Getting Help from Other Caregivers

"Help" Is Not a Four-Letter Word

It's been stated before but bears repeating: consider hiring a geriatric caseworker who can help you determine what kind of regular professional help you can use in caring for your senior.

Supportive care options include facilities and programs to which your senior will go, such as senior centers and adult day care pro-grams, and services that will come to your senior, such as meal delivery, reassurance visits, and home care. Services are provided professionally and on a volunteer basis.

If you primarily care for your senior at home but could use a break periodically, the Senior Corps (1-800-424-8867 or seniorcorps.org) will provide a trained volunteer to come and stay with her once a week. Local religious groups may offer similar volunteer help.

Contact the Eldercare Locator (1-800-677-1116) or the National Association for Home Care (1-202-547-7424) for information about professional care for your senior. Other information resources include local senior centers and religious organizations.

If Mom mainly needs company and activity, she may be fine spending her days at a senior center, many of which will pick her up, provide lunch, and drop her off at home at the end of the day.

Adult day care programs are a compromise between living at home and full-time assisted living for seniors who need supervised care. In a typical program, a van will pick up your father at about 9 A.M.; drive him to a facility where he will socialize, have lunch, engage in activities, and possibly receive routine medical care; and then drop him off at home around 5 P.M.

Ideally, an adult day care program has one supervisor for each six clients, four if the clients are very impaired. The program should also have a social worker and registered nurse on staff.

If you are going away, are temporarily unavailable, or just need a break, you can arrange for professional respite care. This temporary care service can be provided at home or in a nursing facility. Check with your local Area Agency on Aging or any home health care service.

Give your senior time to adjust to anything new.

Grandma will be more likely to enjoy a program that offers the right activities-something that interests her and suits her abilities.

Does your local high school offer courses in home economics? The school might give credit to a student for helping you care for your loved one.

All home care is not equal. Options range from having a caregiver live in the home full-time, to rotating several workers who live outside the home, to having part-time help for when you are not available or need a rest. The type of care you arrange will also depend on your senior's needs, whether it is housekeeping, personal care, or medical supervision. Contact your local Area Agency on Aging for information on the different levels of care available to you.

When hiring caregivers, check references carefully. Personal recommendations are best. When speaking with past employers, ask about the biggest mistake the person ever made, especially if the caregiver is getting a glowing overall report. No one's perfect.

Call elder care agencies in the morning, when they seem to have a lot more time to give you their attention.

Don't let any caregiver just "take over"; your senior should remain in charge as much as possible while getting necessary help.

Be clear from the beginning as to your expectations of a caregiver. Be specific about duties: answering the phone, watering the plants, handling mail, dealing with pets, shopping, cooking, and so on. Also, find out about the caregiver's expectations for the job. What tasks are they trained to do? Are there tasks that they cannot (or will not) do?

Dad will no doubt have complaints about his caregivers, and some of these complaints may be quite serious. You need to take all com-plaints seriously. Even if the exact version your father gives you may turn out to be only part of the story, your investigating will assure him that he is being respected, and caregivers will know that you are paying close attention.

If you've accused a caregiver of bad behavior and it turns out you were wrong, let him know. This is really important. Good caregivers take pride in their work, and being wrongly accused of something can be devastating to anyone.

Consider using one of the many concealed video "nanny cams" that are on the market.

Make sure caregivers understand your instructions. Don't just write them on notes; discuss them as well to make sure the instructions are clear and to determine agreement.

If you are supposed to relieve a caregiver and you're running late, always notify her. Have a backup plan in case this happens. Remember that the caregiver has a life and possibly a family, too.

Make out (private) "report cards" for each of the caregivers you hire so you can refer to these later if you need them. If there's something a caregiver does especially well, note that. Keep notes on the objections you had to prospective caregivers you didn't hire.

Have regular meetings with all caregiving staff. If there is more than one caregiver, you'll be better off if they know one another and can communicate, especially when there are scheduling problems. Now and then try to extend the hours of one or another so that they overlap. They might have a lot to teach each other.

Make sure your father is familiar with anyone who will take care of him. Dad should always have a say in who cares for him. Remember that caregiving can be a very intimate process. It will all go best if you agree up front on the personnel involved, to the extent that that's possible. At a minimum, introduce caregivers to Dad before they actually begin work.

During the holidays, remember any paid caregivers (nursing home aides, day care workers, shuttle drivers, etc.) who help make your senior's life better. Make sure that your gifts are thoughtful and generous.

Let caregivers see photos of your parent in earlier days. Caregivers and others will more easily connect with her if they are reminded of the vitality she once had.

Call at various times a day to check on your parent and on the care-giver. Don't allow your calls (or visits) to become predictable. Showing up at unexpected times is a good idea, especially in the beginning. Of course, you don't have to say you're there to check up. Invent an excuse to drop by.

If you're doing something nice for your parent (baking something special, picking up a small gift), consider doing the same for the caregiver.

If Grandpa is embarrassed about his nursing companion in front of the friends he encounters when he goes out for his walk, tell him to introduce the companion as "my friend." The real nature of the relationship is no one's business.

Create a checklist of issues (e.g., temperature, breathing problems, medication) and ask each caregiver to fill out a column before they go off duty.

Caregivers provide your family with so many of the resources you need to keep your life and that of your parent vital. How much do you know about their families?

Make sure a home caregiver is comfortable in your home, that she knows she's welcome in the kitchen, on the patio, and so forth. Would a small refrigerator or microwave in the room she occupies (or elsewhere around the house) make her job easier?

Be realistic in your expectations for caregivers. Don't expect more of other people than you could ever do for yourself. In fact, accept that no paid caregivers, no matter how dedicated, are going to care as much as you do, and you will never be 100 percent satisfied with their care.