Wednesday, October 17, 2018

Late Life Caregiving


Caregiving for older family members is not only rewarding, but especially challenging when the caregiver is a senior, too.  Due to older persons living longer and healthier lives, it is common for adult children in their seventies caring for their parents, adult children, grandchildren, and great-grandchildren.  Five generations living at the same time has resulted in caregiver burnout and health declines.  Caregiving among family members who are geographically distanced can be especially challenging.  Family members want to provide and typically step forward and embrace the challenge.  However, without resources and self-care, they ultimately suffer mental and physical health declines.  The challenge is to provide care but embrace self-care to avoid burnout and exhaustion.

Long-Distance Caregiving:
“Doris” is a 75-year old retired schoolteacher caring for her 97-year old father who lives 300 miles away in rural Pennsylvania.  She and her 77 year old brother, “Todd,” each live with him for two weeks at a time and then switch off.  Todd lives 200 miles from his father.  Neither of them have had a vacation in seven years.  Doris has become obese, developed diabetes, osteoporosis, and has failing eyesight. Todd and Doris have not had time for medical care or their diagnostics.  Doris has not had a colonoscopy or mammogram.  Todd never had time for his PSA tests.  Now, he has been diagnosed with prostate cancer, Stage III, and is deciding on his next steps.  Both of their spouses are complaining about their lengthy absences from home.   

Alzheimer’s Caregiving:
“Tim” is a 85 and he is a retired firefighter and then retired driving the school bus.  He has been married to “Jennie” for 65 years and he promised her he would never place her in a nursing home after her diagnosis of Alzheimer’s four years ago.  Tim, her only caregiver, has not slept through the night in two years and he is exhausted caring for her.  Jennie requires constant supervision because she wanders and she has become incontinent and does not know Tim or any other family members. In addition to caring for Jenny 24/7, Tim has fallen twice during the night and is recovering from a broken wrist.  Tim will not allow anyone to care for Jennie because he thinks he is the best caregiver for his wife. 

Multi-Generational Caregiving:
“Sally” is 58 and lives in rural Mississippi. She works full-time at a bank and has a part-time hairdressing business in her home.  Her parents, Dale and Patsy, retired and bought a mobile home and moved it onto Sally’s property, an arrangement they agreed to after Dale had his second heart bypass surgery and Patsy had a small stroke.  They both have mobility challenges.  Sally has custody of her three elementary-school age grandchildren because their parents are incarcerated.  Dale and Patsy used to help care for them but now their health is failing.  Sally’s middle daughter, Joanna, was diagnosed with Sickle Cell Disease as a teenager and lives with Sally but requires ongoing treatment and care and she is not able to work.  Sally’s long-time boyfriend, Joe, left last year because the environment was in his description “far too chaotic for my lifestyle.”  Recently, Sally called 911 because she thought she was having a heart attack.  After numerous tests and diagnostics, the diagnosis was severe emotional stress and anxiety.  

All three of these examples are composites of actual scenarios yet and represent an array of contemporary caregiving challenges.  In all three examples, the caregivers were committed to helping their family but at the cost of their own health.  In addition to losing their freedom, they had no self-care, no social life, and no support team, resulting in isolation and physical and mental health declines.

Adult day services are typically in churches or senior centers where older adults gather for social activities, recreation, and a congregate meal.  While some of the seniors have dementia and limited physical abilities, adult day programs provide supervision and safety during normal business hours and allow caregivers to remain employed and get a break from the responsibilities of caregiving. Here is a wonderful resource https://eldercare.acl.gov/public/resources/topic/Adult_Day_Programs.aspx

Caregivers with Medicare are allowed respite care for one week, provided the person they care for is in hospice care.  It entails moving the sick person to a residential hospice facility, a less than satisfactory solution that is often refused.  Sometimes the caregiver refuses and sometimes the loved one.  Nonetheless, it is a free option that provides at least one week of time to decompress and relax.  Here are the details. https://eldercare.acl.gov/public/resources/topic/Adult_Day_Programs.aspx

Resources available to local readers include the following:
Limestone County- Resources are available in Athens at the Council on Aging on Jefferson Street. https://limestonecounty-al.gov/departments/council-on-aging/

Giles County- South Central Tennessee Area Agency on Aging http://setaaad.org/120

Madison County and Northeast Alabama – TARCOG Area Agency on Aging http://tarcog.us/area-agency-on-aging/

Other national resources include:
Family Caregiver Alliance https://www.caregiving.com/




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