writing and Publishing Radio (www.writingandpublishingradio.com) when I spend time chatting with Felice Gerwitz about the choices and craft involved in writing memoir/personal narrative about life’s most painful experiences–the illness and death of our loved ones. Felice and I will be discussing how writers make memoir and meditation inspirational while offering readers the opportunity to grieve and lament.

I will be touching on the important elements of transparency, authenticity, restraint, humor, and grace which are woven throughout my books Precious Lord, Take My Hand: Meditations for Caregivers and Ambushed by Grace: Help and Hope on the Caregiving Journey. Each of these elements played an important role in the message I communicated to my readers. Apart from transparency and authenticity, we cannot communicate with honesty. Without restraint, we will lose our readers in the detail and the weight of our pain. Without humor we cannot be revived and refreshed for the next step of the journey. And without grace, we have nothing to say at all and no hope to share with our readers.

Learn more about Felice Gerwitz and the ministry of Media Angels by visiting Media Angels at www.mediaangels.com.

July 7th Radio Interviews

Be listening Tuesday, July 7th, when I’ll be hosted on Midday Connection with Anita Lustrea at 12:00 noon CST on WMBI, 90.1 FM and 1110 AM. Then on Tuesday evening, I’ll be featured on Christian Devotions SPEAK UP! with host Marianne Jordan from 6:00-7:00 at www.blogtalkradio.com/Christian-Devotions. I truly appreciate these opportunities to speak about my speaking and writing ministries and newest releases, Ambushed by Grace: Help and Hope on the Caregiving Journey (Discovery House Publishers), and The Silent Seduction of Self-Talk: Conforming Deadly Thought Patterns to the Word of God (Moody Publishers).

Discovery House Publishers, 2008

Discovery House Publishers, 2008

 

 

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