Caregiver stress can cause burnout – which is exhaustion, physically, emotionally, and mentally.  Your  attitude can be effected and change from positive and caring to negative and unconcerned. The burnout occurs when family members don’t ask for help. We think we can do it all! I know! If you are burned out you may experience fatigue, stress, anxiety, and depression. We also can feel guilty if we spend time on ourselves rather than our aging relative.

Other Causes of Caregiver Stress & Burnout:

• Ignore our own health
• Don’t pay close attention to our body and mind’s demands
• Ignore fatigue and hopelessness

Questions to ask yourself to avoid burnout:

What are your expectations of yourself as a caregiver?  We expect our care to heal and make our care recipient happy. This may be unrealistic for patients suffering from a progressive disease, such as Parkinson’s or Alzheimer’s.

Do you accept full responsibility of the care? Don’t fall prey to thinking its your full responsibility to effectively plan and manage the aging loved one’s care.

Do you assume the full role of caregiver? But remember you are also their adult daughther or son.

Are you making over the top demands on yourself?  You may be placing undue burden on yourself thinking it’s your ultimate responsibility.

These are few questions to ask yourself.. giving a good check-in to see if the care you give has reasonable expectations. If you have questions or need help seeking care for an elder in Texas, email Carol@WorkingCaregiver.com or visit WorkingCaregiver.com.

If you are caring for an elderly loved one and need help or direction on where to go for senior care at home, please email Carol@WorkingCaregiver.com.  Visit WorkingCaregiver.com for more family elder care and Texas Home Care resources.

When caring for an elder or senior at home, there are several considerations as seen on Today’s Caregiver Magazine:

• Try to make them as comfortable and safe as possible – consider Senior Care Calls to help you keep them safe. This can reduce stress for you too and your aging relative.
• The more safe and secure the senior feels, the less confused, aggressive, or agitated the elder becomes. 
• Remind them to drink water. Keep a small, light weight pitcher filled with water in a convenient place,. It wards off headaches, sleeplessness, and appetite suppression.
• Avoid placing a lot of mirrors around your home. Mirrors can seem confusing for elderly people because they may not recognize their own reflection. This is to prevent your loved one from seeing their reflection.
• Use large dials and number pads. If your loved one enjoys watching television, buy a remote with large numbers. If your loved one can still use the phone, make sure the keypad has oversized numbers. Also, place digital clocks around your home because they are easier for your loved one to read. This will keep them from getting frustrated with trying to read the traditional three-hand clocks.
• Buy your loved-one’s clothing in basic colors like black, tan, white, cream and green. This will make it easier for them to pick out their own outfit.  Place all their shirts on one side of the closet and shorts, pants and skirts on the other side. It is better for your loved one to make as many decisions as possible. This helps them to feel in control and a sense of importance. The main thing is to limit choices, too many can be confusing and overwhelming.

Thank you for visiting. If you have questions, email Carol@WorkingCaregiver.com.  

 

Informal caregivers are family, friends, neighbors or church members who provide unpaid care out of love, respect, obligation or friendship to a disabled person. These people far outnumber formal caregivers and without them, this country would have a difficult time providing funding for the caregiving needs of a growing number of disabled recipients.

Depending on the definition of caregiving, estimates of the number of informal caregivers range from 20 million to 50 million people. This could represent about 20% of the total population providing part-time or full-time care for loved ones.

The typical caregiver is a daughter, age 46, with a full-time job, providing an average of 18 hours per week to one or more of her parents.

Among adults aged 20 to 75, providing informal care to a family or friend of any age, 38% care for aging parents and 11% care for their spouse. About two-thirds of those caregivers for people over age 50 are employed full-time or part-time and two-thirds of those-about 45% of working caregivers-report having to rearrange their work schedule, decrease their hours or take an unpaid leave in order to meet their caregiving responsibilities.

A recent study estimates these people lose about $660,000 in wage wealth over their lifetime because of work sacrifices. And estimates of productivity losses to businesses because of time off for caregiving range from $11 billion to $29 billion yearly. The average amount of time informal caregivers provide assistance is 4.5 years but 20% will provide care for 5 years or longer.

Are you seeking help for home care in Texas?  Go to WorkingCaregiver.com.  Email Carol@WorkingCaregiver.com. Thank you.

Are you a relative or family member of a Texas senior seeking home care help? Please visit our directory for home care resources at WorkingCaregiver.com  or email Carol@WorkingCaregiver.com.

It seems some Assisted Living Facilities in Texas have found a niche in providing care to Alzheimer’s patients and many are exclusively dedicated only to Alzheimer’s residents. The disorder requires close to constant supervision but not necessarily from the more costly skilled medical staff found in nursing homes. It’s a fact that at least 5% of those over 65 and 46% of those over 85 suffer from mental impairment or memory loss and is a potentially large market for Assisted Living Alzheimer’s facilities.

Not all residents of Assisted Living Facilities need care or assistance. Many are there because they want a simpler lifestyle and want little worry or concern of maintaining a home and they seek the companionship of other people their own age. They have chosen assisted living because they may need some minor help with some daily living activities but they anticipate a time when they may need the more intensive care available with an Assisted Living community.

According to an Assisted Living survey by the facilities’ Administrators, their residents who were independent, needing no assistance, were as follows: eating 88%, transferring 84%, toileting 78%, dressing 58%, bathing 49%.  And 24% of their residents received assistance with 3 or more activities of daily living, such as bathing dressing and mobility. An estimated one third of residents had moderate to severe cognitive impairment.

Seeking care for relative at home or Assisted Living facility?  Email Carol@WorkingCaregiver.com. Or fill out our form WorkingCaregiver.com.

If you are seeking home care help in Texas, whether it’s formal or informal, visit our directory for home care resources at WorkingCaregiver.com  or email Carol@WorkingCaregiver.com.

There are sources for caregivers that help with caring for an aging senior in Texas; some are volunteers while others are paid caregivers and providers associated with a service agency who are licensed by the state of Texas.  Senior Services Providers include for-profit or nonprofit nursing homes, intermediate care facilities, assisted living, home care agencies, community services, hospice, church or charity service groups, adult day care, senior centers, association services, state aging services and so on. For additional information on these services, go to our directory at WorkingCaregiver.com. We also offer savings for senior care services at Senior Services Savings.

Ten years ago, 9.5 million patients were served by home health agencies and 576,000 by hospice care. This care was provided by approximately 13,000 agencies, nationwide. The percent distribution of disorders requiring home care were: diseases of circulatory system-25.2%, injuries and poisoning-9.9%, muscle and skeletal disease-8.8%, respiratory-8.4%, cancer-7.3%, endocrine, nutrition, metabolic, immune-5.4%, nervous system- 4.3%, others-balance of distribution. Of the patients served by hospice, about 76% had cancer or heart disease.

In 1997, there were about 17,000 skilled and intermediate term nursing homes in the US serving 1,609,000 residents. About 1,465,000, or 91% of residents, were age 65 and older. Out of those 1.5 million elderly patients in nursing homes in 1997, as a percent of the total, help was provided with 1 or more activities in the following categories: bathing or showering-96.2%, dressing-87.2%, using toilet room-56.2%, eating–45%, transferring to chair or bed-25.4%.

As of the year 2000, an estimated total number of assisted living beds nationwide at 1,387,836 beds with total revenue of $33.1 billion. And this number will continue to grow. If you need help with these senior resources, go to WorkingCaregiver.com.

If you are seeking home care for your loved one in Texas and not sure where to begin the search.. email Carol@WorkingCaregiver.com, visit our website WorkingCaregiver.com, or visit our Senior Services Network in Texas for home care or other concerns dealing with aging or seniors in Texas. 

A Texas hospice team consists of a doctor, a nurse, a social worker, a therapist if needed, a counselor and an aide to provide custodial care. Help with activities of daily living is provided at home or in a Medicare approved hospice facility. Custodial care is always a part of a hospice plan of care and Medicare routinely pays for these services.

I’m not aware of a custodial nursing home in Texas.  All nursing homes are by definition skilled care facilities because they have nurses who are skilled care providers.  Also, I believe, that not all states license intermediate care facilities which might provide less than 24 hour registered nursing care. “Skilled care patients” in nursing homes are referred to as such because they are receiving payment from Medicare or sometimes payment from private health insurance plans.  Practically all nursing home residents have medical needs but Medicare and other insurance plans will only pay for patients that have certain acute medical needs where recovery is anticipated.  Patients with chronic medical problems are typically not covered by Medicare but would be covered by Medicaid.

There’s a lot of confusion about ”skilled nursing care” which may come from Medicare. To be a certified Medicare nursing home and receive payments from Medicare a nursing home must meet the Medicare definition of a “skilled nursing facility”. This means there must be registered nurses on duty 24 hours a day, there must be a doctor on call at all times and there must be ambulance service to a local hospital. Medicare may also require additional staffing and facility arrangements to receive certification. It is unfortunate that the word “skilled” is used in this definition. All nursing homes whether they meet the definition of a “skilled nursing facility” or not provide services from a nurse, doctor or therapist and this meets the medical definition of skilled care.

Some states have adopted the same federal criteria for licensing their nursing homes. ”Skilled” definition is the only option for a nursing home. But in some states facilities with lesser services can receive different licensing classes. These might be called intermediate care facilities or “small nursing homes”.  If you need help understanding these terms or need help locating a quality skilled care facility in Texas email Carol@WorkingCaregiver.com, WorkingCaregiver.com.

Need help with locating home care for aging parents living in Texas?  WorkingCaregiver.com can help you locate quality care.  Email Carol@WorkingCaregiver.com.

When our parents approach the age of needing more care at home that’s when adult children turn on the Internet.  We seek help for them to live out their lives at home.. preferably as comfortable as possible.  This weekend my friend’s dad turns 100!  And believe me he needs some good quality care but he still resists inviting hired caregivers to help.  So, the family members chip in every day of his remaining life to make sure he is safe, fed, and clean.  Unfortunately, it’s not working too well.  A couple of times, in the morning, they’ve found him on the floor. Just recently he had a mild stroke but he refuses help from outside the family.

There are ways around getting help for him which my friend and her family have finally figured out. First off, they got advice from a Geriatric Case Manager, someone who truly understands the old body and it’s surroundings. But who pays for care outside the family?  Here’s are some facts.

Does Medicare Cover Custodial Care?

Medicare routinely pays for custodial care in every skilled care setting for which it provides payment. Medicare will not pay for custodial care in the absence of a skilled care plan.

Medicare covered nursing home stay

A patient receiving skilled care in a nursing home from Medicare not only receives care from skilled providers such as nurses, therapists or doctors but also receives care from custodial providers such as aides or CNA’s. This care usually consists of help with bathing, dressing, ambulating , toileting, incontinence, feeding and medicating. Medicare does not exclude the custodial services but pays the entire bill because custodial care is a necessary part of the skilled care plan in a nursing home.

Medicare covered home care

Custodial care is always a part of a skilled care plan for home care. The patient receives skilled care from a nurse or therapist and custodial care from an aide for help with bathing, dressing, ambulating , toileting, incontinence, medicating and possibly feeding. Medicare pays for both types of services.

Need more help or resources?  Visit our Senior Services Directory. And go here for Senior Services Savings & Discounts.  Email Carol@WorkingCaregiver.com. 

How do familiies determine which care is needed for aging relative?  Custodial care or Skilled care?  you can read the blog dated June 20th to gain insight in both.  For more information go to WorkingCaregiver.com or email your question to Carol@WorkingCaregiver.com.

Most of us are not part of the medical community many times get confused about which care is needed.. custodial care or skilled care?  An example of the differences are explained in the earlier post in this blog describing the activities of daily living and many of the items on the list (see June 20th post in this blog) are care activities defined custodial care.  The monitoring of vital signs, ordering medical tests, diagnosing medical problems, administering of intravenous injections, prescribing and dispensing medicine, drawing blood, giving shots, dressing wounds, providing therapy and counseling are all activities normally associated with skilled care. But many non-medical  professionals don’t know that skilled and custodial refer to the people who deliver the care not the actual care given.

Skilled care provider also provides services normally thought to be provided by custodial caregivers. Such things as daily living help or activities and the instrumental activities of daily living are often furnished by skilled providers in the course of their treatment. A skilled care plan may include services delivered by a custodial caregiver but it would still be under the skilled plan of care. The professionals delivering custodial services may perform activities “supposedly” reserved for skilled providers.  Services such as taking blood pressure, administering medicines, giving shots or changing wounds might be provided under certain circumstances by a custodial provider.

Always consider that the terms skilled and custodial do not refer to specific types of long term care services but rather who delivers those services. Also the delivery of skilled services must be done under a written plan of care which often includes custodial care services.

When Texas families research the differences of care available to their aging loved ones, two come to mind that are used by the medical community, health care plans, health insurance plans, and Medicare, Medicaid, and the Veterans Administration. The two are custodial care and skilled care.

Custodial and Skilled Care are  different in the sense that one is used when care is provided by medical specialists as opposed to care provided by aides, volunteers, family or friends. The use of these terms is important when families are determining whether a health care plan will pay for services or not.

Just so you know, skilled services are paid for by a health care plan and custodial services are not covered, if custodial care is not associated with skilled services. But the custodial services are “almost always” a part of a skilled service plan of care when included, custodial services are paid by the health care plan as well. Many people have the misconception that only skilled services are covered. In a lot of cases, this is simply not true.

American College of Medical Quality says, ” Skilled care is the provision of services and supplies that can be given only by or under the supervision of skilled or licensed medical personnel. Skilled care is medically necessary when provided to improve the quality of health care of patients or to maintain or slow the decompensation of a patient’s condition, including palliative treatment. Skilled care is prescribed for settings that have the capability to deliver such services safely and effectively.

Custodial care is the provision of services and supplies that can be given safely and reasonably by individuals who are neither skilled nor licensed medical personnel. The medical necessity and desired results of skilled care must be clearly documented by a written treatment plan approved by a physician. A patient may have skilled and custodial needs at the same time. In these circumstances, only those services and supplies provided in connection with the skilled care are to be considered as such. The treatment plan must include:

•  The applied therapies;
•  The frequency of the treatment which is consistent with the therapeutic goals;
•  The potential for a patient’s restoration within a predictable period of time, if applicable;
•  The time frame in which the prescribing physician will review the case for the purpose of evaluating a patient’s status and before reassessing the medical necessity of ongoing treatment; or
•  The maintenance, palliative relief, or the slowing of decompensation in a patient’s status, if applicable.

For help on understanding and seeking advice from professionals who deal with these issues, contact WorkingCaregiver.com or email Carol@WorkingCaregiver.com.  Visit Long Term Care Link for more information on these matters.

In simple words, long term care is needed when a person requires help with physical or emotional needs over an extended period of time. This help may include for many activities or needs that healthy, active people take for granted such as:

Walking
Bathing
Dressing
Using the bathroom
Helping with incontinence
Managing Pain
Preventing unsafe behavior
Preventing wandering
Providing comfort and assurance
Providing physical or occupational therapy
Attending to medical needs
Counseling
Feeding
Answering the phone
Meeting doctors’ appointments
Providing meals
Maintaining the household
Shopping and running errands
Providing transportation
Administering medications
Managing money
Paying bills
Doing the laundry
Attending to personal hygiene
Helping with personal grooming
Writing letters or notes
Making repairs to the home
Maintaining a yard
Removing snow

If you know someone who needs help go to WorkingCaregiver.com or email Carol@WorkingCaregiver.com. 

Long-term care help may be due to a terminal condition, disability, illness, injury or the infirmity of old age. Estimates by experts are that at least 60% of all individuals will need extended help in one or more of the areas above during their lifetime. The need for long-term care may only last for a few weeks or months or it may go on for years. It all depends on the underlying reasons for needing care.

Temporary long term care (for only weeks or months)

Rehabilitation from a hospital stay
Recovery from illness
Recovery from injury
Recovery from surgery
Terminal medical condition
Ongoing long term care (need for care for many months or years)

Chronic medical conditions
Chronic severe pain
Permanent disabilities
Dementia
Ongoing need for help with activities of daily living
Need for supervision
Long-term care services may be provided in any of the following settings:

In the home of the recipient
In the home of a family member or friend of the recipient
At an adult day services location
In an assisted living facility or board-and-care home
In a hospice facility
In a nursing home

To read the full story go to: Long Term Care.  And go to WorkingCaregiver.com