September 3rd, 2021 by Caregiving Kinetics
July 30th, 2021 by Caregiving Kinetics
As I meet caregivers across the country, they tell me, time and again, how their lives have changed. Many changes involve the tasks of care that have crept into their lives, but the most remarkable changes I hear about are found in how caregivers perceive their world. While every caregiver’s journey is unique and personal, I have learned that caregivers pass through a series of attitudinal adjustments that loosely align with stages of experience in the care-related role.
New caregivers often report feelings of disorientation and worry, aware that things are changing but afraid of what the future may hold. Resistance, reluctance, or confusion are common responses to the emergent circumstances of their lives.
Caregivers with some experience have adjusted to many of the changes imposed by caregiving, but they may continue to struggle with a life in abeyance. Such caregivers may feel like perennial fence-sitters, caught between what used to be and what is yet to come.
Veteran caregivers, those who have answered the daily call to care over the course of several years, have usually reconfigured their lives to be available to a loved one in need. By now, former fears have yielded to an ambivalent acceptance of reality as well as a persistent focus on the present.
If you’re like most people, as you pass through stages of caregiving and develop resilience, you will probably discover that some of your perspectives and attitudes change. These changes may be manifested in a variety of ways, such as:
- Your confidence to care for your loved one increases or decreases
- Medical treatment options for your loved one are viewed differently
- Time with your loved one grows more (or less) important to you
- Your interest in world events waxes and wanes
- Attitudes about your work/career (if applicable) are affected
- Feelings about family members change
- You worry less about what other people think
- Personal values are refined by caregiving
- Empathy for other people grows
- You appreciate things that you didn’t see before
These succinct examples suggest how caregiving can change a person’s paradigm view of so many things. As I review the examples, I am struck by the fact that my personal caregiving experience produced lasting attitudinal changes for me in every single one of the areas listed above.
How has your own caregiving experience shaped your attitudes? In order to truly reflect on this question, I would encourage you to “lean in” to the caregiving experience, for it is only in acceptance of the caregiver role that the burden of care is mitigated and the beauty of care can be revealed.
May 5th, 2021 by Caregiving Kinetics
When I first introduced the model of caregiver resilience, I explained that this is a learning model. In today’s installment of the series of blog posts on the model of caregiver resilience, I want to explain how care professionals can use this model to engage in learning through self-reflection or to facilitate the learning of others who are in caregiver roles.
Professionals Using the Model for Learning through Self-Reflection
Some time ago, as I was finalizing the model of caregiver resilience, I shared it with two friends, a married couple we had invited to our home for dinner. The wife is a social worker, and her husband is an engineer. Because of the wife’s professional background working with aging populations, I was keenly interested in her feedback about the model I had developed. She immediately saw the model’s value and offered some great insights to me.
While the social worker’s response was reaffirming, I was absolutely delighted to receive the following message the next day from her husband, the engineer:
“Aaron, I wanted to let you know that when I woke up this morning my mind was flowing with ideas of how your model of the 5 R’s of resiliency in caregiving is a framework to use for pondering on a new role I have at work.”
I was struck by the fact that a model developed for caregivers was of value to a professional engineer. My friend’s comments reveal the relevance of the model of caregiver resilience to a wide variety of professional situations.
He also highlighted how the model can be instrumental in the learning process of a professional. We can observe that he engaged in a process of framing, contextualizing, and thinking, as follows:
- Framing: he viewed the model as a framework for pondering.
- Contextualizing: he applied the model to his role at work.
- Thinking: he let his mind flow with ideas.
If an engineer can learn from this model, then surely professionals in care organizations can do so as well. Whether you’re a physician, a nurse, a social worker, a certified nursing assistant, a therapist, an allied health professional, or a healthcare administrator, you can use the model to learn how to improve your resilience at work.
The model of caregiver resilience is a sort of lens that permits you to look at your work situation differently. As you examine how each part of the model applies to you, let the model “talk back” to you. If you use the model’s framework, apply it to your particular work context, and think expansively about the implications, many of the problems and challenges you’re experiencing within your caring role will crystallize, and potential solutions will emerge.
Professionals Using the Model to Facilitate Learning for Family Caregivers
There is a wide range of professionals who routinely engage with families in care-related situations. Social workers, counselors, and care managers have assumed responsibility to professionally support individuals and families through challenges associated with aging, illness, and disability. Skilled medical professionals treat their patients and interact with the families of the patients. Moreover, there are other professionals—such as attorneys, financial planners, clergy, realtors, and funeral directors—who find themselves in discussions with families struggling to care for loved ones.
The model of caregiver resilience is a practical resource that professionals can use to support the family caregivers they encounter. This can be done by using the model to facilitate a discussion with the family caregiver about their situation in order to identify problematic areas and develop strategies for improvement.
When facilitating this discussion, the professional adds one step—prompting—to the above process of framing, contextualizing, and thinking. “Prompting” represents the input of the professional in facilitating a learning opportunity for the family caregiver. The modified steps may be summarized as follows:
- Framing: the professional presents the model of caregiver resilience.
- Contextualizing: the professional references the model in the context of the family caregiver’s individual situation.
- Prompting: the professional asks questions and makes comments to help the family caregiver engage in thoughtful reflection.
- Thinking: the family caregiver and the professional “let their minds flow” about how the model can be applied in the family caregiver’s situation.
You’ll note in this scenario, the professional is instrumental in not only introducing the model but also joining with the family caregiver in applying the model. The model enables the professional to: 1) use shared language to analyze the situation with the family caregiver, 2) listen to the family caregiver’s thoughts, and 3) bring professional guidance to the discussion.
Both participants thus engage in a learning-oriented exchange that will produce insights as to how the family caregiver could approach caregiving more effectively. In turn, actions can be taken that will ultimately make caregiving better for both the caregiver as well as the care receiver. The model can be revisited again and again to evaluate progress and identify new ways to develop resilience as care-related circumstances change and evolve over time.
Over the last several months, we have released a series of blog posts on Dr. Blight’s Model of Caregiver Resilience. By examining a care situation in light of the five “R” words (Roles, Relationships, Realities, Rewards, and Readiness) in the model, you can identify areas that are causing friction, figure out how to address challenges, and learn to make the most of your circumstances.
If you’d like to invite Dr. Blight to speak to your group, please contact us.
April 5th, 2021 by Caregiving Kinetics
Family caregivers often report that caring for a loved one is among the hardest things they’ve ever done. Until you’ve assumed the responsibilities of caregiving, you’re probably unaware of the multi-faceted commitment that must be made to meet the ongoing needs of a loved one who depends on you. Nevertheless, when caregiving calls, you eventually discover how the physical, emotional, relational, and spiritual dimensions of caregiving can cause deep distress and dissonance in your life.
Caregiving has a way of rudely introducing you to things you never wanted to think about. You may choose to ignore some of these things, preferring to avert your eyes from the stark view in front of you. Avoidance can become a default position because it may be more comforting to choose not to think. Denial is a related but slightly different strategy: you know what may occur but refuse to accept that it applies in your situation. Another approach is busyness, where you can be so focused on your “to do” list that you don’t have time to manage the tough stuff.
As difficult as it may be, the best way to handle the hard realities of caregiving is to confront them. When caregivers honestly confront the most troubling aspects of their experiences, they place themselves in positions to find support and solutions that will help.
Every caregiver will face a personalized set of hard realities. While the list of challenges that could arise in caregiving is extensive, here are five hard realities that can deeply affect caregivers as well as care receivers.
Hard Reality #1: Bodies fail.
It’s amazing how easily we take our bodies for granted. We don’t even think about how much we need a particular body part until it’s no longer working for us. You know what I mean if you’ve ever broken a bone, had an organ failure, or thrown out your back. Hopefully you were able to recover and restore proper functioning. But if you’ve ever experienced such incapacitation, then you have caught a glimpse of what care receivers experience. Many care receivers—especially those who are older—traverse through a sequence of bodily failures, one after another.
As if the physical implications of a failing body aren’t bad enough, some bodily failures can also be socially stigmatizing because they make care receivers feel inferior, even less than human.
Care receivers should never feel ashamed of a bodily failure because this is actually the natural order of life. As a caregiver, you have the ability to reduce the potential embarrassment of your loved one and help them retain human dignity by choosing to take their bodily failures in stride.
Hard Reality #2: Sometimes the treatment is worse than the disease.
We are fortunate to live in a time when the miracles of modern medicine enable people to be treated for many serious illnesses and chronic conditions. But some things cannot be fixed, no matter how many medical procedures a person receives. And some things don’t warrant fixing, especially if the patient has lived a full life and finds going through treatment less attractive than living with a medical condition.
In his groundbreaking book, Being Mortal, Dr. Atul Gawande raised compelling questions about the moral implications of relentlessly pursuing medical treatments regardless of the impact such treatments may have on a patient’s overall quality of life. He writes, “The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet—and this is the painful paradox—we have decided that they should be the ones who largely define how we live in our waning days.”
Dr. Gawande suggests that patients, especially those approaching end of life, often have priorities that are outside of the hospital. If the patient finds treatment to be worse than the disease, then it may be time to forego treatment—and that is the patient’s choice to make.
Hard Reality #3: Caregiving causes stress.
Caregiving introduces an entirely new level of stress in your life. At any moment, day or night, you may have to abruptly stop what you’re doing to address your loved one’s immediate need. Sometimes these interruptions are momentary inconveniences, while other times they can completely derail your day or your week.
The frequency and severity of these interruptions are driven by your loved one’s health conditions. Your loved one’s exigencies can make it difficult for you to plan for things like out-of-town trips, daylong excursions, or even a night out for dinner. It can become hard to plan for anything in the future, because your loved one needs you here and now.
The stress induced by caregiving includes a nagging sense of never doing enough despite doing all you can do. It’s accompanied by the knowledge that your loved one is always vulnerable. Studies have repeatedly demonstrated that family caregivers are more prone to stress-related illnesses than people without caring responsibilities. If caregiving is causing you stress, you will benefit from stress reduction techniques like those mentioned in Chapter 6 of When Caregiving Calls.
Hard Reality #4: Caregiving can be an emotional roller coaster.
Caregiving produces a wide range of emotions, from extreme highs to extreme lows and everything in between. While caregiving delivers unexpected moments of joy and solace, it will also challenge your emotions in ways that you haven’t experienced before. Many caregivers carry a worrisome anxiety that causes them to feel emotionally spent, tired, and depressed. Research has shown that rates of clinical depression are markedly higher for caregivers than for the general population. Moreover, guilt and grief—the two “G” words of caregiving—usually make their presence known at various times throughout the caregiving journey.
To help people think about the emotions they feel as they fulfill the caregiving roles, I have created a downloadable list of 148 emotions. If you’re a caregiver, I’d encourage you to download this list and spend a few moments in thoughtful reflection, identifying the emotions you have experienced as you’ve been helping your loved one.
If you perform this self-assessment and find yourself gravitating toward several negative emotions, it’s a strong indication of the impact that caregiving is having on your mental health. It’s important for you to know that negative or anxious feelings are very normal for caregivers. At the same time, please don’t let yourself ignore such feelings. Although caregiving for your loved one is never going to be easy, things will be better when you obtain the support you personally need to address your emotional struggle.
Hard Reality #5: Death happens.
Even after a prolonged period of caregiving, “death” can be the unspeakable word that is never uttered. Our culture tells us that death is to be prevented, battled, resisted. Yet we paradoxically know that death is the inevitable course of our lives.
Caregivers escort their care receivers on a final journey toward the last breath of life. Knowledge of the ultimate destination doesn’t necessarily make either traveler eager to get there. On this trip, you’ll rarely hear a caregiver or care receiver ask, “Are we there yet?” because there are taboos which prohibit such a question. In fact, this might be the only journey where the more frequent question is: “How can we delay our arrival?”
Until you’ve encountered hospice care, you may have never considered the idea of a “good death.” What is a good death? It’s a question that hospice professionals ask all the time. Perhaps that’s why “hospice” is another word that people don’t like to say. However, many families find that hospice offers a refreshingly honest view of death, not to mention life. Honesty about death opens the mind to a greater appreciation of the entire life course, up to and including its final stages. As the fear of death dissipates, the ability to explore and embrace the final moments of life increases.
Confronting Your Caregiving Realities
If you’re a caregiver, there are things you may not want to think about. Hard things. Things that make you uncomfortable. Starting with the questions below, please take an inventory of your toughest realities and decide to confront them. In so doing, you’ll be opening the door to the possibility of better circumstances for your loved one as well as yourself.
Consider the REALITIES of your caregiving experience:
- What is hard about being a caregiver?
- What are the physical, emotional, financial, and spiritual realities you must confront as you care for your loved one?
- How can you respond more effectively to your specific caregiving challenges?
“Confronting Realities” is a component of Dr. Blight’s Model of Caregiver Resilience. By examining a care situation in light of the five “R” words (Roles, Relationships, Realities, Rewards, and Readiness) in the model, you can identify areas that are causing friction, figure out how to address challenges, and learn to make the most of your circumstances. We are discussing each of the five domains of caregiver resilience, one at a time, over the next few months. Next month’s blog will focus on “Rewards.”
If you’d like to invite Dr. Blight to speak to your group, please contact us.
 Gawande, A., 2017. Being Mortal: Medicine and What Matters in the End. London: Picador
March 11th, 2021 by Caregiving Kinetics
Caregiving changes relationships. While this can be disorienting and unwelcome, it’s among the most important things for caregivers to realize as they seek to meet the ongoing needs of a loved one who is aging, sick, or disabled. By recognizing that relationships are changing, caregivers are also uniquely positioned to honor their relationships with care receivers.
If you’ve become a family caregiver, you and your loved one have a shared relationship history. Perhaps you’re caring for your spouse, your parent, your uncle, or a friend. Whatever that relationship is, your interactions with your loved one were historically based upon the roles (e.g., parent-child) that each of you filled in the relationship. The role that you have played in the relationship has personal significance and meaning. The history between the two of you continues to affect the way you perceive and interact with your loved one today.
Caregiving requires a different type of role-based relationship between two people. Remember from last month’s post that the caregiving roles only emerge because of an unanticipated health condition. Nevertheless, if you do it long enough, caregiving will alter the nature of your relationship with your loved one.
You can see how your relationship has changed by comparing the terms of your historic relationship with your loved one to the new terms of your caregiving relationship with your loved one.
For example, think about your relationship with your mother. She bore the special responsibility of raising you when you were a child. Now that you’re an adult, your historic relationship with your mother is embedded in your subconscious mind; it affects how you perceive your mother and how you act around her, even today. Your mom has played a singular role in your life, and it’s hard to imagine her in any other way.
When the mother who cared for you becomes dependent upon care by you, the change can be unexpectedly difficult to comprehend and accept. You might begin the early stages of caregiving by reminding your mother about things she forgets, but eventually, you may find yourself changing your mother’s adult diapers. Family caregivers are not only dismayed to observe a loved one in such need, but they also often struggle to navigate the degree of their own involvement in the caregiving tasks that are required.
Chapter Three of When Caregiving Calls presents research from applied gerontology suggesting that family caregiving is marked by a series of role-based transitions, which start from an initial set of family relations and change over time due to changes in the caregiving context. As the care receiver’s needs become greater, the caregiver’s actions must change—and this changes the caregiver’s role identity within the relationship.
Thus, if you’re caring for your mother, the parent-child history of your lives together becomes intertwined with—or perhaps even subsumed by—the tasks of caregiving that you’re now performing for her. You may even reach the point that you start to ask yourself: who am I now in this relationship?
Although you’re observing changes in your relationship with your mother because of her care-related needs, the woman you’re caring for is still your mother. As a result, honoring your relationship with your mother is a critical component of continuing to care for her.
There are three steps to honoring relationships while caregiving:
- Remembering your historic relationship with your loved one;
- Acknowledging that things are changing due to your loved one’s health conditions;
- Adapting to the terms of an emerging care-based relationship with your loved one without forgetting the history you share together.
Adapting to the terms of a new care-based relationship with your loved one could involve uncomfortable topics of conversation concerning your loved one, the performance of caregiving tasks you never had to do before, or spending more (or less) time together. As the needs of care receivers continue to evolve over time, caregivers must make corresponding adjustments. Through it all, family caregivers remember in their minds and hearts that the person they’re caring for is special.
Honoring relationships allows caregivers to nurture and continue to be present for the important people in their lives. While the functions of caregiving may change the nature of interactions between participants, the historic relationship bond between caregivers and their loved ones motivate caregivers to summon the strength they need to continue to care.
Consider your RELATIONSHIP with your loved one, the care receiver:
- How would you describe your historic relationship with your care receiver?
- How would you describe your current relationship with your care receiver?
- How has caregiving affected your relationship with your care receiver?
- How do you feel about the changes that caregiving has brought into the relationship?
“Honoring Relationships” is a component of Dr. Blight’s Model of Caregiver Resilience. By examining a care situation in light of the five “R” words (Roles, Relationships, Realities, Rewards, and Readiness) in the model, you can identify areas that are causing friction and figure out how best to address those challenges. We are discussing each of the five domains of caregiver resilience, one at a time, over the next few months. Next month’s blog will focus on “Realities.”
If you’d like to invite Dr. Blight to speak to your group, please contact us.
January 5th, 2021 by Caregiving Kinetics
Roles are positions we occupy in the social world. Roles are central to our human relationships as well as our place in society.
Consider these famous words from William Shakespeare:
- All the world’s a stage,
- And all the men and women merely players;
- They have their exits and their entrances;
- And one man in his time plays many parts…
Shakespeare proceeds to trace the roles a person plays in life, up to and including “the last scene of all,” which he describes as “second childishness…sans teeth, sans eyes, sans taste, sans everything.”¹
Although Shakespeare paints a grim picture of life’s final act, he’s also keen to observe how declining health conditions force role changes for people at the end of their lives.
“Care receiver” is among life’s least coveted roles.
And we know that caregivers don’t exist without care receivers.
In Chapter Two of When Caregiving Calls, I describe caregiving by using the metaphor of a stage play, borrowed from the work of sociologist Erving Goffman.² In a caregiving play:
- the care receiver is the star of the show;
- the script is written by the care receiver’s health conditions;
- and the caregiver is a supporting actor.
With caregiving, nobody knows exactly when the curtain will fall and this play will end—not the audience, not the critics, not the supporting actor, not even the star of the show. We do know, however, that when the show is over, the star performer may not be there to take a bow.
While every caregiving storyline is unique, the care receiver and caregiver are always, respectively, the primary and secondary roles in an unfolding drama.
By understanding the roles implicated in caregiving, the caregiver is able to make adjustments to an emerging caregiving story. In making these adjustments, the caregiver learns how to fulfill a supporting role that is exclusively for the care receiver.
As new dimensions of a care-based relationship evolve over time, both caregiver and care receiver adapt their positions but continue to be present for one another.
A reciprocal understanding naturally emerges. Aware of one another’s obvious imperfections, caregiver and care receiver develop a mutual acceptance and, at times, admiration for each other. The roles of caregiving thereby produce a symbiotic relationship that has the potential to reward both of the principal actors.
Consider the significance of ROLES in your personal caregiving story:
- How would you describe your caregiver role? How do you feel about it?
- How would you describe the role of your care receiver? How do you think your care receiver feels about it?
- Take some time to write your caregiving script. What is the storyline? What are some of the lines your role calls on you to speak?
“Understanding Roles” is a component of Dr. Blight’s Model of Caregiver Resilience. By examining a care situation in light of the five “R” words (Roles, Relationships, Realities, Rewards, and Readiness) in the model, you can identify areas that are causing friction and figure out how best to address those challenges. We are discussing each of the five domains of caregiver resilience, one at a time, over the next few months. Next month’s blog will focus on “Relationships.”
If you’d like to invite Dr. Blight to speak to your group, please contact us.
¹Bloom, H., 2004. William Shakespeare’s As you like it. Philadelphia: Chelsea House.
²Goffman, E., 1959. The presentation of self in everyday life. Garden City, New York: Doubleday.
December 9th, 2020 by Caregiving Kinetics
Are you seeking fresh ideas for your caregiver support program during the pandemic? You may want to consider holding a virtual workshop for your caregivers.
I recently created a new workshop outlining the framework for caregiver resilience—which is something all caregivers need, especially now more than ever. I was invited to present the workshop for a few different caregiver groups. In each case, this was originally planned as an in-person event, but COVID-19 turned it into a virtual one.
Admittedly, I was concerned about how the workshop would play out in a virtual setting. In a face-to-face environment, you have the opportunity to engage with participants in a more personal and intimate way. When a participant makes a compelling comment, you can easily ask follow-up questions. In contrast, online participants are physically separated and further detached by the veil of technology that introduces a degree of anonymity to the whole experience.
I found, however, that the virtual setting has advantages. Family caregivers who might otherwise be unable to attend a face-to-face meeting (often due to the needs of their loved one) can participate from their homes. In addition, caregivers participating in the online workshops seemed to be more willing to share their thoughts and feelings in response to questions. Perhaps the anonymity of the computer made them more forthright in sharing their struggles.
The honesty of these comments from caregivers—often delivered via the “chat” feature of the technology platform—was strikingly relatable and illuminating for everyone present. As an example, in one workshop I asked participants what the title of their caregiving script would be. Here are a few of their answers:
“The Amazing Daily Adventures of Grandma.”
“More than a Caregiver.”
“Welcome to Crazy Train.”
“Down the Rabbit Hole of Denial and Stubbornness.”
“Up to the Challenge.”
“As the Chaos Turns.”
By merely reading this list, can’t you just sense something about what’s underneath? I think every caregiver can probably read each one of those titles and relate in their own personal way.
After a few experiences like these, I’ve become a proponent of virtual workshops for caregivers. While they are different from face-to-face groups, the virtual setting enables broader participation by caregivers and offers its own unique rewards in delivering an enlightening and uplifting experience.
If you’d like to create a similar program for caregivers in your area, please let me know. I’d be delighted to work with you—from the comfort of home—to support your caregivers.
September 12th, 2019 by Caregiving Kinetics
“It’s the most wonderful time of the year,” sings Andy Williams in his well-known Christmas song, one of my personal favorites. The holiday season usually marks a time of happiness, togetherness, faith, hope, and thankfulness. But this year things might be a little different with the threat of COVID-19 and the measures you must take to reduce the risk of transmission. If you’re a caregiver, you have a particularly daunting challenge: not only must you look out for yourself, but you must also protect your vulnerable loved one.
In addition to following public health guidelines of mask-wearing, hand washing, and social distancing, I’d like to offer five tips especially for caregivers in this unusual holiday season.
- Recognize that your loved one needs you now, more than ever. No matter how difficult the situation may be, this isn’t the time to step away from caregiving. Your loved one’s vulnerability is even greater in a COVID-19 world, and you are positioned to have a major impact on your loved one’s safety and wellbeing.
- Focus on what you can control, not what you can’t control. Caregiving regularly reminds you that you have limited control over things like your loved one’s condition, treatment, or prognosis. As if that wasn’t enough, the current COVID-19 crisis may make you feel as if life itself has spun out of your hands. Despite such uncertain circumstances, your sustained efforts to address things you can control will allow you and your loved one to lead the best lives possible at the present time.
- It’s still okay for you to get help with the tasks of caring. Caregivers often feel a responsibility to “go it alone” in helping a loved one. A woman I met during a podcast last week called this a form of sacrificial love. However, if you’re sacrificing so much that you’re barely hanging on, then it’s time to give yourself permission to get help. By “sharing the caring” you’ll find some welcome relief—just make sure that those who offer assistance are also doing their part to keep your loved one safe.
- By caring for yourself you’re better prepared to care for others. As a caregiver, you may be so focused upon the needs of your loved one that you fail to take care of yourself. If you neglect your own needs, you can experience significant physical, mental, or emotional challenges of your own. Good self-care habits will make it easier for you to stay healthy and strong for your loved one who depends on you.
- Interacting with your loved one during a COVID-19 holiday season may be different, so learn to adapt and step up your efforts. The public health measures to address the pandemic have contributed to unintended consequences of loneliness and social isolation for vulnerable people. If your loved one is feeling such emotional effects during the holidays, find permissible ways to brighten their day and raise their spirits. While you may not be able to show love in your preferred manner, your sustained efforts to be there will let your loved one know how much you still care.
May 9th, 2019 by Caregiving Kinetics
Caregiving consultant and healthcare speaker Dr. Aaron Blight often takes the time to answer questions on Quora about caregiving organizational development, senior care, healthcare consulting, and many other topics. In this month’s post, we highlight his recent answer dealing with caregivers’ understanding of participants’ needs.
Why don’t all caregivers understand, or at least try to understand, exactly what their participants need, not just the surface stuff, but the deeper things beyond “fed, meds, bed?”
“Checklist care” is faster and easier to provide because it focuses on the physical needs of the care receiver.
This “surface stuff” that is described in the question is easy to observe and relatively simple to do, albeit after a bit of training. A bonus is that after you finish the checklist for the day, you can say you’re done!
“Whole person care” is slower and harder because it adds the emotional, social, and even spiritual needs of the care receiver. It gets messy. There’s not a daily “completion box” that you can check off.
Most caregivers know that humans actually need more than the satisfaction of basic physical requirements in order to thrive. But when someone is dependent upon you for things as simple as eating or toileting, your caregiving starts there.
There are many reasons why caregiving may also end there. The scarcity of time, the requirements of those paying for care, emotional exhaustion, or a lack of knowledge on how to “fix” the deeper needs of the care receiver are some of those reasons. The most tragic reason of all, however, would be indifference to the needs of the care receiver, which I’ve seldom observed.
When a caregiver consciously focuses on “whole person care,” the results may not be immediately visible, but the long-term effects can be life-changing for both the care receiver and the caregiver. It is where the greatest rewards of caregiving are discovered.
Somewhere in the middle is the best you can really hope for, the best you can expect. If you are an aging parent and your adult child genuinely listens, offers help when you want it and when you really need it, and respects the decisions you have made about your life, then you’ve got a pretty good foundation of “understanding and support” that will make the waning years of your life a little easier to bear.
March 7th, 2019 by Caregiving Kinetics
Caregiving consultant and healthcare speaker Dr. Aaron Blight is happy to answer questions on Quora about caregiving organizational development, healthcare, support for family caregivers, senior care, and many other topics. In this post, we will examine his recent answer to a very popular question. What is different about this answer, though, is that Dr. Blight tackles the question from a societal view.
What’s the hardest part about getting older?
Dr. Aaron Blight:
I have read several of the 100+ compelling responses to this question and originally thought I don’t have too much to add to what has been expressed by other writers. Then I considered the fact that the responses I read address this question on a micro-level, at the level of the individual. I’d like to address the question on a macro-level, at the level of society.
Our society is getting older. People are living longer than ever before, with chronic conditions, and there are fewer children. In 2019, for the first time in history, there will be more people over age 65 than under age 5.
The hardest part about getting older – as a society – is that we must culturally redefine what it means to grow older, as a society.
Instead of marginalizing older adults because of their age, we should revere them.
Instead of pushing older adults into retirement homes, we should integrate them into communities.
Instead of looking upon retirement as “checking out,” we should see retirement as an opportunity to contribute in new and meaningful ways.
Instead of accepting ageism as the socially acceptable form of discrimination, we should reject it.
Instead of rushing past that old person we see in the store, we should smile and say hello.
Instead of emphasizing youthful attractiveness, we should focus on learned experience.
Instead of highlighting the disease, we should acknowledge the whole person.
Instead of treating the age 65+ population as a single cohesive unit, we should recognize the broad diversity among them.
That’s all for this edition. So, what do you think the hardest part is about getting older? Feel free to chime in on Quora or email us here at info @ caregivingkinetics.com with your thoughts – and be sure to check back on our blog over the coming weeks and months for more Q&A with Dr. Aaron Blight!
Caregiving consultant and healthcare speaker Dr. Aaron Blight is happy to take the time to answer questions on Quora about caregiving organizational development, healthcare, senior care, and many other topics. In this post, we will examine some of his most recent answers dealing with the healthcare industry.
What condition would be severe enough for a patient to require professional home healthcare 24 hours a day?
Dr. Aaron Blight:
Your question asks about not only the type of care but also the frequency of care for a loved one. This is a question that really requires a case-by-case assessment of conditions and circumstances.
The reason it’s a case-by-case answer is because caregiving tasks are always dictated by the dependencies of the care recipient. Those who provide care must address the care recipient’s unique conditions on an individual basis.
Care recipient needs have a long history of classification through the modern world of hospitals, nursing homes, and long-term care. The established view of care recipient dependencies is based upon a distinction between activities of daily living (ADLs), instrumental activities of daily living (IADLs), and other needs.
Caregiving tasks align across these differing spheres of dependency.
Activities of daily living (ADLs) are a standard list of personal activities that an individual is presumed to be able to do independently: toileting, transferring, dressing, bathing, managing continence, and feeding.
Over 50 years ago, these activities were indexed to create a uniform measurement tool of the needs of the aged population (Katz, Ford, Moskowitz, Jackson, & Jaffe, 1963). This Index of ADL was based upon an eight-year study of the dependencies of 1,001 elderly people, and it has been the foundation of much research on care dependencies and corresponding caregiving tasks since publication.
Instrumental activities of daily living (IADLs) were similarly classified in recognition of the fact that older persons commonly need help with activities in addition to ADLs. Instrumental activities of daily living include managing finances, doing housework, communicating with other people, taking medications, preparing meals, transportation, etc.
Typically within the long-term care system, when a person requires assistance with two or more ADLs, he or she is eligible for nursing home placement.
The same standard of eligibility for nursing home placement is often used by third party payers – such as long term care insurers – to also determine eligibility for reimbursable home care assistance.
Having said that, someone who needs help with 2 ADLs doesn’t necessarily need professional home healthcare 24 hours per day, 7 days per week.
In addition to looking at ADLs and IADLs, here are a few discussion points to evaluate how much professional assistance you might secure for your loved one:
• What does your loved one actually want in terms of help?
• When at home, how safe is your loved one?
• How do medical conditions and treatments factor into the situation?
• What kind of informal support is currently offered from family and friends?
• What kind of informal support could be available from family and friends?
• Do your loved one’s needs follow a regular pattern? For example, is more help needed during night time?
• Can modifications be made to the home environment to make it more suitable for your loved one’s changing conditions?
• How receptive is your loved one to the idea of an outsider coming into their home to offer assistance?
• As you evaluate needs – and include your loved one in the conversation – you will be able to develop a plan that balances not only safety and welfare but also dignity and independence.
How do you get a good job in Sr. Mgmt again (back in the larger market) after being out of the career for several years, caregiving for my aged parent in a small community?
Dr. Aaron Blight:
First, kudos to you for the sacrifice you have made on behalf of your parent. Your offering of self to your loved is a reflection of your character, values, and commitment to the people who matter most.
You’ve probably discovered that job hunting is dramatically different from what it used to be, thanks to the digital transformation of everything. For someone who has been out of the workforce for years, this can be overwhelming.
When you were in senior management several years ago, you knew that the best way to find a job was through networking. Remember that? Networking is when you actually talk to real human beings, and they tell you of job opportunities and maybe even help connect you with one.
It’s the same today.
The best way to find a job is still through networking, except today there are new ways to network.
The good news is that behind all of that digital stuff there are real human beings!
The internet makes it possible for you to expand your network online, using the many social media platforms that are available. As a person who has been in senior management, you may want to start an online networking effort through LinkedIn. Here are some reasons why:
• Linkedin by the Numbers (2019): Stats, Demographics & Fun Facts
There are many human beings on LinkedIn who are in positions to help you return to the workforce.
Start by reaching out to people you know – friends and former colleagues – explain that you’re getting “back in the saddle” and would appreciate any help they can offer in finding a job. Connect with those people on LinkedIn. Ask them if they can refer you to someone they know in your field, and then you can also ask to connect with that newly referred contact via LinkedIn.
Here are a few suggestions for connecting on LinkedIn with someone you don’t know:
• include a personalized message when you ask to connect – explain what prompted your request.
• if the person accepts your request, say thank you and comment on something you learned about them from their profile.
• ask if the person would have a few minutes for a phone call.
• prepare for that phone call.
• make sure to follow up, as appropriate, after the phone call. Your follow-up might lead to an eventual face-to-face meeting.
If you get to that face-to-face meeting with a real human being who happens to be a decision maker, then you have penetrated the digital veil and given yourself a huge advantage in being “top of mind” when that decision maker needs to hire someone. Alternatively, that decision maker could actually refer you to another human being who is hiring – now.
Your future employer should look upon the years you spent caregiving as an indication of your dependability, loyalty, and strength of character. If you meet a prospective employer who dismisses or scoffs at the portion of your life that you devoted to the one who gave you life, then you probably wouldn’t want to work for them anyway.
You still have the qualities that made you a senior manager before you assumed full-time caregiving responsibilities. Management skills are in huge demand today. You may not be up on the latest technology, but you can learn all of that stuff. As you focus on what you have to offer and authentically acknowledge your caregiving sacrifices, real human beings will be impressed and want to hire you.
What’s the hardest part about getting older that no one ever talks about at all?
Dr. Aaron Blight:
Your question made me think of this statement from Dr. Mary Pipher:
“When people are in their thirties, they worry about losing their looks. In their fifties, they worry about losing capacities. By their seventies, people worry about losing everything – control, relationships, and their very lives.” (Quote from Pipher’s book, Another Country, p. 159.)
Aging is a series of losses. Personally, I think the hardest parts of getting older are found in the losses that people don’t want to talk about.
Loss of looks, loss of physical senses, loss of bodily control, loss of functional independence, loss of friends and family, loss of memory, loss of financial security, loss of purpose, loss of hope, loss of self – all of these can potentially creep into the lifelong passage we call aging.
Some of these losses are easier to discuss than others. In addition, what one person may find easy to discuss can be an especially challenging topic for someone else.
Cultural narratives about getting older often focus on the losses and rarely examine the gains.
But a lot can be gained in getting older. If you really think about it, many of the gains stand opposite the losses mentioned above.
Gain of independence, gain of friends and family, gain of memories, gain of financial security, gain of purpose, gain of hope, gain of self. I’d add gain of wisdom, gain of perspective, gain of appreciation of the present.
We all benefit from open and honest discussions about getting older – the reality of aging reaches every one of us – and it’s helpful to acknowledge the bad as well as the good.
That’s all for this edition. Check back in over the coming weeks and months for more Q&A with Dr. Aaron Blight!