The idealic holiday scene. Not so ideal if you're a caregiver

Remember when you were a kid and all you had to do on Thanksgiving was to show up and eat? Caregiving is stressful enough, throw in a couple of holidays you have to do the cooking for—in back to back months—and somebody’s likely to get hurt. The holidays have so many emotional fishhooks—childhood memories (not all good), expectations, in-laws, money issues, a spike in depressions…you get lambasted from every side. Caregiving is all-consuming and complicated enough without adding all these “festive” pressures.

How to Caregive and Put a Turkey on the Table:

Lower your expectations—nix the china and go with Chinet. Pick up frozen pies and cool whip. You can make homemade meringue another year. This year—it’s survival!
Who says you have to cook the turkey yourself? I know, you like cooking the turkey and people like it. Do it if it means that much to you, but be aware it’s not just the cooking involved here. It’s the buying, prepping, storing, and clean up—do you really love it that much? Wouldn’t you like it if they missed you one year and really raved about how good your turkey is?

Just the two of you? Eat out, cater it, or join with neighbors for the holidays. We think everyone else’s house is filled with family—dozens of them. Not true, many families can’t get together for the holidays, and many people are childless. So create your own holiday traditions and enjoy a new gathering of folks.

Go un-traditional. Who says you have to eat turkey? Go for take-out Chinese, shrimp and crab legs, or pizza—this may feel like a day off and who wants to spend their day off in the kitchen? Mix it up and do whatever feels easy—and fresh.

It’s not all about food. Rent movies, play board or card games. Get out the Christmas tree and start decorating. Don’t feel like doing any of that? Turn on the Macy’s Day Parade, eat pie and call it a day. Enjoy this holiday in a way that’s most satisfying—to you.

Don’t forget the thanks. Thanksgiving is a unique holiday. No other country does it quite like us. Even with our economic downturn, many of our family members in the military, and with the strains of caregiving, we have so much to be thankful for. A home. Each other. Good food—whatever our choosing.

Life is still good.

Juggling all that comes with caregiving isn’t easy. At times, you drop a ball or two. What happens when you just can’t do it all?

Most caregivers eventually find themselves in this dark alley with nowhere to turn. The toll of caring for someone 24/7, worrying about finances, navigating through the medical and insurance maze and knowing that no matter what they do, their loved one will most likely get worse—and eventually die—is more than any one person can continue to face alone—and yet that’s what statistics show—that 3/4ths of all caregivers go it alone. (link)

Caregiver Burnout:
You might feel numb. Enraged. Lost. Bitter. You might stop reaching out to others. Eat, not, eat, sleep, not sleep…there’s right or wrong way to get to the end of your rope and it looks and feels different for every person. .

What do you do when you hit caregiver burnout?

The hard part is that you can’t just quit. Who will take your place? If you grab your keys and leave—the person you love will suffer. So you stay. What else can you do?

As much as you don’t have enough energy to lift your pinky finger, force yourself to make a call.

It’s time to ask for help. Put your cynical self aside and realize that there are more resources than ever.

Elder-care issues have come to light and many churches and communities are offering volunteer and respite care.
Contact your area’s senior centers, Council on Aging,
or the Alzheimer’s Association has a 24/7 Helpline
1-800-272-3900
e-mail: info@alz.org, Parkinson’s Society or other disease specific support groups.

Make noise. Demand help. Sound like the scared, angry, lost, exhausted caregiver you are! You are by no means alone.

In some ways it might be time to go back to being their adult child or spouse—that place where you started. Caregiving can feel like a long list of duties. What if you return to that loving, supportive person you always wanted to be? Is that even possible?

Start by asking for the help you and your loved one deserve.

“We’re fine.” “We’ve got Social Security and your father’s pension.” “I do all right, don’t worry about me.” Most adult children don’t pry into their parent’s finances. Even caregivers who know their loved ones are struggling with health issues don’t check on finances and other important documents. They don’t ask. They don’t want to upset their parents.

They tend to either ignore the issues or believe their parents manage their finances just fine. After all, they’ve owned their own home for years. Their parents put them through college, helped them buy their first car or even their first house…but the truth is, people are living longer—and many older adults are no longer “just getting by.”

A recent survey by the Employee Benefit Institute found that 63% of all seniors believe their adult children know where they are financially—and 42% of all adult children also said they have no idea how things stand.

It’s time to ask. More and more seniors are falling into debt—the same survey found 73% of seniors have credit card debt—that’s a higher ratio than any other age group.

Bankruptcy is also another alarming category. It’s 50% for those over 65. Sadly, our parents were hit hard by the recent economic downturn. Many lost their life’s savings, and they’re too ashamed to tell anyone.  

Five Areas of Your Parent’s Finances You Need to Know:

• Monthly income vs. bills—check the bank statement—not just what’s in the register. Many seniors are paying for services they no longer use, are charging items they can’t afford, or are not receiving parts of their pension they deserve.
• Important legal documents (where they’re kept and what’s in them). You need to know where these papers are kept and know where the key to the safety deposit box is. You need to make sure they have a will, they have the deed to their house, title to their car, and other important documents.
• List of personal advisers. Do they have an attorney, accountant or financial advisor? You need their names and phone numbers. Many elders are taken advantage of by shady characters they trust with far too much access.
• Insurance information. Do they have adequate health insurance coverage? Are they utilizing Medicare or are they confused and paying bills they don’t need to pay? Do you they have a life insurance policy?
• Living will/advanced directives. This is a document you need to have a copy of—as well as a copy of their insurance cards. You need to be able to take these with you to the hospital and present them to doctors/staff who are making decisions when you are—or aren’t there.

As uncomfortable as it is, ask, look, find out where your parent’s stand financially. As much as your parent’s may fight you on this, they may also be relieved. Approach them with respect. Keep them involved for as long as you can. This isn’t about taking control from them—in many ways, you’re helping them stay in control.

A recent AARP Magazine survey reveals that more Americans feel lonely today than they even did a decade ago, and older Americans are particularly at risk. In fact, 44 million adults over the age of 45 suffer from chronic loneliness (link).
Why the increase? One factor may be that it’s prime caregiving time.

Caregiving can make you feel like the Lone Ranger—without your Tonto.

You feel like you’re the only one, and although the statistics state that there are 52 million caregivers in our country— (source) but you wonder where they are.

They’re just like you—behind closed doors at home caring for a loved one, or driving to and from care homes, doctor appointments, and pharmacy pick-ups. They’re the ones behind you in line at the grocery store, but the problem is, no one’s talking. We stand zombified in line after line and rarely strike up a conversation. We care for our moms, dads, spouses, grandparents, and disabled family members—and yet we can’t figure out how to open up and start a friendly exchange.

Loneliness can be more serious than you think—Dr. Cacioppo, director of the Center for Cognitive and Social Neuroscience at the University of Chicago has found a correlation between loneliness and diabetes, sleep disorders, compromised immune systems and even Alzheimer’s.

It makes sense. You’re lonely so you eat. You gain weight and put yourself at risk for diabetes. You can’t sleep in part because of depression, but when you’re caregiving it’s likely that you’re up several times a night to check on or assist your loved one—and not enough sleep affects your immune system. The lack of stimulation—lively conversations, travels, furthering our education–causes our brains to shrink and can contribute to dementia.

What to do? The catch is, you feel lonely, get depressed, have more health problems, and don’t feel like forcing yourself to get out and make the effort necessary to change things. Even if you did go to all this trouble you still have to care for your loved one, be available at all hours of the day and night, and juggle a million appointments as well as be home more than maybe you want to. None of that is going to change….or is it?

Practical Ways to Combat Caregiver Loneliness:

1. Reach out and get in touch. When you’re caregiving you need your friends more than ever. And yet it’s easier to just pull in, not call, and give up. Your life can seem so monotonous and bleak that you hate to even talk about it—or you’re afraid all you’ll do is whine and complain and not be able to stop. Get past all that and force yourself to make those calls. If you’re retired or had to quit work to care give, call your co-workers and pick up right where you left off. Meet for lunch and listen to harmless (not hurtful) office gossip, keep in touch with the latest news and genuinely listen and feel compassion for what others are going through. Reach back through time and contact old classmates, roommates, crushes, friendships that dwindled, and relatives you haven’t talked to in years.
2. Join online communities. The world is changing and online friendships can be real friendships. Caregiving based forums such as those on Caring.com and the Alzheimer’s Association forums offer real people in situations similar to you—with a wealth of advice, humor, compassion, and connection. Don’t stop there—join a dog forum if you’re a dog lover, a knitting forum, garden group, a vintage car group or genealogy chat room.  Not everything you do—in your everyday life or online has to be about caregiving—so branch out!
3. Reach out and help someone. Once a month do something for someone who’s got it worse than you. You might not be able to volunteer 8 hours at a time, but find a way to give. Read stories at the Boys & Girls Club near you, write letters and collect care packages for our soldiers, teach knitting to a young girl’s group at your church, serve in a soup kitchen at your local shelter—just one meal once a month. It helps us put our life in perspective and it also serves to get us out of the house and with other people who love to give. You’ll return home grateful for a decent mattress, a coffee pot, and those who love you.

Caregiving and loneliness can go hand in hand, but refuse to see this as your fate. I found friendships in the most ironic places during the years I cared for my mom. (I was even invited to several of my mother’s doctor’s offices Christmas parties—and my mother’s care aides became dear friends). Most importantly, I began to consider my own self a friend. I journaled, took walks, made my bedroom a sanctuary, and began to treat myself with kindness and patience because if I didn’t it was too easy I knew I was just shrivel up and fade away—not to mention how easy it is to play the poor-pitiful-me card.

Think of loneliness as a temporary state—and something you can do a little something about. It takes effort, something that can feel in short supply, but the good thing about reaching out—is that others reach back.

But it’s not impossible. A lot has to do with how you introduce your loved one to their care aide

5 Tips to Ease a Care-Aide Transition:

1. Include your loved one in the choosing process. Only you know if this is a good idea or not—if you know that Mary Poppins wouldn’t pass the muster then make an executive decision yourself.
2. Go with your gut. Chemistry is key. You can’t really explain why you like someone—why your rhythms just jive—but they do. When they don’t, move on quick. The sooner you let the wrong person go, the sooner the right person will enter your life.
3. Do a background search. You wouldn’t take a chance with your baby—so don’t take a chance with your dad. Either go through a company that does thorough background checks or pay for one yourself. And don’t hesitate to nanny-cam. Tell them you will—and then do it. Safety first.
4. Write down your expectations—and directions—and then don’t vacillate. Most relationship issues arise when we don’t state up front what we need and expect. Write it down, make it clear. Not a thousand item list—but a few crucial points. Also write down medicine, eating, physical therapy and other important directions. If you want it done a certain way, train them, write it down, and follow through. Then don’t change your mind and confuse them.
5. Decide what matters most to you. Do you want your mom or dad or spouse to gain a friend? Have someone to pal around with? Play cards with? Or are you more focused on keeping your loved one on a structured routine. Decide what matters most and emphasize that. Make sure that in those early weeks of a “new hire” that you keep the “main thing” the main thing.

Bonus Tip:

If you do find a good fit—treat them well. Ask them about their family, their interests often. Find ways to spoil them—and thank them often. No amount of money can ever compensate for caring for another human being. Show them you appreciate their patience, their humor, their willingness to follow your requests.

If you’re fortunate you and your care buddy can enjoy a long and meaningful relationship with your care aide. Get off to a good start. Establish healthy guidelines, make sure your loved one is safe, be clear, and show your appreciation often. Your parent, your spouse deserves the best care—so do all you can to create the atmosphere and invite someone thoughtful and caring into your life.

The folks at Caring.com have come up with a great way for you to gauge where you’re at—and where you’re going. Steps and Stages (link) can help you figure out where you are and what comes next.

It’s like a caregiving map.

Long range and short range plans are wise—and so are emergency plans. The one thing I know about caregiving is just when you think you’ve got it all figured out the whole thing falls apart and you have to start completely over.

No one can gaze into a crystal ball and foretell how long your spouse or elder parent can live at home. No one can say whether you can incorporate some home care coordinating and enjoy another few years in your loved one’s community—or whether a fall or a stroke or a heart attack might take place at any time.

Maybe your loved one will eventually need skilled care in a facility. You can promise a thousand times you’ll never put them “in a home” as my mom called it—but that doesn’t mean you might not have to.

Knowing the steps and stages—and your options keeps your loved one safe—and you from scrambling at the last second. There’s something comforting about knowing you have a “care team” and that others have already scouted out the territory and can alert you about upcoming roadblocks, hiccups, and plain out disasters that lie ahead.

Caregiving never stays the same. That can sound rather ironic considering that most of your days are so monotonous you could watch penicillin grow in a Petri dish. I found that the minute I relaxed and began to settle in that my mom would wind up yet again in the ER and my whole carefully honed routine fell into total chaos. It would take weeks to get the meds, the physical therapy, and the whole care routine back into a doable schedule.

Change is the name of the game. And doing the one thing you said you’ve never do—will inevitably come. Caregiving humbles you, challenges you, gives you every reason to doubt yourself—and yet in the end you have dig deep and just do the best you can.

How can faith make things better?

Not only do most faiths center on tenants of compassion, hope and solace, they also offer opportunities for social gatherings. Attending church, temple or mosque creates a pattern in our lives. We make connections and can receive genuine support during our caregiving years.

Another important factor is that our faith gives us opportunity to serve

Many, if not most houses of worship offer a vast array of community outreach. Food banks, clothing drives, missionary support (including medical and educational funding) affordable or no cost day-care or pre-school, and reaching out to their own congregation are but a few ways churches meet the needs of those near and far.

The AARP study found people who don’t reach out to help others are at high risk for loneliness. When we know we’re needed we tend to have a sense of purpose. And when we join groups—volunteering, book clubs, travel clubs, hobby clubs, we find natural connections. People who have at least 3-4 friendships and connections are least likely to feel isolated. (More here)

Caregivers have a bigger challenge

Most of their time is spent in the company of just one other person—and that person takes up just about all their time and energy. As caregivers we don’t always feel we can confide and open up to those we’re caring for. It can turn into a one-way street. We listen, we provide care, we spend copious hours doing chores and errands—and yet we carry a brick in our heart. We don’t always have someone to confide in, share our concerns with, or open up about the little every day things that need to matter—to someone. We can’t give out all the time—and never receive.

We have to face that our loved ones can’t always be there for us. Maybe they’re struggling with Alzheimer’s, have chronic pain, or are struggling with depression themselves. We have to love them “as is” and realize we may need more than they can give. When it comes to loneliness, it appears that reaching out to our faith community might be just what we need.

Your back hurts from helping dad out of the wheelchair. Your knees are shot from sports you played back in college so you take Celebrex or get regular Coritsol shots. You can’t sleep because mom’s dementia has given her a ripe case of sundowners—she gets perkier—and more unpredictable—as the moon rises, so you get a prescription for Ambien or some other sleep aid. You can’t wake up because hey, it’s 8am and you’ve only gotten four (interrupted) hours sleep all night. So you ask for a triple shot latte from your favorite coffee shop, pop a can of Red Bull, or some other energy drink to get you going. You cram down some easy, not-so-great-for-you breakfast while you’re standing at the counter or behind the wheel of your car, gulp down your cholesterol meds before a full day of work, caregiving errands and doctor appointments, hassles with the insurance that keep you on the phone for hours on end; then at the end of the day you pop the cork of your favorite wine for a glass (or two or three) to calm your jittered nerves. And the night has just begun…

It’s not that any one of these is necessarily bad, but taken in combination and sometimes in larger amounts or irregular times because of the stress in your life, and these drugs and other forms of self-medication can topple the apple cart, so to speak. It’s too easy to go to one doc for your knee, another for your cholesterol, another prescribes your sleep aid—and no one knows how much alcohol you’re consuming and before you know it, you’ve got yourself one deadly cocktail.

Prescription drugs are the most overused drugs in our country— (source) and with devastating effects. It may have made the headlines with Marilyn Monroe and Elvis, but the long line of celebrities who have died from an overdose/or a deadly combination continue today—from Anna Nicole Smith to Heath Ledger to Brittany Murphy to Michael Jackson. These stars make the news, but thousands each year die—or almost die—and they don’t make the news. So we think it’s someone else’s problem—someone famous—or people “not like us.” Not so, it’s our neighbors, our sisters, our kids, ourselves. Prescription drug abuse is on the rise, particularly pain killers and sadly, among our teens—who are oftentimes “raiding” their parent’s medicine cabinets.

The National Survey on Drug Abuse and Health reports that “ in 2009, an estimated 1.4 million people were dependent on pain relievers in the past year, which was 49 percent more than in 2002. From 2002 to 2009, the number of people who received treatment in the past year for nonmedical use of prescription pain relievers approximately doubled (from 360,000 to 739,000).”

Source

Caregivers are in particular danger. We’re stressed to the nines—and we have access to doctors and legitimate conditions. We’re sleep deprived and can make a miscalculation for ourselves or our loved ones. We’re desperate for relief, in any form, and not because we’re bad people. We’re hurting, anxious, exhausted, and vulnerable…and that’s all it takes.

How To Avoid Prescription Over-Use:

1. Be honest with all your doctors. Take your prescription bottles into the doctor and fully disclose what you’re taking, when, and how much. Also mention any over the counter drugs you’re taking such as Tylenol, Advil, and even vitamins and supplements.
2. Be upfront with your doctors—and yourself about how much you drink or smoke. They’ve heard it all before. You won’t shock them and they can’t help you if you don’t fess up. You might get a lecture, but you also might get help. There are new medications and treatments that can really help you kick an old habit.
3. Get enough sleep. Easier said than done. If you are getting less than 5 hours sleep, you’re in very dangerous country. Sleep deprivation is extremely high among caregivers. You’re setting yourself up to make a bad decision based on exhaustion, pain, confusion, and anxiety. It’s time to get outside help, or place your loved one in a care home. Their lives, other’s lives (Driving a car? Making decisions that affect others?) and your own life is at risk. . Know the signs and break the cycle. See Carol O’Dell’s Caregiver Blog
4. Be willing to replace at least one “crutch” for something better. Doctor Phil said something that really caught my attention. Don’t take away a bad habit—replace it. If you just leave a void (don’t eat the Twinkies, then it won’t be long till you’re double-fisting two Twinkies). Take an afternoon walk instead of that second or third glass of wine. Keep your house stocked with in-season fruit, nuts, and other healthy goodies. If you smoke, get the patch, load up on gum, and ask your doctor for ways to quit smoking. Take fish oil and glucosamine for your joints and cut down on the pain killers by trying acupuncture or heat therapy. Focus on one area for three to four months and I bet you’ll see improvement.
5. Admit how hard all this is, and ask for help. Don’t just ask, beat down every door you have to get the help you need and deserve. We now have many care agencies, many run by the state and free or low cost. Check with your local Council on Aging or senior center to find out what’s out there for you. Most of our stress comes from overdue changes we need to make. It’s hard to reach out, to deal with others, to admit we can no longer do this, not this way, not without help, and maybe not at all. Remember, even if your loved one no longer lives at home, you’re still providing care and making sure they are safe. You’re still a loving spouse/adult child.

Some self-medicating is necessary, but taken to the extreme it’s just plain dicey. Love yourself and those you care about enough to stop this vicious cycle. You’re toying with the most important commodity you have—your health.

It’s not that seniors don’t love their parents, it’s that they have their own issues—health, financial, ailing spouse or they’re already a widow or widower (52% of all caregivers, in fact) —and they’re even a member of the sandwich generation and helping to care for their grandchildren—wedged between adult children, helping to raise grandkids and caring for elder parents—more stress than anyone can stand.

I’ve seen them—at caregiving workshops and talks around the country. These silver-haired caregivers are carrying the brunt of the family on their lone backs. It’s straining their marriages, health and finances. A whopping 85% of all caregivers take prescription drugs—and admit they often to forget to take them because of their caregiving responsibilities.

It’s tough to admit, but many seniors have a hard time with caregiving at a time in life when they thought they’d finally be free to travel, enjoy a bit of hard-earned freedom, spend a few golden years with their spouse they find themselves overwhelmed, exhausted, and oftentimes, alone.

Senior caregivers care for other family members (34% with their mothers, 11% with their grandmothers, 10% their fathers) and many of them live together. Two-edged sword. It saves on money, time in traveling, but the caregiving load is 24/7. They give up friendships, part-time jobs, traveling, personal care, and other privacies in order to care for their loved ones.

Caregiver stress is high. Many senior caregivers place their health and happiness in a far distant second place. If finances are an issue, they’ll skip their doctor appointments and medications in lieu of their elder loved one’s needs. Many times they’re just too tired to do the simple things: eat fruits and veggies, go for daily walks, have sustaining friendships and a decent night’s sleep).

If you’re a senior caregiver, how do you care for the one you love and yourself?

No easy answers here. The only thing that really helps is knowing and believing that by taking care of you—sleeping, medications, walks, friendships—you will actually be a better caregiver. And it’s true. How will you have anything physically or emotionally to give if you don’t make it a daily priority?

Start with five minutes. That’s all.

Open the front door and get five minutes of sunshine. Sit on the porch and bird watch. Call a friend just to say hello. Take a 10 minute nap instead of mopping the kitchen floor. Go to bed before 11—and turn off the television. Buy fresh peaches for dessert instead of ice cream. Simple things. It won’t change your world right away but it’s sending a message—to yourself and to others.

And keep your doctor appointments. Fill your meds. Begin to plan for alternate care for your loved one—just in case.

Believe you’re worth it—and that caring for you is the start of really caring for all you love.

Did you know that Nutrition.com states that by the time you’re 75 years old you have half the taste buds you had when you were 30?

When you factor in medications (that may alter how food tastes as well as your appetite), depression, loneliness, loss of spouse or companion to share meals with, and lack of exercise, it’s easy to see why many elders nibble or even turn up their noses at meals.

Simple Tips to Help Your Spouse or Aging Parent Stay Healthy and Eat Well:

• Be aware of medications that may alter food taste or appetite
  Make sure your elder gets regular dental care. Broken teeth, ill-fitting dentures can make chewing difficult.
• Offer four-six small meals throughout the day—but keep them healthy
  Spice it up. Make sure you cater to their food preferences: spicy, salty, creamy, crunch—what food appeals to them?
• Focus on calcium and lean protein
• Go for a multi-vitamin. Make sure it has B-Complex, D, and other vitamins elders need .
• Sneak in the protein wherever you can—protein powder is a great supplement and can be added to milk, a smoothie, or even soups.
• Get in a walk every day. We need to use our fuel (food) in order to build up an appetite and there’s no better way than light chores, a pleasant walk, or even joining a group that offers senior exercise such as water aerobics, light weights, or dance therapy. Check out your local YMCA for lots of great senior classes.
• Don’t eat alone. If at all possible, make sure that someone is there to eat with your spouse or elder at least once a day.
• Focus less on calories and more on quality. Eating can get to be such a challenge that you’re grateful they’ll eat anything. Offer soft foods if their teeth or chewing is an issue. Offer color, choices they request, and at times, spoil them and let them have dessert first!

Meals aren’t just about consuming calories. It’s a social experience and a time of celebration. Gather your family members near, sit around the dinner table and talk, share your day, and offer foods that are both healthy and appealing. For other great tips, visit the Nutrition.com website.