It’s human tendency to get stuck in our ways as we carry out life’s demands, and caregiving is no exception. But the routines that we fall into could often use some improvements as time passes and new factors arise. With spring upon us, it’s a good time to take a fresh look at our care plans to see if there are areas that need fixing or at least a fresh twist.
Analyzing Your Care Plan
Making pro/con lists of what is working and what is not is an effective method of examining any goal, from budgeting to weight loss. It can be just as effective for honing one’s care plan. Below I’ve provided a template for a hypothetical caregiver we’ll call Ann. If you’re up for a little self-reflection, Ann’s list could help you refresh your caregiving routine and jumpstart your own self-improvement.
First, Ann writes about what’s working well in her caregiving routine:
- I found a wonderful assisted living facility (ALF) for Mom near my home, which has allowed me to enjoy more time with other family members and my friends.
- It took a while, but Mom adjusted to her new life and now enjoys her own friends and the activities the facility provides.
- Mom also feels very safe, which is important to both of us. Knowing she has professional caregivers around allows me to relax at work and not worry so much.
- I’ve developed a good system for shopping for Mom’s needs that integrates with my other errands. This has saved me a lot of time.
Then, Ann writes about her daily challenges and the problematic aspects of her care plan:
- I keep correcting Mom when we are talking. I’m told that, because of her Alzheimer’s, arguing is counterproductive and I should agree with her statements no matter how outlandish they seem. Of course, there are exceptions, but those times are rare.
- I’m angry with my brother because he won’t travel to see Mom. She often doesn’t recognize him and forgets he’s even been there, but I feel that he should visit anyway.
- I’ve been so happy Mom is content that I haven’t followed her doctor’s advice. He says I should use this time to learn about the stages of Alzheimer’s and that I should research possible changes in her care needs.
- I keep putting off making appointments for my physical, mammogram and other routine medical tests because Mom has so many of her own medical appointments. Those take time, and I get tired of sitting in clinics. I think mine can wait.
Reflect on Your Lists
Once you have made your lists, it’s important to take time to reflect on both of them. You have likely worked hard to get to this place in your life and you deserve credit for all that you’ve done. It’s important to acknowledge everything you’ve done right. Caregiving takes a great deal of research, patience, effort, time and trial and error. You’ve made big strides even though it may seem overwhelming at times. Never shy away from giving yourself a pat on the back.
The next step is to analyze your list of caregiving problems and setbacks to see if you can make changes that will improve your life and that of your loved one. Whether your problem list is big or small, do not be intimidated. It will take work, but the goal here is to find solutions to these issues one at a time. This exercise should relieve stress and simplify your life, not cause you to feel more burdened.
Finding Caregiving Solutions
Using Ann’s list above, I devised some solutions that could help fix these hypothetical issues for her and others. Writing down your ideas as your brainstorm will help you remember and track your progress through this list. Even if you can’t see to all of these solutions now, you’ll have a game plan already prepared for when you have a bit of free time to tackle the next issue.
Refresh #1: I keep correcting Mom when we’re talking.
Admittedly, it’s hard to listen to people you once admired for their wisdom make bizarre statements. Our initial reflex is to correct them, which only makes matters worse. Also, you may feel that “lying” to a loved one with dementia is wrong. You may even think that agreeing with them when they are wrong is condescending. This is a conflicting situation that every dementia caregiver experiences, but the answer lies in changing your thought process and approach.
Accept the wisdom of those who have studied the disease. They will tell you that when you validate your loved one, you are showing them compassion, not patronizing them. Conversely, arguing only increases the person’s agitation and decreases their self-esteem. Your loved one is living in an unchangeable reality that is different from yours but that is just as real to them. You are the well person, so it’s up to you to try to share in your loved one’s version of reality and help them accept and work through it. When you adapt to this way of thinking, life will be easier for both of you.
Refresh #2: I’m angry at my brother’s lack of involvement.
As unfair as it seems, there are many reasons why siblings don’t help with caregiving. Even though you do not agree with his reasoning, try to understand why your brother doesn’t feel his visits are meaningful. He travels several hundred miles to visit Mom, who doesn’t remember who he is and will forget his visit as soon as he leaves. Not only do these visits take time and cost money, but he probably feels a great deal of grief during and afterwards.
Instead of becoming angry and reprimanding him for his lack of attention to Mom, suggest that your brother visit whenever he can for his own sake. Let him know that you understand it’s hard for him and it may seem like a waste of time. Thank him for the help and support he does contribute, but offer him the perspective that he’ll probably feel better emotionally after Mom is gone if he visits occasionally, no matter how painful it is.
If visits still aren’t his cup of tea, suggest that he call weekly or write Mom short notes every so often and send pictures of the family. Although communicating by phone and mail can still be challenging and upsetting, they are less involved ways of maintaining this connection and showing Mom that she’s loved. As caregivers, at some point we must realize that we cannot change others and pick our battles.
Refresh #3: I haven’t taken time to learn about the progression of Mom’s condition.
You should be proud of the fact that your mom’s move to assisted living has been successful. You both have more help and resources available, which ensures that Mom is well cared for and gives you peace of mind. However, caregiving needs can change quickly, especially when dementia is a factor.
It would be wise to give yourself a deadline to begin researching the next steps in her care and make a to-do list of all the future bases that must be covered. The first objective is completing the research itself, which can be done at your convenience online. You can also speak with Mom’s doctor, social workers, nurses and other medical professionals to get more personalized insight into her condition. While each dementia patient experiences a unique progression through stages and symptoms, a ballpark idea of what to expect is invaluable.
The next step is to speak with the administrator at Mom’s assisted living facility to learn what their care limits are and ask about price increases as her needs grow. Once Mom surpasses the level of care that the ALF can provide, she will need to move to a higher-level care facility, such as a specialized memory care unit or skilled nursing facility. For this reason, it is very helpful to investigate these facilities in your community so that you are prepared if/when this move becomes necessary. Ask friends, family and medical professionals for referrals, and search online for care providers in your area.
All of this doesn’t have to be done at once, but having these objectives on your radar and planning ahead for them will help minimize unnecessary surprises.
Refresh #4: I keep putting off my own medical appointments.
While it may seem counterintuitive, the cardinal rule of caregiving should be: Take care of yourself. Your mom has professionals looking after her most of the time. Yes, you take her to medical appointments, but you still need to make time for your own. As I mentioned above, care needs can change quickly. Use this time to get caught up on your own care, both physical and mental. It will better prepare you for changes in your mom’s needs. Furthermore, if you neglect yourself and fall ill, then Mom will have nobody to take her to her appointments. The better shape you’re in, the better you’ll be able to care for your loved one.
Refreshing Your Own Care Plan
We’ve gone through Ann’s hypothetical care plan refresher, but now it’s time to examine your routine and write out your own lists. Maybe you’ll only have one or two areas that could use improvement, or maybe you’ll have a significant list of challenges to address. This exercise may seem overwhelming, but it’s crucial to think about your care plan from time to time to ensure you are meeting all needs (including your own), you are able to handle emerging changes, and to certify that your approach is still the most efficient one. Just remember to give yourself credit for your caregiving “wins” and allocate ample time when it comes to rectifying problems. If you take the time to develop a solid care plan now and revisit it every few months, your challenges list (and stress!) should begin to shrink.