THE CAREGIVERS DILEMMA

“…Mom fell again…”, “I’m worried about her, I’m afraid she will burn the house down. She forgot she had the pot on the stove and walked out of the room”. Sound familiar? You have a parent in their declining years and you are starting to think it’s time to move her to a care home? She will fight you all the way, unless it’s her idea and she is young/alert enough to decide on her own to move into a senior residence, or assisted living home. If not, there is an alternative.

Most people want to stay in their own homes. I imagine I will. But if your parent isn’t safe alone, you will need to decide two things up front: When do they need someone around, and who should/could that person be?

Care 24/7 usually is not necessary unless
one has declined a lot physically, or has moderate to severe dementia. Otherwise, it’s likely they will be OK on their own through the night. Do they need help in the morning? Bathing? Probably. Getting dressed? Or getting breakfast? Maybe, maybe not. How about setting out the right pills? Likely. Maybe, for now, Mom just needs someone there in the mornings, someone to prepare meals for her, and someone close by - reachable by phone - in case she falls. Meals-on-wheels and a medical alert pendant or bracelet to call for help, are simple, inexpensive solutions. And senior day programs are a good option a couple of days a week.

But when your parent does need more care at home, get an expert – a Care Manager – to help you determine how much and what kind. The cost for that assessment will save you big dollars and much stress and agony in the long run. And the resulting decisions (the person your parent blames) can be put on the care manager, not you.

Now the dilemma. Who should be the caregiver? You? A joint effort among siblings and/or a grandchild? Or someone you hire? There really should be only two choices: a joint effort among family members, or hiring a caregiver. Making that decision depends on you and your parent. Hiring a trained person, in many ways is easier. But it will cost some money (not as much as any of the long-term care facilities outside the home) and require someone to oversee them. Is there social security, a pension, investments? Hiring part-time help might be the best way to go. Then you can spend quality time just enjoying your parent without the embarrassment (theirs) or frustration (yours) of having to deal with those difficult personal care issues. There are agencies you can hire caregivers through, but I could not find one who would come just the hours we needed. Check through the church or club you or your parent belongs to. There may be a retired nurse looking for just a few hours. Or a student studying in a health related field at the local college.

Just because you love your parent isn’t enough of a reason to take on this job. I loved my dad, but we didn’t see eye-to-eye much of the time and it was way too stressful for both of us. If you decide you are the compatible, patient, problem solver, easy going, not currently employed, best family member available for the job (and remember this is a job), then there are many rewards along with the stresses and frustrations. First thing to remember is you have to take care of yourself, too. No one can do a job, any job, 24/7. You have to enlist family members to help. You need to have days off, regularly. You need nights that you can sleep through. You need to eat well, get regular exercise, and a massage, or at least a long soak in the tub, once in a while. Too often caregivers work themselves into a physical or mental breakdown before the person they are caring for passes on. Then where are you? Get a sibling to cook meals a couple of times a week. And an other one to handle the finances, Medicare/insurance paperwork, maybe pick up prescriptions, or take mom to the doctor.

When there are expenses beyond those that can be covered by mom’s resources (her investments are there primarily for her long-term care - what’s left over is the family’s inheritance), then pull the family together, explain the needs, and insist that everyone share in the costs. You are putting your time in, you should be paid (though you probably won’t be), and you certainly should not be spending down your own resources. Someday you may need them for your own long-term care.

And get support, someone to listen to you and cheer you on. You are doing an extremely hard job, doubly so since it is a loved one you are watching decline. You deserve pats on the back, Hail Mary’s, and chocolates!