Family caregiving is an immense responsibility at the best of times. When a health crisis occurs, a family can feel that they’re in over their heads. Families need caregiving support during crisis more than ever.
At one time, it felt manageable to assist your mother in remaining in her own home. Sure, some weeks were a little more hectic than others, but on the whole, you were managing. Then she fell.
You’re not too sure how long she was on the floor before you discovered her; she was pretty disoriented and doesn’t recall the circumstances surrounding her fall. She was rushed to the hospital and you’ve been visiting her daily. She’s still quite confused and you’re not sure she’d eat anything at mealtime in the hospital without you there to unpackage the food and insist on every bite.
It was fine for the first few days, but your mother isn’t doing as well as you’d hoped and it’s evident she won’t be discharged any time soon. The daily visiting routine you started just isn’t sustainable—especially if your mother goes to Freeport for rehab as the discharge planners are now talking about.
Visiting daily in the hospital is certainly not sustainable long term, and even more overwhelming is the question of how much assistance your mother will need when she does return home, whenever that might be.
Warm Embrace caregivers serve clients wherever they need us most, including in the hospital. Our caregivers can provide daily visits that cover meal times to ensure your mother eats her meals. Between meals we’ll visit with her, enjoying conversation and keeping her mind active and engaged.
If her next move is to Freeport, our Caregivers can continue visiting her there while she recovers. Best of all, when it comes time for discharge, you won’t have to panic. You’ll already have the care in place and ready to go.
The caregivers who have already met your mother and grown to love her can now help her to transition home. The crisis situation of a fall and a fractured hip is much less stressful when you have reliable care that will help you through each stage of the journey.
Instead of feeling like you’re in over your head, you can feel relaxed and at ease knowing that experienced professionals have everything under control.
When you think of family caregiving which words come to mind?
What creates the difference between the first column experience and the second column? How can family caregiving be both frustrating but joyful, a burden and a blessing?
Here are 4 survival tips to take your family caregiving experience away from the first column and into the second column.
1. Take care of yourself
It may sound trite, but self-care is crucial. If you don’t care for yourself, you’ll have nothing left over to give to anyone else. You need to allow yourself time to refuel. How you re-energize will be unique to you; there is no right or wrong answer. Maybe you exercise, or enjoy dinner out, or attend a rock concert, or read a book, or travel. It doesn’t matter what you choose to do; it matters that you take time for yourself and prioritize your own self-care.
2. Allow yourself to be “off-duty”
It is not reasonable to expect yourself—or anyone else for that matter—to work or be on-call 24/7. And yet, when in the midst of family caregiving, people often hold themselves to an unrealistic standard of doing it all, all of the time. You need time when you are not “on-call”.
This includes elderly spouses who have assumed the caregiver role and who live together. It can be tough for the caregiving partner to feel “off-duty” when they are at home together with their partner who requires care. Respite care is critical to help both halves of a couple remain healthy—both physically and mentally.
Feeling “off-duty” also applies to family members who are receiving constant phone calls from their elderly loved one. They need time when they can turn off the ringer and not field any phone calls—a timeframe when they are “off-duty” from repeated calls.
3. Enlist support before a crisis emerges
All too often people will say: “Dad won’t accept help from anyone else, so I have no choice!” Then a crisis occurs and it is Dad who has no choice—he must accept help from another source because you, the family caregiver, are now experiencing your own health issue related to burn out. Sure enough, Dad does accept the help, although it might have been a smoother introduction to care had it not been a crisis situation.
It will be a kinder transition for your father to accept outside support in a graduated care plan, rather than abruptly. With advance notice and the luxury of time, caregivers can be selected to match your father’s personality and preferences. In a crisis situation, you might have no choice but to get a caregiver—any caregiver—in place the same day. A more ideal match could have been made with advance planning.
Best of all, your burnout can be prevented in the first place! It is far easier to prevent burnout by providing support early on than it is to recover after burnout has occurred.
4. Protect Family Roles and Relationships
Caregiving can upset the long-ingrained roles and family dynamics. A husband who is suddenly thrust into the position of caring for his wife may feel ill-equipped for the role of the family caregiver. He doesn’t feel like a husband. . . he feels like a caregiver. And she doesn’t feel like a wife. . . she feels like a patient. Their interaction as husband and wife has been interrupted and they begin to interact as patient and caregiver, which may start to stress their marriage.
It is important that key family roles and relationships are preserved. That couple needs to continue to feel like a married couple. A parent and child need to preserve their mother-son relationship. It may be best to let certain elements be provided by a professional caregiver so the family relationships can remain intact.
Family caregivers are SO important to the health and well-being of their loved ones. It is crucial that their health and sanity is protected. If the family caregiver burns out, then there are two people requiring care!
The only way to survive family caregiving and find the positive is to take care of yourself, have time that you are “off-duty”, get help in place before it’s too late, and aim to protect family roles and relationships for as long as possible.
Inclusion is a hot topic and a very important one for our elderly population. It emphasizes the importance of inviting the active participation of all citizens, including our elderly population, into our social fabric.
The Canadian Network for the Prevention of Elder Abuse (CNPEA) has reported that:
Being socially isolated is a common affliction among older adults. More than 30% of Canadian seniors are at risk of becoming socially isolated.
Isolation and loneliness are as bad for your health as smoking 15 cigarettes a day.
And, social isolation can put seniors at increased risk for elder abuse.
Inviting the elderly population into social spaces is the first step, the second next step is creating an age-friendly community.
What exactly is an age-friendly community?
Being age-friendly means that there are no barriers to accessing services in the community, regardless of age or ability. A city that is designed to include and be accessible for its elderly residents is automatically factoring in the needs of its younger population.
For example, if a community is accessible for someone using a walker or wheelchair, it is also accessible to a parent pushing a stroller. The examples that we think of quickly are usually about physical accommodation such as ramps, wider doorways, longer crosswalk signals, etc. These accessibility features are certainly important, but a truly age-friendly community is about far more than just physical accessibility.
Dr. John Lewis, professor at the University of Waterloo, points out that currently, one-quarter of Waterloo Region’s population is age 55 plus. That number is only going to increase in the next few decades. It is not acceptable that there are ageist prejudices towards 1/4 of our population! If we want to have a community that is inclusive to all members, it needs to be designed to suit those who are age 55 and older.
Age-friendly communities are about inclusion and a sense of belonging. It is about receiving the respect and dignity that all citizens deserve, regardless of ability or age.
Often, these issues relate directly to coping with ageism. Ageism is the stereotyping of and prejudices against someone because of their age. It might include automatically treating someone in a certain way, just because they appear to be a senior.
For example, assuming someone is hard of hearing because they have gray hair is an ageist stereotype. Another example is the way that professionals often speak about a senior to their family members, as though the senior is not even in the room! The conversation should be directed to the relevant person, regardless of age.
In addition to physical challenges, some people experience cognitive changes. These people deserve the same level of respect and inclusion as all other members of society. Brenda Hounam, dementia advocate and spokesperson, highly advises communicating about dementia itself. Rather than hiding her challenges with dementia, she has decided to be very public and make others aware of her disease.
Hounam suggests that people “open the doors for communication—just ask”. She feels that it is much better to ask for clarification and to communicate clearly with someone who has dementia; do not just make assumptions. She asks that people do more than just listen; she wants people to truly hear and validate what she is saying. Hounam’s overarching message is that “we are all unique, and we all have something to contribute until the last breath.”
Being inclusive and respectful of all citizens—regardless of age, ability, or illness—better allows us to fully acknowledge and appreciate the contributions of all members of society.
Don’t be discouraged and let the cabin fever get to you—instead, speed up spring!
One of the best ways to bring spring to you is to start your gardening early—indoors! Rather than waiting on mother nature to cooperate for a display of spring colours, get things started yourself by forcing bulbs.
Indoor gardening is a very accessible way to garden. There is no need to bend over or kneel on the hard ground. Bulbs require very little maintenance or effort. Indoor gardening is a great way to connect with an elderly loved one’s passion and hobby without being overwhelming or too physically demanding. It can also be a great intergenerational activity, drawing children and grandparents—or even great grandparents—together over a common task.
Forcing bulbs indoors mimic the outdoor environment that causes a bulb to grow and bloom. Unlike large, potted house plants, bulbs do not need big pots. A small, shallow dish is sufficient. Many bulbs are easily forced using only water and pebbles, rather than soil, resulting in much easier clean up when gardening indoors. It is also more fun to watch the roots develop and see the bulb change as it grows. New growth development is exciting to see—at any age!
Using your shallow container, fill it half full of pebbles or marbles, then place the bulbs on top of the pebble layer. Gently fill the rest of the container with pebbles or marbles to secure the bulbs in place, but do not completely bury the bulbs. Put enough water in the dish so that the water touches the bottom of the bulb, but do not submerge the bulb in water or it will begin to rot.
The step that is most often overlooked when forcing bulbs is the chilling step. Your freshly “planted” bulbs need to be chilled in a cellar or in the fridge to mimic the winter season. Some bulbs only need a few days of chilling, and others need a much more extended chilling period of several weeks. Be sure to check the specifications on the bulbs that you purchase.
NOTE: Please do NOT store bulbs in an elderly person’s fridge. If that person has dementia or mild cognitive impairment, the bulbs (or pebbles) could be mistaken for other produce. Likewise, if your loved one has impaired vision, the bulbs could appear similar to onions. Senses such as taste and smell become dulled for many people as they age; the smell or bitter taste that might alert you to food being harmful may not alert an elderly loved one.
When roots begin to show you will know that your bulbs are ready to begin their growth cycle and it is time to remove them from the chilling stage. With roots now showing, your bulbs are ready to be moved into warmth and sunlight. You need to introduce them to sunlight slowly, just the way that the spring sunlight is soft at first and then gradually gets warmer. Place your bulbs in a cooler area of your home, away from direct sunlight. When your plants begin to grow and the stems take on a healthy green colour, then it is time to move them to a sunny windowsill to watch the beauty unfold!
In theory, any bulb can be forced to grow indoors, but some varieties are easier to force than others. Paperwhite narcissus grows well indoors and does not require a very long chilling period. They grow well in water and pebbles and are quite fragrant. Amaryllis are very easy to force and the blooms are giant and colourful. They grow so quickly that you can see growth daily.
The warmer the environment, the faster the amaryllis will grow. Once it blooms, it is best to move the plant to a cooler, shaded area for the blooms to last longer, as they can remain for up to a month.
Hyacinth and crocus can also be forced and take eight to ten weeks to grow. Although tulips are a favourite spring bloom, they are probably best enjoyed out in the garden as they can be trickier to force and require a long chilling period of sixteen weeks.
Enjoy your head start on spring by forcing your favourite bulbs indoors, and use this easy, timeless, and ageless activity to connect various members of your family. You will have spring beauty unfolding in your own living room—no matter how much snow remains on the ground outside!
You want what is best for your parents, and you worry that they need additional help. Your parents believe that they’re managing just fine on their own.
So, Who decides?
First of all, you need to consider whether your parents are cognitively well and capable of making sound decisions. A “sound decision” is not necessarily a decision you agree with—two people of sound mind can arrive at different decisions!
Capacity to make decisions is based upon someone’s ability to understand the choices with which they are faced, and the consequences of their decisions. For example, as an adult with capacity, you are aware that your chance of winning the lottery is very limited, and yet you choose to spend your hard earned money on a lottery ticket. Someone could say that is an unwise decision because the consequences are not in your favour; however, you understand the risk involved and the likelihood that you will not win. The reason that minors are not permitted to gamble is that they do not fully understand the consequences of their decisions. As a capable adult, you are permitted to make decisions that others might judge to be unwise, but it is your prerogative to do so.
Your parents have the same right. If they have the capacity—meaning they understand their options, and they understand the risk associated with those options—they are entitled to make decisions.
My parents won’t face reality — they won’t decide anything!
While it might appear that your parents aren’t planning because they aren’t changing anything, they might just be sticking with the status quo because they aren’t aware of all possible options. You feel that your parents require more help—have you suggested various sources or types of assistance?
It is possible that your parents view the decision as a dichotomy—living at home and “getting by” as they always have, versus complete institutionalization in a nursing home. While these may be two possible options, there is a myriad of other options that fall somewhere in between!
Help educate your parents on some of the options for assistance that won’t feel like such extremes. If your parents are cognitively well, it is their right to choose the type of care that they feel will best meet their current needs. Engaging your parents in the research and ensuring that they feel in charge of their own decisions will ease the process. When your parents realize that you’re not just trying to force them out of their beloved home (as so many seniors fear!), they might be more open to alternate care options.
To start your research journey, you can learn about some homecare options that emphasize health and wellness.
You care deeply about each of your residents but sometimes it can be difficult to meet their varying needs simultaneously. It can be especially tough when a resident with dementia progresses, and other residents are perturbed by the new symptoms. Sometimes other residents inadvertently exclude or even ostracize residents with dementia, which only increase agitation and confusion.
Our caregivers can help remedy this situation!
One of our favourite client success stories was with Lydia, who lived in a Waterloo retirement home. Lydia was quite spry physically and she was keen to “assist” other residents. However, her advancing dementia impaired her judgement and her ability to assess the situation. In some cases, Lydia was moving walkers out of reach or rearranging chairs as others were about to sit down, placing others at serious risk of falling.
This presented a challenge for retirement home staff. Of course, the safety of all residents needs to be a top priority, and managing Lydia’s need to be active and assist is also important. The BSO team was brought in to help problem-solve the situation and they determined that the best non-pharmacological option would be attendant care. Since Warm Embrace offers extensive dementia training to our caregivers, our team is particularly well-suited to support residents whose dementia is advancing.
Warm Embrace caregivers were paired with Lydia and found her to be delightful! When redirected to positive and constructive activities, Lydia stopped interfering with other residents. Her need to feel helpful, involved and productive could be met in ways that protected the safety of other residents.
Within a week, the other upset residents had stopped complaining about interferences and they became contented residents again. The staff could return to their regular responsibilities since they no longer had to be completely preoccupied with just one resident. Lydia herself was so much more content and happy; all traces of agitation evaporated.
Attendant care made all the difference in this situation. Retirement home staff were pulled in many directions attempting to meet everyone’s needs at once. By providing one-on-one support to Lydia, everyone’s needs could be met simultaneously, which also relieved the strain and stress on staff.
Which resident in your home could use the same support?
Many of the couples who reside in your home have been with you for years. They downsized out of the large family home when the house maintenance became too much and they relished meals being prepared for them, but they were still healthy and active and ready to enjoy all your residence has to offer.
Over the years though, their health has declined. The hard part is when one person declines more rapidly and begins to need more care, but the couple desperately does not want to be separated. That’s exactly the case with Walter and Margaret.
Walter and Margaret have been married for 64 years, and in all those years, they’ve never spent a night apart. When they first moved into your residence six years ago, they joined every activity and club — they played bridge twice a week, Margaret sang in the choir and Walter joined the woodworking club.
Over the past year, they’ve pulled out of all their activities because Walter is struggling to participate. Now playing Bridge is too complicated to follow and he finds crowds overwhelming.
Margaret is a social butterfly who is missing her friends and her activities, but she doesn’t want to leave Walter alone in their room all day. If she leaves him for more than 10 minutes, he starts worrying and is terribly upset when she returns. You fear the day when Walter’s cognition might require a move to long term care and they could be separated.
Warm Embrace will support Walter and Margaret within your residence, allowing them to remain together in their preferred residence. A Warm Embrace caregiver will spend one-on-one time with Walter, engaging him in activities that he can manage by modifying everything to match his current ability level. Margaret will receive some much-needed respite and an opportunity to see her friends and rejoin her social groups.
Most importantly, Walter and Margaret will still be living together in your residence for their 65th wedding anniversary, maintaining their perfect track record of never spending a single night apart.
Mealtimes don't have to be difficult - We can help!
Wednesday, January 9, 2019
For many of your residents, meals are the favourite times of the day. They line up in the dining room half an hour early in great anticipation. It is the event to savour!
Other residents may struggle with meal time. Some require physical assistance with feeding, and some may need constant cueing and reminders to eat their meal. For those with advanced dementia, the noise and commotion of the dining room can trigger agitation and make mealtime less successful. There are so many different needs to meet at every meal and it can be tricky for dietary staff to meet all those needs simultaneously.
Some residents may benefit from their own dedicated caregiver during mealtime.
Residents such as Lucy, who often became so agitated at meal times that she wouldn’t eat anything at all. At a quick glance, it appeared that Lucy just wasn’t hungry for her dinner. But when we sat with Lucy through her meals, we discovered that much of the time, she was confused and wasn’t sure what to eat or how. It was not because she was not hungry.
When we provided Lucy with a dedicated caregiver who sat with her throughout dinner, Lucy suddenly began to thrive! The caregiver would cue Lucy saying “oh, that roast beef looks delicious, would you like a bite?” and Lucy would smile and take a bite.
A minute later, the caregiver would say “you’re a big fan of mashed potatoes, and look what we have here—your favourite! Mashed potatoes!” By the end of the dinner hour, Lucy had cleaned her entire plate. With cueing, direction and constant encouragement, Lucy ate her food and was mostly able to feed herself. By continuing to cue Lucy and not just take over by feeding her, her own dedicated caregiver promoted Lucy’s remaining abilities and independence.
Do you have any residents who would benefit from patient, one-on-one constant cueing and encouragement? Watch your residents thrive when paired with a Warm Embrace caregiver!
Top 5 Reasons Families Need a Caregiver for Parents in LTC
Friday, August 17, 2018
You can imagine that someone living in a nursing home wants a regular visitor, but can you think of reasons why their families also benefit?
Here are top 5 reasons that families need a caregiver for their parent in long-term care:
1. To Supplement Family Visits
You know how important it is for your father to have a regular visitor, but you just can’t keep doing it all yourself. You can’t manage your own household and your career while also being at the long-term care home daily. He thrives with one-on-one support, but it can’t be you every day.
Warm Embrace caregivers supplement family visits. We never replace family, but we can provide support when a family cannot be present. We ensure that your loved one has a wonderful day and is in better spirits so you don’t feel guilty about not visiting.
2. Family dynamics
Let’s be honest—your family wasn’t exactly the Brady Bunch (don’t worry, neither was mine!). Deep down, you love your parents and your siblings, but loving someone doesn’t mean you get along well! Decades of history aren't erased just because parents become elderly and require more care. Sometimes, those long-standing family issues become even more emphasized when the patriarch or matriarch becomes ill.
You want the best for your parent, and you believe regular visits would benefit your father. Truth be told, you’re not the best person to be doing the visiting. It may not be the most beneficial for your father, and it definitely won’t be good for you. The kindest thing you can do is provide a visitor who can appreciate your father unconditionally—no strings attached, no history, no family dynamics.
3. Families Spread out Geographically
Today’s families are spread across the country and even across the globe! It is not uncommon to have siblings living in different time zones and various countries. With families at a distance, it can be difficult to visit your parent in a nursing home regularly. A local caregiver can provide the tender, loving care that you wish you could provide, if only you lived closer.
Maybe your siblings visit often and you feel bad that you’re not able to contribute. You can send a substitute on your behalf! Of course, we can’t fill your shoes, but we can provide a visit that alleviates your siblings from feeling like everything has been left up to them.
4. Interrupting Patterns
This fits closely with family dynamics, but it is slightly different. Family dynamics are what happens between people; interrupting patterns has more to do with your parent’s personal pattern. Your parent does not yet have a pattern with us, so we have the chance to have a completely fresh start.
Does your mother have a pattern of complaining every time she sees you? We hear this all the time. Your mother complains endlessly to you, but the nurses tell you that she is a sweetheart to deal with. How is it that she can seem like two different people? Your mother may have an ingrained pattern; when she is with you, she complains about anything and everything.
We can’t promise to change your mother’s pattern. What we can do is interrupt that pattern by starting from scratch. Our visits can remain focused on the positive which will keep her in better spirits and prevent you from feeling frustrated over constantly negative visits.
5. Extended family
Your great-aunt listed you as her Power of Attorney and she’s now been moved into a long-term care home. You visit when you can, but all she talks about is how lonely she is and how she wishes you would visit every day. Your own family and career already keep you busy and now your own parents are starting to need some assistance. . . there’s just no way you can visit your great-aunt as regularly as she’d like.
Having a caregiver visit regularly is the perfect solution for those who do not have a close family. We become their proxy family members. We can visit daily and provide the companionship and stimulation that they are seeking—while alleviating you of the guilt that you can’t visit more often.
Remember—the caregiver who is visiting your parent may be enlisted as much for your sake as for your parent’s sake, and that is perfectly okay. We would be honoured to visit your loved one in Long-term Care!
Why are there Private Caregivers in Nursing Homes?
Friday, August 10, 2018
People are often shocked to realize that Warm Embrace provides service within long-term care homes (previously known as nursing homes). We have numerous clients who live in long-term care homes all across the region—in Kitchener, Waterloo, Cambridge, Guelph, Elmira, even all the way out to Palmerston!
If people move into nursing homes to have everything taken care of, then why do they need a Warm Embrace Caregiver?
One-on-one undivided attention
You might think “there are tons of staff at the nursing home, why would we bring in another caregiver?” You’re absolutely right—there are many staff within long-term care. There are nurses and PSWs, housekeeping staff and maintenance staff, administrative staff and social workers—the list goes on and on! Sure there are many people buzzing around, but none of them are there exclusively for your parent.
People know when a visitor is there just for them, versus someone who is there for the whole group. Staff must pay attention to all the residents; even hired entertainers must try to engage the whole audience. The residents inherently know that those visitors are for everyone. It is no different than attending an event at Centre in the Square—the performance isn’t for you personally, it is for the whole audience.
A personal, private caregiver, by contrast, is there for your parent exclusively. They are not rushing out of the room to assist anyone else; they are not turning away from your parent to converse with someone else. They are there to provide undivided, one-on-one attention. It is amazing to see how people KNOW the difference. Someone with advanced dementia who can no longer speak will absolutely light up when her caregiver arrives—she knows the difference between her personal caregiver and any other visitor who is there for the group.
Matching Individual Needs
Residents in long-term care centres have a huge range of needs. Some people are there because of cognitive needs—their brain has been affected by an illness such as dementia. Others are there due to physical needs such as incontinence or requiring a Hoyer lift for transfer. Others may have a combination of both physical and cognitive needs such as those with Parkinson’s or stroke survivors.
The Activity Director has the very challenging job of trying to find group activities that match as many needs as possible. Naturally, the activity director has to cater to the average so that as many people as possible can participate. However, residents on either end of the spectrum may feel left out. Those who are very sharp mentally may feel that activities are too basic or childish. Those with advanced dementia may find activities too complicated or frustrating.
A caregiver matches the individual needs of the resident whom they are helping. The activity can be scaled to suit the ability of their client so that the client never feels frustrated while also ensuring that the client is not bored or under-challenged. Maintaining just the right level of mental stimulation is a delicate balancing act—one that can be managed by a caregiver who is assigned to meet the needs of just one client at a time.
Managing Behaviours (expressive communication)
Moving into long-term care can be a frightening experience for someone with dementia. Suddenly, everything is different. Routines have changed, the environment has changed, and everything seems to be moving so quickly. Someone with dementia may not be able to articulate how they are feeling. Instead of saying: “I feel frustrated and overwhelmed right now” they may instead act in a way that you’ve never seen before.
Their new behaviour is a form of communication. They are trying to tell you something. . . the hard part is to figure out what they’re trying to say. Nursing home staff who are rushing from resident to resident may not have the time or undivided focus to figure out what your loved one is communicating.
Instead of just seeing “challenging behaviour” we see a form of communication. We consider ourselves to be detectives—we are looking for clues to decode what your parent is attempting to tell us. If we can start to pieces together the clues, we might be able to decode a legend of sorts—a legend that will help interpret future communication.
Nursing homes are large facilities with tons of staff coming and going. Warm Embrace Caregivers work alongside long-term care staff to provide the best possible care for your loved one! As a team, we work to ensure all your parent’s needs are being met. Long-term Care staff may focus on their immediate physical needs but our caregivers will take the extra mile to provide your loved one social and emotional support.
I remember working in a facility and wishing I had more time even just to talk with residents who had stories to share. We just couldn't spread ourselves any thinner. Your service would fill some of that gap.