Power of Attorney v. Guardianship

Two types of Power of Attorney:
 
      1. Standard Power of Attorney
 
·       A standard power of attorney document provides the authority for another person (the agent or attorney-in-fact) to make decisions and take actions on the principal’s (the person  needing assistance) behalf when he or she is unable to do so.
· If the principal becomes physically incapacitated, then the power of attorney document would authorize the principal’s chosen agent or attorney-in-fact to; For example – sign documents, receive/pay bills, and make banking transactions on the principal’s behalf.
· A standard power of attorney would become invalid if the principal became mentally incapacitated.
       2.     Durable Power Of Attorney
 
·  A Durable Power of Attorney document would authorize the principal’s chosen agent or attorney-in-fact to: For example – execute documents, receive/pay bills, and make banking transactions just like a Standard Power of Attorney, but would remain effective if the principal became mentally incapacitated.
·  The Power of Attorney document can be drafted to be broad, giving the agent or attorney-in-fact the authority to make any and all property, financial, and personal decisions for the principal or can be drafted to authorize the agent or attorney-in-fact to perform very limited, specific duties.
 
Guardianship:
 
·  A guardianship is a legally binding relationship where a Probate Court authorizes a Court appointed Guardian (Professional or Family Member) to make all personal and/or financial decisions for the incapacitated person as determined by the Court.
·  The Court could determine that the person only requires a Guardian to make decisions regarding his or her finances and property (Guardian of Property), or health and medical decisions (Guardian of Person), or both (Plenary Guardianship).
·  The Probate Court decides on the extent of the person’s incapacity at a hearing.
.  The hearing is to determine what rights the person should retain, if any, and what needs the person is able to meet for his or her health, safety, and well-being.
 
Power of Attorney v. Guardianship:
  •     Incapacity (Medical Status)
    •        The inability to make decisions that affect
      personal health, welfare, and safety, as initially determined by the attending
      physician, and if disputed, by a court.
    •       If a judge determines that someone is legally
      incapacitated, the court has the authority to appoint a guardian to manage the
      person’s property and ensure their daily needs are being met.
  •      Incompetency (Legal Finding)
    •      Incompetency is a finding by the court that an individual lacks the ability to make all decisions, including health care decisions and decisions about creating a health care proxy. A person is considered physically or mentally incapacitated.
    •  Incompetency can also refer to a lack of legal qualification of a person, not measured in terms of mental ability but to act. For example, a person deemed legally incompetent does not have the power to enter a legal contract.
When a Person Cannot Consent:
  • Florida recognizes that the following
    individuals (in particular order) may consent to medical treatment on behalf of
    the incapacitated person:

    •  Surrogate (competent adult expressly designated by the patient/individual to make health care decisions on behalf of the patient). Designation should be in writing.
    •  Court Appointed Guardian (in the absence or a Surrogate, or where a court revokes the\ authority of the Surrogate). All persons who have been adjudged incompetent should have a judicially appointed guardian.
    • A person holding a valid power of attorney (durable POA) which contains language giving the right to make health care decisions for a patient.
    • A proxy (in the event the patient is incompetent or incapacitated) Pursuant to Section 765.401 a proxy may consent (where the patient has not executed an
      advance directive, or designated a Surrogate to make health care decisions).
What is a Proxy?
  •  A substitute, competent decision maker in the
    following order of priority:

    •   Patient’s spouse
    •  An adult child, or if the patient has more than 1 child, a majority of the adult children reasonably available for consultation.
    •  A parent of the patient
    •   The adult sibling of the patient (if more than 1, then a majority of such adult siblings)
    •  An adult relative of the patient who has exhibited special care and concern for the patient and maintained regular contact with the patient.
    •  A close friend of the patient
    •  A licensed clinical social worker (LCSW)
By: Julie DiSalvatore and Lory Smeltzer, MPH, CMC, CDP

Hiring a Aging Life Care Manager

Caring for an elderly loved one can be quite a daunting task, particularly if you live far away or have other competing responsibilities, like work or a young family. There are thousands of people in this situation. The media refers to some as the Sandwich Generation, caught between two generations of family that need them. If you are in this predicament, there are professionals available to help you make the important decisions and arrange for the care of your loved one. There are doctors, elder care lawyers, social workers and a relatively new breed of professionals, Geriatric Care Managers. Selecting the best care solution for your loved one is critical and selecting the right Care Manager can help achieve that goal.

What is a Aging Life Care Manager? 

An Aging Life Care Manager is an individual who specializes in helping families who are caring for older relatives. These professionals are often trained in other fields like nursing, gerontology, social work, psychology or a more business oriented field, like finances. They apply this background knowledge to issues related to aging and caring for the elderly.

Most Aging Life Care Managers have been working in the field for several years. They often have knowledge of and access to services that most individuals don’t know exist. Additionally, they may know of financial benefits, government funds or low-cost services that your loved one qualifies for.ht care manager can help achieve those goals.
What services do they offer?
  • Aging Life Care Management usually includes the following:
  •  Assessment of the individual.
  •  Developing a personalized care plan.
  •  Arranging for services.
  •  Monitoring care. Life Care Managers can be hired for a single task, such as arranging a particular service, or they can take on a long term responsibility. For example, an Aging Life Care Manager can oversee the care-giving process for a long-distance caregiver and, since the Aging Life Care Manager is local to the loved one, be available in the event of an emergency. Many Aging Life Care Managers’s also offer customers a financial assessment with regard to care-giving, including finding potential money wasters such as duplication of services.
Why hire a Aging Life Care Manager?
Identified below are some benefits that may help you determine if you need to hire a Aging Life Care Manager:
  • You are new to elder care and need advice and guidance.
  • You are a long distance caregiver and would like someone close to your loved one that you can count on 24/7.
  • Your other responsibilities make it too difficult to provide the desired level of care and attention to your loved one’s needs.
  • The issues that you or your loved ones are facing are becoming larger and more complex than you can comfortably manage.
  • You have trouble dealing with a family member (whether it is the patient or another relative) and need an unbiased intermediary.
How do you find a Aging Life Care Manager in your area?
There are a few ways to find a reliable care manager:
  • Referral: Absolutely the best way to find a good professional. Seek out the advice of others that are in similar circumstances, ask a trusted local health professional or consult an elder law attorney.
  • Government resources or organization websites: 
  • Local agencies or hospitals may also provide a list of local professionals.

Trying to make the best decisions about care-giving can be difficult for you and your aging loved one. Asking for help is a big step. There are many organizations and professionals that can help you. A Aging Life Care Manager is just one of your options.

Taking care of paid cargeivers

Paid caregivers come in many forms. They may be nurses, certified nurses’ assistants, home health aides, relatives, friends, neighbors, grandchildren, or others. They may work a few hours a day or week, or they may live-in. They may work days, nights, or around the clock. Whatever the arrangements you have made with them, paid caregivers are essential to the well-being of the seniors for whom they work. Often we assume that since they are paid, and since many of them are professionals in the field and/or have many years of experience, they do not experience stress and frustration. This, however, is far from the truth.

Caregiving can be a hard job and a stressful job, no matter who does it. Continuity and stability, however, are extremely important to seniors and to the people who care about them. Most older people find in difficult to bring strangers intotheir home and pay them to do the things they once could do independently. They need time to get to know and trust these caregivers, to teach them how they like things done, to learn to rely on them. Yet all too often these caregivers suffer burnout, quit, and then the senior must start over again with a new stranger.

How can you help prevent burnout in the caregivers that you hire? Here are some simple suggestions. While they won’t work for everybody, in most situations they will help a lot.

  • Make sure caregivers know the senior as a person. Encourage the senior to talk about himself. Tell caregivers about likes and dislikes, including food, music, noise, and smells. Encourage a dialogue between the senior and the caregivers about what the senior can realistically do for himself and where he needs assistance. Encourage the senior to share some of his history; about work, family, ethnic origins, and customs. If the senior cannot communicate this, have a family member or friend do it.
  • Treat caregivers with respect. Caregivers do a very important job, taking care of someone who is important to you and others. It is hard work and it is respectable work.
  • Help caregivers feel comfortable in the elder?s home. When providing caregiving in someone else’s home it is often difficult for caregivers to find a place that is “their own.” Provide a place where caregivers can keep a few personal belongings. Keep food on hand that they enjoy. Make provisions that allow them some privacy, especially if they are providing live-in care.
  • Make caregivers feel appreciated. Sometimes the seniors they are caring for can’t show appreciation. They may be unable to communicate, or they may be so angry or depressed about their need for help that they take it out on others. Then it is the family’s job to express that appreciation. Little tokens of appreciation go a long way. If you bring over a special treat for the senior, share some. Is it a special holiday? Remember the caregiver, too.
  • Keep caregivers informed. When there is information they should have, make sure they are kept in the loop. You are a caregiving team. Make sure paid caregivers feel like part of that team.
  • Paid caregivers need respite too. Be sure they know you are aware of their needs for rest, for sleep. Are they working around the clock? Does the senior keep them up at night? Do they have families of their own who need them? Lend a hand occasionally if you can? pick up a few items at the store, sit with the senior for an hour, or bring over a prepared dish or meal.
Paid caregivers are vitally important. When a senior or family member has searched for, interviewed, and hired somebody they like and trust to do a good job, it is in everybody’s best interest for that person to be satisfied with the job and working conditions, and to stay on for as long as needed. Many families tell stories about beloved caregivers who stayed with a dependent older person through many stages, including the end of the elder’s life, providing warmth and comfort and familiarity when it was needed the most. A little attention to the above suggestions can help make this a reality for the older people you care for.

Sure Fire Stress Busters

Most of you keep a long list of “today?s to-do?s.” The list usually has appointments for the senior in your life, errands for your kids, maybe a favor or two for your spouse. But does it include a treat just for you?

The responsibility, emotion and stress of caregiving put you at risk of exhaustion and illness. That makes a daily break to reduce stress all the more important. But many caregivers never get around to it.

“We as caregivers tend to deprive ourselves and delay and delay and delay gratification until ?the right moment,? until we ?have more time,? or until things ?settle down,?” caregiver Suzanne Berens of Walnut Creek, Calif., e-mailed to us. “It ain?t gonna happen, so do what makes you happy.”
These tips come from caregivers who carve out time for self-care. Just 15 minutes a day can make you feel like smiling again.

Relax your body

  • Get moving. The No. 1 stress-busting physical activity is exercise. A 30-minute workout three times a week sends more oxygen to your brain, rids your body of toxins and gives you an outlet for pent-up emotion. If physical limitations keep you from more strenuous exercise, try lifting 2-pound weights, stretching or simply walking briskly for a half-hour. Aside from the physical benefits, exercise gives you time alone to clear your mind.
  • Pet a cat or dog. It?s been medically proven that stroking an animal?s fur lowers your blood pressure. But you don?t need a clinical study to tell you that interacting with a grateful, gentle creature calms you down.
  • Dig in the dirt. Gardening, whether on a grand scale or in a few pots on your windowsill, brings a sense of peace and well-being. If you don?t have a green thumb, go to a nursery and ask for a selection of hardy, low-maintenance plants (these should be called “caregiver plants” ? they take care of themselves). “Sometimes when I can?t deal with life, I go out in the back yard and stick my hands in the soil,” said caregiver Laurie Grimes of Rockford, Ill. “I grow tomatoes not only because I like them, but it?s good for me to grow them.”
  • Float away. A 15-minute float in a pool can be meditative, almost spiritual, Berens said. “You can?t feel your own weight ? and you hear nothing but the sound of your own breathing, so that?s all you tend to think about once you get through about five minutes of chatter in your head. ? I felt like I was connecting with myself for the first time in a long time ? kind of saying, ?Hey, Suzanne, I haven?t talked to you in a while. What?s going on with you??” This also works in the tub if a pool isn?t convenient.
  • Snooze. A 15-minute nap can be a lifesaver. Listen to your body. It knows what you need, even when you?re too distracted to ask.

Ease your mind

  • Laugh out loud! Call a friend to share a belly laugh, or put a funny show on the tube. “Sometimes I laugh so hard at ?Designing Women? and ?Golden Girls,?” said caregiver Deb Hollinger of Concord, Calif. “I just roar. I sleep better.”
  • Read about a frivolous topic. Make it a romance novel or a magazine about celebrities, hairstyles or tattoos ? only mind candy will do. The point is to relax and escape.
  • Spin some discs. If you?re full of pent-up feelings, get up and dance. If you need to lean back and breathe deeply for a few minutes, play the music that relaxes you. And remember: Music can enhance almost any relaxing activity you choose.
  • Doodle. Get paper, pens and pencils of different colors to make it more fun. You don?t have to be Van Gogh to be a great doodler. Doodling is a good way to take 15 and relax, and it also helps during stressful phone calls, especially when you?re on hold.

Pamper yourself

  • Get a massage. Put yourself in the hands of a massage therapist who knows where most people carry their stress ? in the shoulders and neck. A massage can bring a release of tension. If an hour is too much for you, even a 15-minute session can be relaxing. Many massage therapists use aromatic lotions and soothing music during the session, so it?s a great investment in multi-sensory stress reduction.
  • Smell the roses. Has it been too long since you enjoyed the fragrance and beauty of fresh flowers in your home? Buy a bouquet and sign a card to yourself!
  • Soak in the tub. “What a person really needs is time alone,” Grimes said. What better place than a bathtub full of steaming, scented water and bubbles? Light candles, put on a relaxing CD and lock the door. “Sometimes when I?m feeling sad, deep, penetrating heat tends to pull me out of it,” Grimes said. “When I?m depressed, I get achy.”
  • Have a manicure. Hollinger has a manicure and pedicure about once a month. “I swore I never would pay somebody to do what I could do myself,” she said. “But it just feels good. You sit there for an hour; you feel like you?ve splurged. You feel a little bit pampered.”
  • Perfume the room. Feed your senses with aromatic candles or essential oils. Lavender, mint and lemon commonly are used for relaxation, but all that really matters is what smells good to you. Remember scents from your past you associate with soothing times, such as cinnamon, lilacs or baking bread. Warm essential oils in special holders with votive candles or more simply in a pot of water on the stove. It might be best to avoid incense, which produces smoke.
  • Have a tea party for one. Turn a simple cup of herbal tea into a gift to yourself by using a lovely china cup and tea service. Choose special cookies or biscuits, and sample a new kind of honey to accompany your treat. Put on your favorite music (jazz or classical might add to the teahouse feel), and that plain old cup of tea suddenly becomes 15 minutes of luxury

Why is Setting Limits important

Setting limits means knowing when and how to say “no.” It means understanding your time and energy are limited resources, and people other than the care recipient, a spouse, children, close friends, also need and deserve your attention.

It means establishing a healthy and sustainable balance between caregiving and other aspects of your life, including work and recreation as well as family. And it means acknowledging that you must find others to help in your caregiving and that you also need some time for yourself to recharge.

Setting limits is a survival skill. Caregiving demands such a concentrated effort that those who don?t or can?t set limits are in danger of suffering from burnout or meltdown, anxiety and depression. Caregiving can quickly overwhelm the life of the caregiver, disrupting other relationships and making it difficult to pay attention to anything else.

What are some caregiving myths?

Examine these common myths and determine the ones you have incorporated into your beliefs:
  • If I set limits, I?m being selfish and aggressive.
  • If I set limits, other people will be angry with me.
  • I?m in good health, so I don?t need any time off from caregiving.
  • I have to do it all because nobody else volunteers or knows what needs to be done.
  • Even if someone else knows what to do, they can?t do as good a job as I can.
Only when we confront the distortions behind these notions can we begin to set the limits we need and deserve.

Breaking the myths

  • Setting limits is a gift to yourself and others. You can give nothing of yourself when you have nothing left to give. Exhausting yourself through non-stop caregiving helps neither you nor your care recipient.
  • Setting limits does not mean a lack of love or caring. On the contrary, whatever you do to conserve your energy and preserve your strength will enhance rather than detract from your caregiving skills. In that sense, setting limits is the ultimate act of love for your care recipient.
  • If you?re in good health, you want to keep it. If your health is fragile, you want to stabilize it. Studies show caregivers are at greater risk of illness, injury and emotional collapse. Taking practical steps to reduce your caregiving load will help prevent your health from deteriorating. Recognizing the need for time to be with a spouse, friends, children or alone is a sign of strength, not weakness.
  • Others can?t do everything exactly the way you do, but they will do it in their own way. This does not mean that a poor substitute will suffice. It is important for you to settle on the qualities you consider most important in a paid caregiver and those open for compromise. Even if seniors complain at first, they may come to appreciate another?s approach for a change.
  • Other people might be very willing to help but don?t want to intrude. Or perhaps they don?t realize how much you feel you need help. If you are the primary caregiver, it is part of your job to communicate your needs to other family members and friends who could take over some tasks or to seek out professional caregivers should resources permit.

Tips for caregivers on setting limits

Setting limits is a skill. Some people are naturals at it. Others have to learn. These tips can help:
  • Begin setting limits early so it becomes a natural part of your caregiving rather then a reaction to a crisis, either yours or someone else?s. Setting limits early also helps prevent the care recipient from harboring the unrealistic notion that your life is only about caregiving.
  • Assess realistically what you can and cannot do and make every effort to stick to your plan. If you don?t, you may start to experience anger and resentment ? toward the senior, the situation and everyone else who is not helping enough. You must stop this cycle at the outset.
  • Clearly communicate with the care recipient. Stay focused and speak in a relaxed and compassionate manner. Explain your decision and gently acknowledge any concerns and fears the senior expresses. If the senior protests and the conversation turns heated, take a break and return to the discussion later when you are both calmer.
  • Don?t lay blame on the senior for exhausting you, but don?t back down or apologize for taking steps to help yourself either. And don?t make promises you can?t keep about what you will do for them down the line.
  • Sit down with other family members and friends and determine how much time everyone else is willing to invest. Let go of the idea you are the only competent person involved. Others frequently want to pitch in but may feel they are in the way and don?t know how to volunteer. Set up a caregiving schedule and have others sign up in advance for shifts.
  • Guilt has no place in caregiving. It helps no one, least of all the person in your care. Ignore anyone who attempts to make you feel guilty about setting limits to your caregiving activities.
  • If you are nervous, practice setting limits through mental rehearsal and role-playing. Work through the process with yourself and others before approaching your care recipient. What will you say? How will you say it? How will you respond if the other person becomes angry? Think through the possibilities ? and then initiate the conversation.
  • If you find setting limits impossible, you might need to discuss matters with a therapist to help you discover why. Otherwise, you are far more likely to find your responsibilities leaving you ill, emotionally spent or suffering from caregiver burnout.

Facts on Caregiving

Among working caregivers, more than half have made at least some work-related changes to accommodate the demands of care-giving

  •         Modifying work schedule
  •         Going in to work late
  •         Leaving work early
  •         Taking time off during the day
o       26% have had to take a leave of absence due to care-giving responsibilities
o       30 % have had to give up work entirely
o       15 % took early retirement
  • If the work of caregivers had to be replaced by paid home care staff, the estimated   cost would be $45-$94 billion per year
  • Because care-giving is such an emotionally draining experience, caregivers experience depression at 3 times the rate of others in their own age group, and they are more likely to become physically ill themselves
  •  Female caregivers are more likely to suffer from anxiety, depression, and other symptoms associated with emotional stress
  • A study of elderly spousal caregivers (age 66-96) found that caregivers who experience mental or emotional strain have a 63% higher risk of dying than non-caregivers
  • 31% of those caring for persons 65+ describe their own physical health as ?fair to poor?
  • Studies show that among caregivers, an estimated 46%-59% are clinically depressed
  • Approximately 49% of female caregivers and 31% of male caregivers experience depression as a result of caregiving

Support groups for caregivers

When people suffer hardships, sharing the pain almost always helps. A support group is a gathering of individuals to explore a common cause or problem. Members of the group discuss their experiences, exchange information and provide encouragement and friendship. They also offer shoulders to lean on when times are tough and allow each other to express anger, frustration, resentment and other troubling emotions.

Above all, successful support groups ? also called self-help groups ? create an environment where people grappling with difficult issues feel understood and accepted by those in similar circumstances. As a caregiver you may need a support group, especially if you feel isolated, believe your situation is unique and think no one around you understands what you are going through.Support groups can offer caregivers:

Encouragement. Caregiving is a demanding task that can drain your emotional, physical and spiritual energy. Support groups provide a safe place to recharge your batteries.
Information. Support group members can glean ideas and suggestions from others in the trenches. Other caregivers are often the best source for helpful tips about community resources, medical developments, support services and other key issues.
Emotional support. Sometimes caregivers simply need to vent. Support groups provide a space to unload pent-up frustrations while others in similar circumstances empathize and counsel without judgment.

What should you look for in a support group?

Support groups cover a broad spectrum. Some may be only for people taking care of someone with a particular illness, such as Alzheimer?s, Parkinson?s or cancer. Others may be for anyone caring for a parent or anyone involved in long-distance caregiving.Some support groups are open-ended, with new people joining periodically. Others continue for a defined length of time ? 10 weeks or six months, for example ? and don?t admit new members after the first or second week. Some groups schedule regular lectures or presentations on topics of mutual interest. Others are less structured, with members offering the floor to those who request it.

Think about the kind of group you would prefer. You may need to check out several before settling on one that suits your purposes. To find out about support groups in your area, inquire at community centers, fraternal associations and religious organizations. Hospitals and nonprofit agencies associated with specific diseases or conditions also sponsor them. Check local Web sites, newspapers? community listings, classified ads or bulletin boards for privately organized support groups.

As you evaluate a support group, consider these qualities:

Comfort. Support groups are about relationships. Do you feel at ease with the people? Are they welcoming? Are smiles and hugs freely available? Or do you feel as though you?ve stepped into an refrigerator?
Convenience. Does the group meet at a time and place convenient to you? How far are you willing to drive? If you?re a morning person, does the group meet early enough in the evening for you to get home without falling asleep at the wheel?
Confidentiality. Does everything discussed stay within the group, or does information leak out? If you don?t feel safe, you?re likely to clam up ? which would defeat the purpose of joining.
Sometimes professionals ? social workers, therapists and nurses ? run support groups. Sometimes one group member takes charge, or leadership responsibilities rotate among the participants. All approaches have their advantages, but a designated leader can help keep the group productive and moving forward.Leading a support group is an emotional, draining and challenging task. A support group facilitator should show:

Empathy. An ability to sympathize deeply with others is a prerequisite. An empathetic leader will make people feel welcome and draw out even the most reluctant group member.
Poise. Those who feel comfortable in front of groups, articulate their feelings well and demonstrate grace under pressure can help sustain a group?s spirit in times of crisis.
Enthusiasm. People often share their darkest emotions and fears in support groups. Leaders who firmly believe in the goals and mission of the group will be the most successful in encouraging participants to speak openly. A sense of humor helps, too.
 Focus. A good leader will have a sense of what members are feeling, where the group needs to go and how to guide discussions to get there.

Starting your own support group

If you can?t find a group to meet your needs, start one yourself. It?s not as difficult as it sounds. People who perceive a gap and are determined to fill it make the best support group founders. To organize a support group:
 Start with a mission. Maybe you want to focus on serving caregivers taking care of people with dementia or caregivers coping with difficult family relationships. If you need a particular kind of support group, undoubtedly others do, too.
Locate others. When you have defined your target group, enlist the aid of doctors or hospitals to help you find other caregivers grappling with the same issues. Give the health care professionals your name and phone number and have them share that information with others in similar situations.
 Advertise. Let the community know that the support group is available. Post notices on community bulletin boards. Many newspapers publish public service announcements free. Or try low-cost classifieds.
Find a meeting place. Churches, synagogues and other religious establishments often open their doors to support groups. So do hospitals, libraries and corporate conference rooms. Make sure the meeting place is accessible to all. If necessary, negotiate a price for renting the facility.
Decide whether to enlist a professional to lead the group. The leader could be a health care professional from a local agency, a therapist or someone with support group and caregiving experience.

The Caregiver’s Bill of Rights

Caregivers often lose themselves in providing care. Remember ? you have rights too. Post this Bill of Rights where you can see it to remind yourself of your value.

  1. You have the right to receive the knowledge, resources, training and support you need to be successful as a caregiver.
  2. You have the right to acknowledge your own needs and to expect those needs to be met.
  3. You have the right to enjoy a well-rounded and meaningful life that includes family, friends, work, activities you love and time to yourself.
  4. You have the right to seek and accept help from community, family, friends and support services.
  5. You have the right to access quality services that treat you and the person you are caring for with dignity and consideration.
  6. You have the right to all of your feelings as a caregiver, from the moments of unexpected joy to those of anger and frustration.
  7. You have the right to be a part of a caregiving team rather than having to do it all by yourself.
  8. You have the right to ask for ? and receive ? appreciation and respect for your caregiving.
  9. You have the right to acknowledge that the unique gift of your time, energy and emotions has as much value as any caregiving task.

Effective communication

Caregivers often wait until they have reached a state of desperation before asking for help. Once you have reached this frenzied, and often angry state, it is difficult to communicate your needs. Caregivers may get a btter response by asking for help earlier AND practicing the skills of good listening. Listening sets a strong foundation for communication.

Communicating Our Needs as Caregiver

Asking for help can be a difficult thing to do. It is often most difficult when we are asking for help from the people that we need and love the most ? family and close friends.
One of the most important steps in effective communication is careful listening. Someone who feels truly heard by you is more likely to be able to listen in return, and respond to your needs.
When we listen to what someone is saying, or not saying, it is easier to sense what is going on with that individual. This also increases our chances of getting a favorable response to our own requests. For example, if someone had a bad day at work and you barge in demanding help, you may not get a great response. However, if you take the time to listen to what has happened and respond in a sympathetic way, the door will be open for you to ask for assistance.

Context Matters

Communication skills need to be kept in a cultural context. What is considered polite in one culture may be rude in another. Know who you are talking to both in terms of cultural and personal background and adjust your behavior accordingly. Observe the reactions of the other person. If you notice a person is uncomfortable, adjust your style.

Learn to Listen and You Will be Heard

Often, when one person is talking, the other person is not really listening. Instead, we may be thinking about what we are going to say when it is our turn to talk. Before you can expect to be fully heard, you need to be able to hear the other person. Listening is a skill that can be practiced and improved upon. Following are some concrete suggestions.

Listening Tips

1. Really pay attention to what the other person is saying. The experience of having someone pay attention to you and what you have to say, is so rare that it will be greatly appreciated. The tone and outcome of the whole interaction may change.
Body Posture: You communicate with your body as well as with your voice. You can be telling a person that you are listening; however, if your body language does not reflect this, your message is lost. Important ways to convey the message that you are truly listening and hearing include:
  • Keep eye contact.
  • Face the person you are speaking with.
  • Lean in to the person with your body.
  • Keep an appropriate distance between you and the speaker ? too close makes people feel closed in, anxious and invaded. However, standing too far away can make people feel that you are not interested. This, like all communication, varies from culture to culture and person to person. As a rule, in American society, three feet is considered an appropriate distance.
  • Keep an open posture with your arms loosely by your side. Don’t cross your arms and legs in a way that gives the message of being “closed off” to the person.
Be aware of the movement of your body. You do not want to appear stiff as a board nor do you want to be gesticulating madly. Stay relaxed and be yourself. As noted above, when gesturing it is important to be aware of the other person’s personal space. Also, it is important that any movement is in response to the conversation rather than a nervous tapping of the feet or an impatient look at the watch.
Make every effort to have the conversation in an as nondistracting an environment as possible. For example, turn off the television or the radio before talking. If you are in a crowded room, move to a quiet corner.
2. Invite people to keep on talking and expressing themselves. Sometimes we put roadblocks on the conversation without even knowing it. Ways to keep people talking include:
Verbal cues: Ask them to keep talking by saying such things as ” You were saying,” or “Please tell me more.” Ask questions that allow people to elaborate or say exactly what is on their mind. For example, ask “What are you thinking about?” rather than “Tell me what Susan said when you had lunch?”
Describe the other person’s body language, for example: “You look really happy today,” or “What is wrong? You sound sort of down.”
Silence: Give the person time to think. Many people are uncomfortable with any pause in the conversation. However, people’s style varies and some people like to think before they speak. Let the reflective person have some time to gather their thoughts. There can be a lot going on in the silence. Examples include:
  • Thinking about what the other person is saying.
  • Reflecting on the other person ? how are they feeling, what their body language is saying.
  • Thinking about what the person is trying to communicate, both on the literal level and on the metacommunication or feeling level. What is the underlying message behind the spoken words?
If you integrate the skills of asking for help and careful listening into your life, it will make a difference!

When to ask for Help

By asking for help before reaching a crisis point, caregivers can head off feelings of frustration and resentment. Organizing caregiving meetings is one way to ensure that help is available on a regular basis.
Knowing when to ask for help is just as important as acknowledging that you do need help. Too often, caregivers wait until they are at the end of their rope before seeking assistance. Waiting too long can cause you to unconsciously phrase your requests as demands, allowing pent up feelings of frustration and anger to surface unexpectedly. The person you have finally asked for help may react to your emotions and not respond as you had hoped. Unfortunately, this can push caregivers back into a negative cycle of resisting help and then resentment builds up even further. Many caregivers have vowed never to ask for help again, when if they had only asked for help a little earlier, things could have gone more smoothly. So to reiterate?it is important to know when to ask for help.

Do Not Wait for a Crisis to Ask for Help!

Have regular meetings. Ideally, you should have regular meetings with all the people involved in a senior’s care. Regular meetings ensure that people have an opportunity to discuss their needs and any other issues they may have. It is important that people know that they will have the opportunity to be heard. This lessens anxiety and gives people a chance to talk about concerns before they become issues.

Meetings Can Help All the Pieces to Fall Into Place

During these meetings, people can discuss their needs and responsibilities. Caregivers can bring up items that need to be addressed, identify days that they need help, and just generally solicit assistance. Participants can make a caregiving schedule to ensure that everybody understands their responsibilities and that all the pieces fall into place.

Express Appreciation, Get Appreciation

Regular caregiving meetings are also an important time to validate all the hard work that caregivers do. Appreciation, coordination, and acknowledgement are all key to getting the help you need