Her mom’s surgery became a caregiving trial run

Exercises all the time, great home designer, smart as a whip . . . her 79-year-old mom embraced the knee surgery as a ticket to more action. Being the daughter and her mom’s best friend, Cheryl prepped to provide post-surgery care . . . and then the side effects began . . . Listen to the lively interview HERE. You’ll love these two 🙂

How to Keep Track of the COVID-19 Vaccine

Your senior may not get the COVID-19 vaccine right away, even if they live in a long-term care facility. It all depends on the amount allocated to your county by the state. 

According to the CDC, once a week, the federal government

senior with daughter getting vaccinated announces anticipated allocation figures for each state. The number of allocated doses provided by the federal government is a projection and subject to change.

For instance, my county was given 3,000 doses by Jan. 13. This allocation doesn’t meet the need as our vulnerable population totals two times more than the state average. 

Keep a record of  the vaccinations with this.

The CDC is recommending that the vaccine be administered in three initial phases:

  1. Healthcare workers and long-term care facility residents
  2. Frontline essential workers and people aged 75 and older
  3. People aged 65—74 years; People aged 16—64 years with underlying medical conditions and other essential workers.
PHASE #1 PHASE #2 PHASE #3
Healthcare workers and long-term care facility residents Frontline essential workers and people aged 75 and older People aged 65—74 years; People aged 16—64 years with underlying medical conditions and other essential workers.
What should you do next?

1. Check these resources for local information.

    1. Call your local 2-1-1 (county-funded resource information line) and ask how to get your senior a COVID-19 vaccination.
    2. Check in with your senior’s doctor’s office.
    3. Contact with your state health office and see how and where they are administering the vaccine.
    4. AARP provides state-specific vaccine information.

2.Make sure your senior’s advance directive and medical proxy form is accessible by storing it in a medical document planner. Partners administering the vaccine may require verbal, email or written consent from recipients or their medical advocate/proxy.

Number of weeks until vaccine recipient is immuneThe CDC states that with most COVID-19 vaccines, you will need two shots in order for them to work. Get the second shot even if you have side effects after the first one, unless a vaccination provider or your doctor tells you not to get a second shot. 

Keep track of your vaccinations with a medical document planner.

Download the CDC’s vaccine fact sheet for more answers.

May you find joy, even amongst the pricks. 

Author Debbie McDonald is founder of Ways & Wane and lives in Norther California with her husband.

 

Five Creative Ways to Advocate for Your Parent in a Nursing Home

Understanding the world of assisted living and nursing homes can be like learning a new language. Add a bit of dementia and a worldwide pandemic to the mix and the recipe becomes messy. Advocating for your senior under these circumstances requires creativity and perseverance!

5 strategies to advocate for your senior in an assisted living facility or nursing home

1. Make use of “compassionate care visits”, available under certain circumstances. These may include end-of-life situations, but those are not the only circumstances that qualify. According to the Department of Health & Human Services Centers for Medicare & Medicaid Services, compassionate care situations include, but are not limited to:
• A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family support.
• A resident who is grieving after a friend or family member recently passed away.
• A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or dehydration.
• A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).

Allowing a visit in these situations would be consistent with the intent of “compassionate care situations.” Also, in addition to family members, compassionate care visits can be conducted by any individual that can meet the resident’s needs, such as clergy or lay persons offering religious and spiritual support.

2. Don’t hesitate to speak up as your senior’s advocate. This is not the time to worry about being “liked”. Just remember to be courteous. Dozens of times I specifically spoke up about an IV. I usually say something like, “I appreciate you, but he’s an impossible stick so we need the specialist.” I imagine how I’m going to feel if I don’t stand up and ask for what my senior needs.

woman in nursing home looking outsideIn general, try to understand the situation before you begin expressing your concerns. Let’s say you are concerned that your senior isn’t getting their physical therapy. Bring it up with the most appropriate person by commenting in a neutral way: “My dad said something about not having PT. I’m curious to understand his current PT schedule and how that’s going.” You’ll likely get a much better response than, “Why is my dad not getting his PT?!”

3. Establish one point of contact at your senior’s residence. Discover the best time of day for them to talk with you regarding their updates and observations. Specifically ask, “Do you see any changes that concern you?” If you can regularly talk to the same person, consider setting up a 1-5 scale regarding how your senior is doing overall. This way you can more objectively compare day to day. Keep good notes about these conversations with dates and the names with whom you’ve spoken.

4. Set up a time to talk to your parent using video technology. It’s very hard to advocate for your senior if you cannot see them. When you see them (even if it’s just over video call) you can pay attention to things like: is their hair combed, have they lost weight or simply do they look like themselves or not. Nursing home or assisted living staff should be able to assist you with setting up these calls. Some places have a tablet for video calls that can be sanitized and shared between residents.

5. Should you have concerns about the care your senior is receiving, first ask to talk to the director of the nursing home. Keep good notes about what exactly was discussed. If you feel that the issues or concerns are not being addressed despite your continued attempts, contact the Long-Term Care Ombudsman Program in your state to assist you.

What is a Long-Term Care Ombudsman? 
An ombudsman (pronounced aam·buhdz·muhn) is a trained volunteer who acts as an advocate for residents of nursing homes, adult family homes, and assisted living facilities. Their purpose is to protect and promote the Resident Rights guaranteed these residents under Federal and State law and regulations. They are trained to receive complaints and resolve problems in situations involving quality of care, use of restraints, transfer and discharge, abuse and other aspects of resident dignity and rights.

May you find joy in loving one another well, even if it has to be from afar!

Elizabeth Dameron-Drew is the Co-Founder & President of Ways & Wane. She walked closely with her own father through his years of waning. She lives near Seattle, Washington with her two teenage sons, husband and two rescue dogs. When she’s not working on this platform she’s probably creating books, sewing, or vacuuming, or cooking while listening to the rain and thinking about her next creative endeavor.

How to Balance Work With Your Parent’s Medical Procedure

woman waiting for senior having medical procedureDo you take PTO at work to help your aging parents? Medical procedures like joint replacements, heart procedures and cancer treatments are common among those over age 65. 

Your aging parent may exude health, especially for their age. But it is likely they will experience a serious medical procedure.

Do you need to take time off work in order to help? 

Potentially, yes. But you may be able to show up for your parent while getting some work done using the tips below.

Six Tips to Waiting Room Productivity
  • Prepare to be your parent’s medical advocate.

Before the procedure, discuss what role they would like you to play in different scenarios, both if it goes smoothly and if there are complications.

  • Create a medical document planner with your parent.

Ensure you have copies of their driver’s license, insurance cards, advance directive, medical history and medication list. Make sure you know which pharmacy they use. Both digital and paper copies are useful. Download a free starter kit here. 

  1. Recognize post-surgery support will take more time than you expect. Transportation to follow-up appointments, support through medication reactions and personal assistance may be needed. Enlist other family members to help ahead of time. If you are providing the physical follow-up care yourself, remember self-care so that you can show up as your best self.
  2. Research outside help, even if you think you won’t use it. 

Knowing where and how you would get additional care support gives you peace of mind and allows you to meet your other work and family commitments. Consider getting a home health aide or checking into a rehab facility. Either one takes the physical burden off family members and offers built-in physical therapy. Research providers and read reviews at the unbiased Care Compare.

Many employers offer caregiver support as a part of your benefit package. Ask your HR department to offer the Ways & Wane benefit.
  • Be present in order to honor your parent.

Try to avoid scheduling critical meetings on the day of the procedure, even if you are working in the waiting room. You don’t want to be on an important call when the doctor comes out to give an update. 

  • Prepare your hospital “go” bag. 

Take your work with you. Procedures can be delayed or prolonged. Make sure you have power cords, earbuds, snacks, water and a sweater or light blanket in case your waiting time gets extended.

Download a free guide “How to Balance Work with Your Parent’s Medical Procedure” to share on your company’s Slack or with your HR team.

Care well; work well.

Debbie McDonald is the founder of Ways & Wane, simplifying eldercare decisions for working professionals. She lives in Northern California with her husband.

How to Help Your Senior Dress with Success: These Shoes Won’t Let Me In!

Age-related health challenges like arthritis and reduced mobility mean that many seniors struggle with getting dressed.

Adapting your senior’s clothing for their current capabilities creates a win-win situation. The ability to dress themselves reduces frustration, helps maintain their independence and gives them a sense of control.

senior in assisted living trying to get shoe on
Surprising Options

The world of adaptive clothing offers things like:

  • Pants with side zippers which are easier to use than front zippers
  • Magnetic belt buckles 
  • Front-closure bras
  • Extra wide slippers that velcro completely open/shut, accommodating swollen feet
  • Socks with extra wide tops are easier to put on
  • T-shirts that snap in the back so they are put on from the front without arms being having to be raised above the head
  • Snap back duster-style dresses, eliminate the challenges pants can pose
  • Non-binding elastic waistbands on roomy and stretchy pants allow for fewer adjustments after transfers
  • Wheelchair pants with discreet flaps on the backside make bathroom trips and incontinence easier to manage
  • A wheelchair blanket that snaps to the arm handles so it won’t slip off
Adaptive Clothing Companies

Several companies specialize in adaptive clothing:
1. Canadian-based Silverts allows you to shop based on your senior’s specific condition and has a wide range of colors and patterns.
2. Buck and Buck, a 40+ year old U.S. based company, features items with simple, basic styling.
3. Authored sells streamlined stylish clothing specifically adapted as easy-to-dress.

Do-It-Yourself

Alternatively, a tailor or alterations person (usually drycleaners have this service) modifies your senior’s current clothes. For example, buttons become permanently sewn to the outside of a shirt/pants and velcro attachments are hidden right behind them.

Altering existing clothes proved the best option for my dad. He donned the same kind of button-up shirt for 40 years and didn’t like pullover shirts. Adapting his favorite shirts so that he could velcro the buttons maintained his independence and made him feel “like himself.”

If you are up for a simple sewing adventure or have a friend who is, here’s a tutorial showing how to replace buttons with velcro. 

Simple Solutions

Lastly, these 3 tips help a senior get dressed by themselves:

  1. A dressing stick makes putting on shoes, socks, shirts and pants less of a struggle.
  2. A visit from an occupational therapist maximizes your senior’s current strengths and abilities.
  3. A paperclip looped into the hole in a zipper handle makes it much easier to grasp and pull.

    May your new year be filled with joy, your zippers zipped and your velcro firmly attached!

Veteran? Get Paid or Get Money for Caring

elderly veteran One of our GoKit users found the perfect assisted living facility in Florida for her father. Although at over $4,000 per month, the payments were quite a burden. After a few months, she discovered that her father was eligible for a VA housing benefit of $2,000/month, which was retroactive to the time he moved in. While not every veteran is eligible for this benefit, the VA caregiver program expanded on October 1, 2020 to offer more services.

Veteran’s Affairs offers two levels of support for caregivers: a general program available to all veterans and their families and a more comprehensive program with more strict criteria. The VA trains regional Caregiver Support Coordinators to help you understand which program addresses your situation at no charge.

General
The Program of General Caregiver Support Services (PGCSS) provides resources, education and support to caregivers of Veterans. The Veteran does not need to have a service-connected condition, for which the caregiver is needed, and may have served during any era. No formal application is required.

While the General program offers a range of supportive services, my favorite is the FREE caregiver coaching. You receive four individual sessions over the course of 2-3 months. The coach will provide you with a workbook and help you with a variety of issues caregivers face. They will coach you in stress management, problem solving, self-care and healthy behaviors, as well as, Veteran safety, behaviors, problems or concerns linked to a diagnosis. Your assigned coach will call you for a total of four sessions, over a two to three-month period.  Learn more about the REACH VA Program. Ask your Caregiver Support Coordinator about it.

Comprehensive
The Program of Comprehensive Assistance for Family Caregivers (PCAFC) is for eligible Veterans who have incurred a serious injury in the line of duty on or before May 7, 1975 or on or after September 11, 2001. This program provides resources, education, support, a financial stipend, and health insurance (if eligible), beneficiary travel (if eligible), to caregivers of eligible Veterans.

If you are the primary caregiver, you may receive:
A monthly stipend (paid directly to you as the caregiver.)
Access to health care insurance through Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), if you do not already have health insurance.
Mental health counseling.
Certain beneficiary travel benefits when traveling with the Veteran to appointments. Note for specific details, speak to your Caregiver Support Coordinator.
At least 30 days of respite care per year, for the Veteran. Respite is short term relief for someone else to care for the Veteran while you take a break.
If you are the secondary caregiver, you may receive:
– Mental health counseling.
– Certain beneficiary travel benefits when traveling with the Veteran to appointments. Note for specific details, speak to your Caregiver Support Coordinator.
– At least 30 days of respite care, per year for the Veteran. Respite is short term relief for someone else to care for the Veteran while you take a break.
To enroll or find out which programs your senior qualifies for, find a Caregiver Support Coordinator in your area.

Be sure to check the VA Caregiver Support Hotline for updates or subscribe to receive email updates and information about VA Caregiver Support Program services.

The VA Caregiver Services may help you love your senior well!

The Beautiful Practice that will Give You Peace While Caring for Your Parent

Machines beeping in the hospital ICU.

Never-dimming fluorescent lights.

Leaving home early and coming home late.

Honoring dad’s wishes while worrying about the next decision.

The situations caring for my dad in the hospital, nursing home, and then memory care assisted living seemed to pile up into a mountain of stress. 

At the end of the day I realized . . . I need to give it up.

Not give up, but give it up. To God.

I was out of my regular rhythm and resorting to quick “arrow” prayers instead of praying God’s promises and finding refuge there.

God is constant even when our circumstances are not.

We wanted you to have this Prayer Card to find encouragement as you pray for your senior. It contains four pocket-sized Bible verses to cut apart and tuck into your mirror or keep in your car. 

Now may the Lord of peace himself give you peace at all times in every way as you help your senior in their waning phase of life.

Debbie McDonald is the Founder of Ways & Wane, an online platform that helps you help your aging parent. She lives in Northern California with her husband.

The Elder Care Action Plan that Makes You a Rockstar Caregiver

Three Assessments, Three Checklists and Three Helplines. Receive the elder care answers you need.

Larry with mom Denise

I felt incompetent. 

I didn’t know where to find help for my mom . . . how to sort through the “more care” options she needed. 

I wasn’t used to this feeling and it made me want to retreat into work or Netflix. 

Making decisions about elder care is one of the toughest jobs that face an extended family.  Families are faced with new elder care services, industry-specific jargon, and a number of alternatives that appear to be similar, but may have differences that will significantly impact the care your family member receives.  After factoring in family dynamics and other emotional issues, many family members who are the decision-maker can become overwhelmed and unable to move forward.

Maybe you need to help an elderly person suddenly or maybe you are just starting to get a sense that your elderly friend or parent needs more help and elder care than they are admitting. Either way, it is hard to know where to start and even what questions to ask. 

Step by step, you’ll discover WHAT questions to ask and how to get answers.

  • Assessing your senior’s situation through identification of specific behaviors outlined here 
  • Making a list of your senior’s specific needs using the provided checklist.
  • Call free helplines listed below for answers related to elder care.
  1. Assess your senior’s situation by looking for where they need help. 

It’s easy to miss warning signs because we want to remain hopeful and frankly, sometimes we’re not sure what to do. 

  1. Look around at their environment. Is the house dirty? Are there to do lists that never seem to get done? Food spoiling in the refrigerator? 
  2. Assess their current social habits. Have they stopped leaving the house or doing the things they used to enjoy?
  3. Assess their paperwork and financial situation. Are there piles of unopened mail? Letters from collection agencies?
  4. Look at your senior closely. How is their hygiene? Are they eating? Is their personality different? 
  5. Think about their responses. Are they unable to do things that used to be familiar to them? Do they have trouble following directions?

Here is a full checklist of warning signs. 

2. Make a list of what services your senior may need. 

It’s helpful to know the phrase “Activities of Daily Living (ADLs). The term gets thrown about in the elder care industry and is used to determine how much and what kind of assistance is needed for in-home care, at assisted living facilities and at nursing homes. The five ADLs are:

  • Bathing: personal hygiene and grooming.
  • Dressing: dressing and undressing.
  • Transferring: movement and mobility.
  • Toileting: continence-related tasks including control and hygiene.
  • Eating: preparing food and feeding.

Now, take what you observed in your assessment and know about your senior’s needs and put it into this Needs Assessment Worksheet from the National Caregivers Library.

3. Use your Needs Assessment Worksheet and call these three free elder care helplines: 2-1-1, the Caregiver Action Network and the Eldercare Locator.

Since now you have an idea what help is needed, you need to get answers from a trusted source. Online searches reveal sources paying to get your attention, but how do you know if you can trust them? The top results from an online search typically cover only one area of senior need—housing (specifically assisted living.) It’s easy to get lost in clicking links and trying to figure out what each service offers. Don’t waste your time. 

Just call these three free helplines that can give you elder care advice. Talking to these advisors would have given me a starting point to getting more help for my mom. 

When you make these calls, start by explaining your situation. 

Then use this checklist of questions to navigate the conversation. The list includes questions about transportation, medical devices such as walkers and wheelchairs and canes, financial assistance, housing recommendations (assisted living, nursing home, etc.) and meals.

Call 2-1-1.

  • 2-1-1 is government-funded, but it is not just for the poor. The operators can give you information about support groups, nursing homes, assisted living and other specialized housing options and caregivers.
  • 2-1-1 gives you names and numbers of local companies, nonprofits or agencies that will provide the services your senior needs. 
  • 2-1-1 is open 24/7 and available by phone (best) or chat at 211.org. They report that 94.6% of the U.S. population can access a local 2-1-1 center. My call was answered quickly by phone.

Call Caregiver Action Network.

  • They are a nonprofit and act as aging life consultants for free. They don’t even try to collect information from you. 
  • Caregiver Action Network is open 8:00 AM – 7:00 PM ET and available by phone at 855-227-3640.

Call your local Agency on Aging. 

  • Normally, your local Agency on Aging is a great resource through their Eldercare Locator. But because of the pandemic, they are only offering emergency food help. 
  • If you want to try, contact the Eldercare Locator online or by calling 800-677-1116, Monday – Friday, 9am – 8pm EST. 
  • This government service provides geriatric care consulting for free. They can offer information about transportation options and in-home care support (bathing, dressing, sitter services, preparing meals), home modification and caregiver support/respite. They can also inform you about other local caregiving services, like those provided under the National Family Caregiver Support Program. Find your local office number on their website by easily adding your zip code.

If your senior is a war veteran, find out about eligible benefits from Veterans Affairs.

  • With the Veteran Affairs Caregiver Support Line – 1-855-260-3274 – assistance is just a quick phone call away. 
  • Whether you’re in need of immediate assistance or have questions about what services you may be eligible for, the caring licensed professionals who answer the support line can:
    • Tell you about the assistance available from VA.
    • Help you access services.
    • Connect you with the Caregiver Support Coordinator at a VA Medical Center near you.
    • Just listen, if that’s what you need right now.
  • The VA may also offer caregiver peer support, adult day health care, home-based primary care, skilled home care, homemaker and home health aide program, home telehealth, respite care and home hospice care.

Don’t get derailed by pursuing rabbit trail links through a general online search or get pulled into a recommendation by a biased source. To summarize, here is your “Care for Elderly Action Plan.”

  1. Look at the full checklist of warning signs. 
  2. Fill out the National Caregivers Library’s Needs Assessment worksheet.
  3. Print this checklist of questions to fill out during your helpline calls.
  4. Call the three helplines listed above (211, Caregiver Action Network and your Agency on Aging.)

Find more answers to your long-term care questions with this free Care Package Lite tool. It is full of curated links and templates to help you uncover answers to your tough eldercare issues.

Now may the Lord of peace himself give you peace at all times in every way as you help your senior in their waning phase of life.

New York Nursing Homes: Almost All Have Disease. What About Your State?

This one tool shows current data on COVID-19 cases for nursing homes.

nursing homes

When my dad needed a skilled nursing facility to rehab from a traumatic injury, my first call was to a few friends who had first-hand experience with local facilities. My second action was to visit in person. However, I should have started with the data. 

Data is even more important during COVID-19. While nursing home residents make up just 1.2 percent of the United States population, they account for about 40 percent of Covid-19 deaths, according to the New York Times.

This one tool can help inform your decision. Propublica, an independent nonprofit newsroom, offers an investigative tool to discover reported deficiencies, including COVID-19 cases, within nursing homes. 

Propublic excerpt:

Some of the homes have been cited for putting residents at “immediate jeopardy” of harm or death, our analysis showed.

And many of the affected homes have been previously written up for violating federal standards. That’s true in California, New Jersey and New York.

We introduced this resource in 2012 as a way to search through tens of thousands of nursing home inspection reports to find problems and trends.

You can easily compare the nursing homes in your state based on how many times they have been cited for violating infection control protocols in the past three inspection cycles (roughly three years). We’ve also added data from The Washington Post on homes with COVID-19 cases. 

The Nursing Home Inspect Tool shows this dashboard:

The dark red states show the highest rate of infectious disease rates in the nursing homes. Click on New York on the “Infection-Related Deficiencies” map and you get the report below, showing that 90% of all nursing homes in the state have had at least one case of COVID-19. 

*

ProPublica’s reporting tool also shows that some nursing home chains seem to have higher rates of cases, as well. New Jersey’s CareOne facility had a consistently higher percentage of cases than other chains in the state. 

nursing homes

Looking at these numbers may inspire us to consider more in-home care options—or at least to let data play a part in our decision.

 

The ONE Local Secret to Finding In-Home Care

nursing home

Who wants to be in a nursing home or assisted living facility? My dad certainly didn’t. 

But I couldn’t quite figure out how to manage and afford the care that he would need at home. At the time, I couldn’t quit my job to provide that care myself. Maybe I should have. But that’s another story.

When searching online, it is hard to find an unbiased source. It turns out that it may have been more possible than I imagined to find home health care with the community resources already around me. Drumroll, please . . . this is the one unexpected source of local homecare referrals, even in these crazy times. 

Call your local hospital and nursing home social workers.

Ask them for homecare referrals—even if your senior is not in the facility currently. Sounds simple, right? But it’s a gem.

Social workers can provide the following facilities:

  • A referral for home health services like physical therapy (covered by Medicare for a limited time.)
  • A referral for a homemaker evaluation. The agency will send someone to your senior’s home to discuss services that are needed. After an authorized agency makes their free evaluation, your state may provide caregiving services at no cost. 
  • Their “preferred provider” list of caregivers (which you would pay for out-of-pocket.)
    You can also use the tools in the CarePackage Lite to find the help you need.

After narrowing your list, use Medicare’s checklist to interview each agency.
Their list includes questions like:

  • Do you have staff available at night and on weekends for emergencies?
  • Can you explain what my insurance will cover and what I must pay out-of-pocket?
  • Do you do background checks on all staff?

Also ask specifically about the sanitation and protection protocols they use during COVID-19.

Blessings as you help you senior well in these challenging times.