Eldercare Resources

A nine-part series for family caregivers and employers. When family caregiving roles conflict with work and career obligations.

Part 9 of 9: This is the last part of our discussion about forgetfulness and resistance to help, that could be better understood by looking at reversible dementias. Here is the original question:

My father seems to be getting forgetful and will occasionally think I am his sister rather than his daughter. He is very strong-willed and has traditional masculine values, though, so he won’t admit to needing any sort of treatment or help. How can I help him understand we are on the same team?

In the previous two articles, we examined possible causes of reversible dementia symptoms as one way to explore a solution for this dad. Why? Because reversible dementia could help improve his cognitive wellness. We were working through the dementia mnemonic. Today, we will learn about T, the I, and the A.

• T is for tumors and space-occupying lesions. These can cause pressure in the brain and could affect the neurological areas that are responsible for emotions and reasoning.

• I is for infections. Common infections that can cause confusion in the elderly include sinusitis, urinary tract and respiratory infections, such as bronchitis and pneumonia, to name a few.

• A is for anemias. Anemia is a condition where red blood cell counts are lower than normal. In older adults, anemia is marked by loss of oxygen-toting red blood cells that cause fatigue and muscle weakness. Anemias that are due to deficiency of micronutrients, such as iron and vitamin B12, can also cause cognitive impairment.

I recommend visiting the primary care provider for a workup to rule out other conditions that could contribute to his cognitive impairment. She could also communicate with her father with more “I” statements. If she said, “Dad, I worry when you are home alone,” rather than, “Dad, you should not be living alone, and you need help.” “I” statements demonstrate concern. If I can be of help to your loved one who is challenged with cognitive impairment, please call or email me anytime.

Katie Klem

A nine-part series for family caregivers and employers. When family caregiving roles conflict with work and career obligations.

Part 5 of 9: I have been answering a list of questions that have come via email to the weekly virtual seminar that I cohost.

Q: My parents will not admit that they are having issues, or genuinely do not feel that they have issues, so they refuse to accept hired help or even schedule doctor appointments. Any advice for convincing them to accept help before a crisis? In the last article, we discussed how to get help. For today, how do we get care into the home through the doctor?

A: Nurses have been voted the most trusted professionals for several years straight. I think doctors are not too far behind. The good thing is that many older adults respect and trust their doctors. Here is how to get care into the home through the doctor.

First, be sure to call the doctor’s office ahead of time to tell the doctor that you need his or her assistance to get a caring professional into the home. If the doctor has a nurse practitioner in their practice, that would even be better, because nurse practitioners have a different and unique way to doing patient education.

Second, ask the doctor to use two old fashion prescription pads and on one write “physical therapy evaluation for gait disturbance and home safety evaluation” and on the other one write “home caregiving assessment.” Medicare will pay for the physical therapy assessment partly because 82% of the people who need care in the home have some form of dementia, and with dementia, some patients suffer with spatial difficulties and depth perception. Very often when the physical therapist comes, they will find something to work on. If the therapist finds a need for teaching, such as a new medication, a nurse will be sent in under Medicare. Through the nurse, it would be easier to start the discussion for a home caregiving assessment.

If I can help you get care into the home, please call or email me anytime!

Katie Klem

Q: My parents will not admit that they are having issues, or genuinely do not feel that they have issues, so they refuse to accept hired help or even schedule doctor appointments. Any advice for convincing them to accept help before a crisis?

A nine-part series for family caregivers and employers. When family caregiving roles conflict with work and career obligations.

Part three of nine: I have been answering questions that came via email to our GOING HOME, STAYING HOME questions and answer service. GOING HOME, STAYING HOME is a weekly virtual session that I cohost with other geriatric experts. There were nine questions, and this is the third of nine.

Q: How do I help my parent figure out where money is going? What can I use to help my mom set up to more easily manage her finances and her therapy appointments for the Medicare people coming to the house, and how do I know what accounts exist?

A: Money is one thing that causes conflict in family caregiving. The difficulty of handling money is one of the challenges that aging adults face every day, and it has become one of the signs that someone needs help from others. It threatens the independence of an older person. If you get too involved in managing your parents’ financial affairs, it could potentially cause a change in your role and your relationship. Our relationship with our aging parents is usually better when we remain the child. It is better to engage and retain other professionals, such as care managers, bookkeepers, attorneys, and professional caregivers.

Regarding the management of her finances and identification of where money is going and which accounts they own, I highly recommend that you consider the services of a daily money manager. A daily money manager specializes in helping people manage their day-to-day personal finances—paying bills, tracking insurance claims, organizing files, safeguarding important financial documents, budgeting, and more.

For her appointments, consider a simple calendar and ask the Medicare therapist to write down their appointment dates and times. If someone you love needs care, is coming home from the hospital or the rehab facility, and you have questions, need resources, or want to learn, join me on Tuesdays at 11 am on Zoom. No need to leave your home, office, or business. You can attend from anywhere via your computer or telephone. Call or email me for the link or call in phone numbers.

Call or email me for the link or call in phone numbers.

Part two of nine: Last time, I started a series from questions that came by email (to the Going Home, Staying weekly virtual session that I cohost with other geriatric experts) from the CFO and some of his employees who are also caring for loved ones.

Q: When my mom is coming home from a skilled rehab facility after being in the hospital, what services do I need in place?

Recently I have been cohosting a weekly Tuesday virtual mini-class at 11 a.m. PST on zoom. The title of the class is GOING HOME STAYING HOME: Advice, Tips & Practical Solutions For Caregiving Families.

My last post discussed "How to talk to your aging loved ones in a way that they would listen and respond." I have been co-hosting a free one-hour weekly virtual seminar called Going Home, Staying Home. My co-hosts are nurses and nurse practitioners, and we answer caregiving questions live on zoom. When family caregivers can't attend, they can email their inquiries, and then we will answer the questions and send the replay links.

Last week, we had a very engaging session. We received nine questions from a CFO who happens to need care for his parents and who also needs help for his employees who are family caregivers. Can you imagine the conversations that occur in their break room about caregiving? In the upcoming weeks, I will answer one question each week. Their questions' theme is "Caregiving and what to do when caregiving follows you to work." Caregiving is generally defined as providing unpaid assistance for another person's physical and emotional needs. A study cited in the Academy of Management Journal focused on what today's caregiving employees really need, and it addressed the relationship between caregiving decisions, work-family conflict and work performance. This study showed that employees who are family caregivers frequently suffer high levels of stress, anxiety, irritability, depression, physical illness, obesity, financial insecurity, isolation and poor self-esteem.

In many cases, caregiving employees reported that their home life amounted to a "second shift of work." At an employer level, employees who are also caregiving can directly affect corporate earnings. This negative impact is caused by its effect on the worker's job performance, absenteeism, loss of productivity, time lost from work, inability to stay on the job, higher healthcare cost due to stress, and higher cost of recruitment, retention, training and supervisory challenges.

In my next post, we will begin the 9-part discussion on what to do when your caregiving roles conflict with your work and career obligations. If you are a business owner who provides caregiving or has employees who perform a "second shift of work" as caregivers, I am here to help.

Call or email anytime. See you next time during Going Home, Staying Home.

Photo by Elisa Ventur on Unsplash

Caregiving is universally the greatest art of love. Still, it could wreck your life if you do not apply practical strategies for communicating your needs, being heard, retaining the appropriate professional services, staying sane and finding balance in your role as a family caregiver.

I recently received the following question about resources to help after a hospital stay.

My husband suffered a stroke in March and has been in and out of the hospital ever since. The rehab facility recommends that he be transferred to a memory care unit for a month because he can’t quite remember things. Most people in the memory care unit have Alzheimer’s but he does not. I would rather take him home, but my children are worried that I can’t care for him. I don’t know what to do.

Multiple readmissions to a hospital and/or rehab facility interrupt recovery. The time that could be used for therapy is lost in logistics, admissions and management of symptoms. Very often, patients in rehab facilities seem weaker or worse partly because of the interruptions in the care programs. You have the right to request in-home rehab. A memory care unit will not improve his memory in a month. Actually, it might make things difficult and worse for him because a new environment can cause increased levels of confusion.

Here are 3 simple steps you could use to help him get the right type of care outside of the rehab:

1. Ask the rehab facility to organize a discharge planning care conference so that you can have firsthand information about the amount and level of care he needs at home. A discharge planning meeting is usually attended by the therapists, nurse, social worker or discharge planner.

2. Request for a care management consultation so that a care manager can help develop a restorative caregiving program that will promote his wellness, help him stay out of the emergency room, learn how to live with chronic symptoms, feel happier and thrive regardless of any life-limiting diagnosis.

3. Attend the next GOING HOME STAYING HOME SESSION. These are no-cost telephone or Zoom sessions held every Tuesday (at 11 a.m. PST) designed to provide practical advice and resources for caregiving families dealing with the aftermath of a hospital admission. For more information or to get the call-in numbers or zoom link, call or email me today.