Home nursing and caring / Advice for caregivers Books

Book SynopsisAs the population ages, policymakers must evaluate the nation''s readiness to assist a growing group of people with conditions requiring chronic and long-term care. Based on the 2002 annual meeting of the National Academy of Social Insurance, this new volume offers a variety of viewpoints from policymakers, researchers, and experts who examine how well the needs of the elderly and disabled Americans are being met by today''s financing and delivery systems, in light of potential reform options. Particular attention is paid to care coordination issuesnamely, the impact of acute-care policies on long-term and chronic careto draw attention to how the segmentation of healthcare provision can create disruptions in patient care. Authors address the advantages and disadvantages of varying levels of state, federal, and private involvement in long-term care. Clearly, for people to access appropriate long-term care today and tomorrow, a careful balance of financing sources and integrated

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Book SynopsisThe United States is engaged in a critically important and contentious debate on how to overhaul the way it delivers and pays for long-term care. Most families that are confronted with caring for a disabled elderly relative are often guaranteed financial catastrophe. The authors of this book examine a wide range of financing approaches to reforming long-term care and the impacts they would have over the next twenty-five years. The central issues in the debate about reforming long-term care concerns the relative roles of the public and private sectors. The authors urge that private insurance be encouraged and predict it will grow. Nevertheless, they conclude, private insurance will probably play only a modest role in financing nursing home and at-home care. For that reason, careful attention must also be given to reforming public programs. They recommend a strategy that includes expanded social insurance covering more at-home care and some limited nursing home coverage, the liberalization of Medicaid eligibility requirements so that complete impoverishment is not required before benefits are given, and an enhanced role for private insurance to provide asset protection to the upper-middle- income and wealthy elderly. The authors examine the cost of public and private initiatives and who would pay for them. Their answers emerge from a large computer simulation model that the authors developed. This book is accessible to non-specialists and is essential reading for anyone interested in the future of American health care.

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Book SynopsisShows how hospice can provide compassionate, palliative care to meet the medical, psychological, and spiritual needs of persons with AIDS and those who love them. This guide offers a discussion of the history and philosophy of hospice care; and the costs of medical and pain-relieving care.Trade ReviewAmong Friends will prove increasingly meaningful to all those whose lives have been touched by AIDS." -- American Foundation for AIDS Research "This is a valuable resource for healthcare professionals, AIDS patients and concerned loved ones." - Library Journal

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Book SynopsisService Above Self combines the history of the first fifty years of the Lutheran Hospitals and Homes Society (LHHS) with events that took place in rural health and nursing home care from 1938 through 1987. The Society is unique in healthcare because it pioneered the system s approach for the industry and became one of the giants in the business.

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Book SynopsisCaregiving can be enormously challenging, terrifically rewarding, and potentially draining. Caregivers often wonder how they will navigate the tumultuous waters of caregiving and not lose themselves completely. The Mindful Caregiver highlights two major approaches to help transform the journey: adopting a practice of mindfulness, which helps caregivers become more self-aware and fully present with the person with whom they are caring, and honoring the spirit-side of caregiving which offers new ways of connecting to one another. These approaches take into account not just the needs of the care recipient, but also the needs of the caregiver and other people in his/her life. Remembering to care for oneself when someone else is in great need can be difficult, but with the suggestions and tips in this book, any caregiver can cultivate routines and practices that benefit everyone. Solutions that caregivers can use in their day to day routines are provided, so caregivers who use them can feelTrade ReviewNancy L. Kriseman's new book is an unusual and comprehensive guide to bringing 'mindfulness' to family caregiving, and well worth reading. ... The Mindful Caregiver is about so much more than paying attention to the needs of others. In fact, the central message of Kriseman’s book is that we, as family caregivers caring for a family member or friend, need to pay attention to own needs above all else. ... The Mindful Caregiver could be described not just as a meditation on mindfulness, but as a top-notch 'how to' book for caregivers. Her tips for finding a geriatric care manager, deciding on an elder care facility, or advocating for your loved one in the E.R., for example, seem comprehensive. As readers we benefit from Kriseman’s long career working with elders and their caregivers, and from her ability to write clearly and compassionately. ... [W]hat makes The Mindful Caregiver particularly compelling are the author’s descriptions of the challenges faced by some of her former clients. . . . I appreciated that Kriseman goes into detail for each scenario, offering us a road map if we find ourselves in similar situations. Many readers will see themselves and their families in these pages, and feel both reassured that they are not alone and empowered to put their own needs firsts. * Caregivers.com *If you are facing the need for caregiving in any manner this should be one of your first stops on the path. Be guided by those that have traveled this way before you. * Well Spouse Association *This is a book for caregivers, about how to make the caregiving journey easier and more meaningful for the caregiver, and hopefully better for the recipient of that care. . . .I think this book is very good and it is certainly down to earth and practical. I would be very comfortable recommending it to any caregiver seeking help with their role. Whilst it would be bread and butter for a social worker or an experienced palliative care nurse, I did wonder how your average caregiver would deal with it. It covers a lot of territory. * IAHPC Newsletter *This is an informative book using mindfulness and self awareness to ease the caregiver’s journey. [The Mindful Caregiver is] presented in an easy and insightful reading style. . . .The use of case studies throughout the book present pertinent issues, ideas and strategies . . . [which] help negate the feelings of isolation and loneliness. . . .I believe a caregiver reading this would find their spirits lifted and find their personal fear and guilt subsiding, for these reasons alone the book is worth reading. . . . While the book is uplifting and positive it doesn’t shirk from the realistic and in places honest picture of what it means to be a caregiver. . . .The resources, appendices and bibliography . . . are comprehensive and provide the reader with a starting point and include an excellent appendix on how to evaluate a website. . . .an excellent resource for carers. Its open writing style presents a non judgmental uplifting read with no expectations placed upon the reader. It can be read from cover to cover but provides useful chapters to dip back into at a later day or if requiring a therapeutic pick-me-up. * Nursing Times *This pioneering book reflects Nancy Kriseman’s years of experience, breakthrough insights, and cutting-edge knowledge. It is a true gift to caregivers. -- Mary Erlanger, Ph.D., Geriatric Counselor/ProfessorThe Mindful Caregiver is a book that should be “required reading” for caregivers. Nancy Kriseman tells this story from the perspective of having been a caregiver herself, as well as her years of helping other caregivers. The mortality rate of the so called “well spouse” is unacceptably high; the high depression rate among caregivers also points to how caregivers often overlook their own needs. Nancy’s book offers excellent examples of how to be a mindful caregiver so that diseases, especially Alzheimer’s and Parkinson’s, do not have two victims: the person with the disease and the caregiver. -- Joyce Simard, MSW, adjunct associate professor at University of Western Sydney, Australia; Geriatric Consultant; Professional Speaker; AuthorNancy Kriseman's book is unique and powerful. The Mindful Caregiver offers both personal insights and professional experience on every page. Nancy has been a hands on family caregiver herself for many years, as well as professionally guiding and counseling family caregivers through many challenges in their personal caregiving. Her advice, and the stories she shares, offers a voice that every caregiver can relate to and benefit from reading. -- Connie Goldman, author of Hardship Into Hope: The Rewards of CaregivingNancy Kriseman's book is full of pragmatic and helpful tools for making caregiving easier, but really, her book is about a new way of being a caregiver. Sharing personal and professional stories, she skillfully describes a more intentional path, one that helps caregivers stay resilient and healthy, not with a pill but with self-awareness. Bravo! -- Pauline Boss, Ph.D., author: Ambiguous Lossand Loving Someone Who Has DementiaA gifted writer mindfully melds personal and professional know-how to encourage and inspire family caregivers. Kriseman’s pro-active, positive words honor the spirit of family care relationships while simultaneously acknowledging the losses in providing such intimate care. Her step-by-step guidance will preserve family caregiver strengths. Readers will immediately identify with the poignant well-placed family caregiver quotes from recognition of a problem through end-of-life care. If this was a medication, doctors would be prescribing it to every well-intentioned but understandably overwhelmed family caregiver. -- Lisa P. Gwyther, MSW, LCSW, Bryan Alzheimer's Disease Research Center, Duke University Medical CenterNancy Kriseman has done a masterful job of applying the cutting edge mental health concept of mindfulness to the emerging public health crisis of caregiver burden. This book combines Nancy’s unique perspective based on years of intimate work with her clients and her personal experience as a caregiver for her own beloved mother with Alzheimer ’s disease. This book is an essential read for caregivers of the elderly and infirm as well as the professionals who accompany them on this journey. -- Bruce E. Rudisch, M.D., adjunct faculty, Department of Psychiatry and Behavioral Sciences; teaching faculty, Emory University Psychoanalytic InstituteThe Mindful Caregiver: Finding Ease in the Caregiving Journey is an inspirational book that speaks to the spirit, heart, mind, body and soul of both caregivers and their “care recipients.” Creative, well researched, based on years of personal and professional experience, and loaded with solid practical tips, meaningful anecdotes, and humorous perspectives, Kriseman’s book has a positive, upbeat tone that addresses the benefits as well as the burdens, the pleasures as well as the pitfalls, inherent in the caregiving role. A must read for every caregiver. -- Helen W. Coale, LCSW, LMFT, Atlanta, GeorgiaTable of ContentsForeword Preface Introduction: How to Become a Mindful Caregiver 1: Understanding the Caregiver Role: The Mindful Caregiver 2: What is Realistic to Expect? 3 : Self-Care Absolutely Matters 4: Incorporating Mindfulness into Self-Care: Creative Ideas and Exercises 5: Inspiring More Meaningful Engagement: Finding Ways to Be Together 6: Navigating the Maze of Resources and Services 7: Advocacy and Partnership 8: When the End is Near: Finishing Well

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Book SynopsisCaregiving can be enormously challenging, terrifically rewarding, and potentially draining. Caregivers often wonder how they will navigate the tumultuous waters of caregiving and not lose themselves completely. The Mindful Caregiver highlights two major approaches to help transform the journey: adopting a practice of mindfulness, which helps caregivers become more self-aware and fully present with the person with whom they are caring, and honoring the spirit-side of caregiving which offers new ways of connecting to one another. These approaches take into account not just the needs of the care recipient, but also the needs of the caregiver and other people in his/her life. Remembering to care for oneself when someone else is in great need can be difficult, but with the suggestions and tips in this book, any caregiver can cultivate routines and practices that benefit everyone. Solutions that caregivers can use in their day to day routines are provided, so caregivers who use them can feelTrade ReviewNancy L. Kriseman's new book is an unusual and comprehensive guide to bringing 'mindfulness' to family caregiving, and well worth reading. ... The Mindful Caregiver is about so much more than paying attention to the needs of others. In fact, the central message of Kriseman’s book is that we, as family caregivers caring for a family member or friend, need to pay attention to own needs above all else. ... The Mindful Caregiver could be described not just as a meditation on mindfulness, but as a top-notch 'how to' book for caregivers. Her tips for finding a geriatric care manager, deciding on an elder care facility, or advocating for your loved one in the E.R., for example, seem comprehensive. As readers we benefit from Kriseman’s long career working with elders and their caregivers, and from her ability to write clearly and compassionately. ... [W]hat makes The Mindful Caregiver particularly compelling are the author’s descriptions of the challenges faced by some of her former clients. . . . I appreciated that Kriseman goes into detail for each scenario, offering us a road map if we find ourselves in similar situations. Many readers will see themselves and their families in these pages, and feel both reassured that they are not alone and empowered to put their own needs firsts. * Caregivers.com *If you are facing the need for caregiving in any manner this should be one of your first stops on the path. Be guided by those that have traveled this way before you. * Well Spouse Association *This pioneering book reflects Nancy Kriseman’s years of experience, breakthrough insights, and cutting-edge knowledge. It is a true gift to caregivers. -- Mary Erlanger, Ph.D., Geriatric Counselor/ProfessorThe Mindful Caregiver is a book that should be “required reading” for caregivers. Nancy Kriseman tells this story from the perspective of having been a caregiver herself, as well as her years of helping other caregivers. The mortality rate of the so called “well spouse” is unacceptably high; the high depression rate among caregivers also points to how caregivers often overlook their own needs. Nancy’s book offers excellent examples of how to be a mindful caregiver so that diseases, especially Alzheimer’s and Parkinson’s, do not have two victims: the person with the disease and the caregiver. -- Joyce Simard, MSW, adjunct associate professor at University of Western Sydney, Australia; Geriatric Consultant; Professional Speaker; AuthorNancy Kriseman's book is unique and powerful. The Mindful Caregiver offers both personal insights and professional experience on every page. Nancy has been a hands on family caregiver herself for many years, as well as professionally guiding and counseling family caregivers through many challenges in their personal caregiving. Her advice, and the stories she shares, offers a voice that every caregiver can relate to and benefit from reading. -- Connie Goldman, author of Hardship Into Hope: The Rewards of CaregivingNancy Kriseman's book is full of pragmatic and helpful tools for making caregiving easier, but really, her book is about a new way of being a caregiver. Sharing personal and professional stories, she skillfully describes a more intentional path, one that helps caregivers stay resilient and healthy, not with a pill but with self-awareness. Bravo! -- Pauline Boss, Ph.D., author: Ambiguous Lossand Loving Someone Who Has DementiaA gifted writer mindfully melds personal and professional know-how to encourage and inspire family caregivers. Kriseman’s pro-active, positive words honor the spirit of family care relationships while simultaneously acknowledging the losses in providing such intimate care. Her step-by-step guidance will preserve family caregiver strengths. Readers will immediately identify with the poignant well-placed family caregiver quotes from recognition of a problem through end-of-life care. If this was a medication, doctors would be prescribing it to every well-intentioned but understandably overwhelmed family caregiver. -- Lisa P. Gwyther, MSW, LCSW, Bryan Alzheimer's Disease Research Center, Duke University Medical CenterNancy Kriseman has done a masterful job of applying the cutting edge mental health concept of mindfulness to the emerging public health crisis of caregiver burden. This book combines Nancy’s unique perspective based on years of intimate work with her clients and her personal experience as a caregiver for her own beloved mother with Alzheimer ’s disease. This book is an essential read for caregivers of the elderly and infirm as well as the professionals who accompany them on this journey. -- Bruce E. Rudisch, M.D., adjunct faculty, Department of Psychiatry and Behavioral Sciences; teaching faculty, Emory University Psychoanalytic InstituteThe Mindful Caregiver: Finding Ease in the Caregiving Journey is an inspirational book that speaks to the spirit, heart, mind, body and soul of both caregivers and their “care recipients.” Creative, well researched, based on years of personal and professional experience, and loaded with solid practical tips, meaningful anecdotes, and humorous perspectives, Kriseman’s book has a positive, upbeat tone that addresses the benefits as well as the burdens, the pleasures as well as the pitfalls, inherent in the caregiving role. A must read for every caregiver. -- Helen W. Coale, LCSW, LMFT, Atlanta, GeorgiaThis is an informative book using mindfulness and self awareness to ease the caregiver’s journey. [The Mindful Caregiver is] presented in an easy and insightful reading style. . . .The use of case studies throughout the book present pertinent issues, ideas and strategies . . . [which] help negate the feelings of isolation and loneliness. . . .I believe a caregiver reading this would find their spirits lifted and find their personal fear and guilt subsiding, for these reasons alone the book is worth reading. . . .While the book is uplifting and positive it doesn’t shirk from the realistic and in places honest picture of what it means to be a caregiver. . . .The resources, appendices and bibliography . . . are comprehensive and provide the reader with a starting point and include an excellent appendix on how to evaluate a website. . . .an excellent resource for carers. Its open writing style presents a non judgemental uplifting read with no expectations placed upon the reader. It can be read from cover to cover but provides useful chapters to dip back into at a later day or if requiring a therapeutic pick-me-up. * Nursing Times *Table of ContentsForeword Preface Introduction: How to Become a Mindful Caregiver 1: Understanding the Caregiver Role: The Mindful Caregiver 2: What is Realistic to Expect? 3 : Self-Care Absolutely Matters 4: Incorporating Mindfulness into Self-Care: Creative Ideas and Exercises 5: Inspiring More Meaningful Engagement: Finding Ways to Be Together 6: Navigating the Maze of Resources and Services 7: Advocacy and Partnership 8: When the End is Near: Finishing Well

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Book SynopsisFinding the right fit to match aging adults with the best caregiver to assist them in their home can be fraught with challenge. In today's pressurized world, the process involves overstressed family members and a shortage of great caregivers. So many adult children are seeking a helping hand and a friendly, experienced voice to guide them through this emotionally charged rite of passage. Aging with Care: Your Guide to Hiring and Managing Caregivers in the Home, takes a personal, professional, and sometimes humorous approach to the challenges, benefits, pitfalls and problems of hiring in-home caregivers. Here, two geriatric care experts explore the essential credentials and experience a home caregiver should have, pitfalls to avoid, hiring options and managing costs, and the decisions that go into finding the right fit for your loved one to be able to age in place. Sharing stories and insights from interviews with caregivers and elders, as well as industry experts, they walk you throughTrade ReviewMost seniors want to age in their homes. But what if simple, daily tasks are becoming too difficult? What if family members aren’t able to give round-the-clock care? Where does the family turn? Lambert and Eckford, both experienced in geriatric care, do a thorough exploration of the challenges of providing home care. Although Lambert advocates working through an accredited agency, and Eckford leans toward private caregivers, they agree on the importance of careful selection, monitoring, and communicating with workers. It’s also important to both that the patient has a say in his or her care, that caregiver and patient mesh, and that the family is kept up to date on the elder’s progress. The authors provide checklists for deciding on the level of care, picking a caregiver, and monitoring day-to-day operations. They discuss security issues, potential abuse, and boundary setting. And they offer creative solutions when at-home care isn’t working. Interviews with agencies, caregivers, and patients round out the coverage. Packed with practical information, online tools, and common-sense suggestions, this book will be reassuring for readers facing these important challenges. * Booklist *[I]f you’re faced with taking care of your aging parent(s), this book offers solid, reliable information on a multitude of questions.... The book abounds with real life stories that demonstrate problems, pitfalls and possible solutions.... [T]he book is an excellent guide. And a help for you to set guidelines for a time when you might be the one in need of care. * Chicago Lady Boomer Examiner *Lambert and Eckford bring to life the terrors and treasures of managing caregiver help for yourself or loved ones. With their clear expert guidance, you will be an informed consumer, able to navigate the best choice for your care needs. Through stories, interviews, and resources I found they understand the care options from home to facility and where the pitfalls and advantages lie. As a daughter having personally experienced care coordination and as a care manager and guide to others, I know firsthand what a vulnerable task finding care in the home can be. Lambert and Eckford offer the tools to make care an opportunity for the best quality of life so you and your loved one can not only survive but truly thrive! -- Mary Jo Saavedra, CMC, CSA, CAPS, gerontologist, life planning counselor, and author of Eldercare 101: A Practical Guide to Later Life Planning, Care and WellbeingLambert and Eckford have done an amazing job of bringing clarity to an issue that is often confusing and emotionally distressing, yet so important given today’s aging and longevity trends. Through the use of real-life anecdotes, as well as their professional skills and personal experiences, they guide readers through the process of selecting a caregiver most appropriate for their individual circumstances. This is a must read if you’re facing such difficult decisions, even if you think you already know the best path to take. -- Rob Pascale, Ph.D. author of "The Retirement Maze" and "Making Marriage Work"Table of ContentsIntroduction WAKING UP TO A NIGHTMARE What would you do if you realized that the caregiver that you hired to take care of your elderly parents in their house turned out to be stealing from them and exploiting them? Leslie shares her horror story of realizing that the hired caregiver that she knew, liked and trusted turned out to be robbing her family blind. She describes her professional background as a geriatric nurse and Licensed Clinical Social Worker and her dedication to supporting her parents to age in their own home. She assumed that even though she lives far away from her elderly parents, she would know enough to make the right choices. But all of this was not enough to protect her family from being taken advantage of. When she discussed her family's plight with her friend, Amanda Lambert, also a geriatric professional as well as a certified geriatric care manager, they realized that though they agreed on many approaches to home care for the elderly, they diverged when considering hiring privately or through a care agency. Thus, the idea for this book was born: to share our professional and personal experience to assist others to make educated choices about hiring employees to be elder caregivers for their family. Chapter 1 FINDING MORE THAN ONE WAY HOME: TWO APPROACHES TO HIRING CAREGIVERS While Amanda and Leslie agree about the value of aging at home and promoting safety and quality of life for all elders, they have some different approaches on how to hire the right caregivers for home care. Even after the criminal caregiver fiasco, Leslie still prefers hiring privately. Amanda has a different perspective related to her experiences as a geriatric care manager. Amanda describes her duties in this professional role, its definition and how she helps elders and their families navigate the challenges of staying in place to age. The tremendous growth of people who are over 65 and the increase in life expectancy is creating an Aging Tsunami. As more Americans grow older, more can expect to eventually need some assistance with daily care such as preparing meals, dressing and bathing and mobility. Where will they get that care? In recent history, older adults have been encouraged to move into assisted living or other retirement communities. However, in poll after poll of older Americans, they clearly express their desire to stay at home. Staying at home is one thing, but being on the receiving end of personal care is another. Invasion of privacy, and loss of control are considered in the context of real life experiences of elders. Two different ways to hire a caregiver (private hire or through a care agency) are presented with the Pros and Cons of each. Families are encouraged to consider the needs of elders and their choice of hiring the best caregiver on a continuum. Needs for assistance can change as one's health does, thus impacting the type of caregiver that will be best. Leslie describes the advantages of privately hiring a caregiver (more control over who is chosen, less turnover and more consistency of care, reducing cost of third party) and disadvantages (such as the need to vet individuals for criminal backgrounds, time required for hiring process and management). Amanda offers a contrasting perspective for hiring with a care agency: the upside includes less hassle for the family, the agency will take care of any sick calls and other unavoidable problems, and it saves time. She acknowledges the downsides such as an increased hourly rate for the consumer and higher rate of staff turnover which can be upsetting and disruptive for seniors. Each chapter ends with Take Away Points that emphasize the most important concepts for the family to consider as they embark on increasing home support. (See Sample Chapter) Chapter 2 GETTING STARTED: HOW MUCH HOME CARE DO YOU NEED? Knowing if or when to begin considering care in the home can be complicated. Typically an event, or trigger, can be the precipitating factor for family members or even the elder themselves to realize that help is needed. The cost is potentially staggering. Is it the right decision for you or your family member? Learn some basic terms and vocabulary about home care as it differs from care in a setting like a nursing home. Doctors may refer to home care in ways that may be confusing and lead you to believe that all home care is covered by some insurances when it is not. Refer to a useful sidebar to demystify the differences between Medicare and Medicaid. This chart will answer your burning question: which home care expenses do they really cover? Use our Needs Scale to determine the type of home care that will assure your successful stay at home. A Home Care Needs Scale will assist families and elder persons to assess what care can be done by a family or friend versus a professional caregiver. The best planning will figure out which activities, such as medication management or bathing, are most important to this individual. Emphasis is on flexibility. For example, it could be an advantage in areas such as how and when to schedule caregivers. The Home Care Needs Scale will help you determine if staying at home is a realistic option for you. Instructive stories based on real elders' experiences are incorporated throughout to learn how others initiated care in their home. Having "the talk" with older family members will help everyone to reach agreement about possible circumstances that trigger the need for care. Talking openly with one's family about whether or not staying at home with care is a viable option is a source of dread for many. With all the parent-child dynamics in play, strategies for segueing into to and staying on topic are critical. How to deal with elderly family who are resistant to having any care at all. How to incorporate the Advance Directive as a tool to ensure that a person's wishes are honored. Recognizing what each side can be flexible about can further the process. This is an expensive proposition. Individuals and families need to deal with the real costs of home care. Talking about money between generations can be perceived as an intrusion on one's privacy. Full access to varied factors (savings, equity, net worth, overall health and prognosis) are necessary to create a budget for the cost of home care. An unique plan of care for each person is needed. While a certain amount of help for part of the day can be manageable and less expensive than moving to assisted living, the price soars with round the clock care. What to do if private caregiving is something you and your family simply cannot afford. We discuss options for care when finances are tight. Throughout, real life stories of how different families have come to terms with the costs of staying at home are shared. Chapter 3 FINDING THE RIGHT HIRED CAREGIVER FOR YOU AND YOUR FAMILY Most elders and families have only a vague familiarity with the world of caregiving. In order to hire a caregiver, it helps to start with the basics: who they are, what their training is and where to find them. There are a variety of definitions for certifications. Contributing to the challenge in making a good choice of caregiver is the complicated lexicon for home care workers. Caregivers can be CNAs, PCAs, medication techs and more. The type of care that is needed may dictate the certification that is most appropriate. There are significant differences in the typical training caregivers receive in the United States. Skills level, oversight of caregivers in the home, and background checks vary widely from agency to agency and state to state. Knowing the typical training that caregivers in the US receive for levels of certification will help in decision making. There are more choices than ever before in looking for caregivers with pros and cons of each path. Recently, there has been an increase in the number of online companies that match the caregiver to the consumer such as Care.Com and Carelinx.com. Thousands of agencies across the country are vying for the business of providing caregivers. Some families decide to go it alone and rely on other family members or people recommended from the community. Each of these options has potential and each has its dangers and complications. Interviews with the online services such as the CEO of Care.com provide insights about the changing terrain for private hiring and how the process is becoming more accessible and streamlined. Caregiver interviews tell the story from the trenches. Caregiver interviews provide insight into their unique and personal perspectives on working at agencies versus working privately. Caregivers share their frustrations as well as their passion for doing this kind of work. Chapter 4 BUILDING THE BEST CARE PARTNERSHIP The hope of every family seeking a caregiver is to find "the one" that is a good fit. It is a huge responsibility to be the family manager who must have the time, the skills and motivation to be the supervisor of an ongoing, at-home care program. A skills list clarifies what individuals need to manage caregivers in the home setting whether hiring privately or through an agency. Delegating and contracting out when possible become essential tools. It sounds obvious, but the plan will not succeed without the family elder being on board. Tips are outlined to engage the elder family member in the search and to deal openly with their desire and understanding of their need for caregiving. Negotiate a list of the characteristics of the caregiver that you want to hire and reach agreement on key expectations. How to assess resistance and objections from the family about a caregiver. Sometimes, it is simple complaining but other times it is more significant. Having strategies for a successful fit for the elder and the caregiver includes effective communication between you, your parent and the caregiver. Clear, direct and honest communication with a caregiver will help avoid problems down the road. Have you really explained to the caregiver how much your parent detests his or her constant chatting, or have you just hinted at it? It is to everyone's advantage to discuss concerns in real time. Chapter 5 KEEP YOUR EYE ON THE BALL Security and legal protection are top priorities for families that choose to hire caregivers. Families often set up home care quickly in response to changing functional status of the elder. Reducing liability and increasing household safety can be an afterthought. Even if you hire through an agency, you are not guaranteed protection. From the beginning, smart family managers require background checks, drug screening before and after employment, and an employee contract. Nobody wants to turn their family home into a police state, but there are some high tech and low tech approaches that can lend added security and peace of mind. Long distance family members are wise to consider camera systems. Learn how to build a circle of protection with unplanned visits and enlisting friends, neighbors and family to be on alert. Reviewing homeowner's insurance policies and agency policies are a must. If you see a red flag, don't ignore it. Denial is a powerful enemy to your family's security. Recognize your denial thoughts ("I'll just wait and see how this turns out; I don't have time to deal with this now; it's probably not as bad as it seems.") That feeling of discomfort is sometimes your best indication that something is wrong. We outline a plan that will help clue you into the bigger picture. Think ahead and take legal precautions to prevent potential legal disasters. Chapter 6 YOUR HOME, YOUR CARE Independence is a uniquely American ideal that shapes our attitudes about aging. Dependence is a consequence of aging that most everyone wants to avoid. As society adjusts to a more vibrant and vocal aging cohort, new ethical dilemmas come into play. The "dignity of risk" concept suggests that people have the right to make possibly unsafe decisions about the way they live and assume responsibility for the consequences. For example, an elderly person living at home wishes to forgo wearing oxygen at night even though his doctor orders it for medical reasons. Does he have the right to do this? Family members and caregivers can be stuck in the crossfire of competing legal and ethical imperatives. Some care companies have policies that place constraints on their employee caregivers so that they may not allow the client to fail. We provide actual stories of these controversial issues. Few families are in complete agreement about how to respond to the question of freedom of choice in their parents' extended lifespan. Families in this situation may differ greatly in their viewpoint generationally. We provide a series of questions for you and your elder to discuss if there is a difference in point of view. We tie this into the use of the advance directive as a tool to clarify your elder's wishes.[G6] . Chapter 7 WHAT CAN POSSIBLY GO WRONG? When families hire caregivers, it pays to take a good, hard look at some of the pitfalls. Being forewarned is being forearmed. Actual personal and professional stories provide an inside look at what can and does happen. Hired caregivers can bring joy, and enhance the quality of life of elders while relieving the burden on families. In contrast, there are terrible caregiving outcomes - poor boundaries, lack of confidentiality, bringing children and other relatives to work without permission, and interesting explanations for failed drug tests, to name a few. With careful planning most disasters can be avoided. Even the most thorough pre-employment background checks do not discount the need for ongoing attention and vigilance in knowing what goes on in the home when you are not there. Identifying and embracing these responsibilities, whether working with an agency or outside an agency, will make the journey less stressful. Chapter 8 PLAN B: THROWING IN THE TOWEL One of the most difficult decisions families face is when it is time to consider a higher level of care. Every member of the family team, including the elder, the family, the medical professionals and the caregiver, needs to have a voice in the discussion. Knowing the circumstances under which it may be time to discuss a higher level of care can make the conversation and transition easier. Be clear with your elder family member and caregiver that you will assess the living situation at regular intervals, such as a monthly or semi-annual check-up, to make sure that the goals of care and health is intact. Learn what some of the red flags are. Being vigilant about the effectiveness of caregiver interventions may help to avoid difficulty later. As challenging and time consuming as it may be, examine evidence of a slow decline and what it may mean for the person's health. Family members can assemble a team including a good geriatric physician who can provide their opinion and possible options for continued support. Consider that in-home, 24 hour care is expensive, complicated and intrusive. Compile a list of triggers and conditions that may necessitate taking this step and calculate the costs of 24 hour care compared with assisted living. Issues of safety, risk, quality of life, and autonomy should be considered in making decisions that are always in flux. Years of professional and personal experience have taught us successful and unsuccessful approaches to care in the home and the complications that arise from the day to day management of caregivers. The reality is that for many families, the cost of in home care will drive decisions. Chapter 9 THE MANY PLACES TO GO FROM HERE The current state and future of caregiving is by necessity undergoing tremendous change. For many, caregiving options as they exist today are completely impractical and unaffordable. Many aging advocates are exploring new ways of providing care in community such as the co-housing movement, continuing care communities, and elder villages. Some health care systems, such as the VA Medical system, have already established a Community Residential Care model which provides housing for elderly individuals in small apartment communities with regular care included. A look to the past finds models of care that kept elders in the community. Older adults in the past transitioned to living with extended family or a boarding house. With imagination and initiative, these models can be updated and improved. There are an array of new concepts, such as caregiver cooperatives that provide a better quality of care. In all of the alternatives, the bottom line is that elders should never be kept in isolation and benefit in numerous ways from community contact, support and engagement in decisions that affect their lives. Chapter 10 HOME, SWEET HOME In the final chapter, Leslie describes the aftermath of the legal entanglement with the criminal caregiver. Living at home with caregivers, even when circumstances are not so dramatic, requires a flexible outlook and acceptance of change. Leslie's worst nightmare comes to resolution. Learn how her family went from picking up the pieces after having a deceitful caregiver, to building a team of truly loyal and dedicated caregivers. Finding and assembling the right caregiving team can have lasting positive impacts on an elder's health and well being. Identifying not only the caregivers, but other people and places in your parent's community (physical therapist, taxi driver, barber shop, coffee shop) can enhance their regular activity schedule and can have a positive impact on their quality of life. Spread the net wide to find activities in unexpected places that can be modified for elders to be involved.

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Book Synopsis Progressive, untreatable nerve and muscle diseases transformed the author''s life from having been a college athlete to needing a wheelchair and special equipment for day-to-day activities. While dealing with his own conditions, he was faced with the unique challenge of being the sole caregiver for his wife who suffers from Alzheimer''s disease. He has written this experience-based book to help people with life-altering medical conditions and those dealing with challenging caregiving responsibilities. Comprehensive in scope, it covers topics including grief, finances, safety and end-of-life planning. This is a resource book containing many references aimed at helping the reader overcome their challenges, maintain their independence and have happy, fulfilling lives.Table of ContentsForeword by Marwan Noel Sabbagh, M.D. 1Preface 3Introduction 6Section One—Life Forever Changed  13 1. Recognition and Diagnosis 14 2. Dealing with Grief 17Section Two—Acceptance and Adaptation  21 3. Family, Social and Religious Support 22 4. Stay Healthy, Maintain Your Strength 25 5. Build Your Essential Help Network 29Section Three—Safe Personal Mobility Solutions  33 6. Initial Solutions 35 7. Rolling Walker 38 8. Motorized Scooter 42 9. Acquiring a Wheelchair 5210. The Consequences of Wheelchair Use 6411. Dealing with House Level Changes 70Section Four—Independent Life  7512. How to Prepare for Emergencies 7613. Stand and Transfer Safely 8114. Handicap Toilet Progression 9215. Showering Safely 9516. Food and Shopping 10117. Solutions to Daily Issues 103Section Five—Vehicle Mobility  10718. Vehicle Adaptation for a Motorized Scooter 10819. Public Transport 114Section Six—Learning to Drive with Handicaps  11920. Don't Assume You Can't; Most Can 12021. Certified Driver Rehabilitation Specialist (CDRS®) 12422. Vehicle Modification and Selection 12623. Controls Installation CA: It Shouldn't Be This Hard! 13124. Controls Installation AZ: Will the Problems Never End?! 13825. Training, DMV and Insurance 145Section Seven—Caregiving from a Wheelchair  14926. Caregiving Introduction 15027. Caregiving at Home: Before the Crisis 15528. Potential Solutions 16429. The Crisis: Big Problems, Out of Answers 16930. Senior Living Decision Rationale 17631. The Challenges of Moving to Senior Living 18132. Initial Accommodations, Serious Threats 18633. Social Integration 19034. Jodie's Successful Adaptation, Unexpected Positives 19335. Final Update and Closing 197Epilogue 204Appendix I: Senior Living Care Options 209Appendix II: ­Long-Term Care Insurance 223Appendix III: Documents Your Heirs Will Need 226Appendix IV: Ready Document Access Is a Must 234Acknowledgments 237Chapter Notes 241Bibliography 245Index 249

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Book SynopsisTrade Review. .. .Eckstrom comes across as knowledgeable, clear and compassionate — the provider everyone's mother should have. Yet few of us will find someone similarly informed. .. .In fact, this is a book for everyone — if not this moment, then eventually. It will be a book to keep handy when the elderly in your life become frail; and beyond that, when you yourself begin to forget things and wonder if it's the onset of dementia or when the pill bottles begin to gather by the side of your bed. Reading this just might be the best preventative medicine you can find. * The Oregonian *This is a remarkable book. The story of Marcy Houle’s family’s discovery of their father having dementia reads like a novel. So many of the reactions a family can experience during this journey are portrayed in a caring but honest light. Houle’s willingness to describe the struggles to accept the diagnosis and help her parents adjust serves as a model for other families facing this challenge. Hers is not a story just of struggle, but one also suffused with love and meaning. Dr. Eckstrom’s chapters are very helpful—brief, but written in clear, understandable language, and very accurate. Hearing her approach to patients with dementia will enable readers to know what to look for in a caring and competent physician. -- Kenneth Brummel-Smith, MD, Charlotte Edwards Maguire Professor and chair, department of geriatrics, Florida State University College of MedicineHoule’s story will resonate emotionally with anyone who has cared for a parent or older relative. It also offers a practical guide for readers who are care-giving now and who want to give their loved ones the gift of good care.- SeniorAdvisor.com * Senior Advisor *Informative, insightful, and clear, The Gift of Caring provides a moving exploration of what growing old means and how we as children, friends, and neighbors should respond. It provides extremely practical advice which serves as a wonderful roadmap to a better way of caring for older adults in America. I cannot recommend it highly enough. -- Rachelle Bernacki, MD, MS, director of quality initiatives, Adult Palliative Care, DFCIWith the growth of the elderly population, particularly those over eighty-five years of age, there is a tremendous need for resources like The Gift of Caring. There is so much to be learned from others who have traveled this road. -- Dr. David B. Reuben, chief of Geriatric Medicine, UCLA; past president of the American Geriatric Society; past chair of the board of directors of the American Board of Internal Medicine'This is a book for everyone- if not this moment, then eventually. It will be a book to keep handy when the elderly in your life become frail; and beyond that, when you yourself begin to forget things and wonder if it’s the onset of dementia or when the pill bottles begin to gather. Reading this just might be the best preventive medicine you can find. ' * The Oregonian *"Must Have Book for Caregivers. .. .This book has a really interesting approach. Marcy Cottrell Houle – a professional writer – writes a memoir about caring for her Dad with Alzheimers and her frail mother. The story is interspersed with expert advice from Dr. Eckstrom that the author wishes she had known about avoiding pitfalls in our modern healthcare system. It’s new and definitely will serve you well." – Anne Tumlinson * Daughterhood.org *Table of ContentsPart I: The Airplane Diaries 1 Colliding Worlds 2 First Decline What I Wish I’d Known: Early Warning Signs of Dementia (Elizabeth Eckstrom, MD, MPH) 3 Panic Attack 4 Countdown to Advocacy What I Wish I’d Known: What Is Dementia, Mild Cognitive Impairment, and Alzheimer’s Disease . . . and How Do You Tell the Difference? (Elizabeth Eckstrom, MD, MPH) 5 A New Way of Seeing 6 Passages What I Wish I’d Known: How to Find a Good Memory Facility (Elizabeth Eckstrom, MD, MPH) 7 Montavilla Beginnings What I Wish I’d Known: Moving Day: How to Ease the Transition (Elizabeth Eckstrom, MD, MPH) 8 Dallas II 9 Visiting Hours 10 The Phone Call What I Wish I’d Known: Falls—A Leading Cause of Death in Older Adults and What You Can Do to Prevent Them (Elizabeth Eckstrom, MD, MPH) 11 Surgery for an Alzheimer’s Patient 12 It’s a Matter of Life or Death What I Wish I’d Known: A Deadly Fate with Few Symptoms—Dehydration—How to Recognize It and How to Prevent It (Elizabeth Eckstrom, MD, MPH) 13 Forsaken 14 No Man Is an Island 15 Do No Harm What I Wish I’d Known: The Problem of Pain in Dementia and Why Millions of Seniors Are Suffering (Elizabeth Eckstrom, MD, MPH) 16 Return of the Man Part II: A Good Ending 17 A Radical Prescription What I Wish I’d Known: The Best “Anti-aging” Pill of Them All (Elizabeth Eckstrom, MD, MPH) 18 No Senior Left Inside What I Wish I’d Known: The ABCs of Exercise (Elizabeth Eckstrom, MD, MPH) 19 I’m Not Cedaring; I’m Scissoring What I Wish I’d Known: How to Ensure Parents’ Wishes for Care Are Met—Before a Crisis Hits (Elizabeth Eckstrom, MD, MPH) 20 Who’s Shelby? What I Wish I’d Known: What Is a TIA? And What Do I Do If I Think My Parent Is Having One? (Elizabeth Eckstrom,MD, MPH) 21 Stories from the Fall 22 The Very Best Christmas Ever 23 Three Things What I Wish I’d Known: The Art to Aging . . . Healthfully. . . for Your Body and Your Mind (Elizabeth Eckstrom, MD, MPH) 24 I See Little Green Men What I Wish I’d Known: Come to Your Senses! The Value of Aids (Elizabeth Eckstrom, MD, MPH) 25 Delirious 26 Paging Doctor HIP! What I Wish I’d Known: What Delirium Is, and Why It’s Essential You Know How to Spot It (Elizabeth Eckstrom, MD, MPH) 27 “Sometimes It’s Better If They Never Wake Up” What I Wish I’d Known: The Most Important Medical Word That Can Save Your Parent’s Life—“Baseline” (Elizabeth Eckstrom, MD, MPH) 28 Where Old People Are Sent to Die 29 The Lazarus Syndrome 30 A Hope and a Future 31 So What’s a Geriatrician and Why Should I Care? What I Wish I’d Known: The Tsunami Is Coming . . . and Why You Should Be Worried (Elizabeth Eckstrom, MD, MPH) 32 Pharmacopeia What I Wish I’d Known: Too Many Pills—The Fourth-Leading Cause of Death in Seniors (Elizabeth Eckstrom, MD, MPH) 33 The Search Begins 34 Honey and Dummy 35 Mountains and Valleys What I Wish I’d Known: The Care and Maintenance of Caregivers (Elizabeth Eckstrom, MD, MPH) 36 Who’s Taking the Trazadone? What I Wish I’d Known: How to Get a Good Night’s Rest— Naturally (Elizabeth Eckstrom, MD, MPH) 37 The Art of Caregiving 38 Living to One Hundred 39 And They Shall Inherit the Earth 40 Go GICU! Stop Step-Down! What I Wish I’d Known: The Serious Problems of Today’s Hospitals for Older Adults—Why We Need to Demand a Change Now (Elizabeth Eckstrom, MD, MPH) 41 How to Pack for the Next Trip 42 Faithful Companion 43 Crossing the Line What I Wish I’d Known: What Is Palliative Care, and How Can It Help My Parents and Me? (Elizabeth Eckstrom, MD, MPH) 44 A Good Ending Appendix 1 The Drugs Seniors Should Not Be On but Are Too Often Prescribed, as Determined by the American Geriatric Society “Beers List” Appendix 2 Health History Sheets: What Every Senior Must Have Appendix 3 Continuity of Care: The Daily Checklist for You, Your Parent, Your Caregiver, and Your Doctor

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