How to Help Family Caregivers During the Holidays

In health care settings, the body gets medical attention, but the mind and soul matter, too. Older adults in medical care face a battery of health questions, but too often the most consequential one goes unasked and unanswered: What does a good day look like for you today?Medicare requires people to receive a spiritual assessment within their first five days of admission into hospice. Many states allow a nurse to conduct the initial spiritual assessment, but I think it helps both the person and the health care provider for the assessment to be done with someone who has theological training. Many have been certified in clinical pastoral education, or CPE. Nurses can get so focused on the technical to-do lists of medical work  the measurements, the tests, the drug regimens that it can be hard to make time for the issues that matter most to the living human, namely, their happiness, peace and contentment.  As a spiritual care provider with 17 years in senior care facilities, and as a chaplain in the Army National Guard and Air Force National Guard, I have counseled hundreds of people in the final days of their lives.  For older adults and their families, one of the most valuable resources is also little-known a Medicare option that provides spiritual counseling for people in hospice. Longing for ConversationToo often older adults in care are being talked at, not listened to. Many times, I've found that people in the last chapter of life want to discuss their path to the end more than their medical professionals and, especially, more than their loved ones.  It often helps to have that discussion with a professional who is trained to hear them, and, if requested, to comfort and advise them.  RecommendedOpinion: Why I Went on Hospice Even Though I'm Not Dying | Personal PerspectivesThe code of ethics for the leading chaplain and spiritual care associations all prohibit proselytizing. A spiritual care provider should be able to work with someone on their own terms, no matter their beliefs. The United States may be turning more secular, but the fact remains that older adults are the most faith-affiliated of any demographic age group.This initial spiritual meeting is likely to be about the basics: Is the person religious? What is their support system? Will a certain faith-based ritual bring meaning or comfort? Do they have a preferred faith leader? Or is a secular discussion a better fit for the person's beliefs? 

Guardianship is a serious legal process that serves as a last resort for caring for an elderly parent who can no longer make sound decisions for themselves. It requires a court hearing and confirmation of incapacity by medical providers.What is Guardianship?Guardianship means an individual is appointed by the court to make medical decisions and manage daily care for an elderly parent. This typically occurs when an elderly parent:Is diagnosed with cognitive impairments like dementia or Alzheimer's diseaseHas suffered brain injuriesExperiences serious health conditions that impair decision-making abilitiesKey Considerations in GuardianshipEmotional ChallengesDeciding to pursue guardianship often involves mixed emotions. Adult children may feel uncomfortable, especially if family members disagree about the necessity of guardianship.Legal RequirementsTo establish guardianship, documentation must be submitted to the court that:Substantiates the degree of cognitive impairmentProvides evidence of poor decision-makingIncludes a medical assessment, potentially a neuropsychological evaluationTypes of GuardianshipGuardian ResponsibilitiesMake medical decisionsManage daily careAdvocate for the elderly parent's best interestsFollow the principle of substituted judgment (making decisions the parent would make)ConservatorshipIn most situations, a conservator is also appointed to manage money and property. This can be the same person as the guardian or a separate individual.Challenges of GuardianshipAdvocacy and Medical InteractionsGuardians must:Navigate complex healthcare systemsCommunicate with medical professionalsUnderstand and research medical conditionsMake thorough, prudent decisionsFamily DynamicsGuardianship can create:Potential conflicts between family membersDisagreements about care and spendingEmotional stress that may damage relationshipsState-Specific ConsiderationsGuardianship laws and terminology vary by state. Some states have:Different definitions of guardianshipVarying availability of professional guardiansUnique legal frameworks for elder careImportance of PreparationRecommended StepsHave early discussions about care preferencesDocument the elderly parent's wishesUnderstand the full scope of guardianship responsibilitiesSeek support and resources for caregiversAs the population ages and chronic diseases become more prevalent, understanding guardianship becomes increasingly important for families caring for elderly parents.

You think you or your loved one might need some help around the house, but youre not sure what. Youve done a bit of research, but the language can be confusing. Whats the difference between home care and home health care? What services does a companion provide? And most importantly, which services do you need? Each type of service, from companion care to skilled nursing care, caters to different needs and offers varying levels of support. Knowing the differences can help you make an informed decision thats best for your family, says Siarra Thorning of Right at Home Grand Junction. Heres a breakdown of the primary in-home caregiver services available. Companion Care (or Sitter Services) Companion care, sometimes known as sitter services, mainly provides companionship for seniors or individuals who do not require intensive medical care but may need supervision and light assistance. This service is ideal for those who wish to remain in their home and maintain a level of independence. Companion care helps ensure the individual is safe in their home and gets regular social interaction. Caregivers in this role engage in activities such as:         Conversation and companionship, including hobbies, games, and walks         Meal preparation and dining company         Light housekeeping         Errand services, such as grocery shopping         Transportation to appointments or social events         Medication reminders Companion care is suitable for individuals who are mostly independent but may be at risk if left alone for long periods, such as those with early-stage dementia or limited mobility, says Thorning.  Personal Care (or Home Care) Personal care professionals provide a more hands-on level of support, helping with the personal care of an individual. This service is often more generally called home care, explains Thorning.  These caregivers have more training than companion caregivers and can assist with the physical aspects of daily living. Their tasks typically include:         Bathing and personal hygiene         Dressing assistance         Mobility assistance         Incontinence care         More detailed medication management         Monitoring of vital signs under some circumstances Personal care is ideal for individuals who need regular assistance with personal care tasks but do not require medical intervention. Its a good fit for those with moderate disabilities or more advanced stages of age-related conditions. Home care visits are typically a minimum three-hour shift as often as needed up to 24/7 care and can continue as often as visits are needed. Nursing Care (Home Health Nurses) Nursing care at home is provided by registered nurses (RNs) or licensed practical nurses (LPNs). This type of care is necessary when an individual needs medical care at home, whether theyre recovering after a hospital stay or need help managing a chronic condition such as chronic lung or kidney disease. Home health nurses perform a range of medical tasks, including:         Wound care         Administering medications, including injections         Pain management         Medical equipment operation         Monitoring health status and adjusting care plans accordingly Nursing care is suited for individuals with significant medical needs that require professional health monitoring. Its commonly used for recovering from surgery, managing serious illnesses, or managing complex health conditions requiring regular medical attention. Home health visits are often intermittent and limited. As Thorning notes, They last until recovery goals are met or the health care provider certifies the visits can continue. How To Decide What Type of In-Home Care Is BestThorning says its common for care needs to cross over these categories. For example, someone who needs a nurses help managing their lung disease at home may also need the housework-type help provided by a home care aide. Here are some additional thoughts to help with the decision:         Evaluate the individuals level of independence and medical needs. A person with lung disease may not need help around the house.         Consider the care recipients preferences and financial situation. Insurance (including Medicare/Medicaid) typically does not pay for in-home care or may pay only under limited circumstances.         Consult with healthcare professionals for tailored advice and guidance. What kind of care does the primary care physician recommend? Patients who are being discharged from a hospital or nursing home may also receive recommendations from the discharge staff. Remember, advises Thorning the goal for receiving care or assistance at home is to maintain the highest quality of life possible. If you are helping a loved one or friend decide on care, respect their wishes and needs as they age or recover in the comfort of their own home. Questions To Ask When Considering In-Home Care Providers As you research in-home care options, ask each provider these questions to ensure the company is reputable and will provide exceptional, quality care:         Are Social Security, federal and state taxes, and unemployment insurance paid? Are the caregivers bonded/insured? Are workers compensation and professional liability insurance paid? A trustworthy company will pay the taxes and insurance for its caregivers, so you are protected from legal and financial responsibility.         Is the required state licensing up to date? Have all caregivers undergone background checks, including references and criminal records?         Are supervisory home visits conducted to verify that quality care is being provided?  Asking these questions will help sort out which providers have a good reputation and are highly regarded in the community and which do not have these qualities. Above all else, ensure that dependable, quality care will be provided by people you can trust.About Right at Home of Grand Junction   2777 Crossroads Blvd Ste 3 Grand Junction, CO 81506 Our office of Right at Home is a locally owned and operated franchise office of Right at Home, LLC, serving the communities of Mesa, Garfield, Eagle, and Pitkin Counties.  For more information, contact Right at Home by Calling 970-697-1331 | Email: Care@gjhomecare.com | Web Address: www.gjhomecare.com