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The Conservator may be a relative, friend or an appointee from the Conservator's office. An individual has to be adjudicated to be gravely disabled before being placed on an LPS conservatorship. Grave disability is defined as the inability to provide for one's food, clothing, shelter and proper medical care due to a mental disorder.

It is important to select an attorney who is knowledgeable in the areas needed estate planning, will drafting, probate or conservatorship. Anyone who accepts the responsibilities of a caregiver must also understand that there are a number of legal duties or liabilities that come with it. Many states including California have passed elderly abuse laws. Caregivers are bound by these laws in two ways: not to abuse the elder person physically, mentally or monetarily and report any incidents of abuse or suspected abuse to California residents only -- the Adult Abuse Reporting line or Residents of states other than California : Check you local telephone directory for the Adult Abuse Reporting telephone number or contact your county mental health services for guidance.

As a caregiver, you must provide a clean and safe environment, nutritious meals, clean bedding, and clothes. At the same time, if you are in charge of the elderly person's finances, you must use that money properly, purchasing necessary services for the benefit of the person to whom care is given.

Failure to provide care, failure to get care, and failure to purchase care are all forms of abuse or neglect. In addition, caregivers may not physically, sexually or psychologically abuse the person receiving the care. Yelling, screaming, withholding affection, etc. Therefore, if you are contemplating becoming, or are now a caregiver, you must be ready to accept the physical, psychological and legal duties to provide the necessary care. If you are reaching a point where you are no longer able, physically or emotionally, to provide the proper care, we urge you to consider the alternatives to personal caregiving and to seek help with this decision from a counselor.

As we have stated repeatedly throughout this booklet, caregiving is a very stressful situation. Stress either causes or exacerbates some 70 to 90 percent of all medical complaints, including tension and migraine headaches, high blood pressure, asthma, nervous stomach, bowel problems, and chronic lower back pains. There is research evidence indicating stress plays a role in a person's susceptibility to heart disease, stroke, and cancer. Stress has also been implicated in psychological disorders such as anxiety reactions, depressions and phobias, as well as poor work performance, drug and alcohol abuse, insomnia, and unexplained violence.

If you are experiencing any of the above, it is extremely important that you learn and use various techniques for stress reduction some are mentioned in this booklet , contact one of the professionals in Appendix A or come to the decision, both for your well-being and that of your care-receiver that It is time to stop caregiving. Below are some telltale signs which can help you assess when you have reached this fork in the road; seek help professional help, utilize more stress reduction methods, or stop caregiving:.

While these are not exclusive, they indicate a classic picture of caregiver burnout. The treatment for caregiver burnout is simple -- get help and get away for extended periods, either through stress management respite help or through a complete change in caregiving. No one can remain a full-time caregiver forever; the job is much too strenuous and stressful. The point we wish to set forth is: When should I say this is my limit; I am not able to do any more.

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Be honest with yourself, and when that limit has been reached, STOP! Research alternatives, request help from qualified professionals, and rest easy, because you did the right thing! In making the decision to seek an alternate living arrangement for your care-receiver you will first need to consult with your physician.

from Upper Arlington Commission on Aging

The physician can be your best ally since most facilities require a current complete physical exam and the physician can assess the level of care your care-receiver needs. The RFE is for non-medical care and supervision which may include personal services help in bathing and grooming, guidance in dressing, aid in taking self-administered medications and help with other daily living activities. Seek a licensed facility, since people who need care and supervision are often defenseless against abuse or exploitation. The law requires that care facilities be licensed. So when you select a care facility, check for the license to assure the protection provided by law and quality care for your loved one.

It is ideal if both you and your care-receiver could preview a care facility prior to deciding. Both prior to and during the preview process you have the opportunity to further discuss your feelings in making the decision. Since you have many things to do during your visit, you will find the outing less stressful and easier afterward to evaluate if you organize your thoughts beforehand, write down the questions you wish to ask, carry this checklist during your visit and make notes while looking around and talking to different people.

Some items you may want to cover during your initial visit to insure quality care are:. All Rights Reserved Longtermcarelink. Are you looking for ways to fund eldercare or long term care? We help aging seniors locate care and financial services in their area. Guide to LTC Planning From its inception, the goal of the National Care Planning Council has been to educate the public on the importance of planning for long term care. San Diego , CA Robert Torres-Stanovik, LCSW, Editor Because of ongoing changes and problems in collecting data, San Diego County cannot assume responsibility for the accuracy of the information printed herein, nor does this handbook provide listings of all resources.

Copyright The following is added at the request of the San Diego County Mental Health Services: The content of this document is public information and may be copied by governmental and non-profit entities for use in their caregiver training and related healthcare programs and for free distribution to the general public for those purposes. Acknowledgements I wish to especially thank the Beatitudes Center , D. Foreword Older citizens are more likely to be disabled or dependent due to medical problems. Page 5 List of Needs, Types of help available, When community agency help is needed, Services available to impaired elderly.

Page 9 Caregiver's self-rating scale, What can I do to help myself, Seek Information, Join a caregiver support group, Set realistic goals, Practice good communications skills,Communicate with your family and friends, Use community resources, Use respite care services, Maintain your health, Relaxation exercise, Laughter is the best medicine, Avoid destructive behaviors, Seek help, Build your self-defense, Caregiver's bill of rights Chapter Personal Care. Page 14 Bathing, shampooing and shaving, skin care, Toileting, constipation or irregularity, Assisting with eating, transferring, rest and sleep, Tips for encouraging self-care, Nutrition, Nutrients listed on food labels, Adapting meals for people with dietary restrictions, Four food groups, Common problems interfering with good nutrition, General tips for helping the older person to eat well Chapter Nutrition.

Page 20 Encouraging routine physical examination, Keeping records and managing medications, Choosing a doctor, Emotional and intellectual well-being, Depression: signs and causes, Suicide prevention, Promoting emotional well-being, The importance of lifetime learning,Memory problems, Sensory problems, Confusion, Behavioral problems, Mental stimulation Chapter Emotional and Intellectual Well-Being. Who is going to provide the care? How can living arrangements be changed to help the person stay in the home or become more independent? If outside services are needed, does the impaired person have the resources to pay for them?

How can they be obtained? How can care be given to the person in need without denying attention to others spouse or children for whom the caregiver also has responsibility? Do you as the caregiver feel tired or frustrated from caring for an older person? Physical Stress Providing physical care to an impaired older person can cause physical stress. Financial Stress The care of an impaired elderly person has many financial dimensions. Environmental Stress The proper home setting has to be chosen.

Social Stress Providing personal care up to 24 hours a day can cause social stress by isolating oneself from friends, family and a social life. Emotional Stress All of these factors often result in tremendous emotional stress. Conclusion For family members providing care, the various forms of stress can result in different feelings. Chapter Types of Help Available Family or Friends First make a detailed inventory of any assets individual family members and friends can contribute, including the assets of the impaired elderly person needing the care.

Community Agency Help When family or other volunteer help is not available or cannot meet your needs, caregivers or care-receivers may wish to seek help from agencies. Chapter Caring for the Caregiver Caregivers experience mixed emotions. Caregiver's Self-Rating Scale: Below is a scale to evaluate your level of caregiving. Abandonment to withdraw protection or support or to actively abuse your care-receiver. Neglect to allow life-threatening situations to persist or to display consistent coldness or anger. Concerned only with physical well-being of your care-receiver.

General Support given freely, with a guarded degree of warmth and respect, occasional feelings of manipulation. Concerned with both emotional and physical well-being of care-receiver. Expressed empathy the ability to feel what your care-receiver feels. Sympathy feeling sorry for care-receiver, giving sympathy, focusing on the losses experienced by care-receiver.

Occasional over-involvement care characterized by periodic attempts to do for rather than be with. Consistent Over-involvement care-receiver regarded as object of series of tasks which must be performed.

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Heroic Over-involvement care characterized by sometimes frantic and desperate attempts to provide for every possible need your care-receiver has; increased dependence, care-receiver not allowed independence. Fusion of personalities between caregiver and care-receiver. What can I do to help myself? I don't have enough time for myself. I don't have time to be with other family members beside the person care for. I feel guilty about my situation. I don't get out much anymore. I have conflict with the person I care for. I have conflicts with other family members. I cry everyday.

I worry about having enough money to make ends meet. I don't feel I have enough knowledge or experience to give care as well as I'd like. My own health is not good. Seek Information Check your public library for books, articles, brochures, videotapes, and films on caregiving. Join a Caregiver Support Group In addition to offering useful information, such groups provide a unique forum for caregivers to come together and share their feelings in a supportive environment.

Set Realistic Goals Caregiving is probably one of the many conflicting demands on your time. The list may include: running an errand for you, preparing a meal, taking your care-receiver for a ride, taking our children after school one day. Practice good communications skills Do not expect that others will ask if you need help. It is up to you to do the asking. Communicate with your Family and Friends Turning to family members or friends for emotional support and help can be a mixed blessing.

Use Community Resources Investigate community resources that might be helpful. Use Respite Care Services When you need a break from providing care to your care-receiver, look at respite care. Maintain your Health Your general well-being affects your outlook on life and your ability to cope. Relaxation Exercise: Sit or lie down in a comfortable position.

Close your eyes. Allow your mind to drift a few seconds, go with it wherever it goes. Wiggle your fingers and toes, then hands and feet, ankles and wrists. Loosen tight clothes, belts, ties. Sway your head from side to side, gently, gently. Now you have prepared yourself to relax physically and psychologically. Now concentrate, still with your eyes closed, on some one pleasant thing you really want to think about; maybe it is a place you have visited in the past, or your dream place of your own imagination.

It might be the seashore, or high on a hill, or in a field of grass and flowers. Become totally immersed in the place. Smell the smells you best remember. See the sights it offers. Hear the sounds. Feel it, whether it be water or sand or soil or snow. Fully realize this place or situation you are in: if it is on the sandy beach, sift your fingers through the warm sand and smell it, hold the sand to your cheek, smell the salt of the sea, search the skyline for gulls and terns and low clouds in the distance. Your body is totally weightless. You are totally in control of this scene. It is so relaxing and pleasant and beautiful, you are breathing slowly, peacefully.

This is YOUR place and no one can take it from you. After you have sufficiently experienced your peaceful imaging, whenever you have a chance, return to your special place, close your eyes again, tune in, relive those these special few moments in the world of your choosing where everything is perfect and everything is yours. This relaxation exercise can benefit you all day.

Check your local library or book store for books, audio tapes, videotapes or films on relaxing and managing stress. Laughter is the Best Medicine This is an old expression popularized by Norman Cousin's book Anatomy of an Illness, in which he describes his battle with cancer and how he laughed his way to recovery.

So for yourself and your care-receiver: try to see the humor in being a caregiver; write on a card Have you laughed with your care-receiver today? If you find that you are feeling hopeless, and humor or laughter is not affording you the up-lift you want, contact a counselor. And remember, laughter is the best medicine.

Try it, you'll like it! Avoid Destructive Behavior Sometimes people handle stressful situations in ways that are destructive. Seek Help You do not have to go it alone.

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Build your Self-Esteem Continue to pursue activities and social contacts outside your home. Caregiver's Bill of Rights You have rights, too. Caregiver's Bill of Rights Caregivers have the right to receive sufficient training in caregiving skills along with accurate understandable information about the condition and needs of the care recipient.

Caregivers have the right to appreciation and emotional support for their decision to accept the challenge of providing care. Caregivers have the right to protect their assets and financial future without severing their relationship with the care-receiver. Caregivers have the right to respite care during emergencies and in order to care for their own health, spirit, and relationships.

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Caregivers have the right to expect all family members, both men and women, to participate in the care for aging relatives. Caregivers have the right to provide care at home as long as physically, financially and emotionally feasible; however, when it is no longer feasible caregivers have the obligation to explore other alternatives, such as a residential care facility.

Caregivers have the right to temporarily alter their premises as necessary to provide safe and livable housing for care-receivers. Caregivers have to right to accessible and culturally appropriate services to aid in caring for aging care-receivers. Caregivers have the right to expect professionals, within their area of specialization, to recognize the importance of palliative ease without curing care and to be knowledgeable about concerns and options related to older people and caregivers.

Caregivers have the right to a sensitive, supportive response by employers in dealing with the unexpected or severe care needs. Chapter Personal Care Personal care activities include eating, bathing, shaving, caring for the skin, hair and mouth, and transferring moving from chairs, toilets or bed.

Bathing Bathing an older person may require strength, special equipment and skills. Shampooing and Shaving Visits to a barber or hairdresser are very positive experiences. Skin Care Keep skin clean and dry, especially when people are having problems with bowel and bladder control. When washing, use a mild soap, rinse well, and dry thoroughly. Keep bed linens clean, dry and free of wrinkles.

Disposable bed pads can be purchased at a drug store and can keep sheets dry so that the caregiver does not have to change sheets so often. Massage skin gently using a light, circular motion. Change the position of older people at least every two hours, particularly for those confined to a bed or wheelchair. Encourage them to shift their weight between position changes to redistribute pressure onto other areas.

Encourage good nutrition and adequate fluid intake. As a supplement to your family member's diet, give a multi-vitamin every day to ensure proper nutrition. Check with the physician as to the appropriate supplement. Use mattress and chairs that are soft and form-fitting rather than rigid and hard. Example: egg crate mattress and sheep skin. This spreads the weight over a larger skin area, decreasing the pressure under the bones. Encourage movement or mild exercise; this helps stimulate circulation which is good for the skin.

Combing hair and helping with bathing and dressing are good ways for frail people to get exercise and be more independent. Watch for possible sources of pressure on anything that would interfere with good circulation, such as tight shoes, elastic cuffed socks or tight undergarments.

Bony prominences are prone to skin breakdown. They are heels, feet, behind the knees, hips, buttocks, sacrum, elbows and shoulder blades. A special air mattress may be ordered by the doctor to prevent skin breakdown. Watch for any redness or a break in the skin and report it immediately to the doctor or nurse, and keep the care-receiver off the affected side. Toileting Safety features in the bathroom, such as grab bars and raised toilet seats, make using the bathroom safer. A commode or urinal may be necessary when flexibility and distance to the bathroom are a problem.

They may be especially helpful at night. Lack of control over bowel or bladder functions can be embarrassing and older people may try to hide it from caregivers and professionals. Be sensitive to the older person's feelings, and mention this to the doctor. Loss of bowel and bladder control is not a part of normal aging and often can be controlled.

Specialized programs exist to retrain a bladder and bowel function. Check with your doctor or nurse for a program in your area. Constipation or Irregularity: Many elderly become constipated due to medications and inactivity. If your care-receiver is experiencing this problem the doctor or nurse can suggest a stool softener. Other important factors are: Eat plenty of fresh fruit, vegetables and foods high in fibers. Drink at least 8 glasses of water a day.

Avoid constipating foods like cheese, rice, bananas, etc. Exercise as much as is tolerated. Be sure your doctor is aware of all the medications being taken. Assisting with Eating Eating can be very time-consuming, especially if the older person must be fed. Here are some suggestions for encouraging independence: Check gums for areas of redness.

Dentures may not fit correctly and cause the family member pain when chewing. Provide adaptive equipment such as plate guards or special silverware with built-up handles. These can be purchased from medical supply houses listed under Hospital Equipment and Supplies in the Yellow Pages. An occupational therapy evaluation can recommend the best for each individual. Prepare finger foods which may be easier to eat than those requiring utensils. Encourage older people to use a straw, cups with 2 handles, or a glass with ribbed surface for independent drinking.

If the older adult has limited vision, consistent place setting of food and utensils helps to know where to find silverware, beverage, etc. Using the clock method to locate food may be helpful; for example, Your meat is at 9 o'clock, your potato is at 12 o'clock and your carrots are at 3 o'clock.

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Reminder: Treat older people who are being fed as adults, not children. Disciplining poor eating habits should be avoided. When they lack interest in food, try to learn the reason. For example, ask if they are thirsty or not feeling well, or if the food in not appetizing on this occasion. Transferring: Moving people who cannot move safely by themselves requires skill, knowledge, and some strength. For every type of disability, there is a specific technique to use. Ask a doctor, therapist or attend caregiver training for specific techniques. In all cases, remember: When lifting, do not add your own weight to whatever you are lifting -- get close and keep balance centered.

Do not use weak back muscles to lift - use your leg muscles because they are much stronger. Do not twist when you are lifting - instead, change the position of your feet so that you face the older person, keeping your spine straight. Balance is vital - spread your feet to serve as a base for support. Your doctor can refer you to a physical therapist who can teach you to transfer safely.

Rest and Sleep As we age, our sleep patterns change. Tips for Encouraging Self Care Allow the care-receiver to do as much as possible; provide only as much help as needed. When older people do all or part of their own personal care, it is a form of exercise that will help maintain strength as well as promote independence.

No matter how small the activity holding the soap, combing the front of the hair, etc. Adapt the home to allow the care-receiver to do more things. Install equipment such as grab rails in the bathroom, wheelchair-accessible sinks and mirrors, bath bench for the shower or tub, and lights with switches that can be easily reached.

Seek the aid of therapists or nurses to teach you how to perform personal care tasks safely and effectively. If the older person cannot perform a certain activity, see if there is a part that can be done. For example, one might be able to independently dress the upper body if sitting, but require help dressing the lower body. Sometimes, slowing the pace of an activity allows older people to do more for themselves. Be aware of changes in the care-receiver's health and abilities. Your plans for care will change as the care receiver changes.

Chapter Nutrition Good nutrition is important in order that people live life to its fullest. Nutrients listed on food labels The table that follows summarizes essential nutrients which you may also finds listed on food labels and their functions.

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  • Adapting Meals for People with Dietary Restrictions If an individual is on a special diet low salt, diabetic or low saturated fat , the Basic Four Food Groups Guide which follows can still be used. Nutrients on Food Labels and their Function Protein: For preservation and repair of tissue; formation of antibodies to fight infection. Carbohydrates: For energy; fiber to help prevent constipation. Fat: For energy; healthy body and skin.

    Vitamin A: For healthy eyes, skin, hair; resistance to infection. Vitamin C: For healthy gums, skin; healing of wounds, bones; resisting infection. Thiamin B1 : For digestion; healthy nervous system. Riboflavin 2 : For healthy eyes, skin, mouth; use of oxygen from air. Niacin: For healthy digestive tract and nervous system. Calcium: For preservation and repair of bones, teeth; muscle contractions; blood clotting. Iron: For building red blood cells to carry oxygen to all parts of the body.

    To simplify daily meal planning, foods are grouped according to the nutrients they supply. Plan your diet to include the recommended number of servings from each group. Common Problems Interfering with Good Nutrition Illness, disability and depression can affect an older person's desire and ability to eat properly.

    Constipation Take high-fiber foods and plenty of liquids, Exercise, Add bran when cooking or baking 1 - 2 tablespoons of bran for each cup of flour , Drink hot beverages which act as stimulants. Diarrhea Eat small meals frequently, Drink clear liquids, Avoid high fiber and greasy foods, Replace fluid loss with liquids between meals. Nausea, Vomiting Avoid unpleasant odors, Eat small meals frequently, Chew slowly and thoroughly, Sip cool, clear liquids between meals, Rest after meals with head elevated, Avoid hot, spicy, strong-smelling foods or fried, greasy foods, Try foods which are cold or at room temperature, and low-fat food, Eat dry or salty food, Try fresh air and loose clothing.

    Dry or Sore Mouth Drink plenty of liquids, Suck on ice chips, Suck on popsicles made of milk or non-acid juices, Dunk or soak foods in liquids, Use extra gravies, sauces, salad dressing, Rinse mouth frequently, Suck hard candies or chew gum, Eat sweet or tart foods if no sores in mouth, Artificial saliva can be used.

    Use a variety of foods from each of the four food groups, Prepare foods that provide a variety of texture, color, and temperature, Provide a pleasant setting, i.

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    We will be in touch with you soon. Senior Living Blog. By : Sarah Stevenson. Pin It. Who Are the Caregivers? Top Books on Caregiving Not surprisingly, a great book can be an immense source of stress relief for caregivers. We Can Help! Our local advisors can help your family make a confident decision about senior living. About the Author Sarah J. Stevenson is a writer, artist, editor and graphic designer living in Northern California.

    Her visual art has been exhibited around California, and her writing has appeared in a variety of web sites and print publications. Please share your thoughts or comments on this article:. By clicking Go! You also consent that we, or our partner providers, may reach out to you using a system that can auto-dial; however, you do not need to consent to this to use our service. Anosognosia and Alzheimer's Posted On 22 Mar Posted On 28 Jun Newsletter Signup.

    Get the latest tips, news, and advice on aging and caregiving. Join our ever growing community. For both caretakers and their patients, these changes can produce an emotional wallop of confusion, anger, and sadness. At the same time, the ability of your loved one to show appreciation for all your hard work will diminish. Caregiving can literally seem like a thankless task. Though it may be hard to contemplate such a difficult outlook, the sooner you put plans in place, the more your loved one can be involved in the decision-making process.

    Balancing the enormous task of caring for a cognitively-impaired adult with your other responsibilities requires skill, attention, and meticulous planning. Ask for help. Accepting help for mundane tasks such as grocery shopping and cleaning can free you up to spend more quality time with the patient. When someone offers to help, let them. Caregivers who take regular time away not only provide better care, they also find more satisfaction in their caretaking roles.

    Learn or update caregiving skills. Learn all you can about symptoms, treatment, and behavior management.

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    Join a support group. Make use of available resources. There are a wealth of community and online resources to help you prioritize your efforts and provide effective care. These organizations offer practical support, helplines, advice, and training for caregivers and their families. They can also put you in touch with local support groups. See Recommended reading section below for a directory of associations.

    Plan for your own care. Visit your doctor for regular checkups and pay attention to the signs and symptoms of excessive stress. Take time away from caregiving to maintain friendships, social contacts, and professional networks, and pursue the hobbies and interests that bring you joy. Learn how to manage stress. Fitting these activities into your life can help reduce the stress of caregiving and boost your mood and energy levels.

    Recognizing the signs of caregiver stress and burnout is the first step to dealing with the problem. If you experience any of these signs of stress on a regular basis, make time to talk to your doctor. Denial about the disease and its effect on the person who has been diagnosed. Social withdrawal from friends and activities that once brought pleasure. Anxiety about the future. Depression that begins to break your spirit and affects your ability to cope. Exhaustion that makes it nearly impossible to complete necessary daily tasks.

    Sleeplessness caused by a never-ending list of concerns. Irritability that leads to moodiness and triggers negative responses and actions. Lack of concentration that makes it difficult to perform familiar tasks. Health problems that begin to take a mental and physical toll. Burnout reduces your productivity and saps your energy, leaving you feeling helpless, hopeless, angry, and resentful.