Caregiver Stress–How to Move Beyond the Burnout

by Kristen Heck, President, Loyal Care

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You’ve heard that you can love others unconditionally only after you love yourself. The same notion is true for caregivers. You can care for others unconditionally only after you care for yourself.

The time and energy demands required to care for a loved one can be overwhelming. Adding dimension to that is the awkwardness in managing the role reversal of an adult child caring for parents. Over time caregiver burnout might ensue—physical, mental, and emotional exhaustion manifested by the chronic conditions of stress.

What compassion fatigue feels like.Compassion Fatigue

Perhaps you’ve noticed your compassion for caregiving has faded to going through the motions of care. The special attention you once paid to dignify the life experiences of your loved one has been replaced with a short temper.

 

And you can’t help yourself. You want to return to the level of care you know you’re capable of, but don’t know how, or when. It seems time is no longer on your side, just an all-consuming apathy you wish would vanish with one good night’s sleep.

It’s In the Tone of Voice

Bridget Wirth, an R.N. and Loyal Care’s Administrator, listens for signs of compassion fatigue when working with caregivers. “When I hear exasperation in a caregiver’s voice,” she says, “or a disrespectful tone, or tiredness in a response, it grieves me to hear that, because I know it’s not the person, only that the caregiver really, really needs a break.”

So often those that need and want care think they can arrange for that care themselves, and then manage it, too. “‘Oh, my daughter, she can help me,’ a client will explain to me,” Bridget says, “while the daughter is struck with panic, feeling she can’t do one more thing and desperately wants me to intervene.”

“Listen to your tone of voice,” Bridget advises stressed caregivers. “If you find that it has a sharpness and you want to move it back into kindness, realize you’ve got compassion fatigue, and  take that very seriously.” To do so, Bridget says you’ve got to take care of yourself.

Self-Care is First Mindset, and Then a Behavior

It takes a lot of mental energy to change a behavior, such as making time to care for yourself. “And with their mental energy already shot, caregivers desperate for physical, mental, and emotional relief don’t know where to start,” Bridget explains.

She suggests that once you realize you’re not in control of your emotions, it’s time to find ways to restore a compassionate environment. “Begin by changing attitudes about your caregiving schedule and behavior around caring for yourself,” she offers.

To get started on that attitude change, Bridget suggests caregivers envision actually caring for themselves in some way, large or small. Here are some scenarios to help you adopt a new mindset about caring for yourself.

  • Speak with someone you respect and trust. Ask for feedback on what action you might take to improve your situation. If it is something you can see yourself doing, act on it.
  • Make changes in your schedule.  Set aside small amounts of time to do something you love—something you know that will refresh you.
  • Examine your expectations while considering all of your resources—your own and those of your loved one. What is stressing your or your loved one’s mental, emotional, and physical energy most? What about your or your loved one’s financial resources, what is stressing them most? What one small change can you make to relieve stress?

Take Action

By combining your resolve to care for yourself with specific actions to do so, over time you will adopt your new behavior for self-care. Asking others for help during this time will breathe fresh energy into your caregiving. Who can you turn to?

  • Family members, friends, and spiritual or religious advisors.
  • Community or church group leaders conducting workshops designed to help you make the most of your caregiving time and self care.
  • The staff at County healthcare services.
  • The staff at non-medical, in-home care services, such as Loyal Care.

***

“Taking care of yourself while caring for others is not an option,” says Bridget, “it’s a requirement, and it’s really the only way to maintain the compassionate environment you created at the onset of  your caregiving.”

Related Reading

What is Compassion Fatigue? by the Compassion Fatigue Awareness Project
Heart Disease and Caregiver Burnout by WebMD

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT. We serve individuals, including Medicaid-eligible and Veterans, who need short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.

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Home-Based Care Trends & Issues

by Kristen Heck, President, Loyal Care

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The home-based care industry is booming. Aging baby boomers, their adult children living an hour or more away, rising healthcare costs—they all affect the demand for home-based care and the quality and types of care available.

 

In-Home Care--Patterns, Trends, IssuesAn entire blog could be devoted to trends and issues in the home-based care industry. Its fast growth has the attention of individuals far beyond primary caregivers and those receiving or looking for care: regulators, entrepreneurs, public-policy makers, city and county social services, the Census Bureau and Department of Labor, advocacy organizations, digital health care developers, the list goes on.

With all this attention, the industry will change in many ways, with the primary objective of ensuring the safety and well-being of individuals who receive care.

In this post we present a few trends and issues we feel are basic to understanding where the industry is headed and what that means for you as a caregiver or recipient of care.

Demographics

Eight thousand baby boomers turn 65 every day.[1] They will live longer than their parents. In fact, men turning 65 today are expected live an average of 17.4 more years; women an average of 20.3 more years. Today, 89 percent of the elderly want to be cared for at home for as long as possible.[2] That trend is expected to continue.

Adult children typically become primary caregivers, even when they have to travel long distances to provide care. And individuals who have cared for an aging parent often become professional caregivers or begin a home-based care career. Most caregivers are women, but men are increasingly becoming caregivers, too.

All this points to steady increases in demands for home-based care. It also means more people will enter the industry to provide care, oversee it, broaden services, advocate for legislation to protect individuals receiving care, adjust labor laws to reflect the needs of caregivers and the industry, and provide more ways to pay for long-term home-based care.

Financial Costs

Right now the cost of home-based care remains steady. Over the last six years, the U.S. average hourly rate for homemaker services increased two percent during that period; home-health aide services, one percent. In Montana for that same period the average hourly rate for both homemaker and home-health aide services increased five percent.

As demand continues to increase, so will costs. But home-care costs are expected to remain significantly lower than nursing home facilities. Currently it costs about $18,000 per year (for 20 hours a week of care) for home-based care compared to over $69,000 for nursing home care.[3]

Primary caregivers may find they have to dip into retirement savings or their children’s college funds to cover caregiving costs, or they may lose income because of too much time away from work caring for a loved one.

What all this means for you are more offerings of long-term care insurance as a way to pay for home-based care, possible changes in Medicare laws to remove restrictions for home-based care, and more financial education that will help families become better prepared to manage long-term care costs.

Medicare.gov provides a long-term planning tool that will help you determine costs of long-term care.

Non-Financial Costs

For primary caregivers, the biggest non-financial cost is stress. Finding balance among personal, family, work, social, and caregiving responsibilities is a tall order.

Siblings, spouses, and family members may bicker over time spent (or not) caring for their aging loved ones, or what level of care should be given.

Many primary caregivers live an hour or more from their aging parents. Time spent traveling to and from their parents’ homes and wondering how to best care for loved ones from afar adds even more stress.

In search of stress relief, primary caregivers will seek respite care as a way to gain a life balance. And to better manage care of loved ones from afar, primary caregivers will also seek long-distance care services as a way to gain peace of mind.

For more information on the non-financial costs of caring for a loved one, read our blog post: The Cost of Care: Making the Most of Your Home-Based Care Dollars

Regulation

Some states require caregiver licensing and training, some don’t. Individuals may be inclined to hire caregivers working as independent contractors because their hourly rate is usually lower. These independent contractors may accept requests to work “under the table.”

Some of domino effects of all this are:

  1. an increasing number of elder-abuse cases
  2. individuals not realizing they have legally become an employer when hiring a caregiver directly (and not through an agency) and therefore responsible for caregiver screening, background checks, and payroll taxes.
  3. caregivers not paying into Social Security—a “forced” savings in a way—jeopardizing the amount of their Social Security benefits received upon retirement.

Compared to last year, the number of companies offering home-based care increased by 50 percent. Regulators and advocacy organizations are taking closer looks at how to legislate for senior and elder safety while they receive home-based care. That will likely include some regulation on caregiver screening and better enforcing home-based care laws that already exist.[4]

 ***

As you conduct your search for home-based care, ask caregivers or hiring agencies what trends and issues you need to know about and how they will affect your ability to either receive or give quality care.

[1] [2] [3] National Private Duty Association (NPDA), Private Duty Care Fact Sheet (PDF)
[4] Bloomberg Business Week, Home Care’s Booming, and So Is Regulation

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT. We serve individuals, including Medicaid-eligible and Veterans, who need short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.

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Where the Joy Is

by Kristen Heck, President, Loyal Care

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When Connie’s husband suffered from memory loss, she became his full-time caregiver. Connie’s family members, unable to provide consistent help, allowed Connie some flexibility for personal time. Knowing that their mother’s well-being was as important (if not more) than their father’s, Connie’s family encouraged her to hire a caregiver for a couple hours a week.

Find Joy through Companionship

Find joy through companionship care.Connie wasn’t interested in help from a non-family member. Along with caring for her husband, she loved her independence and didn’t want to spend the money.

But, there was one thing. Connie didn’t have time to attend her Bible study classes, something that gave her great joy. So, with a lot of encouragement and a bit of financial support from her family, Connie ended up hiring a Loyal Care caregiver. The bond of friendship that formed
between them surprised and delighted her.

We see this happen often between our caregivers and clients. Expecting excellence from caregiving services received is a given for our clients. What they don’t expect are the deep personal connections formed with our caregivers. In this sense, our commitment goes far beyond the services we provide, for our important work is hiring caregivers who intuitively–effortlessly–connect with others in a deep yet unobtrusive way. As a result, our real service is advancing our clients’ overall well-being.

“Little” is the New “Big”

Before our client Malina, a widow, hired us, her three sons were only able to take care of “big” things for her, such as transporting Malina to and from appointments. Her sons wanted to do more—to do “little” things that would make positive differences in their mother’s day-to-day experiences. Not only did their workload and geographic distance interfere, but as loving and well-intentioned Malina’s sons were, they knew a woman could provide those “little” things.

Malina and her sons hired Loyal Care for two 2-hour shifts per week to not only fill in where the sons couldn’t, but to help them better manage their mother’s overall care. Several “little” manicures later, along with several trips to the mall and help in managing Malina’s personal belongings, Malina and her caregiver share a respectful bond.

***

Growing old isn’t for the faint of heart, you’ve heard. Accepting and dealing with life changes takes courage. Often there is great sadness to overcome. Our staff understands this and is ready to go the distance—to figure out where our clients’ joy lies, then help them restore it.

Related Reading
Seniors’ Scoop: A Perfect Match
A Northwest Montana publication listing resources for mature lifestyles. Read “The Perfect Match” on Page 4 of the February 2012 issue, a story about the relationship between a Loyal Care caregiver and her client

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT. We serve individuals, including Medicaid-eligible and Veterans, who need short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.

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Identity Theft—What Is it and How to Prevent It

by Kristen Heck, President, Loyal Care

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On the heels of holiday mail is tax-related mail—reminders to begin organizing your financial paperwork for tax preparation.

How private is your personal information?
A lot of your personal information is on your tax-related paperwork—information you will exchange through the internet or postal mail. So we thought it timely to talk about keeping that information private—safely managing your personal information as a way to help prevent identity theft, now and always.

What Is Identity Theft?

Identity theft occurs when someone steals your personal information to commit fraud. Your personal information includes:

  • your name
  • your Social Security number
  • your driver’s license number
  • your date of birth
  • your address
  • account numbers at financial institutions, such as your bank, credit, investment, or mortgage account numbers
  • Medicaid and Medicare account information
  • answers to security questions often used with financial accounts (example: the name of your first grade teacher)
  • your personal identification numbers (PINs) or passwords you use to access your accounts at medical and financial institutions
  • information on your paycheck stubs
  • documentation from any medical or financial institution

Ways Identity Thieves Steal Your Information

Your mail box, purse, and wallet; and your email and online accounts are the objects of identity thieves’ affection. They hold the personal information thieves are after.

Identity thieves steal your hard copy or online information:

  • from your wallet, purse, or mailbox
  • from dumpsters (dumpster diving)
  • by changing your address: filling out a (1) “change of address” card obtained at the post office or (2) the “change of address” portion of your credit card statement pulled out of your mail box
  • over the phone or through email, under the pretense they’re a representative calling from a financial institution to “protect your security,” “verify your account,” or to get you to sign up for a nonexistent service

What Do Identity Thieves Do with Your Personal Information?

Essentially they create chaos in your life that could take months to deal with. Identity thieves steal your personal information for their gain—usually financial—and your loss.

Here is an example.

An identity thief steals social security numbers to open credit card account in victims’ names, uses the full credit limit to make purchases, then never pays for them.

Not paying bills is the single biggest hit to anyone’s credit score, meaning it could potentially fall to the point where a financial institution could deny credit, possibly at a time when it is really needed.

When victims become aware of identity theft, they open a case with each of the credit reporting agencies (Experian, Equifax, and TransUnion) and begin an exchange of information to rectify the situation. This can last for months.

Identity thieves also:

  • file for bankruptcy in your name to avoid paying back debts
  • give your name to the police during an arrest; when you don’t show up for the court date, a warrant for arrest is issued in your name
  • buy expensive items, such as a car, equipment, appliances, or furniture with a loan in your name
  • get a driver’s license in your name but with their picture on it

How to Prevent Identity Theft

Two rules of thumb will help protect you in the majority of identity theft attempts:

  1. Vigilantly protect your personal information!
    * Always know where it is—in your house, in your wallet, online—and carry as little of it in your purse or wallet as possible.
    * Shred any document that contains any of your personal information before putting it in the trash.
  2. Never, ever, give someone your personal financial information unless you initiate a conversation about it.
    For example, if you contact a medical or financial institution about one of your accounts, often you will be asked to identify yourself by stating your account number, the last four digits of your social security number, or the answer to a security question. It is safe in this case to give out your personal information.But, if someone you don’t personally know contacts you and asks for your information, either hang up, or, if you think it the call might be legitimate, ask the caller for a name and phone number and explain you’ll call back another time. You can either look up the phone number in the phone book or online to determine if the caller is trustworthy.

Again, be sure anyone who asks for your personal information has honorable intentions. If you can’t be sure, or suspect foul play, keep your personal information to yourself.

Please refer to these additional resources for more information about identity theft.

Deter. Detect. Defend.
The Federal Trade Commission (FTC) site on identity theft.

OnGuard Online
A consortium of U.S. government departments to help citizens safely use the internet.

Rutgers University Identity Theft Assessment Quiz

Loyal Care is a non-medical, in-home provider of private duty care located in Kalispell, MT, serving individuals, including Medicaid-eligible and Veterans, needing short-term, long-term, or long-distance home-based care.

For information about our home-based care services, please visit www.loyalcaremt.com.

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Why Choose In-Home Care?

November 15, 2011
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With in-home care services, you get to choose only the services you need, and when and how often you receive them. When appropriate, Medicaid and Medicare are encouraging individuals to use in-home personal care and in-home health services (also called Long-Term Support Services, or LTSS) rather than receiving comprehensive services offered by assisted living communities [...]

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The Cost of Care: Making the Most of Your Home-Based Care Dollars

September 28, 2011
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In 2011, the average U.S. hourly rate for homemaker and home-health aide services ranges from $9 to $34. In Montana, that hourly rate ranges from $17 to $25. [1]   As you begin to assess how you will spend your home-based care dollars, or perhaps develop a budget for home-based care during your or your [...]

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A Short Overview of Long-Term Care (LTC) Insurance

September 28, 2011
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The U.S. Department of Health and Human Services provides comprehensive information on Long Term Care (LTC) insurance—the types of programs available and potential options on how you might pay for them. Here, we give you a quick overview on LTC insurance benefits. To help you get started on your search for Long-Term Care (LTC) insurance, [...]

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Choosing an In-Home Care Agency: Not-So-Obvious Issues to Consider

August 29, 2011
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The pros and cons of choosing an in-home care agency are well-documented. So are the questions to ask that will help you make your final agency selection. But what are some of the subtleties you might consider to find out if the agency you want to select will meet or exceed your expectations?   You [...]

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The Story Behind Loyal Care–A Message from Loyal Care’s President

July 14, 2011
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In 1993 I found myself in dire need of non-medical, in-home care for my mother. At that time I was caring for my two young children, working, and caring for my mother full-time. I was exhausted and felt I couldn’t be the mother, employee, and caregiver I knew I could be. So I began looking [...]

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Making the Call—Why Is it so Hard to Ask for Help?

July 14, 2011
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How to view asking for help with daily activities or personal care as a way to gain independence. It’s official: Asking for help is hard. It’s even harder to ask for help so you can save energy to do the things you like to do, rather the day-to-day activities you think you should do, such [...]

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