Caring for the Caregiver

Additional Info

• Segment Number: 3
• Audio File: healthy_talk/1522ht3c.mp3
• Featured Speaker: Stephanie Erickson, Clinical Social Worker
• Guest Website: Erickson Resource Group
• Guest Bio: Stephanie Erickson is a clinical social worker with over 20 years of experience as a geriatric social worker. Her primary area of practice focuses on dementia and decision-making capacity.
  
  She works with seniors living autonomously, in care facilities, in acute care at the hospital, and who are living with family. Stephanie also provides training and consultation to families, the Alzheimer's Society, community groups, financial and legal institutions and at professional conferences. She hosts her own weekly podcast called Caregivers' Circle on WebTalkRadio.net.
• Transcription: RadioMD Presents: Healthy Talk | Original Air Date: May 27, 2015
  
  Living longer and staying healthier. It's Healthy Talk with Dr. Michael Smith M.D. Here's your host, Dr. Mike.
  
  DR MIKE: So I'm here with Stephanie Erickson. She's a social worker with over 20 years' experience in social work. She focuses a lot in the elderly, dementia, decision making capacity and she has her own podcast called Caregivers Circle on WebTalkRadio.net. Stephanie, welcome to Healthy Talk.
  
  STEPHANIE: Thank you.
  
  DR MIKE: So, Stephanie, we just ended up talking about home care versus assisted living. We were talking a little bit about cost. You really surprised me with a number that you came up with. [Inaudible] You mentioned $120,000 or so a year?
  
  STEPHANIE: You have full time home care. That's full time 24 hours/7 days a week.
  
  DR MIKE: Are there financial aid programs for families that want to go that route?
  
  STEPHANIE: Well, there are insurance products that cover that kind of care that people can purchase. I mean, I purchased that already because I'm in the business and I know what to look forward to as I age. For those that don't qualify for Medicare or Medicaid aid, you are really looking at some basic resources that perhaps the Alzheimer's Society or some other organization can give to you. But nothing is going to be full-time care. You might get three or four hours a week but, unfortunately, it's never really sufficient for what the family needs.
  
  DR MIKE: Let's switch the conversation over to the caregiver. I think this is just as important. Caregivers are taking care of parents that are getting older. As you mentioned before, there could be memory issues or full blown diagnoses like Alzheimer's and stuff. I think sometimes the caregiver forgets about themselves, don't they? How often do you see caregivers not taking care of themselves?
  
  STEPHANIE: I would say 100% of the time. Now, the not taking care of themselves, there is a range, but every single caregiver that I have ever met neglects some part of themselves whether it's something that they were passionate about, a hobby, perhaps its hygiene or sleep or their own medical appointments, their social relationships. There is always something that the caregiver is not doing for themselves and, instead, is pouring that energy into their loved one.
  
  DR MIKE: How do you define a caregiver? I think when I hear the word caregiver, I'm thinking of the spouse that is taking care of the other spouse full-time with Alzheimer's. Or, I'm thinking of a daughter taking care of her mom full-time. There's more of a wide range of caregivers, aren't there?
  
  STEPHANIE: There really is and I'm really glad that you asked that question because I think part of the reason why caregivers don't take care of themselves is because they are not identifying as such. They are identifying as "I'm a daughter". That's it. "I'm a daughter and I'm assisting my mom." Again, I think that caregiving begins very early on.
  
  So, it's simple things. Like in my own family, my mother-in-law, every time she goes to see her financial advisor, she wants my husband to go with her. Now, she doesn't need help really making decisions but already he's doing little things here or there. Or, she doesn't like to drive at night so we pick her up and drive her to our house to have dinner. This is already our introduction into being a caregiver even though we are not defining it as that. That really is the beginning of a long journey.
  
  DR MIKE: You talk about a working caregiver. Do you want to explain that?
  
  STEPHANIE: Yes, that's a large percentage of the people. A working caregivers is someone who is putting in full or part-time hours into traditional business. They are a lawyer; they work at the retail outlet, whatever it might be. At the same time, they are providing support for their aging relative.
  
  That support could be everything that I said, like doing a little bit of transportation, going to appointments, going to their house and making dinner, cleaning out their refrigerator, shoveling the snow for them during the winter. At the same time, they really have their own work responsibilities and, really, their own family responsibilities most of the time.
  
  DR MIKE: Is it a common scenario, let's say you have a family, maybe you have two or three siblings, maybe the father passed away, maybe the mom has some memory issues, how often do you find that it's just one sibling doing most of the caregiving? If that's the case, what kind of advice can you give that caregiver to get more of the family involved?
  
  STEPHANIE: I would say that that's the most common scenario. It's not necessarily a bad scenario because as you probably know with the position, healthcare professionals like to have one person to speak with. They don't want to have to explain everything to a million family members.
  
  It's good when one person takes the lead. However, if that person needs assistance, it's really important that the other family members chip in and do their part. That's not always possible because of dynamics within relationships, trust issues, history of family conflict.
  
  DR MIKE: Geography, too.
  
  STEPHANIE: I always encourage the caregiver to be honest with their family members. Instead of telling them what they should be doing, ask them what they are capable of offering. That way they don't feel like they are being forced but they can just offer what it is that they want.
  
  DR MIKE: So, leading the care for a parent or a spouse is fine but that's not the same thing as doing everything yourself, right? So, delegating a little bit to some other family members is important.
  
  STEPHANIE: There is a difference between "I'm the one doing all of the work" but there's also" I'm the one organizing it all". I'm creating a schedule so, my sister, I'm asking if maybe she's going to be visiting my mom Monday, Wednesday, Friday. I'm going to visit my mom Tuesdays, Thursdays and the weekends.
  
  My brother, who is a lawyer, he's going to be taking care of managing all of the money because he's really good that way. And we can sort of divide and conquer.
  
  DR MIKE: What's the best way for a caregiver to care for themselves?
  
  STEPHANIE: I think they need to understand and recognize what it is that their neglecting first. Because most of the time caregivers say "No, no, no, I'm fine". So, I think just really reflecting and looking deep within and saying "Who was I. What did I do prior to taking on this additional responsibility?"
  
  Then, we can start to say, "These are the pieces of my life that I am missing". Then, literally, pen and paper in hand, make a plan to make sure that you are giving yourself back some of those things that brought you enjoyment prior to taking on the responsibility.
  
  DR MIKE: It's okay to take a break as a caregiver, right?
  
  STEPHANIE: In fact, you have to. If you don't, you're not going to do your job as well. You might be resentful, you might be angry, fatigued and in the end you will hurt the person that you are trying to help because you are so exhausted and angry and resentful. So, it's really mandatory, in my mind, that caregivers take a break for themselves.
  
  DR MIKE: I had some experience with this. A friend of mine was taking care of her mom and she wasn't taking care of herself at all. I noticed, just like you said Stephanie, some of the things she used to enjoy she wasn't doing. Some of the hobbies. She used to love to do yoga. She wasn't doing that anymore. She was also and she still is very headstrong and I knew that I couldn't just go in there and say – I don't want say her name- "Alright you have to go to your two-hour yoga class today".
  
  She just wasn't going to do that. So, we took the dogs for a 20 minute walk. We just did little things to get outside again and little by little she started getting back in. That was somewhat successful for her. She's still not doing enough though, to be honest, Stephanie. Now, you have a personal website. Do you want to give that to my listeners?
  
  STEPHANIE: Sure. It's ericksonresource.com.
  
  DR MIKE: And what kind of information is on that site?
  
  STEPHANIE: I have a blog that goes up all the time. Information about my podcast is up there and I write a lot of articles. I also have worksheets and webinars that people can access. It's a very active site, so you can find a lot of information and resources about caregiving.
  
  DR MIKE: Stephanie, thank you so much for what you're doing. I really am impressed by the work you do and I just want to say thank you.
  
  This is Healthy Talk on Radio M.D. I'm Dr. Mike. Stay well.
• Length (mins): 10
• Waiver Received: Yes
• Host: Mike Smith, MD