Caregiving & Eldercare Assistance
If you are helping or caring for an older person, the first thing this directory can do for you is offer ideas about where you can find practical help. Research shows that caregivers can do a better job of caring for their relatives if they don’t try to do it all themselves but take advantage of community services and take some time off (often called respite).
Information and assistance for caregivers is available through the Office on Aging at 524-2786 or through the East TN Area Agency on Aging & Disability at 691-2551. They can advise about available resources such as respite, home modification, safety devices, adult day programs, and in-home services.
“Activities of daily living” and “instrumental activities of daily living” (ADLs and IADLs) are terms you may encounter, used by social workers, health-care professionals, and insurance policies. ADLs are functions that healthy people can do for themselves but that sick or frail people can lose the ability to do without assistance. ADLs include eating, bathing, grooming, dressing, toileting, walking, and transferring (from bed to chair, in and out of bath, etc.). IADLs include preparing meals, shopping, managing money, using the telephone, housework (light and heavy), driving, or using public transportation. IADLs can also include the ability to remember to take daily prescribed medications.
Caregivers are often at a loss to know what is causing a behavior change in the older person they care for, what to expect next, and what they can do about it (for example, the older person seems sad or depressed for long periods of time, is confused, or is irrational). A geriatric assessment program can often offer explanations and recommendations. Mental and behavioral changes can result from disease, poor nutrition, reactions to medicines, and the stress of major life changes (such as a move from the family home or a death in the family). Assessment programs administer a variety of medical, psychological, and mental tests. Staff members interview both the older person and the family members involved. A variety of professionals, including physicians, nurses, social workers, and psychologists, study the results of the tests and make recommendations for action. They explain the test results, help the family plan, and suggest services that might help. Geriatric care managers can do a somewhat simpler assessment.
Caregivers must deal with all of the tasks of everyday life, including, for many, a job outside the home in addition to providing care for an elderly person. It therefore helps to be as organized as possible and keep track of all of the tasks and all of the paperwork. Caregiver training and support groups are available through the Office on Aging’s Project LIVE. Call 524-2786 for information.
This Senior Service Directory has a section on resources for people dealing with Alzheimer’s Disease. It tells you where in the book to find services related to living with and caring for someone with the disease. Another section, Family Caregiver Support (pages 85-86), lists other helpful resources for caregivers of older persons, including a program called the Family Caregiver Support Program.
Support groups for caregivers can provide valuable information and emotional and psychological support. They offer a chance to share with people who have similar experiences and to learn practical solutions to everyday problems. If you cannot join one already in existence or start your own, do remember, at least, how important it is to talk to understanding and supportive people about your caregiving experience.
If you have no one to help you find services or manage your personal and financial affairs, or your older relatives live where no family members can provide assistance, you can obtain help, for a fee, from certified geriatric care managers and some CPA firms and bank trust departments. Eldercare assistance starts with a comprehensive assessment of the older person’s situation so that a plan can be developed to arrange for services and regular visits to check on the older person; to coordinate medical, legal, and financial services; and to report to the family, when appropriate.
Eldercare providers might charge an hourly rate, a flat rate, or a monthly rate; some require a retainer as well. If financial management is needed, a mentally competent senior can sign a power of attorney to give a designated agent the legal authority to handle all or specific financial matters. In most cases, the first choice is to have a family member be the power of attorney. Even if the designated family member lives far away, he or she can then hire and fire others to help, as appropriate. If there are no suitable family members to manage financial affairs, arrangements can be made for the eldercare assistant to handle finances. That can be done by giving a power of attorney and setting up a separate bank account with deposits made by the older person or family on a regular basis. CPA firms that offer eldercare assistance can pay bills out of a retainer paid by the client, with reimbursement on an agreed-upon basis. When an eldercare assistant has financial responsibilities for the older person, requiring bonding would be a wise step. See "Legal Services" for more about powers of attorney.
When choosing an eldercare assistance provider, ask for and check references, ask about and require bonding and insurance, and develop a contract detailing duties, hours, reporting, payment, and expectations.
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