Tag Archives: caregiving

Tough Choices from Tender Hearts: Caregiving During a Pandemic

About a month ago, the Centers for Medicare and Medicaid Services (CMS) issued new guidelines that advocate family visitors to return to nursing homes. At this time only three states are not allowing visits. The guidelines provide specifics on how to visit a family member while remaining safe. Unfortunately, it still means making tough choices between a resident’s mental and physical health.

Reducing Social Isolation

These guidelines highlight the need for residents in long-term care to see family members and loved ones. With these guidelines in place, it helps to bring loved ones back together. What about caring for family members who remain at home? What are the recommendations for keeping everyone at home safe?

Guidelines for Home Visits

In May 2020, AARP published an article on steps to take in safely visiting older family members in their home. Those steps included keeping visits short and wearing protective masks and eyewear when possible. The article also suggested staying away if you feel sick, keeping younger family members away for the time being, and visiting while outside.

Making Tough Choices

Despite the good intentions of these guidelines, serious questions are raised. How are caregivers managing? They are making decisions based on what is best for their family members while balancing issues of safety, health, and protection. These kinds of decisions are not new in caregiving.

The combination of trying to provide care while maintaining social distance and health is even more difficult. And caregivers are also conflicted about bringing love ones into a nursing home and out of the home environment, even though it may be the best possible option.

Lessons Learned?

The COVID-19 pandemic highlights the overwhelming need to address caregiving and those who provide it. We need to take the lessons learned from this ongoing experience and make better options for caregivers, both paid and unpaid. Caregivers continue to continue to give their best. It’s more than past the time to focus on their needs and provide better choices.

Kathy Dreyer, Ph.D., is an Advisor at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com

Infection Control and Expressive Touch: We Can Have Both

The healing benefit of expressive touch is lacking in the lives of older adults.

The topic of infection control almost always enters the conversation when I deliver Compassionate Touch training.  This training teaches caregivers the skill of expressive touch.

Hand, back, and foot rubs used to be a part of the care process.  Seasoned nurses consistently confirm this fact.  In contrast,  newer nurses and nursing assistants report that expressive touch was not a part of their training.

This lays the foundation to discuss the reasons why older, frail adults lack expressive touch in their lives.

Glove Culture and Expressive Touch

Infection control is consistently cited by skilled nursing employees as a reason for the lack of expressive touch in the lives of older adults.    Furthermore, employees fear citations from surveyors for not using gloves.

Megan J. DiGiorgio, MSN, RN, CIC, FAPIC  coins the phrase “glove culture”.  In addition to the wasteful use of resources, the over-use of gloves increases disconnection and a lack of trust in caregivers, among other negative outcomes.

Burdsall, Deborah Patterson, MSN, Ph.D.,  identified situations that require the use of gloves.  Touching intact, non-infectious skin of older adults in healthcare settings does not require gloves.

Skilled nursing caregivers do expressively touch their residents.  Indeed, holding a hand or giving a hug communicates how much we care and provides comfort.  We can incorporate more of this excellent medicine of expressive touch in our caregiving practices and still uphold infection prevention standards.

Gloves are not used with Compassionate Touch techniques. I urge those I am teaching to resist the temptation. The benefits of touch would be lost for both the resident and care provider.

Consider evaluating the extent to which gloves are used in your community and understand the unintended consequences.  Even more, it seems like this would be a worthwhile QAPI project.

 

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  she provides training and educational programs on elder caregiving to private and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.

Did Your Know that Practicing Gratitude Can Actually Improve Your Health and Well Being

Don’t you enjoy being around people who are naturally grateful?  Can we cultivate an attitude of gratefulness ourselves?  Of course, we can!  Practicing gratitude not only is good for our souls but can improve our health and well- being.

Let’s look at some research:

  • A study in the Journal of Applied Psychology, it was concluded that subjects who wrote down what they’re thankful for just before bed fell asleep faster and stayed asleep longer.
  • A University of Utah study showed that gratefulness is linked with optimism, and optimism has been linked to a better and stronger immune system.
  • A 1995 study in the American Journal of Cardiology showed that appreciation and positive emotions may be beneficial in the treatment of hypertension and in reducing the likelihood of sudden death in patients with congestive heart failure and coronary artery disease.
  • A 2003 study in the Journal of Personality and Social Psychology found that gratitude can boost pro-social behaviors, such as helping and lending emotional support to others, while a series of experiments detailed in the same journal concluded that a daily practice of listing all the things for which you are thankful is linked with a brighter outlook on life and a greater sense of positivity.

Like other good habits, practicing gratitude can be learned – at any age!  Here are a few suggestions for fostering gratitude in your life.

  • Keep a gratitude journal where you write down specifically what you are thankful for.  You’ll be amazed at how long your list becomes with a regular habit of journal writing.
  • Take a break a few times a day to focus on a spirit of thankfulness.  It might be a moment of meditation, prayer or walk in the garden.  Just slowing down for a moment to think about the things in your life that you are thankful for will become a habit of practicing gratitude.
  • Surround yourself with thankful people!  This may sound simple, but gratitude is contagious and being around people who are practicing gratitude will naturally be a mood lifter.
  • Share with others what you are thankful for.  It will not only help you in practicing gratitude but will also reinforce your feelings and inspire others.

Like any habit, gratitude gets easier with daily practice.  Let today be the first day of your healthy, grateful life!

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  Please let me know if you this is helpful!

When to Say Yes and How to Say No – Creating Healthy Boundaries

Caregivers are a unique group of people.  Naturally nurturing and compassionate, such empathetic traits can also lead to complex challenges.  Creating healthy boundaries is especially tough when you are the type of person that wants to help.  Learning when to say yes and how to say no is essential for caregivers to stay physically, emotionally and spiritually healthy.

Before I jump into my tips, tools, and suggestions, I’d like to share a story.   It relates to boundary setting and caregivers who merely do too much for their well-being.  For the sake of anonymity, I’ll refer to this person as Susan, whom I met with over the course of several years while facilitating a caregiver support group many years ago.  Susan’s mom, Jean, lived in her own home about 20 miles from Susan.  Jean’s husband had passed away five years earlier, and Jean never dealt with her grief and worked through the healing process. Her husband’s death left Jean depressed and angry.  She no longer socialized with friends and extended family, was not keeping up with responsibilities of home ownership, and was not addressing  her  health issues.  Jean was showing signs of cognitive decline.

Susan, who was her primary caregiver, had a demanding job which required some travel and many hours. She had talked to her mom many times about moving to a senior community, where she would not have the responsibilities of keeping up her house and would once again be able to enjoy the company of others.  Jean would not hear of it.

Instead, Jean relied solely on Susan to take care of home repairs and expected Susan to visit during the week and spend almost every Saturday with her.  Susan’s marriage was suffering, as her husband felt as if her mom had taken over their life.

Susan loved her mother but knew that she was collapsing from the weight of being everything to her. She knew that as long as her mom refused to move into a care community, that the situation was only going to become more overwhelming.

When we discussed boundaries, Susan broke down in tears.  She had read about the importance of creating healthy boundaries in relationships, and especially when one is caregiving for an older adult.  She didn’t know how to solve the problems she had with her mother.

Creating healthy boundaries allow us to take care of ourselves first so that we can enjoy healthy relationships with others.  When caregiving, it is especially important to step back and ask the following questions regularly:

  •  When I say “yes” to something that has been asked of me, how does it make me feel?  In other words, is saying yes causing stress or feelings of anxiety? If so, this is a sign that perhaps you are saying ‘yes’ to requests that you should be instead learning how to say ‘no’.
  • By saying ‘yes,’ what are you giving up? Is it time away from others that you love or maybe time away from being with yourself doing such things as reading, meeting with friends, exercising or other activities that you find joy in doing?
  • Does a “yes” put me in a position of having to choose between people whom I love and care for and does it make me feel conflicted?
  • What would happen if I say NO? Think about the consequences (or choices) that would have to be made?  Are you willing to lovingly say ‘no’ even though it may cause hurt feelings?  (I hope the answer to that is a YES!)

Creating healthy boundaries is not easy, and in fact, may cause hurt feelings.  It’s also essential to preserving your health and well-being. Caregivers cannot be all things to all people, no matter what the circumstance.  Moreover, if you continually say ‘yes’ when you want to say ‘no’ it will inevitably lead to enormous resentment with the person for whom you are caring.

During our time together, Susan did help her mom through the move to a senior care community.  Her mom wasn’t happy and continually played with Susan’s emotions by making her feel guilty for not being there as often and saying that she hated the food and they she hadn’t made friends.  Surprisingly (or not so!) when Susan talked with the staff, they told Jean seemed to enjoy many activities and ate at almost every meal. They did not see an unhappy resident.

With coaching, Susan was able to lose some of her guilt, spend more time with her husband, and learned to set boundaries when her mother tried to break down the fence.  After a fairly rough three months, Jean has acclimated to her new home, Susan and her husband have taken a trip, and Susan even learned how to set boundaries with her job!

Creating healthy boundaries is not easy, but it is essential and will be one of the best gifts you can give yourself and those whom you love.

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those who serve them.  She is the creator of the internationally recognized Dementia Live® simulation and empathy training program;  pam@ageucate.com