Stepping into the caregiver role
Most Americans will be caregivers at some point during their lives. In fact, informal caregivers, mostly women, provide 80 percent of the long-term care in the United States. Many caregivers have a family of their own, including children, as well as jobs that are necessary to support their family. The term "sandwich generation" is quite fitting – caregivers are stuck between the needs of their parents and the needs of their nuclear family. It can be exhausting.
"Caring for my mom is stressful, sad and very upsetting," says Debbie Walden, age 42. Walden is a mom of two and executive recruiter who is balancing family, caring for her 75 year old mom with Alzheimers', and a full time job.
"The first sign of my mother's cognitive decline was about 1-1/2 years ago when we noticed that there were some unpaid bills and some checks that went to the wrong companies," recalls Walden. "In addition, she was having problems completing sentences. I called my older brother and said, 'We need to do something.'
The toll of caregiving
When the physical or mental health of a parent (or both parents) starts to fail, it's a natural instinct to want to come to the rescue. After all, your parents have cared for you throughout your life. Stepping into that caregiver role, however, often puts your own physical and mental health at risk.
"Women in the sandwich generation often try to do it all," explains Claudia Fine, LCSW, MPH, CMC, executive vice president and chief professional officer at SeniorBridge, a professional geriatric care management company. "It's very difficult to juggle working, childcare, marriage and now parent care and impossible to do well. Then, when you don't do it well, it leaves you with a sense of not feeling good or competent, and perhaps even guilty."
Fine has worked in the field of eldercare for over 20 years and was a partner with the New York City-based Fine & Newcombe Associates, a pioneering firm in the private eldercare field which was acquired by SeniorBridge.
"We know these kinds of stressors contribute to mental health problems and physical problems, such as hypertension, overeating, being too busy to exercise and simply not attending to your own needs," the eldercare specialist adds.
In addition to health problems, your marriage can suffer. The level of attention you are now giving to your parent can make your spouse and children feel abandoned, angry and resentful, even though they love the parent in need of care.
Caregiving with outside help
Fine suggests that as soon as you start feeling "sandwiched" you should seek the advice of an eldercare professional – and not
feel guilty about it. It can not only reduce a significant amount of stress for everyone involved but will also probably improve the care your parent receives. She explains, "A geriatric care manager looks at the entire constellation of factors that contribute to problems and stressors and considers each individual's assets and strengths… and can link you to the right resources, and ultimately partner with you to coordinate them."
Further, your ailing parent may be able to remain at home with professional geriatric care instead being hospitalized. According to a 2009 AARP study, 90 percent of seniors want to stay in their current home as long as possible, and those that do, actually fare better. "Evidence shows that we can better health outcomes and be more cost efficient with our health spending when we can provide chronic care for the most common conditions in the home, says Eric C. Rackow, MD, a national authority on critical care medicine.
Dr Rackow is president and chief executive officer at SeniorBridge, and chairman of the board of trustees of the Weil Institute of Critical Care Medicine, a well-recognized international center of medical and biomechanical engineering research in critical care and resuscitation medicine.
Be proactive with your parent's care
Dr Rackow suggests that members of the sandwich generation should think proactively about aging. That means getting professional advice about what to expect with their parents' care before
a crisis and need for hospitalization occurs.
Examples of being proactive include:
- Instead of waiting for your mother to break her hip from a fall, get a professional to conduct a home assessment.
- If your parent is having memory lapses and taking more than three medications a day, consider having someone manage their medications before medication errors occur.
- When you see cognitive impairment warnings signs, ensure bill pay is overseen before parents becomes victims of financial abuse.
- Be aware that as we age we are more susceptible to depression. Support your parents' social activities and make sure they don't become isolated.
"These are the types of services a professional geriatric care management company provides," the critical care expert adds.
Another way to be proactive is to encourage your parents to take care of their health (and you do the same). "Clearly it all starts with prevention," says Dr Rackow. "If people learn how to eat right, exercise, and lead healthy lifestyles, they will be less apt to have chronic illnesses like obesity, diabetes and pulmonary disease."
Approaching your ill parent about geriatric care
Even though you are an adult, your mom and dad still see you as their child. Telling them that they need geriatric help can lead to a power struggle and hurt feelings. Fine says that despite it being hard news to deliver, there are a few effective ways to approach your ailing parent about introducing outside senior care.
1. Put them in the driver's seat. Position the help that you are introducing in as someone your parent will manage - that they are employing - even if this might not be the case. Language like "Mom, I'm going to give you a consultant to help you organize the papers piled up in the house" is the kind of message you want to convey as opposed to "you need help."
2. Let them parent you. Explain to your parents that this kind of help is as much for you as it is for them. Tell them you need to know they are safe in order for you to have peace of mind.
3. Bring in the experts. Ultimately these approaches may not work and you will need to back away. Consider asking a doctor, lawyer, or financial advisor to recommend or even prescribe that your parent hire a geriatric care manager.
You can approach your parent alone or do it with a sibling or another close loved one – just don't make it seem that you are "ganging up" on your parent. You may find that your parent is more receptive and that finding care for your parent with another loved one can give you the support that you personally need. Walden teamed up with her brother to care for her ailing mother. "My brother and I are close; the experience of caring for my mom has strengthened our family relationship," she says. "We found out that we are team players and are giving mom the care she needs now after all the years she took care of us."
Take care of yourself
According to WomensHealth.gov, the federal government source for women's health information, about 75 percent of caregivers who report feeling very strained emotionally, physically, or financially are women. Walden suggests making the time for self-care, something that has helped her successfully manage her mother's care, keep her family together, and continue on in her career.
"Make time for yourself every day – make it a priority to schedule an hour a day for yourself," she stresses. "Even if it's 9pm, I walk outside or go on the treadmill."
Walden also recommends spending time with friends outside of family, such as a girl's night out (even if it is only once in a while), and staying proactive about communicating needs to family members. "My kids know that Grandma has memory problems and needs extra help, so if I miss a game because I have to go down to Grandma's, they understand and do not blame me," she adds.
Dr Rackow can't emphasize enough that geriatric care management is a crucial step in making sure that everyone involved gets the best care possible. "We don't realize what kind of impact the stress of being responsible for a parent can have on us -- and caregiver stress can negatively impact your health," he explains. "That's why it is important to share the responsibilities and perhaps seek professional help."
More on caring for your family
To learn more about how a professional geriatric care manager can help you care for your elder parent, visit www.seniorbridge.com.