I want to make your caregiving life easier and less stressful by providing you with information you need (or will need) to care for your aging loved one, who might be a parent, spouse, partner, relative, or friend. I’m on the journey with you, caring for my 82-year-old mother.
Dive Into Caregiving is a weekly blog where we can share what we’re learning and help each other find answers to questions. Tips, solutions, information, and the occasional rant — it’s all about figuring out what we need to know to help the people we love. For example, what services does a home health company provide and will Medicare pay for those services? Or, where in her house might your loved one have stashed her insurance policies?
Please let me know what’s keeping you up at night or driving you crazy. What information are you looking for but haven’t found? I can’t answer all of your questions and I can’t give you legal advice, but I can help you through the information maze.
Who am I? I’m a caregiver, author, lawyer, teacher, and former professional organizer. I wrote a book, Become an Informed Caregiver: What You Should Know When Caring for an Aging Loved One. It’s about the information caregivers need, and it will be available on Amazon in October 2016.
Having been in an accident that left me unable to easily communicate with first responders, I have even more appreciation for the value of a current emergency medical information card.
But it’s not just medical information that needs to be accurate. Take a close look at the person designated as the contact person on your loved one’s form or card. If it’s not you, be sure the contact is still capable of taking on that role and knows to get in touch with you. For example, an elderly gentleman designated his wife as his emergency contact years ago. She now has dementia and cannot serve as the contact. His card needs to be updated.
Remember to check your own emergency contact and be certain she’s still able and willing to be that person for you. My card listed my mother as my contact, but she was so badly injured (and injured in the same accident) that I wished I’d listed a second person. I/we needed someone to call other family members and clergy and begin to build the support network we’d need.
Finally, while you’re taking a look at your loved one’s card or form, double check that the medical and drug information is also current and correct. Do the same for yourself.
I’m curious about how and what your loved one carries. Is it a card or form or is it the printout she received at the end of her last medical appointment? How have you marked it so it’s easy for first responders to find in a wallet or purse? Please share in the comment space.
The last thing I did to care for my mom was to instruct doctors to disconnect the ventilator keeping her alive. That was on November 8, 2017. She died Nov. 13 at age 83.
My brother, Mike, and sister-in-law, Trisha, arrived at mom’s from their home in Virginia on Nov. 2 to celebrate Mike’s birthday. We enjoyed three wonderful days together. On Sunday, Nov. 5, the four of us headed to church with Mike driving. We were on Interstate 40 just outside Raleigh, NC when he suddenly lost consciousness. The car left the highway and went into the woods at highway speed, finally crashing into some trees. Trisha died at the scene and mom sustained severe injuries. Mike and I were also injured, though not as seriously.
On Monday, doctors rushed me into surgery to repair a perforated bowel. Later in the day, they took mom into surgery. There she went into cardiac arrest and they put her on the ventilator. They did so because I was so out of it I couldn’t tell them that’s not what she wanted. Finally, by Wednesday, I could explain that I was her healthcare power of attorney and she absolutely did not want to be kept alive artificially if there was no hope of recovery. There was no such hope.
A team of cardiologists diagnosed Mike with ventricular tachycardia and coronary artery disease. I’ve recovered from surgery, a broken rib, friction burns (seat belt), and concussion
I loved my mom, who was also my best friend. I loved being her caregiver, even on those days when she drove me nuts. I miss her more than I can say, and find myself envious of other mothers and daughters I see out together, the daughter holding onto an arm, or reading a menu, or helping her mom into a car.
Although I’m no longer a caregiver, I remain passionate about you — the millions of people in our country who are caring for aging loved ones. I will continue to provide you with information you can use.
As ever, if you have questions related to caregiving, leave them here. I’m happy to try to answer them for you. Thanks for reading.
(Note: This week’s blog is by Annette Adamska, Life + Legacy Organizer.)
Caregivers, I know you’re busy. Not only do you have to manage a slew of information for your loved one, but you have to do the same for your own family. It’s easy to prioritize others’ needs over your own, but collecting and storing vital pieces of information in one place enables you to get ahead and act strategically in anticipation of future needs, instead of feeling reactive to everything that goes on.
Put systems in place to enable you and others to access your loved one’s information when it’s needed. Here are a couple of tips to help get you started:
Use a Password Manager. Your brain is for thinking, not remembering. A password manager enables you to create complex, less hackable passwords without having to remember all of them. It also helps you more easily access information about your loved one that’s stored on online portals (such as medical information) and to access online banking and bill paying. The industry top three are LastPass, 1Password, and Dashlane. (Bonus tip: The Wirecutter is a great online resource that does all the researching and comparisons for you; from home goods to electronics. Here are The Wirecutter’s thoughts on password managers.)
Make it a double! Any task you do for your loved one, also do for yourself. In fact, this can be a way to approach your loved one for information without confrontation. You can approach the conversation as, “I’m doing this task for myself, and I’d love to talk with you and make sure we have everyone’s information that we need, if/when we need it.” This task involves making a list of all contact information, including contacts for emergency situations, healthcare providers, home maintenance, insurance, veterinarian, etc. Be sure all these contacts are in one easily accessible place and that they remain current.
Overwhelmed? Need help or a guiding hand, for either yourself or the person you care for? Please reach out and schedule a complimentary 20 minute consultation call with me to discuss your needs, and how I can help. I’d love to hear from you.
I met occupational therapist (OT) Netta Farber at a caregiver conference over the summer and learned what OTs can do to help seniors and their caregivers.
OTs perform home inspections, identify potential hazards, and make recommendations for modifications that will allow seniors to remain at home — to age in place. The most common problems Farber finds when she does home inspections include lack of grab bars in the shower, around the toilet, and on the side of the bed. Also, many seniors lack a shower bench and raised toilet seat. OTs can bring in samples of needed materials and make recommendations on what to install. Insurance, including Medicare, does not cover OT home inspections.
Medicare Part B does cover OT outpatient services that involve teaching patients how to function when they return home from the hospital or a nursing home. Skills include transferring in and out of bed and the shower, functioning in the kitchen, and activities of daily living such as dressing and using the toilet.
What questions do you wish clients would ask you? I asked Farber. “I wish they’d ask, ‘What habits could I change?’ and ‘How can I make my life simpler?’” she responded. But seniors are often resistant to change. That’s why an OT is more likely than family members to convince a senior to make needed changes. So when you look for an OT to help your loved one, look for someone who is not pushy and works to build rapport, Farber suggested.
(Editor’s Note: Netta Farber works at Physical Therapy 4 You in Cary, NC.)
If you don’t know about Certified Senior Housing Professionals (CSHPs), you should! I didn’t know they existed until I met CSHP Freda Hamlett over the summer at a caregiver conference.
CSHPs are real estate agents who, like other realtors, earn their money when a house sells. What makes them special is their breath of knowledge about seniors and the experts who can help them when it’s time to move. CSHPs assess a senior’s immediate and long-term housing needs. They then bring in help, including (though certainly not limited to):
- financial planning
- assessment of health issues
- home health options
- placement in appropriate senior housing (assisted living, memory care, etc.)
- packing or disposing of everything in the house
- repairing, staging, and selling the house and
Hamlett, a Cary, NC-based CSHP, earned her certification through the Senior Real Estate Institute (SREI). The certification provides CSHPs with “core competencies” necessary to work effectively with “older adults, senior living communities, and an array of service providers involved in late-life relocations,” according to the SREI. The training is rigorous and includes not only classroom work but also visiting senior housing facilities and meeting with home health companies, senior move managers, occupational therapists, and others.
One thing I found particularly striking is that Hamlett will not put a client’s house on the market until the client has a housing action plan. A house can sell the same day it goes on the market and that’s not good when the senior homeowner doesn’t know where she’s going next or is still on a waiting list to get into a facility.
There are only about 150 CSHPs in the United States. The SREI certification is relatively new can take a year to obtain. That’s why the Senior Real Estate Specialist designation — obtained through the National Association of Realtors — is a “diluted version” of the CSHP certification, Hamlett told me.
To find a CSHP in your area, visit the Senior Real Estate Institute website.
“Does she have an advance directive?” You’ve probably been asked this when interacting with your loved one’s medical providers. It’s important that you understand the different kinds of health care advance directives.
A Do-Not-Resuscitate Order (DNR) instructs medical professionals (such as hospital and nursing home personnel) not to perform cardiopulmonary resuscitation (CPR) when a person’s heart and breathing stop. A DNR covers only CPR; it does not apply to other medical conditions. If your loved one has a DNR it means that if/when her heart stops beating she will die because no one will do anything to resuscitate her.
A Medical Order for Scope of Treatment (MOST) is a medical order a physician, physician assistant, or nurse practitioner issues. In some states the MOST is known as a POST (Physician Order for Scope of Treatment) or a POLST (Physician Orders for Life Sustaining Treatment). A MOST instructs other health care providers on what to do (or not do) in certain situations. These situations typically include: CPR (thus replacing the DNR), different levels of medical intervention the patient does/does not want, and whether to administer antibiotics, fluids, and nutrition.
The original MOST should be in your loved one’s medical record. You need a copy of the completed form so you’ll know what it says. Ask your loved one’s health care provider for a copy. Be prepared to give that person a certified copy of the Power of Attorney; it’s what will give you access to the MOST.
You haven’t heard from me for a while. I’m still alive and kicking, but overwhelmed at the moment with caregiving, teaching legal research at Duke Law School, marketing my book, chasing dust bunnies, programming a new cell phone … You get the picture. So, I’m cutting myself some slack and taking a few weeks off from researching and writing blog entries. I know you understand and I’m grateful that you do!
In the meantime, this article on WRAL’s website caught my eye today. It’s an excellent overview of what happens when a loved one needs to move from a hospital to a rehab facility or nursing home. I don’t like the “What to do with grandma” title, however. She’s not a thing after all. But the article has great info.
Hope you have a great couple of weeks and that you’re cutting yourself some slack so you can take a breather, no matter how small the breath.
“I can’t remember if I took my [fill in the blank with a prescription drug name] this morning, so I just took it.” Have you ever heard this from your loved one and shuddered with fear that he might have taken a double dose? The last time I visited my pharmacy I learned it’s offering a new service to seniors to help prevent confusion about what to take and when. So I whipped out my phone, took these pictures, and decided to share what I learned.
A company called Omnicell produces SureMed, a cardboard card with plastic shells for inserting pills. What makes it special is that your loved one’s pharmacist fills the shells with his prescription and over-the-counter medications, on either a weekly or monthly basis. With experts counting out and filling the shells with the correct meds, your loved one is more likely to take what he’s supposed to take and in the proper dosages. As you can see, the shells specify the day and time of day to take the medication (morning, afternoon, evening, etc.).
According to the folks at my pharmacy, only independent pharmacies are offering this service. There’s small charge for it ($2.50/week at my pharmacy).
If you’re wondering whether indy pharmacies are paying me to blog for them (I’ve written a couple of blogs about the services they offer), they’re not! I’ve simply found that they provide a number of services unique to seniors that will benefit your loved one and help you care for him.
On an unrelated note, a big thanks to all of you who contacted me after my last post expressing concern about my family emergency. My younger brother had a heart attack August 16, and Mom and I rushed to Richmond, Virginia to be with him and his wife. He’s doing well thanks to the marvelous people in the cardiac cath lab at St. Mary’s Hospital. He goes back to work today and starts cardiac rehab this week.
Due to a family emergency last week, I don’t have a new blog for you this week. Sorry about that. You can look forward to new information next Monday, August 28. Thanks for your patience. And thanks for reading this blog!
Recently mom’s smoke detector batteries began their ear-splitting, dying-battery beeping. The local fire department changed the batteries and afterward she asked me the same question she always asks after such episodes: Why do I have to replace batteries in a smoke alarm system that’s hard-wired into my home’s electrical system? Rather than offering my usual shrug, I decided to find the answer. Here it is.
Some smoke detectors rely only on batteries for power. Others are hard-wired into a home’s electrical system and also have a battery to operate the device when the power goes off. Being plugged into the electrical system does not keep the battery charged. It loses its “juice” just like other batteries do over time. That’s why the fire department keeps replacing the batteries in mom’s system.
How can you tell which type is in your loved one’s home? Remove the alarm from the wall. If there are wires coming out of the back, then the system is hard-wired. Note that a hard-wired system may also be tied into the home’s security system.
Check with the fire department in your loved one’s community to find out if replacing smoke detector batteries is a service offered to seniors. If so, remind your loved one to take advantage of the program, especially if he or she cannot or should not be climbing on step stools or ladders (or chairs) anymore.
On a somewhat related note, my research also revealed there are three different types of smoke detectors: ionization, photoelectric, and a combination of the two. Ionization detectors are more responsive to flame, while photoelectric detectors are more responsive to smoke. That’s why fire officials encourage people to install the dual-type. For more information, visit the National Fire Protection Association’s website.