Caring for Seniors

Article Five

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Tina Steele, MA

Tina Steele is a Science and Medical correspondent who will help you to understand the roles of conventional and alternative, or complimentary, medicine in creating and maintaining health and wellness.
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Caring for Seniors

Being a caregiver is never easy, and if anyone tells you that it is they are not doing their job properly! Whether you already are, or will be, looking after your own elderly relatives, or someone else's, there are some things that you should know to make your life easier, and theirs too. This is not a subject that can be covered in just one column, it would take a book, but it is my hope that you will at least glean some useful informationÉ..and it might also help to know that you are by no means alone when occasionally you want to scream!

Unless you are extremely blessed, your charges will expect to continue to do exactly what they want, when and how they want, but chances are that this is no longer going to be an option for any of you. The reason that you have become a caregiver is because those in your charge need to be cared for: whether it's for help with simple tasks, such as shopping and cleaning, or includes ensuring that medications are taken and on schedule, diets adhered to, exercise (under a doctor's supervision, of course) accomplished, and appointments kept; essentially the minutiae of daily living.

You may be expected to have some clearly defined responsibilities, but there will also be a plethora of other jobs that need doing that will not be immediately evident or in your job description, be it formal or informal. Just imagine how it would be for you if you were unable to do even the simplest things that we all take so much for granted, such as sewing on a button, going to the Post Office for stamps, paying a bill, or picking up something that has fallen on the floor. For many of those we care for, the day will come when they can no longer undertake such basic actions, and so we must gently and unobtrusively do those small things in their place, without the necessity of being asked or making an issue out of it. You see, some would construe an inability to do for themselves as an admittance of defeat, or incapacitation; it becomes a matter of pride and more than that, a loss of independence, which is a terrifying reality for anyone to face, let alone someone who is reaching the end of their life, or the end of a life as they knew it.

The best way to put this into perspective is for you to be conscious of the little things that you do for yourself, and then ask . . . "can my charge do this"? If the answer is 'no,' then you will be better aware of when to step in to help.

Depression is a very real issue for the elderly, and even seemingly less significant hindrances can soon become amplified into a succession of perceived failures, leading to a slide into a depressive state. It is something that caregivers must be on the lookout for, and therefore here are some signs to be aware of, which could indicate that your loved one, or charge, is becoming depressed:

•   Loss of appetite
•   Apathy, i.e. no longer interested in what is going on around them, e.g. on the news
•   Sleep disturbances (sleeping too much, or too little)
•   Unwillingness to leave their bed/house/room
•   Constant sighing or expressions of hopelessness
•   Crying for little or no reason
•   Uncharacteristic outbursts or general irritability
•   Anxiety or panic attacks or nervousness.

If you suspect that depression is becoming an issue, it is very important to notify your charge's primary care doctor as soon as possible. Sometimes depression can be caused by medications, when it is known as Pseudo Depression; something my father suffered from, and you need to rule out this possibility before considering psychological causes. If depression does rear its ugly head, there are many things, including highly effective treatments, available and you will need to talk with either a licensed psychologist or psychiatrist to explore all avenues.

A great website to access regarding depression in the elderly is: (because of the length of the URL, you may need to cut and paste this into a document, such as notepad, first then copy it into your browser).

Much as you can swear that this could never happen to you, sometimes you are going to be driven to feel very angry at your loved one, this is considered normal. They may push you to the point of wishing to do them physical harm, but you don't act on it, ever. However, if you do get to the point that your emotions are getting out of control LEAVE THE ROOM, IMMEDIATELY. You need to calm down, so take long, deep breaths, count to 100, do whatever you have to do . . . I have bitten into my own finger before now, but whatever you do make sure that you do not lose control. You WILL be pushed to the edge, possibly quite often, especially if your loved one or charge is a stroke victim or is slipping into dementia, but if you find yourself getting angry on a regular basis, you should seek professional help; either from your own physician, a help line, support group, social service agency or pastor.

Here is the American Psychological Association's site to help you decide if anger is becoming an issue for you, and offers some highly effective ways to control it:

There are programs in existence which provide respite for long-term caregivers, and allow a much-needed break away from the home. Eligibility and availability are often determined by where you live, but here is one site, for Florida residents, that will provide you with some basic information on the sort of services you can expect:

If you are taking care of someone else's loved ones, you should keep the family members 'in the loop' about any unusual happenings; such as a refusal to eat properly, an increase in alcohol use, mood or behavioral changes. The same applies to the flip side; if good things happen, progress is made, or difficult tasks accomplished, you should be quick to pick up that phone and sing the praises of your charge, and try and do it so that they can hear your end of the conversationÉeven if your praises fall on deaf ears at the other end. An unfortunate reality of taking care of other people's relatives is that all too often you are there because they don't want to be, or care enough to be. However, do not be deterred about providing regular updatesÉI often 'vented' to the daughter of the folks I had been caring for; when they veered off their diets (I knew when they snuck off to eat fast-food!), or perhaps decided to go driving when a storm was impending. I could not stop them, but I made darn sure that the daughter knew that I had tried to. I felt much better about voicing my frustrations and I also got myself off the hook had anything gone wrong, and on a few occasions it did!

Whether your charges are your own or someone else's' loved ones, always try to reinforce your support and respect for them, which can often be difficult especially when you have to bathe them, or help them with going to the lavatory. It is so hard for anyone to keep their dignity under such trying circumstances (as any woman who has been to an OB/GYN will attest to), so it is very important that you show that what you are doing does not affect how you feel about them. Both my Grandmother and Father, proud and independent, towards the end of their lives would not let any other family member minister to them, except me. I believe that they understood that my love for them could never be affected by the decidedly clinical things that had to be taken care of, but it was still hard for them to accept my help.

If your loved one or charge is not lucky enough to pass away in their own bed, no matter how well you take care of them, sadly the day will come when even you can no longer cope with caring for them alone, and it will be time to think about assisted living, a nursing home or other long-term care facility. It is a heartbreaking and often contentious issue, especially if there is an estate that could be heritable, because entire endowments can be swallowed up in a very short time in a senior home. If you have power of attorney, or a position of authority/decision making in the family, the first thing that you need to do is consult an attorney, and preferably one who specializes in the field of elder care and inheritance.

Although taking care of seniors may be trying at times, it can also be very rewarding, and I hope that you will be able to look back on your experiences with fondness, not regret. Making peace with a loved one is vital to your wellbeing as well as theirs, so if there is any antagonism, anger, or resentment between you, please ensure that you resolve it sooner, rather than later. Nothing could be worse than losing someone without dismantling the issues that caused you both anguish. I have witnessed the pain and suffering that this can cause for those left behind, so whatever you do, make amends now . . . even if the separation is only going to be as the result of moving into a home. You never know what may happen.

Tina Steele, MA


And, talking of homes . . . here is a useful site for identifying which one would be best for your family member:

Nursing Home Inspector is a fee-based service (one-time charges ranging from approx. $9 for one report, $20 for a month's unlimited membership, and up to $99 for a year) that can provide information on nursing homes in the US, including territories, there is also a lot of useful free information available on their site:

For additional information, I would recommend the following sites:

This may be a small organization, but they have a great site with lots of useful information:

Geriatric Care Management may be the answer for those who can afford this type of high end service, this is a site which will explain what a Geriatric Care Manager does, and provides other important information for the loved ones of those who need care: is an online resource for seniors' caregivers:

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Editors note:

We are honored to have Tina Steele's participation and contributions to Pathfinders and look forward to learning of the ways our readers have benefited from her articles and guidance on healthcare.
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