Caregivers and Depression

Everyone knows the risks associated with smoking, living dangerously, and overeating.  We’re aware of what happens to our bodies if we don’t exercise or use harmful drugs.  Unfortunately, most of us are ignorant when it comes to how caregiving affects our health.

A conservative estimate reports that nearly 20 percent of family caregivers suffer from depression, while some experts claim the rate is much higher.  According to California’s Caregiver Resource Centers, 60 percent show clinical signs of depression.

Why such a risk for depression?  And how does it affect family caregivers?

Caregiving and Depression

Caregiving does not cause depression, and not every caregiver will experience the same emotions.  But the fact is most caregivers often sacrifice their own personal health and emotional needs in order to provide care for their loved one.  The strain of caregiving affects even the most capable of individuals, and exacts a heavy toll on their health and happiness.

Although everyone experiences feelings of depression differently, common symptoms often include:

  • Fatigue
  • Overeating or not eating enough
  • A loss of interest in favorite pastimes
  • Change in sleep patterns
  • Becoming easily agitated or angry
  • Feelings of sadness, worthlessness, or hopelessness
  • Thoughts of death or suicide
  • Unexplained headaches or digestive disorders

Unfortunately many individuals are under the impression that depression is a sign of weakness.  This could not be further from the truth.  Just like cancer or diabetes, depression is an illness.  The symptoms you experience are simply your body’s way of telling you a change is needed.

Preventing Caregiving Depression

The best way to avoid caregiver depression is to watch for early signs that you are becoming depressed.  You’ll also want to take active steps to prevent depression, such as:

  • Reaching out for help.  Don’t let your responsibilities overwhelm you.  Seek out respite care or ask another family member to pitch in.
  • Taking time for yourself.  Rather than cramming all your commitments into your spare time, set aside an hour or so that’s strictly for yourself.  Read a book, take a hot bath, or go for a walk.
  • Joining a support group.  Being with others who understand your struggles is incredibly comforting.

Treating Caregiver Depression

A National Mental Health Association survey found that many women do not seek treatment for depression.  41 percent admitted refusing to get medical help because of embarrassment or shame.

Unfortunately, these sentiments are all too common.  While women may internalize their emotions (which will eventually lead to burnout), men deal with depression differently.  Men generally “self-treat” their depression by overworking or turning to alcohol.  Such self-destructive behaviors can quickly spiral out of control.

Taking care of your mental health is not only vital to your personal happiness, it will make you a better caregiver.  Giving into feelings of frustration, anger, or powerlessness may eventually lead to dangerous consequences for yourself and your loved ones.  If you are experiencing any of the symptoms of depression, seek treatment now.  Ignoring your emotions won’t make them go away.  On the other hand, getting necessary help will have you feeling like yourself once again.

Clutter vs. Hoarding

All of us have precious mementos and priceless collections that we are determined never to throw away.  We may have saved old love letters, drawings from our children, and other personal items that hold special memories.  But when do collections – or even clutter – become dangerous?

Hoarding, defined as excessive collection of items with an inability to discard them, affects one to five percent of the U.S. population, although some experts estimate the percentage is much higher.

What is Hoarding?

Compulsive hoarding, also called pathological hoarding or compulsive hoarding syndrome, may be a symptom of obsessive compulsive disorder or be the result of a tragic event, such as the death of a loved one.  Experts say that seniors are prone to hoarding because of a variety of reasons, including fear of loss, anxiety, depression, or emotional attachment to items that represent happier times.

Hoarding is far different from collecting.  Collectors deliberately search out specific items for their collections, carefully categorize them, and display them in an organized way.  Hoarders save random items they encounter on a daily basis and store them in a haphazard way.

Hoarders may believe their items are valuable, or they may understand that the items are useless but keep them anyway.  Some hoarders may have refrigerators filled with spoiled food well past their expiration date, but are unable to bring themselves to throw anything away.

Most available space in a hoarder’s home is taken up by “stuff.”  Countertops, sinks, stoves, stairways, desks, chairs – virtually every area of the home is stacked with outdated, useless possessions.  Old newspapers, junk mail, trash, pizza boxes, broken appliances – the list of items a hoarder may save is endless.  If you’re thinking that hoarding is harmless, think again.

The Dangerous Risks of Hoarding

“A lifetime accumulation of possessions combined with a daily influx of junk mail, bills and newspapers can quickly overwhelm seniors who may already be struggling physically, mentally or emotionally,” says Home Instead Senior Care Co-Founder Paul Hogan.  Besides the obvious emotional turmoil the senior is in, there are many other complications and dangers of hoarding, including:

  • Increased risk of falls
  • Unsanitary conditions may make the senior sick
  • Rodent or pest infestations
  • Family conflicts and arguments
  • Fire hazards and blocked emergency exits
  • Inability to perform necessary daily tasks, such as cooking or bathing
  • Social isolation as a result of senior’s shame and embarrassment

If your loved one shows symptoms of hoarding, talk with a doctor or mental health professional right away.  Trying to talk to the senior alone may backfire on you.  Even if the senior’s home is unsafe and unsanitary, he may resist any efforts you make to help.  He may feel threatened, as if people will determine he is unfit to care for himself and will be sent to an elder care facility.

With the help of a professional, you will be much more successful in helping a loved one with a hoarding problem.

How To Prepare Your Home for an Elderly Parent

It is becoming increasingly common for elderly parents to move in with their children rather than a nursing home or assisted living facility.  It’s estimated that at least 34 million Americans serve as unpaid caregivers for elderly relatives, spending an average 21 hours a week providing care.  This arrangement can be beneficial in numerous ways, but it requires a considerable amount of self-sacrifice and patience. Preparing your home before Mom or Dad moves in is an excellent way to get the arrangement off to the right start.  “Elder-proofing” your home will prevent accidents and make life safer for the senior.  Here are a few suggestions to get you started.

How to Make Your Home Senior-Friendly

Whether you are sprucing up a spare bedroom or building an addition, specific adjustments will need to be made to accommodate the senior moving in.  You will need to:

  • Lay down anti-slip mats under your throw rugs, or remove all rugs completely.
  • Fit furniture bumpers over sharp corners to soften the edges.
  • Ensure all walkways are well-lit.  Plug night-lights into the bedroom, bathroom, and hallway.
  • Replace door knobs with easy-to-open handles.
  • Install grab bars in the bathroom.
  • Reposition any furniture obstructing walk ways.
  • Install ramps for wheelchairs and widen doorways if necessary.

How to Make Your Home Their Home

Making your elderly parent feel at home is just as important as keeping them safe.  Adjusting to a new home and lifestyle will be difficult, so you’ll want to make it as seamless as possible.  Here are a few tips.

  • Bring in as much of your parent’s furniture as possible.
  • Decorate the senior’s bedroom with their tastes in mind.
  • Try to make room for your relative’s pet (if they have one).
  • Get your parent a cell phone, or at least put a landline in their room.

You may also want to consider having a separate thermostat in your parent’s bedroom.  Older ones often like it warmer than the rest of the family, but they may not speak up if they are uncomfortable.  If a separate thermostat is not an option, purchase a space heater. The lengths you go to determine your parent’s safety and comfort will determine the success (or failure) of the living arrangements.  Remember, your parents did everything they could to care for you as a child; this is your chance to return the favor.

Are You Ready for Retirement?

Are you ready for retirementWith all the concern surrounding our nation’s economy and talk about vanishing retirement funds, many soon-to-be retired Baby Boomers are questioning the financial aspects of their retirement planning.  A less common question is: what about retirement living?  Have you really given serious consideration to what you will do with your time once you retire?

A person can stand almost anything except a succession of ordinary days,” said Johan Wolfgang Von Goethe.  In other words, people quickly become bored without adequate activities and mental stimulation.  So how do you prepare yourself for a successful retirement?

“A Failure to Plan is a Plan for Failure”

No doubt you’ve heard this familiar expression, but few have actually realized its value with regard to retirement.  If you’re one of many who simply cannot wait to be done with the whole nine-to-five scene, likely you’ve given quite a bit of thought to what you’ll do with your newfound freedom.  For others, the thought of what they’ll do during their golden years fills them with apprehension – even fear.

Retirement is different for everyone.  Some will want to find some sort of work, while others will revel in remaining work-free.  Regardless of your circumstances, finances and goals, the time to start planning for retirement is before you draw your last paycheck.   Don’t assume you will automatically find enough hobbies and activities to fill your days; after all, you can only play so much golf.

Leaving everything up to chance and a vague “I’ll do whatever I please” attitude will only lead to disappointment.  If you want your retirement to be everything you dreamed it would be, you need a plan.

What Will You Do with Your Life?

Joan Carter, co-founder of Life Options Institute recommends everyone contemplating retirement to do the following:

  • Make life plans.  This is just as important as financial planning.  Knowing what you want to do with your time – and making realistic goals – will help you navigate the new world of retirement.
  • Find a purpose.  It’s unrealistic to believe you’ll simply know what you want to do with your spare time.  A surprising number of retirees end up fighting off feelings of depression once they no longer work for a living because they have stopped feeling useful.  Finding a purpose means involving yourself in ongoing activities that will make your life meaningful and add structure to your life.
  • Develop new friendships.  Resist the urge to withdraw socially as you “figure out” what you want to do with yourself.  Check out volunteer organizations or community centers that include people who share your interests.  This is especially important if many of your regular friends are still working.

Experts agree that a successful retirement depends upon the individual pre-determining the specific factors that will make their personal retirement satisfying.  They also recommend developing an alternative plan in case you experience a temporary setback in your finances that make your original plan unfeasible.  The better you plan ahead, the more you’ll enjoy your retirement.

Letting Go: How to Say Goodbye

There is nothing more difficult than saying a final goodbye to someone you love.  Unfortunately, the older we get, the more goodbyes we’re forced to say.  Watching a friend or family member decline in health is incredibly challenging, and when the end finally comes, many of us are at a complete loss as to how we should act and what we should say.

Obviously each family – and every situation – is different, but there are a few steps that can help you through the process of losing a loved one in death.

Tread Carefully when Discussing the Illness

When it comes to talking about the illness (or death itself), let your loved one take the lead.  It’s certainly fine for you to ask how he is feeling, but don’t probe him for details if it’s obvious he’d rather not discuss it.  If you have questions, ask his doctor.  Your loved one is likely struggling to maintain a positive attitude and if you repeatedly bring up the subject of his illness, it will only unnerve and upset him.  When he’s ready to share, he will.

Be a Good Listener

When your loved one is ready to talk, you must be ready to listen.  Don’t interrupt, and don’t try and belittle her feelings.  If someone is terminally ill, the last thing they want to hear is “Don’t worry, you’re going to be okay.”  Speak honestly, but with kindness.  Your loved one may ask for advice, but unless it is solicited, refrain from giving your opinions.  What she really needs is a listening ear and a shoulder to cry on.

Maintain a Peaceful Atmosphere

Whether your friend or family member is at home or in the hospital, you can create a soothing atmosphere that doesn’t remind him of his illness or impending death.  Try to avoid using harsh, cold lights, and hide or disguise medical equipment.  Surround him with familiar and comforting things: flowers, favorite photos, beloved artwork and music.  Most importantly, surround him with people he loves.

Give Permission to Let Go

No one wants to say goodbye.  Death is scary and unnatural and fills us with sadness.  Yet the way we – the surviving family members and friends – behave can have a significant effect on the dying person’s final moments.  If we are crying hysterically, begging them to hold on, it’s only going to cause them further pain.  What our loved ones need is reassurance that everything is taken care of, he will be remembered and cherished, and it’s okay to let go.

Losing a loved one is never easy, but with these simple steps, we can make it easier for them.

When Your Parent Wants to Go Home

If you have a parent in a care facility, you’ve likely heard the plaintive plea “I want to go home.”  For families with a loved one suffering from dementia or Alzheimer’s, this request is often heard on a daily basis.  So how do you answer the senior when going home is impossible?  And how do you cope if your “refusal to help” turns your parent against you?

When a parent or grandparent is placed in a nursing home or other care facility, their lifestyles change dramatically.  No longer are they in control of when or what they eat, or what time they go to sleep.  Much of their daily life becomes a monotonous routine with precious few variations.  A private person may now be forced to share a small space with a roommate.  A senior who is used to making her own decisions may be at the mercy of an unyielding staff with a strict set of rules.  Whatever the situation may be, it’s certainly understandable why seniors often wish for home sweet home.

Understanding why the senior feels the way she does is the first step in successfully handling her request to go home.  Is there something you can do to make her room more comfortable?  Would it be possible to move her to a single-patient room?  Could you bring in a few familiar mementos to make the facility seem more like home?  While these suggestions may not completely take away the desire to go home, they can certainly help.

For patients suffering from Alzheimer’s, they can get very confused and agitated when told they cannot leave the care facility.  The surroundings are unfamiliar, the staff is made up of strangers – even you, their child, may not be recognized.  Explanations and reasoning won’t work in this case, but distractions just might.  Take your parent to a window or another object of interest.  Many care facilities and nursing homes feature aquariums or bird cages, which can be a source of delight.  The distraction might only last for a few minutes to an hour, but it’s a start.  It may give you a chance to run to the patient’s room to grab a photo album or scrapbook – another excellent distraction.

Talking with your loved one about fond childhood memories is another effective way of turning the conversation away from going home.  Reminiscing calms the senior down and puts him at ease.  Unfortunately, the issue is far from dropped – it’s just temporarily forgotten.  You must arm yourself with understanding and acceptance – especially when the senior becomes upset.  Remember, it’s not you that the senior is angry with; it’s the situation and circumstances that are out of his control.

Hearing “I just want to go home,” will never be easy.  But with advanced preparation and understanding, you can successfully help the senior feel at home – wherever he is.

Financial Abuse of Elderly on the Rise

financial abuseSince 2008, financial abuse of the elderly has risen 12 percent, according to a recent study from MetLife.  It’s hard to get our hands on real numbers,” says Sharon Merriman-Nai, co-manager of the National Center on Elder Abuse at the University of Delaware, but she estimates between 750,000 and 3.5 million Americans have been victimized by financial exploitation.

In 2008, seniors had lost a collective $2.6 billion, but this figure rose to $2.9 billion in 2010.  Why is financial abuse of the elderly so prevalent?

Merriman-Nai attributes the exploitation to the senior’s hard-earned savings.  “The elderly have assets,” she explains, adding, “They’ve had their lifetime to acquire savings and property.”  In today’s tough economy, those savings are mighty tempting to individuals who are financially strapped.  Notice we didn’t say “criminals” or “strangers.”  According to the MetLife report “Broken Trust: Elders, Family, and Finances,” approximately 34 percent of such crimes are committed by family, friends, neighbors, and caregivers.

Fred Joseph, Colorado securities commissioner and president of the North American Securities Administrators Association says that “elder financial abuse is becoming the crime of the 21st century.”  Joseph adds, “There is definitely more fraud than there has been…as the senior population is increasingly targeted.”

Who is more at risk?  Reports show that seniors with health problems – especially dementia – are more likely to be victimized.  You’re also more at risk if:

You are a woman between the ages of 80 and 89
• You live alone and require assistance from a caregiver
• You have a visible disability (use a cane, have a handicap tag in your car, etc.)

Some cases of elder abuse can be quite extreme.  In California, an 85-year old woman was found in Maine – undernourished, disoriented, and robbed of her life savings by a trio of “friends.”  The woman told the police that she had sold her home and moved into an apartment building where she met three friends – who gained her confidence as well as her bank account information, then dragged her from state-to-state without a single care for her well-being.

Steps are being taken to eradicate elder abuse, but it’s really up to each and every senior to protect themselves.  Use common sense and caution – especially with regard to new acquaintances.  Always ask a trusted family member for advice before giving out any sensitive information, and remember to think twice before making any transactions online.

How You Can Avoid Nursing Home Care – Part Two

In our last blog post, we discussed five creative ways to avoid nursing home care.  For more tips and tricks, check out the rest of our suggestions.

6.  Make a Move

If in-home care is unreasonably expensive in your area, consider relocating to a less costly location.  Cost of living is often more expensive in urban areas, as well as along the east and west coasts.  With a little research, you may find a new location with affordable homecare.  Is there a relative in another city or state that could help share responsibilities?  This often helps make a major move more sensible.

7.  Get Financial Help

If you consider a lack of cash as the main reason your loved one can’t remain at home, check out two often-overlooked sources of funds:

  • Cash for life insurance.  Some life insurance policies can be cashed in with the insurance company for 50 to 75 percent of the policy’s face value.  A “life settlement” may also be possible, but the amount you get will depend on the policy benefit amounts, premiums, and the policyholder’s age and health.
  • Reverse mortgage.  For those who own their own home, a reverse mortgage might raise enough money to pay for a significant amount of in-home care.   The money from a reverse mortgage is available for homecare as long as the homeowner lives in the home.

8.  Check out Assisted Living

If you’ve exhausted the possibilities for homecare, look into your community’s assisted living facilities.  These facilities are beneficial for seniors who need regular monitoring, but not round-the-clock care.  Assisted living offers basic supervision and services – such as meals, housekeeping, and help with daily tasks – while some facilities even offer specialized care for people with advanced illnesses.

Seniors often enjoy assisted living because they can associate with other seniors in the common areas, and still have privacy in their own apartment.

9.  Call Medicaid

In recent years, Medicaid has begun to recognize that the alternative to unaffordable in-home care is nursing home care, which Medicaid covers.  As a way of allowing Medicaid recipients to stay at home (saving Medicaid nursing home costs), some states have established Home & Community Based Services (HCBS).

These services offer Medicaid coverage for a limited amount of in-home care and adult daycare.  Not every state offers HCBS, so contact your local Medicaid office at Benefits.gov to check out your eligibility.

10.  Ask About Veteran Benefits

If your family member is a veteran or spouse of a veteran, he or she may qualify for Veterans Affairs (VA) benefits.  The VA may offer in-home care and adult daycare benefits, homemaker services, community living centers, or cash benefits – just to name a few.  To get free information regarding your potential benefits, call the VA’s Vet Center in your state.

Avoiding nursing home care may mean utilizing several of the suggestions we’ve provided.  You may also want to contact a geriatric care counselor for more practical ways you can safely and affordably stay in your home.

How You Can Avoid Nursing Home Care – Part One

Home is where the heart is.  There’s a reason this saying has retained its popularity throughout the years; simply because it’s true.  For most of us, our homes represent security and stability that we are unlikely to find anywhere else.  This, combined with other factors, results in the majority of seniors preferring to remain at home during their golden years.

There’s no question that nursing homes provide quality care to countless individuals.  Most nursing homes employ caring workers who try hard to make elderly ones feel as comfortable as possible.  In spite of this, most of us want to avoid nursing homes if at all possible.  Whether you are considering your own future, or thinking of a loved one, here are a few good tips on how you can stay out of a nursing home.

1.  Pool Resources

Hiring a paid caregiver can be expensive.  Even with a combination of professional homecare and family caregiving, the costs may be more than one family member can handle.  Caregiving is also extremely stressful and tiring.  For families who want to help their parents or grandparents remain at home, responsibilities need to be shared.  Pooling resources can take some of the sting out of expensive homecare, while sharing daily tasks will ward off stress and exhaustion.

2.  Share Care

Is there someone in your parent’s apartment building or neighborhood who also needs in-home care?  If so, it may be possible for them to share caregivers.  Bringing the neighbor into your parent’s home or taking your parent to the neighbor’s means that one caregiver can provide care to two seniors at once.  This is a great way to cut costs in half while providing companionship at the same time.

3.  Use Adult Daycare

Despite the somewhat childish connotation of the term ‘daycare,’ these facilities are actually a really great way to keep your loved ones out of nursing homes.  Adult daycare centers offer meals, transportation, exercise, and social interaction.  It’s a nice change of pace for seniors, and most centers charge considerably less per hour than in-home caregivers.

4.  Consider Free or Low-Cost Care

Ask yourself what type of care is really necessary.  Many seniors require assistance only part of the day – typically first thing in the morning and at night.  If you don’t need a full-time professional caregiver, check out what low-cost or free options are available in your area.  Many communities have volunteer church groups, senior-to-senior programs, and college kids who provide free local services like companion care.

5.  Look at Your Backyard

Ever heard of an ECHO or ADU?  A small, separate living unit in a backyard or other open space is sometimes called an Elder Housing Cottage Opportunity (ECHO) or Accessory Dwelling Unit (ADU).  The addition of such a unit is not cheap, but overall costs may be significantly less than nursing home care.

Stay tuned for our next post with five more “out of the box” tips!

Managing Stress in an Alzheimer’s Patient

If you are the primary caregiver for an Alzheimer’s patient, you know how important it is to keep your own feelings and emotions under control.  But how do you help the patient do so?  Different stress-reducing techniques work better for some than others, so it may take a bit of trial-and-error before you find one that is most effective.

When an Alzheimer’s patient is stressed, he may exhibit a wide variety of behavioral problems.  Common behaviors include:

  • Confusion
  • Aggressiveness
  • Oversleeping
  • Eating problems
  • Anger or irritability
  • Wandering

By learning how to make changes in the home environment, providing a caring and calming atmosphere, you can help reduce stress and improve problematic behavior.

Identifying Stressors

Problem Behavior is often the only way an Alzheimer’s patient can communicate.  As a result of the disease, normal conversations are no longer possible, and the patient may act out.  In many cases, the patient’s behavior is a reaction to an uncomfortable or stressful situation.  If you can identify why the patient is stressed, you can resolve the problem much more easily.  If it helps, keep a daily journal with the patient’s behaviors and reactions.  You may uncover a pattern or situation that is triggering the patient’s agitation.

De-stressing Techniques

In order to manage your patient’s stress, you must be calm yourself.  Getting anxious or acting upset will only trigger the same emotions in the patient.  Keep your voice – and body language – calm, relaxed, and at ease.

Other helpful hints are:

  • Modifying the environment to reduce stressors (such as loud noises, clashing colors, reflective surfaces)
  • Instituting a regular exercise routine
  • Calming leisure activities
  • Listening to soothing music
  • One-on-one time with friends
  • Getting a friendly pet

Although caring for Alzheimer’s patients is extremely challenging, approximately two-thirds of those suffering from this disease are cared for at home.  As the disease progresses, it becomes increasingly important to rely on others for help.  Don’t hesitate to reach out to family members and friends, local volunteers, or professional caregivers for assistance.