WELCOME

1. WELCOME

2. Caregiver you are a gift • Presented by Neosho County Community College • Karla Jamison RN, BSN This project is funded in part (79%) by a grant under the President’s High Growth Job Training Initiative, as implemented by the U.S. Department of Labor’s Employment and Training Administration.

3. CAREGIVER THE GIFT OF CARING FOR OTHERS CARING FOR YOURSELF

4. Gift of being a caregiver • This class will assist you to become better at your job as a caregiver. You will be able to understand how to assist others without burnout. You are a gift.

5. CAREGIVER EDUCATION • This program’s goal is to educate the caregivers. • Enabling caregivers to care for their loved ones, and themselves. • They will learn techniques to empower themselves to accomplish this goal with their resources and the resources of the community.

6. Goals of Program • 1. What types of caregivers are out in the community? • 2 . What a caregiver does and what is your worth. • 3 . Why more people are choosing home or assisted housing for their place of care. • 4. The impact of care giving on the family and care provider. • 5. Direct and indirect costs to the family unit with an ill member. • 6. The impact of loss to all members of the family unit. • 7. How to make the daily tasks of care giving easier. • 8. How to make the daily tasks of care giving more organized. • 9. How modern conveniences can help with care giving tasks. • 10. Caring for yourself. • 11. The goal of a successful caregiver!

7. 1. What types of caregivers are out in the community? • Relatives- by blood or marriage • Significant others • Friends • Lovers • Ex-spouse • Neighborhood families • Church families • Paid Caregivers

8. Paid caregiver • Someone you pay to care/live with your loved one • In home interim care • In home based state care for the frail elderly or developmentally disabled • In your home or assisted living • You can have paid caregivers in your home or assisted living

9. Insurance or Medicare/Medicaid paid caregiver • Short term • Must meet criteria • unable to leave home • must need a skilled service • Therapy –physical, occupational, or speech • Nursing-education, injections, wound care, etc… • Need someone to help provide care when caregiver not there • May be co-pay with insurance

10. Long Term Care Insurance • Is any in home care included? • Is assisted living and nursing home both in policy? • What is the criteria? • Read the policy !!! • Ask your vendor about services ??? • Ask if this is regular insurance coverage or is it same as medicare services?

11. Medicaid HCBS services • Criteria Less than $2000 in assets • Spouses can split assets • Assets can be seized by the state recovery fund if not in home long enough after use of the funds • Includes all assets: car, house, personal property of value • Who to talk to • Social and rehab services • Area Agency on Aging • Care needs based on need (amount of time given to the client) • First come first served • Usually a waiting period until funds available

12. Vendors in this area • Get book from Area Agency on Aging • http://www.agingkansas.org or 800-432-3535 • Resource Guide for Seniors • Explore Your Options • Misc. other resources • Lists Nursing Homes , Assisted living, Home Plus • Lists Home Health agencies • Lists Organizations for local area to assist with needs and where to go • Lists equipment suppliers • Lists your rights, consumer information, financial assistance, housing, legal assistance, ect…

13. 2. What a caregiver does and what is your worth? A. Companion B. Assist with ADLs C. Manage needs of household D. Liaison E. Finance assistant

14. A. Companion • Shoulder to cry on • Hands to hold and person that touches them • Hugs • Physical touch—pat ,contact to skin, backrub, ect… • Visiting daily about everything from personal needs to illness • daily needs and desires • normal conversation • fears and hopes

15. B. Assist with ADLs (Activities of Daily Living) • Toileting and incontinent care if needed • Hair care • Bathing • Walking • Transferring- if unable • Using wheelchair for mobility • Dressing • Assisting at meal time as needed • AM and PM care • wash face • brush teeth and floss – denture care • cleanse as needed to prevent body odor • apply toiletries such as deodorant and colognes • reposition as needed—Every 2 hrs • feeding-cooking

16. Cont. B. Assist with ADLs • Chauffer for physician visits or for any activities or secures rides • Delivery driver for groceries, meds, and ect… • Handles finances • Prepares meals and clean up • Cleans house • Laundry • Medication administration and setup • Organization of care schedule • Decision making for the ill loved one

17. C. Manage needs of the household • upkeep on house • upkeep on yard • upkeep on the automobile or securing other means of travel-(w/c van ect…) • Ensure that bills and utilities continue to be paid

18. D. Liaison for the ill patient • Working with Doctors and other healthcare workers • Understanding the disease • Understanding the treatment • Understanding medication regime • Understanding the signs and symptoms of disorders • Understanding death and dying • Communicating with the family members • explaining about disease process • explaining about the treatment • explaining limitations and needs of ill loved one • explaining about medications and usage • explaining to family members about finances and needs

19. E. Finance Assistant • Checkbook • deposits • check account management • Paying bills • consumer accounts • rent or mortgages • utilities • taxes • medical care- physician bills & medication costs

20. AVENUES OF ASSISTANCE Groceries—Special diets can be costly Food Pantries Angel food program Toiletries/Laundry Products/etc Food pantries at Salvation Army, Churches, and community groups These are harder to obtain due to some places are limited on supplies Medicines Medicare D Medicine programs Companies-- 90 days supply for lower prices Drug companies medications - will send with the help of physicians Physicians offices- samples from med representatives. Especially for short term items like antibiotics Community help agencies SRS has a list Counties often have programs through misc organizations Programs to assist with med costs even if minimal costs are difficult Utilities Programs to assist with med costs even if minimal costs are difficult Fixed payment plans Limited services on phones Using LEAP to assist Government program to assist with utilities each year –refunded costs for low income

21. Budgeting for fixed or limited income when costs are more expensive than ever before • physician bills • medication costs • grocery costs • less income than ever before • staying at home instead of working • disability insurances and other coverage's end

22. The worth of a care giver !!! • Unable to calculate your worth!! • Too many jobs to imagine the worth!!! • Money could not pay for what you do!!! • Your only payment will be Love and the only way you would do this is for the sake of Love and Concern for others above yourself!!!!!

23. 3. Why more people are choosing home or assisted housing for their place of care • More independence • Want to stay home as long as possible • Personal setting- own room and house things they are comfortable with • Pets can be close • Family with them or them with family • Can keep personal possessions with them-more space • More choices about what they want to be carried out daily • Can carry out their routine not that of the facility– meal times, bath times, ect… • Cheaper than Long Term Care • Average Cost of LTC- $ 130 -190 a day • This is for Private Pay --Includes: • Room and Food • No Medication • No Supplies- briefs, dressing supplies, Oxygen, ect…

24. COMPARE THE COST • Average Cost of LTC- $ 130 -190 a day • This is for Private Pay --Includes: • Room and Food • No Medication • No Supplies- briefs, dressing supplies, Oxygen, ect… • Cost of Assisted Living • High—Specialty Care-$150 a day • Low ---$85 a day • Does not count the special needs that are contracted for the person-these residents are to be able to be independent • Baths • Medicine setup • Laundry services • Cost of private paid caregivers (often only use as needed or a few hours a day) • Low-$10 hr • High-$15 hr • Cost of a caregiver from agency(often only use as needed or a few hours a day) • Low-$15-20 • High-$20-25

25. 4. The impact of care giving on the family and care provider. • May need to leave job-especially toward end of life • FMLA-Family Leave Medical Act • must work one year at your job • papers must be filled out • no guarantee the job you left will be the one you come back to • Set number of weeks leave- then it is completed • To be paid--may have to use vacation before or during FMLA • To be paid--may have to use sick leave for FMLA • criteria for FMLA • small companies —ask human resources • large companies —ask human resources

26. The impact of care giving • Loss of income • Loss of work related relationship • Loss of freedom • Exhaustion from 24 hr a day care • Expectations that feel overwhelming • Family members often criticize instead of assist with cares

27. 5. Direct and indirect costs to the family unit with an ill member. • Direct Costs- • Financial • Time • Freedom • Stress • Sleep • Loss of peace of mind • Increases Stress- uncertain future • Strained relationships– with ill loved one and with other family members • Unexpected expenses • Loss of privacy • More travel- Dr appointment, ect… • Unexpected problems– things that you do not think may occur– family events even holidays are not the same. –Need a caregiver to stay if you leave.

28. 6. The impact of loss to all members of the family unit • Dr Elisabeth Kubler-Ross "On Learning from Death & Dying“ studied death and dying and found that all individuals suffer losses in the same way. • Denial • Anger • Bargaining • Depression • Acceptance • The ultimate lesson all of us have to learn is unconditional love, which includes not only others but ourselves as well.

29. 7. How to make the daily tasks of care giving easier. • Bed making • Incontinent Care • Catheter Care • Repositioning • Ambulating Safely • Bathing • Transfers • Infection Control • Medication • Vital signs

30. 8. How to make the daily tasks of care giving organized. • Get a calendar or a date book • Appointments • When you need to perform procedures • Use as a diary for doctor visits • Record Vital signs • Add to date book-- • Blood Glucose readings • Weights • Visitors like nurse visits, ect… • Dates others can come to give respite care for shopping ,ect…

31. Being Organized • Make a daily routine. • When people are ill it helps them remember what is going to happen and what to expect. (If they have memory) • Repeat the same words and schedule--- it keeps everyone on the same page • Make sure everyone understands it is easier when everyone that helps does the same routine.

32. Being Organized • Am Cares: • Wash face and hands • Clean mouth and teeth or dentures • Toilet and refresh perineal area • Clean clothing and bedding as needed • Breakfast • Clothing Protector • Help set up food and feed as needed • Cleanse hands and face • Offer plenty of fluids except if on fluid restriction • Mid Morning • Offer fluids and snacks • Cleanse face and hands after snacks • Offer toileting and cleanse • Noon Meal • Clothing Protector • Help set up food and feed as needed • Cleanse hands and face • Offer plenty of fluids except if on fluid restriction

33. Being Organized • Mid Afternoon • Offer fluids and snacks • Cleanse face and hands • Offer toileting –cleanse and freshen perineal area • Evening Meal • Clothing Protector • Help set up food and feed as needed • Cleanse hands and face • Offer plenty of fluids except if on fluid restriction • PM Cares– Bedtime Cares • Offer fluids and snacks • Cleanse face and hands after snacks • Offer toileting and cleanse • Back rub • Calm atmosphere • Calming or enjoyable music or sounds like nature sounds-waterfall-rain-ocean-ect…

34. 9. How modern conveniences can help with care giving tasks • Lifts • Gait belt • Lift sheets • Lift/Incontinent pads • Briefs • Electric beds • Bedside toilets • Bedside bathing and hair washing • Bedpan/ Urinals/ Catheters • Wet Wipes /warmers • Creams and emollients • Skin Protection area

35. 10. Caring for Yourself • Your needs • Physical • Rest & sleep • Naps • Bedtime • Energy • Nutrition and fluids • Elimination • Oxygen • Emotional • Someone to talk to • Time to yourself • Respite care—time off • Possible needs for medication • Anxiety • Depression • Pain • Your disease processes

36. Caring for Yourself • Spiritual • Church to become involved • Talk to spiritual friends on the phone • Continue to attend church –get sitters from family and friends • Pray and follow your faith, whatever it is • Gives you strength to carry on • Provides you with comfort and peace in times of trouble • Respite Care • Family and others involved • Schedule changes ahead of time for days off • Schedule weekend caregivers • Paid caregiver • Family caregiver • This will help you be a better care giver • Refreshed • Renewed • Fresh view of situation

37. 11. Goals of Successful Caregiving • Personal Goals • What do you want to occur in this situation • What will you do after • Focus on these goals • What does the family expect of you • Your responsibility • Family responsibility • What if outcome is not as desired • Family meeting and agreement on possible outcomes

38. Goals of Successful Caregiving • What does the ill loved one want done • Living wills • Advance directives • What they told family and you • What will happen if death would occur • Who will handle this • What will happen before occurrence • Hospice –symptom and cost control • Support for all- family and the patient • DOES NOT MEAN YOU HAVE TO DIE!!!

39. Goals of Successful Caregiving • Live life as you and your loved one would want • Do not live up to anyone else expectations • Enjoy life with illness like you enjoyed life before----Thing and situations have changed • No Matter What!! • YOU ARE STILL YOU!!!!!!!!!

40. Life is Fragile as the petals of these flowers. Remember to count the blessings.Remember to savor the wonderful fragrance of living each day. Do Not Let Illness stop you from Laughing Crying Sharing Loving Others And Living-Really Living!!

41. Thank You