Modern Family: Rise of the Multi-Generational Household

“Grampa is coming to live with us.” “Mom, I’m moving back home.” A struggling economy and an aging society is creating a new living dynamic in American — the three- (and sometimes four-) generation home.

We know that people are living longer and, while long-distance family caregiving is still common, it is also expensive. Families may use senior home care agencies to provide professional care to assist their elderly relatives with activities of daily living. Costs can skyrocket in times of crisis when a son or daughter finds themselves scrambling to make last-minute travel plans and miss work. Senior care costs such as those for nursing homes and assisted living communities continue to increase,  and many families may find it more economical to take a parent or parents into their own home.

According to the Pew Research Center, 57 million Americans, or 18.1% of the population lived in multi-generational family households in 2012. That number has doubled since 1980. Why the uptick? Many factors come into play, but The Great Recession of 2007-2009 has had a huge effect in the change in living arrangements. Many families lost their homes in the collapse of the housing bubble, forcing them to combine households. Young adults aged 25 to 34 have become a new demographic; known as the “boomerang youth’, they find themselves returning to the family home when it’s no longer economically viable to live on their own.

I’m part of the “Sandwich Generation”. I care for my children as well as an aging parent. The time and effort (and money) I spend supporting two households could be minimized if I could just combine them. I might also be able to claim my parent as a dependent if I pay more than half of their financial support. As a dependent, my parent’s exemption will be worth $4,000 in 2015.

Multigenerational living is not a new concept by any means. In fact, prior to WWII, it was the norm. But prosperity and suburban sprawl gave way to the migration of the nuclear family. According to the Pew Research Center, in 1940, about a quarter of the population lived in a multi-generational home; by 1980, just 12% did.

The trend reversal has benefits that extend beyond the financial. If the grandparent is healthy, they can provide free childcare to the working parent(s). Many find that daily contact between grandparent and grandchild to be invaluable. And, of course, senior isolation is nonexistent. However, there are drawbacks.

The only way to make it work, according to many multi generational families who live together, is to find a space that provides separation and retrofitting existing living spaces to accommodate the elderly. This means building an addition to a current home to provide an “in-law” apartment, or adding an elevator to ease access to multiple floors.

Some builders like Lennar with their NextGen homes, are creating “homes within homes” — complete with bedroom, full bath, kitchenette, living room, laundry room and separate entrance.
Be prepared to see more of these types of living situations. It looks like I may have to give it a go in the near future. And while I’ve always dreamed of living on the Kennedy compound, I have a feeling my multigenerational family home will look a lot more like the Waltons.

Festive Lights: Stress Relief Photo

The holiday season is in full swing, and there are lights and celebrations all around, brightening December's darkness. It can also be a very stressful time of year for many. At Caregiverlist we know the realities of caregiver stress. This week's photo of holiday lights was taken on the busy Oxford Street in London. Caregiverlisinvites you to enjoy the photo and share it with loved ones.Thank you caregivers and certified nursing aides for your hard work and caring for our seniors. Senior care training assists caregivers to better manage a senior's care needs and manage caregiver stress. Please remember to take a moment to yourselves and have a great week.  

"We cannot hold a torch to light another's path without brightening our own."

 -Ben Sweetland

Holiday Stress Relief for Caregivers

The holiday season is in full swing and while it’s certainly a joyous time of year, it’s also a time when we are all are prone to holiday stress. Senior caregivers are especially vulnerable. It’s easy to become overwhelmed with senior care when family demands are also so high. Caregivers often have to two sets of holiday chores like shopping, wrapping, and writing cards; and if the caregiver is stressed, believe me, the senior experiences stress as well. Here are some ideas to help alleviate the stress and find time for some fun amidst the chaos that is the holiday season.

Take a Mental and Physical Break
Often when the to-do list looks overwhelming, caregivers can feel that taking a break is somewhat indulgent. Not true. According to The Energy Project’s Tony Scwartz, we can accomplish more by doing less. Taking breaks can help you avoid burnout and stay motivated. Watch an old holiday movie like Christmas in Connecticut or The Bishop’s Wife and don’t feel compelled to multi-task when you’re doing it.

Get Some Fresh Air
If you live in a colder climate, it may feel like you’re running from indoor heated space to indoor heated space — from home, to car, to store, and back again. Caregivers know that it’s important to keep a senior active, even during the frigid months. But winter’s cold can limit a senior’s mobility and slick sidewalks can cause treacherous falls. If your city has an indoor botanical garden or conservatory, take your senior client or loved one for a stroll through some much needed fresh (warm) air. Check schedules for special programs like holiday markets, flower shows, concerts, caroling, and holiday light shows. I like to sit on a bench in Chicago’s Garfield Park Conservatory’s Fern Room and pretend that spring is right around the corner. Many conservatories are free (like the aforementioned Garfield Park Conservatory) or have discounted senior pricing.

The photo above shows the Garfield Park Conservatory White Holiday Flower Show in 2007

Eat Right
During the holidays, treats are everywhere! And when we’re stressed, we tend to gravitate to comfort foods that are not necessarily nutrient-rich. It’s especially important to eat healthy during this frantic time. Eating well not only strengthens our immune system (so important during cold and flu season,) but good carbs, fruit, and vegetables have been shown to raise serotonin levels, helping us to relax. And citrus fruits, in season this time of year, are chock-full of precious vitamin C and other antioxidants — known stress-busters.

Get Some Help
Don’t turn down any offers of help from family, friends, or neighbors. Sometimes caregiver stress can be alleviated with just a few hours away. If there are no offers on the table, consider hiring some respite help. Call a quality senior home care agency early in the season to book a companion caregiver to help with a senior’s activities of daily living, freeing you up to take care of your own holiday needs.

Caregiverlist wishes you the best this holiday season. If you feel overwhelmed as a senior caregiver, remember to take a few minutes out of your busy schedule to stop and enjoy all the holiday goodness around you. Remember, it’s your holiday too!

Feel free to post your own suggestions for beating holiday stress in the comments.

Chicago Approves Minimum Wage Hike

The Chicago City Council resoundingly agreed, by a vote of 44-5, to raise Chicago’s minimum wage to $13 and hour by mid 2019. it’s estimated that the wage increase would affect 410,000 workers, or nearly one-third of all Chicagoans.

Currently, Chicago’s minimum wage is $8.25. Under the proposal, the minimum wage would increase to $10 next July and rise incrementally each summer until 2019. But according to the bill, the increase is long overdue. "...rising inflation has outpaced the growth in the minimum wage, leaving the true value of lllinois' current minimum wage of $8.25 per hour 32 percent below the 1968 level of $10.71 per hour (in 2013 dollars)."

With this bill, Chicago joins the current trend of a metropolitan area having a separate minimum wage from the rest of its state. New York City Mayor Bill de Blasio signed an executive order on Tuesday to raise the minimum hourly wage by more than a dollar to $13.13. The mayor said his plans are to increase the minimum hourly rate to $15.22 by 2019. Currently, the New York state minimum wage is $8 an hour.

In San Francisco, voters approved a rise to a $15 minimum wage in 2018. The state legislature, however, is just now proposing a hike in the state minimum wage to $11 an hour in 2016 and to $13 in 2017. And on On June 2, 2014, the City Council of Seattle, WA passed a local ordinance to increase the minimum wage of the city to $15 an hour by 2017, giving it the highest minimum wage in the United States.

Some Chicago aldermen like Tom Tunney (44th) argued Wednesday in the special City Council meeting that the wage increase would have adverse consequences by driving away businesses to other parts of the state or force companies to pass those bottom-line increases to the consumer.

There’s also talk that Chicago’s minimum wage hike has more to do with Mayor Rahm Emanuel’s upcoming reelection than with concern for a living wage for Chicago’s workers. Not surprisingly, mayoral challengers 2nd Ward Alderman Bob Fioretti and Cook County Commissioner Jesus "Chuy" Garcia are are critical that the Mayor Emanuel’s proposal doesn’t go far enough, saying they would raise the minimum wage to $15 an hour.

But it has had the effect of sending state legislature scrambling for a state-wide referendum that would raise the state's minimum wage to $9 an hour July 1. The rate would increase by 50 cents an hour each year until 2019, when the wage would reach $11 an hour.

Senior care agencies already pay more than minimum wage and the average caregiver hourly wage is 38% above national minimum wage, but there’s no doubt that new minimum wage proposals would affect caregiver wages. The question is, will costs be passed on to seniors and their families? Will higher wages in cities drive senior care company growth in suburban and rural areas? There’s no doubt that the cost of living is higher in major metropolitan areas, but will the cost of doing business become too high? I look forward to reading your comments.

Cyber Monday Holiday Gifts for Seniors

Everywhere you turn, retailers are offering up Cyber Monday gift ideas. I happen to be in the market for a holiday gift for my elderly mother. When asked, of course she tells me she has everything she could ever want or need, but that won’t stop me from trying to find the perfect present to knock her (supportive) socks off.

I have never been to, nor will I ever attend, a Black Friday door-buster event. Luckily for me (and you), Cyber Monday provides many excellent deals to be had from the comfort of my (and your) own keyboard. Here’s a few that I found.

Digital Photo Frame — Best Buy
As the family gets bigger, there’s no more room on surfaces for conventional photo prints in traditional photo frames. I wanted to find a digital picture frame that was easy to set up, loaded photos quickly, had good quality resolution, and decent internal memory. Best Buy came through with their VistaQuest 8" Digital Photo Frame in Espresso, on sale for $29.99 (down from $79.99.) It scored a 4.1 out of 5 stars from its reviewers and 87% of customers would recommend this product to a friend. Will my normally tech-averse mother like it? At that price, I’ll take the chance. And she’ll get to see a changing array of photos of her favorite people without taking up more precious table space.

E-Reader — Amazon.com
She’s a voracious reader, and it pains me to see my mother struggle with diminishing eyesight. My mother has nearly exhausted all the large-print books the local library offers, and it’s hard for me to keep track of what she’s read so far. What to do? An e-reader like Amazon’s Kindle holds thousands of books, is lightweight, and gives the reader font-size control. The very basic version is listed at $79, does not come with a power adapter and, most importantly, does not have a built-in light. The Kindle Paperwhite is the next step up in Kindle e-readers and it provides improved resolution and the all-important backlight, but at $119, I think I’ll pass unless I see it deeply discounted.

Warm and Cozy Throw — Wayfair.com

Chicago winters get cold and seniors tend to feel the chill more than others. I wanted to splurge on cashmere but I have to be somewhat frugal as well. Wayfair.com carries Cashmere Republic’s Signature Waterwave Cashmere/Wool Throw in a variety of colors on sale for $132.99 (a 26% savings.) One reviewer says it feels like being wrapped in a large cashmere sweater. Just the effect I was looking for!

Fragrance — Department Stores; Beauty retailers
Chanel No. 5 will never find itself on a discount list. Everywhere I look, the 1.7 oz. Eau de Toilette spray comes in at $78. My goal is to find the online retailer that will offer me free shipping and maybe a little extra gift that I can use as a stocking-stuffer for my daughter or a special little gift for myself. Sephora not only offers free 3-day shipping on purchases over $50, but also give you a Cyber Monday Mystery Bag containing 7 free samples when you use the code: SURPRISE at checkout. Macy’s gives me 3 sample fragrances along with a choice of a free silver or gold clutch along with free shipping. Unfortunately, my purchase doesn’t qualify for the store-wide 15% Cyber Monday discount. Nordstrom Online also doesn’t offer any discount on Chanel, but gives me an option to add 3 of a variety of beauty samples, including Laura Mercier Tinted Moisturizer. All the sites charge IL sales tax.

Of course, the most important gift we can give the elderly is the gift of our time. If you find yourself too far from home to give the gift of family caregiving, consider contacting a quality home care agency who can provide companionship care for your senior loved one. And don’t forget those important caregivers on your holiday shopping list!

How Long Should We Live?

Recently and rather infamously, Ezekiel Emanuel, Chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania and brother to Chicago’s own mayor Rahm Emanuel, wrote a piece for the Atlantic entitled Why I Hope to Die at 75.

Citing the physical and mental degeneration that often accompanies old age, Dr. Emanuel asserts in his essay that he will forego not only life-sustaining interventions such as dialysis, ventilators and defibrillators after the age of 75, but also simple diagnostic and preventative measures, like colonoscopies and flu shots.

Reading his essay, one gets the distinct impression that Dr. Emanuel doesn’t buy the notion of aging well — the idea that as we increase our lifespans, diet and exercise (both mental and physical) can delay the decline and disabilities we face as we age. Instead of what he calls “American immortality,” Dr. Emanuel espouses his “75 and no more” philosophy.

It was like the shot heard ‘round the world, prompting responses and rebuttals from all over the web. As you can imagine, such a provocative essay hit people where they live (pun intended.) When one imagines a long life, it comes with the caveat of being able to continue functioning fully, without descending into frailty or senility.

What got me, however, was Dr. Emanuel’s supposition that your creativity declines as you age — his assertion that the elderly have nothing left to give to society. I disagree. Heartily. And I am not alone. Our friends at Homecare Together, a Dublin-based quality home care agency, sent me this wonderful infographic, Life Begins at 60+, which presents examples of seniors who changed direction, reinvented themselves, gave back to the community, and prospered well into later-stage life.

 

Of course, not all of us will enjoy such a run, but it won’t happen without trying. I may not take drastic measures to prolong my life after 75, but I hope by the time I get there, with the help of an exceptional senior caregiver ( or perhaps a robot companion), an aged quality life full of vim, vigor, and creativity will be the rule and not the exception.

"Do not go gentle into that good night... Rage, rage against the dying of the light" — Dylan Thomas

Thanksgiving with Seniors: Checking for Signs of Dementia

Thanksgiving is right around the corner and with it, the holiday season officially begins. If you are like the host of other Americans that celebrate by gathering with family and sharing a delicious meal, it’s a great time to assess the health, both physical and mental, of the aging member(s) of your group.

Holidays are a prime time for families to detect dementia in a family member, according to the Alzheimer's Foundation of America, especially if it’s been a while since you’ve seen your older family members. While it’s certainly an exciting time, it’s also an extremely stressful time — regular routines are disrupted, and large groups of people means noise and excitement — it’s sort of a perfect storm of a time to determine if your aging loved one is exhibiting signs of memory loss.

If you spend Thanksgiving at your senior’s home, a quick bit of detective work will give you some insight into their mental health. Remember to do this stealthily! This is not the time for confrontation, but an opportunity to gauge if your loved ones are living their best lives.

Take a good look (and smell)
Has there been obvious weight loss? People with memory loss often forget to eat. If they are depressed, which often happens when someone begins to experience mental acuity changes, they may decide that cooking is too much bother.

How is their personal hygiene? Are clothes clean? Make note of their grooming to determine any odd or peculiar changes in their regular appearance.

In the house
Check the refrigerator for expired food. Or multiples of the same food. Take a look in the living areas; are they clean and free of clutter? Peek at more personal spaces. While common areas might have been picked up in anticipation of guests, out-of-the-way areas like bathtubs and closets might give a truer picture of a senior’s ability to keep up with general tasks. If they have plants or animals, are they thriving?

Is there any unopened mail hanging about? Paying bills, especially, may seem overwhelming. According to Forbes, financial decision-making capacity erodes early on in those suffering with memory loss, dementia, or Alzheimer’s disease.

Talk to neighbors
If you aren’t around much, talk to those who are. If you happen to see neighbors, ask if they have noticed any changes in your senior loved one. A certain red flag is isolation. If they don’t see your senior as often as they used to, it can be cause for concern. Now is the perfect time to exchange phone numbers and ask them to contact you if they see anything remiss.

If you do suspect that there are changes in your senior loved one’s mental acuity, don’t hide your head in the sand. Take the opportunity to talk to other family members and make a plan of action. The first step? Consult your elder’s primary care physician and in the meantime, perhaps enlist some help.

From all of us at Caregiverlist, we wish you a happy and healthy Thanksgiving.

Veterans Benefits for Senior Care

Veteran’s Day is the day we set aside to appreciate those who have served in America’s wars. No matter what your political ideology, both sides of the aisle can agree that elderly veterans are entitled to our support, especially as they age.There are many benefits available to elderly veterans, but bureaucracy can make getting those benefits challenging. It helps to know to which benefits you’re entitled and how to apply for the assistance you need.

Elderly Veterans
According to the U.S. Census Bureau, there were 9.3 million veterans 65 years and older in 2013 (including America's oldest living veteran, 108-year-old Richard Overton.) The Department of Veterans Affairs (VA) is committed to providing benefits and services that help address the needs of the aging veteran population.

VA Benefits for Elderly Veterans
Elderly Veterans may be eligible for a multitude of benefits including:

A relatively unknown but extremely helpful benefit is available for senior veterans. The Aid and Attendance and Housebound Improved Pension benefit, known as A&A, can cover the costs of caregivers in the home. Our family found out too late that this can include sons and daughters who are paid to be caregivers, (but not spouses) or be used in assisted living or a nursing home. 

According to the VA, Aid and Attendance (A&A) is paid if you meet one of the conditions below:

  • You require help performing daily functions, which may include bathing, eating or dressing.
  • You are bedridden.
  • You are a patient in a nursing home.
  • Your eyesight is limited to a corrected 5/200 visual acuity or less in both eyes; or concentric contraction of the visual field to 5 degrees or less.

Learn more about these benefits on the Aid & Attendance Housebound benefits page.

How to Apply
Caregiverlist has provided a comprehensive webpage that discusses the Veteran's Aid and Attendance Benefit for Senior Care. In it, we discuss what it is, who qualifies, the dollar amount of financial requirements and benefits, and links to all necessary paperwork.

Unfortunately, LGBT veterans and their spouses do not receive the same full and equal benefits if they live in a state that doesn’t recognize same sex marriage, even though the benefits are on a federal, not state, level. At present, a petition is pending in the United States Court of Appeals for the Federal Circuit [AMPA v. MacDonald, No. 14-7121 (Fed. Cir. 2014)].

Family Caregivers
The VA also provides a website specifically designed to support VA family caregivers. It’s mission is to:

  • inform you about assistance from the VA
  • assist you in accessing all available services and benefits.
  • put you in touch with your local VA medical center family Caregiver Support Coordinator
  • lend you a sympathetic ear

The VA's Caregiver Support Line is toll-free at 1-855-260-3274

As always, Caregiverlist thanks all veteran’s for their service and a special thanks to all the caregivers who aid and assist them.

Golden Light in Wisconsin: Stress Relief Photo

The late afternoon sun sometimes casts a beautiful golden glow.  This week's stress awareness photo is of a fountain in Lake Geneva, Wisconsin, and was taken at the end of the day as the sun was getting ready to set. Caregiverlisinvites you to take a moment to enjoy the photo and inspirational quote and share it with loved ones. Thank you caregivers and certified nursing aides for caring for our seniors. Senior care training briefs help senior caregivers to understand various senior illnesses and keep up with the latest care techniques to relieve caregiving stress. We hope you can take some time to yourselves and have a great week. 

"Don't judge each day by the harvest you reap but by the seeds that you plant."

-Robert Louis Stevenson

Hospice is End-of-Life Care with Comfort and Dignity

For senior caregivers, the word “hospice” is a double-edged sword. Hospice is end-of-life care, so the inevitable is on the horizon. The care recipient is terminal and the focus of care shifts from extending the quantity of life to preserving the quality of life left.

November is National Hospice Month and a great opportunity to thank those who make the care recipient’s final months, weeks, and days comfortable and as pain-free as possible. As hospice care turns 40 this year, Caregiverlist invites you to learn more about this special breed of caregiving.

The National Hospice and Palliative Care Organization (NHPCO) defines hospice care as a specialized kind of care for those facing an end-of-life illness, their families and their caregivers that:

  • addresses the physical, emotional, social, and spiritual need of patients
  • provides care in the patient’s home or in a home-like setting
  • concentrates on making patients free of pain and as comfortable as they can be so they and their families can make the most of the time that remains
  • includes family members an essential part caring for the patient
  • stresses quality of life over length of time left

Hospice centers on caring, not curing. That care is delivered holistically by an interdisciplinary team that consists of physicians, nurses, in-home caregivers, therapists, counselors, and social workers. Their combined goal is to provide compassionate and comprehensive care that includes patient pain management and family support so the care recipient can die pain-free and with dignity.

The number of patients and families utilizing hospice has steadily increased over the last few years. In 2013, an estimated 1.5 to 1.6 million patients received hospice services. The median length of hospice service in 2013 was 18.5 days.

Who pays?
The Medicare hospice benefit, established 1982 by the U.S. Congress, is the predominate source of payment for hospice care. As of today, 42 states also offer Medicaid coverage for hospice. Private insurance and VA benefits cover this end-of-life care as well.

Few caregivers, especially family caregivers, are prepared to handle the events and changes that happen at the end of life. To that end, the Hospice Foundation of America has published a guide called The Caregiver’s Guide to the Dying Process. The booklet is designed to help the caregiver

  • address the needs of the dying by providing descriptions of the physical, emotional and spiritual changes occurring near the end of life
  • help to understand and recognize what is happening physically and emotionally to the terminally ill care recipient
  • suggestions for what you, as the caregiver, can do to ease distress and make
  • the dying person as comfortable as possible
  • information to help you, as the caregiver, communicate effectively with the hospice team
  • insight on how you might feel as the caregiver for someone who is dying ideas of how to care for yourself

My personal experience with hospice occurred with my good friend (and senior) Louie. Louie knew he was dying. At the time, he was in the hospital and asked to go home, where he could spend his last days surrounded by his family in the home he’d shared with his late wife and look upon the garden he’d tended for the last 45 years. Hospice brought a hospital bed into the greatroom, where he could look out onto the backyard and his garden. They eased his pain with generous doses of morphine so he showed no signs of physical duress as family and friends came to hold his hand and say goodbye. All the while, members of the hospice team were in and out, making sure everyone involved had all they needed to make Louie’s passage as warm and peaceful as possible. They made it possible for Louie to die at home, as he wished, listening to his favorite big-band music as they attended to his comfort. It was a beautiful and natural way to die and I will forever be grateful to them all for their inestimable services.

Join the NHPCO hospice community on Facebook and help ensure all Americans get access to quality end-of-life care.

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