Things I wish I had known about eldercare

So, okay, I've said before that I came into caregiving with little preparation. I didn't grow up around elder folk, never knew my grandparents, and anyone older than my parents were healthy and independent. I (actually) thought that when you got to the place in life you couldn't take care of yourself anymore, you went into a nursing home.  And truthfully, I had just never given it any significant thought.

How I wish I had! But God has had us in the old learn-by-doing school, and our education has been filled with all kinds of excellent helps and helpers. I might add that the lessons continue every day--not just the nuts and bolts of a person’s care, but how to depend on God to give grace and patience for every moment, trust his wisdom for the constant decisions, and seek his love to buffer the bumpy edges of service. I hope I've changed for the good through this experience--mostly I'm aware of my failings and how much I need the Lord to make me able to do His will. I pray often, "Lord, thank You that You promised to give me both to will and do Your good pleasure." (Philippians 2:13)

There are over 40 million caregivers of the elderly in the U.S. today, most of whom are caring for aging relatives. You might be one of those caregivers. If you are, I daresay there is much I could learn from you!  And if you're not now, you might one day find yourself in that role. I'd like to share a few things we've learned that might help you not 'go blind' into that experience.

What you need to know as a caregiver:

  • This is not an isolated incident, it's a season and life-style change.  If you don't make that mental adjustment at the beginning, you can set yourself up for resentment, frustration, and a host of detrimental and debilitating emotions.
  • You need a support network! This includes prayer partners, helpers of any kind who offer to bring food or come in to give you a couple of hours off, etc. There's a wealth of good helps of every kind on the Internet, and often there are local caregiver support groups. Don't be afraid to let others know if you have a need; sometimes they can help, and if not, that listening ear can often diffuse the emotions and frustrations you feel. My sister was a huge help to me--she'd walked this out before me and gave wonderful advice, tips, and loving understanding. 
  • Patience, patience, patience. Eldercare demands a lot of grace and patience—your loved one might move more slowly, take longer to make decisions, forget things, repeat things, or find they sometimes can’t do even the smallest tasks. (I might add that you’ll need a lot of patience in dealing with doctors, hospitals, care centers, etc. The wheels of the medical community often grind very slowly.) I pray a lot!
  • Find out what services are available in your area. It's good to know who can provide:
    • In-home care:  This can just be a few hours a week for help with personal care, up to full-time. This is a wonderful option to provide time for shopping, appointments, and down-time.
    • Respite care:  Some assisted-living places provide short-term care to give caregivers a true break, time for travel, etc., while giving your loved one quality care in a safe environment.
    • Specialized care centers that offer rehabilitation, Alzheimer's/dementia care, etc.
    • Hospice care:  We have been so amazed at the wonderful level of care and services they provide (funded through Medicare), and thankful for this amazing gift of support. Our community provides hospice respite care a few days a month at a special facility, designed to give top-notch care to your loved one while you can take a much-needed break from the caregiving responsibility.
    • Legal services, such as trust and will preparation, property issues, and others:  DON'T WAIT TO MAKE THESE ARRANGEMENTS! A crisis can happen in a moment and that's not the time to be scrambling to find paperwork and making huge decisions. 
  • Who in the family is acting as trustee, Power of Attorney, and the executor of the estate? Has your loved one designated medical power of attorney? Is there a will? Where is it? Do they have a living will? What about accounts and policies?
  • Caregiver burnout is a real issue. It's good to plan regular breaks or mini-vacations if possible to give yourself the physical and mental refreshment you need for the long haul. Just say yes to offers of help, and try to keep up with whatever your own interests are to provide you with emotional balance. I love to read good historical fiction and have found that a book can take me 'away' in mind if I can't get there bodily. A couple of hours out to shop by yourself or have coffee with a friend can siphon off overwhelm.
  • Your life will change. Caregiving adds not only a new level of work and responsibility, but limits your outside life. Instead of focusing on all you're not able to do anymore, try instead to enjoy the quality of what you can do. It's really a good time to savor the little things of life and let them feed your inner person. One of the blessings I'll always treasure about this season for me is the times my daughter and I have headed off "after hours" to watch our favorite British period dramas.

What your loved one needs:

  • Patience and love, lots of it. It helps to imagine yourself in their shoes and how much you need to be understood and have others be patient with you. Impatience with them actually can make a situation worse--it just feeds agitation and depression. Hugs reassure them that they’re not alone.
  • Simplicity in everything. Often their mental processes have slowed down, so keep a simple schedule, keep explanations short and sweet, give two choices instead of several, etc. Don’t try to explain very much; they might not get it.
  • Similarly, try to keep a routine as much as possible. It works well for everyone if things happen the same time every day. 
  • Exercise limitations, not too much of anything at one time. Space out activities and visitors so they (and you!) don’t get overtired.
  • Positive encouragement! Positive and cheerful words! Smiles! 
  • Recognize that they won’t be restored to their former selves. This is a hard one because we knew them full of life and competent, and it’s hard to accept their decline. But for their good and yours, you have to keep a clear and honest mind about the situation. God will help you do and say what you have to.
  • And along that same line, recognize that they need to talk about their fears and end-of-life questions. If you need help with this, a pastor or chaplain can visit, pray, and talk.

And here are a few helpful tips:

  • Keep visitors' time on the short side. Though nice, talking can be very fatiguing to your loved one. Let visitors know ahead of time what their 'window' is--they'll appreciate the heads-up.
  • Tell visitors please don't bring plants...bring cut flowers. The caregiver is left with the responsibility of watering, pruning, transplanting, etc.  They don't need more work!
  • Pick your battles. The ones you need to prevail in have to do with safety and well-being, not the optional stuff. You can get tied in a million knots of frustration if you try to control every little thing, even if you're 'right.'  With an elderly loved one, remember they've often lost much, if not all, control of their lives. If you honor their wants on the negotiables, it can go a long way to easing their angst over this difficult season.
  • Keep a caregiving journal and/or calendar. (This is a biggie.) Record things like diet, sleep and nap times, health issues, medications, notes from doctors' appointments, etc. Since you become your loved one's health advocate, it's a huge help to have this record to share with medical staff or to help you recognize patterns or issues.

Probably most caregivers would say that this kind of responsibility is a mixed bag—a challenge and a blessing both. A few years into it now, I’m grateful to God for all the lessons I’ve learned. You will find if you walk through this journey with Him, you’ll discover how very faithful He is.

What about you?  Do you have any helps you could share with us about elder care?