In-home help: how, when and why

I am an 82-year-old woman who is caring for my partner with Parkinson’s disease. I am feeling tired and can’t get things done around the house and do what needs to be done for my partner. I feel as if I am failing him. What options do I have? What can I do? — T.M., Oakland

Managing a household is hard enough, let alone taking care of your aging loved one as well! It’s perfectly normal to have a mixture of emotions in this situation.

According to a New York Times article in July (http://tinyurl.com/p45t28o), a recent report by the National Alliance for Caregiving and the AARP Public Policy Institute on the state of American caregiving found that caregivers over age 75 constitute 7 percent of those providing unpaid care to a relative or friend. Of the more than 3 million senior caregivers, almost half of them were helping a spouse.

People over 75 spend an average of 34 hours a week on caregiving tasks, according to the National Alliance for Caregiving.

You may be among those caregivers — assisting their partner with bathing and dressing, shopping, preparing meals and doing laundry, or even performing medical or nursing tasks to address multiple chronic conditions. Having a partner with Parkinson’s certainly puts you in the latter category. The physical strain alone can be hard, especially if your own health is compromised.

Somewhere along the line, someone has probably suggested that you think about maximizing your energy to prevent burnout. By giving yourself time to take care of your own physical and spiritual health, you may feel reinvigorated and ready to give care to your partner.

You’ve probably thought: That’s easier said than done.

Most people will advise you to get some help — a pair of extra hands in the house to delegate certain tasks to. While this is sound advice, where do you start and what is the best way to plan it out?

Bringing a stranger into the house, making sure that it’s a good match and figuring out what this person should do, takes a lot of thought and organization. There also is the concern about whether or not your partner will like this person and accept his help. These are common worries among those considering hiring a home assistant.

It’s helpful to first write a list of tasks appropriate to hand off to a caregiver. These may include some personal care, housekeeping, cooking and helping with exercise.

At this point, you may want to get some advice from a specialist on aging or a geriatric care manager. A one-hour discussion or ongoing consultation on an as-needed basis may help you determine the best way to configure the support you and your partner need. A geriatric professional will take into account your partner’s situation and desires as well as your own respite needs. This professional can also help interview potential caregivers to find a good match. The professional also can examine the budgetary implications of care, helping you determine the most financially sound plan.

Hiring a caregiver through a home care agency versus doing a private hire is an important decision, and there are pros and cons for each option. Private hires are often less expensive per hour, but the family member doing the hiring must secure the caregiver from a reputable source and be responsible for tracking and paying employer taxes, doing payroll, and knowing all the applicable labor laws.

A home care agency will be more expensive per hour, but will offer you more protection by screening, fingerprinting and training the caregiver, and ensuring that the caregiver has the required skill set and personality to work with your ltoved one. A home care agency also will handle all the human resources aspects of hiring and paying the caregiver and will find a replacement if the caregiver gets sick or goes on vacation.

No matter how you hire the caregiver, once you’ve decided on a person, remember to go slow and develop a consistent schedule. First introduce the caregiver to your partner for a few hours a week. If the match is working, slowly extend the hours.

I once helped match a caregiver with a gentleman I’d been working with who had mid-stage Parkinson’s disease and didn’t want his wife to ever leave the house. This wasn’t a tenable situation, so the wife decided to hire a home care worker.

To introduce her husband to his new caregiver, we set up some mugs of tea and a teapot in the family room and explained that the caregiver was a colleague of mine. Meanwhile, the wife was able to run some errands.

Her husband loved baseball and the Giants were his favorite team (information we relayed to the new caregiver). As I was preparing the tea, the two men were already discussing who was going to win the World Series that year. Later, the caregiver left the room, washed the dishes, put them away, and got the client’s afternoon medication ready to administer.

When the wife arrived home two hours later, she was relieved to find that some housekeeping had been done and that her husband had already started bonding with the caregiver.

The next meeting was four hours long, and the relationship started blossoming.

This is precisely the benefit of bringing help into the house: Your aging loved one will be well taken care of and you will get a chance to rejuvenate and address your own needs.

 

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Rita Clancy

Rita Clancy, LCSW, is the director of adult services at Jewish Family & Children’s Services of the East Bay. Have questions about your aging parents? Email rclancy@jfcs-eastbay.org or call (510) 558-7800, ext. 257.