Concierge Services – The Best Value in Home Care

Moi a Fall Risk?

My orthopedic surgeon spoke concisely and with all seriousness, “The bad news is that you have a torn meniscus.  The good news is that it is repairable.”  I had been diagnosed with arthritis in my knees some time ago and had been living with a daily level of discomfort.   In recent months the pain in one knee became noticeably worse and much as I tried denial and rationalization, I had to come to terms with the fact that I could no longer sleep, sit, walk, or conduct my routine activities comfortably.  My knee felt unsteady and uncontrolled.  

Aches and pains are part of life’s journey and I accept them as part of the whole package.  Old injuries and age come home to roost and I am no youngster.  I realized that the pain would not cease and was at risk for a less than ideal situation if I fell.  The number one cause of hospitalizations for seniors is falls, the second is medication issues.  Yep, that’s me.  Just write a check in the boxes.     

Surgery is scheduled – now what?

Typically, pre-admission testing, approvals from physicians are needed prior to surgery.  You are also given a set of pre and post-operative instructions and prescriptions specific to your procedures.   Aside from the usual activities of daily living, I also run a business.  The order of my life will be changing substantially during the recovery period.  Mobility and independence will be limited. Someone must drive me to and from the surgery center, physical therapy and follow-up visits to my physician.  I may not be able to function on my own for a temporary period.  Egads.  Time for a plan.

Technology is a wonderful thing.  It allows one to function outside of a formal work environment as well as be a great asset to the homebound.  However, the home environment is frequently the most challenging issue.

Your Home is Not Your Friend

 As I surveyed the floor plan and outside access of my home, I realized some quick changes were needed to ensure my safety and recovery.  Mobility would be dependent on crutches and paths had to be clear.  Scatter rugs had to go and stairs temporarily forbidden.  The bathroom is my worst enemy unless safety equipment is in place.  Non-slip footwear is absolutely required.

Pain medications can have side effects such as dizziness or drowsiness.  I will need someone with me temporarily.  Having meals ready to reheat in advance, dry shampoo, sponge bath necessities, changes of clothing located conveniently are all organized and in place.  A portable bed and/or commode are also useful for those first days after surgery.  A sturdy chair with arms a must. Outside paths are cleared of debris.  Fortunately, I have a choice and decided to do this before the winter season. Crutches do not respond well upon contact with bottle caps, wet leaves, uneven pavement, acorns or ice.  

Consider Concierge Services

Concierge care is comprised of customized home care plans and services created around a specific procedure for a short term period.  Agencies offering these kinds of services work closely with your attending physician(s) and customize the services as prescribed  The services include driving the client to and from surgery, picking up medications, shopping, housekeeping, meal preparation as well as skilled services for wound care, therapies and home health aides.   Concierge services may be daily for a specific time period, 24 hour coverage, or can be a live-in situation for a set number of days depending on the procedure performed.  If you live alone or otherwise have no one nearby, able or qualified, Concierge Services are the perfect solution.

Me, The Agency, and Irene Zeitgeist

 

Doing our best in the worst of times...reflections on this week's events

Historic is the buzzword of the week in describing the mass exodus of folks from the south to points north with the goal of escaping the pending mayhem named Irene.   We of the Northeast are a hardy lot.  Accused often of being loud, mouthy, rude, aggressive, and in-your-face. We have been the butt of all jokes Jersey and beyond.  And your point is???
Call us anything but late to the party...we can pull it together when shake comes to splash.    

Bake, Shake, and Soak

  

The week started typically enough with references to a tropical storm, growing into a hurricane and possibly threatening the east coast.  Yep, been there, heard that.  Summer was still very much in the present here.

By midweek our world was rocked literally for some seconds.

One does not put earthquake and New Jersey in the same sentence.  We are relatively fortunate compared to our southern and western counterparts when it comes to natural disasters.

Got our Emergency Plan-check, know the status of the clients-check, got the team in place-check.  We accounted for everyone.  Once we were certain that all clients and aides were in good stead, we stepped down from high alert status.  Home health agencies are no strangers to challenging conditions.  It is part of our function to have emergency procedures in place in the event of disaster.  Curiosity and bemusement were the overwhelming response to the afternoon disruption.  We were to learn that Fate was about to play her next hand... 

  

During a time in the season when shore waters were warmest and visitors at a high, we noticed northbound traffic was on the rise with boats, trailers, and campers in tow.  The initial projections and rumors had become a reality named Irene.  There was no longer any doubt to the certainty of her destination and the strength of her destructive resolve. Our emergency procedures were back to high alert and plans executed for clients and personnel.  

Exit Stage North our Heros and Heroines

My office is in a lovely little town on a main roadway leading to the shore. 

Most of the citizens are seniors with a friendly atmosphere and high sense of community.  By this time, evacuation orders started flooding the news. 

People boarded homes, packed up, and were on the roads at unprecedented volumes.  Huge lines at gas stations and crowded stores 

in preparation for the storm turned the laid back community into a beehive of activity.  Seniors slow?  Think again.

Despite the grim predictions, cooperation and calm prevailed.  Many of the neighbors formed their own support trees and banded together to ride out the storm.  The media, municipalities, county and state offices of emergency management are doing a superb job of keeping citizens informed and overseeing evacuations.  Some folks even decided to have hurricane parties featuring...what else?  The Hurricane Cocktail!

Waiting for the Beast

Saturday morning brings a dark, eerily humid stillness. Not a hint of a breeze anywhere. Our little town is no stranger to power outages during storms.  The yards are cleared of anything that may be blown away and containers filled with water.  My normally taciturn husband has undertaken homestead disaster preparation with a military precision.   

I learned that history is not the sole property of those exiting from the south.

There will never be enough libraries built to house the individual stories of those who chose to step up and keep it all together not only for themselves but for their families, friends, and neighbors.

In my town, we all hope this will blow out to sea and give each other the 'thumbs up'.   NJ's signal for 'Game On!'   You were expecting something else?  Fuggedaboudit!

We can only hunker down, stay safe, dry and do the best we can till this nasty lady makes her exit.

    

Good night Irene and good riddance!

                                                                      

Respite Care – Help for the Caregiver

Renee T. writes in:  “I work and care for my disabled father as well as my own family.  I’m exhausted and feel stretched to the limit.  What do I do?” 

Our loved ones cared, nurtured and supported us.  It is natural to feel the duty and obligation to return the love and care they gave us.  At best we feel torn that we have neither enough time nor energy to properly give to our children, spouse, home, job or ourselves.  Even the best professional caregivers know they must take down time. 

We all need a period of rest, relaxation and rejuvenation and to reclaim our smile.

What Is Respite Care?

Respite, or break for caregivers and families, is a service in which temporary care is provided to children, seniors, adults with disabilities, individuals suffering from chronic or terminal illnesses, and to children at risk of abuse and neglect. Respite care is available in or out of home settings for any length of time, depending on care needs and family resources.  Certified caregivers provide personal care, companionship, light housekeeping, meal planning and preparation plus many other services.

It is not unusual for a client to tell me that their loved one does not want a stranger in their home or does not tolerate change well.   A modest start is recommended until your loved one becomes accustomed to the change and then you can gradually increase the services. Another suggested alternative is to consider taking the care yourself.  Hire the aide to provide services in your home and cut your workload in half.  When you have completed caring for your loved one, you will not have to undertake another list of household chores.  Your stress level will be reduced and you will feel an improved measure of control.

In addition to providing direct relief, respite has added benefits for families, including:

• Relaxation.  Your family gains peace of mind, able to take a vacation if desired, and refresh their energies and humor. 
• Enjoyment.   Pursue favorite pastimes and new activities.
• Stability.  Improves the family's ability to cope with daily responsibilities and maintain solidarity during crisis.
• Preservation.  Helps preserve the family unit and reduces the pressures that might lead to institutionalization, divorce, neglect, and abuse.
• Involvement. Allows families to become involved in their community, activities and minimizes feelings of isolation.
• Time Off.   Allows families to spend time together and alone.  
• Enrichment.  Establish individual identities and cultivate their own growth and development.

Adding home care services will improve the quality of life for both your loved one and you.  After all, isn’t that what we want for our families and ourselves?

May is my favorite month of the year.  Spring truly shows its colors and showcases one of the biggest days of the year--Mother’s Day.  We show our love and honor them in so many ways.  We spend time with our loved one reminiscing and building new memories.  Gifts of service are from the heart but the following inquiry reminds us that we should give careful thought as well… 

Fred H. writes in:  “Why do I need an agency? My neighbor hired a private aide and the care is just as good and cheaper.” 

Many families seeking to hire in-home staff turn to private individuals rather than working through an agency. Initially it can appear to be a perfect solution--and a bargain.  Is it really?  There is a significant financial, legal, and regulatory responsibility in hiring and managing a home health aide.  Some food for thought follows…

Tax Issues

As the private employer, the individual or family is required to pay Social Security, payroll and unemployment taxes. Home health aides will represent themselves as independent contractors, relieving the hiring individual of these tax obligations. It is the responsibility of the hiring party to be sure that the aide truly is an independent contractor and is therefore paying their own taxes.

Often, the aide does not meet the legal criteria as an independent contractor.   If the aide does not meet his or her tax obligations, the responsibility falls to the employer. The repercussions for noncompliance of this obligation are serious because it may involve interest on back taxes, civil fines and possible criminal penalties. Potential private employers should seek the advice of a labor lawyer to assure appropriate hiring practices with respect to federal and state tax laws.

Example: A home health aide was hired by a family on the basis of a recommendation from a neighbor who also employed this individual.  As time passed, the health of the client declined and the amount of care increased to a point where total care was needed and the aide was converted to a full-time live in status. This status lasted until the death of the client.

The aide filed for unemployment benefits. At that point, that the IRS became aware of the employer and filed a lawsuit for back unemployment taxes, penalties and fines. The family did not understand their responsibilities as an employer and found themselves in a legal action that took many months and many thousands of dollars to resolve.

Workers' Compensation and Liability Issues

As the employer, the individual or family paying for the private aide can be held liable for any work-related injury that occurs on the job. This can include the cost of all medical expenses and any disability payments that may be applicable.

This is a huge risk, especially if the care services include lifting, transferring or bathing. There are also risks related to communicable diseases if the aide does not comply with universal precautions that are required by all licensed agency personnel. 

Additionally, any injury to the person being cared for or any other person on the premises places the employer in a position of liability. In the event a home health aide were to cause an accident in which others suffered harm or loss, the employer would bear the full responsibility for all costs and compensation.

Example: A home health aide, suffers an injury while caring for a client.  The injury is severe and the aide is no longer able to work in his or her profession and subsequently applies for worker’s compensation and disability benefits. 

As the government became aware of the employment situation where the injury occurred, the family was pursued for medical expenses and for disability coverage. This cost the family many times more than it would have if they had the appropriate insurances or if they had worked through a licensed home health agency.

Abuse and Exploitation

Most individuals who become home health aides do so out of a desire to help others and demonstrate remarkable patience and care for those in their charge.  They have brought untold relief for many families and without these workers many individuals would never be able to remain in their home.

Sadly, there will always be those who see this type of work as an opportunity to take advantage of someone. This becomes especially easy when the aide and the recipient of care who may be frail, functionally limited and cognitively impaired are secluded in a private home setting with little or no supervision.  

Families do not fail to provide supervision out of malice or neglect. Supervision may be difficult because of geographic distance, lack of expertise, or close emotional bonds that may form between the aide and the person receiving the care. Furthermore, families often have neither time nor the resources to perform criminal background checks, or contact references, if they even think to ask for references. Families are so grateful for the care provided by an aide that they may place themselves in a position where they are vulnerable to manipulation and exploitation.

Agency Supervision

A licensed home care agency is responsible for providing ongoing supervision for their employees. This includes helping the aides to understand the changing needs of clients, assuring the proper limits of care according to the plan of care for the various levels of professionals, and mediating difficult relationship issues. 

Providing supervision is as important for the aide as it is for the family. Home health aides can experience very challenging situations within the private home environment.  Agency supervisors clarify the roles of the home health aide, and the expectations of both worker and care recipient. Furthermore, the agency directs the aide in setting appropriate limits on the types of care that can be provided. For example, an aide may not provide high tech care that is legally the responsibility of a licensed nurse. 

In situations where there are personality issues because of cognitive changes or a history of difficult relationships, agency supervisors are available to provide guidance and support to both staff and care recipient.  The support of a supervisor can help the aide understand that this is part of the disease process and cope with the behaviors so that the aide and the client can have a successful relationship. Supportive supervision is a key element in making a challenging situation work. 

Families need to make a basic decision about the source of the assistance when a considering home health services. The decision needs to take into account the type of help needed, financial and tax implications, how care is supervised and the relative vulnerability of the care recipient.  

If choosing a private arrangement, consultation with an attorney and an accountant is recommended to assure all arrangements meet required obligations.  If the family is unwilling or unable to assume the full scope of responsibilities, they would be best served working through a licensed agency. 

Types of Home Care Aid – Part Three

Jean S. writes in:   “Does having home health care mean I am required to hire a private duty nurse or therapist?” 

The short answer is that Home Health Care does not automatically require skilled services.  Skilled care, depending on the needs of the individual can be quite complex, specialized and comprehensive.  Last month the discussion centered on the responsibilities of Personal Care/Home Health aides and that they are trained to provide more assistance for individuals requiring an increased level of personal care.  As in the cases of companion and personal care, an assessment of the client in their home by the agency’s Clinical Services Director is part of the process in developing the plan of care.   Additional instructions for skilled care in the home include physician orders and/or other healthcare professionals.   Part Three and the final of this series focuses on Skilled Care.

What is Skilled Care?

Skilled care is a type of health care given when individual circumstances dictate that   an individual requires skilled nursing or rehabilitation staff to manage, observe, and evaluate his or her care. Nursing, physical therapy, occupational therapy, and speech-language therapy are considered skilled care and the most frequently utilized. In addition to providing direct care these professionals manage, observe, and evaluate the individual person’s care.  Any service that can be safely done by a non-medical person (or on your own) without the supervision of a nurse is not considered skilled care. 

Skilled services are typically prescribed by physician order and are of relatively short or intermittent duration compared to employment of companion or home health aides.

Discharged hospital patients who have relatively short-term needs as well as those with chronic medical conditions are the primary recipients for skilled care.  Depending on the individual plan of care both skilled and unskilled services may be necessary.

Skilled Nursing care is care given or supervised by licensed nurses.  Nurses provide direct care, manage, observe, and evaluate a patient’s care and teach the patient and his or her family caregiver. Examples include: giving IV drugs, shots, or tube feedings; changing dressings; and teaching about diabetes care.  Skilled nursing includes a number of highly specialized treatments (which may require additional accreditation and licensing) that focus on care for more critical medical conditions or age groups such as pediatrics.

Speech Therapists specialize in the study and treatment of communication problems. These licensed therapists assist with problems involving speech, language, and swallowing. Communication problems can be present at birth or develop after an injury or illness, such as a stroke. 

Occupational Therapists are trained and licensed to specialize in providing services to help the individual return to usual activities (such as bathing, preparing meals, and housekeeping) after illness either on an inpatient or outpatient/home based basis. 

Physical Therapists are trained and licensed to specialize in the treatment of injury and disease by mechanical means such as heat, light, exercise and massage.  Depending on the condition of the patient, treatment can be done at a rehabilitation facility or at home.

Counseling Services are available when counseling may be beneficial to the overall health and well-being of a client and are also provided under the care and direction of a physician.  The availability of these services may depend on state and local regulations and may include:

• Medical Social Services
• Dietary Counseling
• Psychiatric Nursing
• Advocacy and Case Management

Skilled care plans vary greatly for each individual.  Like the aides, skilled care professionals may either visit multiple clients daily or work solely with one client.  

  

                                            Warmest Regards and a Happy Spring at Home,

                                               

                                                Catherine Stelianoudakis Prochaska, CSA 

                                                                                Questions?:

                                                                               

                                                                      

                                                                                                                                 

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Types of Home Care Aid – Part Two

Frank C. writes in:   “My mother is unable to bathe or dress on her own.  What kind of service is best for her?” 

A great opening question to this month’s discussion on Personal Care.  The previous month discussed the responsibilities of Companion Care aides which are non-medical.  Personal Care or Home Health aides are trained to provide more assistance for individuals requiring a more ‘hands on’ level of care.  An assessment of the client in their home by the agency’s Clinical Services Director is the part of the process to help determine the best care ‘fit’ for the individual situation.   Additional instructions for personal care in the home may also include physician orders and/or other healthcare professionals.   Part Two of this series focuses on Personal care.

What is Personal Care?

Personal care generally involves working with individuals who cannot live alone without help. The nature of the assistance requires physical interaction between the client and the aide.  Personal care/home health aides complete both a training program and a competency evaluation or state certification program. Training includes information regarding personal hygiene, safe transfer techniques, reading and recording vital signs, infection control, basic nutrition and much more.  Requirements for certification may vary by state.  They receive detailed instructions explaining when to visit patients and what services to perform. Personal care/home health aides are largely employed by facilities and agencies and are under direct supervision of a medical professional, typically a nurse.

Personal care is available and utilized by all age groups who are unable to live independently without significant assistance in their activities of daily living or ADLs.  Depending on the circumstances the aides can be assigned on either a short or long term basis.  Discharged hospital patients who have relatively short-term needs as well as those with chronic medical conditions are the primary recipients for personal care.

As implied by the job title, the primary focus of a Personal care or Home Health aide is providing personal/hands-on care as well as emotional support and encouragement to the client. Personal care/home health aides help keep the household running as normally as possible and enable the individual to remain in the comfort of their home environment. Personal aides also provide respite care for the family caring for a convalescing adult and/or child.  Personal care is also appropriate within Assisted and/or Independent Living facilities where more individualized personal assistance is needed and either cannot be provided by the facility or is otherwise not available. Personal care/home health aides also assist in hospices and day programs and help individuals with disabilities go to work and remain engaged in their communities.


The Personal/Home Health aide may do light housekeeping for the safety and comfort of the patient - not heavy full housekeeping.  Aides also may help clients get out of bed, bathe, dress, use the toilet, and groom.  Personal aides also plan meals which can include special diets, shop for food, and prepare meals. They will also accompany the client to doctor appointments and social activities.  They report changes in the patient's condition to the family member and/or nurse supervisor and keep records of patient care.


Unlike companion care, the personal care duties are more physically demanding and daily routines can vary greatly. They may go to the same home every day or week for months or even years and often visit multiple clients on the same day. However, some aides may work solely with one client who is in need of more care and attention. In some situations, this may involve working with other aides in shifts so that the client has an aide throughout the day and night. Aides also work with clients, particularly younger adults at schools or at the client’s work site.

Home health aides and personal and home care aides generally work alone, with periodic visits from their supervisor. Aides are responsible for getting to patients' homes, and they may spend a good portion of the work day traveling from one patient to another.   Many of these workers work part time and weekends or evenings to suit the needs of their clients.  

                               Warmest Regards and Happy Spring Holidays at Home,

                                              

                                          Catherine Stelianoudakis Prochaska, CSA 

                                              Send Home Healthcare related questions to:

                                                                                                                                                         

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CareMinders Home Care - Whiting, NJ - Home Health Care in Whiting, New Jersey

CareMinders Home Care - Whiting, NJ - Home Health Care in Whiting, New Jersey

Types of Home Care Aid – Part One

Happy February--The month of showing love and care for those you hold in your heart..

Renee H. writes in:  “I’d like to get some help for my father, but I don’t know what kind of assistance is best.”

Great question and one I am frequently asked when someone inquires about home care!  Care aide responsibilities are not all equal.  Depending on what is needed, care can range from a non-medical companion to a full time skilled nurse or other professional.  An assessment of the client in their home by the agency’s Clinical Services Director is typically part of the process to help determine the best care ‘fit’ for the individual situation.    The Clinical Services Director is a Registered Nurse who is well experienced in home health care.  Part One of this series will discuss companion care.

What is Companion Care?

Companion care generally involves working with a mostly healthy individual who requires assistance in some of his or her Activities of Daily Living otherwise known as ADLs. The nature of the assistance is non-medical. A companion aide does not usually become involved in the more detailed aspects of patient care.  Companion care is not limited to the elderly and is available to all who just need some extra help on either a short or long term basis.


As implied by the job title, the primary focus of a Companion is providing emotional support and companionship to the client. In addition to their regular duties, they help the elderly client to live as independently as possible. Elder caregivers provide companionship services and help keep clients mentally healthy and alert by having conversations with them, playing games (crossword puzzles, board games, cards, etc.) and assisting them to be as physically active as is possible.  A companion aide can provide much needed respite care for the family caring for a convalescing adult and/or child.  Companion care is also appropriate within Assisted and/or Independent Living facilities where more individualized care is needed and either cannot be provided by the facility or is otherwise not available.


The companion may do light housekeeping for the safety and comfort of the patient - not heavy full housekeeping. They will clean and/or straighten a client's room, kitchen, and bathroom, laundry, and change bed linens, and remind the client to take their medications.  Companions also plan meals which can include special diets, shop for food, and prepare meals. They will also assist the client with activities outside the home, including driving to markets, doctor appointments and social activities. They may interact with other family members, particularly by reporting changes in the client's condition to the family member and just as importantly, the agency that employs the aide.


Companion aides perform many of the same job activities as those of a Home Health Aide but will not have the training or experience with patient care. Unlike home health aides, the companion position is less physically demanding as the overall condition of the client is healthier and more mobile.   A companion's role is more that of friend and confidante.  They help relieve the loneliness of an older adult who lives alone, reduce the workload of a family caregiver and bring peace of mind to family members concerned about the overall well being of the individual.

Care Management Techniques You Can Use

Did you ever wish you could just pick up the phone and call someone who can assess your situation, help you access the right services, counsel you and your family to help resolve some of your differences, then monitor your progress with an eye toward channeling your energy and abilities as effectively as possible?

If your answer is “yes,” you are not alone.  Having the help of a care coordinator or care manager could make all of our lives easier, less lonesome, and help us be more capable family caregivers.  While most of us may not have access to a care coordinator, we can all learn how to think and act like one, thereby reaping numerous benefits for our loved ones and ourselves.

What Is Care Coordination?

Although every case is different, the care coordination approach usually involves:

• Gathering information from healthcare providers

• An assessment of your care recipient and the home environment

• Research into available public and/or private services and resources to meet your

  loved one’s needs; 

• Ongoing communication between all parties to keep information up to date regarding

  services that are appropriate and effective.

Unfortunately, an assessment of your abilities and needs is not necessarily a standard part of the process, but it should be. A complete view of the situation cannot be gained without considering these factors.  The objective analysis of your health, emotional state, as well as other commitments are key elements in determining how much you can and cannot do yourself and what type of outside support is needed to ensure yours or your loved one’s health and safety.

Become Your Own Care Coordinator

By learning and applying at least some of the following care coordination techniques and ideas, you will be in a much better position to develop an organized course of action that will help you feel more confident and in control — a goal well worth achieving.

Educate yourself on the nature of the disease or disability of your care recipient

Reliable information is available from the health agency that deals with your loved one’s

condition as well the National Institutes of Health.  When using the Internet, stick with well known medical sites.  Understanding what is happening to your care recipient will provide you with the core knowledge you need to go forward.  It will also make you a better advocate when talking with healthcare professionals. 

Write down your observations of the present situation including:

• Your loved one’s ability to function independently, both physically and mentally.

• The availability of family and/or friends to form a support network to share the care.

• The physical environment: Is it accessible or can it be adapted at reasonable cost?

• Your other responsibilities — at work, at home, and in the community.

• Your own health and physical abilities.

• Your financial resources, available insurance, and existence of healthcare or end-of-

   life documents.

This assessment will help you come to a realistic view of the situation. It will let you know which questions still need answers.  It can be a handy baseline for charting your caregiver journey and reminding you just how much you have learned along the way.

Hold a family conference.

At least everyone in the immediate family should be informed about what is happening.

A meeting can set the stage for dividing responsibilities so that there are fewer misunderstandings in the future when more help may be needed. A member of the clergy, a professional care coordinator, or even a trusted friend can serve as an impartial moderator.  A family meeting is a good way to let everyone know they can play a role, even if they are a thousand miles away. It can help you, the primary family caregiver, from bearing the brunt of all the work all of the time.

Keep good records

Emergency numbers, doctors, daily medications, special diets, back-up people, and other pertinent information relating to your loved one’s care should be current and accessible. Update as necessary.  This record will be invaluable if something happens to you, or if you need to make a trip to the ER.  If you can maintain a computer-based record, it will make updating all that much easier and it might even allow you to provide the medical team with direct access to the information.

Join a support group

Or find another caregiver with whom to converse. In addition to emotional support, you’ll likely pick up practical tips as well. Professionals network with each other all the time to get emotional support and find answers to problems or situations they face.  Why shouldn’t family caregivers?

Start advance planning for difficult decisions that may lie ahead

It is never too early to discuss wills, advance directives, and powers of attorney, but there comes a time when it is too late.  It is also vital that you and your loved one think through what to do if you should become incapacitated or worse.  It can happen.

Develop a care team to help out

Especially during emergencies, or over time if the situation is very difficult.  In an ideal world there will be lots of people who want to help.  More likely you will be able to find one or two people to call on in an emergency or to help with small chores.  The critical thing is to be willing to tell others what you need and to accept their help.

Establish a family regimen

When things are difficult to begin with, keeping a straightforward daily routine can be a stabilizer, especially for people who find change upsetting and confusing. 

Approach some of your hardest caregiver duties like a professional

It is extraordinarily difficult to separate your family role from your caregiver role, to lock your emotions up in a box while you focus on practical chores and decisions. But it is not impossible to gain some level of detachment some of the time. It requires an almost single-minded approach to getting the job at hand done as efficiently and effectively as possible. It takes practice, but it is worth the effort.

                               Warmest Regards and a Happy New Year at Home,

                                              

                                       Catherine Stelianoudakis Prochaska, CSA 

                                                                                                                                    

Email:  homefront67@live.com