Experiencing the Sandwich Generation (Part II)

In this second of two blog posts, contributor Renata JL talks about saving your sanity and creating a balance while living in the Sandwich Generation.

My mother is an eighty-something year old widow who is relatively healthy and vital enough to live on her own. I started my family a little later in life, so my two children are still in elementary school. That means that I am, many times, caught in the middle, caring for both ends of my family’s generational spectrum. Most of the time, I like to think that I handle the pressures of care with efficiency and aplomb. But sometimes, especially during a health crisis, I find myself stretched pretty thin. And I know I’m not alone. Welcome to the world of the Sandwich Generation.

The term “Sandwich Generation” was first coined in by journalist Carol Abaya in 2006 to describe the growing segment of society simultaneously caring for both their children and their aging parents.

In a previous post, I wrote about my aging mother’s unexpected trip to the hospital and my subsequent scrambling to make sure all of my responsibilities would be met. It turns out her hospital stay (with its requisite daily visits) was not the ideal situation, but between Medicare and her insurance, the cost of her care was minimal and she had the around-the-clock attention she required. As her release date approached, we were aware that Medicare would pay for the first 20 days in a Skilled Nursing Facility, so with the help of the Caregiverlist’s Nursing Home Star Ratings system, we were able to find her a quality Nursing Home in her area. When those initial days are complete, the real challenges of being a member of the Sandwich Generation begin.

There is, of course, the financial stress involved with caring for my children and my parent, while planning for my own retirement. In this economy, I fully expect that I will need to help support my children for a longer time. Couple that with spiralling living costs, and I’m not sure how much I will have left over to help cover the costs of caring for mom, whether through the costs associated with Assisted Living or Senior Home Care. While the financial costs and responsibilities are fairly cut-and-dried, the emotional stress is the one that can really take its toll. Resentments can easily build between siblings dividing responsibilities, children losing the attentions of a parent to grandparent, and the senior realizing their diminishing independence. There are things that I plan to do to help prevent, or at least alleviate some of the stress involved with generational caring.

Here are some suggestions I found helpful:

Don’t Go It Alone
According to AARP, 29% of adult Americans spend 20 hours per week on caring for their parent(s). This growing demographic means and increased presence on the internet. Web sites catering to the Sandwich Generation abound. Look to them for ideas and support. Sites like sandwichgeneration.org, and AARP have a wealth of information about resources and support.

Talk About It
Gather family together, including children, parents, spouses. If you have siblings (even those living distantly), request that everyone participate in the plan of action. Communication is key and my help minimize or prevent feelings of resentment. Encourage everyone to voice their concerns and work together to find solutions.

Don’t Forget About You
If you are the primary caregiver for both children and parent(s), it may be difficult to carve out time for yourself, especially if you work outside the home as well. Although it may be difficult, you must treat the care you give yourself with as much gravity as the care you give to others. If you are fatigued, depressed or fall ill, you won’t be able to care for those around you. This one rings especially true because, as you know, we here at Caregiverlist are big advocates of “Caring for the Caregiver”.

The future will be demanding, I’m sure. I feel a little like I felt before giving birth, knowing that I would soon be entrusted to care for another human being and not sure if I was up to the task. That worked out somehow — some days are more demanding than others — but with the help of my family, my community and Caregiverlist’s resources, I hope to rise to the challenge of my new caregiver role with as much grace as I’m able to muster.

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We at Caregiverlist, along with the rest of the world, were deeply saddened by the December 14th, 2012 events at Sandy Hook Elementary in Newton, CT. We offer our sincerest condolences to all those affected — family, friends, neighbors. This tragedy reminds us that, in the midst of all the challenges we face as part of the Sandwich Generation, we are truly lucky to have the ongoing opportunity to care for our loved ones.

Geriatric Care Management Can Deliver Quality Care

Geriatric Care Managers are trained professionals who help families plan and manage senior care services. At some point in your lifetime, either you or one of your family members or friends may need extra assistance from a trustworthy, knowledgeable person to help them with their health care needs and household management.

Geriatric Care Managers assist seniors through the sometimes rough waters of senior care and map out a plan for the later years in life. Geriatric Care Managers are certified individuals who meet with seniors and their families and assess and then advise as they determine the best path or care or treatments needed. They then organize your life, and bring family members together to form a unit and prepare a plan for the good and bad times to come. This is especially valuable when there are complicated care needs, memory loss or adult children do not live near their parents.

Aging is never easy and many people are not well versed in how to handle this new phase in life. What does Medicare cover? What about Medicaid if you run out of private funds to pay for senior care needs? What if you are diagnosed with memory loss or another age-related illness? Where do you receive the best care and how do you plan for end-of-life care?

A good Geriatric Care Manager can help navigate the way to aging gracefully and enjoying the later years in life which we all work so hard to be able to enjoy. I had the opportunity to work as an aspiring Care Manager with some of the best professionals in senior care as part of a Florida geriatric care management service. I was taken under the wing of a true compassionate real-life miracle worker. She showed me how to work with families and not judge or change what each person wants.

One of the main things I learned is that people have different ideas or what their lives should be and the best way to help them is to ensure they have the proper structures in place to live safely. Last year I was given my very first case with a lovely little woman who had just suffered the loss of her husband of 60 years when he passed away on New Year’s Eve. He had been her caregiver who she had relied on fully as her adult children were living more than one thousand miles away. Her husband’s death was devastating for her but she did not show it on the outside.

The first time I met her she was cheerful and a gracious hostess, offering me frozen chocolate from her freezer and offering me her best wine. It wasn’t until spending the next few weeks with her that I realized just how life-changing losing her husband was for her. While she lived in Florida, her daughter lived a few states north and hired our service to be her Care Manager to help her in this major life transition. Her daughter’s work and family responsibilities prevented her from being able to be present full time and this is another example of when a geriatric care manager can be a valuable service to smooth out transitions as we age and lessen further disruptions to our families.

My sweet little senior lady had secretly stopped showering, was barely eating, and would try to give away everything in her home. This was her way of coping with the loss of her husband. The daughter thought it would be best to move her up north to live with her. So my new task was to help sort out her personal belongings in a non-invasive way, help her pack, organize the travel arrangements for her move, organize medications, set-up insurance and…..facilitate the sale of her husband’s belongings (he was a painter, body builder, wrestler,salesman, and magician!). They had many interesting possessions. In helping with this project I learned all about their life together and had the opportunity to help a family in need. We moved her up north with her daughter after 1 month of working with her and she currently lives there safely with her family.

Geriatric Care Managers are one way to receive assistance from those who have vast experience in senior care and understand both the emotional and physical challenges of aging. They know what works, what doesn’t work, and which course is the best to take. In a way--- hey get you there faster. Senior care options include nursing homes (Medicare only pays for up to 100 days in a nursing home after a major medical event), senior home care and moving to an Assisted Living community. Geriatric Care Managers can assist with all aspects of senior care and also inform families about the financial requirements of each senior care option as well as connect you with the top medical providers in your area.

Guest Blogger: Caregiverlist Sherpa Lauren Tyner.  Caregiverlist’s Job Applicant service connects senior care companies with the highest quality professional caregivers, Certified Nursing Aides and Certified Home Health Aides using proprietary technology to deliver efficiencies to the recruitment and hiring process. Caregiverlist’s Sherpas guide senior care companies on the best way to use the interactive hiring tools.

Lauren Tyner is in the photo below next to the Caregiverlist office, just under the real bridge to nowhere with Caregiverlist Sherpas Patrick Welch and Samantha Franklin on each side of her.

 

Caregiver Sherpas - Happy Holidays from Caregiverlist

 

Happy Holidays from Caregiverlist's Caregiver Sherpas!  Stop by and visit us if you are ever in downtown Chicago - we are right on the Chicago river (or wave at us if you pass by in a tour boat - you'll see our banner on the window).

Caregiverlist pioneered proprietary technology for the senior care industry - created by senior care professionals - all of our Caregiver Sherpas have experience in the senior care industry and enjoy making senior care more efficient for senior care companies and senior caregivers.

 

Medicare Open Enrollment: Going on Now til December 7th

Medicare, the health insurance benefit for all Americans once we turn age 65, offers an annual "open enrollment" period, the same as employer-based health insurance plans.  The open enrollment for Medicare just opened in October and will stay open through December 7, 2012.

Medicare does not pay for all the care needs a senior may require.  For instance, Medicare does not pay for ongoing care in a nursing home for seniors.  However, if a senior on Medicare has experienced a major medical event such as a stroke, hip replacement or heart attack and has been hospitalized, they will most likely receive approval from a medical doctor for rehabilitation in a nursing home.

As nursing homes have become an extension of a hospital stay, Medicare will pay for up to 100 days in a nursing home but the benefit may not cover all the daily costs.  Caregiverlist provides the only resource with the daily costs of nursing homes nationwide, to assist seniors and their families to determine the best nursing home for their rehabilitation needs.

Long-term care insurance is an additional option seniors may want to consider, to have a way to pay for the additional nursing home care, should the need arise.  Medicaid, which very low-income seniors will switch to, from Medicare, does pay for ongoing care in a nursing home.  As nursing homes may costs as much as $300 to $400 per day, sometimes seniors will exhaust their personal finances and will "spend down" to qualify for Medicaid.  This is never something we want to think about but Americans can know that they will always be cared for in a nursing home, even if they do not have their own personal funds.  Review the Medicaid financial qualifications in your state to understand the income limit for qualifications.  There is the anti-spousal poverty law which allows one spouse to maintain certain assets while the other spouse spends-down to qualify for Medicaid.  This can unfortunately be a need if one spouse has memory loss which requires around-the-clock care.

Caregivers should remind seniors to check their Medicare options during the Open Enrollment period.  Seniors with the Medicare Advantage plans which provide the private H.M.O.'s or P.P.O.'s, should just check in to make sure their plan is still the best option.  Remember, just as with health insurance plans provided for those who are not yet seniors, benefits may change from year to year.

Visit the Medicare.gov website to access a tool that will help in comparing options for Part D drug coverage plans and Medicare Advantage plans, based on where the senior resides.  Seniors may also call, toll-free:  800-MEDICARE or 1-800-633-4227.  You may also want to access Consumer Reports' review of Medicare plans.  Seniors may also request senior care services in their area to understand the costs of care and plan ahead.

 

  

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Senior Caregiver and C.N.A. Pay

 

Senior care has been identified as a top employer for the coming decade, as the large Baby Boomer generation moves into their retirement years and will live longer lives while needing more care.

Part-time and full-time senior caregiving positions are available as senior care companies hire new caregivers and Certified Nursing Aides each week in order to keep up with their staffing needs.  Seniors may quickly be discharged from a hospital or nursing home after a stroke or hip replacement and require more care.

Senior caregiving delivers fulfillment beyond a paycheck but at the same time, a paycheck is important.

Caregiverlist provides a detailed overview of caregiver and C.N.A. pay rates in their C.N.A. and Caregiver Pay Guide.

This comprehensive guide allows you to review caregiver and nursing assistant pay rates in each state.  You may apply for a caregiver job in your area in our Career Center and also create a customized caregiver resume.  Certified Nursing Assistants can apply for a Certified Nursing Aide job near them.

Seniors who are still active and are looking to earn some extra income may also consider becoming a companion caregiver.  Many times seniors with memory loss just require companion caregivers to keep their daily activities on track.

Caregiver Pay Survey: How Much Should Senior Caregivers be Paid?

Senior caregivers who excel at their work bring compassion and caring to their job duties.  Quality caregiving requires emotional intelligence along with knowledge of how to interact with seniors who are dealing with a variety of health issues.  Learning how to safely transfer someone with mobility issues and provide for personal care and monitoring meals and medications keeps a caregiver busy throughout their day.

Some caregivers have advanced training to work with seniors with memory loss, provide hospice care or rehabilitation after a stroke or hip replacement.

The big question is:  how much should senior caregivers be paid?  Senior care companeis provide for payroll taxes to allow a caregiver to collect Social Security benefits when they retire and provide for unemployment insurance and worker's compensation insurance, as required by law. This guarantees a caregiver they can collect unemployment benefits and receive compensation if they are injured on the job.  Some positions provide for additional benefits.

Share your opinion on senior caregiver pay to help educate the industry and seniors and their families:

Take the Caregiverlist Caregiver Pay Survey

We will share the results on Caregiverlist.

 

Katie Couric & Sesame Street Help Families with Grieving

Katie Couric visited Chicago last Friday and spoke to a group of business owners about current news topics and also shared with us some of her current projects which include a new cancer center in Virginia, in honor of her sister, Emily, who died of pancreatic cancer at age 54.

And, Katie said she was invited to talk about handling grief for a Sesame Street special and the reviews have been very positive - she has already received e-mails from parents who lost a spouse and found the Sesame Street show helps to discuss the loss of a loved one with children.

The Sesame Workshop special, called  "When Families Grieve" features Katie Couric and the Sesame Street Muppets. The show aired on PBS on April 14th and presents the personal stories about coping with the death of a parent and the strategies families have used to move forward.

Caregivers and families may view the special and learn about the grief kits Sesame Street is distributing to military families, by visiting their website.

Caregivers may also share their own caregiving story with others and learn about coping skills for caring for terminal patients on Caregiverlist's Career Center.

Certified Nursing Aide Test Questions

Many senior caregivers are Certified Nursing Aides, Certified Home Health Aides or Certified Personal Care Assistants (the Department of Health in each state establishes the guidelines for caregivers staffed by licensed nursing homes, assisted living companies and senior home care agencies).

The training requirements for certification allow the hiring senior care companies to know the person will understand how to interact and care for seniors appropriately, both physical care and emotional care.  If you are a caregiver interested in obtaining certification or already have certification status in your test (you must complete a certification course at an accredited school, complete clinical assignments in the field and then pass the state exam), you may take answer Caregiverlist's "Question of the Day", take the 10-Question Sample Nursing Aide test or take the full Certified Nursing Aide Practice Test.

What kinds of questions are asked on the Certified Nursing Aide test?  You will find questions about what temperature bath water should be, use of a catheter and feeding tube, memory loss, range-of-motion exercises, bed sores, taking someone's temperature, managing for bed sores and questions about how to properly report certain items to managers and interacting with difficult clients.

Take our Sample Certified Nursing Aide test - it is free and you'll probably learn something and even if you know all the answers, being told you are "brilliant" is kind of nice!

 

 

 

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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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Preventing Elder Abuse

Several cases of alleged senior abuse have crept up across the nation during the past month. On March 30, 2009, a 31-year-old former nursing home employee in Oklahoma was accused of abusing his senior patients and videotaping it, according to a Fox 23 news report.

Experts say many of these crimes against the elderly in long-term residential care are never reported to law enforcement or to the state and say it’s imperative for us to always be vigilant if we have a loved one in long-term care,” reported Kaci Christian of FOX 23.  The article describes the shock a family felt when they discovered their 60-year-old female relative, who was living in a nursing home and suffered from Alzheimer’s disease, “badly beaten, with her face swollen and discolored."

There are many ways to reduce the risk of senior abuse. First, consider home-care options that allow more control over the caregivers who are in contact with your loved one.

The process of selecting home care can be overwhelming, with more than 5,000 senior home care agencies nationwide.

The Caregiverlist Checklist for standards of quality care for senior home care agencies is a resource that outlines requirements for safety and consistency in care, making it easier for families to make an educated decision. Regardless of what long-term care option is best suited for your loved one, it helps to be aware of some less obvious warning signs of abuse. The following warning signs are part of an extensive list compiled by the The National Center on Elder Abuse:

  • Broken eyeglasses
  • Physical signs of being subjected to punishment or signs of being restrained
  • Senior’s sudden change in behavior
  • Caregiver’s refusal to allow visitors to see an elder alone
  • Senior acting extremely withdrawn and non-communicative
  • Senior displaying unusual behavior usually attributed to dementia, such as sucking, biting, rocking

If you suspect senior abuse, call the NCEA hotline at 1-800-677-1116. The NCEA web site offers a host of additional information on identifying elder abuse.

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