www.ipced.com

Caregiver Certification: why it matters to you

Joe was a stubborn old man.  Set in his ways, determined to do what he wanted, when he wanted, he was not about to let some young “girl” come in and help him with a shower. “I’ve tried everything I know to do,” said one. “Nothing ever works with Joe!” said another. “I’m going to try what I just learned in my caregiver class,” said the third of the three caregivers huddled in the hall. They knew that Joe hadn’t bathed now in several days, and his out-of-town daughter was coming to visit that afternoon.  It would reflect poorly on their care if Joe was clearly a little too musky for comfort – not to mention making it tough for the daughter to relax and enjoy the visit. One hour later Joe emerged from the bathroom with slicked-back, shiny hair and the scent of fresh soap, instead of the reek of body odor.  The successful caregiver also had a glow, knowing she had achieved what seemed impossible.  Even more important, it had been a positive experience for both Joe and his caregiver. All three caregivers had good hearts.  All three wanted to be the best caregivers they could be.  The difference?  Good training that taught the one caregiver important skills that increased her ability to be the best caregiver possible.

For family members selecting an assisted living community or home care agency this is a crucial difference.  Compassion and a big heart are still vital, but skills training brings it all together and gives the compassionate caregiver the tools to deliver what the family is looking for – and the person receiving care really needs. Personal Care Aide (PCA) Certifications are just emerging as one form of caregiver certification that is uniquely designed to prepare the caregiver for home-style caregiving.  They typically cover all the basic skills required for care, including skills in communication, decision-making and respect for the rights of the person in their care.  They reinforce, through the training, principles of independence, choice, dignity and privacy.  A caregiver learns to see challenges through the eyes of the client, and to include families in the unit of care.  Within the coming decade PCA Certification will likely become the minimum standard for all direct-care workers. For now, it is one way for families to feel increased confidence that the person providing care has more than a good heart:  she has skills and a unique understanding of the difference a good caregiver can make in enriching the lives of the people in her care. Learn more about IPCed’s Personal Care Aide Certification course

Caregiver Certification eases fears

I remember hearing a family member tell me that leaving their mom with a new caregiver and walking out the door to go to their own home reminded her of leaving her child at day care for the very first time. It’s scary. It means trusting someone you don’t know well to care for someone you love and feel responsible for. Your stomach churns and there’s a sick feeling deep down. Your mind circles around the fear: what if the caregiver doesn’t listen to her? What if she speaks sharply to her, or is rough with her? You worry if she really has the skills and knowledge to provide the care your mother needs, and the judgment to know what to do if something awful happens (a fall? wandering off?). You wonder if your mom will ever forgive you for not caring for her yourself; for turning to strangers to provide care.

There’s no easy way to get past these initial feelings when you place your precious loved one (parent or child) in the care of someone else. Here’s one idea, though, that’s gaining a lot of traction nationally: make sure that the caregiver has solid, formal training with a certification to show for it. It’s a fast-growing field for training, and new online courses like our Personal Care Aide Certification course make certification available to anyone with an internet connection. Ask – and expect – anyone who provides caregiving to your loved one to be appropriately certified. It might not take away the initial “first day” jitters, but it will give you a sense that you’ve taken one more step to ensure the safety and care of your loved one.

My papi, who lives about 12 miles from me and who also has a full-time caregiver was very understanding about the situation.  He’s just turned 80 and has many health issues.  He can’t walk anymore and he’s totally incontinent.  His short-term memory is shot.  You can imagine the rest.

My focus was my husband and I totally let Larry, my papi’s caregiver, take full charge of my papi’s needs.  Larry is wonderful.  He has this great relationship with my dad and this puts me at ease.  I really don’t worry.

I went to see dad for a couple of minutes 2 or 3 times during all this drama.  Then, as you well know we had one snow and ice storm after another in this part of the country.  I live around the Blue Ridge Parkway in Floyd, Virginia.  We own 40 acres and we got snowed in.  Could not get out until we had some friends come over with a heavy-duty tractor and opened the driveway.   The other day I went to papi’s, made him lunch and spend some time with him.  The next day Larry told me that papi was very relaxed, calm and happy.  He hadn’t been like this since about December 14 which was the time I moved in the ICU with my husband.

The reason I mention this is because I realized how important it is to physically go see my dad and spend some time with him.  We all know this but I really didn’t “know” this until I felt it in my heart.  Don’t get me wrong, I go visit but there are times when I visit and do things.  I straighten out, clean some, do laundry, groceries and all that stuff.  This last time, I made him some soup (his favorite) and sat with him even the times he fell asleep.  I held his hands, cut his fingernails, massaged him, talked with him and prayed with him.  I was totally present with him and he noticed.  This was truly a blessing for me and brought me back to what is important.  Wether  we feel like it or not go visit and spend quality time with our loved ones.  Forget about what needs done.  Whatever it is it can wait.  Just be present and loving.  By present I mean put all your attention to this person in front of you and extent all the love that flows through you.  This was my Valentine’s blessing to myself.  And my husband did just fine on his own for 4 hours.  I love Life!

All these months that Bo’s been in and out of hospitals and rehab I’ve had the blessing of friends in our life that makes life wonderful.  Friends have shared themselves with massages, prayers, food, house cleaning, dog sitting, keeping the fires burning and much more.  Most importantly, just being present and loving us unconditionally is the best gift we can ever experience.

It takes trust from a caregiver’s part to allow ourselves to ask for help and recognize we just can’t do it all.  It turns out that friends have lots to offer at all times but especially in times of need.  If a friend offers to help in any way, go for it.  Allow yourself to acknowledge you need help.  It’s very liberating!  What I had to realize is that it was helpful to my husband also.  We forget that part where the caregiver and the care receiver are a team and both of us need help.

Bo and I are truly blessed with abundance of friends.  Our abundance is overflowing our hearts.

Life is not measured by the breath you take, but by the moments that take our breath away! Friends take my breath away every time I allow myself to trust and accept their gift of love.

Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. The Privacy Rule applies to all forms of individuals’ protected health information, whether electronic, written, or oral. The Security Rule, a Federal law that protects health information in electronic form, requires entities covered by HIPAA to ensure that electronic protected health information is secure.

I found the above somewhere and thought it was to-say-the-least interesting.  Having been in the hospital with my husband for most of 4 months (in and out) I found it amusing how there is so much paper wasted on this so-called Federal Law and you have ERs with 2 or 3 people in a big room separated by curtains with no privacy.  Your neighbor can hear everything the doctors and nurses tell you.  If you go on to the floor, and don’t have a private room, where is the privacy that everybody is so worried about?

You’re there with your loved one for days and you can’t even get a cup of coffee.  We have to go and ask a nurse for everything because of the HIPAA law.  It doesn’t make sense.  Nurses are overworked and that’s what we the caregiver, health advocates are there for.  I thought the purpose is to make the patient as comfortable as possible.  If it’s not for a caregiver that’s there 24/7 it won’t happen.

My sense of what institutions like hospitals and rehab centers are interested in is the insurance to get paid.  Patients themselves come secondary.  All this money spend on printed material that goes out the window when they put it into practice.

You can already see the decay and changes in the healthcare system and we as recipients have to make it known to our enlightened government officials that it’s not acceptable the way things are done and something needs to change.  The art of giving is fading quickly in our Western society.

They call it Skilled Nursing Facility Rehab but guess what?  It’s a nursing home environment.  Nursing homes are moving away from their 24/7 full-time Medicare/Medicaid elder population and moving towards the part-time full payment PT/OT rehab.

They send you from the hospital to a place that you don’t know.  You feel you’re down the rabbit hole as you walk into the nursing home.  They don’t separate the rehab area from the rest of the nursing home.  It’s depressing the first 3-4 days.  Then you start to see light at the end of the tunnel.  Your mind starts to see things in a new light and you get adjusted mentally and physically to your surroundings.

As I’m there almost 24/7 with my husband I come to observe the seeming loneliness for most of these residents.  Most of them have no visitors or maybe once a week someone shows up for about 15 minutes or so.  Not that they’re all there, mind you.  Many are in their own world or seem to be.  Some residents respond to familiar faces — and they’re starting to respond to me… I’ve gone there for almost 20 days.  They smile and extend their hand for me to touch them.

Residents are clean and the place doesn’t smell — the one thing I notice however, these people don’t get the pleasure of the touch.  They get no hugs, kisses, warmth and fussies — lack of human contact. Wow!

Brought my black lab there one day and many had smiles on their faces and she was a success.  Touching is a proven healing tool and I’m so surprised at the lack of it in the nursing home environment.

I can go on and on but I’m asking you to just go and visit an elderly loved one (if you have any) and remember to hug and touch them often.  Let them know you love them and you care.  We’re all in need of a healing touch!  It does wonders for the soul.

It is our responsibility to write down, remember all relevant information on our loved one’s reactions to different meds, environment, smells… practically all.  They depend on us to make informed decisions.

For whatever reason, doctors seem to talk to patients that are not totally there, not with it.  We, the caregiver, the responsible party, has to make sure that all parties are with the program that “I am in charge here” — we are responsible, therefore we are in charge.

Be proactive, get involved in the hospital case management, ask the questions that our loved one probably can’t remember.  We know better than anybody what’s in their best interest.

What is my lesson in all of this drama!  My only function is to see my husband healed and whole.

What do you do?  You can get pissed or you can take control.  I’ve taken the responsibility to be my husband’s caregiver/advocate.  When you take on this responsibility you don’t realize how much you learn, how assertive you have to be with nurses and doctors and the whole system.

I choose my battles (sometimes) — I chose to let go of being so upset at my husband and put my energy on making sure I am fully involved in his treatment of care.  Making sure the doctors and nurses and hospital and all parties involved now that they work for “me” and we are a team.

Most of the time, doctors and nurses respect that and will work with you because we know what’s in the best interest of the patient.  This is my responsibility and duty as a caregiver.

I don’t consider myself like a sandwich in my caregiving relationships.  Being a history buff it seems to me that we have done the same caregiving we’ve always done.  I don’t think that the art of giving has changed at all.  Our life styles have changed.  We’re always in a rush and we mostly have deadlines.  We have more gadgets, bigger homes or little castles, lots more debts.  We seem to have lost time — time to spend with our loved ones.  Time to get to know mom and dad better.  The way society is going we’ll end up taking care of our elders anyway.  We always have, we always will.  It is part of our DNA.  It is part of who we are.  Humans (whether we want to accept it or not) have always and will always take care of each other.  Granted, we have exceptions but for the most part we do.  We are tribal creatures.  When we accept this life will flow with grace.  I like that Life will flow with Grace when we accept who and what we are.

Of course being a wife and mother is the 1st sign that I am a caregiver in some form.  I’m also an only child of older parents.  They don’t call me “Momma T” for nothing.  The nickname should give me away.

When I was in high school my mom went through a major crisis in which she had to take almost a year off from work.  I was about 15-16 at that time and a full-blown teenager.  Even though my mom didn’t say much I intuitively realized this was serious and I needed to help out.  I started cleaning more around the house, I got a part-time job in a grocery store which gave me the money I needed to purchase some of the teenage needs and I did contribute to some groceries.  It was a quiet process and I felt left out and alone.  I was scarred and always wondering what I did wrong and if she was going to die.  This was my first official caregiving experience.  As you can see, no experience required.

Next, of course got married (if that isn’t caregiving), had kids (more caregiving) and mom had her first round of cancer.  Being an only child and believing I have to do it all, I tackled treatments, doctors, hospital, more doctors and constantly managing the care of my mom.  I was a working mom so I gave the responsibility of the children to the husband, went to the hospital about 5-6 am (when you can talk to nurses and doctors), went to work, and after work went back to the hospital or mom’s place to do chores there and make sure all was well.  When she was in the hospital she was in ICU for about 3 weeks or so.  I lived there.  My world evolved around her needs.  I know, obsessive I am.  Controlling I am.  I like my world to be in order and running smoothly.

Mom snapped out of cancer (Hodgkin’s Lymphoma stage 4) even though they gave her for dead and chemo almost killed her (she was allergic to the treatments) — she lived for another 14 years and when the cancer finally returned, she chose to forgo treatments and die.  Together we chose the process of cremation, hospice, all the legal documents arranged long before her death.  — I must say this part of my life even though very difficult was the best time with my mom I experienced.  We learned to know about each other and this was my beginning of learning The Art of Giving — it surely takes a community of family, friends and services to help with our transition from body to bodiless.

Mom was easy.  She was my learning ground, she had insurance, retirement — money was not a problem and hospice was the best thing I did.  In those days (in the 90s) it was still non-profit and they were excellent.  I’ve haven’t had the need for their service since.

Years later I have my father!  Had to move him from Chicago to Floyd, Virginia (mayor, mayor, mayor) — before this I flew up there a couple of times when he was in hospital.  Had to close his apartment, get rid of his stuff and set him up in a nursing home.  Visit nursing homes in Chicago (which I know nothing about) — just imagine the insanity.  He got better in the nursing home.  Ran away from nursing home.  Moved to a hotel.  This man had no money and his body was “used up” but his mind still thought he could just be who he was.  Totally different from mom.  No money.  Living on social security and SSI — brilliant man who had a stroke in his late 40′s, lost the part of his brain that he worked with so he couldn’t work — from then on… — Dad just lived his way and only his way.  So, after running away from nursing homes (2), trying to make it in an assisted living, having heart, diabetes, mental, physical, etc. he had a choice.  I finally had to give him an ultimatum; Floyd or the streets.  He chose Floyd.  I drove to Chicago from Floyd to pick him up and move him.  Physically, he couldn’t do the plane thing and so there I went on another “Caregiving Adventure.”

Before I moved him, I had to find a place for him to live.  I learned that if he lived with me I would die or go crazy and my marriage would not survive.  I called out for help big time.  This wonderful woman Janet Brennend from the New River Valley Agency on Aging was a life saver.  She’s the Ombudsman for this area (everybody should know how to find your ombudsman in your area).  I went out and pursued all the programs available that I could find.  Social Services was extremely helpful.  Our SS office in Floyd is priceless.  When I moved him, he had his apartment, all the benefits he had in Chicago and he had his family.  It did take a huge toll on me physically, mentally, emotionally.  Not spiritually; this part improved with help from my friends and my sweet husband.  I then tackled the art of finding a professional caregiver (meaning paid) to stay with dad while I worked.  The 1st 6 months where very challenging.  I found Larry and it was a match made in heaven.  I’ve been very lucky in that respect.

Dad has been in and out of hospitals since he got here.  Had to take time out from work to be in Chicago, every time he goes in hospital, to spend time with him, to clean his place, groceries and all we do in the caregiving department.  Yes, I got pretty stressed out.  My employer was wonderful and always worked with me and helped me out as much as possible.  Taking time was no problem (I gave them 110% when I was there).

I could have continued the way it was but this year 2009 however, my husband got sick and ended up in the hospital.  This was the end of March. I could not physically, emotionally, mentally handle husband and father at the same time.  I went part-time at work.  My husband had COPD, congestive heart failure and atrial fibrillation.  From March on I saw him deteriorate what seemed to me was speed of light.  Finally, I had to quit work in September and he had heart surgery in October.  Recuperating from heart surgery is extremely slow.

I have a wealth of knowledge on the art of caregiving.  This aft entails all aspects of living included but not limited to

• How to get all information from doctors, hospitals, insurance, pharmacy, nurses, etc.
• How to get nurses to be aware of individual needs of patients
• We are so short-staffed in the health community that it’s a must to have family become your personal “health advocates” — YOU HAVE TO SPEAK UP FOR YOURSELF AND YOUR LOVED ONE.  NO ONE IS GOING TO DO IT FOR YOU.
• Do not rely on hospital staffing for your needs.  You let them know what your needs are.
• You, the caregiver has to take charge.  The patient is sick, drugged and you are the best person to do the job.  If you cannot, delegate this part to someone you trust.
• Ask, ask and ask some more.
• You teach the doctors how to answer your questions and how to deal with your loved ones.
• We are individuals not a herd therefore our needs are individualized.

OK, so I can go on and on about this.  As you can see I am very passionate about this topic and if I could, I would teach every one of you the art of giving.

I am not working at the moment.  I had to give up my salary, health insurance and other benefits to accomodate the needs of the people I love; and I’ll gladly do it all over again.

I call myself an informal caregiver due to the fact that I don’t get paid monetarily for this title I have earned.  I will leave you with one of my favorite sayings my friends “Life is not measured by the breaths we take, but by the moments that take our breath away.”

Until next time:)

Anyway, in the article they stated that at some point in our lives, most of us have been or will be caregivers; included but not limited to daughters, wives, husbands, sons, grandchildren, nieces, nephews, partners and friends.  Most of us rely on unpaid assistance from families, friends and neighbors.  Some people will rely on paid caregivers but these are the minority.

They continue to say that for some of us caregiving occurs gradually over time.  For others, it can happen overnight.  Caregivers may be full- or part-time; live with their loved one or provide care from a distance.

They provide extensive statistical information that you can read by going to their website.  The key about all this information is

• Impact on Physical and Emotional Health
• Financial Issues
• Work and Eldercare
• Legal Issues
• Need for Support
• Policy Implications

We all have our stories to share about these different points.  Therefore, I encourage you express your comments and help me with this mission I’m in to promote, teach, and help to make caregiving an easier task for all of us.