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Hiring a Caregiver: A Cultural Consideration

by Sharon K. Brothers, MSW
      CEO, Institute for Professional Care Education

If you've hired a private caregiver you probably know this already; the nation's caregiving community is composed largely of individuals who are foreign born or from minority ethnic groups.

For many families, this is a challenge, but one that can be overcome. Sharing your cultural heritage and learning about another person's culture can often be fun and rewarding, especially if you overcome some of the most basic challenges:

Communication. Let's start with the basics: communication. It's tough to communicate with a caregiver who speaks limited English. It's even tougher to ask this caregiver to communicate with an elderly loved one who may suffer from hearing loss, dementia or other conditions that impair communication in the best of situations. Yet caregivers from other cultures, who speak very limited English, can be compassionate, gentle, reliable sources of care for our loved ones. Try these approaches to bridge the communication gap:

Values and traditions. Today's American values provide many opportunities for culture clashes with the values and traditions of a caregiver from another culture. These can range from the caregiver who is extremely uncomfortable speaking with a family member of the opposite sex, to the caregiver who comes from a background of strong familial responsibility and can't understand or accept our busy lifestyle. Learn as much as you can about the values and culture of your caregiver by asking questions and researching to avoid cultural misunderstandings and conflicts.

Diet. Caregivers often work through mealtimes, especially those that work full days or overnight. Many families assume that caregivers will eat with the client in the American family style. Talk about food with the caregiver, and your expectations for mealtimes. Your caregiver may not feel comfortable eating with your loved one, and may have distinctly different food preferences. Cover these topics to avoid misunderstanding:

Cultural differences between client and caregiver are facts of life for many families today. That doesn't mean that care must be compromised, or communication limited. It does mean that we must learn to develop a greater awareness of the caregiver's culture and sensitivity to working together for the best care of your loved one.

In the end, taking the extra effort can result in a rich, rewarding experience for everyone involved.

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Resources for Caregiving

by Sharon K. Brothers, MSW
      CEO, Institute for Professional Care Education

If you're busy caring for a parent or spouse you may not have heard the rumbling from all corners lately.

Family caregiving is finally getting a little respect.

Suddenly, we've become aware that it's not just the hidden few in our community who are responsible for managing care — or providing it hands on to a loved one.

It's nearly one out of every four households in the U.S. today, according to a recent AARP-MetLife survey.

While there's some comfort knowing you're not alone in your caregiving challenges, the real advantage comes from the actions that this is inspiring.

Just check out the Internet these days. Type in "family caregiver" in any search engine, and watch the websites, news articles and information start pouring in. You can find tons of helpful articles and resources if you've got the time to wade through the results.

Of course, if you're busy caregiving you probably don't have a lot of time to sit at a computer searching for resources.

You may just want to read a good mystery at the end of the day, or watch a mindless sitcom on TV.

No one would blame you for wanting a real break, when you finally get to take a break.

But I'd like to encourage you to take a few minutes to seek out some resources that work for you, especially information, training, or resources that make your caregiving job easier.

Imagine if you could communicate more clearly to the person in your care, and avoid some of the frustrations you now encounter. Imagine learning how to ask your friends or siblings for help in a way that they respond to, without getting offended.

Imagine learning tricks to make the tasks go easier for both of you.

Caregivers who take the time to attend training classes say, "It saved my life." Often, they don't realize how hard their job is, and how many little things they can do to make it easier, until they take a step back to learn from an expert.

You don't have to dedicate every waking minute to this.

You've already taken one big step by accessing this resource center. Stick around and check out the many resources here. You might just find that one tip to make your whole experience more enjoyable.

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Prescription: Join a Support Group

by Sharon K. Brothers, MSW
      CEO, Institute for Professional Care Education

In our caregiver support group we often talk about our caregiving experience as a journey.

Some days, you're slogging through some pretty deep muck. You feel like you're battling to get anything done. You feel like you're doing nothing but battling with — or for — your loved one.

Some days, you're hiking up a steep hill in shale. It takes every bit of effort you have to move a few steps forward — and then you slide almost all the way back to your starting point. The saying, "Three steps forward and two back" feels like positive thinking.

Then there are those rare days when the sun breaks through the clouds and you feel blessed and so very privileged to be able to care for someone you love.

In our group, we listen to other people's stories. We reassure them ("No, you're not crazy!") and we reassure ourselves ("At least I don't have to deal with THAT!").

If we're lucky, we find a lot to laugh about, from one caregiver's story about her mom, ("So then she said...") to another's joke ("You know you're crazy when...").

By the end of the evening, we're all glad we came. We're relieved that we could share our challenges, and listen to others. We feel a little glow inside as we realize that we're not alone on this treacherous journey through uncharted land.

I hear from families who can't get to the support groups. Often, they're the ones that could use the support and encouragement the most. They have no one to give them a little break; to stay with the person in their care so they can get out and get refreshed.

When it comes to caregiving, like so many of life's most challenging tasks, it does, indeed, take a village. Don't go it alone. Find a support group in your local community and check it out. It just might be the prescription that saves your sanity!

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It's "Hug Your Sister" Month

by Sharon K. Brothers, MSW
      CEO, Institute for Professional Care Education

It's not really "Hug your Sister" month — but maybe it should be.

If you're a caregiver, you probably can relate to the groans I hear whenever a family caregiver starts talking about their siblings.

"He's a great help — as long as he can phone it in."

"I'm doing all the work, and she shows up once a year to visit. The way our parents treat her, you'd think she was the one doing all the work — not the one popping in to tell me how it should be done."

"My sister disagrees with everything I want to do. She insists mom isn't as bad as I say she is — she has no idea."

It seems like every family has a breakdown among siblings, especially when mom and dad need help. One child — usually a daughter — becomes the primary caregiver or decision-maker. The other children typically take a seat as far removed from the action as possible.

Stop for just a minute this month to look at your own family situation from your siblings' perspective. Maybe they're not doing the work, but look at the time they're missing out on, too.

Francine Russo tells the story in her book, They're YOUR Parents, Too ( of being the "bad sister" — the one who rarely visited and left the heavy lifting to her sister.

At her mother's funeral, Francine realized how much she had missed by not being actively involved in her mother's care. While feeling relieved that she didn't have to do the work, in reality she was robbing herself of an opportunity — forever gone — to get close to her parents and to have the kind of relationship that her sister had.

She learned, as many, many caregivers learn, that the greater the challenges of caregiving, the greater the rewards and sense of joy and accomplishment the caregiver often feels at the end.

So this month, if you're tempted to think, "Why doesn't she step up and take some of the load?" try rephrasing the question.

Try thinking, "She's missing so much. I'm sorry for what she's missing."

And go hug your sister.

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Caregiver Love Means Laughter Instead of Tears

by Sharon K. Brothers, MSW
      CEO, Institute for Professional Care Education

I've got 30 minutes until my next appointment and I need to buy a sweater. There's only one person working the cash register, but the line is short so I should be OK.

In front of me are a middle aged woman and an elderly woman, probably her mother. They've got an arm full of items, but the cashier is working quickly, ringing each item up and folding it carefully.

The elderly woman hands a card to the cashier, who suddenly stops. She looks up at the woman and says, in a loud, slow voice, "This is your insurance card. Do you have any card that has a VISA or MASTERCARD written on it — down here in the corner like this?"

The woman looks through her wallet anxiously. I'm getting nervous for her (and checking my watch). She pulls out a few more cards: her social security card, a membership card, a Costco card. No credit card.

She glances up at her daughter with her head lowered and her eyes downcast. Their eyes connect. I wait for the blame to start: "Mom, what were you thinking?! How could you come shopping without your credit card?"

Instead, they both burst out laughing. The daughter quickly hands over her own credit card and the crisis passes.

For that moment, I forget all about my next appointment. All I can see is the warmth, love and patience that I have been privileged to witness.

Maybe the mom has a touch of memory loss. She might have Alzheimer's disease and significant impairment. Her daughter clearly has spent the afternoon shopping with her, and clearly expects mom to pay for her purchases. It could have been one of those moments where caregiver stress maxes out the meter. The daughter could have simply lost her temper, and the mother ended up in tears.

Instead, they both end up laughing so hard there are tears in their eyes. They see the humor of the "senior moment," and — instantly — the tension is gone.

Maybe they know, like so many other caregivers, that sometimes you've just got to laugh — or you might never stop crying.

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Guilt and the Family Caregiver

by Sharon K. Brothers, MSW
      CEO, Institute for Professional Care Education

When my kids were little, they'd get sick and I'd start stressing. Should I take them to the doctor? Should I let the bug run its course?

Either option seemed to generate a bucket full of guilt. If I called in to the advice nurse the advice was — without fail — bring them in. I'd get to the doctor, and hear what sounded to my ears something like, "Don't worry so much. All kids get bugs from time to time. Don't be such an anxious mom." The doctor would give me the "lots-of-rest-and-plenty-of-fluids" advice, and I'd be home thinking about the time I'd wasted and the expense of taking a kid to the doctor — again — who didn't really need to go.

So the next time a kid got sick I'd say, "We're going to just let this bug run its course. We'll get plenty of rest and lots of fluids. I'm sure in a day or two she'll be fine."

A day or two later, the bug is no better so I finally take the child to the doctor. This time I hear, "Why on earth did you wait so long to bring the child in? She could have died!"

No matter which choice I made, I felt profound anxiety and guilt.

Caring for our aged parents seems to be much of the same: equal parts anxiety and guilt, no matter what we do.

It's easy to let guilt guide our decision-making. It's easy — but not wise. Just like my parenting guilt could have led me to take the kids to the doctor with each sniffle and sneeze, I learned to accept that either decision would most likely result in guilt. And then I made the decision that seemed, based on the facts as I knew them, to be the most appropriate.

With our aging parents we need to make decisions based on facts, too. We need to set feelings of guilt aside and ask ourselves — and our loved ones — what best meets their needs.

When my mom needed 4 people to help her to the bathroom, I had no option. I felt guilty about moving her into a nursing home, but I would have felt guiltier — and been a less responsible daughter — if I would have brought her to my home and then left her with no one to help while I attended to my own work and family needs.

While we're not parenting our parents, we are making choices and decisions, often without their input, on matters that affect nearly every aspect of their lives.

Try these questions to help you check whether you're making decisions based on fact — or on emotions like guilt:

Who can help? If you parent moves into a care community, someone will always be available to help. Often, more than one person will be available. Usually someone will be awake and ready to help even during the night. In a good care community, those helpers are trained and supervised by experienced caregivers. If you choose to leave your parent at home — yours or theirs — can they get the same level of attention and care? Can you bring in home care workers to support your loved one when you're not available?

What's my role? Often I hear from family caregivers that are exhausted from night time demands, or from caring for their own family, doing their own work, and then trying to do the tasks their loved one needs. Sit down and chat? Go through an old family photo album together? Who has time for that?! If your caregiving tasks demand all the energy you have available, who can provide the companionship and company to your loved one? Consider hiring professional caregivers — at home or in a care setting that fits for your loved one - to free you up to just enjoy a little time together.

Is there joy? I'm a profound believer in finding joy in caregiving. Yes, a lot of the care we provide to loved ones — whether 2 or 102 — is not a lot of fun, but is necessary. At the same time, we find ways when we're bathing the baby to laugh, make bubbles and sing together. What about when we're caring for an elderly loved one? Is there joy being shared? Laughter? Find a way to discover the joy in the relationship, or get help with the tasks so you can find new ways to a joyful relationship.

Caregiving, like parenting, will naturally have moments of guilt, anxiety and despair. But if we're caring because we're family, caregiving can also be filled with deep satisfaction and joy.

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© Institute for Professional Care Education®, LLC, 2015