Coping with Caregiver Burnout

Enjoy Summer Fun By Managing Caregiver Stress



Summer is finally here. While many people are firing up their grills, going fishing and pulling down their beach towels, it’s common for caregivers to feel exhausted and lack the desire to be social.

Think you might be suffering from caregiver burnout? Read on to identify the symptoms, and discover tips to help you unwind and enjoy the season.

Here’s ten ways to tell if caregiving is putting too much stress on you, according to the U.S. Department of Health and Human Services: 

  • feeling overwhelmed
  • sleeping too much or too little
  • gaining or losing a lot of weight
  • feeling tired most of the time
  • loss of interest in activities you formerly enjoyed
  • becoming easily irritated or angered
  • feeling constantly worried
  • often feeling sad
  • frequent headaches, body pain, or other physical problems
  • abuse of alcohol or drugs, including prescription drugs

Here are the Health and Human Services Department recommendations for reducing caregiver stress, so you can get back to enjoying the summer: 

  • Find out about caregiving resources in your community.
  • Ask for and accept help. Be prepared with a mental list of ways that others can help you, and let the helper choose what she would like to do. For instance, one person might be happy to take the person you care for on a walk a couple times a week. Someone else might be glad to pick up some groceries for you.
  • If you need financial help taking care of a senior relative, don't be afraid to ask family members to contribute their fair share.
  • Say "no" to requests that are draining, such as hosting holiday meals.
  • Don't feel guilty that you are not a "perfect" caregiver. Just as there is no "perfect parent," there is no such thing as a "perfect caregiver." You're doing the best you can.
  • Identify what you can and cannot change. You may not be able to change someone else's behavior, but you can change the way that you react to it.
  • Set realistic goals. Caregivers can break large tasks into smaller steps that you can do one at a time.
  • Prioritize, make lists, and establish a daily routine.
  • Stay in touch with family and friends.
  • Join a support group for caregivers in your situation, such as caring for someone with dementia. Besides being a great way to make new friends, you can also pick up some caregiving tips from others who are facing the same problems you are.
  • Make time each week to do something that you want to do, such as go to a movie.
  • Try to find time to be physically active on most days of the week, eat a healthy diet and get enough sleep.
  • See your doctor for a checkup. Tell her that you are a caregiver and tell her about any symptoms of depression or sickness you may be having.
  • Try to keep your sense of humor.

Caregiverlist offers a wealth of resources for caregivers. Caregiverlist's Community section provides an opportunity for caregivers to share their story, and become inspired by stories submitted by other caregivers.

http://www.blogcatalog.com/directory/health

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Insider's Guide to Becoming a Nursing Aide

There are many different paths to becoming a caregiver.  Some senior caregivers first provided care to a friend or family member before becoming a professional caregiver.  Others may have worked in other industries which did not provide flexible schedules or personal fulfillment. 

For those caregivers seeking to become certified in their state as a certified nursing aide or home health aide, Caregiverlist provides an Insider's Guide with tips and interviews from nursing aide schools, including the 6 Success Tips for Becoming a Certified Nursing AIde:

1) Be proactive during the application process

2) Prepare before the first day of class

3) Be aware of the duties involved for Certified Nursing Aides

4) Set aside time to focus on the program

5) Apply early for financial aid

6) Research job opportunities ahead of graduation

Home Care Workers Exempt from Overtime for Live-in Caregiving

We are often asked about caregiver pay and the difference between hourly and live-in care.  Senior home care agencies employ caregivers and provide for all of their payroll taxes and worker's compensation insurance, as required by law.  This protects both the caregiver and the senior client they are caring for in the event of an on-the-job injury as worker's compensation will provide for the caregiver's needs and the client will not be responsible.  The payroll taxes also provide for the caregiver's retirement benefits through Social Security when they retire.  In addition, senior home care agencies have policies in place to protect the caregivers and to make sure the plan of care can be successfully implemented.

Hourly caregivers work a set schedule of hours each week and are paid an hourly rate.  Live-in caregivers stay with a client for a few days at a time, sleeping at the client's home each night and are paid a flat daily rate for their work.  Usually live-in caregivers will receive meals and their own room to sleep in.

Senior home care agencies do pay for overtime pay for employees who work more than 40 hours per week as hourly employees, as required by law.  However, live-in care is not considered hourly work and is paid at a daily rate and because of this, overtime pay is not provided on an hourly work week for live-in caregivers.

The Fair Labor Standards Act (FLSA) imposes minimum wage and overtime requirements on employers and specifically exempts from overtime any employee employed in domestic service employment to provide companionship services to individuals who, because of age or infirmity are unable to care for themselves.  Live-in caregivers meet this requirement.  The Department of Labor created a controversy with respect to this exemption several years ago when it adopted seemingly conflicting regulations.  One regulation refers to persons who provide services "in or about a private home of the person by whom he or she is employed."  You have to love the legal language - they always seem to take the long way around to get to the point, or maybe they just want to make sure lawyers will always have jobs in order to translate this stuff for us.

The other regulation, which helped confuse matters, expands the coverage to persons who are "employed by an employer or agency other than the family or households using their services."  Legal challenges to this have been made over the years, based on the argument that it is inconsistent to the first regulation.

Then Evelyn Coke, a 73-year-old immigrant from Jamaica, sued New York based Long Island Care at Home for failure to pay her for overtime.  A federal court of appeals ruled in her favor, overturning the Department of Labor regulation, determining that it conflicted with congressional intent.  Then the Supreme Court reversed this, taking us back to where we started:  no overtime pay for companion care services.

It is important to remember that each state maintains their own minimum wage laws and their overtime requirements, and some of these laws are specific to home care workers (this is the the term they use, rather than "caregivers").

The basic rule you can follow is that "companionship services" are exempt from overtime when the care is not hourly.  Companionship services include household work for aged or infirm persons, meal preparation, bed making, laundry and other similar personal services.  General household work is also included, as long as it does not exceed 20 percent of the total weekly hours worked by the companion. 

Most senior home care agencies have policies in place which require live-in caregivers to sleep at least 8 hours at night, with a minimum of getting up twice to assist the client, along with a couple of hours of downtime each evening.  At the point when a senior client needs a caregiver to get up repeatedly at night, which would not allow the caregiver to receive adequate sleep, it is time for the client to switch to hourly care.

Note:  most senior home care agencies do pay for overtime hours at time-and-a-half for hourly caregivers who go past the 40 hour work week, even though depending on the state and the type of care assignment, they may not be required to do so.

 

 

 

 

 

 

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Early Warning Signs for Alzheimer's Disease

Senior caregivers know the difficulties of caring for someone with memory loss.  But sometimes when you see someone daily, you do not as easily notice some of the early warning signs for memory loss in the form of Alzheimer's Disease.  The Alzheimer's Association has been promoting their new "Know the 10 Signs" for early detection and early diagnosis of Alzheimer's Disease.

 These 10 signs include:

 

1) Memory changes that disrupt daily life

 

2) Challenges in planning or solving problems

 

3) Difficulty completing familiar tasks at home, at work or at leisure

 

4) Confusion with time or place

 

5) Trouble understanding visual images and spatial relationships

 

6) New problems with words in speaking or writing

 

7) Misplacing things and losing the ability to retrace steps

 

8) Decreased or poor judgment

 

9) Withdrawal from work or social activities

 

10) Changes in mood and personality


As soon as you notice signs of memory loss, it is a good time to make sure the senior has an estate plan in place and to understand the ways to pay for senior care as many years of caregiving are often necessary for those living with memory loss.


 

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Senior Caregiver Pay: How Much Should Caregivers Be Paid?

This past weekend the Washington Post magazine published an in-depth story about senior caregiving, profiling a 63-year-old caregiver, Marilyn Daniel, who cares for multiple senior clients as a home health aide.  The story mentions the turnover rate of 40 to 60% for direct-care workers and the low pay.  Although the article says caregiving does not pay much more than minimum wage, which is actually inaccurate, as the federal minimum wage is $6.55 per hour and Marilyn Daniel is paid $12.40 per hour, nearly double the federal minimum wage.

Caregiving actually does pay much more than the minimum wage in every state and Caregiverlist provides the minimum wage information in every state to help caregivers negotiate their pay rate.  The highest minimum wage is in Washington state, at $8.55 per hour, followed by Oregon state at $8.40 per hour and then by California, Connecticut, and Massachusetts, all paying $8.00 per hour.  Most state minimum wages are somewhere between $6.55 and $7.25 per hour.

As is often noted, the Bureau of Labor Statistics reports the occupation of senior home care aides as the second-fastest-growing occupation in the U.S.A. with projections for a more than 50 percent increase in caregivers during the next decade.

Payroll taxes are typically another 25% of a caregiver's pay (Social Security, Unemployment, Worker's Compensation Insurance), although a caregiver does not see this money as take-home pay, but rather as payments direct to these benefits.

How much do you think caregivers should be paid?  Should there be set increases according to advanced training completed and skills tests?

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HBO's The Alzheimer's Project:: May 10 - 12

Caregivers and family members of those with Alzheimer's Disease will find this upcoming documentary informative and supportive of the challenges of caring for seniors with memory loss.  HBO reports Alzheimer's Disease is the second most feared disease after cancer and more than 5 million Americans are affected by it.  As there is currently no cure for the disease, it is also predicted that this number will more than double in the next 30 years.

This 4-part documentary, The Alzheimer's Project, will air on May 10 - 12 on HBO and includes 15 short films highlighting the latest research for a cure, profiles community programs and looks at 7 individuals who are living with Alzheimer's Disease, including a focus on their caregivers who must cope with the progression of the disease. 

HBO has also launched a website to provide educational information on The Alzheimer's Project. Check it out and spread the word.

Caregivers and seniors can also learn more about caring for those with memory loss by reading the stories caregivers share on Caregiverlist (and you may also share your own story).

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Senior Long-term Care Costs in U.S.A.

Where are the Best Places in America for Long-Term Care?

An annual senior care cost survey highlights U.S. states with the most affordable long-term care options.  It seems the heartland states, not the sunshine states, offer the most affordable and diverse care choices for seniors.

A regional gap exists in the U.S. between areas where people have access to a broad number of affordable, long-term healthcare options for seniors, according to a recent study by Genworth Financial.

The study, which involved more than 14,000 nursing homes, assisted living facilities, and home health and adult day health care providers nationwide, found that Midwesterners enjoy more budget-friendly long-term care options than their east and west coast counterparts. 

Here’s a snapshot of the top 10 states for nursing home care availability and choice:

1. Iowa

6. Oklahoma

2. South Dakota

7. Missouri

3. Kansas

8. Arkansas

4. Nebraska

9. Wyoming

5. North Dakota

10. Louisiana

 Other key findings from the study, as published by Genworth Financial, include:
  • The cost of care in a nursing home or assisted living facility continues to rise at a rate nearly twice that of the median annual inflation rate of 2.3 percent.  The annual cost for a private nursing home room is $74,208, or $203 per day, representing an increase of 4 percent annually since 2005.  At this rate, the cost is expected to exceed $270,000 a year in 30 years, when the nation's youngest baby boomers will be in their mid-70's.
  • It is important to do research to make sure you get the most out of your investment when selecting a nursing home for an aging loved one.  You may review our complete list of  nursing homes, including details on Medicare and Medicaid, the number of beds and the owner of the facility.
  • While nursing home and assisted living costs have risen sharply over the past five years, home care costs have remained relatively flat.  The hourly private pay rate for a non-Medicare certified, state licensed home health aides is $18.50. Since 2005, the cost for this type of care has increased an annual rate of just 2 percent.

You may learn more about quality standards for senior home care agencies and request rates and services in your area to find out the pricing in your area and other details.  This can assist you in planning for a loved one's care and developing a budget or exploring long-term care insurance options to assist with payment.
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Caregiver Job Application

What information should potential caregivers expect to be asked on a senior care job application?

Individuals interested in working as senior caregivers should be able to demonstrate they are dependable and trustworthy throughout the caregiving job application process.

You will be asked about your previous caregiving experience, work experience and your caregiving skills.  Names and addresses of past employers will be needed.  You will be asked to provide the start and end dates for your previous jobs and the reason for leaving.

You will also need to provide copies of any certifications and completed training programs.

Be sure all of your information is accurate, including the previous addresses where you have lived, in order for this information to match your background check.

As the most important aspect for success in caregiving is a caring personality and an interest in providing care and assistance to someone, think about how you can communicate your reasons for seeking this type of work.  If you can share stories about experiences you have had with family members or friends or through volunteering, you will be able to provide evidence that you truly are a caring individual.

You may view a sample senior home care agency job application on Caregiverlist.

Health Care Reform Policy Debate Affects Seniors

Health care reform policy debate affects seniors
Summary: The health care policy options under debate could reduce costs and dramatically improve quality of long-term health care for seniors.
 
On Wednesday, Members of the Senate Finance Committee will debate health care policy options aimed at making the health care delivery system more effective and efficient. Many of the proposed options have a high potential to benefit the long-term care of seniors.
 
The policy options, released by Senate Finance Committee Chairman Max Baucaus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa), would create incentives for health care providers to focus on high quality care and to closely coordinate with a patient’s other doctors and providers. This is important for seniors who seek care from multiple doctors and risk doubling up on prescriptions that could have harmful interactions.
 
The proposed health care policy revisions, which will be debated in a closed-door hearing, also target changes in how private insurance companies bill Medicare patients, and are intended to reduce fraud, waste and abuse in the Medicare system.
 
The following details, as released by the Senate Finance Committee, reveal aspects of the health care policy options that would have a dramatic impact on seniors who receive continued care for chronic illness:
 
Promoting Quality Care: Medicare currently reimburses health care providers on the basis of the volume of care they provide. For every test, scan, or procedure conducted, providers
receive payment – regardless of whether the treatment contributes to helping a patient recover. Medicare must move to a system that reimburses health care providers based on the quality of care they provide. The policy options would shift Medicare from volumebased purchasing to valuebased purchasing. Under valuebased purchasing, Medicare would provide new payment incentives for care that contributes to positive patient outcomes. The policy options would establish a valuebased purchasing program for hospitals starting in fiscal 2012, direct CMS to develop plans to establish valuebased purchasing programs for home health and skilled nursing facility providers by 2012, strengthen and expand programs that will eventually lead to valuebased purchasing for doctors, reduce inappropriate ordering of imaging services like CT scans and MRIs, and start inpatient rehabilitation and longterm care hospital providers on a path toward valuebased purchasing program.
 
Promoting Primary Care: Primary care doctors are vital to reducing costs and improving quality in the health care system. Primary care doctors provide preventive care, help patients
make informed medical decisions, serve a critical care management role and help coordinate with other doctors. Despite their critical function, primary care doctors receive significantly
lower Medicare payments than other doctors, which has led to a shortage of primary care doctors. To encourage more primary care doctors to be part of the system, the policy options would provide primary care practitioners and targeted general surgeons with a Medicare payment bonus of at least five percent for five years, and provide Medicare payment to primary care practices that provide specific transitional care services for beneficiaries with high costs, chronic illnesses.
 
Fostering Care Coordination and Provider Collaboration: Today, many doctors want to spend more time working together, but report that current payment systems often discourage care coordination. When providers in different settings, like doctor’s offices, hospitals, nursing homes, and rehabilitation facilities work together, patients can get well sooner and costs in the
system are lower.
 
Chronic Care Management:To encourage chronic care management, the policy options will foster innovation by allowing broadscale Medicare pilot programs of patientcentered care
coordination models for the chronically ill that improve quality and reduce spending, and allow preliminary rapidcycle Medicare testing of evidencebased care management and coordination models across various settings to determine best models for success.
 
Provider Collaboration:To encourage hospitals and other health care providers to work together, the policy options will provide Medicare payment incentives to hospitals that reduce
preventable hospital readmissions, and provide a single bundled Medicare payment for acute and postacute episodes of care.
 
Payment for Accountable Care:To incentivize providers to improve patient care and reduce costs by offering patients access to care at a wide range of health care providers and settings, the policy options would address the impending cuts to physician reimbursement rates, allow highquality providers to share in savings they achieve to the Medicare program through increased collaboration, and expand Medicare participation in communitylevel health care delivery system reforms.
 
Quality Measure Development: The policy options will focus on quality measure development by requiring the Department of Health and Human Services to partner with stakeholders to
develop a national quality improvement plan and encouraging development of next generation quality measures that are aligned with delivery system reform goals like, for example, measuring
care coordination for chronically ill.
 
Health Care Workforce: Ensuring America’s health care system has a sufficient supply of health care professionals to meet the demands of a changing and aging population is essential to
maintaining focus on highquality, cost efficient care. To strengthen the health care workforce, the policy options would increase graduate medical education training positions for
primary care and implement other immediate modernizations to the Medicare GME program, and develop a proposal that requires Health and Human Services to work with external
stakeholders to develop and implement a national workforce strategy, in conjunction with the Senate Health, Education, Labor and Pensions Committee.
 
Medicare Advantage: Private insurers that participate in Medicare should bring value to the program and to beneficiaries. Health care reform should ensure payments to private insurers in the Medicare Advantage program bring high quality, efficient plans into the Medicare program. The policy options would use current measures to pay plans for quality improvement, change statutory benchmarks or set benchmarks based on competitive plan bids, provide a bonus payment to Medicare Advantage plans that use evidencebased programs to manage care of the chronically ill, and allow plans to continue to offer extra benefits, but reducing wide variation among plans.
 
Combating Fraud, Waste and Abuse: Reducing fraud, waste, and abuse in Medicare will reduce costs and improve quality throughout the system. The Medicare improper payment rate
for 2008 was 3.6 percent, or $10.4 billion, and the National Health Care AntiFraud Association estimates that fraud amounts to at least three percent of total health care spending, or more
than $60 billion per year. The policy options combat fraud, waste and abuse by enhancing the review of health care providers prior to granting billing privileges, leveraging technology to
better evaluate claims, educating providers to promote compliance with program requirements, monitoring programs more vigilantly, and penalizing fraudulent activity swiftly and sufficiently.
 
Caregiverlist provides a helpful breakdown for individuals trying to better understand what Medicare covers.
 
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Swine Flu Symptoms: Keep Seniors Safe

What should seniors and their caregivers be aware of with the recent announcement of the swine flu virus?

Seniors are always impacted more by illnesses because their natural defenses are no longer as strong to fight diseases and their bodies may already be weakened by age-related illnesses.  A geriatric doctor once told me that pneumonia is an old man's best friend as he had so often seen it be the cause of death when a senior was successful in fighting every other age-related disease.  Seniors and their Caregivers should be extra careful to be aware of the symptoms of the swine flu virus in order to take quick action if they occur.

The Department of Health and Human Services issued the declaration of public emergency as a routine step to make sure we stay aware and take precautions.  If a senior develops any signs of illness, as always, you should call their doctor and follow their advice.  The health alert was issued to assist Americans to learn about the illness in order to prevent further spread of the virus in the U.S.A.  The good news is you do not get the swine flu from eating pork. 

What are the symptoms of swine flu?

The symptoms of swine flu are very similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea.

Can humans catch swine flu?
Swine flu viruses do not normally infect humans which is why this outbreak has caused some alarm.  The causes of human infections in the past have been extremely rare but have occurred when a person had direct contact with pigs with the disease, which happened in Wisconsin in 1988.  People who interact with pigs as farm workers usually are the ones who first contract the swine flu illness and then spread it to other humans.

How common is swine flu infection in humans?
The Center for Disease Control reports approximately one human swine influenza virus infection every one to two years in the U.S., but from December 2005 through February 2009, 12 cases of human infection with swine influenza were reported.

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