One of my organizing clients had parents who needed to move to assisted living. His mother had, over the course of her 87 years, collected over 600 pairs of costume jewelry earrings. “Mom,” he said, “you can’t take all those earrings with you.” Her response: “If I can’t take them with me I’m not going!” That’s when he called me. Thanks to special training and years of experience, I was able to sit with his mom, look through her earring collection with her, and convince her to donate 500 pairs to charity.
Professional organizers (POs) are a terrific resource for caregivers. As neutral third parties they can often diffuse tensions like the one I described. Downsizing is one task they can help with, and they know where and how to dispose of things your loved one no longer wants or needs. They also have an eye for what will fit into a smaller space and can keep you from having to be the “bad guy” — the person who says, “No, you can’t get that table into your new apartment. You have to get rid of it.”
If your loved one doesn’t want you sticking your nose into her business, a PO might be able to do what you can’t: help your loved one gather vital documents, legal papers, and financial and insurance information and organize and update it.
The National Association of Professional Organizers’ (NAPO) website lets you search for POs by zip code. Before hiring a PO, ask about his or her membership in NAPO and about certifications. Be sure the PO is insured and has the experience you and your loved one need.
At some point, you’ll need a break from caring for your loved one — time to rest, take a vacation, catch up on your own life, or do nothing at all. Respite care is the means to this much-needed time off.
Respite care is care provided to your loved one by someone other than you. It covers a broad range of care and services and may last a few hours or several days. Respite care providers include:
- Family, friends, or neighbors
- A companion or home health aide
- Adult day care
- Assisted living
- A nursing home
A good place to start your research on respite care options is with your local Department of Social Services, senior center, or Area Agency on Aging. These government entities can give you a list of respite care providers in the area and also tell you if there’s grant or other money available to help you pay for respite care under the federal Lifespan Respite Care Program. If your loved one has a long-term care insurance policy, contact the company and ask if the policy covers respite care.
Before you bring anyone into your home to care for your loved one, be sure he or she can provide the level of care your loved one needs. If you decide to hire someone on your own rather than using an agency or company, use the vetting methods described in Chapter 9 of Become an Informed Caregiver: What You Should Know When Caring for an Aging Loved One. Be sure your substitute has up-to-date lists of your loved one’s medications, allergies, limits on activities of daily living, and other vital information.
Finally, give yourself permission to take a break. It may feel scary but it’s important to take care of yourself — to put yourself first rather than your loved one.
Do you have experience with respite care? If so, I’d love to hear about it.
In April I blogged about Social Security Representative Payees (SSRP). But a question after my presentation last Monday night at the Chatham County (NC) Senior Center prompted this clarification.
The question: Does a caregiver need to ask the Social Security Administration (SSA) to appoint her as SSRP for her husband if the two have a joint bank account and the government automatically deposits her husband’s monthly benefits into that account? This is actually two questions. The first is whether the wife needs to be appointed as SSRP for her husband. If he’s unable to manage his affairs (incompetent), the answer is yes.
Assuming he’s incompetent, the second question is whether it’s acceptable for the husband’s Social Security benefits to go into their joint bank account. The answer is yes. “A common checking account for all family members living in the same household who receive benefits may show a parent or spouse as the owner of the account,” according to the SSA (emphasis added).
The answer is different if, for example, the SSRP is the beneficiary’s son. In that situation, the son must set up a separate bank account for his mother’s Social Security benefits. Although the mother owns the account, she cannot have direct access to it because she’s incompetent. The SSA recommends the son use one of two methods for titling the bank account:
“(Beneficiary’s name) by (your name), representative payee.” or
“(Your name), representative payee for (beneficiary’s name).”
Hope this helps! Let me know if you still have questions.
Sandra’s husband, Clyde, was a business owner for 30 years. He recently suffered a stroke and now lives in a nursing home. He can no longer manage his business. Sandra is his Power of Attorney and asked me whether she’s responsible for Clyde’s business matters in addition to his personal care.
The answer depends on many factors. The first is the legal form of his business: sole proprietorship, partnership, or corporation. A sole proprietor is the single person who owns and runs a business. If Clyde was a sole proprietor, the next factor is the Power of Attorney. Sandra needs to take it to a lawyer who can advise her on what to do — whether the document does or does not mention Clyde’s business. Among the questions she needs to ask:
- When quarterly taxes are due and how she can find out how much is due
- The papers she needs to file with the state to close the business and notifications to state and federal tax agencies
- Whether it’s appropriate for her to inform Clyde’s customers/clients of the situation
- How to dispose of property belonging to the business
- How long to retain financial and other documents
If Clyde was a partner in a business or owned a corporation, Sandra needs to read the partnership documents or articles of incorporation to determine what, if anything, she must do. Again, she should consult with an attorney for guidance on gaining access to those documents and on her responsibilities as Clyde’s POA. She also needs information on any rights Clyde retains, such as health insurance, retirement benefits, stocks, and so on. The information is crucial in determining how much money is and will be available to care for Clyde and for her, when the time comes.
Your loved one moved from her home into an apartment or assisted living facility, and there isn’t enough storage space in her new home. Additional downsizing is likely part of the solution, but you can also create more storage space in her home.
Tip 1: Use wire racks on pantry, kitchen cabinet, and closet shelves. This rack lets me stack items in my tiny pantry and remove them easily.
Tip 2: Install wire shelving on the insides of doors. It can accommodate many kinds of things. Warning: Shelves mounted by hanging over the top of the door can pull the door out of alignment, so don’t put a lot of weight on the shelves.
Tip 3: Small rolling carts fit into all sorts of spaces. This one is in mom’s laundry room and houses her tools, picture hooks, batteries, and similar items.
Tip 4: Use vertical space. Here, we hung the folding racks mom uses to dry clothes that can’t go into the dryer. We also hung her broom and Swiffer. It’s all out of sight behind the laundry room door.
Tip 5: Install a cabinet (like this one) or a larger piece that sits on the floor over the toilet for more bathroom storage. If you use one that sits on the floor, attach it to the wall with straps or screws.
Tip 6: Use this thin but sturdy shelf liner for wire shelves and racks to keep small things from falling through the gaps in the wires.
Tip 7: Finally, specialty hangers that hold multiple garments or other items are a great way to save space in closets. As you can see, I use a pants hanger for my shawls. Specialty hangers are available for ties, belts, scarves, pants, skirts, blouses, purses, and more. Before you buy any with clamps, be sure your loved one has the strength to open and close them.
Happy Independence Day! I’m taking the holiday weekend off, so there’s no blog this week. Look for the next blog on Monday, July 10.
Also, I wanted to let you know I’ll be doing a presentation and book signing at the Eastern Chatham Senior Center in Pittsboro, NC on Monday, July 17 at 6:00 pm. I’d love to see you there!
Thanks again for reading Dive Into Caregiving and for your feedback. Feel free to send me suggestions for future blogs by sending a comment below. I won’t publish your comment unless you give me permission to do so.
If I was President, I’d invite every caregiver to the White House. You would emerge from a limo in your finest clothes onto a red carpet, temporarily blinded by camera flashes. Once inside, I would place a medal of honor around your neck and give you a hug. This is what I would say.
I see you. I see your late nights and early mornings. I see the job or career you had to leave in order to care for your loved one, and I see the consequences of that loss of income and benefits. I see your frustration with insurance companies and bureaucracy and the hours you spend on the telephone. I see the strains on your marriage and relationships with family and friends. I see you spending your savings to care for your loved one and I see your fear of having nothing left for your own care. I see the deep breaths you take before you repeat what you just said — for the tenth time in two minutes. I see your grief each time your loved one looks at you and has no idea who you are. I see your heartbreak when your loved one is suffering and you can’t do anything to help.
When I look at you, I see courage. Behind that courage, and behind the stress, anxiety, exhaustion, frustration, grief, joy, and fear, I see your love.
Thank you for all you do, for your compassion, generosity, patience, courage, and love. Thank you on behalf of loved ones who no longer know what you’re doing for them or who cannot communicate their thanks. And thank you, on behalf of our nation, for your selflessness, the example you set for others, and for caring. You are deeply and profoundly appreciated.
You’re out of town when your loved one calls and tells you he’s having intense chest pain. You tell him to call 9-1-1. Emergency responders arrive at his home to find him unconscious, unable to give them any information about his health history, the medications he takes, his allergies, or your contact information.
Sounds like a nightmare for everyone, yes? But what if, when EMS arrived, they saw a Vial of Life sign on his front door? That sign would send them to his refrigerator where they’d see a Vial of Life magnet on the fridge. Inside, they’d find a large pill bottle labeled Vial of Life in the refrigerator door. Inside the bottle, they’d find a health information form you filled out earlier with all the basic information they need to treat your loved one and to take to the hospital.
Contact the fire department in your loved one’s community and ask for a Vial of Life. If they don’t participate in the program, make your own Vial of Life and put signs on the front door and refrigerator. If you need an information form, send me an email (use the comment space below – I won’t make your email address public) and I’ll send you a pdf.
Important: Fill out the form in pencil! Medications and other information change and you need to be able to update the form. The system doesn’t work if the info isn’t current.
Imagine lying in your bed, unable to move or summon help when suddenly hundreds of red imported fire ants sting you repeatedly. Every summer this nightmare happens in a nursing home or hospital in the southern part of the country. Sometimes the results are lethal. So with summer in full swing and the ants making their way into other parts of the country, I thought I’d call your attention to their threat.
Red imported fire ant stings are painful, but for immobile, cognitively impaired seniors, their stings can be lethal. These ants are aggressive and attack en masse by the hundreds or thousands. Each ant can sting multiple times. Their venom can cause anaphylactic shock within minutes of their stings. People with heart conditions or diabetes may be more vulnerable to the venom.
Deaths usually occur because nursing home personnel fail to check on patients as often as they should or fail to notice or remedy infestations. If your loved one is in a nursing home or hospital, look for these ants. They’re easy to spot because they travel together in trails. If you find a mound in your loved one’s yard, contact an exterminator immediately.
Red imported fire ants have so far infested Alabama, Arkansas, California, Florida, Georgia, Louisiana, Maryland, Mississippi, New Mexico, North and South Carolina, Oklahoma, Tennessee, Texas, Virginia, and Puerto Rico.
I recently talked with a friend whose mother (I’ll call her Betty) has dementia and lives in a senior housing facility. One of Betty’s paid caregivers took her out one morning last week. By the time they returned to the facility, temperatures were in the high 80s with high humidity. When the caregiver got out of the car to get Betty’s wheelchair, she closed the driver-side door. Her keys were locked in the car with Betty. Because Betty has dementia, she couldn’t unlock the doors or open a window.
The caregiver called AAA for help getting the car unlocked and also called EMS. Once Betty was out of the car, emergency medical personnel evaluated her and gave her water. Betty was fine. My friend was freaked out and asked me to remind my readers that the elderly have as great a risk of dying in hot cars as do children.
Older adults — those 65 years and older — are more susceptible to heat stress than younger people for several reasons, according to the Centers for Disease Control and Prevention.
“1. Older adults do not adjust as well as young people to sudden temperature changes.
2. They are more likely to have a chronic medical condition that changes normal body responses to heat.
3. They are more likely to take prescription medicines that impair the body’s ability to regulate its temperature or that inhibit perspiration.”
So please don’t leave your loved one in a hot car this summer, particularly if she is unable to get out on her own for whatever reason. And remember to check on her one two or three times a day during heat waves to be sure she’s staying cool and hydrated.