Becoming Caregivers: “The Call”

It all started with a phone call, as these things often do. In this case, it was actually a text from my Mom vacationing on the other side of the world telling me to call Grandma’s sister. Apparently, Grandma had fallen and was in the E.R. But, it turns out she’d already been released.

Of course, the story was far from over. Our bumpy caregiving journey was just beginning. Grandma was in a lot of pain and not eating or drinking since leaving the hospital. She feared getting up to go to the bathroom so she was avoiding liquids. I’d seen that many times before with clients and knew it would become a real problem. Grandpa, an 89-year old hemophiliac, had worn himself out caregiving so her sister had moved in to help. Aunt Jo found herself providing round-the-clock care at 84-years old. My grandparents’ private housekeeper performed some household duties and supposedly provided assistance. However, I was a bit dubious about how helpful she really was.

Finding the Right Solutions in a Crisis

It was a relief having Aunt Jo to help temporarily so I could get the right care team in place. I knew she couldn’t sustain this long-term so I moved quickly. Fortunately, our family’s experience in elder care cut down on learning everything from scratch. For most people in crisis, this is an absolutely essential time to call a care manager. You don’t have time to learn all the terminology, ins and outs, and research who to contact (and even what to ask).

Quickly, I rescheduled my day so I could spend time getting things organized. I didn’t live in their area so I had to start calling and interviewing home care companies. We had one shot to get this right or my grandparents would reject the care. This is where experience running a home care company helped. I knew what we wanted, but also knew to prioritize. We needed the right team and this might mean adjusting our desired schedule to get the best people. Aunt Jo could help out for a few days while we worked things out. Sometimes it’s worth buying yourself time with a temporary solution to make sure things work in the long run.

But Will My Loved Ones Accept My “Right Solution”?

You may have the best solution, but if your loved ones won’t accept it then it’s no solution at all. I explained my concerns to the home care company. We worked together to get the caregivers familiar with my grandparents and family. Being able to chat about family reference points–the family dog, the grandkids, etc.–made all the difference. The caregivers were able to immediately gain trust and form bonds with my grandparents.

Objection #1: Entertaining Caregivers

Many elders object to having a caregiver because they worry about how they’ll “entertain” the person in their home. This generation takes the duty of being a gracious host seriously–what a wonderful trait!  I shared the process we use at EasyLiving with the home care company so we could overcome this objection with my grandparents.

At EasyLiving, we have solved this issue by developing a comprehensive care plan outlining step-by-step instructions and tasks for the caregivers to accomplish while in the home. The care plan is very specific, from identifying how the client wants household chores completed to how many sugars they want in their coffee.  This working care plan limits the client’s need to provide instruction. It calms the worry about what the caregiver is going to do with their time. This is a win-win for the client and caregiver while providing a metric to measure the success of the visit.

Objection #2: Having a Stranger in the Home

As mentioned, I worked with the company ahead of time to help the caregivers feel more familiar. I also spent time telling them about my grandparents and answering their assessment questions so they could find the right match.

At EasyLiving we work closely with the client and family to ensure the caregiver we introduce is the right caregiver for them. Our Supervisor attends the first meeting to make the introductions and ensure it is a good fit. She can also then see if there are additional needs to set the caregiver up for success. We do quality assurance calls and visits with all parties, removing the burden from the client of having to point out concerns.

In my case, I did a series of calls on day one so we could address any concerns immediately. I called my grandparents to check in first. Then, I spoke to Aunt Jo to get her thoughts. Finally, I called the home care company and made sure they’d also followed up by talking to the caregiver. I repeated this on following days and got a recap of how things were progressing.

On day two, we made some care plan adjustments. I encouraged Grandpa to let the caregivers help take Grandma to the bathroom and get dressed. I continued checking in after that and adjusting where needed. Clients don’t usually point out problems until they’ve already decided this won’t work out. By checking in, we could make adjustments to keep everyone happy.

Meanwhile, I was relaying all this to my parents who were still vacationing. Even though they felt confident in my decisions, I needed the affirmation. It also helped to vent some of my stress.

Objection #3: Cost of Caregivers

The median national cost of a home health aide is $127/day. This figure is based on about 44 hours of care/week or about 6-7 hours/day. Therefore, the hourly cost hovers at about $20.50, with wide variation by area. In our area (Tampa Bay, Florida) the price for an accredited, fully insured, licensed home care agency is $22/hour. By using advanced technologies to develop incredible service and training, EasyLiving has been able to maintain an affordable price without sacrificing quality. We can pay and reward caregivers well by cutting down on inefficiency.

Here are a few ideas to overcome the price objection:

  1. Introduce your loved one to a few hours of home care/week to assist with the basics of cleaning, laundry, changing the bed, and cooking a meal.
  2. Supplement family caregiving with respite care from time to time. This provides socialization for your loved one and gives the full-time caregiver some downtime. It also gets everyone accustomed to respite caregivers. This means you know where to turn in a crisis and don’t start off in a panic like I did.
  3. Personal hygiene is a tough thing to need help with, especially having our son or daughter see us naked and all the related dignity issues. Introduce a professional caregiver, much like hospital care, to assist with bathing, hair washing, and other personal grooming that will enable the client to feel better about themselves.
  4. Talk to the home care company about the most effective way to use time. A good assessment can determine where (and when) clients need the most help. The care plan can ensure time is well-spent, maximizing bang for your buck.
  5. Work with a home care company that can help put your long-term care insurance to work for you. At EasyLiving, we help clients understand the elimination period and level of care requirements. We help negotiate to obtain the coverage needed.

We had already started helping my grandparents with bill paying and management. So, they trusted us when we assured them that we had worked out the budget. We had an easier time because we’d already made those arrangements.

All these things made such a difference in our caregiving journey. There were more bumps along the way, which I’ll share in a future post. But, having a good care team in place let us go from stressed out caregivers to a happy family again.

Takeaways from Our Experience

Don’t neglect the warning signs.

Our family should have brought in help sooner. We didn’t realize how hard it was on Grandpa. He was doing double duty taking care of himself and Grandma. Without proper nutrition and rest, he became frail and weak.

Grandma wasn’t eating and drinking properly. She was afraid of getting up to go to the bathroom, so she became dehydrated and weak. Sometimes she wet herself because she couldn’t get up. They weren’t able to cook proper meals and both didn’t have much appetite.

Talk about wishes and make plans for aging.

The less you have to deal with in a crisis, the better. Not starting from scratch made our process much smoother. Additionally, plan for coordination. Have a point of contact to manage care, make decisions, and simplify communication. Technology can make communication easier, with simple options like a group chat or online care management tools. We had two adult children and spouses (one set traveling overseas), husband, sister, family friends, the preacher, their “housekeeper” and now the home care company and caregiver…all with opinions. It’s a disaster without coordination and someone to make decisions.

The right care team/plan means thriving, not just surviving.

My grandparents started gaining weight and energy. Smelling food cooking stimulated their appetites. Homemade meals are not only healthier but way more appealing than cold snacks. Besides the socialization of the caregivers, my grandparents felt comfortable having visitors again. Their moods improved with support and confidence.

Grandma’s memory is better now that she has a routine. She and grandpa now take their medications regularly and eat real meals.

When I call them, we talk about activities they’ve done rather than a list of symptoms or pains. They tell me about games they played, listening to their church podcast, and stories from their caregiver.

Once the crisis is averted, think long-term.

Once we had a great care team in place, we had to start planning for the future. I contacted their long-term care insurance and made a new budget. Our family started looking at different options such as assisted living facilities. But, if they decide to make that move we want to be sure they can stay together. By being proactive we can be better prepared.

Contact us for a care management consultation. Start planning, stop waiting for the crisis call.

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