Tag Archives: leadership

Careers in Aging – Proactive Approaches to the Looming Crisis

March 3 -7 is Careers in Aging Week and an appropriate time to talk about the importance of this topic.  No longer are the shortages of direct care staff and others in long term care a subject of the future.  The crisis is looming and it is serious.

The number of Americans 65 and older is projected to grow to 98 million by 2060, more than double the number we had in 2016.  According to the Population Reference Bureau, between 2020 – 2030, the number of older adults in America will grow by 18 million as the youngest baby boomers hit 65.

Like me, the baby boomers that are marching forward are asking ourselves, “Who will take care of me?”  While families have and will be forced to take on the caregiving tasks for their loved ones, it simply is not the answer or reality for many Americans.   Boomers and GenXers are working,  families are not geographically close enough to take on the role of primary caregivers, the numbers of widows and widowers are growing and many elderly are childless.

According to Government statisticians, home care is one of the nation’s fastest-growing occupations, with an additional million workers needed by 2026!  That is an increase of 50% from 2014.

Without pouring through any more statistics,  growing careers in aging is no longer an option – it must become a priority that starts with our government leaders and is embraced by stakeholders across the spectrum.  It is not a US-only challenge – it is a worldwide crisis that must be addressed sooner rather than later.

Work in long term care, especially direct care workforce has long been associated with low wages, often inconsistent work schedules, limited company benefits, and poor training.  The economic boom has pulled workers from long term care into retail, restaurants, hospitality and other similar businesses that are paying higher wages.  It’s been a catch-22 but the fact that the shortages are colliding with an unprecedented demand is especially frightening.

Without pouring through any more statistics,  growing careers in aging must be a priority that starts with our government leaders and is embraced by stakeholders across the spectrum.  It is not a US-only challenge – it is a worldwide crisis that must be addressed sooner rather than later.  Unfortunately, advocacy and lobbying take many years, of which we simply do not have time to wait.

What are the solutions?   There are not any easy ones, but perhaps looking at what we can do locally to turn the tide is going to result in positive outcomes.  We see our partner providers taking our Dementia Live® training to nursing schools, high school students and even out into communities who are embracing Age-Friendly and Dementia Friendly initiatives.  Raising awareness of the growing elderly population and their needs is huge.  Intergeneration programs among schools and churches and the elderly are setting an early example with children that respecting and taking care of our older adults is our duty.

Building awareness is a grass-roots effort and home-grown.  It means take creative efforts to work with others that include public entities, community-based organizations, political leaders and the private sector.  It means elevating the professional standards for those who choose careers in aging.   Careers in Aging is a field that is extremely rewarding.  We can do a better job of conveying this to our younger generation, and even an older generation who is looking to keep working and giving back.   What better way is there to give back than to serve others.

I’d like to hear what you are doing to bring awareness and educate others in your community!

Pam Brandon is President/Founder of AGE-u-cate Training Institute and a passionate advocate for older adults and those who serve them.  You may reach out to Pam at pam@ageucate.com.

I Just WISH I Could UNDERSTAND what Mom is going through…

blackboard against red barn wood

Understanding someone with dementia is not easy.  What are they thinking?  How are they feeling?  Why are they acting the way they do?  These are fundamental questions that perplex professionals and quite simply leave families feeling confused, angry, guilty and helpless.

I have been a family caregiver and moved into the aging and dementia training space to help older adults and the growing numbers of families and professionals who are serving them.  Because I experienced for myself the helplessness that caregivers feel, I can relate well to family members who feel isolated, lost and desperately seeking answers.   Because I was a family member seeking help I know how little was out there 20 years ago.  Guess what?  There is still not enough support out there for families.  We’ve come a long way, but because the numbers of caregivers have swelled so quickly, this will remain a huge challenge in the years to come. Educating, supporting and providing resources for family members who are caring for aging adults, especially those who are living with dementia, is all of our jobs.

Short of a soapbox moment,  we need to get back to basics when it comes to dementia education.  We need to provide powerful, effective and feasible means to deliver education that will help professionals and families in understanding someone with dementia.  We must start with a foundational tool.

Our partner providers, those in elder care communities, home care, hospice, hospitals, community-based organizations, and others are consistently sharing with me their challenges – how to help families who are most often in crisis when they seek their services.   My discussions with leaders across the spectrum of care share a common theme.  Most, and I venture to say that is over 90% of families who are caring for someone with dementia, are in crisis when they transition to home care, an elder care community or reach out to a community-based agency for help. This is an alarming number of people who are exhausted, experiencing caregiver burnout –  physically, emotionally and spiritually, and dealing with overwhelming guilt, anger and hopelessness.

Back to basics in dementia education is greatly needed.  A tool that allows a family and professional to experience what their loved one is struggling with, and to then have someone to talk to that can walk them through the “why” of it all is enormously beneficial.  It’s experiential training at its core.  Stepping into their world for just a moment to allow caregivers to understand mom, or dad, husband, wife, resident or client is HUGE.

Quality education does not have to be complex.  In fact, simple, effective and feasible should be in the mind of everyone who leads education and training.  The next questions should be asked – is this providing a tool?  We need applicable tools that we can walk away with and immediately make changes in how we care for another person.  And these tools should not only improve the quality of life of the person we are caring for but reduce caregivers stress and make their jobs as care partners easier and more rewarding.

In short, we need strong foundational tools that are proven,  successful and work for everyone – from care providers, to their staff and to the families and residents/patients/clients they serve.

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 Dementia Live® Simulation and Empowerment Experience being embraced by caregivers worldwide.

 

 

 

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

Is Stress Reaction a form of Behavioral Expression in Dementia?

Stress Reaction is a term being used more often to describe communication in persons living with dementia.  Behavioral expression, too, is communication.  In a growing number of circles, the term behavioral expression is being replaced by stress reaction simply because behaviors sometimes leans toward being a negative descriptive of how persons with dementia express unmet needs.

Stress reaction is communication that is caused by changes taking place in the brain caused by the progression of dementia.  These changes can cause behaviors such as:

  • Aggression
  • Irritability
  • Pacing or wandering
  • Withdrawing
  • Resistance to care
  • Crying
  • Yelling

It is important for care partners to understand that stress reaction is always caused by an unmet need.  The most common causes of unmet needs can be categorized in the following areas:

  1.  Physical discomfort – perhaps caused by pain, hunger, thirst, fatigue or other barriers.
  2. Nonsupportive environment – this might include noise, chaos, inadequate lighting, temperature changes or excessive clutter.
  3. Unmet social needs – boredom, lack of sense of purpose, lack of companionship, touch deprivation are some examples.
  4. Ineffective care partnering – examples include unrealistic expectations from caregivers, distrust from either care partner or inappropriate care (care that is not conducive to caring for persons with dementia)

Now that we’ve discussed stress reactions from persons living with dementia, we must then look at stress reactions from caregivers.  Understanding that it is how we as caregivers react to their stress reactions, is a core value of person-centered caring practices.

We cannot control their behavior, but we can control how we respond to their behavior.   Healthy care partnering means we understand that they cannot change what’s going on in their brain.  Their behaviors or stress reactions are a response to unmet needs, and it is the care partner’s responsibility to put the puzzle pieces together to help their care partners meet their unmet needs!

A few basic guidelines for care partners to keep in mind when there is a stress reaction:

Allow adequate space (in other words, step back if necessary)

The rule is always safety first for both care partners

Observe the environment, and what can quickly be changed, such as taking the person from a noisy room to a calm atmosphere

Observe body language and facial expressions, especially if the person is non-verbal.  What might they be trying to express?  And care partners, observe your own body language and expressions, as your stress reaction can either cause the situation to escalate or de-escalate

Watch your tone of voice!  It’s amazing how a calming voice will immediately bring calm to another person.  And just the opposite is true.  If stress reaction is met with similar behavior, it’s almost always a certainty that the outcome will not be positive.

And finally, learn techniques and tools that can prevent stress reactions.  Touch, music, redirection techniques, companion pets or dolls and more can have amazing outcomes and are simple to implement with the correct training.

Pam Brandon is the President/Founder of AGE-u-cate® Training Institute, creator of the Dementia Live® Sensitivity and Empathy Training program and directed the development of Compassionate Touch® for persons living with dementia and end-of-life.  She is a passionate advocate for older adults and those who care for them.