Your Mom Just Now Needs More Care at Home-Great Ideas-

by francy Dickinson                     www.seniorcarewithspirit.com

Dear francy: After realizing that mom needed more care than a phone call each day things have changed. We just got through cleaning Mom’s home after years of her ignoring the mess. She had not hoarded she just did not clean. So rooms were filled with old things and now the family has cleaned it out and we are starting fresh. We had every room painted and the bath faucets updated and the kitchen got a new smaller stove and new microwave. We took your advice and got it ready for care givers. One of the bedrooms is now ready for an overnight guest or caregiver, the closets of old clothes in each room are clean too. Now it looks empty and mom is really feeling a cross between happy to have it clean and making it her own again. She is recovering from her stroke but I live two hours away and can only do so much with my weekly visits.

Well, lets start at the beginning, what a great job you and your three brothers did on the house. And how smart of you to clean and paint and ready the house for a sale if that has to happen in the near future. Since your mom is doing so much better and only needs her meals and a daily care visit of two hours, I think you have a great program going. The job now is to keep your mom busy and that might take some thinking.

Lets talk about depression its much more common than you can imagine. Strokes often effect the brain with sadness and so does the recovery from other health issues and of course the loss of a spouse. This whole house cleaning could also set off sadness in her daily routine. Even though your dad passed years ago, she is now just facing her own older and less able to do things lifestyles. I’m sure she thought that your dad would be there to help her at this time of life and the grieving can resurface. It can be treated with drugs that help so much, but so does therapy. Even though your mom is older it would not hurt to have her do a 4 session therapy round to give her a chance to express her personal feelings to someone other than family. She may smile when you are there but she may be very sad or teary on her own, so check this out. That way she can really close some personal issues and adjust to her new life of being less mobile and more home bound. It is not easy to make that change. So even though you are there for her and your love and support is strong…your mom needs some time talking things through and getting her new lifestyle started with healthy thoughts. What you dont want is for her to be upset or confused or just feeling lonely and no one really knowing about it because she is keeping quiet.

So, lets remake the home area that has been so well cleaned and updated.  Start with an area for her to write down things she needs on a listing by her chair. If she thinks of something she writes it down and when you come on Tuesdays she can give the list to you. You can review and try to handle what ever is on the list in a wise manner. That will keep her feeling that her inability to leave the house and drive is not stopping her from getting things and items in order in her life.

Put together a plan to decorate in a lovely way for each season so she can enjoy her home or any room she lives in as time passes.  Take older pictures of family and choose one or two and have them enlarged and put up on the wall like large art pieces. This removes the clutter of fifty small family frames, into a just a couple of stellar photos that reflect years ago and the current family picture. The older pictures can be scanned and put on a nice mp3 frame that will show a slide show when you touch the screen. Always put your father’s picture in a nice frame and have it where she can enjoy it..maybe one with them both as a couple but do not over do. Memories are to be cherished not overwhelming.

Add a little color with throw pillows and a good lap throw so she has color around her without changing wall color. If there is some money, recover  her better furniture It will be familiar but updated to a current nice color that reflects her personality. Add a grandchild corner with a big basket of toys for the visiting little ones. That way the kids enjoy the visit and she has a reminder of her lovely little ones around her. The house will remain clean, safe to walk around and yet feel updated with things that are currently special to her. Not things that have been there and forgotten for 30 years.   

Remember that when any person pulls their world back down into their own home or care center, their universe is smaller and therefore becomes more intense. So do not be alarmed if she gets upset with things that you feel are small and silly. The room temperature  may bother her to distraction, the way she feels sitting in her chair may be uncomfortable. What used to be a minor issue among many daily tasks is now the only issue. Deal with them as they come up and just allow her to vent until you arrive each week.

Here are some changes that you will have when your Senior is home bound:

  1. The TV may not be right for her. It becomes a big part of her life, so a new set that she can see and use the remote. Adding Dish or Comcast will give her more channels and a constant reminder of how to use the channels and the remote will be required for quite a while tell she understands the process. You might also try moving an old set in a closer position or get her headphones that plug into the TV so she hears without a high volume. History, sports and Military channel for the guys and food, home, mystery channels for the ladies…it makes a huge difference. Set the TV with text to run on the bottom of the screen if your senior is hard of hearing so they really enjoy the viewing time.
  2. Get her into a senior center and drop her off once a week to involve her with other seniors for as long as she can do this with her health issues. This can be cards, bingo, special exercise classes, lectures, lunches, food gifting, crafts and outings. You will find that the first visit needs you by her side and then they get drawn in and really enjoy this time. It will fill their mind with things during their week and help their emotional stability. It is worth having a care giver or senior in neighborhood driving them to and from and that could be a $10-$20 investment well made for the transportation. There are vans for seniors and you can try that too.
  3. Plan events in their homes for your active family members. OK so Thanksgiving is coming up. Did you know that around the holiday many local grocery stores do full turkey dinners? You can order one for a week before Thanksgiving. They will cook the whole meal and it only needs to be picked up, warmed and served. Then invite some family and old friends over for and early Thanksgiving. This will be a full month of getting ready and making plans without the worry over the cooking and lots of left overs to give away. Then the actual holiday comes and your senior can attend the family dinner or stay home without sadness because they had their own nice celebration the week before. Works well for many.
  4. Each visit you need to open the refrigerator and make sure the senior is eating food that is being delivered and prepared. Just because food is in the house does not mean the senior is eating it. So look through the refrigerator. If the senior gets into a special diet of potatoes or just canned chili or other items dont worry, it will work itself out. Just make sure they are eating and add a Boost dietary drink so they get plenty of protein. Tell dr about the eating if it gets bad and he will prescribe meds that increase the hunger issue.
  5. On your visit ck the cleanliness of the kitchen that is a care giver job and you want to make sure the staff you hire for your senior is doing their job. Clean counters, floors, and appliances are a must…check. If it is not clean, report the caregiver to the service and ask for another care giver or more time each week for a good cleaning.
  6. Check on the bathroom for the senior, it should be very clean, the caregiver also is responsible for that area. The bathchair should be in the tub the handheld shower should work and be clean. The towels should be in order. If your senior has old towels remove them. You will need four good bath towels and a stack of hand clothes to make sure your senior is able to get good care. I am sure you know that the most important person you can hire to care for your senior is a bath lady. They are well trained to do a great job and will report injuries, sickness, dizziness and any other problem with your senior. You always find professional at a “In home care service” they provide a variety of care people to hit the needs you might have. They are licensed and bonded but once you use them…all expensive jewelry and family things should be given away or put into the bank box…you dont want great grandma’s brooch to be lost to the family because you did not follow through with this.
  7. How is the mail box at your senior’s home. Is it on the porch and easy for them to use, or across the street? Maybe you need to buy a new one that is larger and easier to use. Or have the mail all forwarded to the home of the person caring for your seniors finances. Getting mail each day, can be a dangerous task for those that do not walk well. If they still want their daily mail, put the pick up on the care givers to do list. Or ask a long time neighbor to drop it off and put a box on the front porch for them to do so. Then  make sure you thank the neighbor often with cookies or a box of candy so they know they are appreciated. This daily ck in by a neighbor can save a life one day.
  8. Watch the charge cards of seniors, they tend to build up if they sit and order items from TV or the phone. You can stop unwanted calls by removing their names on phone lists. You can get a special service added to the phone that will filter calls from anyone but approved family and friends. You can also get a good easy to hear phone with special features for hearing disabled. You can add a cell phone to your own family plan and have your senior wear it on a holder around their neck or in a belt. Teach them how to call for help and call you…you can also add a home protection service that is a button for the senior to push if they are hurt or need help.
  9. If the senior looks out into the yard from their family or living area…get the grass cut and the bushes trimmed and load up the beds with bark. You dont have to make gardening a hobby at your mother’s place, but keeping it looking in order will relax her and help the home to re-sell in the near future. If you have teens in the family ask them to make the garden and grass their task and pay them a small amount. Taking care of the home and keeping it safe will allow your senior to relax and enjoy their life. Instead of them worrying over uncut grass and the house slowing breaking down around them.
  10. Make rules for your time…if your siblings want to visit great…but remember your mother is a part of your family…just a part. Make her needs work into your life with your calendar days not her’s. She is at home each day you are working and keeping another home. So be kind, but be strong about saying I will come down on Tuesdays and get what ever I can done that afternoon and evening…the rest will have to wait till my next visit. She will soon learn the routine and she will be happier knowing you give time to her but still have time for you and your own life.
  11. Care starts small…a day here, an hour there and soon it becomes overwhelming. Remember when you make any decision have an idea of what will happen in time to come. That way each step your mother takes in her recovery and her advancement with her declining health issues- is a step that fulfills her life but is in line with her future care. What I mean is do not spend a lot of her money on things for a home that will not repay, her money is limited and will be needed for care giving in the future. If she wants fancy clothes but she can not go out the door, try to adjust her thinking to clothing that is fresh and easy for at home comfort. It takes a mind change for you both…and that is what you now must make a change and realization that your mom is older and is declining in health.But her today and tomorrow can be happy and fun and filled with hope.

I appreciate your email and that my ideas have already helped you make solid decisions on your mom’s care. You are doing a great job and thank you for your care. Please do visit my web site and remember I have written a book on Senior Care Workbook 101 that really helps with all the decisions and care that will be happening as time goes on. You will find the workbook on my website www.seniorcarewithspirit.com

Blessings, francy

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Senior Refuses to Eat Real Food – Getting Weak

by francy Dickinson                        www.seniorcarewithspirit.com

Dear Francy; My dad is just not eating. He will make an occasional piece of toast and he will eat if I am in front of him and the meal is fresh. He refuses frozen food, left overs, and canned food and I am watching him get thin and weak in the body and emotionally. What can I do?

There are lots of things to review and many of them will take professionals to help you. Doctor, counselor, additional help with in-home care…let’s see what we have for you:

  • Questions: Is he depressed and missing his wife and just not eating because of those memories? If you know this, a primary care physician can help with meds to bring his emotional level up and help him handle the grieving. If you do not know, then a trip to a family counselor to have him talk over his problems about his grief and his eating might be even more helpful – before he sees his doctor.
  • Does he just have nothing in his life and his days are melding into weeks and months? That can really effect a person that has always had someone to keep him company and keep him busy. If so then you can take steps and get him into a senior center once a week. Have him volunteer once a week to use his talents. If he tinkers- then a Boys & Girls club with all the equipment and repairs that are needed all the time is good. Just use your creative thoughts on this and find a place that can fill his needs. Even if he does not like it, make him do it. If he will not go out to others have him come in to you. A day or two at your place on the weekend when he is surrounded by family and have him working on your yard, porch, paint, or fix the leaks in the faucets. You can think of things to do for him, he needs to be busy in his mind and helping you at the same time is “a feel good for him”. If he can not do it alone, you will just have to give him a gentle, but consistent push.
  • Make sure your dad is included in a monthly family outing. That’s a trip to a movie, a museum, a community event like a street fair, a car trip to a larger city, or family birthday celebration. These are the things that give a life structure- when there’s an event on the calendar other than a doctor’s appointment!
  • He likes your food, how about finding someone in the neighborhood that is older and will share dinners with him. You can pay them $20-$50 a week for food and they can send over a dinner to him each night. Perfect for a retired lady in the neighborhood, gives her food to cook and an extra income. Plus, he gets a visit, or a walk each evening. If nothing in the neighborhood, ask around to friends – you will find so many single ladies all alone that would love to be busy. This is not looking for love for your dad…we are talking good food here. He helps her she helps him, healthy business.
  • Can he afford an assisted living?  This is where he has a place that is an apartment type of residence and they go out to the main hall for dining three times a day. They have other people there for companionship and many different events to keep them all busy. If he misses people and is retreating, this might be his answer. He could sell the house and leave those memories in place and then move into a new life. I know it means money, but that is why he has invested in a home all of these years, to give him security and care now that he is older.
  • Could he afford an in-home care person? You just call a care service and ask them for an assessment and they will tell you what is needed and then you tell them what your budget is and together you come up with a care plan. A care giver will be in his home each day for a few hours that can make the meals and keep him up to date on meds and his exercise. You come and visit on the weekend or in between what you can afford to pay for care givers. You work less, your dad gets more care…it’s a nice fit. Plus, everyone is nicer to an outside of the family care giver. It is just the way of life. So, if he does not eat for you, he will eat for the care giver.
  • Can you make a deal with a family member to come over once or twice a week and then you come over the same and he is covered most days? I know this is hard, but you know, your sibling, his sister, or a niece might do it, or a close family friend and they will just come and give him a couple of hours. Now, they will not be cleaning or doing chores, they will visit and do his food. But if money is really low, you need help, you need to ask the family to give time. Most of the family can commit to a day of a couple of hours. Do the math, two family members and you makes a good care plan.
  • Can he come and spend weekends with you? Even if you both do not want to live together, you might find that the weekends of living together will give him good food, interaction and raise up his emotional level to help him through the week. You send home meals for the rest of the week. Buy good plastic covered dinner containers and as you cook just make one more portion, that way he has food that is not frozen and tastes like family cooked it!
  • This all sounds great but your dad is a stubborn and does not respond to anything? Well, here is the truth, life is never perfect and he has to know that is the case. So if he feels this way and will not respond, then you get together with your husband or other siblings and go and sit down and have a talk with him. Circle around him and tell him, this is the way life is going to be. You can not sit here and do harm to yourself. You are not dying you are well and you are doing very bad job of taking care of yourself. We as a family are going to have to make some decisions on your care. If you want to help us, then here are three choices you can make, otherwise, we will have to make the decisions for you. If you need to have a third party with you then you  hire a Senior Care Consultant, that is what I do. I help them with family meetings and get the ball rolling. There is no anger or childish behavior during the meeting, this is all for your dad. You decide.

I hope that you have already gotten his power of attorney for health reasons. If you do, then the decisions that you need to make for your dad are all in your hands. If not, get that done. I have the information in earlier blogs and in my Senior Care 101 Workbook – http://tinyurl.com/d6a5e5  

I always try to put my mind into the senior that I am caring for at the time. Have they suffered a loss of a wife, child, job, health, strength, or are in dementia? Those things make their lives so much more complicated. Try to remember that when you are treating the body, that the mind and heart are all in the mix together. So proper medication, clean surroundings, good companionship, a few laughs, busy days, events on their calendar, and good food all go together to make a senior have a life that feels worth living.

You have been so good to your dad, like my mother, he does not even see you standing there. I know it’s frustrating when you’re trying to help him and he does not respond, but you just have to force yourself not to take it personally, he does love you. As a matter of fact; he is probably mad at the fact that you have to bother over him. My mother told the care givers that she just wanted to go and let me live my life – That made me feel so sad that she was that upset about having to “need care”. There is no way out as we go into advanced age and need help, we need help. And there you are – standing next to your dad giving him love, that is a very good thing.

I know you can be creative with all of this – you have already done so much for your dad. Keep it up- the times you spend with him right now, in the middle of all this care giving, will enrich the rest of your life. Thank you, francy

Family Robbing the Old – Just when they need help!

by francy Dickinson                             www.seniorcarewithspirit.com

Dear Francy: I have two brothers and one has POA for my mother. I take care of her in her home and he makes sures she has funds for all that she needs. She has had a stroke and needs full time care and when I went to check her into the center, I found out my brother had taken most of my mother’s money and gotten a reverse mortgage on her home. I am in shock, but more than that, I need to care for mom. Help?

No, I am not a lawyer and your financial problem is legal in nature and you need to find a lawyer to help you. If you do not have personal funds to find one, call social services, senior division, in your area and ask them for help they’ll guide you to a legal center that can help you. The POA has to be rescinded right away and that can happen immediately. This sounds very serious and I would think the state may even enter into this and adjust her Power of Attorney to you and your other brother to share and then figure out the financial problems. You may be in for a surprise, very few areas actually prosecute family members for stealing money from parents. But if I were you, I would try hard to get the law to deal with this as if her funds were stolen by a stranger. She is now in need of care and no money to pay for it. She saved all of her life, had a home and both she and your dad understood it would provide for them in their later years. This is a horrible thing that has happened to your family. But you are not alone.

How can I say this nicely…OK, I cann’t – there are kids that want money and could care less if they steal it from their parents. It happens so often it is shocking. Sons and daughters that say they are into their church and caring for parents and then it turns out they are robbing the parents. What can you do?

Very little, money spent is gone. Gone and will not magically come back. So take these ideas and think on them before you are faced with siblings or others that have ruined your own seniors life.

  • When you set up the Power of Attorney have more than one name on the bank and tell the bank that all parties have to agree for any expense over $500. That way the bank can take on some of the responsibility if money is just shifted from here to there, the red flags on the bank’s computer will at least come alive.
  • Power of Attorney can be health, or financial, or both – decide what is called for in each case. The sibling over seeing health care should have the health care directive and the Power of Attorney for health issues and a second name that is like an aunt or brother of the senior has the back up.  The person paying her bills needs to have a family member as back up and the family needs to review the bills each month or at least each quarter, even if your parent has little money…it has to be overseen by family. That keeps it all in the open.
  • Do not forget that siblings have spouses. Some times it’s the spouse that says she or he wants funds for all the time the family member spends on the senior. Or they want to do a loan or a charge card and have the parent pay for it because they give so much to the senior. You have no idea of what a spouse of your sibling is like with money so set up a review before you find out. This is a business not a family…your business is to give long term care to your parents, or aunts or other relatives and that means you set it up in the open with checks and balances.
  • The Power of Attorney is a very important document and should not be done lightly. That is why you need to have it in place and have it checked on a regular basis. It can save the parent from harm. Many times dementia/Alzheimer’s can take the seniors ability to spend money away. They will buy from the TV, catalogs and give money to people who call on the phone. This has to be protected and it takes all of you to over see this situation.
  • The family that has a lot of money can lose a lot of money. There has been a recent investment scam that has taken retirement funds from lots of families and really ruined their lives. There is little you can do about that sort of thing, but a sibling or a lawyer that is saying how they are going to oversee the investments for ageing folks with a nice retirement fund, they have to be watched and a report on a monthly basis has to be provided to review and I mean review. Every few months you need to call the bank or investment company and find out of all is in order. If you just let it all go and then a year later you find that someone has taken money you are out the money and the person who took it has probably taken from others. So keep on top of it.
  • By far, the problem is in the senior that has a few hundred or a thousand or two in the bank and owns a home free and clear. They are the ones that have very little and the family just assumes they are OK. But that is when no one is looking and suddenly two charge cards have thousands of dollars charged on them and it was not your parents who did that charging. Or the house has a loan out that has not been paid…it is sad stuff, but happens all the time.
  • Make sure you have the ability to check your parents funds. Just as you would not think twice of checking to see if you mom or dad were still driving safely by sitting in the drivers seat as they drive you to the grocery store. You need to check and see that mail is being delivered and they are opening it and checking on those bills. Once or twice a year you can do a credit check and get a report on their funds that would show if they had “secret” to you credit accounts taken out in their name. You also need to check on the automatic payments. One family found that the daughter had her mother paying her cable, phone, and light payment automatically out of her checking account each month.
  • Start from today – tell you family you need to be more aware of your own finances and you want to also be on top of your parent’s so you would appreciate seeing the accounts once a month and making sure all is in order. If they get upset, there may be a reason, so talk to your parents and let them know, you want a back up check. This day and age anyone can steal funds, not just siblings, other family members, legal and investment people and strangers that steal identities. So, do not be embarrassed about this family open policy, it should be just another part of the care that you give to aging family members to keep them safe.

Thanks for all you are doing for your mother, keep up your care and your chin…you have to be tenacious over this situation but it will pay off with your mother’s care being covered, once you get to the bottom of it. Please do check out my website and see all the information I have for families that give care to seniors www.caregivingwithspirit.com

Thank you francy

How much do I pay my brother to care for my dad?

by francy Dickinson              www.seniorcaretips.com

Dear Francy;  My family has been paying one of my brothers to care for our aging father.  The money is coming from my father’s account, so he
is actually paying it, but he has one of my siblings in charge of his money. As my father ages and needs more assistance -my brother is giving it more time and energy. We all agree he needs a raise in pay. Do you have any information concerning how folks typically compensate family members as care givers?

First there are a couple of things I want to share. Family, money and caregivers are hard to mix. So, when your family is talking about this, talk about it as a caregiver. That way it is a position instead of thinking about your actual brother. Because after all he might not want to continue to give care as things heat up in the future. That thought aside.

The caregivers that are in-home range in price from what a private person will pay to what a service will charge. Most services charge from $18- $30 per hour. That depends on the amount of skill that is required and such. The actual caregiver receives about $12 an hour from the service provider. The service comes into the house and does an assessment and then gives you a price and a health care plan.

The private person will pay from an average of $10-$12- up to $22 per hour. Once again this depends on what amount of skill is required. So, my example for your dad is that he has to have his house tended and food prepared and light assisting to walk and medication reminders and such. That is basic and light and can be from 2-6 hours a day without skill involved. I would say that would range from $10-$14 dollars per hour.

(Ballpark – light care would be $1,000-$1500 flat rate per month with 6 hours a day. With it going up from there as you add time and the medical and personal care to that listing.)

Example: Assisted Living Caregiver (neighbor) did three meals a day, prepared medication, and did some personal appointment calls for a gentleman (no housekeeping, yard work or medical required) /Two visits per day = 4 hours-6 days a wk. She would also take him back and forth to doctor & grocery visits. She received $275 a week with extra gas money & fee for driving

Now, when things start to get more extended in time and your brother is working 8-12 hours, or living-in the home with your dad….that is a higher amount and would be a flat fee basis that would include food and lodging for your brother and it would be around $350-$500 a week. Now, you are getting into the range that a care center would begin to charge. They run around $1800 to $3,000 for basic care for each month and your dad would live there full time. Additional charges would be added as needed if you are talking a lot of care with health issues and/or Alzheimer’s care. 

As care is needed, I would always suggest an outside person to do your father’s baths, once or twice a week. It gives the son the release from the private bathing time. As well as the bath person reports to the person in the family that writes the checks and they are legally required to report any bruise or hot spot on the body so it can be cared for- immediately. That way you always have a back up to the care. This is not to be thought of as a negative, just a fair reality of life. Bed sores are not a pretty picture and are hard to treat, so this keeps everything in view to the whole family.

Now next you want your brother to know if he is going to give care, he needs to take a care-giving class. He may think this is stupid. But I assure you these classes are really important. I review everything on this subject in my Care-givers Workbook 101(ebook or printed)- I really spent a lot of time putting together all the tips for care givers that are not professional nurses – so the families could learn how-to tips. You can find the book on my website under Products    www.seniorcarewithspirit.com

Next comes the thought pattern. Your brother is the caregiver and he needs to follow a care plan. You will find out how to build one in the workbook. This plan is so nice because then he has a daily outline of what the family expects him to do when caring for your dad. Makes it all very seamless and no hurt feelings – keeping this on a business type of relationship, so down the road if things get difficult you have the family in tact and another caregiver can just walk in the door and take it from there.

When your dad needs more care than your brother can give him, it’s time for a care facility or for advanced in-home care. That’s when I come in and talk to you about what is needed and then help you find a facility that works for your dad and the family. I also have the instructions of how to do this in the Care-givers Workbook 101.

The problem with care-giving is it starts out with time, energy and love and then it will start to move into difficult decisions and hard work. So, just be aware that if you keep your brother thinking that this is a floating situation that has to updated every few months. You will find he will take it all on a less personal basis. It is very kind of him to give his time and love to his dad…he could be doing other jobs that are less stressful. But on the other hand, your father is your primary focus and his well being has to be on top.

Thanks for sending your question, it was one that lots of folks wonder about. I do want to stress that many families go through really sad arguments about caring for their parents. This care giving is more than you think. There is nothing so sad as a family that separates because of hurt feelings on one side or the other – we have long lives and need our siblings to be there with us as we go down our life path. So, good luck on this and please do visit my website and get a copy of the workbook, I know it will help your brother.

Thank you, francy