caregiver overwhelm Archives ⋆ Cathy Cress

Before a Parent Moves in-Check if You Can Handle the Care

October 14, 2019

Happy Birthday to my Dad, Harry V. Cress.

Today he would have been 99. He was a father who had severe PTSD from being imprisoned in a WW2 prison camp in Germany. So, at times , he was a difficult Dad. He worked all his life as an advertising man. But, he suffered from all the PTSD symptoms from what he thought was the good war, so he never reached out for help. He moved in with me in 1989, after he lost his house on the New Jersey coast to ” The perfect storm”. But, once I got him into the VA in Menlo Park, California, he lived with me and my family for 20 years and was the perfect great grandfather, grandfather, and father.

However, as a cautionary tale, I was first surrounded by a very supportive loving family as a caregiver and second was a geriatric care manager. I also had the full help of the VA and all their incredible GRECC services that covered all the medical care, caregivers, geriatric social workers to support me as a caregiver, as my Dad, as a PTSD survivor was 100% disabled. He was a happy independent person for 14 years making our family a three-generation web of real happiness and constant family celebrations as a living ” whole” family. But as he gradually aged, developed vascular dementia then cancer, dying at our home in 20o8

So, moving a parent in your home is not for everyone

Moving an aging parent in your home encompasses not just the present but perhaps 20-30 years in the future. It means accepting the parent as they are in the moment, which may be ambulatory, cognitively intact and independent but seeing they will be gradually affected by the decrements of aging.

What challenges do you face?

Your parent may have perfect vision now and because of macular degeneration need a great deal of support in mobility, eating, and all the activities and daily living in the future. They may eventually be bedbound or is the later stages of dementia. The geriatric care manager needs to discuss the move in terms of what the future may bring for the adult child caregiver and discuss whether they feel they can accept this increasing level of care, if they could face caregiver burnout, if there are financial assets to hire caregivers to assist them or should there is a plan that may move the older person eventually to a higher level of care when care needs to increase.

What are the answers?

The GCM can do a GCM caregiver assessment if care needs to be rendered when the parent moves in. This will help the adult child see their strengths, skills, and abilities needed to provide care. This might include their own medical issues preventing caregiver tasks like lifting and tasks that they find and tasks they find repulsive, like changing adult diapers. This assessment can include a care plan that recommends family caregiver solutions, like aging technology, social supports, formal supports, respite, and training.

At my Dad’s funeral, my daughter said, ” we thought we were saving him but is so many ways he saved us. So Happy Birthday Dad you saved all the love for you I might have missed. Thanks for that grace.

What are the 3 Steps to Do a Caregiver Assessment?

October 12, 2019

Where Do You Do A Caregiver Assessment?

Caregiver assessment is best done in the care receiver’s home so you can actually observe the care. It is best completed out of earshot of the older person who is cared for so the caregiver can feel free to talk openly. As caregivers suffer high levels of stress, giving them a separate space to share their feelings is an important part of the caregiver assessment. However, the caregiver assessment should be done in a place that is convenient to the caregiver, which could be a donut shop, the home, or any comfortable venue. If to do the caregiver assessment the GCM must arrange respite, like bringing in another family member or paid caregiver, then that is another way to make this assessment go forward.

How Will A Genogram Help A Caregiver Assessment?

A genogram also helps the GCM assess whether any extended family and friends will make suitable and emotionally appropriate caregivers or not. For example, if a son has a historically strained relationship with his father, is he a good choice as a caregiver? The genogram helps to assess this old family tension and helps the GCM decide with the family as to who can really be good caregivers.

How Does a Psychosocial Assessment Bolster a Caregiver Assessment?

In addition, a psychosocial assessment, done at intake or updated as more care is needed, assesses key abilities and availability of the extended network of family caregivers. The psychosocial assessment illuminates the client’s financial status, including income, assets, benefits currently being received, health and long-term care insurance coverage, and eligibility or potential eligibility for entitlement programs. This information helps the GCM assess whether outside paid care providers can be afforded if needed to replace a family caregiver. The psychosocial assessment also tells about the family, formal and informal support networks, present and potential caregivers, and cultural variables.

Find out more in the YouTube from My Geriatric Care 1 Channel.

Caregiver Assessment- Can it Prevent Caregiver Burnout?

October 3, 2019

Caregiver Burnout is Big Federal Problem

Family caregivers are so many times in a complete state of caregiver burnout. From a policy perspective, the federal government and the long-term care system in the United State cannot afford to neglect the burnout and strain of millions of Americans caregivers any longer.

Despite the rewards caregivers get from giving care we know from years of research that being a family caregiver results in brutal losses. These degradations and deficits include role conflict and overload from the never-ending tasks demanded of a caregiver. Left in a permanent state of worry and anxiety much of the time, caregivers are working in a deteriorating and unpredictable situation.

Caregivers Feel Trapped

Caregivers can feel entrapped by there the restrictions on their own life. They are often beset by fiscal worries because they are not paid except in some states, like California under Medicaid. Yet the caregiving situation explodes in cost through medical bills, medical equipment and informal care that must be brought in, if the family can afford it.

Caregivers Are Not Attorneys

Family caregivers face a quagmire of legal problems including untangling wills, trusts, and inheritance issues which generally complicate care both emotionally and physically. Many times these family caregivers compound their fiscal woes by having to quit their job, running the risk of never being hired again, and that is if they can eventually return to work.

Caregivers Mental Health Ravaged

The caregivers own physical and mental health is often ravaged. They have to do medical tasks that years ago family caregivers never had to do. If they were paid by an agency, this would be a workman’s compensation nightmare for the company, yet these family caregivers are never even paid. So it is time that geriatric care managers and other professionals in aging started to respond to this family caregiver nightmare and use a caregiver assessment every time they assess an older client tended by a family caregiver.

Find out more in the YouTube below from My Geriatric Care 1 Channel.

Innappropriate Threat of Placement =Caregiver Assessment

September 30, 2019

When a Caregiver is so Overwhelmed that A SNF is a Choice but a Very Bad Choice

If the family is so overwhelmed by the care that they are considering placement, this threat should trigger the GCM to do a caregiver assessment immediately, found in the Handbook of Geriatric Care Management If the GCM is called to relocate an older person and the underlying cause seems to be caregiver burnout, this can be another trigger for a caregiver assessment. If caregiver abuse is suspected, a caregiver assessment is a critical immediate tool. This is a situation where the GCM must contact Adult Protective Services, following their own state’s laws. Elder abuse can be triggered by caregiver stress in some situations. Depression that reaches a clinical level in a caregiver can be predictive of elder abuse of an elderly client can prompt a GCM to do a caregiver assessment. You should also do a geriatric depression scale at the same time. Use the GDS and the caregiver assessment to help both the caregiver and the care receiver at the same time.

Mrs. Handy has Two Dads in Her Head

Mrs. Handy our caregiver in many other blogs is about to place her Dad because she is besieged by so many other stressors. Her own health is deteriorating because she cannot get any sleep, due to her Dad going to bed so late and her inability to rise above her old self when her Dad was 40 and she was 19 and what he said she did. Now he is 70, very impaired with vascular dementia, incontinent and she needs to be who she is in the here and now a woman of 40, caring for an impaired Dad in her 70’s. She needs to set the boundary of him going to be early. She needs help in getting rid of the old parent in her head and putting the 70-year-old demented incontinent parent before her. This is what a geriatric care manager can do for her to help avoid unnecessary placement.

Caregiver Assessment- When The Caregiver Loses Sense of Self

September 22, 2019

One Homeostatic System

When you assess an older client with a family caregiver, you really have two clients. The needs of the family caregiver are different than the needs of the care receiver and the geriatric care manager or aging professional must differentiate those needs to make sure the care receiver’s functional and psychosocial needs are met. The care receiver and the family caregiver are one homeostatic system encompassing the whole aging family. To keep that family healthy and whole, in the middle of swirling care crisis, the care manager must first recognize that there are multiple clients including the person who gives or supervises care. In a health care insult, family members who give care are often referred to by the inanimate wooden term “ resources”. They have also been referred to as “ informants “.

Stripping Caregivers Personhood

This stripping of personhood denudes them of their status as individuals and melts them into the caregivers, thus breeds professional ignorance, like the crowd who watched the emperor with no clothes. We are blind to caregiver’s humanity and thus their own needs.

Seld-Esteem Vanishes With Caregiving

Many family caregivers lose their self-esteem because they fail at so many other parts of their lives when their whole life seems to be taken up by caregiving. They do not get vacations as the care-receiver does not take a break from illness and aging. Often there are few others to give them respite. Caregivers, often they just do not know where to find help or even ask for it. If family caregivers have children and husbands, they are often squeezed between their needs, the needs of the care receiver – thus have no room for their own needs. They are breathless and slogging forward.

Innappropriate Threat of Placement =Caregiver Assessment

When a Caregiver is so Overwhelmed that A SNF is a Choice but a Very Bad Choice

Mrs. Handy has Two Dads in Her Head

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