If you are still unsure if it is time to step in, let’s help you identify where you are.
Gerontology specialists use two main measures when evaluating whether a person needs outside help and intervention. The first are the Activities of Daily Life mentioned earlier in section 1. If your loved one has problems with the following activities, then intervention is required:
• Incontinence
• Eating, and feeding oneself
• Getting in and out of bed
• Toileting
• Bathing
• Dressing
• Safety
The second list of activities, known as Instrumental or Intermediate Activities of Daily Life, are also essential when living alone:
• Managing finances
• Using the telephone
• Shopping
• Preparing meals
• Housekeeping
• Doing laundry
• Driving or using transportation
• Managing medications
Keep in mind, if your parents cannot maintain all the activities listed, that doesn’t necessarily mean they can no longer live independently in their own home; it just means they will require some support in order to do so for the time being.
While it may seem like the inability to do any of these tasks would be easy to spot, remember that it is difficult to notice many of these challenges unless you are living with the person. Simply asking for updates on the phone may not be sufficient as your parents may not want to worry you with the truth if they are having trouble. Acknowledge that as their child, you may not want to hear the truth yet either, as it means you will have to face some potentially scary health information about your loved one, as well as need to step in and take action. As scary as the truth may be, the sooner you know, the better.
Getting an honest picture of how your parents are doing requires a bit of detective work. Here are some things to look for the next time you visit their home:
• Observe how well they are dressed and their personal hygiene, especially when compared to how they typically looked in the past.
• Check the fridge and look into the level of food they keep on hand, and compare that with how frequently they are able to get to the store for more. Is it enough?
• Ask to see where they keep their medication. Compare the number of tablets in each bottle with the date the prescription was filled and ensure it is depleting at the correct rate.
• Make sure bills are being paid by checking for overdue notices, and seeing whether the phone, television, and electricity are all in working order.
• Check on levels of things such as laundry and garbage, and the cleanliness of their clothing, rooms, and bedding.
• Check that major changes haven’t happened without you knowing, such as the loss of their driver’s license, falls or injuries, or instances of getting lost.
• Ask for details about their social activities and take note of any social withdrawal behavior, such as no longer playing cards with friends or other activities they used to do regularly.
• Take note of any memory issues they exhibit, such as forgetting names of grandchildren or friends during conversation.
• Ask about their health. Sometimes they might not want to burden you with bad news, but if you ask a direct question about any new conditions they might have, or whether they’ve had to make any recent trips to the doctor, they’ll be more likely to tell you.
4. Are You Ready to Be a Caregiver?
Given the likelihood of you or your spouse taking on caregiving responsibilities at some point in the future, it is helpful to consider your readiness in doing so as early as possible. Whether or not the role of caregiver is taken on by choice or out of necessity, one of the most important things to consider and be aware of is the impact such a role will have on your life.
While caregivers can enjoy a great sense of satisfaction and purpose in knowing they are helping a loved one, there are challenges to be aware of including:[5]
• Financial stress
• Loss of social life
• Giving up personal interests due to lack of time or money
• Emotional stress including anxiety, loss of appetite, and depression
• Behavioral stresses such as dealing with challenging family dynamics and loss of privacy
Examining the full scope of a caregiver role is helpful in understanding what you can do ahead of time to prepare. Worksheet 1 can help gauge your readiness and point you towards the questions you need to start asking. (This Worksheet is in the download kit so you can print a copy or complete it on your computer using MS Word or compatible software.)
Worksheet 1: Determine Your Readiness to be a Caregiver
If your answer is “no” to any of these questions, it is time to take action and start preparing. Fortunately, you have already taken a big step in reading this book. Don’t be afraid. The answers and preparations you need are in your hands right now! Preparation doesn’t need to be overwhelming, and the earlier you start, the better. By following the action plan that comes next, you can do a lot to get ready.
5. The Seven-Step Action Plan for Caregivers
If you are entering into a caregiver role, or simply want to start preparing for the possibility, the following seven-step action plan will help you get started, clarify the steps you need to take, and outline key points you need to explore. Many of these steps are outlined in more detail throughout this book, with additional tools to help you through this process.
1. Educate yourself about caregiving and the health-care system: Look for books on caregiving in your local library, helpful articles and websites online (there are many), and reach out to other caregivers you may know to get their advice and perspective. Touch base with your local community care action center or community support services to find out what services are available in your community to serve the needs of seniors. Be prepared for the losses your parents may face and how you may have to deal with them, including incontinence, memory loss, wandering, and inability to recognize you or other loved ones. The more you know, the fewer surprises you’ll be faced with later.
2. Get to know the financial and tax support available: There are many tax benefits and government programs aimed at assisting those in caregiving roles and helping to minimize the financial burden involved. (See section 6. for more information.)
3. Get organized: Find the documentation you will need to fulfill this role. This means ensuring your parents’ will and power of attorney forms are completed, up to date, and easy to find. Ensure any financial documents related to bills, pensions, insurance,