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Do Working Caregivers Provide Less Care for Loved Ones?

There’s a common assumption that when a loved one needs care, family members who do not work outside the home will be first to step up and provide support. Of course, in reality this is not the case. Many other factors come into play as a family’s caregiving arrangement takes shape.

In a series of studies over the past year, the United Hospital Fund and the AARP have been looking at the facts about family caregiving in the U.S. One thing they’ve discovered is that family caregivers today are performing more and more medical and nursing tasks for their elderly relatives. Family members are providing medication management, performing wound care, monitoring their loved ones’ health conditions and operating specialized medical equipment. The researchers also looked at the level of care and number of care hours provided by family members who were also employed outside the home, compared with those who were not. Said Susan Reinhard of the AARP Public Policy Institute, “We expected that caregivers who didn’t have to manage the demands of a job would have more time to take on these challenging tasks—tasks that would make a nursing student tremble—but our data shows that there’s little difference between the two groups.”

Though working caregivers were only one percentage point less likely to be providing this kind of care (45 percent of them, versus 46 percent of non-working caregivers), the percentages diverged dramatically in another category. Said Carol Levine of the United Hospital Fund, “Where we did find a difference was in the stress associated with juggling the demands of caregiving with other responsibilities.” Levine reports that while 49 percent of family caregivers who are not employed report feeling stressed, fully 61 percent of the working caregivers reported such stress.

This study is yet another reminder of how important it is for our nation to support family caregivers, whose unpaid work is worth billions of dollars each year, and many of whom are also productive members of the workforce.

Read the entire study [link to: http://www.uhfnyc.org/assets/1157] on the United Hospital Fund website.

Source: AgeWise reporting on research from the United Hospital Fund and AARP.

 

Home Care Supports Seniors Who Want to Age in Place

The U.S. Census Bureau reported last year that the percentage of seniors who are living in a nursing home dropped by 20 percent over the last decade. Are seniors just healthier today? The truth is, older adults today need as much care as did previous generations, but more of them are receiving it in assisted living communities, adult day centers and, in growing numbers, in their own homes.
This information comes as little surprise to the 65 million Americans who are already serving as family caregivers for older loved ones who need help managing health conditions and the activities of daily living. Many of these caregivers are members of the baby boom generation, who are reaching the age when they themselves might be expected to need care! From the local to the federal level, government agencies, too, are taking notice of the financial impact resulting from this population shift. The discussion about how to best and most cost-effectively care for our seniors is taking center stage.
The Census study showed that 90 percent of seniors would wish to receive care in their own homes. Is this realistic? Can they be safe and well-cared for even if they are living with age-related illnesses such as heart disease, diabetes, arthritis, or memory loss? Several demographic changes in our society make this more of a challenge than it was in the past:
• A University of Michigan study showed that almost 40 percent of chronically ill older adults in the U.S. live alone, and the majority of those who are married have spouses who are themselves facing health challenges.
• Our lower birthrate equals fewer adult children to help out as parents’ care needs increase.
• Adult children are more likely to live at a distance, having moved to find employment.
• A higher divorce rate means more seniors live alone, and family caregivers’ financial and time resources are stretched when parents live in different households, or even in different parts of the country.
The cost of institutional care continues to grow. For some seniors with medically complex health challenges, nursing homes and other residential health facilities are the best choice. But for many other seniors, home care is a desirable and cost-effective arrangement.
Dr. Soeren Mattke of the RAND Corporation noted, “The aging of the world’s population and the fact that more diseases are treatable will create serious financial and manpower challenges for the world’s healthcare systems.” He added, “Moving more healthcare into the home setting where patients or family members can manage care could be one important solution to these challenges.”
A wide variety of care services can be provided right in a patient’s home:
Skilled healthcare services can be provided at home and are cost-effective. Visiting nurses and rehabilitation professionals provide skilled medical services in the home. Registered nurses (RNs) and licensed practical nurses (LPNs) perform hands-on procedures such as wound care and IV therapy. Rehabilitation professionals include physical, occupational and speech/language therapists.
Nonmedical home care provides companionship and homemaking services that support the senior’s independence, at a much lower cost than nursing care. Caregivers provide supervision, assistance with dressing grooming and other personal care, laundry and housekeeping, meal preparation, transportation, socialization, and respite for family caregivers.
Dementia support is also available. Even when adult children live close to home, dementia complicates the caregiving dynamic. Trained in-home caregivers who understand the challenges of Alzheimer’s disease and similar conditions can help patients remain home longer, even as the need for assistance and supervision grows.
Many experts believe that bringing more care into seniors’ own homes will allow them to take better charge of their own care—and will save seniors and the healthcare system money.
Source: IlluminAge AgeWise, 2015

Do Working Caregivers Provide Less Care for Loved Ones?

There’s a common assumption that when a loved one needs care, family members who do not work outside the home will be first to step up and provide support. Of course, in reality this is not the case. Many other factors come into play as a family’s caregiving arrangement takes shape.

In a series of studies over the past year, the United Hospital Fund and the AARP have been looking at the facts about family caregiving in the U.S. One thing they’ve discovered is that family caregivers today are performing more and more medical and nursing tasks for their elderly relatives. Family members are providing medication management, performing wound care, monitoring their loved ones’ health conditions and operating specialized medical equipment. The researchers also looked at the level of care and number of care hours provided by family members who were also employed outside the home, compared with those who were not. Said Susan Reinhard of the AARP Public Policy Institute, “We expected that caregivers who didn’t have to manage the demands of a job would have more time to take on these challenging tasks—tasks that would make a nursing student tremble—but our data shows that there’s little difference between the two groups.”

Though working caregivers were only one percentage point less likely to be providing this kind of care (45 percent of them, versus 46 percent of non-working caregivers), the percentages diverged dramatically in another category. Said Carol Levine of the United Hospital Fund, “Where we did find a difference was in the stress associated with juggling the demands of caregiving with other responsibilities.” Levine reports that while 49 percent of family caregivers who are not employed report feeling stressed, fully 61 percent of the working caregivers reported such stress.

This study is yet another reminder of how important it is for our nation to support family caregivers, whose unpaid work is worth billions of dollars each year, and many of whom are also productive members of the workforce.

Read the entire study [link to: http://www.uhfnyc.org/assets/1157] on the United Hospital Fund website.

Source: AgeWise reporting on research from the United Hospital Fund and AARP.

 

Raining? Snowing? That’s No Reason to Skimp on Physical Activity

Mom always told us to get outside for some exercise. But if you’re like many of us in the U.S. these days, freezing cold, snow and ice might make it unsafe—at the least unpleasant—to get our workout in the great outdoors.

If it’s too cold, rainy or icy (or in a few months, too hot), it takes a little creativity to be active indoors. The National Institute on Aging (NIA) offers these great ideas for seniors who want to get some exercise even when weather conditions aren’t great:

  • Walk on the treadmill, ride the stationary bike, or use the rowing machine that’s gathering dust in your bedroom or basement. Or use one at a nearby gym or fitness center.
  • Work out with an exercise DVD. You can get a free one from the NIA’s Go4Life program (www.nia.nih.gov/Go4Life).
  • Go bowling with friends.
  • Join a local mall walking group.
  • Walk around an art gallery or museum to catch a new exhibit.
  • Check out an exercise class at your neighborhood Y or senior center.
  • If you like dancing, take a Zumba or salsa class.
  • Try yoga or Tai Chi.
  • Go to the gym and work on your strength, balance, and flexibility exercises or set up your own home gym. All you need is a sturdy chair, a towel, and some weights. Soup cans or water bottles will do if you don’t have your own set of weights.
  • Go to an indoor pool and swim laps or try water aerobics.
  • How about a game of indoor tennis, hockey, basketball or soccer?
  • Go indoor ice skating or roller skating.
  • Maybe it’s time for some heavy-duty cleaning. Vacuum, mop, sweep. Dust those hard-to-reach areas.
  • Play ping pong with the grandkids.

The NIA reminds us that we’re more likely to exercise if it’s convenient. Put your weights next to the sofa so you can do some lifting while you watch TV. Walk around the house while you’re talking on the phone. Make an extra trip up and down the stairs when you do the laundry.
Visit www.nia.nih.gov/Go4Life to find more tips and resources for staying active.

Source: National Institute on Aging, adapted by IlluminAge AgeWise.

Is Online Socialization Really Socialization?

Spending time with others is crucial for the physical and cognitive health and all-around quality of life of seniors. University of Chicago researcher John Cacioppo even says, “Chronic loneliness belongs among other health risk factors such as smoking, obesity or lack of exercise.”

But many seniors live alone. Mobility challenges, retirement, vision problems, perhaps the loss of spouse and friends—all make it harder to stay connected.

Fortunately, like people of every age these days, many seniors are supplementing in-person social connections with social media and other online technologies. Indeed, Pew Research Center reports that people over 65 are the fastest growing group to take up email, Facebook, Twitter, blogging, Skype and other electronic communications. The question is: Are these forms of communication really effective in meeting the social needs of older adults?

Many experts say yes! While online connections can’t completely take the place of in-person visits, or a hug, or meaningful time spent in the presence of others, studies are showing that it can be a beneficial supplement to more traditional human interaction:

  • Online social contact builds continuity in relationships, allowing for frequent interaction that was not available in the days when letters or long distance phone calls provided the only connection with far away friends and loved ones.
  • Online communications provide intellectual stimulation, keeping seniors in touch not only with friends and families, but with the world at large.
  • These technologies can be a lifeline for those with health problems that keep them confined to home.
  • Seniors who socialize online are also likely to increase their in-person social activities.

In December 2014, University of Exeter researchers reported the results of a two-year experimental program that supplied vulnerable older adults aged 60 to 95 with a computer, broadband connection, and training. Reported the team: “Those trained had heightened feelings of self-competence, engaged more in social activity, had a stronger sense of personal identity and showed improved cognitive capacity. These factors led to overall better mental health and well-being.”

Said senior participant Margaret Keohone, “Having this training changes people’s lives and opens up their worlds, invigorates their minds and for lots of us gives us a completely different way of recognizing our worth as we age.” Keohone said that before she began the program, “I was just slipping away into a slower way of life.”

Families, senior living communities and other organizations that serve the senior population are finding that with a little help getting set up, older adults can take advantage of these tools to feel more plugged in to family and community events.

Copyright © IlluminAge AgeWise, 2015.

Alzheimer’s Caregiving Tips: Sundowning

Late afternoon and early evening can be difficult for some people with Alzheimer’s disease. They may experience sundowning—restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade—often just when tired caregivers need a break.
Sundowning can continue into the night, making it hard for people with Alzheimer’s to fall asleep and stay in bed. As a result, they and their caregivers may have trouble getting enough sleep and functioning well during the day.

Possible Causes

The causes of sundowning are not well understood. One possibility is that Alzheimer’s related brain changes can affect a person’s “biological clock,” leading to confused sleep-wake cycles. This may result in agitation and other sundowning behaviors.

Other possible causes of sundowning include being overly tired, unmet needs such as hunger or thirst, depression, pain and boredom.

Coping with Sundowning

Look for signs of sundowning in the late afternoon and early evening. These signs may include increased confusion or anxiety and behaviors such as pacing, wandering, or yelling. If you can, try to find the cause of the person’s behavior.

If the person with Alzheimer’s becomes agitated, listen calmly to his or her concerns and frustrations. Try to reassure the person that everything is OK and distract him or her from stressful or upsetting events. You can also try these tips:

  • Reduce noise, clutter, or the number of people in the room.
  • Try to distract the person with a favorite snack, object, or activity. For example, offer a drink, suggest a simple task like folding towels, or turn on a familiar TV show (but not the news or other shows that might be upsetting).
  • Make early evening a quiet time of day. You might play soothing music, read, or go for a walk. You could also have a family member or friend call during this time.
  • Close the curtains or blinds at dusk to minimize shadows and the confusion they may cause. Turn on lights to help minimize shadows.

Preventing Sundowning

Being too tired can increase late afternoon and early-evening restlessness. Try to avoid this situation by helping the person:

  • go outside or at least sit by the window—exposure to bright light can help reset the person’s body clock
  • get physical activity or exercise each day
  • get daytime rest if needed, but keep naps short and not too late in the day
  • get enough rest at night

Avoid things that seem to make sundowning worse:

  • Do not serve coffee, cola, or other drinks with caffeine late in the day.
  • Do not serve alcoholic drinks. They may add to confusion and anxiety.
  • Do not plan too many activities during the day. A full schedule can be tiring.

If Problems Persist

If sundowning continues to be a problem, seek medical advice. A medical exam may identify the cause of sundowning, such as pain, a sleep disorder or other illness, or a medication side effect.

If medication is prescribed to help the person relax and sleep better at night, be sure to find out about possible side effects. Some medications can increase the chances of dizziness, falls, and confusion. Doctors recommend using them only for short periods of time.

Source:  The U.S. Alzheimer’s Disease Education and Referral Center, a service of the National Institute on Aging, part of the National Institutes of Health. For more caregiving tips and resources, visit www.nia.nih.gov/alzheimers/topics/caregiving or call toll-free 1-800-438-4380.

Caregiving in the Blended Family

Caregiving in the Blended Family

“I felt so insulted and so hurt. It was like their father had met some gal at a bar and married her the next day, and she wanted all his money. I felt they didn’t give me any credit, or any respect, appreciation or anything. It still hurts.”—Remarried wife of 12 years, caring for husband with Alzheimer’s disease, about her adult stepchildren.

Late-life remarriage complicates caring for an ailing spouse, according to a University of Michigan researcher who conducted one of the first known studies to focus on the challenges facing older remarried caregivers—a growing segment of the older U.S. population.

“Caring for an aging spouse is extremely difficult under the best of circumstances,” said researcher Carey Wexler Sherman. “When stepfamily tensions and conflicts are added to the mix, the stress can become overwhelming.”

With funding from the national Alzheimer’s Association, Sherman interviewed about 125 men and women with the goal of documenting the type, level and quality of social support received from stepchildren and other social network members, and assessing how late-life remarriage affects the experience of caregiving.

“Past research and current public policy relies heavily on the assumption that most older people who develop dementia are in long-term, intact marriages where the spouses—most often the wife—and adult children will provide most of their care,” said Sherman, a research investigator at the University of Michigan Institute for Social Research. “It’s not clear exactly how late-life remarriage and stepfamily relationships affect the spouse’s ability to get meaningful help in providing that care.”

Sherman explains, “Sometimes remarried partners and adult stepchildren come to consider each other ‘family,’ and sometimes they don’t. Often you hear people talk about ‘my father’s wife’ or ‘my husband’s children’—which can be a sign that a family hasn’t really blended. Ambivalent feelings among family members may carry over in all kinds of ways when a step-parent needs help providing care for an aging parent.”

An adult child of remarried parents herself, Sherman believes that her personal experience as well as her doctorate in family psychology and gerontology have helped to inform her approach to this difficult subject. “When my father needed care, I saw how challenging it can be to negotiate medical and care decisions when you are working within a stepfamily context. I was fortunate that my stepmom and I were able to become partners in that process,” she said. “But among the older remarried women I’ve interviewed, there is often a feeling that they are not accepted by their adult stepchildren. Many also report that they either get little or no help from stepchildren, or that the stepchildren challenge the decisions or choices made by the caregiver.”

In a prior study of late-life remarried caregivers, Sherman explored the financial tensions and conflicts between step-parents and adult stepchildren. In a paper in the journal Family Relations, she noted that adult stepchildren often resisted the step-parent’s financial role, even going so far as to “reclaim ownership” of family furniture, heirlooms and other objects when their biological parent and step-parent were away from home.

“Commonly, old family and financial grievances get revisited when a parent becomes ill,” Sherman said. “And the onset of dementia in the biological parent leaves the caregiving spouse and stepparent on the ‘front line’ to deal with any unresolved or contentious issues.”

Source: University of Michigan