Posts tagged ‘Caregiving’
LIVE Home Modifications Course!
Inclusive Housing: Space Planning, Design & Building a Business
Dates & Locations:
April 13-14, 2016 Austin, TX
May 16-17, 2016 Hamden, CT
May 19-20, 2016 Philadelphia, PA
June 13-14, 2016 Charlotte, NC
June 16-17, 2016 Virginia Beach, VA
June 20-21, 2016 Arlington, VA
The course is scheduled as a two-day course; however, attendees can choose to register for just one day or both days of the course.
Discounts for groups of 2+, email dyoung@empowerability.com
FOR MORE INFO & to REGISTER: http://www.empowerability.com/ProfessionalEducation.html
A personal note on Aging in Place
It is what I talk about all of the time; the importance of thinking about your home and if your home will meet you and your family’s changing needs in the next 5, 10, and 20 years. It may be a need for yourself, or it may be that you have a child that sustains a broken leg due to a skiing accident, or an aging family member that needs to move into your home. We are all temporarily able-bodied; will your home be up to the challenge? Will you have enough supports in place to manage having to be cared for, or caregive for someone else?
These are questions that most people do not ask themselves until there is a need. Recently, my Mom underwent major surgery, requiring added time in recovery and subsequently becoming deconditioned. This led to a month stay in subacute rehabilitation. As a family, it was decided that my Mom would be discharged to stay with my brother, temporarily, prior to going back to her own home. Although it would seem easier to have my Mom come to my house (a universally designed ranch style home that is 2.5 hours away from her home), it made more sense for my Mom to stay closer to her own home, closer to her own doctors and closer to her friends and familiar supports by staying with my brother who lives 10 minutes from her own home. I immediately went into full home modifications mode.
My brother’s house is a typical three-story condominium with a 180* short radius stairway configuration from the first level to the second as well as from the second level to the third. The second level of the home is the main living area with a half bath; Full bathroom and bedrooms on the third level. Prior to this major surgery, my Mom has had longstanding issues with her knees and would typically only go up and down her stairs one time a day, as she is not yet receptive to a stair lift (wink wink smile)
So, it was time to put my money where my mouth is! My Mom was very active, ambulating without assistance or an assistive device, and independent with all activities of daily living prior to the surgery. She made great strides in subacute therapy and was discharged to my brother’s home utilizing both a rolling walker and a cane. Our plan: put up handrails on the stairway, as there were none currently in place. We measured the length of the wall space based on installation of the handrails at 35” above the finished floor (as this falls within the 34”-38” range). The handrail height could have been determined specific to my Mother, but being that this was my brother’s home, and to meet the needs of future residents, we decided to utilize a more universal height, opting for the lower end of the range as my Mom is only 5’3” tall. We purchased a basic handrail of 1 ½” diameter, and handrail brackets with load weight capacity of 500# from one of those big box stores 🙂 Most importantly, we installed the brackets into the studs to ensure that the determined weight load capacity would be supported. Voila! She is able to independently get up and down the stairs and the handrails look like they have always been there. Ideally, and what I typically recommend, is installation of handrails on both sides of the stairs. However, as professionals, we have all instances where our clients are not always receptive to our recommendations and in these instances, we continue to educate about the benefits and plant seeds for future change (wink wink smile some more)
Will your home meet you and your family’s changing needs in the next 5, 10, and 20 years?
New Thinking for Effective Caregiving: A Conversation Between an Occupational Therapist and a Caregiver Coach (Part 3)
Training Family Reinterpretation (continued from Learned Helplessness, Part 2)
Holly:
This idea of reinterpretation comes up often during caregiver coaching sessions. What other kinds of reinterpretation crop up in your work with clients?
Debra: Well, Holly, it can come up in the way a family member talks about their loved one’s condition. From a medical perspective, I may be working with a client in the kitchen to functionally walk with their mobility device to retrieve items from the cabinets and refrigerator for meal-prep. The family will say, She’s not walking! I have to counter, No, she’s walking, but she’s doing it differently. We need to help the family to see the picture differently, to reinterpret what is happening.
Or if someone has had a stroke, and one side has some paralysis, a family member will say, That’s the bad hand” or “bad side.” We have to help them to see that there’s no such thing as good or bad, it’s always a matter of degree of functionality.
Holly:
Oh yes, the words caregivers use directly impact their own peace of mind and that of their loved ones. In my book, “The Caregiver’s Compass,” a main focus is noticing the words one is using, and then switching them to words that are more empowering. The theory is called “action language,” the idea that language doesn’t just describe reality, it creates it. Speaking is an action that generates your experience of your world. Self-talk is an example. But in life, we don’t live in isolation, so we’re like fish swimming in a goldfish bowl—what we say also creates realities or meanings for those around us. A daughter saying to her dad, “You’re not walking!” as he’s inching forward on his walker, is not helpful. It’s disempowering. When I run into someone negative, I’ve been known to say, “Stop pooping in the fishbowl!”
—Holly Whiteside, caregiver’s coach & advocate, is author of “The Caregiver’s Compass: How to Navigate with Balance and Effectiveness Using Mindful Caregiving.” She invented Mindful Caregiving tools during her caregiving decade by applying to herself the life coaching principles that she had been teaching others. Find her book at Amazon.com, or learn more at www.CaregiversCompass.com. Holly can be reached at MindfulCaregiving@comcast.net.
New Thinking for Effective Caregiving A Conversation Between an Occupational Therapist and a Caregiver’s Coach (Part 2)
Learned Helplessness – (continued from Family Wellness Part 1…)
Holly:
This topic of family dynamics is so rich, Debra. Are there other ways in which you encounter and work with family dynamics?
Debra:
Sure. For instance, when there’s a disability issue, there almost always needs to be a shift in family dynamics, because our goal is client empowerment. The client’s roles and responsibilities may have been changed due to the illness, injury or disability, while other family members may have to take on new roles and responsibilities. These changes are both sources of possible stress on the family dynamics. These stresses require a shift in family dynamics or the family runs the risk of promoting helplessness in their loved one.
As the OT, I do a lot of family training around the client’s ability, showing family how independent the client is, or can be. I find many times family members aren’t nearly as patient as I am with my client. They may have to watch their loved one struggle taking off a shirt or tying a shoe. Ideally, to truly help the person without taking over, getting dressed may take two hours. But that might not work for the family. We want the client to be as independent as possible, so we have to get it across to the family member that sitting on your hands can be helping. It’s important to give the client the time that they need.
It can be a critical choice; either the family member does a task faster, OR they support their loved one in working toward independence. Doing everything for the disabled loved one promotes what we call “learned helplessness.” It doesn’t help the client to be as independent as possible. We need to meet everyone’s needs, or at least find a compromise that works.
This pattern of learned helplessness can be compounded by a family’s culture. Especially in transgenerational households, people are more family oriented, helpful (at times to a fault,) and they may have specific habits, roles and responsibilities to which they are accustomed. Out of love, the family may want to do everything. It may just be an inherent part of their culture. As OTs we have to be respectful of the culture, yet still be an advocate for the wellness of the client. We draw a balance and try to teach them new ways of being loving.
Holly:
That’s beautiful Debra, and such a challenge. This comes up regularly with caregivers. I find it helpful to teach them about the distinction between helping, fixing, and true service. Rachel Naomi Remen (Clinical Professor of Family and Community Medicine at the UCSF School of Medicine) spells out the difference between fixing, helping, and serving in her book, “My Grandfather’s Blessings.” To sum it up briefly here, chronic helping supports the helplessness or neediness of the other, and fixing presupposes that the other is broken. Though helping, fixing and serving can look alike to the observer, the inner experiences differ. Over time, fixing and helping are draining, while service is renewing. When we serve, our work sustains us.
Robert K. Greenleaf, gives us the litmus test to know whether we are truly serving our loved ones. “Do those served grow as persons? Do they, while being served, become healthier, wiser, freer, more autonomous?”
So really, Debra, we’re talking about helping caregivers to reinterpret their role, changing it to a partnership with their loved one in a way that empowers them, helping them to grow and to be as independent at possible. This idea of reinterpretation comes up often during caregiver coaching sessions. What other kinds of reinterpretation crop up in your work with clients? (to be continued…)
—Holly Whiteside, caregiver’s coach & advocate, is author of “The Caregiver’s Compass: How to Navigate with Balance and Effectiveness Using Mindful Caregiving.” She invented Mindful Caregiving tools during her caregiving decade by applying to herself the life coaching principles that she had been teaching others. Find her book at Amazon.com, or learn more at www.CaregiversCompass.com. Holly can be reached at MindfulCaregiving@comcast.net.
New Thinking for Effective Caregiving: A Conversation Between an Occupational Therapist and a Caregiver’s Coach (Part 1)
Family Wellness-
Debra:
We all are touched by injury, illness or disability. At EmpowerAbility, LLC, we know that for a client, everyone in their immediate circle plays a role in how well they heal. Whether I’m completing a home assessment, or working directly with the client in Occupational Therapy, it’s not just about the client, it’s about everyone around that person. It’s making sure that the environmental modifications I’m recommending in the home work for everyone.
The time we spend is frequently an almost equal split between time with the family and time with the client. In OT, we have to simultaneously be aware of everyone’s capabilities, limitations, and expectations. One example was with a caregiver whose father had Alzheimer’s. OT was a lifesaver. We were able to pull the daughter aside and help her sidestep burnout, by giving her strategies that helped her complete daily living activities while emphasizing the positive aspects of care. We gave her strategies for communicating with her father that let her get back in touch her values and social relationship that underlie her caregiving role. We also found her local resources that provided respite care (giving caregivers that much needed break,) and also caregivers groups where she could talk with others who fully relate to the caregiving role.
Everywhere along the spectrum, from acute care to outpatient and home health Occupational Therapy settings, the families are involved.
Holly:
So, Debra, you’re really talking about holistic wellness within the family system. Often the caregiver is the one left out of that picture because self-care can seem counter-intuitive from the caregiver’s perspective. Initially, there’s a sort of blindness caused by resisting what is happening, feeling they must “fix” the situation or their loved one. “I’m trying to help my dad, to slow down his decline, and you’re suggesting that I focus on myself?!” That blindness prevents them from seeing their role in the bigger picture. Seeing caregiving with a broader view requires a new way of seeing for the caregiver. Once they ease up on their resistance and begin to accept that changes are normal and inevitable, they become freer to question, “What is My part in this?” And then they are more open to seeing the need for their own self-care.
So, caregiving is rife with unknowns and things that can’t be controlled. The one thing over which caregivers do have control is their own health and well-being. The family is a dynamic system—what one family member says, and how they are, effects the others. If I’m a caregiver experiencing a mood, it can infect others. If I’m letting myself get burned out, I’m not available to do the caregiving to which I’ve committed. So in order to do my best job, I am actually required to take care of myself, get the support I need, manage my emotions honestly and well. Selfcare is no longer a frill—it’s a necessity.
This topic of family dynamics is so rich, Debra. Are other ways in which you encounter and work with family dynamics? (to be continued)
—Holly Whiteside, caregiver’s coach & advocate, is author of “The Caregiver’s Compass: How to Navigate with Balance and Effectiveness Using Mindful Caregiving.” She invented Mindful Caregiving tools during her caregiving decade by applying to herself the life coaching principles that she had been teaching others. Find her book at Amazon.com, or learn more at www.CaregiversCompass.com. Holly can be reached at MindfulCaregiving@comcast.net.
Cyber Care: Robots and Aging in Place
It seems the new buzz-word is Cyber Care. As a follow-up to my last post, I located a very recent article from Scientific American that also discusses the current development of Elder Care Robots to assist seniors with Aging in Place. The article reviews the current work of robotics companies that are “designing prototypes to provide automated assistance to the elderly at home, targeting a market that promises to grow as people live longer.”
Like any other piece of technology, user acceptance is always a concern. How do you think seniors will accept the use of a robot in their home?
The future of Caregiving
More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled or aging family member or friend during any given year and spend an average of 20 hours per week providing care for their loved one. (Caregiving in the United States; National Alliance for Caregiving in collaboration with AARP; November 2009) Therefore, it comes as no surprise that we are seeing a boom of innovations that are geared toward assisting those millions of people to safely remain in their homes for as long as possible. From Gero-technology systems to Mobile Service Robots (MSR), we are certainly changing the future of caregiving.
GeckoSystems is a company that has created “Emily”, a Mobile Service Robot (MSR). Emily is a CareBot, which the company describes as just another type of “labor saving, time management automatic home appliance”. Like any other appliance in your home, the CareBot is a convenience. Although, this convenience is specific to caregiving, allowing the caregiver less “time stress” with managing their own day-to-day tasks compiled with the caregiving needs.
“Emily” may alleviate some of the “time stress” a caregiver may feel by alerting the client of reminders throughout the day such as when to take medication as well as allowing the caregiver “virtual visits” via internet access to view the client in their home. The MSR also provides a potential for the feeling of companionship, as it has the ability to hold a basic level of conversation such as telling jokes, reciting Bible verses, retelling family anecdotes, and even playing songs and music. The MSR will also notify designated caregivers, including 911, in the event of an emergency.
The market for Gero-technology type systems is certainly growing with more and more seniors choosing to age in place. Although “Emily” certainly does not hold a candle to Rosie from the Jetsens, I do think this technology has specific applications. One overwhelming obstacle to the use of a MSR is the many homes that are more than one level and/or have steps to transition from one room to the next. Among other concerns regarding this system, I also wonder about how the MSR stays charged and how this system is maintained to ensure it is working properly.
What are your thoughts on “Emily”?
Do you like the idea of using a home system setup to monitor a loved one, or a Mobile Service Robot (MSR)?
An 81 year old foster son?
As I was watching last night’s evening news I was intrigued by a story about a family that has decided to foster; not a child, but an 81-year-old veteran. The VA Medical Foster Program “pairs veterans who would be in nursing homes with families who are willing to take them in.”
Aligning with aging-in-place, fostering a veteran in one’s home is more cost-effective than nursing home care. The costs are nearly cut in half. Per the article, “the money received goes to the caregiver”. In this instance, the” foster parent” quit his job in sales to become a caregiver within his own home. Not only is this program cost-effective, it also brings back the family experience for the veteran. It is the program participant’s beliefs that they are giving back and never forgetting the commitment and sacrifices of our veterans.
This program is yet another great housing alternative to nursing home care. However, deciding to open your home and become a caregiver is not a decision to make in haste.
What are your thoughts on this program?
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