Caregiving Support

1. Caregiving Support Alexandra Morris, Gerontologist Alzheimer’s Association Northern California & Northern Nevada 800-272-3900

3. Data: Caregiving for an Elder • Caregiving for a frail or ill elder is a marathon: Ave 4-6 years • Research shows that caring for a frail or ill elder creates physical, emotional and financial challenges for the caregiver • Greater risk of developing or exacerbating stress related illnesses; i.e. heart disease, hypertension, depression & anxiety, ulcers and increased risk of injury or accidents • Caregivers often ignore their own health conditions • 30% of caregivers are still employed • Caregivers are at higher risk of social isolation

4. Making the Most of Caregiving • Education • Support • Respite

5. Education • Investigate the disease or condition though on-line sources, books & journals www.alz.org • Attend classes, seminars and conferences www.alz.org/norcal Click on Education or Professional Education • Talk with professionals in the field • DPOA- Health- Finances/ Trust / POLST • Attend elders doctors appointments

6. Support • Helpline 800-272-3900 • Support Groups: www.alz.org/norcal Click on “Support Groups” • Friends and Family • Care Consultations at Alzheimer’s Association Offices • On-Line Coordinated Care: www.alzheimersnavigator.org or www.Lotsahelpinghands.com • Family Meetings at Alzheimer’s Association Offices • Care Management • Low income or other criteria for free, limited care management • Geriatric Care Manager www.caremanager.org

7. Respite: In-Formal and Formal • Family and Friends • In-Home Care • Adult Daycare • Over-Night Care in a Facility • Call us at 800-272-3900 or in Northern California/ Northern Nevada www.alz.org/norcal list is linked in middle of home page: Discover Community Resources

8. Options for In-Home Care • Independent Contractors • In Home Care or Nurse Registries • In-Home Agencies • Home Health Care Agencies • IHSS: Low Asset Medicaid (Medi-Cal)Program

9. Cost and Other Considerations • Independent Aides: They are your employees • You set the pay, likely the most cost effective in-home care • You screen and perform reference and background checks (Live Scan) • Consider costs of payroll services, workmans comp and liability insurance • Training & supervision is your responsibility • What happens when they are sick? Or need to leave town? Or hurt themselves? • Registries • Check the fine print, not all registries are the same. Some provide “payroll” services and background checks, others do not • Consider costs of payroll services, workmans comp and liability insurance • Aides have expectations as to the hourly rate. Likely still less expensive than in-home agencies • Training and supervision your responsibility • In-Home Agencies • Provide home health aides or CNA’s at modest cost • If aide is ill, they can send another quickly • Oversight and training by the agency • Often task oriented and English a second language • Minimum hours (3 or 4 hours) • Home Health Care Agencies • Provide skilled nursing or therapy level care at premium cost • Oversight and training by agency • Well-trained professionals • IHSS • No cost to client who qualifies under Medi-Cal • Hours limited by an assessment of physical needs • IHSS allows family or friends (after training) to provide the hours or they provide a list of aides

10. The Interview • Prepare by writing down what your expectations are: Companionship, Supervision, Personal Care, Medical Care. Be specific, for example, light meal prep, taking PWD on walks, shopping and the number of daily or weekly hours expected and time of day/night needed. • Training • Consider paying for dementia training, body mechanic’s, infection control and recognizing illness training • Temperament • Ask “What would you do if” questions • Be honest about your PWD behaviors and physical challenges

11. Reasonable Expectations • The aide may not do things exactly as you do. Be reasonable. Choose your priorities. • Punctuality and appropriate notice of changes in schedule a must. • Alzheimer’s Association have lists of agencies. Call us at 800-272-3900 or in Northern California/Northern Nevada www.alz.org/norcal list is linked in middle of home page: Discover Community Resources

12. Adult Daycare • Social Day Programs • Less expensive/ usually sliding fee schedules • Hours typically from 9am to 3pm • Social program, no health services • Usually mixed elders (not dementia specific) • Day Health Programs • More expensive but Medi-Cal may cover limited days • Longer hours • Health Services: i.e. PT, OT, Speech Therapy • Often have other services: i.e. Social worker, support groups, education

13. Overnight Care in a Long-Term Care Facility • Residential Care Facilities for the Elderly (RCFE’S) AKA Assisted Living and Board and Care Homes • Skilled Nursing Facilities (SNF) aka Convalescent Homes or Rehabs with respite stays • Minimum stays • Lots of paperwork and preparation • Expensive: $200 day + • Medi-Cal may cover for SNF • VA Respite for those who qualify

14. Take Care of Yourself • Honor yourself, your body and your role in another persons life by taking care of yourself • Make a list of enjoyable activities and engage in at least one enjoyable activity a day • Keep up on your own health: Doctors appts, Dentist appts, take medications and follow doctors recommendations • Research shows that Yoga, Tia Chi, meditation or focused breathing (signal breath) can be very beneficial for stress reduction • Exercise and eat nutritiously • Drink alcohol in moderation or not at all and don’t smoke • Socialize

15. Caregivers Doomsayers would preach that the world has been overtaken by rage, greed and resignation. I believe if you look into the private rooms of caregiving, you will find the true nature of things as they are. There you will find great kindness and devotion, a trust of life that surpasses doubt or pain. There you will find the highest expressions of who we are. Beth Witrogen McLeod