Wednesday, May 5, 2004

Caring for elderly parents

Tips for stressed-out adult children with caretaker burnout

The toughest question any child will ever face is how to best care for their aging parents. Many adult children believe that their love will see them through. But what do you do when love is not enough? Often, care decisions must be made quickly, usually after a life-threatening experience. But caregivers also find themselves stressed out and in the position of having to make decisions after months and years of at-home care when they accept that, finally, they need help.

“For most elders receiving care, the primary caregiver is a spouse, with the nearest daughter being the second most likely primary caregiver,” said Lynne Horne-Moyer, a Ph.D. and associate professor in the Georgia School of Professional Psychology at Argosy University/Atlanta. (Also, many women have responsibilities of caring for children and elderly relatives at the same time which can be doubly stressful adds Horne-Moyer.) “Elders with only sons are typically cared for by daughters-in-law.” And, while there is usually a primary caregiver, the entire family is often involved in making decisions and providing care of all kinds including:

• Overseeing finances.

• Providing socialization opportunities and moral support.

• Providing transportation.

• Coordinating medical care.

• Providing housekeeping or home maintenance.

• Providing ADL’s (Activities of Daily Living).

When do children know it’s time to make the leap to a nursing home or an assisted care facility? Horne-Moyer, a clinical psychologist, said, “In many families this decision is an agonizing one. Most caregivers try to keep their elderly parents at home until safety issues are glaring right back at them.” She underscores the importance of family involvement and offers these tips for making the move:

• Investigate potential facilities as much as possible, and work with staff to make sure the elder’s treatment matches their needs.

• Frequent visits are helpful, even if the elder appears not to respond to or recognize family members. The feeling of familiarity is related to well being.

• Family members can often be rewarded by an occasional “good day” when there is more recognition from the parent.

• Try to be matter-of-fact about the change and deal with guilt with others.

• Home visits may or may not be appropriate, depending on the ability to adjust to leaving and returning to the care facility.

• Address adjustment difficulties with staff, who may be able to provide a friendly visitor, additional activities, physical therapy, or other individualized services, depending on a particular elder’s needs.

“In Alzheimer’s disease, care giving is most difficult when the parent wanders, is physically combative, or when personality changes emerge,” says Horne-Moyer. In early stages of Alzheimer’s family members need to monitor for self care, such as remembering to bathe, eat and take medicine. Caregiving in Alzheimer’s is emotionally and physically draining for the primary caregiver. Feelings of guilt over not providing enough care, feelings of having lost the relationship, and fears over safety are common. Family conflicts can be expected.

How can adult children cope?

• Self-care is key. Horne-Moyer stresses to her clients that they have to preserve their own health and well-being.

• She encourages the use of formal and informal supports, including adult daycare, home health agencies, and family and friends.

• Stress management techniques can be helpful.

• Treating depression and anxiety in both the elder and the caregiver is extremely important.

• Support groups, both formal and informal, are helpful.

• Many self-help books exist (Horne-Moyer suggests “The 36-Hour Day.”)

Horne-Moyer says it is far too common that caregivers are neglectful of themselves. If you feel exhausted, chances are you are neglecting you. She encourages a caregiver to give elderly parents the time they need, but recognize that it’s perfectly acceptable to allow others in your life to take the wheel when you need to take time out for you. It will not feel as unfair or as tiring knowing that you have the chance for a bit of rejuvenation.

That is how to avoid burnout and save yourself from your caregiver self. The burdens we place on ourselves are the ones that are the most difficult to bear. Ask yourself if you’ve demanded too much from yourself? Would you impose the same burdens on a friend? Remember, you are your own best friend.

For more information on Argosy University, call (800) 377-0617 or visit Argosy University at www.argosyu.edu.

— ARA Content

The parent company of Argosy University, Education Management Corporation (www.edmc.com) is among the largest providers of private post-secondary education in North America, based on student enrollment and revenue. Student enrollment exceeded 58,000 as of fall 2003. EDMC has 66 primary campus locations in 24 states and two Canadian provinces. EDMC's education institutions offer a broad range of academic programs concentrated in the media arts, design, fashion, culinary arts, behavioral sciences, health sciences, education, information technology and business fields, culminating in the award of associate's through doctoral degrees. EDMC has provided career-oriented education for over 40 years, and its education institutions have more than 150,000 alumni.