Facing The Tough Decision To Place Mom In An Assisted Living

As my readers know I am not only a professional caregiver, I am also, along with my sister caring for my 91 yr old mother. Now we are at a crossroads in her care.

The task of caring for her at home is becoming just to much for my sister and I. And so we are searching for the next place to plant our foot on this journey of family cargiving. This is the toughest step we have had to take so far, but for the sake of all of us it is a step I feel we must take. Even if the road is a bit rocky and our footing is a bit unsure we must trudge ever forward.

Today we looked at a facility that is classified as an adult foster home in Michigan. It is the largest of its type, as classified in the state, being a 20 bed facility. In Michigan there are 3 types of adult foster homes licensed by the state, which are also called homes for the aged. They are 6 resident, 7-10resident and 11-20 resident.

The facility was nice with private rooms with private bath, staff seemed nice and she can bring some of her own furniture. And best of all it is close to all of her family and friends and so visiting will be easier. The only draw back is she only has enough money to stay there for 2 yrs which means if she runs out of funds and has to go on Medicaid we will have to move her again in 2 years. 

Monday I will reach out to the Area Agency on Aging ( most every county in the U.S. has one) to see what advise they can offer as we make some very tough and sometimes scary decisions.

My mom is a wonderful person and a great parent, grandparent and great grandparent and we want see to it that she is as happy as possible during her final years. And that is why these decisions are so hard to make.  I will share with all of you the progress we make as we take these next very tenuous steps. The time has come, the time no child looks forward to, when we have to make decisions for our parents that they may not at first like, hopefully mom will understand and know it is for the best. At least I pray she does.

Until next time

Take care my friends and share the story of your journey on this road with us. The old saying goes there is strength in numbers, and we all need strength on this journey.

Ruth Anne

This always reminds me of a verse in scripture which says:

"Very truly I tell you, when you were younger you dressed yourself and went where you wanted; but when you are old you will stretch out your hands, and someone else will dress you and lead you where you do not want to go." -John 21:18, New International Version 

It is a big responsibility.

Will

Families: Why Consider A Professional Independant Caregiver

When the time comes to look for more help to care for your loved one, you as family members have two options:

1. Hire a caregiver through an agency, or.
2. Hire a Professional Independent Caregiver.

Our goal here is to help families see the value in hiring Professional Independent caregivers.

When you chose the later consider the following:

An Independent Caregiver will more times than not have a more vested interest in their business / career. It is their sole source of income for many and it is their business, they want it to succeed. How do they do so? By providing exceptional care for their clients. They depend on referrals  to keep them working. If their performance is poor they will have no referrals to keep them employed.

At PAL Caregivers we are building a resource spot for Independent Professional Caregivers to draw from. We will be providing links for them to help them boost their knowledge and share best practices with each other.

I have worked as an independent caregiver for sometime now and have observed caregivers who work for themselves and those who work through agencies. I believe that with the proper resources, independents are to a great extent the way to go.

Also consider this... When you hire through an agency your hourly rate will be 20-25 an hour with 9-10 going to the caregiver, not a living wage and barely more than a fast food worker. However if you hire an independent, you can pay them 15-16 an hour, feel good about that and at the same time get better care at a lower rate than the agency.

A good place to look for independents is at the website, Care.com. You can place an ad on that website and also see profiles of those you would like to interview.  When I decided to go back into caregiving I looked at the ads on this site and found a wonderful family to work for. When my client passed that family referred me to another family, so for me Care.com was a great resource. I am not sure of the rate to place an ad for help, but I think it is in the 35-40 dollar range and your ad is posted for a good length of time. This site also helps connect people who need nannies and pet sitters. Check it out, you may find that special someone who you've been looking for to care for your loved one.

A Professional Independent Caregiver
A Person You Can Know and Trust

Also consider that when you hire an independent, you have the same person all the time, or perhaps two individuals if extended hours are needed. That way the needs and personalities of both the caregiver and the person receiving care came become familiar. They begin to establish a relationship and that makes it so much easier on both parties. When you hire an agency they may say they will send the same person, however that is just not always true. They may try, however their turn over rate is high because of the low wages they pay so over the course of just a few months you may have dozens of different people in your house, people your loved ones don't know and you don't know.

I do think companies are a valuable resource for backup, vacation time and such so it would be good to establish a relationship with an agency for those needs. But think about an independent for the reasons I mentioned above. Also, on Care.com they have an application that allows you to pay your caregiver through them so taxes are taken out and all the obligations of both you and the caregiver are met.

It's a great way to go. Give it a try.


Until next time take care

Ruth Anne

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Two Types Of Power Of Attorney We All Need

Sorry for the delay everyone. It's been a busy week, but I wanted to get back to finishing the three major pieces of paperwork everyone should have (that is every adult - not just the elderly).

We talked about the Will and the Advanced Medical Directive in two previous posts. Now we will talk about the Power Of Attorney forms and what they are needed for.

As I said, every adult should have these forms made out signed, then stored in a safe place well before they are needed. If you make them out as a younger adult you can always change them during the course of your life and update them as events change and people in your life change. However the need for these can arise at any age so don't wait until it's to late!

There are two types of Power of Attorney designations you will want to consider. The first was touched on in my post on Advanced Medical Directives. This type you chose for Power of Attorney for Health Care - a PAHC, also referred to as your Patient Advocate. When you chose your PAHC, the person(s) should be the someone most likely to be available should you have a medical emergency and need someone to speak for you. Many times a spouse is chosen and then and alternate such as a child who lives close by, a sister or brother etc. As I mentioned in the post about AMD, it is important that these people have copies of your Advanced Medical Directive and know your wishes as written so they can follow them should the need arise. A particular instance that I can think of would be someone with deeply held religious views on things such as the use of blood. I know Jehovah's Witnesses do not accept blood transfusions, so a person who was to be a Patient Advocate for one of Jehovah's Witnesses would want to understand their religious view and agree to uphold it for them. Choosing your Power of Attorney for Health Care or Patient Advocate should not be a hasty decision, but one that is well thought out and talked out with the person chosen.

The second Power of Attorney is the one we are most familiar with and that is Power Of Attorney for Financial Transactions.This form too can be found on the Internet and printed off and filled out easily. However you must have this one witnessed and notarized for it to be accepted by your financial institutions. Once you complete it do not sign it until you are in front of the notary, as they have to physically witness your signature.

Your Power of Attorney for Financial Transactions designate should be your most trusted associate, for you will be giving them the power to run your finances (usually all of your money and assets) should you be unable to manage your affairs. This person can be given limited (such as bank accounts only) or broader  (such as real estate, stock as well as bank account access) power.

One big misconception is that the Power of Attorney is good and in effect after you die. That is simply not true. This document is valid only while you are alive. Once you die your Will comes into play and the Power of attorney document becomes void.

I hope this information has been helpful. As always if you have any suggestions, comments or concerns we welcome then.

As caregivers we should make sure those we care for have their paperwork in order and that we know where it is. Don't be caught unaware be prepared.

Until Next Time, Take care of yourself!

Ruth Anne

Macular Degeneration and Hallucinations

Hello Everyone, hope all are well. As I mentioned a couple of days ago, today I will share some interesting information on macular degeneration and hallucinations. Although unknown to many of us, people with macular degeneration or other low vision problems often see hallucinations. I became aware of this one day when I took my mother to the eye doctor many years ago.

 
Macular Degeneration. The macula is made up of millions of light-sensing cells that provide sharp, central vision. It is the most sensitive part of the retina, which is located at the back of the eye. When the macula is damaged, the center of your field of view may appear blurry, distorted, or dark.



My mother's macular degeneration started some 28 years ago before there was any real research being done on the affliction. There were no shots to slow the progression as there are today, so she lost most of her sight in just the course of a few years. She was, as she is to this day, almost totally blind, having no central vision at all and only hazy peripheral vision.

One day before her sight was as bad as it is now I took her to a wonderful sight specialist in Grosse Pointe, Michigan. Her name is Lylas G. Mogk, M.D. She is a lovely doctor, very kind who had a father with macular degeneration. She also wrote a very wonderful book on the subject sharing not only medical information about the affliction but she also shared many personal items about how her father coped with losing his sight. As we walked down the hall to the exam room we noticed some drawings on the wall that looked like they had been done by children and we thought how quaint. As it turned out, those drawings were not done by children but in fact by her patients. They were drawings of the hallucinations they had experienced. Several of the drawings were remarkably similar, rows of houses with long stairs or children playing in the yard.

My mom could still see a bit better back then, and when she saw the drawings she said, "those look like the things I see". Until then I did not even know she was having hallucinations. She never talked about it, fearing people would think she was crazy. And that is how many people who have these hallucinations feel. They know the things are not real and if they talk about them maybe someone with think they are losing their mind, so they stay quiet.

There is in fact a real syndrome that people with vision problems relating to hallucinations may suffer from called - Charles Bonnett Syndrome or CBS.

If you would like to read more about this condition,  Charles Bonnett Syndrome, I have included a link to a web page with more information : CLICK HERE

If you are a caregiver and your client or family member says they see things that are not there, don't jump to the conclusion that they are starting down the road to dementia. If they have not had their eyes checked recently, then now may be the time. The things they see may be related to the development of macular degeneration, glaucoma or some other vision loss affliction. The sooner they can receive treatment the better is the hope that they can preserve as much of their vision as possible. I asked my mother yesterday if she still had these hallucinations and she said only very rarely, not like she did before. And the information on CBS does say that most of the time these hallucinations stop occurring or lessen with time.

If you know or care for someone with vision trouble, and they had never said anything about seeing strange things, maybe it's time to ask them in a kindly way. If they have had hallucinations, it could be a wonderful relief to them knowing they are not the only one seeing things that are not there. No one wants to be the only one.

I hope this information has been informative and helpful. The more we as caregivers know about such things, the better we can help those we care for and that in turn leads to less stress. And what caregiver does not want less stress! If you have information or experience with any of the things you read here or want to ask a question, please feel free to do so. We are on this journey together and remember it takes a village....We are your village!

Until Next Time Take Care

Ruth Anne