We are all different in our ability to provide care to family and friends. At the end of the day, “providing care” is the envelope I use to describe someone who is able to see that someone needs something and then can, in a way their family member can accept, provide that “something.” I’m sure you know people (who probably frustrate you, maybe even family members) who just don’t get it.

Do you know that for many people, they just don’t have the “gift,” but can be taught. For many people it’s not something they are comfortable with, or have experienced. Maybe because the humanness of it makes them uncomfortable. There are many different reasons…

Did you know that for many of these people, they are more than willing to learn if given the opportunity. Sometimes family dynamics make it hard to ask, sometimes they don’t know to ask, but if you can start, just start, they can learn. While they may never become a highly intuitive person, sometimes starting with the mechanics is best. Show them what to do, and let the love of a family member motivate them to go outside their comfort zone. Acknowledge that discomfort. For many people, they don’t know where to start and are so worried about making a mistake and doing something wrong that they don’t try.

If you are feeling bad that you are not getting the support you would like in a caregiving situation, consider that others may not know what to do, may not know how to ask, may be uncomfortable with the situation. That by asking for specific things (could you come over today and sit with mom while I go to the store/doctor/spa), starting small and growing, you may add a dimension to their life, alleviate your frustration and help your family member.

Remember that we’re all different. Different things are meaningful to each of us. We can each “see” or “feel” different things. It doesn’t mean we can’t learn, it just means that some things we do have to learn…

Some clients are very clear about their wants, others just don’t want to be a bother. It can be hard to know how to approach those who don’t want to be a bother. Should you make a suggestion and see how it goes? Should you push a little harder? Should you not bother because your client seems to know what they want?

Any time a client is making a choice because they don’t want to be a bother, it is a bad choice. It is a bad choice because they are not getting what they want or need because they don’t want to bother whoever is there to help, pro or family. It may make the day easier for the Caregiver, but that’s not why you’re there.

Back to the question… The answer comes in two parts…
First, it depends on what it is. How important is it? Second, it depends on how well you know the person. Is it in character? How does it impact their quality of life? Are they trying not to be a bother or is there something else going on?

Some ways to approach these situation are… For some people, making a suggestion is all that it takes and should be the first approach. For other clients, it takes making a suggestion and then literally taking steps – like getting up to start what ever it is, to allow them to let you help. Don’t ever force someone to do something. If you don’t know a client well enough, ask a family member or a case manager. Get their suggestions.

Some specifics are…If you’re ending a shift with a client who hasn’t had a drink in a little bit, leave them with a drink before you leave. If the mail needs to go out, or the garbage, suggest to do it on your way out. If you know a client enjoys walking, suggest that you’d like to go for a walk at an appropriate time (set the stage) and then follow through. Maybe they don’t enjoy walking but need to get the exercise. They might just do it if they have company. You can suggest that it’s more fun with someone else. Arrange to do something on your next visit, put it on the calendar and leave a reminder note when you leave. On your next visit, bring it up first thing.

There are so many things you can do to help a client who doesn’t want to be a bother that will make their day. It just takes a little investigation and a great presentation.

What is the message? As we age and our systems age, we may not be eligible for surgical interventions that may improve our quality of life. It is a difficult decision to opt for surgical intervention. The surgical risk, the recovery…

Consider that while it’s a difficult decision for surgical intervention, it may be harder hearing that while that surgery you have been putting off may solve your problem, you are no longer a candidate.

Information on this blog is opinion-based and is not a medical forum. Please consult an appropriate medical professional for medical advice.

So what do you do if you visit a family member and there is a significant change in their appearance, level of confusion and the things they can do from your last visit?

Get medical help… Quickly… Feel comfortable calling 911… Even if your family member says no… Just do it… It may save their life…

Your family member will probably tell you (if they can) that everything is fine.

Did you know that there have been significant advances in the treatment of strokes that are time sensitive? While there are many other sources to explain weakness, confusion and motor skill changes that are easily remedied (dehydration, urinary tract infection to name two) a stroke has a window of time for effective treatment. It’s better to err on the side of caution. If there are existing medical conditions – dehydration, missing meals, missing medication, reactions to medications – may cause your family member to have a change. In some cases, it’s an easy solution. In some, not so easy but better if caught early.

So if you observe a change, take an action!

Sound familiar? We hear of similar situations every week. As a well-intended adult child I can relate to the concern we feel for our parents, and as a provider of care to those fiercely independent family members can respect their desire for independence. As they tell me all the time – it’s their life, they ARE adults and CAN & WILL make their own decisions. Yes, definitely.

There are many ways we can go with this conversation – and will over the coming weeks. Today I’d like to talk about two factors to consider as you begin to have conversations with your loved ones about alternate living arrangements – perspective and “digestion”.

In our concern, we can get lost in trying to solve what we perceive to be a problem. Remember it may not be a problem to your loved one. To them, life is good, they cannot see a reason to make a change. That is one of the biggest reasons that I tell families to start these conversations – which may be uncomfortable – early. It’s easier to have difficult conversations when there is no added external stress. Don’t laugh, but at 46 I’ve already started to talk about it with my next generation. It’s easier when your perspective isn’t trying to solve a problem, and your family members perspective isn’t trying to hang on to a lifestyle created over a lifetime (not a problem). So, if you’re coming from the problem side of the perspective fence, how do you convey that there is a problem? Now comes the “digestion” side.

It takes any person time to “digest” an idea. In a crisis, there usually isn’t time to allow for a comfortable digestion – it’s definitely a heartburn experience. Taking that one step further – it may be that what you view as a crisis isn’t, at least to your family member. It actually may be one more symptom of a developing issue. That’s good, because it means you have some time. Getting back to digestion – a friend once shared with me that it takes 7 (+/-2) touches or presentations for an idea/though/concept to be conveyed to another person. Wow! That was an eye-opening revelation that got me through many days as a parent! By starting conversations about lifestyle and life choices before there is a problem, it provides for learning, exploring, listening and sharing. It avoids defensiveness, posturing and hiding. It creates a basis for the conversation when one side thinks there is a problem. It builds an expectation for what it might take for the concept that there is a problem to be received. Give yourself or your family member time for that 7 (+/-2) touches.

I started titling this perspective, because it is in part about perspective but really it’s about giving yourself and your loved one time to work through this process of life. To work through the changes that come about as we age; physical, emotional, cognitive or changes to our roles & relationships. We all bring different perspectives to the table, but like in many things in life, if we can get past the raw emotion, look at the situation, look at the options and make an informed decision, it’s win-win for us all.

To close, it is important to stress that this article assumes that you are not in the midst of a medical emergency or that there are not real safety concerns regarding your loved ones independence. Those cases are the heart-burn times when while it’s great to have the luxury of time – you don’t. We’ll talk more about that in another post.

Some of the solutions are plastic devices with or without arms that affix to the toilet. While they look nicer than the stand-alone solutions (so are the choice of many women), they come loose or break easily. If it comes loose it can cause a fall – something we are all trying to avoid!

Our recommendation is to get a stand alone commode which can be placed over the toilet. They come with an adapter for use over the toilet. Better yet, it has it’s own legs and is stable. Of course, it’s not as pretty but far safer.
Thanks for your time!

If your loved one is in the hospital or rehab, ask to speak with a social worker. If you belong to a church, call them. If your loved one hasn’t been hospitalized but you are concerned, call their physician. If your loved one has a long-term illness, most have support organizations (Alzheimer’s, Parkinson’s, Lupus, Cancer, etc), call them. They’ve all been through this before. Keep asking questions until you get the answers you need. If they can’t answer your questions, ask for a referral to someone who can. Remember that everyone is busy and you may need to be persistent. Your local Senior Services Office can be a fantastic resource.

By spending time early, especially when you feel like you just don’t have it, it may make those days of care giving or recovery much easier. Sometimes just knowing that you are not alone can relieve 10lbs of stress. Remember that you are not bothering anyone. You are making contacts to add tools to your care giving toolbox.

I attended a function about “Aging in Place” the other day. It started with a very nice, professional, knowledgeable Occupational Therapist speaking about how those over 50 can “Age in Place.” Ok, so I’m 45. At 50, I really don’t see that my life is going to be significantly different than it is today (God willing) but you have to start somewhere I guess. It got me thinking about myself, my husband and our parents – mostly healthy, independent, vibrant people in their late 60s to late 70s. We do this for a living, this providing assistance so that people can “Age in Place.” We are so-called experts at it. But really, 50? Either way, we’ve had the conversation – with our kids and parents. Given what we know today, talked about our choices. It may change, but at least we’ve started so we can keep talking.

There are some things that you can do to make “Aging in Place” easier for your family. The first and most important is to start the conversation about your or your family members wishes. We can start with your/their wishes in case of a medical emergency, in case of difficulties being at home, in case life support is needed, in case of sudden death. It’s important that you know how they would like the situation handled. And what assistance you are willing and able to provide.

Every family is different. Because of family dynamics and personalities, the conversation can be easier for some than others. SO… While you can, and as I said – in many cases it is NOT easy, start the conversation. It may take many attempts. Really, who wants to talk about unpleasant subjects? But start the conversation and start it early, while everyone is healthy or relatively healthy, of sound mind and able to have the conversation. Before there is a problem. Start the conversation about what your or your family members wishes are.

Understand that people have different types of relationships with different family member sometimes. You may not be the right person for your family member to talk to. Don’t feel bad or look at this as something negative. It is what it is. Help the person who CAN have the conversation. That help may be in helping them to see that they are the person your family member will talk to, it may be in helping them to see that being proactive makes it easier in the long run; it may be to help them to see that this will probably take time and a number of discussions; let them know that it can be started informally by discussing other situations, that it can be started slowly; it may be to help them by doing the background work to know what needs to be discussed, what needs to be done and what the options are.

At the end of the day, by starting the conversation before you have to, you can get your ducks in a row to be prepared. To get prepared when there is no or little stress is far easier than waiting until an emergency arises. Remember that for most families this is a process, not a single event.

So start the discussion… Next time more on what to talk about.