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How do Caregivers Find a Balance?

I Promised Mother I'd Never Put Her In a Nursing Home

By Sharyn Russell

Mary is a working mother of two teenage sons. Her 82-year old widowed mother lives nearby in her own home. Over the past two years she has experienced significant bouts of forgetfulness and depression, with increasing frailty due to a heart condition and diabetes. Sometimes she forgets to take her medication and she has had two falls. She was hospitalized once, and went home with VNA services for two weeks, but that was discontinued.

Mary has a high-pressure job that requires significant overtime. Her children have active after-school lives. Mary feels guilty and concerned about her mother living alone. She calls several times a day, but feels that is is affecting her work and her relationship with her sons and husband. She is exhausted from trying to juggle it all, and feels alone.

This situation probably sounds familiar to the growing number of adult children caring for the 7.3 million older people in this country who now need help with their activities of daily living (bathing, dressing, cooking, ambulating).

According to the US Department of Labor, the fastest growing age group between 1990 and 1995 was those aged 85 and older. The vast majority of these elders are being cared for by their families, whether they are living together or separately. Caring includes taking elders to doctor's appointments, helping with shopping, running errands, and providing hands-on care. 
All of this while at the same time being employed!

So how do the caregivers find the balance, while stretched by conflicting demands of spouses, children, bosses, and self, to be able to help elders without neglecting their own needs? How do caregivers find out about options for addressing the long term care needs of their elder relatives? 

Professional Aging Life Care Experts specialize in helping older people and their families develop a plan of care that maximizes independence while providing necessary care. An ALCA can conduct an assessment to identify problems, make recommendations about services that provide needed help, and arrange and monitor services, whether they are provided in the home, or in another living setting.They can act as a liasion to families who live at a distance and need a parent's situation monitored. They provide assurance, as well as referrals, for family members.

Mary called the EAP (Employee Assistance Program) where she works and got the name of a Professional Geriatric Care Manager(ALCA). This person met with Mary and her mother, reviewed the history and the current situation, talked to her mother's physicians, and developed a care plan. This care plan included a psychiatric evaluation which did indicate a clinical depression, which was treated with antidepressants. Mary's mother became much less confused when she was not depressed. 

The ALCA arranged for a homemaker to provide some company, meal preparation and supervision that she was eating regularly , and to do some light housework. A Visiting Nurse monitored her while her medications were being adjusted, so that there would be no adverse side effects. 

The ALCA talked with both of them about legal and medical decision-making while Mary's mother was healthy enough to be able to do this. Mary's mother soon began to look forward to the company of her homemaker, and eating meals regularly with company resulted in a 10 pound weight gain. Since she had regular staff coming in, she was less lonely and frightened, so she called Mary less frequently.

The ALCA suggested to Mary that she schedule two check-in calls with her mother per day at a specific time and encourged her to take a yoga class that she had been eager to join. Knowing that there were professionals seeing her mother regularly, doing her yoga class, plus supportive phone calls to the ALCA helped to relieve some of Mary's stress. 

For a free brochure entitled A Guide for the Family Caregiver, call (617)426-3533.