All posts tagged: communication

How to Communicate With Someone With Alzheimer’s.

  It’s tough looking after an elderly person especially, someone who has a condition that doesn’t allow them to be as independent as they used to be. I’ve been caring for my mother who has Alzheimer’s for over 5 years now, and as her memory and motoring skills become worse, the most significant difficulties I’ve experienced while caring for my mother, is communication. Whether it’s asking what she wants for her dinner or reminding her who I am, I’m always struggling to find a way to talk to her. This should be easy though, right? She’s my mother, I’m her child. She raised, she fed me, she clothed me. She attended all my doctor and dentist appointments with me. Well now it’s my turn to take on the maternal role. However, there are just times I cannot find a way for her to understand me, and vice versa. Whilst juggling laundry, grocery shopping, feeding and clothing my mother, I’ve found some time efficient ways on how to take things one step at a time.

Tips for communicating with a person with Alzheimer’s

  1. Let them know you’re there. It might sound obvious enough, but patients with disorders may not be aware of their surroundings or people. A gentle “hello, how are you doing?” or a simple touch to the hand every now and then won’t go unappreciated
  1. Distract them if they get upset. This is what I’ve found to be the most useful method had there ever been one! It’s often difficult for caregivers to figure out what’s wrong or what the problem is when the patient is distressed, but it’s incredibly frustrating for them when we can’t figure out the cause. Instead of investing time to find solutions, distract them with something they can relate to. For example, my mother loved getting dolled up to attend weddings and events, so I would show her all the fancy dresses she used to wear and remind her she can wear them on our next outing
  1. Make them feel involved. Inform the person with Alzheimer’s of current events and affairs, or make them help you fold the laundry. It may be meaningless to their lifestyle, but it’ll feel nice for them to feel involved with daily routines. Making polite small talk helps them to feel included. It’ll remind them of times in the past where they were active contributors to society. This is also a good way to pass time.
  1. Don’t be a fuss pot. Sometimes, they like to be just as they are. It’s important to give them their independence and space. This is as important to them as it is to you.  Giving them space will also improve your patience with them. Let them hold that glass of water all by themselves. Teach them how to hold a spoon or plate during dinner. This way, both you and the person with Alzheimer’s are helping each other, and this creates a special bond during these difficult times
  1. Patience goes a long way. Cliché, I know, but it really does go a long way! A lot of people think caring for an elderly person is a lot like looking after a child. It is. But it’s far more difficult than that. Children can be taught how to dress themselves; they can remember events from the day before. Elderly people can’t necessarily do these things anymore, or not as well as they used to. It takes time and a whole lot of patience to care for any person and the best way to do so, is to take one day at a time, one step at a time.
Some motivation for caregivers of adults with Alzheimer’s: At the end of the day, you, the caregiver, are there to provide the best care you possibly can for the person suffering from symptoms of Alzheimer’s disease. It’s the little things you do that help them throughout the day. They may seem likes chores at times but you’re making a huge difference in their lives. Although they’re a big part of your life, you’re the main part of theirs. You may be the only person the person with Alzheimer’s can remember or the only person they have to talk to. But, my final piece of advice as someone who is quite experienced in looking after the elderly (adults with and without Alzheimer’s) as well as children – don’t forget to look after yourself!  

Want to know more about working with someone with Alzheimer’s? CareAcademy’s professional online caregiver courses jumps-start your eldercare career.

Siddiqa KhalifaHow to Communicate With Someone With Alzheimer’s.
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How to Spot Changes in Older Adults

Caregivers for older adults need to understand when and how to get assistance. In particular, non-medical caregivers should be clear on when to refer to a registered nurse, and when to call 911 in an emergency.

Identifying Changes in an Older Adult’s Condition

When you are a caregiver, things can happen any time and you always need to be prepared with a plan of action in case of emergency. The older adult may stop breathing, have a heart attack, stroke, a diabetic complication or other physical or mental emergency.
If you ever feel that the older adult or you are in any immediate danger, you need to call 911.
You may also consider completing a first aid or CPR course, which can be enormously helpful.

Early Identification is Key to Best Response

Early identification of changes in an older adult’s daily routines, behavior, ways of communicating, appearance, general manner or mood, or physical health can save his or her life. When you have spent time with a person, you get to know what is normal and usual for them, and you will be able to tell when something has changed. Some of the changes you can observe yourself, and others the older adult themselves will complain of.
What is most important is a CHANGE in the patient’s condition, or something different than usual.  
Look for changes in their functional ability, body, mental status and environment.

How to Spot Physical Changes in Older Adults

For physical changes, you should first ask yourself:   Are there any changes to any part of the older adult’s body that you notice? Physical changes in older adults to pay attention to include:
  • Overall: fever, lethargy (tiredness), chills
  • Head & Neck: headache, stiff neck, dizziness
  • Skin: redness, swelling, cuts, rash, new numbness or tingling
  • Eyes: redness, drainage, swelling, reports of pain or burning
  • Ears: pulling at the ear,ringing in the ears, diminished hearing, drainage, dizziness or pain
  • Nose: runny discharge, rubbing the nose, congestion
  • Mouth & Throat: eating less, redness, white patches at the back of the throat, hoarse voice, fever, toothache, facial or gum swelling, bleeding, pain when swallowing
  • Muscles & Bones: limited mobility in a leg or arm that the older adult could previously move, stiffness, pain, limb out of alignment with the rest of the extremity, joint swelling
  • Heart & Lungs: chest pain, new or changing cough, shortness of breath, wheezing, new numb or cold hands or feet, swollen ankle
  • Abdomen: abdominal pain, nausea, vomiting, loose stools or diarrhea, constipation, blood in vomit or stools, painful or burning urination, changes in urine color
  • Women: new or changing vaginal discharge, itching, unusual odor, burning, bleeding
  • Men: discharge from penis, pain, itching, redness burning.

Paying Attention to Mental and Emotional Changes in Older Adults

For mental and emotional changes, you  should ask yourself the following questions: Does the older adult appear to be “himself” or “herself”? Has their ability to communicate change? Have they lost interest in taking care of themselves or doing any activities they previously enjoyed? Has their mood changed and do they want to be alone more? Mental & Emotional changes in older adults to pay attention to include:
  • Overall attitude: An older adult who is usually very friendly becomes quiet and to themselves; an older adult who is usually very talkative suddenly wants to be alone more.
  • Behavior: an older adult who is usually calm is more irritated or aggressive than usual.  It could also be the opposite – they may become less active than usual.
  • Ways of communicating: an older adult who usually is talkative stops talking; speech becomes garbled or unclear; the older adult doesn’t seem to understand you, but they usually do.
  • Relationships: The older adult may act distant or afraid when certain family members, visitors or professional caregivers are around.
Changes in the older adult’s home environment to pay attention to:
  • Finances: see if their are any obviously unpaid bills, utilities cut off, and if there is sufficient food available.
  • Cleanliness: Ensure the older adult is able to continue their previous level of housekeeping chores
  • Home maintenance/safety: See if there are any repairs that need to be done that could cause a health or safety hazard.

Top communication skills help caregivers give better care. Check out our online course for Communicating with Older Adults.

Madhuri ReddyHow to Spot Changes in Older Adults
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How to Resolve Conflict

This is the second in a two part series to help in-home professional caregivers learn the fundamentals of professionalism. This article focuses on how to resolve conflict, utilizing good problem-solving skills, which is necessary for anyone to be seen and treated as a professional.

Resolve conflict utilizing good problem-solving skills

Problems or conflicts are a normal part of any healthy relationship. After all, people and teams can’t be expected to agree on everything, all the time.  That is why learning how to resolve conflict, rather than avoiding it, is very important. In fact, when conflict is handled in a respectful, positive way, it can become an opportunity to strengthen the bond between people and groups. Conflict arises from differences, both large and small. These disagreements can trigger strong emotions. Once emotions are involved, it can become very difficult to get the other person or group to see what you are seeing.

Proper problem-solving

The ability to successfully resolve conflict depends on your ability to manage stress quickly while remaining alert and calm; control your emotions and behavior; pay attention to the feelings being expressed; and be aware of differences and respect them.

Tips for managing and resolving conflict

Pay attention to nonverbal communication.

As we discussed in our blog about how to be a better communicator, the most important communication is wordless, expressed by facial expressions, posture, tone and intensity of  voice. Listen for what is felt as well as said. When we listen in this way, we connect more deeply to our own needs and emotions, as well as those of the other person, and may help you figure out what the other person is really saying. A calm tone of voice, a reassuring touch, or an interested or concerned facial expression can go a long way toward relaxing a tense exchange.

Make conflict resolution priority

Rather than winning or “being right,” focus on resolving conflict and coming to agreements that people can live with. Maintaining and strengthening the relationship, rather than “winning” the argument, should always be your first priority. Be respectful of the other person and his or her viewpoint.

Focus on the present.

If you are holding on to grudges from previous arguments, your ability to see the reality of the current situation will be impaired. Rather than looking to the past and blaming someone else, focus on what you can do in the here and now to solve the problem.  
  • Find a point of agreement
  • Acknowledge the other person’s statements.
  • Listen carefully and repeat what you heard
  • Separate the behavior from the person
  • Describe how you feel
  • Describe how this affected you.

Pick your battles.

Resolving conflict can be draining, so it is important to consider whether the issue is really worth your time and energy.

Be willing to forgive.

Resolving conflict is impossible if you are unwilling or unable to forgive. In order to resolve a problem, we need to be able to let go of the urge to punish, which only adds to our injury. Don’t further deplete and drain your life.

Know when to let something go.

If you can’t come to an agreement, agree to disagree. It tasks two people to keep an argument going. If a conflict is going nowhere, you can choose to disengage and move on. The bottom line in: when you care about someone, you will attempt to resolve conflict with them in a mature, kind way. Be sensitive and respectful. Present the feedback (if to your employer) as a gift, then let the conflict go.  

Become a professional Eldercare Provider. Get certified with CareAcademy.

Madhuri ReddyHow to Resolve Conflict
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How to Be a Better Communicator

This is the first in a two part series to help in-home professional caregivers learn the fundamentals of professionalism. This article focuses on how to be a better communicator. Good communication skills are necessary for anyone to be seen and treated as a professional.

What is communication?

What does the word ‘communication’ mean to you?

If you think communication is about “talking,” you are not wrong. But talking is only one part of communicating. Communication is a way of connecting with others and sharing information.  Not only does it include “what you say,” but also “how you say it.”  Being able to communicate well is one of the most important life skills.  How well you are able to both give and receive information will demonstrate just how good your communication skills are.  

Effective Communication Is A Marketable Skill Set

Good communication in eldercare is an essential skill that employers look for. You need to be able to communicate well with your client, their family, your supervisor and your co-workers. Through communication you can gather information, build trust and request assistance.  Being able to comfortably talk with others and listen to them opens the door to cooperation and positive relationships. Learning how to be a better communicator is important. In all interactions, communication is the bridge to learning what your client, supervisor, and co-workers need and want. From introductions to day-to-day communication, you will establish many relationships. Have the courage to say what you think, and be confident in knowing that you can make good conversation.  Developing great communication skills begins with simple interactions, and like anything else, it requires practice. It is never too late to work on your communication skills and improve your quality of life.  Improving your communication skills will help all aspects of your life, from family life to social gatherings.

A Good Communicator’s Secrets

There is a secret to good and effective communication, and it includes the following key parts:
  • Verbal communication
  • Non-verbal communication
  • Being a good listener

Using Verbal Communication

How to properly introduce yourself. One critical skill everyone should be able to do well is introduce themselves. You will be introducing yourself many times throughout your workday, especially during the first few weeks of work. The first few minutes you meet someone are extremely important, because first impressions have a significant impact on your future communication with that person.
  1. Introduce yourself by using your first and last name the first time you meet someone.  It might be a good idea to wear a name badge to help others remember your name until they get to know you better.
  2. A handshake is often appropriate.  Make sure that it is firm, but not too firm.
  3. Be friendly, with a smiling face. This is much more likely to encourage communication than a blank face, or a facial expression that makes your look bored or irritated.
  4. Use a relaxed and friendly tone of voice. This will help keep you and the other person calm.
  5. Use your client’s proper name when speaking directly to or referring to them. Some clients may ask that you call them by their first name. Others may prefer that you address them by Mr. (last name) or Mrs. (last name). You should not call them by nicknames such as “honey” or “sweetheart.”

Using Non-Verbal Communication

Body language By “using” non-verbal communication, we mean how to be a better communicator without talking or using words.  One major way to communicate non-verbally is through body language, or the movements and positions you put your body in to express feelings and other information.  Remember that your “body language” will say more than words.  For instance, positive body language is more likely to encourage open communication from other people. 

Tips to using body language effectively:

  1. Your body language should match what you are saying. Even people with severe memory problems who have difficulty understanding what you say, can still “read” your body language.
  2. Establish eye contact. This means looking at the person to whom you are talking. Eye contact tells the other person you are listening and that you mean what you are saying.
  3. Want to look friendly? Smile!
  4. Nod to show that you are listening to what they are saying to you.
  5. A touch can help build a warm connection and show that you care.  Just think of something as simple as touching the older adult’s shoulder, or holding their hands. It doesn’t have to be a huge gesture. Of course, you should only touch someone if they allow you to touch them.  This shows that you respect their personal space.
  6. Keep your cell phone off and out of sight when having a conversation with your client, supervisor, or co-worker.  That way, you can keep your attention on them.

Being a Good Listener

Listening is extremely important, often more so than talking. “Active listening” requires practice and self-awareness to do well.

Essential tips for effective and active listening:

  • Be prepared to listen
  • Keep an open mind and concentrate on the speaker’s message
  • Delay judgment until you have heard everything
  • Do not be trying to think of your next question while the other person is talking.  Most of us spend more time thinking about what they are going to say next instead of listening to what the other person is trying to say.
  • Repeat back the main point of what the person said.  You can even do this in the form of a question.  Doing this helps show that you find the conversation interesting, as well as the person.  It also shows that you understand what was said and would like to learn more.
The hard work that eldercare givers perform every day is based on being a great communicator. No one who works with people can communicate ineffectively and keep up the job for long – there’s just too much personal communication involved. Learning how to be a better communicator always pays off – at work and in your personal life.  

Being a true professional is invaluable. Eldercare professionals are certified by CareAcademy.

Madhuri ReddyHow to Be a Better Communicator
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6 Tips to Avoid Family Conflicts

One of the most trying aspects of life comes when a family member is aging. Whether the argument is over driving privileges, housing options, or financial issues, getting older can definitely take its toll on even the closest of families. In order to avoid these kinds of family conflicts and trying arguments, verse your family in these tips to make getting older a less frustrating process. Be Open Arguments build over time when the people affected do not speak up soon enough. Avoiding family conflicts becomes easier when everyone understands how someone is feeling. If your mother or father do not want to give up their right to drive a car, it is important that he or she says so. If your children think it is important for you to stop driving for your safety, it is also important that they say so. Heated arguments can be avoided, if you just take a little time to listen and communicate how you are feeling. Be Sensitive Now that you have learned to communicate your feelings, it is also important to be sensitive. Aging is a hard process for everyone, and there is no right way to settle your affairs. Be sure to be patient and kind when discussing matters such as housing, diet, exercise or driving. This way, elderly family members are more likely to come to compromises with their children or other relatives. Be Gracious Finally, remember that things change. While one situation may have worked out for you and your family in the past, it may be time to move on to new and better things. By understanding that aging happens to the best of us, you are that much closer to still living your life.

Tips To Help Your Family

Here are 6 tips to help avoid family conflicts:
  1. State the problem and determine who needs to work together to develop the solution. When family members clearly identify a problem, they can begin to work on it. However, when people don’t acknowledge the problem, or avoid discussing it altogether, a successful resolution becomes impossible.
  2. Establish ground rules for resolving the problem. Before discussing ways to resolve the problem, set some rules for the discussion. For example, agree that no one will call anyone names, or ban yelling. Encourage small breaks from the discussion if tempers flare, and emphasize the importance of resolving conflict peacefully.
  3. Brainstorm solutions to the problem. Allow everyone involved to offer input into potential solutions. During the brainstorming process, don’t judge whether each solution is good or bad, but instead, create a list of potential solutions.
  4. Evaluate the risks and benefits of each potential solution. Listen to each family member’s input about the pros and cons of the solutions.
  5. Reach a solution as a team. Try to reach a consensus about which solution will best resolve the conflict. Be willing to negotiate, and encourage family members to be open to new solutions.
  6. Identify what each family member will do to work on the solution. Each person should identify action steps he or she will take to work toward the solution.
There are many ways you can prepare your family for the transitions that come with aging together. Want to learn more about professional caregiving, conflict resolutions, and solving family conflicts? Check out CareAcademy’s Eldercare Classes for more.
Elayne Forgie6 Tips to Avoid Family Conflicts
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How to Be Part of an Elder Caregiver Team

This is a multi-part series to help in-home professional non-medical caregivers learn practical non-clinical skills on approaching their day to day professional life. In Part IV, we will discuss your rights as a professional caregiver and your role as a team player.

Your Rights As a Professional Caregiver

Now that you know about your responsibilities and what you should expect on the job, we will now discuss your rights.  There are several rights that you have that are protected federally and no matter what state that you live in.  As a professional caregiver, you have the right to:
  • Provide input for changes to a client’s care plan
  • Receive timely payment for services, including salary and mileage compensation (of course, where appropriate)
  • Take care of yourself
  • Work in a safe environment without workplace violence
  • File a complaint without the fear of retaliation
  • Not to be abused emotionally, sexually, financially, or physically
  • Be informed when a client files a complaint against you
  • Be entitled to a confidential investigation and a fair hearing, in addition to being told what the outcome will be, when addressing the complaints against you

Team Work

Caregivers are often part of a team that help to make the home run smoothly and make sure that clients receive the best care. Each caregiver needs to fulfill their responsibilities. When you begin working, it will be important to know what your responsibilities are and how to carry them out.  What’s equally important is getting to know the other workers who make up your shift or team. Professional caregivers are extremely important to the day-to-day operation of the home, in addition to being important to the clients themselves. When you are scheduled to work, the entire team is depending on you to be there, including the clients who depend on you for their basic care. When staff calls off, it slows the whole team down, and often makes it harder to get the job done. The members of the care team will vary, depending on the size and organizational structure of your agency. A likely team will consist of your direct supervisor, who may be a nurse, specialists and nutrition staff, as well as other shifts of caregiving staff.  At the center of the care team is the client, surrounded by their needs and preferences. When a team works well together, it can provide better and more comprehensive care to a client than staff members working separately. Good teams have the following traits.  They are:
  • Able to work together toward a common goal of providing the best care possible for clients
  • Communicate well with the team with each other and their clients.
  • Support of one another in caring for the client and each other.
  • Able to share responsibility and do what needs to be done attitude.
  • Striving to improve through continual learning and growth.
Working as a professional caregiver means that you are working as part of a team. The rest of the team includes the older adult, their families (spouse, adult children), supervisor, agency, and also probably others including a nurse, therapists, and your client’s physician. It is important to know when to call these other team members for help, and it’s important to have excellent communication skills.  

Being A Team Player:

As a professional caregiver you play a key role on the care team because you provide the day-to-day care for clients. You see more than anyone else about what is going on with your client. You are responsible for contacting your supervisor or others on the care team to get the help any client  needs. You need good observation skills and good communication skills to relay the information you observe about your client to other members of your team. You need to follow these steps: Watch for changes: Notice changes that may signal the need for special attention or additional care. Report all changes, including changes in a client’s needs: Reporting is when you verbally communicate observations and actions to your supervisor. This helps other members of the team keep up with your client. If you are in doubt, it is always better to report something, and always better to check if something is within your scope of your role. It’s always better to ask for help, than not ask and risk putting you, yourself, and your agency in danger. Document carefully: Documenting is the written record of what happened, what you did, and how the patient reacted. The other word for “documenting” is “charting.” If it isn’t written down or documented, it is like it wasn’t done. It can be very important to protect you legally, so make sure you write down everything. Use ink to neatly write everything that you did, as well any changes in the older adult’s condition, and whether you informed anyone (like your supervisor) or the older adult’s family. Write down what you did or didn’t do as it is written in the care plan. Sign and date all your documentation. Make sure you communicate regularly with your supervisor and the caregivers on the shifts before and after yours, so that care transitions can be made smoothly. Want to boost your entire team? Become a Certified Professional Elder Caregiver.
Madhuri ReddyHow to Be Part of an Elder Caregiver Team
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Professional Caregiver for Older Adults – Part II: Getting to Know your Elder Client

This is a multi-part series to help in-home professional, non-medical caregivers learn some practical, non-clinical skills on how to approach their day to day professional life. In Part II, we will discuss how to get to know your elder client, communicating with your employer, maintaining your client’s privacy, and how to best manage your cell phone use.

Getting to Know Your Elder Client

Imagine being an older adult and as you get older, having to rely on a series of caregivers from your adult children to a rotating assortment of different caregivers with different names and faces. As caregivers, we need to understand that this is the reality for many of our clients. It’s important to get to know our clients on the very first day, the things that they like and don’t like; this helps them maintain a sense of connection to independence while helping to provide the best professional care. At CareAcademy we believe that you’re not just caring FOR your clients; you’re a team caring WITH your clients to help make sure they can stay at home for as long as possible. No matter if your elder client is fully cognitively intact, very active or even has dementia, on your first day make sure to greet your client and introduce yourself. Make sure to smile keeping your voice warm and inviting. Whether you’re in the home for 2 hours a week or every day, this first impression goes a long way. You are a stranger until they learn more about you and you make an attempt to learn more about them. A great way to get to know clients is to ask them to show you around their home and ask questions. For instance, a caregiver may ask a client living in their home “What is your favorite chair in the living room?” or if you’re putting something away and doing housekeeping, you could ask, “Where should I put this or where does this go?” It is a small way off offering the elder client independence while maintaining the privacy of the client that may not be ready to share with a new caregiver. Even beyond the first day, keep asking questions to make clients feel in control and opening up the lines of communication and trust. Some of the things you can try first day is to ask about likes and dislikes. If you’re making lunch ask your client what are some things that they may like to eat. If an elder client isn’t verbal or able to tell you start taking note of  some of the things that they do like. It can be a good idea to keep a journal of observations that are separate from a care plan to notice small details that may be more about likes and dislikes that help you get to better know and learn a little more about your clients.

Communicating With Your Agency or Employer

Many older clients don’t manage their own care; it’s often left to a family member such as an adult child, spouse, or other family member. Your agency may have software or a calling system and procedures about how you check in. If you have to call in to make sure that your hours are counted as starting work, make sure you do so. One of the things caregivers can do is set two alarms in the morning on a personal cell phone. The first one is to wake up, the other is to make sure that you call in or check in with your agency or clients’ family. It’s easy to get started on your day and completely forget, so make this a priority in order to build trust with your employer and make sure you’re paid for your work. Throughout the working day make sure you return any calls from your clients’ family or agency promptly and if this is your first day on the job, program all necessary phone numbers into your cell phone before you start the day.

Maintaining Your Client’s Privacy and Respect

The first day is always the best day to show how you respect your elder client in words and actions. A professional caregiver thinks about how we care not just for but WITH our clients. To think about the ways that we help care WITH our clients we can try putting ourselves in our clients’ shoes. If you relied on a caregiver for bathing or toileting, how would you want to be treated? Actions speak louder than words and whether or not there is someone else present, make sure to maintain your client’s dignity. Let’s say that you’re bathing an older adult. Make sure to close any doors or curtains before starting to bathe a client. If you’re using a washcloth use several blankets or covers to keep warm and hide any areas that you’re not cleaning. Finally, the best way to maintain dignity is to talk with your clients. Ask questions about how comfortable they may feel for instance, ask if your elder client would like to clean any hard to reach spots themselves. These little cues gives all older adults a sense of autonomy and respect and should be part of getting started the right way.

Being Present and Your Cell Phone Use

It’s very easy in this day and age to stay in contact with anyone from anywhere though smart phones and PDAs. Ironically, this makes it even harder to connect to the people right in front of us. If you’re a parent or have a loved one that seems attached to their cell phone then you know what I mean. Likewise, on the job with our clients we can get distracted by the keeping up with a legitimate distraction like a sick child or just wanting to find out the latest celebrity gossip on Twitter. However, as a professional caregiver one person is depending on you to be present right here and right now: your client. Manage your phone responsibly. If you have a personal family concern make sure family members check in with you at regular intervals to briefly update you, and schedule times strategically to check your phone or call but keep these calls very brief. If you have to be on your phone or get tempted easily, leave your phone in a closet or a place where you’re not checking it constantly. Every time you’re on your phone you’re missing some time to engage with your elder client and just like you would, they know when you’re distracted. Show professionalism in all aspects of your job and make sure to give the client your full attention. Learn more about being a being the best professional caregiver you can with CareAcademy’s new online eldercare course.
Madhuri ReddyProfessional Caregiver for Older Adults – Part II: Getting to Know your Elder Client
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A Patient’s Perspective: Things I wish my Eldercare Provider Knew

The feedback I received from my blog post on caregiver fatigue reminded me of an important set of facts I have learned in therapy with both patients and caregivers.
  • First, people with serious and chronic illness are incredibly grateful that they have consistent, supportive caregivers, but that gratitude is part of a complex emotional mix.
  • Second, there are times when an illness significantly complicates communication in a relationship.
  • And finally, it can be tough for a person dealing with illness to convey to their caregivers how they most want and need to be helped.
This post includes a “cliff notes” summary of feedback I have heard from many people facing illness. I hope it opens the door for an eldercare provider to ask questions (and give answers) that might deepen their relationship with the person they care for.

Complex Feelings

Older Adults with serious and chronic illness are incredibly grateful for their caregivers. This may seem obvious. An eldercare provider often makes significant sacrifices in order to provide care and support. It seems like it just makes sense that the person who is receiving care would be grateful. This gratitude is complex, however. Many people facing illness are frustrated that they need care. Many people living with illness are grieving their own health. Many people who need caregiving struggle with a resentment of the healthy—nothing personal, just a painful combination of jealousy, grief, feeling like a burden, and a wish for their own health. Because human beings are complex, and capable of complex emotions, many people with illness feel all of these things at the same time. So the gratitude that patients truly feel may not show at all times. Or it may be mixed up with all of their other complicated feelings. If you feel like you have been getting mixed signals from the person you care for, you may be spot on. You may be getting a front-row seat to the roller coaster emotional ride that they are on.

Complicated Communication

When you combine the complex emotional experience that people with illness are having with the complex emotional experience that caregivers are having, you have the chemistry for some very complicated communication. Communication is a challenge that all of us have to navigate in our relationships. We have to help our partners and loved ones understand what words like “help, support, encourage, and love” mean to us and how they look in action. When you add serious or chronic illness into the mix, that adds layers of medical appointments, medication management, changes in household functioning and more to an already challenging process.  Don’t despair. Communication can get better and stronger in the face of health struggles. It just takes awareness and effort from both parties.

I Wish You Knew…

So now what? Well, now we get to the final fact. It can be difficult for a person living with illness to effectively communicate to caregivers how they most want and need to be helped. I have been working in this population for over ten years; and here are a few things that come up again and again in the list of, “things I wish my eldercare provider knew:”
  • Illness steals independence. This might seem obvious, but the loss of independence can be even more hurtful than physical pain. Loss of independence can be increased when those around a person with illness rush in to help before checking with patients about what they need.
  • Sometimes needs change from day to day. Many of the folks I talk to have conditions that don’t impact them in a consistent or predictable way. One day they may be able to run a 5K. The next, they may be in too much pain to get out of bed.
  • Physical difficulty does not always equal mental difficulty. All too often, if someone has been ill for a long time, people around them are at risk of treating them as less adult or mentally independent than they are.
  • The general public can be a gauntlet of invisibility or over concern. This is particularly true for people who have a visible marker of illness (wheelchair, brace, etc) or who are in a community that is aware of the illness. Going out in public can be a trial.
  • Being sick is not a vacation. This also may seem obvious. But, if you have run the household and held down a job and been the medical coordinator for months or years, it can start to feel as though the person you care for is getting the easy end of the deal. Every person with a serious illness that I have worked with wants to be healthy; they would love to go to work. They might even love to scrub the toilet. They want to be helpful and engaged.
  • Patients want their eldercare provider to do self-care. It’s hard enough to need the help. They don’t want you to kill yourself providing it.

What an Eldercare Provider Can Do

With all of that in mind, here are a few tips for caregivers on navigating the labyrinth of emotions and communication challenges that serious illness delivers:
  1. Start with communication.
  2. Check in about today’s pain and mobility levels.
  3. Ask if there are things that the person you support needs from you or wants to try on their own today.
  4. Challenge yourself to continue including the person you support in decision-making, planning, and other activities they would have done without you when they were healthy.
  5. Share your own plans and ask if those match up with your patient’s needs.
  6. Ask the person you support about their concerns for public events. Don’t strand them.
  7. Check in with yourself to see if your fatigue has led you to be short with your patient or to feel as though they are “taking advantage.”
  8. Do good self care. If you aren’t okay, you can’t provide for them.
Finally, remember that you aren’t in this alone. If the communication is bumpy, let someone help with that. Get support from groups, friends, and/or a psychologist. Get it for you and for your patient.  If you would like to learn more about offering proferssional eldercare, please check out CareAcademy’s newest, online eldercare classes
Ann Becker-SchütteA Patient’s Perspective: Things I wish my Eldercare Provider Knew
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Maintaining Clear Boundaries while Providing In-Home Eldercare

It is very difficult to maintain your boundaries when you are in a home-based situation and there are family members and other caregivers present. While in the process of finding the right caregiver, family members perform the necessary responsibilities. Then when the caregiver is hired, who does which responsibility? When boundaries are spelled out it becomes much easier to maintain them. This article spells out five things you can do to get the boundaries clear.  

Maintaining Clear Boundaries Requires Getting your Responsibilities in Writing

Ask for a very specific list or work contract which spells out in detail what your professional responsibilities entail. A lot of times it takes starting out on the right foot to avoid stepping on other people’s toes. In the process of working together in a home base situation it can often be more difficult. This is because there aren’t specific professional boundaries that you find in traditional caregiving. Getting your responsibilities in writing will help everyone to understand what your role is and hopefully what their roles are in the home as well. Many times it is easy to get territorial in a home-based situation. This is especially true of family members who have known this person for many years and love them. It is much easier to address the situation by bringing out your list or contract and reviewing it with them. Then asking them if there are some changes they would like to see made. Often times they don’t realize that they are overstepping their boundaries or pushing you out. Reviewing the contract is a way which helps you to remain neutral in non-threatening review. What you are doing by simply referring back to your contract is asking for any reviews or changes that may need to happen.  

During Your First Week Review your Responsibilities with the Eldercare Team

On your first day of entering the home to carry out your responsibilities; it is beneficial for you to take out your contract or list and review with the other caregivers and family members in the home. If they have issues or questions about your responsibilities at that point; refer them to the person who hired you. This will allow you to remain neutral, while they get a complete understanding from the person who hired you. Any changes you make should come directly from the person who hired you. It is their decision to make, no one else’s. Make sure you follow up with them and get any changes in writing. If there are caregivers who only come in a couple of days a week review responsibilities with each new person.  

Keep your Duties in the Forefront of your Mind

Review and maintain your responsibilities often to ensure that you are not overstepping your bounds or neglecting what you should be doing. One way to ensure you are maintaining clear boundaries is to review your responsibilities regularly. I recommend daily for the first few weeks, then weekly for the next three, and finally monthly. Pick a specific date and put it on your calendar (15th off every month). The more you review them the better prepared you will be to carry them out.  

Recognize Sometimes Boundaries Need to be Crossed

There are times when boundaries are crossed because there’s so much going on that territory no longer matters. There can be times when a boundary should be crossed; it’s okay if there is an emergency or if the older adult specifically asks for someone to do another person’s responsibility. Every person who works in the home is part of the eldercare team. Establishing clear and fixed boundaries is important. However, it is not more important than ensuring that the older adult is taken well care of.  

Ask for Help if you Need It

If necessary review with the person who hired you, family members, and other caregivers your responsibilities. Ask if changes need to be made or if you should continue on with your given duties. Many times family members and other caregivers become territorial and also belligerent about carrying out specific duties. If this should occur then it becomes necessary for you to get the person who hired you involved. Under no circumstances should you become belligerent yourself. The best way to deal with other’s inappropriate behavior is to request the person who hired you to come and sit down with you and the other caregivers to clearly discuss what everyone’s responsibilities are. Obviously this should be your last resort in getting these boundaries clear. Most times it will simply take a gentle reminder or questioning about responsibilities that will get people to back off. Though, there could also be times when a person just becomes downright aggressive about doing ‘your’ job. If this becomes the case use the person who hired you, as an advocate. You want to remain as professional as possible, not causing any problems for the person in your care. Ultimately, maintaining clear boundaries is about you knowing exactly what you were hired to do. Then make sure that you do it in the best way you can. Be kind, be professional, and honor the family members and caregivers who are part of the eldercare team. If you’re an eldercare agency, register for a demonstration and free class from Care Academy by going to our site and clicking Request a Demo.
Barbara HarveyMaintaining Clear Boundaries while Providing In-Home Eldercare
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Caregiving with Siblings: Six Strategies for Survival

Yesterday I was speaking with an eldercare attorney about ways in which caregivers could better manage estate planning and caregiving overall. “It would help,” he said, “if siblings divided up the work.” Yes, yes it would. However, as most family caregivers know, “There’s always one.” In most families there is typically one sibling who shoulders most of the responsibility of caregiving. Who that “one” is depends on a number of things. In some families, caregiving falls to the sibling who lives the closest to Mom or Dad. Some families assume a sibling who is unmarried or has no dependents of their own should take on the role. Sometimes a parent decides who they want to manage their affairs. Some siblings raise their hand and say, “I’m in charge.” No matter how it happens, caregiving with siblings is fraught with challenges. Think about it: is there anyone in your life who can push your buttons as quickly and artfully as your sibling? A harmless comment, even a compliment, can trigger a feeling from childhood and revert the most mature adults back to their seven-year old selves. Think, “She’s looking at me,” or, “He started it!” Whether you are “the one” or a supporting player, all siblings have a role in keeping the peace, and most importantly, supporting your aging parent or parents during a time of need. So how can siblings work together and avoid the emotional landmines during one of the most important times they may ever face as a family?

Here are six strategies for surviving caregiving with siblings:

    1. Play to each sibling’s strengths: We all have different strengths. I am great at execution; I can manage logistics like nobody’s business. I’m also great at research. I can find the answer to anything with Google.  I’m not so good at the softer skills so I’m not the best sibling to put in charge of keeping the relatives and neighbors updated when a family member is sick. During a stressful time such as caregiving, try to focus on what each family member is best at and assign tasks accordingly.  
    2. Don’t try to fix anyone. Likewise, we all have different weaknesses and caregiving is not the time to try to get a sibling to be different. If your younger brother has always been disorganized, he’s not going to become organized amid a caregiving crisis. Again, play to people’s strengths.
    3. Communicate often and broadly. Information will flow best if everyone in the family is hearing the same messages at the same time. Avoid confusion, misinformation, and misinterpretations by planning group conversations that include all siblings whenever possible. Schedule regular family meetings, set up group emails, or plan a Google hangout so everyone hears the same thing at the same time.
    4. caregiving with siblings professional helpSeek professional help. If you and your siblings have questions or conflicts, perhaps you should call in a professional. An eldercare attorney can help sort through estate planning in a way that honors your parents’ wishes and is most equitable for all. A senior housing specialist can help defuse some of the emotions that arise when caregiving with siblings and deciding whether or not to relocate your parents from a family home to assisted living. Financial planners can provide peace of mind that the family is saving and spending as prudently as possible. A few good dollars spent can save thousands in the long run – and spare hurt feelings too!
    5. Take charge. If you are ‘the one’ chances are you are, or will be, your parents’ power of attorney and healthcare proxy. If that is the case, own it. While you may choose to seek input from your siblings, you, and they, must respect your parent’s decision that you have been placed in charge. Your parents gave you the role because they trusted you. You need to trust yourself. If your siblings don’t like it, that is unfortunate but hopefully they too can respect your role. If they do not, know that you acted to the best of your ability and let that be enough.
    6. Leave Mommy and Daddy out of it. Perhaps when you were kids, you and your siblings ran to your parents to sort out petty squabbles and more significant misunderstandings. Those days are over. Do not burden the person who requires care with sibling disagreements. They have enough to worry about and do not need the guilt, worry, and stress that comes from knowing the family is at odds.
Liz O'DonnellCaregiving with Siblings: Six Strategies for Survival
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