2m elderly will have no adult child to provide care by 2030

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• UK should build ‘new community institutions’ for elderly

Empathic Urbanite

Wow. 2 million of us without carers! When I started this enterprise I knew that we were an ageing population and there’d be a lot of need for care in the future. But I hadn’t considered that there’d be so many childless people, which basically DOUBLES the number of people who will need paid care workers.

“By 2030, 230,000 people who need more than 20 hours of care a week will not have a relative to provide it, the think tank said.”

This is an IPPR report, so it’s solid evidence that our society, culture and especially government needs to start supporting care agencies and offering much better individual training and organisational opportunities if we are to meet this massive challenge. And don’t forget, when we talk about older people in the future, it’s not a report about some vague ‘other’, this time, we are talking about ourselves!

Three Sisters…

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[Reblog of an Alzheimer item] The 36-Hour Day Podcast: Getting Help

 

Write text here…

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Johns Hopkins University Press Blog

Today is the fifth and final in a series of brief podcast excerpts from The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss. This bestselling title by Nancy L. Mace, M.A., and Peter V. Rabins, M.D., M.P.H., is in its fifth edition and is now available in an audio edition.

Podcast #5: Excerpt from Chapter 10: Getting Help

In this excerpt from Chapter 10, Dr. Rabins focuses on the need for caregivers to have outside help and have time away from the responsibilities of caregiving. He describes how to find good information on available services, how to seek and accept help from friends and neighbors,  and how to address problems you may encounter.

You can find this podcast and the rest of the series of podcasts here.

These podcasts are excerpted from a Johns Hopkins University Press audio…

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NLM Director’s Comments Transcript Caregiver Assistance & Better Communication: 09/30/2013

From the 30 September 2013 transcript by Robert Logan, Director of the US National Library of Medicine

Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I’m Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what’s new this week in MedlinePlus.

The extent of caregivers’ assistance to patients — and suggested strategies for physicians to assist caregivers — are detailed in an interesting commentary recently published in the Journal of the American Medical Association.

The commentary’s author (who is a professor at Harvard Medical School) explains about 42 million Americans are caregivers and they assist patients for an average of 20 hours a week. Muriel Gillick M.D. reports the majority of caregivers are middle-aged women caring for aging parents.

Dr. Gillick notes caregivers often assist patients with daily living activities, such as shopping, cooking, bathing, and dressing. However, Dr. Gillick writes (and we quote) “Nearly half of all caregivers report responsibility for complex medical tasks that often are the province of a professional nurse or trained technician’ (end of quote).

Dr. Gillick finds caregivers report they are responsible for clinical activities including: diet adherence, wound care, treating pressure ulcers, providing medications and intravenous fluids, as well as operating medical equipment.

Dr. Gillick notes the recipients of caregiving are likely to be seniors in the last stages of their life. In the year before death, Dr. Gillick explains only 17 percent of Americans are without a disability while about 22 percent have a persistent severe disability. She reports the largest groups of caregiver-dependent adults include seniors who are frail or have advanced dementia. Dr. Gillick notes about 28 percent of Americans are frail and 14 percent have advanced dementia in their last year of life.

Dr. Gillick adds patients who are frail or have dementia often cannot participate in the management of their care, which necessitates a caregiver’s involvement. Dr. Gillick writes (and we quote): ‘If (end of life) medical care is to be patient centered, reflecting the values (patients) no longer have the cognitive capacity to articulate, clinicians must rely on surrogates to guide them. Yet, few programs caring for patients with dementia (or frailty) regularly incorporate caregivers in every phase of care’ (end of quote).

To improve assistance to caregivers, Dr. Gillick suggests physicians need to better explain a patient’s underlying health condition as well as work with caregivers to prioritize a patient’s health care goals.

Dr. Gillick adds caregivers should be encouraged to provide input about a patient’s surroundings as well as more fully participate in health care planning in a partnership with attending physicians.

Dr. Gillick notes caregivers are especially helpful in creating a continuity of patient care within different settings. She writes (and we quote): ‘In the complex US health care system, in which patients are cared for in the home, the physician’s office, the hospital, and the skilled nursing facility, the most carefully thought-out plan of care will prove useless unless its details can be transmitted across sites’ (end of quote).

Dr. Gillick concludes physicians as well as health care organizations need to provide more educational support to help caregivers.

Meanwhile, MedlinePlus.gov’s caregivers health topic page provides comprehensive information about caregiving’s medical and emotional challenges. For example, a helpful website from the American Academy of Family Physicians (available in the ‘start here’ section) helps caregivers maintain their health and wellness.

A similar website that addresses overcoming caregiver burnout (from the American Heart Association) can be found in the ‘coping’ section of MedlinePlus.gov’s caregivers health topic page.

In addition, there are special sections loaded with tips to provide caregiving to seniors as well as women and children within MedlinePlus.gov’s caregivers health topic page.

MedlinePlus.gov’s caregivers health topic page also provides links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to clinical trials that may be occurring in your area are available in the ‘clinical trials’ section. You can sign up to receive updates about caregiving as they become available on MedlinePlus.gov.

To find MedlinePlus.gov’s caregivers health topic page, type ‘caregiver’ in the search box on MedlinePlus.gov’s home page. Then, click on ‘caregivers (National Library of Medicine).’ MedlinePlus.gov additionally features health topic pages on Alzheimer’s caregivers, child care, and home care services.

It is helpful to see JAMA address some caregiving issues. Let’s hope other medical journals will help educate caregivers and encourage more physician-caregiver communication.

Before I go, this reminder… MedlinePlus.gov is authoritative. It’s free. We do not accept advertising …and is written to help you.

To find MedlinePlus.gov, just type in ‘MedlinePlus.gov’ in any web browser, such as Firefox, Safari, Netscape, Chrome or Explorer. To find Mobile MedlinePlus.gov, just type ‘Mobile MedlinePlus’ in the same web browsers.

We encourage you to use MedlinePlus and please recommend it to your friends. MedlinePlus is available in English and Spanish. Some medical information is available in 43 other languages.

Your comments about this or any of our podcasts are always welcome. We welcome suggestions about future topics too!

Please email Dr. Lindberg anytime at: NLMDirector@nlm.nih.gov

That’s NLMDirector (one word) @nlm.nih.gov

A written transcript of recent podcasts is available by typing ‘Director’s comments’ in the search box on MedlinePlus.gov’s home page.

The National Library of Medicine is one of 27 institutes and centers within the National Institutes of Health. The National Institutes of Health is part of the U.S. Department of Health and Human Services.

A disclaimer — the information presented in this program should not replace the medical advice of your physician. You should not use this information to diagnose or treat any disease without first consulting with your physician or other health care provider.

It was nice to be with you. I look forward to meeting you here next week.

 

 

Read entire transcript here

 

Training Caregivers Not To Underestimate The Abilities Of People With Alzheimer’s Disease, Promoting Independence

 

This article resonates with me.
When my father was dying, it was a struggle not to help too much..and to make sure he made the decisions he was capable of, and physically moved on his own as much as possible.

Last week, as part of my volunteering at a senior residential center, I took a resident shopping. Although she had recently returned from the hospital, I did insist she go into the store with me (I was thinking exercise, she doesn’t move around much) …on the pretense that although she had a list, that would be the only way she would be assured she’d get what she needed.
She did manage! and thankfully wasn’t in pain (at least she didn’t complain).
As a volunteer at our local Area Office on Aging, it is challenging to offer options, but allow the clients to make their own decisions. Active listening is hard at times, but it does pay off in the end.

 

From the 21 July 2012 article at Medical News Today

Family members or professional caregivers who do everything for older adults withAlzheimer’s disease may just be wanting to help, but one University of Alberta researcher says that creating excess dependency may rob the patients of their independence and self-worth.

U of A psychologist Tiana Rust, who recently completed her doctoral program, says her research indicated that caregivers adopted a “dependency support script,” assuming control of tasks they believed patients seemed no longer capable of doing for themselves. She says this model shows that the caregivers’ beliefs, rather than the person’s real abilities, drove their interactions with the patients. Her research also showed that the caregivers’ actions were also seemingly incongruous with their values of wanting to treat patients with respect and promote their independence.

With an aging Canadian population, the number of people suffering from the disease is expected to increase over the next 20 years, she says. Thus, changing behaviour becomes critical – and she’s hoping her U-of-A based research will help spark that change.

“When we create this excess dependency that doesn’t need to be there, this is a problem,” said Rust. “1.1 million Canadians are projected to have dementia by 2038. So, if we’re able to maintain and promote independence to the degree permissible by the disease, that’s important.”

Help not necessarily wanted ….

 

Related articles

• Helping Alzheimer’s Patients Stay Independent (eurasiareview.com)
• The Alzheimer’s Caregiver™ – Bridges the Gap between Research and Caregiving (alzheimersspeaks.wordpress.com)
• Newly Released Report, Women and Alzheimer’s Disease, The Caregiver’s Crisis Finds 82% of Women Caring for Alzheimer’s Patients, Primarily at Home (prnewswire.com)
• Changes in walking may indicate Alzheimer’s disease (foxnews.com)
• New Study Shows The Stress of Working, Caring (caregiving.com)
• What Does Alzheimer’s disease and a Box of Cracker Jacks Have in Common? (alzheimersspeaks.wordpress.com)
• Caregivers need relief, respite from Alzheimer’s, too (miamiherald.com)

 

Stress in America 2011

From the 3 February Full Text Report summary

Stress in America 2011

Source:  American Psychological Association

From press release:

The American Psychological Association’s (APA) newly released report, Stress in America™: Our Health at Risk, paints a troubling picture of the impact stress has on the health of the country, especially caregivers and people living with a chronic illness such as obesity or depression.

The Stress in America survey, which was conducted online by Harris Interactive on behalf of APA among 1,226 U.S. residents in August and September, showed that many Americans consistently report high levels of stress (22 percent reported extreme stress, an 8, 9 or 10 on a 10-point scale where 1 is little or no stress and 10 is a great deal of stress). While reported average stress levels have dipped slightly since the last survey (5.2 on a 10-point scale vs. 5.4 in 2010) many Americans continue to report that their stress has actually increased over time (39 percent report their stress has increased over the past year and 44 percent say their stress has increased over the past 5 years). Yet stress levels exceed people’s own definition of what is healthy, with the mean rating for stress of 5.2 on a 10-point scale— 1.6 points higher than the stress level Americans reported as healthy.

While 9 in 10 adults believe that stress can contribute to the development of major illnesses, such as heart disease, depression and obesity, a sizeable minority still think that stress has only a slight or no impact on their own physical health (31 percent) and mental health (36 percent). When considered alongside the finding that only 29 percent of adults believe they are doing an excellent or very good job at managing or reducing stress, APA warns that this disconnect is cause for concern.

“America has a choice. We can continue down a well-worn path where stress significantly impacts our physical and mental health, causes undue suffering and drives up health care costs. Or we can get serious about this major public health issue and provide better access to behavioral health care services to help people more effectively manage their stress and  prevent and manage chronic disease,” says psychologist Norman B. Anderson, PhD, APA’s CEO and executive vice president. “Various studies have shown that chronic stress is a major driver of chronic illness, which in turn is a major driver of escalating health care costs in this country. It is critical that the entire health community and policymakers recognize the role of stress and unhealthy behaviors in causing and exacerbating chronic health conditions, and support models of care that help people make positive changes.”

Related articles

• Stressed women know it. Stressed men … not so much. (psychologytoday.com)

• Human Immune Cells React Sensitively to ‘Stress’(ScienceDaily)
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• Survey: 1 in 5 Americans very stressed (boston.com)
• Is Stress Causing Your Hair Loss? (everydayhealth.com)
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Epidemiology: What Is It and Why Should Adult Children Know About It? With Link to a Related Supercourse

From the 14th January posting at As Our Parents Age – Timely Topics for Adult Children

It happens over and over again as I listen to the radio or read the news. I hear about an aging parent issue or a disease that is increasing in magnitude. Or sometime it’s a health issue that is affecting certain groups of people or a new bit of research the describes problems with an intervention — one that I thought was working well. Invariably these stories make me ask why? Sometimes I ask a more personal question, “If that seems to work for me, how come researchers say is isn’t effective?”

In just about every case, I answer my question by learning more about the study of epidemiology — a field that explores and collects data about how diseases specifically and health issues in general occur and affect people and in certain places. Epidemiology measures by some period of time. This short video from the Centers from Disease Control explains more.

Epidemiology can be difficult to understand, especially because people, including me, tend to personalize the issues. Here are just a few questions to illustrate this personalization.

• What risk factors for exposure to hazards contribute to aging parent falls as individuals age (in fact we are talking here about people over 60)? Why don’t people worry environmental health problems  and do things early on to prevent falls?
• How come after years and years, I’m suddenly told that yearly mammograms are less important?
• Why are men being cautioned to reconsider using prostate tests for routine cancer screening?
• Why are older seniors now being told to consider getting fewer screening tests such as colonoscopies as they age?

Click here to read the rest of the blog item

Related Resource

Supercourse: Epidemiology, Global Health, and the Internet

Supercourse is a repository of lectures on global health and prevention designed to improve the teaching of prevention. Supercourse has a network of over 56000 scientists in 174 countries who are sharing for free a library of 5050 lectures in 31 languages.

Related articles

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Paid Caregivers Struggle to Follow Doctor’s Orders

Struggling to follow doctor’s orders
Paid caregivers may lack the skills to take on health-related tasks in senior’s homes

From a February 22, 2011 Eureka news alert

CHICAGO — Paid caregivers make it possible for seniors to remain living in their homes. The problem, according to a new Northwestern Medicine study, is that more than one-third of caregivers had difficulty reading and understanding health-related information and directions. Sixty percent made errors when sorting medications into pillboxes.

The study will be published in the Journal of General Internal Medicine. It has been published online.***

In a first-of-its-kind study, nearly 100 paid, non-family caregivers were recruited in the Chicago area and their health literacy levels and the health-related responsibilities were assessed, said Lee Lindquist, M.D., assistant professor of geriatrics at Northwestern University Feinberg School of Medicine and physician at Northwestern Memorial Hospital.

“We found that nearly 86 percent of the caregivers perform health-related tasks,” said Lindquist, lead author of the study. “Most of the caregivers are women, about 50 years old. Many are foreign born or have a limited education. The jobs typically pay just under $9.00 per hour, but nearly one-third of the caregivers earn less than minimum wage.”

Lindquist found that despite pay, country of birth or education level, 60 percent of all the caregivers made errors when doling medication into a pillbox. This is an alarming statistic, because patients who don’t take certain medications as prescribed could end up in the hospital, Lindquist said.

“Many of these caregivers are good people who don’t want to disappoint and don’t want to lose their jobs,” Lindquist said. “So they take on health-related responsibilities, such as giving out medications and accompanying clients to the doctor for appointments. Most physicians and family members do not realize that while the caregiver is nodding and saying ‘yes’, she might not really understand what is being said.”

Right now there isn’t a standard test family members or employment agencies can use to gauge a caregiver’s ability to understand and follow health-related information, Lindquist said.

“Currently we are developing tests consumers can use to evaluate caregiver skills as well as studying the screening processes caregiver agencies use,” Lindquist said. “But, if you really want to know if the caregiver is doing a good job and is taking care of the health needs of your senior, start by going into the home, observing them doing the tasks, and asking more questions.”

###

The title of the study is “Inadequate Health Literacy Among Paid Caregivers of Seniors.”***

For suggestions on how to get this article for free or at low cost click here.

 

 

Related Articles

• Managing Medications: Tips for Family Caregivers (homecareminneapolis.wordpress.com)
• How to Create a Pill Card to Keep Track of Meds

Caring for the elderly: Dealing with resistance

Caring for the elderly: Dealing with resistance
Caring for the elderly can be challenging — particularly if a loved one is resistant to care. Understand what’s causing your loved one’s resistance and how you can encourage cooperation.

Excerpts From the Mayo Clinic Tip Sheet

What’s the best way to approach a loved one about the need for care?

If you suspect that your loved one will be resistant to care — whether from family, other close contacts or a service — you may be hesitant to bring up the topic. To start communicating with your loved one about his or her need for care:

• Choose a time when you and your loved one are relaxed. This will make it easier for you and your loved one to listen to each other and speak your minds.
• Ask questions about your loved one’s preferences. This will help you provide the type of assistance your loved one wants. What type of care does your loved one want or need? Does your loved one have a preference about which family member or what type of service provides care? While you may not be able to meet all of your loved one’s wishes, it’s important to take them into consideration.
• Enlist the help of family members. Family and friends may be able to help you persuade your loved one to accept help.
• Don’t assume that your loved one is unable to discuss care preferences. While your loved one may be ill, he or she may still have care preferences and be able to make some decisions regarding care. If your loved one has trouble understanding you, be sure to simplify your explanations and the decisions you expect him or her to make.
• Don’t give up. If your loved one doesn’t want to discuss the topic the first time you bring it up, try again later.

What are the most effective strategies for managing resistance to care?

Getting an aging loved one to accept help can be difficult. To encourage cooperation, you might:

• Suggest a trial run. Don’t ask your loved one to make a final decision about the kind of care he or she receives right away. A trial run will give a hesitant loved one a chance to test the waters and experience the benefits of assistance.
• Enlist the help of a professional. Your loved one may be more willing to listen to the advice of a doctor, lawyer or care manager about the importance of receiving care.
• Explain your needs. Consider asking your loved one to accept care to make your life a little easier. Remind your loved one that sometimes you’ll both need to compromise on certain issues.
• Pick your battles. Focus on the big picture. Avoid fighting with your loved one about minor issues related to his or her care.
• Explain how care may prolong independence. Accepting some assistance may help your loved one remain in his or her home for as long as possible.
• Help your loved one cope with the loss of independence. Explain to your loved one that loss of independence isn’t a personal failing. Help your loved one to stay active, maintain relationships with caring friends and family and develop new physically appropriate interests.

Keep in mind that these strategies may not be appropriate when dealing with a loved one who has dementia.

Two related resources

• Caregivers (MedlinePlus) has links to overviews, coping materials, organizations, related issues, and much more
• National Association of Area Agencies on Aging provides information on how to locate a local area agency for personalized responses to questions, caregiver support and resource information , and additional resources and programs

 

 

 

 

 

The elder care study: Everyday realities and wishes for change

December 13, 2010 15:33

The elder care study: Everyday realities and wishes for change (PDF)

Source: National Association of Area Agencies on Aging

Although there are many important studies of elder care conducted by a number of pioneers who have blazed the way, we see The Elder Care Study adding to this literature for two reasons.

First, this study is unique in its design. It is typical for research to have to make tradeoffs between breadth and depth. For example, if the study is a nationally representative study, it has breadth, but may lack depth because cost and time constraints limit the number of questions the researchers can ask or the number of times they can repeat the study. If the study is a qualitative study, it has depth, but may lack breadth because the people in the study may not be typical of caregivers.

This study has both breadth and depth. It is based on a nationally representative sample of employed caregivers, drawn from the Families and Work Institute’s ongoing National Study of the Changing Workforce (NSCW). The NSCW is a very comprehensive study with over 600 data points on employees’ lives on and off the job. Based on the 1977 Quality of Employment Survey conducted by the U.S. Department of Labor, the NSCW was first conducted by Families and Work Institute in 1992 and has been conducted every five to six years since then.

With its 54.6% response rate, it provides very rich quantitative information on working family caregivers of the elderly over the past 16 years.

Category:

Age and Aging

Children and families

Social and cultural issues

Source:

National Association of Area Agencies on Aging

Family Members Caring for Veterans Sacrifice Their Own Health, Jobs

From a November 11 2010 Health Day news release

THURSDAY, Nov. 11 (HealthDay News) — Many family caregivers of U.S. veterans sacrifice their own health and jobs to care for their loved ones and experience high levels of stress. Even so, 94 percent say they’re proud of their role, says a new study. “The care of a veteran is unique, and in many ways these caregivers are facing even greater challenges than other family caregivers,” said Gail Hunt, president of CEO of the National Alliance for Caregiving (NAC), which released the study to coincide with Veteran’s Day.”This report serves as a reminder that we need to come together to make sure caregivers have adequate resources and support,” Hunt said in an alliance news release.