Keeping Loved Ones Safe and Caregivers Sane

By Carolyn Campbell

"I'm not a caregiver yet. I don't take care of Mom 24/7," says one Salt Lake woman. "Once a week, I clean her house, pay her bills, and style her hair. That’s all.” Nancy Stallings, Program Manager for the Caregiver Support Program with Salt Lake County Aging, would probably disagree.  Caregiving isn’t always a 24-7 job; even a little extra time spent helping out aged parents qualifies as caregiving.  In a recent interview, Stallings stated,  "Identifying yourself as a caregiver is the first step toward getting resources, finding out what is available, and deciding what you will need for future planning." 

What Do They Really Need?

 When my father's caregiver in Oregon resigned, Dad moved back to Utah to live near me. I was surprised to realize how much his level of independence had decreased.  One day when I went to visit him, he hadn't eaten breakfast and it was time for lunch. I asked, “Why haven’t you eaten, Dad?” He responded, “I just didn’t think about it.  Could you come every morning and cook my breakfast?”  Through my own experience, I learned that caregivers must evaluate how well the person is functioning in crucial daily activities and how safe the living environment is in order to determine appropriate caregiving needs. 

My two siblings and I started taking turns going over and fixing Dad’s favorite scrambled eggs each day. However, mornings when none of us were available brought us to the realization that our family needed outside help.

Stallings suggests we ask the following questions in order to determine what help is needed: Is the house clean? Is the elderly person donning clean clothes daily? Is she taking her medication on schedule? Have there been falls or kitchen fires? Are there only cookies in the kitchen cupboard, or is he eating fresh fruits and vegetables?

Although anyone could forget to take medication on an occasional bad day, look for patterns of behavior, Stallings advises. "When forgetting medication or wearing the same clothes for days seems to be a pattern, or a if a parent loses ten pounds in a short period of time, either the family caregivers need to come more often, or it could be time to add outside services."

It's possible to excuse or rationalize an elderly person's behavior. Stallings said, "We are often reluctant to accept the fact that the person needs more help [than they themselves can give]. We may not want to accept the fact that a loved one is becoming more frail (due to progressive illness or age)."

The Caregiving Continuum

Stallings explains that caregiving is a continuum. "At first, the care receiver may be relatively independent. But sooner or later, an elderly parent needs more help or different kinds of help than the family can provide."

Caregiving Responsibilities Will Likely Increase As Time Passes.

Because aging is a long-term process, caregiving can often be a long-term responsibility, with tasks that multiply and increase in complexity as time passes. "Caregiving situations are not likely to improve, and the care receiver will usually need more and more help to keep going," says Stallings. "For example, a person diagnosed with Alzheimer’s or dementia can live for ten or more years. Caregivers during that time period will have increasing responsibilities."

Think Ahead

Advance planning promotes the care receiver's safety, functioning, and peace of mind. "Nobody wants to be dependent or to become a burden. We all want to stay in our homes and be safe and independent as long as possible," says Stallings. Finding out early what the care receiver's issues are and helping him prepare for the future can help ensure safety. Stallings advises, "If your elderly parent has hearing and vision problems, you need to think how to make the home safe.  For example, to support those who have a hearing loss, you can purchase equipment that visually notifies them that someone is at the door or that the phone is ringing.” 

Along with caregiving tasks, caregivers can observe ways to help make an elderly person's living environment safe by problem-solving in advance. Adding grab bars, better lighting, or a motion-triggered light at the top of the stairs can help contribute to a safe environment. Chair lifts for certain stairs can be helpful.walk-in tubs may solve problems for others.. Stallings suggests that a caregiver might say to the care receiver, "You fell this week. Neither of us wants you to fall again. Maybe it is time for you to learn to use a walker."

Make Mutual Decisions

Whenever possible, involve the care receiver in making caregiving choices. Talk together about future caregiving options, suggests Stallings. Give the person needing more care feedback, and mention reasons a particular situation is not working. You might say, “We want to be sure that you stay independent as long as possible. We can see that you need more help to do that. You are not eating well, and if someone doesn't help you with food, you might get weak and fall. Having an aide come to help you with breakfast and dinner will help you stay safe and healthy.” Or "You've lost ten pounds in the last month. I'm worried that you aren’t eating enough, and I can't be here twice a day to see that you eat well. Why don't we try having a part-time aide come in to help with meals?" You might also suggest trying meal delivery services such as Meals on Wheels.

Along with traditional caregiving tasks, other help options, such as in-home physical therapy, can help preserve independence. "Mention that physical therapy can help maintain strength and balance, when falls are a concern," says Stallings.

She suggests trying a new caregiving situation, such as hiring a neighbor to cook dinner, or adding part-time in-home help for two or three months before re-evaluating it. "See how it works, and feel free to tweak the plans if necessary. Add services when you need to, through more family caregiving, Salt Lake County Aging Services, or paid services," Stallings suggests. "Try adding services first before you think of rushing someone to a nursing home."

Caregivers Are Heroes Who Deserve Respect and Respite

Stalling describes family caregivers as the every-day heroes of our community. "One in four households has a caregiver. Family caregivers provide hours and hours of care every week—everything from cooking meals to counseling. The market value of services that family caregivers furnish nationwide is 360 billion dollars. Our nation could not afford to pay for that. We have to keep our family caregivers keeping on.” She stresses the importance of respite care in helping caregivers avoid burnout.

By "respite," we just mean taking a break—taking a day, a week, or a weekend off on a regular basis. Part-time help, outside services, and time off can help smooth the relationship between caregiver and care receiver.  Caretakers are like grandmothers, who have more fun with grandchildren when they aren’t with them all the time.

Stallings says, “The family caregiver is often pulled in 16 different directions. If you don't take time to catch your breath, your health or energy could run out. Seeking respite is very important and doesn't mean that you don't love your care receiver. Caregiving is not about seeing how much of a superwoman or superman you are, and it is not about doing everything all by yourself perfectly. It means being realistic about what you can and can't manage."