Dear Francy; My dad is 82 with mild dementia and osteoporosis and my mother is 80 with heart problems and weakness. They simply can no longer care for their own needs without my help. I have increased my time with them up to 2 hrs a day but I am at the end of my ability to care for them. We have no money for a retirement home and I do not know what to do? I have three siblings, all male and unable to give care and so I am on my own here.
OK, if there is simply no money (I understand they are in a smaller and older home) Here are some steps to help you out:
Make sure you have your name on the Health Care Directive for both of them. This is a form that is filled out and it then goes to the notary so you can make decisions legally for your parents.
Remove your attachment to your parent’s home and look at it with an eye if you were going to sell the home tomorrow. Walk through the house and mark down what has to be done to ready for sale. Heavy cleaning with older folks living there unable to see dirt or move furniture or refrigerators to get things cleaned. Walls need paint, wall paper needs to be removed, bathrooms need painting and new faucets, updating and kitchen needs declutter? Write it all down in a notebook. Edit down their things no longer used as much as you can and still keep your parents feeling safe and cozy in their home. Changes are hard for elders so make them with ease and in a quiet manner.
Now, think about getting a reverse mortgage, that’s a way a lot of families are dealing with monthly income. Call a reverse mortgage place and have them come and look at the home and explain all the benefits and downfalls. That is what they will do. They will make a flat fee for doing the paperwork on the mortgage and it is done through the government, so you can feel free to take their time and ask questions. It means it is a way for your parents to get the money they have invested in their home out each month. Then when they pass the home is sold and if there is anything left it goes to their heirs on their will.
Call a local real estate person and ask them to simply come and view the home and evaluate it for you. They will do this with the hope that you will use them as an agent when you choose to see the home. Also ask them if the home is rentable as an income instead of selling, they will know the area and give you guidance.
Call the Veterans Association, if one of your parents has served in the military and see where they are on the health care coverage. You will find it’s a sliding scale according to the time and type of service they served. If the Vets will help with care you can enjoy their services and save some money on care.
Call their Medicare supplement insurance company and tell them you need them to send you a booklet on the outline of what care their plans are providing. Then you know where you stand with money for services for your parents. Twice a year you can change Medicare supplement insurance companies, you may find that now that your parents are in a higher need of care, there is other insurance policies that will cover more of the costs. Make some calls and study the Internet on this issue, it can make a big difference in money spent.
If they have attended a faith center call and ask what type of community care they provide. Often large faith centers have seniors that will give you an hour or two a week, a dinner program, or in home visiting program. It all helps.
Ask about Meals on Wheels in your parent’s area, this program is delightful for seniors that no longer cook. You can supplement the extra pie or cookies, take them extras on the bigger meals you cook at home and still have the meals in the freezer for your parents to microwave. If they no longer can cook or reheat, then that option will not be there for you.
Call the state welfare and ask for a booklet on what type of care they provide for seniors with small incomes and they will send you information on that form of help. This is really important, because once you know what money you have to work with you can then move on and hire help accordingly. Lets say the state will only give you food coupons, that means a couple hundred a month on their income that can be spent on care givers not food. It is a good thing to ask for help, it is there for elders and it has been paid for by your parents in their taxes for years. The state may also pay you to care for your parents so your own time with them could be increased with an income or other care services could be added.
Now that you know about their money income it is time to add to your in home care assistance or to a more traditional adult care home, or assisted living facility.
It is not easy to keep a couple together in assisted living if they have different types of care required. Dementia has a staff trained to handle emotional problems and health side problems. Health care for mom takes care givers that are trained for challenging medications- those are two different care giving situations and it may take time and extra looking to find a facility or home that will fulfill both care issues. So start to call today, if you think your parents will need a spot to go to in the next few months. There are waiting lists in many facilities and you want to be prepared not stunned when the time comes to take that step. Even if you think it will be another year, talk and get on waiting lists.( This is what I do for my income, I help families find those facilities and make their senior’s transition into them. I do not charge the family a fee.)
If you are going to be staying on as their care giver you have to know it will be a more time consuming effort than what you are giving now. You will sit down with your brothers and have a talk. It is no joke, this has to be an adult conversation about your parents, without your parents in the room. So you can be free to speak of their health challenges and let them all know that things are heating up and growing out of control for you personally to care for them. Many family members respond to money rather than time. So explain it will take a min of $10 up to $25 dollars an hour for in home care. If they need only 4-5 hrs a day that is $100 a day…that can add up fast and then show them your parent’s income. This is how people look at problems. To sit down and say, I need help is not enough — show them, the needs, the time,and the money needed — that is what will shake them into understanding the problem.
Tell them your options, you have now done your home work so show them the different ways that care can be given and afforded. Then ask for their support, not their help. If they have not helped in the past, they will not help now. But ask them to support you with additional money each month, even if they give you $35 a month that could buy the Ensure that your parents drink everyday, or the Depends they use, or help with a bath lady each week. Every small amount is appreciated and the commitment has to be long term. The bath lady has to be paid each week if they give the money or not. Make decisions on reality not promises.
If the house is going to be sold to pay for your parents care, then you ask the family to help you ready it for sale. You may not be able to remodel or update, but you can clean. Just take one room at a time, clean out closets, give things to family and good will, do not put yourself through big yard sales, they are to hard on you. Giving time and care is overwhelming, do it with thought about your own health.
Paint as many rooms as you can to give it a low key color update. Use colors that are popular in your area. Update little things like lite fixtures in the bathroom and new faucets in the kitchen. Use the inexpensive vinyl tiles that you can easily put down over old vinyl floors, remove carpets if the house has wood floors and polish the floors. If you plan your actions over the next two months with help from your brothers on room by room, the house will look fresh and clean and update the yard to make it have nothing junky outside and just a clean lawn and some bark on the flower beds. Then you will be able to get the most for the house without remodel prices.
You will need to keep your parents calm while you are doing this so if the project is big ask a brother to take one or both of your parents for a weekend so you can do the work without them worrying over it all.
If you are not going to sell the home right away, still do as much of work as you can as you go along. The day of selling the home will be close in the future and work has to be done now or then.
You will need to call an in home health care service. They have trained nurses, PT, OT, nutrition and bath ladies. They also handle the care giving with light housekeeping, cooking and tending care givers. All trained, bonded and ready to help you with chores for your parents. What you can not do, they fill in. This is easiest way to get help. You can add a few hours a week at first, a bath lady is my favorite pick and then increase as the need and finances are there for extra help. They are also ready to be your back up if you are unwell and unable to attend to your parents needs. They will come to your home and do a review and then you set up a plan of needs.
If you choose to directly hire someone to cover for you each day, make sure you do a background check and call the references, you want a quality person to care for people you love. Horror stories can be avoided with doing a good check on the person’s prior job abilities and people skills. No smoking, drinking or drugs are allowed by any care giver so let them know that from the get go. Ask your Tax Person how to make the payment to the person you hire on your own. A service takes care of all taxes and pays your caregiver for you. I you hire a person on your own, payment for the person is up to you. Remember to ask if the care givers are a tax deduction for your parent’s taxes too. Remember if your parent or parents are in your home, they can be your own tax deduction for their care.
Now, I have a workbook that was designed for family members to read and use if they have never had any training in caring for a seniors. You will find my book under Products page of my website www.caregivingwithspirit.com. Its called Care Giving 101 Workbook and you can download it as an E-book or as a printed workbook sent to you via mail. That will detail the basic care giving needs and how to handle them for you as time goes on. I have both health and Alzheimer’s tips in the workbook. Its been a great help for many who are facing giving care to parents and or spouses.
Hope this all helped you – you can find me on Twitter @seniorcaretips and this wordpress site has many older blog entries that you will find helpful as you add giving care to an already busy life with your own family and job. I also have a talk radio site that is fun to give a listen – its an easy click from my website…thank you for your time and blessings on your giving care.
Please do send me emails if you have a question on care, I am happy to help. francy
Dear Francy: Mom in-law is in care facility and we’re visiting twice a week. It’s clean and she seems well fed but angry. Her dementia is still raging and she took a fall out of her bed and hit her head two days ago. How can I help keep her safe and sound in the care facility?
Here are a few tips:
Visiting twice a week is very good. Change your days and your times, so you’re there, but not on a routine. That way you can see the progression of the daily care staff, as the weeks go by.
Check the facility for being clean, the patient room, the eating facility and the public rooms are easy to see. But a walk down the hall will show you how the storage closets are kept orderly, the shower area clean, how the kitchen is run and the pill dispensing cart is being used. You just observe, even if you know nothing about care giving – you will see that organization is the key to good care, and cleanliness is right behind. If you have a question – ask the management about the staff, not the staff. It keeps the resentment from the questioning from reflecting on your senior’s care.
Do not be afraid to ask for a review of a fall. It should be logged in and reviewed by the staff. If it’s a staff problem you need them to make adjustments to the procedures in the facility and make sure they adjust the monthly payment to reflect any incident that caused harm to the patient. If it’s the patient that is being unwise in their movements or manners, then review how the care staff can make changes to avoid a repeat of the problem.
Take treats into the staff. This is open to what you like to do yourself. But once a month, I would bake brownies or cookies, or stop off at a special candy store and gather together some treats. You could buy some expensive coffee beans for the lounge or bring root beer and ice cream for a treat in the summer. Be creative, but be smart. Drop them off at the nursing lounge with a thank you card that has the patient’s name and your name. This goes along way for the staff to know you care about them and in turn they will care about you and your senior patient.
If the patient has dementia/Alzheimer’s let the staff know the real patient as you do. Take in pictures of the patient when they were young and first married, have a little label with names of spouse and family in the picture. Make a copy of a college degree or service certificate, so others visiting for the first time see that a very valuable person is inside of that patient. Honoring who a person is, inside, makes the current situation more understandable to strangers.
See if you can surround the senior with things that bring a feeling of home. A favored piece of art on the wall and a small shelf with bits and bobs from their collection. A throw that was crocheted by the senior or a book that has always been a favorite. Things from the past will surround a person and give them a feeling of safety. Ask about the rules of the facility and then make the creative side of you bring just the right stuff in to the room to perk it up!
Always ask the senior what they did yesterday?? Have them tell you what ever they remember. It’s important to take note. If they are abused or do not like things, it will come up in one of these conversations if you keep asking. You can hear what is bubbling inside of them, what bothers them or makes them happy. You do not need to worry about the details; just the feelings you get from the senior.
Food treats for seniors. If a senior does not have a food restriction, then do bring along something special for them. They may love some chocolate, cracker jacks, or a dinner of food from your family heritage. Heritage food is lost in care centers and still is so important to the senior.
A small covered jar of wrapped hard candy for visitors or care staff is always a nice lure to get them into the room to check up on the senior
Take a container of those cleaning wipes and each time you visit. Take them out and go over public surfaces around the senior’s room. A double protection against germs is always good.
Make sure the senior has a way to call home. If you need to put a large printed sign with your phone number taped to their room phone, do it. If they want a cell phone and are able to use it wisely, do it. They need to have a way to feel connected, not dumped. If that is hard to do, then make a quiet evening time call each night. Set a time that is good for you both and just make it an evening call each evening. The repeat of the calls is what the senior will feel – they can count on you is what they will think. Those are good things.
Check the senior for signs of red marks on their skin and ask each week if any skin irradiation has shown itself during the week. That is a very important point. Hot spots on older skin are hard to heal, if you catch them before they happen it makes life easier. The skin will show if the staff is not moving the patient around, bathing them carefully, or changing their bladder control products on time. Each time they do a bath, they will make note of the skin problems, you can ask to see that chart and take note that there are none. If they have them, then ask how they are being treated and stay on top of it until it is healed. If it repeats often, there is a care giving problem to be addressed.
Bladder infections or UTI’s are very common in seniors in care. You want to make sure they have cranberry pills added to their daily intake and you want to know that the infection is being treated, but the cause is researched and addressed.
Just because the senior is in care, does not mean they cannot add supplements. You can talk to their doctor and supply the supplements for daily dispensing. Turmeric is very popular for dementia and infection treatment…our doctor just added it to the OK list and mom was able to enjoy the supplement each day.
Remember, the facility wants to have you in charge and up to date, they want you to be involved, so do speak up. Read about your senior’s care and bring up the ideas you gather during the family meetings at the care center. You can have a monthly meeting at the care center if you like. I love them, you keep up with their ideas and how things are going – good stuff.
Hope these ideas help you with your care for your senior in a care center. It is always a hard choice to make when you place them in care. I have a free service for families called Loving Memories it helps family place seniors in good care facilities. We review the senior and their needs and then find a care facility that meets those needs. I also have care tips, workbooks, on demand talk show information and just all around good stuff on my website. Please do visit www.seniorcarewithspirit.com
Dear Francy; My brother is gay and has had two very long lasting relationships and now he is facing a terminal illness and he wants both of his former partners to participate in his care. It is way to complicated for me, but I have been asked to help him with this. Guidance?
OK, first take your mind off the Gay part and just see your brother with two x wives and how he might want them to be with him on and off during this time of his passing. See? That makes it easier for those that are not Gay to understand, it’s just past lovers that mean so much to the senior that they want them to be next to them during this time of transition.
Just as you would with an xWife club members, you should treat the two former partners with kindness and just ask them if either one has a problem being in the room or the home when the other is there to visit or spend time with them. It’s not a bad question, I ask that of many family members, lots of families have had disagreements and members do not get along and I try to give them time with the senior and space from the family that upsets them. I think that you will find his former partners are still caring towards him and would enjoy a routine visit.
How do you plan visits to a sick senior?
Make sure the past is left at the door, they should be there for loving support and to talk about old times and funny things and just enjoy life, not bring up sad times.
Timing is important. Usually a weak senior has a range of 10-25 minutes of energy to spend with someone that is just visiting and talking away- it is very tiring for the senior.
If the person is coming to stay for a day; they will know to settle in and keep busy and the time with the senior is not spent talking all the time, but letting life unfold as it would naturally. Watching TV or movie together, taking the senior out for a walk, having lunch, talk a little and leave the room for napping for both of them. One day a week, is the most they need to give, that means that they have lots of time for sharing and not so much time that they wear out and lose the special feeling of the moment.
No matter who it is that comes to visit. Have rules on the door that fit the situation, Do not enter if you are sick, This is a Stress Free Happy Area, Everyone Crossing this Line is a Friend and will be Treated as One – what ever you want to post. Make it light and fun, but remind them you want loving in the room not distress.
Inform those that stay longer than a 30 minute time period what the senior can or can not do. They may not understand the senior has to go to the bathroom every 10 minutes, or has a breathing machine on for 20 minutes and can not talk during that session. Remember they are not care givers, so inform them how to lightly help and be there for support.
Life is life and seniors that are Gay need to be visited by their Gay adopted family members. You will have to just release all of your preset ideas and know who ever calls on the phone or shows up on the door step – is a friend and should be treated with kindness and hospitably while they’re visiting your brother.
If the Gay lifestyle bothers you, that is OK…just slip out the door and come back to check on him when needed. You are not expected to change – you are just expected to allow your brother to be all he is around his actual straight family and his adopted Gay friends and family. It is all love to him, he is the one facing illness and transition, so he needs to work through all of his own feelings and ideas.
Ask your brother if there is a special Chaplain that he would like to have over to talk to and pray with at this time. Many times those in the Gay community have special ministers that include not exclude the Gay community from their faith groups. So, make sure his needs are being met by using someone that is special to him, not just your own family minister.
Loving your brother has probably not meant you were exposed to his friends and his Gay culture. He knows that and he does not want you to be uncomfortable, so he would not ask you to do anything that makes you upset. So it is your place to tell him, that you love him and want him to have those around him that support and love him. Let him know you will welcome his friends and loved ones into the home or care facility with open arms and he only has to guide you with the information of how to notify them of his needs.
I know that care giving is a very difficult thing to do for anyone, but giving to your brother is such a dear thing for you to do. Thank you for your time. Would you be kind enough to visit my website www.seniorcarewithspirit.com and click for the on demand radio show to hear more about care giving tips and go to products page to check out my book Care Giving 101 Workbook, that has so many helpful tips for those that do not have a background in nursing and still want to give good care to family and friends.