Caregiving can be physically and emotionally draining, so as a caregiver it is crucial that you care for yourself first in order to prevent burnout. Read on to learn ways to access help so that you can avoid feeling overwhelmed or burned-out.
Help! I’m An Overwhelmed Caregiver. What Are My Options?
By Claudia Fine, LCSW, MPH, CMC, CCM – Aging Life Care Association™ Member and Fellow of the Leadership Academy
Do you provide care for an aging parent, spouse, or loved one?
Caregivers are family members, friends, or neighbors who provide unpaid assistance to someone with a chronic illness or debilitating condition. The average caregiver spends over 20 hours a week providing care to their loved one, often in addition to working outside the home and caring for children at home.
Caregiving can be physically and emotionally draining, so as a caregiver it is crucial that you care for yourself first in order to prevent burnout. Here are a few things you can do to prevent feeling overwhelmed:
Put your physical needs first – In order to care for others, you must make sure your needs are met so you can be at your best. Eat three well-balanced meals a day whenever possible, find the time to exercise, and nap during the day if you’re not getting enough sleep at night.
Call on community resources – Research community resources available in your area such as home health aides, homemakers, and other service providers. Perhaps the individual’s insurance company has a care management program, or there may be volunteers or staff available from church or civic groups who could visit, cook, or help with driving. Consider hiring an Aging Life Care Professional™ (also known as a geriatric care manager) to identify resources to which you’re entitled.
Say yes to offers for help – It’s okay to acknowledge that you may need additional help. Utilize far-away relatives by making a list of what needs to be done and delegating.
Don’t be afraid to say no – Remember you are only one person; you can’t do everything. It benefits everyone if you first ask yourself “Can I handle this?” and “How long can I sustain this level of care?”
Connect with friends – Get together regularly with friends and relatives. Being with those you care about can help you keep a positive attitude.
Acknowledge your feelings – Connect with others who are in your same situation by joining a support group (online or in-person) or seek counseling to help manage stress.
Take a break – Make sure you’re finding time for activities you enjoy, such as reading, walking, or going to the gym to recharge your batteries. Think about arranging respite care with friends, relatives, or volunteers. Take a weekend or longer vacation. Home health agencies, nursing homes, assisted living residences, or board-and-care homes may be able to help you.
Talk with your employer – If this is an option, talk about making adjustments with your work schedule to help manage your caregiving responsibilities.
Take it one day at a time – Keep perspective by remembering that there will be both good and bad days.
Alternatives to Caregiving in the Home
When bad days are happening more frequently and you’re feeling drained and worried about your loved one’s safety, it may be time to discuss if your current situation continues to be sustainable. Is your loved one safe? You might consider a move closer to family, hiring in-home help, or placement in an assisted living facility or nursing home.
Remember, you are not alone in making these decisions. You can turn to the individual’s doctor or other medical professionals for guidance. If you feel overwhelmed with the prospect of caregiving on your own, you may want to seek out home caregiving assistance from outside sources. The following information will help you determine the type of services needed and how to choose the best agency for your loved one.
Selecting Quality Home Care
Home care services vary from helping with chores around the house to skilled nursing visits. The main goal of in-home care is to promote independence and delay or prevent stays in skilled nursing facilities. With home care, many older adults are able to stay at home instead of moving into a skilled nursing facility. The type of care received will depend on the medical conditions and limitations of the older adult.
How do I find a caregiver?
The most common approaches to finding private-pay caregiving in the home are:
- Pay an agency to provide you with a caregiver
- Get a referral from a friend or registry
Here are some considerations.
1. Time invested in screening and supervising
Bringing a stranger into the home of a vulnerable older person poses emotional, financial, and physical risks. When working without an agency, the responsibility of limiting exposure to an unfit caregiver falls on the family. Make sure you’re equipped and willing to carry out important functions such as proof of training credentials, citizenship, and criminal background.
2. Hidden costs and legal obligations
The IRS has clear guidelines for determining the status of a caregiver as an employee or an independent contractor. If you determine a caregiver’s schedule and tasks or pay the worker more than $1,500 per year, you most likely have all the responsibilities of an employer unless you contract with an agency. As an employer, you’re responsible for paying Social Security, Medicare and unemployment (FUTA) taxes, meeting state and local regulations such as workers’ compensation coverage and local taxes and more. Usually, an agency whose caregivers are on staff will take on the obligations of an employer. If you decide to hire privately, be sure to check with your insurance about liabilities.
3. Management and supervisory responsibilities
If you are considering hiring a homecare aide privately, consider whether you are prepared to assume the primary responsibility of overseeing caregiving. Ask yourself: who will manage and oversee the care on a daily basis so you’re confident the care is safe, appropriate, and consistent with professional recommendations? Who will provide coverage when he or she gets sick, needs a vacation, has a personal emergency, or otherwise needs time off? How will you manage medical emergencies and other healthcare crises that may arise? Recognizing that caregiving often is required for long periods, how will you avoid burnout of the primary caregiver? If you work with an agency or a private Care Manager, many of these responsibilities can be handled by them.
Selecting a home care agency
Homecare agencies vary in scope and culture. When considering home care services, here are some things to investigate and ask:
- What is included in your caregiver screening process?
- Do you provide documents about financial arrangements before service begins so there’s no misunderstanding about the service and cost to be provided?
- Do you handle payroll, taxes, unemployment insurance, workers’ compensation and general liability insurance?
- Are the providers of care insured and bonded?
- Do you guarantee coverage when a caregiver takes vacation, gets ill, has a personal emergency or otherwise needs a day off?
- How often do you supervise your caregivers in the home?
- What procedures does the agency have for client emergencies? Is there a nurse supervisor on call and available to intervene on the phone or in-person even during off hours and weekends?
- Are you accredited by an independent accreditation body such as Community Health Accreditation Program (CHAP) or Commission on Accreditation of Healthcare Organizations (JCAHO)?
- Is it possible to interview several potential aides and make a selection after those interviews?
- Will you develop a written plan of care?
- How do you take into account my needs and preferences?
A great way to find quality care is to talk with an Aging Life Care™ Manager by browsing ALCA’s Find An Aging Lifecare Expert directory. An Aging Life Care Manager help you identify your needs and hire and supervise care. You can also contact the National Association for Home Care & Hospice (NAHC) and your local Area Agency on Aging, or use the Eldercare Locator, which is a service of the Administration on Aging.
About the author: Claudia Fine, LCSW, MPH, CMC is a pioneer in the field of Aging Life Care™ / geriatric care management and has served in industry and community leadership roles throughout her 30-year career in elder care. She is the Chief of Professional Services at SeniorBridge, a national health care company offering individually tailored care management and home care services, and a past president of the Aging Life Care Association. Email Claudia at cfine@seniorbridge.com or follow SeniorBridge on Facebook, Twitter, and LinkedIn.
This blog is for informational purposes only and does not constitute, nor is it intended to be a substitute for, professional advice, diagnosis, or treatment. Information on this blog does not necessarily reflect official positions of the Aging Life Care Association™ and is provided “as is” without warranty. Always consult with a qualified professional with any particular questions you may have regarding your or a family member’s needs.