Tag Archives: caregiving

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

How Can we Avoid and All-Out Family Feud over Mom’s Teapot?

I was very fortunate, for  when my sweet mom passed, no one else asked for “the teapot”.  It wasn’t particularly pretty, and certainly of no monetary value.  But to me it was priceless reminder of the tender moments we had together to talk about an endless number of topics that mothers and daughters share. Often accompanied by a scrumptious homemade sweet, we always had back-up favorites in the freezer so we were never without an accompaniment for our favorite Bigelows “Constant Comment”.   When we weren’t chatting and sipping, we would often play a quick game of Yahtzee, Gin Rummy or in latter years, our absolute favorite go- to game,   Rumikub.

Being the last of 5 girls, I suppose Mom had more time for girl time than the businesses of her earlier life.  The teapot symbolized was our shared, sacred time together that will always be treasured.

What happens when those special items are sought after by more than one family member?  All too often, that’s when the family fireworks erupt.  Surrounding that item may be emotional and sentimental feelings that a person (s) may long to hold onto.  There is nothing wrong with this… unless there is one item and multiple people who want it!

How can we avoid World War III?  As I remind aging parents, especially those who are downsizing or contemplating who gets what of the family heirlooms, you do have options in passing on your personal belongings.

The safest way (in terms of avoiding family feuds) is to gift it while you can make the decision to do so.  Talking to various family members about what they would like also helps narrow the choices.  Our parents lovingly started putting names on items that one of the children or grandchildren has requested along the way.  Of course, it was their decision, but for the most part, they did this fairly and with thought put into why the family member wanted certain items.  Most were tied to memorable occasions, special trips or life events which included that person.

When it came time for the “major downsizing” when they moved to a retirement community, for all other items, some which has value, my mom created a well thought-out lottery which had items grouped by approximate value.  We were each given an option to choose one from each category.  For the most part, this execution of non-titled property was brilliant!  They knew who was getting what, and each child was the recipient had at least one top item of the various groups.   My parents were happy to lighten their load, and us kids were thankful for the opportunity to be a part of the process, knowing both our wishes had  been fulfilled.

My parents also enjoyed many years of seeing their treasured things in our homes, knowing they no longer had to care for them or worry about what would happen to them when they passed.

Does this plan always work?  I can tell you most certainly that no it does not.   Maybe because no one wanted to part with the “stuff”, children couldn’t agree on anything, so parents gave up, or the topic was never broached.  There are many other reasons, like sudden illness, estrangement or unfortunately and sadly, children that announce they want nothing of their parents.  Personally, I think this is not very compassionate.  Many of our parents came from the depression-era, and they worked very hard to acquire what they had, and for the most part, these items were treasured, as it was before everything on the planet could be mass or re-produced at a fraction of the cost.

When I talk with families, I often ask what they are gaining, except hurt feelings, by wincing at the idea of taking mom’s “junk”.   Instead, encourage and even help your parents inventory their belongings, asking what they would like to keep and what items they would like to pass on now.  These treasures make wonderfully thoughtful birthday and holiday gifts, and with some coaching and ideas of how to creatively get this often insurmountable task done, take it one step at a time.

Pam Brandon is President/Founder of AGE-u-cate Training Institute, a passionate advocate for older adults and those that serve them.  

www.AGEucate.com

The Art of Caregiving – Can it be Mastered?

Artist and blogger Phil Davies say the reason most frustrated artist stay frustrated is that they don’t know how to practice their drawing and painting skills.  Each time they draw or paint a picture, they just hope it turns out better than the last one.  If we approach caregiving skills as an art, the question then is can it be mastered?

Davis says art is supposed to be a rewarding hobby, when most of time one is stressing over every pencil mark and brushstroke, desperate not to make a mistake.  Could it be that many artists don’t have the skills, techniques and confidence to enjoy what they are doing?

Like artists, caregivers need to break down the big, difficult skills into smaller building blocks.  The problem is that very few caregivers (or artists) do this.  Depending on your current skill level of caregiving, whether you are a professional or family member – you want to practice with smaller building blocks first.

Artists must first learn the art of color mixing.

Additive mixing is used  to produce a wide range of colors using only three primary colors additive mixing of colors is unintuitive as it does not correspond to the mixing of physical substances (such as paint) which would correspond to subtractive mixing. For instance, one can additively mix yellow and blue by shining yellow light together with blue light, which will result in not green but a white light. As in this example, one should always have the mixture of light in mind when considering additive color mixing as it is the only situation where it occurs. Despite being unintuitive, it is conceptually simpler than subtractive mixing. Two beams of light that are superimposed correspond to additive mixing.

By convention, the three primary colors in additive mixing are red, green, and blue. In the absence of color or, when no colors are showing, the result is black. If all three primary colors are showing, the result is white. When red and green combine, the result is yellow. When red and blue combine, the result is magenta. When blue and green combine, the result is cyan.

Like color mixing, caregivers blend many skills (that first must be learned) so that the outcome is a well blended hue of providing safety, security, trust and enhanced quality of life.  In order to achieve this, it takes dedicated practice –  understanding and accepting that mistakes will be make along the way.   There are so many variables to the art of caregiving that when blended together can result in a beautiful (not perfect!)  care partner relationship, healthy care receiver and empowered care giver.  Like art, it’s a work in progress.  Can it be mastered?

I believe that caregivers can gain enormous confidence with exceptional training, continued education and the will to keep learning.   Caregiving, like art, is an every changing range of color and feelings, and for that I would say our mastery is in the journey.  Like artists, if this approach is practiced, it will transform quality!

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and a passionate advocate for older adults and those that serve them.  Pam seeks to empower professional and family caregivers, faith communities and organizations in better understanding older adult and caregiver needs. 

www.AGEucate.com

 

Boomers Optimistic about Their Future – Until They Need Care

A survey form the National Council on Aging, UnitedHealthcare and USA Today concluded that most Boomers are optimistic about their future.  That is until you ask them about needing help as they age.  When it comes to the issues surrounding who will provide caregiving when they no longer are able, optimism turns to fear.

The Paraprofessional Healthcare Institute (PHI), a New York-based nonprofit that supports the home care industry, has created a new campaign to address and solve the chronic shortage of health care workers in the United States.
The “60 Caregiver Issues” campaign points out the country needs five million caregivers in the next seven years in order to keep pace with the growing demand from a rapidly aging society. The first issue briefing, The Future of Long-Term Care, lists eight signs the shortage in paid caregivers is getting worse. Those signs are:

  1. The population of older adults in the U.S. continues to rapidly age, igniting demand for long-term services and supports.
  2. A sizable growth in elders and people with disabilities means a growing demand for paid caregivers: home health aides, nursing assistants and personal care aides.
  3. The primary labor pool for direct care workers isn’t keeping pace with national trends, raising concerns about the broad appeal of this occupation.
  4. Direct care workers are leaving the occupation in droves.
  5. The workforce shortage in paid caregivers might be affecting areas of the country differently.
  6. Policymakers, long-term care providers and the general public are hampered by the lack of available data and research on the direct care workforce.
  7. Home care providers and other long-term care entities cite the workforce shortage as a top concern for delivering quality care.
  8. The shortage in workers extends beyond long-term care—and is garnering public attention.

Now let’s look at the state of family caregivers.  A report by the Public Policy Institute (2013) researched the statistics for family caregivers, who provide the majority of long-term services and supports (LTSS).

The Caregiver Support Ratio is defined as the number of potential family caregivers (mostly adult children) aged 45 – 64 for each person aged 80 and older – those most likely to need LTSS.  The caregiver support ratio is used to estimate the availability of family caregivers during the next few decades.

In 2010, the caregiver support ratio was more than 7 potential caregivers for every person in the high-risk years of 80-plus.

In 2030, the ratio is projected to decline sharply to 4 to 1;  and is expected to further fall to less than 3 to 1 in 2050.

Steep rising demand as the population rapidly ages, combined with professional caregiver shortages and shrinking families requires more than policy action.  Every stakeholder (and that takes in to account ALL of us) must take it upon themselves to be better educated on aging issues, plan for their future and make healthy aging a priority.   Just as healthcare has created the need for us to be our own advocates for our health,  we must certainly take this same position with decisions that we make as we age and may eventually need care.

http://www.nahc.org/NAHCReport/nr170213_1/

www.AGEucate.com

Pam Brandon is President/Founder of AGE-u-cate® Training Institute and passionate advocate for older adults and those that care for them.