Recent Caregiver Blogs

Posted: 1/19/2018 1:45:02 PM

Knowing When an Older Client Needs to Give Up Their Car Keys

One of the most difficult things to give up is our independence. For the elderly who have been driving a vehicle for decades, taking their car keys permanently from them might feel like cutting off one of their legs. As their caregiver, you might feel hurt for them, too, as you see them struggle with their feelings when they lose their driving privileges.

Some older drivers might readily accept their situation and hand over their driver’s license and keys, but do so with a heavy heart. And then there will be those who will not give up without a fight. They will bargain, cry, shout, curse, and even insist on driving without a license. The challenge lies in dealing with these clients.

For older people whose physical and mental conditions make them unfit to drive, particularly those with worsening dementia, the main issue is their safety and the safety of their passengers and others on the road. As a caregiver who is helping them with their activities of daily living, you should be alert for these signs that your client may need to stop driving for good:

1. Straining to see road signs clearly because of visual problems, such as tunnel vision

2. Frequent fender benders, traffic warnings, or tickets

3. Getting lost on a familiar route or forgetting where they are going

4. Confusion between the brake and gas pedals

5. Drowsiness or chest pains when driving

6. When riding with them:

a. Delayed reactions to people and cars on the street

b. Hitting curbs or denting the car frequently

c. Difficulty backing out of the driveway

d. Difficulty parking

e. Frequent close calls or near misses

f. Difficulty making safe turns or maintaining the correct lane

g. Other cars frequently honking at them

h. Driving too fast or too slow

If you notice any of the above signs while caregiving, you must inform the client’s family and your supervisor of your observations immediately, so that your client’s ability to drive can be properly evaluated by a physician. The physician will determine if the client should be allowed to drive or if they need to follow certain restrictions, such as only driving to nearby shops or taking familiar routes. Remember that acting quickly may mean saving your client’s life.

Knowing if your client is still fit to drive is only half of the story. When the physician says it’s time to take away the car keys permanently, the next big challenges are breaking the news to them and making sure they do not drive anymore:

- Support the client and their family as they discuss this painful change. If the client resists and insists on continuing to drive, the physician may be the best person to tell the client why they can no longer drive.

- Show empathy and be an attentive listener. Suddenly losing driving privileges is a huge adjustment for an older client. Let your client express their anger, humiliation, and frustration, without being judgmental of them.

- Know how you can help the client get to the places they want to go, whether by driving them yourself or assisting them in taking the bus or a taxi. Always refer to the care plan when helping clients make these decisions.

- Check in with the client often. Depression can set in because their independence has been limited.

- It is important to lessen the impact of the client’s inability to drive due to changes in their physical or mental conditions. Invite them for some socialization while reminiscing with them. Talk to their family and find out how clients can still go to family gatherings and special events.

- Help your client develop routines and look for activities that do not require driving. Introduce gardening, yoga, or swimming, if this is feasible and safe for them.

- Depending on what you and the family have discussed, help keep the client from driving by hiding the car keys or clamping the steering wheel of the car.

Caring for an older client who suddenly has lost their driving privileges can be very challenging. Expect that the client will not give up their car keys without fighting to keep their driving privileges. An extra dose of patience and understanding can go a long way toward making your client’s transition easier.

Posted: 1/12/2018 3:53:22 PM

Caregiving and Depression: Fighting the Battles Within

Depression is beyond normal sadness. When depression strikes, it knows no race, religion, economic status, or profession. It can be experienced by anyone at some point in their lives. Yet, some people are at higher risk of being depressed than others. Caregivers, for example, are 49% more likely to experience depression than people who do not perform caregiving duties.

How do you know if what you are feeling is more than the ordinary blues? Would you notice if your colleague is depressed?

For starters, not everyone with depression is tearful and confined to their bed. Some are ready to give a smile or even manage a warm “hello,” even if they are feeling totally broken inside. If you experience the following for longer than two weeks, then your feelings have escalated beyond normal sadness:

1. Feelings of extreme sadness, hopelessness, emptiness, worthlessness, or not being good enough
2. Tearful, quiet, or lonely
3. Anxious
4. Loss of interest and pleasure in doing otherwise enjoyable things
5. Use of alcohol or drugs
6. Lack of focus, logical thinking, and motivation
7. Weight loss or gain or having an unkempt appearance
8. Thoughts of death or suicide
9. Increased number of mistakes and errors while performing tasks as a caregiver

The next question is, if you feel depressed, what is the best thing to do? How do you fight the battles within? Can you overcome it on your own?

The truth is, there is no perfect recipe to deal with depression. If there was, depression would not have become one of the leading causes of disability in the U.S., affecting more than 16 million Americans. Dealing with depression is not a matter of simply “changing your state of mind” or “looking on the bright side.” It is also not survivable by just “snapping out of it.” This is what separates it from the normal feelings of sadness. It takes the shared efforts of the person with depression, their support system, as well as professional help.

If you are a depressed caregiver, you could be feeling overwhelmed with negative emotions, and that you need help, but are sure that your case is hopeless. If you are starting to feel these emotions, the first step is talking to someone you can trust, like your supervisor or spouse, so that they can help you seek a mental health professional.

Clinical depression is not a trivial matter. It is a disorder that needs to be treated like any other disease, such as diabetes. Your challenging work as a caregiver does not make your situation any easier, because your lack of focus can endanger a patient’s’ life, which must be avoided at all cost. The earlier you recognize these feelings as signs of depression, the sooner that help will be available. Remember that there is nothing to be embarrassed about if you’re battling depression.

Once you are able to talk with a mental health professional, you will undergo psychiatric evaluations and different therapies. The psychiatrist who would handle your case would discuss ways to cope, with you and your family. They will also prescribe medications, and determine if you are still able to work or need to take a break from caregiving.

Perhaps the most important thing to do when everything feels pointless in life is just to let others help you. Keep in mind that with the help of your loved ones, colleagues, and your doctor, you do not lose anything, but just gain something big that will help you fight the battles you have within.

Posted: 1/5/2018 10:23:00 AM

To Tell or Not to Tell: A Caregiver’s Dilemma

Caregivers spend a significant amount of time with clients, and they can easily earn their trust. Frequently, a client will tell their caregiver personal details about themselves and their families. A caregiver must be mindful about discussing a client’s personal life with others, whether in or outside of the workplace, including secrets they would not want to be shared with others.

Keeping a client’s secrets may make the caregiver uncomfortable and feel obligated to keep all information to themselves but, in some cases, these “secrets” must be reported to the healthcare team or the authorities.

If you are a caregiver, be alert and knowledgeable about the situations in which you must disclose what your client has confided. If you are experiencing a professional dilemma and are unsure of what to do, always remember that in any case where a client’s or another’s life is in grave danger, it is necessary to report this information to the care team or the proper authorities.

Case #1 – “My daughter hits me and locks me in my room when no one is around.”

What to remember: Any case of abuse must be reported. Caregivers who are directly involved in client care are required by law to report both cases and suspicions of abuse. Abuse may take many forms, including physical, sexual, financial, and emotional abuse, as well as neglect.

What to do: You are not in a position to investigate, however you may check for possible signs of abuse such as wounds and bruises. Inform the client that you must tell the supervisor and make a report, and that the proper authorities will be contacted to keep them safe.

Case #2 – “It is over for me. I have plans to take my own life.”

What to remember: “Taking one’s life” refers to suicide, and is the 10th leading cause of death in the U.S. overall. Suicidal thoughts and plans must be taken seriously and never regarded as simply attention-seeking. As a client who requires caregiver assistance tending to their needs, their condition makes them vulnerable and at risk for harming themselves.

What to do: Ask about the details of their plan, such as when they plan to do it and how. This will help the care team prevent the client’s suicide. Tell them that help is available and that you need to inform the supervisor and the team of their plan, to help keep them safe. Encourage them to talk about their feelings and their plan. Be there for them, listen to them, and offer your support.

Case #3 – “I think I have an STI.”

What to remember: Sexually transmitted infections (STIs) are passed from one person to another through sexual contact. STIs can cause pain, sores, fertility problems, and other complications that often only show up years later, if left untreated. The danger is not only to the client but their sexual partners as well. Many STIs are treatable, and early reporting is advisable so that testing and treatment can start immediately.

What to do: Encourage the client to tell their physician immediately, because STIs pose a serious danger to themselves and their sexual partners. Assure them that only the staff directly involved in their testing and treatment needs to know. Do not be judgmental while discussing it with your client, and tell them that there are treatments available if they test positive.

Caregivers are a client's confidante. As such, caregivers are obligated to keep to themselves the personal details that clients share with them, except those that threaten the client's life or the life of another.

Posted: 12/29/2017 8:33:01 PM

Family Life and Caregiving: Achieving Balance

Ella has been working as a caregiver for almost eight years. She started when her eldest child was barely a year old. Ella loves caregiving, even though after work she is usually too tired to attend to her home life. After giving birth to her third child, she feels that her family needs her more than ever, yet the pressure at work leaves her exhausted and unable to be the wife and mother she wants to be. The result is burnout and an overwhelming feeling to give up her job as a caregiver to care for her own family full-time.

Ella’s experience is not unique. Many caregivers can relate to her story with their own version of their frustrations. How can you juggle work and family life properly? Achieving balance is not easy, but it is doable with these helpful tips:

First, manage your work to prevent burnout. You’ll have to learn how to leave job-related problems at work and not to bring negativity home with you. Cranky co-workers and patients do not live with you, so learn to forget about them after work. If you can master only this tip, then you'll be able to come home in a good mood, greet your loved ones positively, and have a great time with them.

Next, change your game plan. If your workplace is far from home, you may want to consider a company that is nearer, even for less pay. In the long-term, spending less time commuting will mean more time to rest and have quality family time.

It might also help to consider changing the type of caregiving work you do, or changing shifts. If you find that working as a home health aide is less stressful than working in a home health facility, then consider this option. Or, perhaps taking the night shift where the workload is easier would be a better choice, because mornings at home are more productive for you. Whatever the case, brainstorm ways to make more time and energy for your spouse and children.

Maximize your paid leaves. Talk to your employer about your situation and try to take a break for days in a row. Check to see if there are assistance programs for employees that can help you.

Take advantage of technology. While focusing at work is important, you will also create more connection with your loved ones if you stay up-to-date with what's going on in their lives by making video calls to family members during breaks.

Take care of yourself. Being kind to oneself is another excellent means of creating a balance between work and family time, because you are healthy enough to enjoy your time at home. This means that you have enough energy to be productive in the things you want to accomplish, not just sleeping for hours on end. Eat right and stay hydrated. Take supplements, such as vitamins B and C if needed. These vitamins supercharge you by helping you get more energy from the food you eat.

When working as a caregiver, finding a good work-family balance is an achievement in itself. As such, you need to keep at it until you find solutions that work for you. It might require some major changes, but in the end, your efforts will be worth it.

Posted: 12/22/2017 11:16:04 AM

Why All the Talk About Aging? – Part 2

The talk about aging is becoming more relevant than ever, as we expect a significant number of baby boomers to reach their 60s in the upcoming years. As a caregiver, you will find yourself caring for more older clients in the future, and one of the best ways to supercharge your career as a caregiver is to learn all you can about aging and how expected changes can guide the way you provide care.

In the Part 1 blog about aging, we talked about changes in the eyes, ears, bones, muscles, and skin as we reach old age. Those changes alert us to certain needs that must be met in older clients.

Here are more changes to expect:

1. Circulatory system

In older people, the heart and blood vessels become stiffer so that pumping and circulating blood becomes more difficult. The heart also takes more time to fill with blood.

Caregiver alert: Blood pressure tends to increase in the elderly, which can possibly lead to stroke and other complications. The heart has more difficulty adjusting to a sudden increase in activity, so older people tire easily. Provide rest periods in between series of activities. Avoid serving foods that are high in saturated fats or bad cholesterol, which tend to stick to the walls of the arteries and block blood flow.

2. Digestive system

The stomach empties more slowly into the small intestines. The digestive tract has less of the substance that digests milk. The bowels are slower. The liver also becomes smaller and less efficient in removing toxic materials from the blood.

Caregiver alert: Older people tend to feel full for longer periods of time. Avoid giving your older clients and loved ones large meals. Small, frequent, nutrient-rich meals are best. Also, because the elderly have less of the substance that can digest milk, they can feel bloated or have diarrhea when they drink milk or eat cheese. If this is the case with your client, limit their intake of milk while providing other sources of protein and calcium, the nutrients found in dairy products.

Slower bowels lead to constipation, so provide a diet rich in fiber and other nutrients, such as those found in fruits and vegetables, because these foods help the bowels move faster.

The less-than-efficient liver will have more difficulty processing drugs in the blood, so the medications that older people take stay in their blood much longer than in adults. Caregivers helping older and confused clients take their medications must be alert for double-dosing or unintentionally taking a due medicine twice because of forgetfulness.

3. Urinary system
In advanced age, the kidneys become less efficient in removing waste from the blood and may remove more water from the body than usual. The bladder becomes stiffer and weaker and may empty uncontrollably. The sphincters, or the valves that hold urination, do not work properly.

Caregiver alert: Waste products in the blood may increase in older people because of kidney changes. Together with the problems of an aging liver, medications remain in the blood longer so caregivers need to be alert for double-dosing as explained earlier. Older people are also prone to dehydration, so offer them water more often.

The bladder leak urine. Faulty sphincters cause urge incontinence wherein they pass urine before the person can get to the toilet on time. Caregivers need to be patient when helping older people with incontinence. They can offer support by giving them choices of undergarments to wear. They must also help the clients clean their private parts after each incontinent episode.

4. Immune system

Older clients have weaker immune systems, so they cannot adequately fight off diseases such as pneumonia, flu, and cancer.

Caregiver alert: Caregivers can help strengthen the immunity of older clients by providing them with the right diet, keeping them hydrated, and encouraging them to exercise. They can also offer support when it is time for their patient's flu vaccine.

Aging brings a lot of changes to a person’s life, most of which may be difficult to accept and adjust to. Caring for older clients should remind us to be humble enough to accept the reality that we, too, will someday have the same needs as we age. As a caregiver, you play a special role in an older client’s life by helping make their challenges easier to overcome.