5 Best Family Caregiving YouTube Channels

We collected a list of helpful family caregiving YouTube channels that every caregiver should check out. The videos available provide expert and crowdsourced tips, meaningful material, demonstrations on ‘how-to’ many actions, and other supporting topics for caring for an aging parent. Keep in mind that these are not a replacement for medical advice from your doctor so always check with your physician if you have any additional questions.

Peruse the channels compiled below and you may be surprised at how much content is available on everything from a 2-minute video on medication management to longer posts about caregiver stress.

Top 5 Best Family Caregiving YouTube Channels

Check out the YouTube channels below. You will find a variety of videos on how to take blood pressure, best dental cleaning advice and other general care topics for your aging loved one.

Family Caregiver Alliance Family

Caregiver Alliance, National Center on Caregiving is a public voice for caregivers. The pioneering programs — information, education, services, research, and advocacy — support and sustain the important work of families nationwide caring for loved ones with chronic, disabling health conditions.

Caregiver Stress

Home Instead Senior Care created the Caregiver Stress video channel, and caregiverstress.com to bring caregivers helpful resources and tips related to caring for a senior loved one. It’s their small way of trying to help you navigate what they know from their own experience can be a trying time.

AARP

AARP is a United States-based interest group whose stated mission is “empowering people to choose how they live as they age.” The videos covered are on topics such as highlighting caregivers, learning healthy habits and how to disrupt aging and live independently.

National Institutes on Aging

The National Institute on Aging is the U.S. Government’s lead agency on aging research and is part of the National Institutes of Health. NIA supports a broad scientific effort to understand the nature of aging and extend the active, healthy years of life.

Care.com

Care.com believes in being there for one another. They help families find the care they need and caregivers find the jobs they want. Browse their channel for caregiving stories, advice, recipes, activities, and tips for using care.com.

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5 Tips for Communicating with Someone with Alzheimer’s

Did you know that 5.5 million Americans are currently living with Alzheimer’s disease? Communicating with someone diagnosed with Alzheimer’s can be challenging and often create frustration. However, communication is possible if you remain patient, avoid distractions, avoid pointing out mistakes, utilize nonverbal communication, and keep it simple. Read about these tips in more detail below.

5 Tips to Communicate Effectively

Be Patient

When communicating with someone with Alzheimer’s, make sure to prepare yourself before entering into a conversation. You need to be remain patient and know that it may become challenging. Do not raise your voice, show stress, or demonstrate frustration. Allow your loved one to take their time. Remember to listen and do not interrupt.

Avoid Distractions

Take away the distractions by having the conversation away from competing sights and sounds. You can do this by using a quiet room in the house (like a den or bedroom) so the attention is focused on you and not the T.V., the cars driving by, or other background noise. Doing so will at least create a clear pathway for talking.

Avoid Pointing Out Mistakes

You can easily get off topic or lose someone’s attention if you point out a mistake or correct something he or she said. Avoid this mistake and avoid arguing with your loved one.

Utilize Nonverbal Communication

Communication uses both verbal and nonverbal messaging. Try to use visual and nonverbal cues (i.e. hand gestures, facial expressions, etc.) to get your message across.

Keep the Conversation Simple

Depending on where the disease is in its progression, you may need to keep your sentences short and to the point. Eventually, as it progresses, you may need to keep your questions to yes or no answers. In addition, breakdown larger concepts into smaller, easier-to-understand talking points. For example, if you need to discuss a new medication – consider all of the items you need to communicate: the name of the medication, its purpose, why it’s happening, when it needs to be taken, how often, etc. Break down each of this and take time messaging it.

Remember not to take any issues or comments said personally. By being patient and showing respect to your loved one you can set the tone for the conversation.

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Good Communication Can Save Lives When Dementia is Involved

Coping with dementia is a reality for many caregivers and their elderly loved ones. As the cognitive faculties in a person with dementia deteriorate, maintaining effective communication—even in routine and familiar settings—often becomes difficult.

 

The web offers a lot of excellent strategies to develop communication styles that take into consideration the changing needs and abilities of individuals exhibiting signs of dementia. But without adequate attentiveness, these strategies can be challenging to implement for even the most patient caregiver, resulting in frustration and confusion. This is especially true when a loved one with dementia experiences a medical emergency and stress levels skyrocket.

 

Thinking ahead as you learn the best methods to communicate with your loved one can make a tremendous difference in the outcome of a potential medical emergency. After all, it is likely that you will know better than emergency responders and hospital staff how to interpret your loved ones verbal and nonverbal cues.

 

This means you have an important role to play should the worst occur. Your expertise enables you to provide crucial information to medical professionals that will lead them to an accurate diagnosis more quickly. This, in turn, means that appropriate treatment can be administered sooner, likely improving your loved one's prognosis.

 

Here are 4 strategies to make communication go smoothly--even in a crisis:

1. Know their baseline: One of the biggest advantages available to you as a caregiver is the time you spend with your loved one. Developing an intimate knowledge of their baseline behavior, health and demeanor, and the causes of Alzheimer's anger will allow you to better recognize and interpret changes.
2. Keep calm and carry on: Similarly, the more time you share with your loved one, the better equipped you will be to soothe and focus them during a precarious situation. Typically, a person with dementia will lose verbal capabilities before their ability to read nonverbal signs and signals. This means that you'll need to be especially aware of the messages you're communicating with your body language, facial expressions and physical contact. Also take note of the tone you're using when speaking. This is another form of communication that a loved one is likely to pick up on, even if they cannot comprehend the words being said. If your loved one is in distress, the best course of action is to present yourself as cool, calm, and collected—even if you feel quite differently on the inside. Showing your own worry can create confusion for your loved one, which may negatively impact their capacity to communicate. This will limit your ability to accurately interpret what they are telling you.
3. Set a good example: While emergency medical personnel generally serve more elderly patients than any other demographic, they do not always receive training particular to evaluating and treating those with dementia. Alzheimer's training is increasingly required for police officers and other responders, but emergency care providers are primarily experts at administering treatment. You, however, are an expert in the needs of your loved one. While you certainly do not want to impede their work, it is important to set a confident example for first responders. Illustrate the best way to communicate with your loved one. Encourage eye contact, as well as reasonable tone and volume. Pay attention to and help interpret meaningful gestures or facial expressions. Doing so can help medical professionals reach more informed, accurate conclusions regarding your loved one's condition.
4. Learn as much as you can: In addition to researching the medical conditions your loved one has, learn more about the common conditions they may experience. Generally speaking, increased age carries an increased risk of stroke and heart attack. Knowing how to recognize these and other cardiovascular events will allow you to have more productive conversations with emergency dispatchers and medical personnel.

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Having "The Talk"

Wondering how to start the conversation with an aging parent about a sensitive topic? Whether you need to talk about moving, giving up driving, or bringing in help, knowing which words to use and to avoid can improve the odds of moving toward solutions.

Start by realizing that there are fundamentally two different types of parents. Those with whom you have a relationship in which you can be straightforward and they welcome your ideas and feedback, and those who tend to be more self-conscious or private and don't welcome this kind of discussion -- and may even find it somewhat insulting.

Even if, in the past, your parent was sharing and receptive, this can change due to aging-related issues such as depression, creeping dementia, lowered self-esteem, or other frustrations. On the other hand, a close-lipped parent may be relieved to talk because he or she is worried, too.

What to say about sensitive subjects can also be tricky because you have different goals. Adult children want to solve the problem and move on. Their parents, however, want foremost to maintain a sense of control and dignity in a season marked by many losses. Your goal in how to have "the talk": Balance both sides' needs by moving forward slowly and with care.

Plan Ahead

Do some homework.

Before you say a word, take time to collect some information and research possible solutions. Ultimately, the goal is to problem-solve together through a dialogue with your parent (not to dictate the solution or to convince through arguments). But if you gather facts first, you'll be able to help in a way that's better informed and less stressful for everyone.

• Driving
  Watch your parent drive, looking for signs of an unsafe driver. Research the alternate transportation services in your parent's area or explore other ways he or she might get around if there's no personal car.

• Health issues
  Observe what specific kinds of limitations you're seeing: Trouble climbing stairs? Cooking? Managing finances? Grooming? Thinking in terms of specifics helps you figure out the best solutions, as well as be able to describe the problem accurately to your doctor (and your parent).


• In-home care
  Closely observe what activities your parent is having trouble with. Look around the house for concrete signs he or she may not be faring well independently. Start to research sources of in-home care help and costs.


• Moving or relocating
  Check out a few places on your own so you have concrete examples to talk about. In general, most people have more difficulty with abstract conversations about assisted living. If you live in a different city, you can read reviews about options and make appointments to check them out when you're there, or consult a local geriatric care manager to get recommendations. Don't think of it as being "sneaky" -- it can be less anxiety-provoking for your parent if you present winnowed options. You can always go through the whole list of choices together if he or she prefers.

Test the waters.

Also before you start the conversation, take time to get a sense of whether your parent is open to it. You can do this by first introducing an unthreatening related topic -- by phone before a visit or, if you see your parent often, in a separate visit. This isn't yet the time for hot-button topics, criticism, or anything contentious.

Stick to the positive and general. Does he or she respond openly? Defensively? Evasively? This will give you important insight into how to proceed.

Say something like:

• "How's the house? It must be hard to keep this place in good shape."
• "How's your health? What's the doctor saying these days?"
• "How's the car? Still driving to the city every weekend?"

If your parent sounds interested, say something like:

• "Is there some way I can be helpful?"
• "Yes, I can see why that would bother you. Let's talk about it more when I see you."

Even if, in a test-the-waters chat, your parent sounds receptive to discussing a tough issue, it's usually best not to plunge in yet. In this first talk, you just want to float the issue, not problem-solve. You want to show in a respectful way that you can be a helpful, nonjudgmental resource.

If he or she asks you, "What should I do?" say something like:

• "I'll be there soon; let's work on it together then."
• "What are you thinking? Give me some time to think about that, too."

What not to say:

• "Yup, that's a problem. I'm going to do X and Y to take care of that for you."
• "Sounds like it's finally time to move to an assisted living place."
• "You sound mixed up; I'm going to call your doctor."

Choose the best messenger.

What if your parent resists any talk about his or her future? Pause to consider whether this conversation is best had by another party. a neutral third party -- a doctor, a family friend, a cleric -- is often better suited to bring up tricky topics like driving or whether to live independently.

These people can lay the same groundwork, explaining what seems to be wrong and suggesting options for fixing it, without risking a strained relationship in the way an adult child does when a parent is especially resistant or feels manipulated.

Start a Conversation

Set the right tone.

So you've done some homework and gotten a sense of how ready (or indifferent) your parent is. How do you take the plunge? Plan to start the conversation on a different day from your test-the-waters chat, in person if possible. This feels less threatening and overbearing, and more natural.
Don't get critical the minute you walk in the door. Focus on connecting and having fun, while also using this time to observe. You may be on a mission to resolve the problem, but you'll have a more ready audience if you first take the time to enjoy one another's company before diving in.

Try opening with compliments -- say something like:

• "I like how you've . . . "
• "Wow, looks like . . . "

Look for an opening.

The best time to segue into a serious conversation is when your parent brings it up first and asks for your help. Failing that, look for an opportunity when everyone is relaxed. Then take the plunge. Describe what you're seeing.

If a direct approach feels welcome, say something like:

• "I see the steps are a problem for you and you almost fell this morning. Is that happening a lot?"
• "It looks like you're having trouble getting off the couch, and you seem a little lonely and mixed up when you're tired. You know they say that people do a lot better where there's a lot of activity going on, and things to enjoy."
• "Mom said you got another ticket, and I noticed the rear fender of the car is bent again. What do you think is going on?"

If an indirect approach feels better, say something like:

• "I read about this man in the paper who lost control of his car and killed some kids on the sidewalk. He was about your age. It made me think we should consider what's in your best interests with the car now."
• "Lauren's parents just sold their house on Elm Street and moved to a retirement community -- you should have heard her mom rave about not having to do any more yard work."
• "Remember Jack, my friend who became a doctor? He told me that his whole family has living wills and I'm thinking we should all do that, too."

What not to say:

• "The house was a mess last time I was there. You need a housekeeper."
• "Mom, Dad looks awful! We need to go to the doctor when I get there, because you obviously are having trouble looking after him."
• "When are you going to give up driving? I heard you had another accident."

Listen and Follow Your Parent's Cues

Use reflexive listening, an effective communication technique for difficult conversations. Rephrase what your parent says, as a way of playing back that you understand -- making your parent feel supported -- and then move the conversation forward.

Say something like:

• "I hear you saying . . . but it's also worth thinking about this. . . ."
• "Yes, I agree that . . . on the other hand. . . ."
• "I know you're really worried about. . . . Me, too -- but if X doesn't happen. . . ."
• "That sounds upsetting for you. . . . Have you thought about. . . ?"

Realize that some older adults can't articulate the real issue. They may shy from change, perhaps because they fear what it would be like or they lack the energy to deal with it. Often they avoid making a change not because of their own preferences but because they worry about upsetting someone else.

If she's anxious, say something like:

• "You're right that moving is a huge hassle. But we'll help you sort and pack and you won't have to do much. We'll set up your new bedroom to look just like this one."
• "I know we've always spent the holidays in this house, but we'd love to have Thanksgiving at our house this year. You can still make your special pies there without having to worry about all the getting ready or cleaning up."
• "You may call them ugly old grab bars, and that's what they used to be. But I was reading how universal design is really trendy, attractive home design right now."

Find ways to be reassuring, talk up the positives, or stress how the solution is good for everyone.

If she's resistant, say something like:

• "Bob says he'll pick you up for Breakfast Club every morning so you won't have to miss it, and I'll get your groceries."
• "Let's make a list of pros and cons."

To help with resistance, focus on the solution. Or, look for the underlying cause. Some people push back for a specific unmentioned reason, which may be emotional, physical, or cognitive. Maybe Dad doesn't want to talk about moving because he thinks he can't afford it. Maybe Mom lacks the cognitive ability to realize she can't live alone. If the person is very resistant, the most successful person to have the conversation is not usually the adult child. A family friend or doctor may have better luck.

If she's interested or agreeable, say something like:

• "What would it mean to you if you stopped driving/had someone to cook meals/moved?"
• "What would be the most difficult thing about. . . ?"
• "Let's make a list of what you can do about this."
• "Let's think through the pros and cons of each situation."
• "Why don't you try doing X for a couple of months and see how it works for you?"

The goal is to encourage more input and to keep the discussion positive and collaborative.
If you want a parent to consider an assisted living option, one option is to casually drive by the best place you've identified through prior research, and suggest dropping in together to have a look. Better yet if you have a logical pretext -- visiting a friend's parent, stopping to see a "friend" who works there, participating in an activity or meal you've prearranged. Make sure it's a place you've prescreened so that you're pretty sure your parent will find things to like.

Even if there's not much choice, lay out the options and their pros and cons, strategize solutions to the biggest problems, and let your parent draw his or her own conclusion (assuming dementia is not an issue).

Follow Up

Let it percolate awhile.

Whatever you do, don't launch an aggressive "sell" on your favorite option the minute you get back home or the next time you talk. Don't push for making a decision right away. Try not even to hint or nag at first.

What not to say:

• "I hope you've been thinking about our idea of bringing in some help."
• "So, selling your car -- have you done anything about it yet?"
• "Wasn't that place we saw nice? We need to get you out of here!"

Be ready to continue the conversation at any time.

If your parent mentions the conversation at all, use this as a wedge to revisit the matter in a supportive way.

If he or she offers something positive, say something like:

• "Yes, I could see you being happy there. What do you think it would be like to live there? Let's think about what we'd have to do to make that happen -- I can help."

If he or she expresses a concern:

Take it as a positive sign that he or she is at least aware of the issue and thinking about it. Go over the facts as well as the solutions again in a nonthreatening way.

If he or she says something negative:

Don't fall into an argument. Be patient and try to get at the underlying concern. Is it fear of running out of money? Is it a feeling that admitting help is necessary is also admitting failure of some kind? Look for ways to address and support the concern. Maybe you give a weekly cleaning service as a Mother's Day gift "because I don't know what else to get you and you deserve to be treated like a queen," for example.

Test the waters (again).

After some time passes, if your loved one doesn't give you an opening, you can try bringing up the issue again in a test-the-waters way.

Say something like:

• "How's the car?"
• "What did the doctor say?"

Know when to bring in help.

Total resistance means it's time for a third party (not the adult child) to try. This conversation may need to be more direct. It may have to include a discussion of the risks and the possibility that if they don't voluntarily yield, say, their driver's license or residence -- there is a risk that others will take over because of the dangers involved, and then they may have less say in what comes next. They can be told it's better to work on it voluntarily with someone who loves them and only wants to help them get what they need.

If the issue is critical and the person still won't make a safe choice, it may be time to get a family doctor and lawyer involved to evaluate competency and, if appropriate, activate a power of attorney or appoint a guardian who can make safe choices on the person's behalf.

Make it clear that you're comfortable with any decision.

If your parent is of sound mind but just making decisions that you disagree with (not endangering ones), all you can do is continue the conversation in a positive way. Any choices are ultimately his or hers. You may not like the choice, or you may end up needing to revisit the matter later, but you can't make the decisions for him or her in that case.

What you can do, is to remain upbeat and supportive, even if you're frustrated or worried. This keeps you a welcome sounding board as your parent moves, however slowly, toward resolution.
Remember that transitions involve an ongoing dialogue. Difficult as that first conversation about a sensitive topic is, it's only the first of many you're likely to have as you strategize your way toward a solution that everyone can feel better about.

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Dementia Signage for the Home

Can We Talk?

Ever feel like you don't know what else to say to a loved one? Longtime companions often feel "talked out." For others, making conversation with a frail older adult can be hard if you're unsure what's safe or comfortable to bring up. Many people balk, for example, at broad questions like, "What's your favorite memory from childhood?" because they feel put on the spot. And people with dementia may resist direct questioning because they feel like they're being quizzed and get nervous about being unable to supply a "right" answer.

Despite obstacles like these, talk is worthwhile because it passes the time, illuminates things you might not have known about your loved one, and builds new and cherished memories.
In a pinch, try this conversation-starter alternative: "Tell me about . . . "

These three little words are nonthreatening and inviting. Casually curious, they work for any topic, from the weather to politics. They allow for open-ended responses. The conversation may go nowhere (try again another time) or take off.

Here are some examples you can try:

• "Tell me about what winters were like in North Dakota when you were a boy."
• "Tell me about your wedding day."
• "Tell me about this blanket -- you knitted it, didn't you?"
• "Tell me about that pet cow you had."
• "Tell me about the garden you always had."
• "Tell me about why you joined the military."
• "Tell me about how you stay so calm all the time."
• "Tell me about your mother."

They're almost as good as those other three little words ("I love you")!

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Communicating Effectively with Your Insurance Company

Before you pick up the phone to speak to a claims representative, you need to gather some information. Be prepared to give the person you talk with:

• Your name and your relationship to your care recipient
• The care recipient's birth date
• The insurance policy number
• The name and address of the organization that sent the bill
• The total amount of the bill
• The diagnosis code on the bill
• The Explanation of Benefits (if you are questioning an insurance payment).

When you start the conversation, ask for the name and telephone extension of the individual who is handling your phone call. If you need to call again, you will want to try to speak with the same person.

Keep in mind that billing office personnel and insurance claims representatives are there to serve you. You are the customer. Be assertive. You should expect to:

• Be treated with respect and consideration.
• Have your concerns clarified.
• Have your questions answered with accurate and timely information.
• Be informed of any steps you need to take to move things along.

Communication Tips
Here are some tips for communicating effectively with people who work in the health insurance system.

• Be Prepared. Before you call an insurance company, write down a list of the questions you have so you can handle everything in one phone call.
• Take Good Notes. Take notes about your phone conversations, including the date of the call and the information you were given as well as whom you spoke with.
• Be Clear and Concise. State clearly and briefly what your question or concern is, what you need, and what you expect.
• Be Patient. Health insurance issues are frustrating and time-consuming. Accept that you will spend a certain amount of time navigating through automated telephone menus, waiting on hold and waiting for the claims process to be completed.
• Be Considerate. Most insurance personnel want to do their jobs well, and they have a tough job to do. Thank them when they have been helpful. Speak to them kindly. Assume that they are trying to help you, not that they are "the enemy."

- Artnip Dementia Signage for the Home

 

   

 

  

 

Saying "No" Means "I Love You"

How does a caregiver know when he or she can no longer manage the daily caregiving routines and planning responsibilities? What signals alert the caregiver that he or she is in trouble of getting lost in caregiving? Can a caregiver who cherishes a loved one set limits on responsibilities without feeling guilty or morally bankrupt? These are questions at the heart of successful, long-term caregiving. Unfortunately, for most caregivers, these questions do not arise until they are feeling overwhelmed and depleted. Being able to say, “No, I can no longer continue to provide care in this way,” may not only save the caregiver from emotional and physical burnout, but can also open up opportunities of shared caregiving responsibilities with others while deepening the level of honesty and openness in the relationship.

Saying “No” may seem like a harsh statement to a caregiver who prides herself on being a helpful, kind and loving person. In fact, most caregivers choose to become one because they feel a moral imperative to do so. This imperative may come from a number of sources including family relationships and roles, friendship ties and social expectations. Families often select the primary caregiver from cultural norms such as the youngest unmarried daughter or the oldest son as being responsible for a parent’s care. Friendship ties provide many single elders with caregivers who act in lieu of local family members. In the United States, the social norm is for family and friends to provide care to elders first before the government. Current statistics show that the majority of elder care is provided by families and other members of an elder’s informal social network. Proximity is also a component in caregiving. The closer one is geographically to a loved one, the more likely he or she will become the caregiver. Personal values derived from one’s faith or spiritual practices may lead a person to feel called to provide care. Moral decision making based on humanistic values such as, “Everyone has the right to stay at home if they choose no matter what,” may encourage a person to become a caregiver. Wherever the imperative is coming from, the role of the caregiver is intimately linked to that person’s code of ethics and the way in which the person chooses to act in his or her own life.

What does saying “No “mean anyway?

Is it a final giving up of duties that implies the caregiver is ending the relationship and leaving a loved one to fend for himself? Maybe the “No” means, “I’m tired and feel trapped.” Maybe the “No” means, “I have failed to be all I could be as a caregiver.” Maybe the “No” means, “I can’t do what you want me to do and I feel inadequate.” Or maybe the “No” just means, “ I am so tired, I have to stop.” The word “No” can have different meanings for different people. “No” doesn’t necessarily have to have a negative connotation attached to its meaning. “No” can be understood as a pause, a time for reflection, a breathing period or, “Let’s stop and talk this over. Things need to change.” Exploring the meaning of “No” for the caregiver is often the first step in establishing better emotional boundaries.

Healthy emotional boundaries are important in helping the caregiver distinguish between his or her own needs and the needs of the person being cared for. Boundaries remind the caregiver and elder that their relationship is between two adults and that there need to be expectations of mutual respect and autonomy for the relationship to be successful.

The ideal time to discuss caregiving boundaries is in the beginning when both people are new to the process of developing this special relationship.Talking about needs in a calm and supportive way allows each member to feel the other’s concern while acknowledging that the relationship will have some limitations. In an idealized world of caregiving, the care recipient could turn all problems over to the caregiver without any worries or stress and the caregiver would have limitless capacity for love and work. But neither of these situations is realistic. Getting off to a good start by talking about boundaries as part of a healthy relationship lays the groundwork for developing emotional resilience and flexibility to respond to an increase in the elder’s care needs, while managing the inevitable caregiver stress.

In practice, most caregivers address the issue of their own limits after the caregiving relationship gains full steam. Caregivers often get inducted into helping through a sudden major health crisis of a loved one (such as a heart attack) or by the slow but steady process of taking on tasks and responsibilities for the elder as she experiences aging and the loss of function. In either situation, the caregiver and care recipient aren’t necessarily thinking about being in a relationship but about getting the jobs done that need to get done. In the first instance, addressing the immediate and critical health care needs of the elder takes precedence over long-term care planning. However, as soon as the elder is stable, the time is right for the caregiver to discuss boundaries and limits. In the second instance, caregivers need to raise the issue of boundaries as soon as they begin to detect the first signs of their own stress or burnout. Signs such as avoiding the loved one, anger, fatigue, depression, impaired sleep, poor health, irritability or that terrible sense that there is “no light at the end of the tunnel” are warnings that the caregiver needs time off and support with caregiving responsibilities.

Setting emotional limits involves a process of change with five key steps.

First, the caregiver must admit that the situation needs to change in order to sustain a meaningful relationship. Without change, the caregiver risks poor health, depression or premature death. The primary caregiver is such an important person to the elder that impaired caregiver health puts the elder at further health risk. Second, the caregiver must reconsider personal beliefs regarding what it means to be a good caregiver. Since the caregiver generally has moral expectations of his or her own behavior, redefining what “should” be done to what is reasonable and possible to do can be a liberating moment. This may include lowering some expectations of one’s ability to do things and delegating tasks to others. Third, the caregiver needs to identify key people (friends, family or professionals) who can support and guide the caregiver through this change process. Frequently, caregivers join support groups with other caregivers to reinforce their commitment to change or hire a geriatric care manager coach. A support group is also a place to express anger, anxiety, frustration and sadness about the caregiving experience instead of inadvertently having these feelings pop out during a tense conversation with a loved one. Fourth, the caregiver needs to develop communication tools to express the need for boundaries. Honesty and simplicity in talking about feelings and needs does not come easily; particularly if one is not familiar with having these types of direct discussions. Lastly, the caregiver must be able to sustain this new approach while allowing the elder time, to react and express his or her feelings about the changes. Readjusting the balance in any relationship takes time, especially when both members have competing needs.

There is a simple but effective communication approach that can help caregivers express feelings and set boundaries.

This approach encourages the caregiver to speak from an “I” point of view, in a non-accusatory fashion, expressing the caregiver’s limitations or feelings and offering an alternate solution. Some examples of “I” statements are:

“I can no longer drive you to all of your medical appointments due to my work schedule and my limited time off. I know this will be a change for you. I suggest we look into other transportation options such as the Busy Bee Medical Transport Service.”

“Mother, I am unable to continue with the responsibility of cleaning the house weekly. I want to spend my time with you on other matters. I know it’s hard to let newcomers help, but I think it is time to hire a homemaker service you would be comfortable with.”

“Dad, I can no longer assist you down the outside stairs. I am worried about your safety and mine. I believe we need to build a ramp for easier access to your home. I have found a carpenter who has reasonable rates for construction.”

In each of the above statements, there is a presentation of what the speaker cannot continue to do, an acknowledgement that the change will have a consequence for the elder and a suggested solution. No attempt is made to make the elder feel guilty about the effort the caregiver is expending or the caregiver’s stress level.It is understood the elder knows the caregiver is working hard. Setting the boundary is the caregiver’s responsibility. There is, however, an invitation for discussion and joint problem solving. At first, expressing boundaries in “I” statements may feel awkward, but with practice, caregivers can learn to raise difficult topics by establishing a comfortable atmosphere for discussion.

Initially, the caregiver may experience resistance on the part of his or her loved one to dialogue about changes as to the provision of care. Gentle persistence is needed to attend to the need for new boundaries. Discussions that can be introduced at a time when both individuals have lower stress and are feeling quiet and comfortable with each other are discussions that have a greater chance of success. Avoid making decisions about change during emergencies. Waiting until the situation is calm, and both parties can take time to think through issues, creates an atmosphere of joint decision making and ownership of the outcome. Making changes in small steps toward a larger change gives everyone a chance to adapt comfortably.

Caregiving is a dynamic relationship that evolves over time. As caregiving tasks increase, so will stress on the caregiver. A caregiver and his or her loved one will manage this challenge successfully if each person is able to express directly what he or she needs, wants or can do. A relationship that allows for and respects boundaries and individual limitations can expand to include other caregivers without the risk of lessening the importance of the primary relationship that sustains the elder in the aging process.

Dementia Signage for the Home

  

  

  

  

How Are YOU? Part 2

Communicating with caregivers about their role can be challenging. Two national caregiver organizations conducted focus groups with caregivers to find out what they think about their role. Some highlights of the final report are provided here, and offer some insight into ways to improve communication with caregivers whether you are a healthcare professional, a social worker, or a friend or relative of a caregiver.

• Caregivers focus on their loved one, not on themselves. In general, most caregivers see caregiving as a role they play in relation to their loved one, not something they need to support themselves in doing. Many say they are "putting their own lives on hold" to care for their loved one and will "balance it out" later.
  
  
• Many caregivers are hesitant to share duties with other family members. Participants are reluctant to seek help with their caregiving duties — even from other family members — for many reasons. Some feel that no one can care for their loved one as well as they do, and so feel guilty leaving their loved one with anyone else. Others feel they have no one to ask for help, or are waiting for people to volunteer.
  
  
• Most caregivers are unfamiliar and uncomfortable with outside services. Participants are especially resistant to the idea of receiving respite services from an outsider. Few were aware that such services are even available, and most assume that they would have to pay someone to provide this service. Many argue that their loved one would not feel comfortable having a stranger care for them. Many say they would not feel comfortable using a respite service to do something "just for themselves," and would only use such services to get things done like shopping or laundry.
  
  
• Caregivers are reluctant to discuss their caregiving responsibilities at work. Some of the caregivers have talked with their employers about the affect caregiving has on their work lives, and many have found their employers to be supportive and flexible. However, this is not always the case. Some are reluctant to talk with people at work about their caregiving. A few say they have harmed their careers — or even had to give up jobs — because of their caregiving role.
  
  
• Many caregivers are reluctant to talk about — or even speculate on — whether or how caregiving affects their own health. They admit to feeling tired and stressed, but few talk of other effects. Only a handful have talked to a doctor about their caregiving. On the other hand, a few say they have been clinically depressed or physically ill as a result of caregiving.
  
  
• Most caregivers, if they are looking for help or advice of any sort, are interested in how they can do a better job as a caregiver or improve their loved one's quality of life. This suggests that the best way to approach caregivers is to start by talking about caregiver resources, ways to help the person for whom they are caring, and improving themselves as caregivers. Then, you can talk about making things better for themselves, focusing on the fact that getting the help and support they need, and taking time for themselves, will make them better caregivers.

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