Senior Caregiving: It Takes an Army
If it takes a village to raise a child, it can take a small army to care for an aging loved one.
Think of all the roles you juggle: personal shopper, housekeeper, chauffeur, legal advisor, accountant, crisis manager and social worker. Plus, you may be a plane ride away.
"Caregiving is a job with a lot of moving parts and you can't do it alone," says Lisa Winstel, chief operating officer of National Family Caregivers Association. Many primary caregivers are reluctant to ask for help, she adds, because they feel guilty or think they should manage it all alone. Yet, an overwhelmed caregiver is prone to depression, insomnia and illness, Winstel notes, "And that's not good for the caregiver or the elder loved one."
Share the care by building formal and informal networks to delegate caregiving responsibilities. Start by listing friends, family, neighbors, clergy members, professionals, as well as local and online resources. On another list, prioritize weekly tasks. Simple, concrete requests work best, i.e. "If you could pick up Johnny after soccer practice, then I can take Mom to the doctor."
Consider your helpers' strengths and preferences. If your brother is less squeamish about hands-on care, he might give Dad a sponge bath. Your chatty sister in California could call Dad in Florida every day to ease his anxiety. Perhaps a young mother would like a part-time job handling a senior's grocery shopping or transportation during school hours. Even your folks' letter carrier can keep an eye out for uncollected mail.
More resources are just a mouse-click away. Websites of local and national organizations like Alzheimer's Association, American Cancer Society and Hospice Foundation of America provide information and links to on-line or local support groups for caregivers and seniors.
"You're not as alone as you think you are," says Care.com senior care advisor, Carol Laibson, a licensed independent clinical social worker. Laibson, who has two decades of eldercare experience, receives calls from all over the country. Some clients want help planning ahead, while others call in a crisis: a parent has fallen, broken a hip and requires immediate in-home care. Or a 90-year-old man calls because he can no longer drive at night and wants help getting to the theater.
Seniors often resist help. In that case, Laibson includes the elder in planning, if possible, to build trust. In one case, Nancy, a former nonprofit executive in her 90s, was accustomed to being in charge. Although her health was failing, she resisted family members' efforts to hire the in-home help she needed. "Nancy was a passionate gardener, but could no longer care for her yard, so we suggested bringing in someone to help to plant and prune," recalls Laibson. Laibson worked with a local home care agency to find a companion caregiver who was available to do light gardening and understood the family hoped she and Nancy would develop a trusting relationship which would lead to acceptance of more help in the near future. After bonding over the garden, the caregiver was hired to drive Nancy around and help out more around the house. After learning to accept more help, Nancy finally agreed to move into an assisted living facility where she thrived in a more social environment.
Family dynamics can make managing siblings and others the trickiest members of a care team, says Francine Russo, author of "Their Your Parents Too!"
"So quickly we slip back into childhood roles without realizing it," she says. Those old roles can prevent siblings from seeing each other as adults and adapting to this new stage of family life. "Just because you live closer does not mean your brother the family clown or that emotionally needy little sister might not be a better choice to be primary caregiver," says Russo. "Think hard. Do you really want the job and can you share it?"
It is not uncommon for overwhelmed caregivers to become angry that siblings are not helping, Russo adds. "But it's counterproductive to communicate anger and resentment," she says. Vent your concerns to a nurse, counselor or clergy person to find less emotionally charged ways of communicating with siblings.
Beware of perfectionist tendencies that prevent others from helping, she adds. Maybe you know Mom hates the color red and prefers chicken to fish. Better your brother lets Mom wears the red blouse while she eats the fish while you get a day off.
There are unexpected bonuses to dividing the care of an elder loved one. "You have an amazing opportunity to see your siblings as adults, not the bratty little kids you shared a bedroom with," Russo says. "Through teamwork you can resolve your differences, learn from each other and reap rich emotional reward from pulling together."
Finally, Russo says, asking for help is a sign of strength, not weakness or failure. "It's an acknowledgment of how complex caregiving really is." Just don't forget to say thank you.