Assembling the Right at Home Team

The 2010 NFL draft recently took place – the day when pro football teams “draft” college football players they believe will improve their chances of being successful.

When I was a kid I loved the draft. Between the 4th and 12th grade, I faked being sick every single draft day so I could stay home and watch this annual event. Whether something would shock you (the Raiders always do something kooky) or just confuse you (the Giants once drafted a player who was blind) I always find the NFL draft to be fascinating.

So what does this have to do with providing caregivers? Well I feel that we hire caregivers not unlike teams evaluate college players. We check references (teams review college games) and conduct competency tests and background checks (teams conduct athletic tests) before we’re ready to draft – or more accurately hire – someone as a caregiver.

We recognize mistakes we’ve made in hiring and learn from that. Sometimes we’re pleasantly surprised with how good one of our caregivers turns out to be.

And as time passes, you assemble your team. Caregivers like Susan from Glendale, our 2008 Caregiver of the Year, who’s has been called “family” by virtually every client she’s worked with; Megan from Eagle Rock, who hasn’t shown up late in nearly 2 years; George from Santa Monica, who one client called “truly gifted” or Charmie from Reseda who her client refers to as “the kindest person ever.”

Not all of our employees turn out to be the equivalent of an All-Star player. But you can trust that at Right at Home we make sure we have our own Super Bowl caliber team ready to help you and your loved one when you need us the most.

Tips for Caring for an Elderly Loved One - Day 5

Jacqueline Marcell wrote a book a few years back titled Elder Rage-or-Take My Father... Please! This is Day 5 highlighting some tips from the book about how to handle certain difficult issues.

Gets mad when told “No” they can’t do something?

Avoid responding with a flat-out “No” to their request. Let them know that you have considered the issue and understand their viewpoint, but explain that it’s not a good idea right now. Indicate that maybe next time, or at a later date, you will be able to handle their request. Cheerfully distract their attention to something else more positive. Most of the time, they will completely forget about this request and have a different one by the next day.

Just like some children, the more some elders are told “No” they can’t do something, the more they will keep fighting to do it. It can become a test of wills for power and control. In some instances, it may be best to just let them have their way (if there is no danger). Usually they will come to the conclusion on their own that it really wasn’t such a good idea after all.

Tips When Caring for an Elderly Loved One - Day 4

Jacqueline Marcell wrote a book a few years back titled Elder Rage-or-Take My Father... Please! This is Day 4 highlighting some tips from the book about how to handle certain difficult issues.

Prefers to stay in bed or do nothing-”waiting to die”?

This could be an ulterior motive to get more attention, or it may be a sign of depression. Carefully evaluate what’s going on. Drop in unexpectedly a few times and observe their level of activity. If you suspect depression, ask their doctor to consider prescribing an anti-depressant. There is such a wide range of effective medications available today that there may be no need for them to suffer.

Then, get your parent enrolled in Senior Day Care to create a life outside of lying in bed all day. They have to have something to look forward to, friends to see, varied activities to do. You cannot supply all this stimulation yourself day after day. Go with them a few times, have lunch and introduce them to everyone to encourage the making of new friends. Additionally, many centers have a shuttle service to pick them up and bring them home.

If your parent is a “Sundowner” who wants to sleep all day and be up all night, there are a few things you can do to alter this pattern. In the morning, open all the windows and drapes to let in fresh air and sunlight; make lots of noise by turning on the radio and television, running the vacuum cleaner, dishwasher, etc.; plan activities, exercise and visitors. Getting an hour or two of sunlight daily can help regulate their circadian rhythm. Ask your doctor about Melatonin that may help them sleep at night. Make sure they are not getting any caffeine from coffee or chocolate in the evening. Also, have their doctor regularly review all of their medications to see if any may be causing daytime drowsiness. If possible, switch them to be taken at night.

Tips Wend Caring for an Elderly Loved One - Day 3

Jacqueline Marcell wrote a book a few years back titled Elder Rage-or-Take My Father... Please! This is Day 3 highlighting some tips from the book about how to handle certain difficult issues.

Has become suspicious and paranoid?

Don’t make light of it, argue, or tell them that their fears are irrational. Calmly acknowledge how awful it must be to feel that way and assure them you don’t think they are crazy. Make them feel safe, loved, and assured of your continued support. Report these symptoms with examples to their doctor. If you get an unconcerned attitude from their doctor that it’s just part of the aging process, insist on taking them to a geriatric psychiatrist for evaluation. With the proper medication, these fears may be greatly reduced.

Tips When Caring for an Elderly Loved One - Day 2

Jacqueline Marcell wrote a book a few years back titled Elder Rage-or-Take My Father... Please! This is Day 2 highlighting some tips from the book about how to handle certain difficult issues.

Complains about real or imagined physical symptoms?

Set a time limit for these health “complaint” sessions. Listen, be sympathetic, and offer solutions. Then, declare the complaint time over and divert their attention to a different topic or activity. If the moaning and groaning doesn’t stop, give three warnings, use the silent treatment, then walk away.

Try a simple test to see if their symptoms might be psychosomatic or just for attention. The next time they complain of a minor ache or pain, quickly put a vitamin pill in their mouth, pretending the pill is an aspirin. See if the mysterious pain immediately goes away. Don’t tell them that their pains are not real, but privately let their doctor know what you discover.

Together, write down their symptoms in order of what bothers them the most. When you go to the doctor, see which symptoms they actually end up complaining about. Have the doctor address each issue, take notes, and cross each item off the list as they are reviewed. If your loved one is embarrassed to complain to the doctor, take charge and make sure the doctor knows all symptoms including: sleep, appetite, energy changes, memory problems, alterations in mood, inability to do basic things, incontinence, depression, anxiety and anger. Speak with the doctor in private if necessary.

Frequently bring all medications (prescriptions and all over the counter vitamins, etc.) to the doctor’s to make sure there are no interactions. When a new medicine is prescribed, ask if any specific foods and alcohol should be avoided while taking this drug. Should this drug be taken with or without food? Should this drug be taken at a certain time of day? Is it all right to continue normal activities, such as driving? All drugs have side effects, and can interact with each other and produce further complications.

Get a lock box for their medications if you have any suspicions that they are not being taking appropriately. Hide a spare key someplace in their home in case you forget or lose your key, or if someone else has to give the medications if you cannot get there.

Tips When Caring for an Elderly Loved One

Jacqueline Marcell wrote a book a few years back titled Elder Rage-or-Take My Father... Please! This week we will highlight some tips from the book about how to handle certain difficult issues.

How Do I Handle My Elderly Loved One Who:

Makes constant unreasonable demands?

Focus on the positive things you can do for your parent and don’t emphasize the things that you can’t. If you continue to eventually give in to their extreme demands these behaviors will get worse. Assertively set your boundaries of what you will and won’t do ahead of time and stand firm, giving sympathy and empathy where appropriate. Don’t let your better judgment be swayed by your sense of responsibility. If their demand strikes you as illogical or irrational, BIG FLAG-it is! Call the Alzheimer’s Association to find out where your loved one can be tested for dementia. If the bad behavior stops, give positive reinforcement by acknowledging their ability to control their conduct. You may want to give a specific reward to further encourage them. If the negative behavior continues, give three warnings, use the silent treatment, then walk away.

Home Care Helps Seniors Manage Painful Conditions

Pain isn't "just a part of growing older"

Though physical pain isn't inevitable as we grow older, seniors are more likely to have arthritis, osteoporosis, fractures, angina, shingles or other conditions that cause pain.

Home care worker with senior clientPain diminishes quality of life and independence. It even increases the risk of falls. And yet, while older adults are more likely to experience pain, they are the least likely to ask for or receive relief. Many believe they are "just getting older." Or, they hesitate to speak up because they "don't want to be a bother."

How can family help? If your loved one is experiencing pain and hasn't recently raised the subject with his healthcare provider, encourage him to request an evaluation of his current pain control regimen, and to discuss alternate solutions that might be more effective. Today's pain specialists have a wider array of treatment options than ever before.

Finding the right "prescription" for pain control is only the beginning. Following the doctor's instructions best ensures positive results, but a senior who is experiencing chronic pain may find it difficult to comply with the pain control strategy. Families can help by offering encouragement and helping with practical tasks. And when family can't be there, professional home care services can provide an extra measure of support.

Home care professionals have learned from years of experience that supporting pain management is a vital quality of life element for the seniors they serve. Home health aides support pain management in several proactive ways:

Medication management: The doctor may prescribe pain control drugs. Common drugs include:

* over-the-counter products such as aspirin and ibuprofen;
* opioid drugs such as morphine and codeine;
* antidepressants;
* muscle relaxants;
* steroids; and
* topical medications.

It is important to take these medications correctly, but this can be a challenge, especially if your loved one has multiple health conditions. A home health aide can remind your loved one to take medications on time and in the way they are supposed to be taken. The aide can also take your loved one to the pharmacy or pick up prescriptions, help with pill organizers and dispensers, and report any signs of side effects.

Promote compliance with physical treatments. Medications are not the only option for pain relief. Your loved one may benefit from physical therapy, which might include massage, heat and cold, biofeedback or electrical treatments such as a spinal cord stimulator or TENS device. Pain control specialists might also prescribe relaxation techniques, such as yoga, tai chi or breathing exercises. A home health aide can transport your loved one to appointments or classes. If home exercises are prescribed, the aide can provide encouragement and supervision.

Encourage physical activity. Staying active may well be the most important "medicine" for your loved one's health. Study after study confirms that physical activity improves arthritis, osteoporosis, heart disease and other painful conditions. And exercise increases the production of endorphins, the body's own pain reliever. Families report that the presence of a professional caregiver gives their loved one the self-confidence to follow their individual exercise plan, and to be more active in general.

Decreasing depression and anxiety. Pain isn't "all in our head," but how we think about pain does make a difference. Depression, anxiety and loneliness magnify the perception of pain. Families understand this, and often worry about their loved one being home alone while they can't be there. An in-home caregiver can provide transportation to the senior center, to Bible study or to other social events your loved one enjoys. Seniors report that just having another person around the house is a mood brightener that "takes your mind off your aches and pains."

Dementia care support. Pain control is especially challenging when a loved one has Alzheimer's disease or other dementia. Sometimes pain underlies behavior changes such as wandering and aggressiveness. Yet your loved one may be unable to express that they are feeling pain. According to professional in-home caregivers, it's important to be aware of signals that indicate pain, such as slower movements, decreased function, wincing or irritability.

Untreated, pain can lead to a cycle of decline that makes it impossible for a senior to stay in his or her home or retirement community. Persistent pain that has an impact on physical function, psychological function or quality of life should be treated appropriately. In-home care can be an effective addition to the pain management team.

Senior Care Tax Deductions

With taxes due in just a few days its a good reminder that often times in-home care can be deducted from your taxes.

Our friends at caregiverlist.com provide a nice little recap of possible tax deductions for care below.

As the tables turn and children become the caregiver for their parents, and as the senior care expenses begin adding up, family caregivers often ask if Uncle Sam offers a tax deduction similar to the tax deduction for child care.

The answer is, yes, if you are able to claim the elderly relative as a dependent (your parent does not have to live with you but you must be providing for more than half of their financial support, which includes food and transportation). If you and your parent meet the Internal Revenue Service's criteria, you will be able to deduct up to $3,400.00 from your taxable income (for year 2007). Social Security benefits are not counted in most cases.

In addition, the Internal Revenue Service lets you deduct medical costs as long as they are more than 7.5 percent of your adjusted gross income. This may include the medical (and dental) expenses of everyone listed on your tax return, including your spouse and dependents. You may be able to include some of the expenses paid for a parent, along with expenses for a caregiver.

Keep in mind medical expenses include travel expenses to and from medical treatments, along with uninsured treatments, such as hearing aides and false teeth. If more than one child participates in the financial support of the parent, some families rotate the deduction to a different child each year.

Please do consult your accountant and review the specifics on the IRS publication guides (IRS Publication 502 covers medical expense deductions and IRS Publication 554 covers dependent care deductions).

A new baseball season offers new chances for family to come together

So we've all seen Field of Dreams. James Earl Jones, playing a reclusive author, talks about playing and talking baseball with his father. The whole reason for Kevin Costner to build his "Field of Dreams" in a cornfield is to recreate a chance to finally play catch with his father.

Similar sentiments are expressed by Daniel Stern in City Slickers when he reminisces that no matter how bad things got between his father and him he could always talk baseball with him.

My father wasn't necessarily a great baseball guy, but he is the reason I became a New York Met fan growing up in Jersey. My father grew up in Queens and was a fan of the Giants. After they moved west and along came the expansion Mets in 1962 it was just natural for my father to become a Met fan and thus it seemed natural that I too cheer for those Miraculous Mets.

We once had a client here at Right at Home who, after he retired, worked as an usher for many years with the Dodgers. Disease overtook him, but I remember stopping by once just to say "hi" and then sitting with him for the next 2 hours as we watched the Dodgers play the Arizona Diamondbacks. He could be a difficult client, but you could just tell how appreciative he was of having someone to watch the game with.

The 2010 baseball season just started. The Dodgers and Angels are both expected to be in contention. The Yankees and Red Sox continue to throw obscene amounts of money at players while teams like the Royals and Pirates just can't seem to compete. Everyone thinks the Phillies will the National League East and everyone thinks the Nationals will finish last in the National League East.

But regardless of who your favorite team is, this might be a nice time to visit your father or grandfather (or even mother - my mother-in-law is a huge Colorado Rockies fan and watches every game) and watch a baseball game with him. It might be appreciated far more than you know.

How the City Crisis Hits Home

It's been a little while since I posted an article from Stephanie Vendig of the Greater Griffith Park Senior Center, but her take on Los Angeles' budget crisis is certainly worth a read. You can read Stephanie's column every month in the Los Feliz Ledger at www.losfelizledger.com

The news is bleak for our city, including our school district, as never before. And when you add in the State, it is pretty catastrophic. For these local public entities these days, it is not about tightening the belt or getting rid of the fluff. We are talking about core services that impact all of us, in one way or the other. In order to avert bankruptcy or other costly consequences, there is a scrambling to find all kinds of ways to reduce the financial burden.

The recommendations of Miguel Santana, City Administrative Officer, in his “Three-Year Plan for Fiscal Sustainability” report to the Mayor and the City Council on January 29th spelled out the alarm in 273 pages. LA’s economic woes are mainly due to the economic recession beginning in 2008 as a consequence of our local real estate downturn, which has been severe, and the unemployment rate higher than in all previous recessions. The revenue that mainly comes from, sales, business, hotel, communication users, and gas user’s taxes, hasn’t been enough to cover the costs. Currently, the City Council and the Mayor are struggling to come to agreement on the recommendations.

Because of my involvement with Los Angeles Dept. of Recreation and Parks at the Griffith Park Adult Community Center (GPACC) I am paying attention to this crisis a little more than usual. The department is asked to reimburse the general fund for their utility costs, which has not been done in the past, and for their pension costs. As a result of these and other recommendations, the department may end up with a different sense of itself in order to live within the budget. However, these recommendations raise the specter of potentially hurting the recreational function of the department.

Already, layoffs have started with Recreation Coordinators, Child Care programs, and Therapeutic Centers. The early retirement of some Facility Directors may mean no replacement, and a group of current Facility Directors has been warned of possible layoffs by July. There are more than 390 sites, including 28 senior centers that provide recreational opportunities in Los Angeles. The idea that quality recreation programs can operate with limited staff is not very reassuring. Not only that, if there is not enough experienced and trained staff within these programs, the recreation part of “Recreation and Parks” will suffer.

I would say it is letter-writing time. We should remind councilmembers that cost-saving decisions must not result in the substantial reduction or the potential elimination of the recreation function of the department. Los Angeles deserves better.

Happy Easter from Right at Home

All of us at Right at Home would like to wish all of you a very happy Easter Sunday.

Caregiver of the Month - Annette P.

Right at Home is proud to announce that Annette P. has been named the Right at Home caregiver of the month for March 2010.

Annette is a C.N.A. currently going to school to become a Registered Nurse. She has worked with Right at Home since last year, primarily working 5 days a week on a case in the Los Feliz area for the past 5 months. As the case has grown more difficult and the clients needs have increased, Annette continues to work diligently to provide the best care possible while navigating a difficult family dynamic as well.

We are proud to have Annette has an employee of Right at Home.

Congratulations Annette!