Empathy and Boundaries: Building Emotional Resilience in Caregiving

Submitted by Harry Cline

Taking on the role of a caregiver is a profound gesture of love and responsibility, which can also bring a unique set of challenges and stresses. As a new caregiver, you will likely encounter situations that test your patience, resilience, and emotional well-being. It’s crucial to develop a self-care routine that sustains you and empowers you to provide the best care for your loved one. ElderCARE explains how integrating simple yet effective self-care techniques into your daily routine can shield you against burnout and enhance your ability to support those who rely on you:

Discover Laughter in the Everyday

Finding humor in caregiving can significantly lighten your emotional load as a powerful antidote to stress, pain, and conflict. Laughter offers a quick reset for your mind and body and fosters a positive, optimistic outlook through life's ups and downs, infusing you with courage and strength. Even a simple smile can shift your perspective, spread joy and resilience during tough times, and prove that laughter is contagious.

Continue Your Growth

As a caregiver, prioritizing your personal and professional growth is essential. Enrolling in an online degree program, such as a Bachelor's or Master's in Psychology, allows you to balance caregiving with advancing your career and educational goals, fitting seamlessly into your schedule. Understanding your studies' cognitive and affective processes enhances your caregiving skills and provides deep insights into the emotional and psychological needs of those you care for (this deserves a look).

Build Your Support System

Seeking emotional support from friends, family, or support groups is vital in managing the stresses of caregiving. Talking about your feelings and experiences with others who understand can make you feel more understood and less isolated. This support network can provide practical advice, emotional solace, and a different perspective on your caregiving situation. Whether it’s a shoulder to cry on or a friend to laugh with, maintaining these connections can bolster your emotional health and prevent feelings of burnout. Emotional support functions as a buffer against the adverse effects of caregiving stress.

Prioritize Personal Passions

It is important to reserve time for activities and hobbies that rejuvenate your spirit and reconnect you with yourself beyond your caregiving duties. Engaging in your favorite pastimes, whether it's reading, gardening, or other creative endeavors, can provide a necessary escape from the demands of caregiving. These activities cultivate joy and a sense of accomplishment, boost your mood, and keep your stress levels in check. Regularly carving out time for yourself is not a luxury—it’s essential to maintaining your health and well-being, making you a better caregiver.

Indulge in Relaxation

Indulging in relaxation practices like getting a massage can significantly alleviate caregiving's physical and emotional strain. Massage or similar relaxation techniques can help reduce stress, improve circulation, and restore energy levels. The soothing power of touch provides comfort, reducing tension and anxiety and fostering a sense of well-being and calm. Remember, taking care of your body and needs is not an indulgence but a necessity for maintaining the stamina required to care for another.

Cultivate Positive Dialogue with Yourself

Practicing positive self-talk can profoundly influence your mental and emotional health. Encourage yourself daily with affirmations that reinforce your capabilities and worth. Remind yourself of the good you are doing as a caregiver and the strength it takes to meet another person's needs. Positive self-talk helps in building resilience against the negative aspects of caregiving. You can combat stress and invite more peace and satisfaction into your caregiving journey by consciously shifting your internal script to a more encouraging and forgiving tone.

Adopting these self-care practices enhances your well-being and improves the quality of care you provide. Each step toward self-care enriches your caregiving journey and sustains your ability to support others effectively. This commitment ensures that you and those you care for enjoy a higher quality of life. Embracing these methods allows everyone involved to thrive, creating a more positive and supportive environment.

Older Americans Month

This feature was adapted from the U.S. Department of Health and Human Services, Administration for Community Living in honor of Older Americans Month.

Established in 1963, Older Americans Month (OAM) is celebrated every May. Led by the Administration for Community Living (ACL), OAM is a time for us to acknowledge the contributions and achievements of older Americans, highlight essential trends, and strengthen our commitment to honoring our older citizens.

This year's theme, Aging Unbound, offers an opportunity to explore a wide range of aging experiences and promote the importance of enjoying independence and fulfillment by paving our paths as we age.

This May, join us as we recognize the 60th anniversary of OAM and challenge the narrative on aging. Here are some ways we can all participate in Aging Unbound:

• Embrace the opportunity to change.

• Explore the rewards of growing older.

• Stay engaged in your community.

• Form relationships.

• For more information, visit the official OAM website, follow ACL on Twitter and Facebook, and join the conversation using #OlderAmericansMonth.

Aging Around the World and At Home

According to AARP and the World Health Organization (WHO), older adults are a growing proportion of the world's population, mainly due to healthcare and public health gains. WHO lists these critical factors associated with global aging.

 All countries face significant challenges to ensure that their health and social systems are ready to make the most of this demographic shift.

• In 2050, 80% of older people will be living in low- and middle-income countries.

• The pace of population aging is much faster than in the past.

• In 2020, the number of people aged 60 and older outnumbered children younger than 5.

• Between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%.

The Public Reference Bureau's July 15, 2019, Factsheet describes U.S. demographic shifts in older adult populations as more racially and ethnically diverse, more educated, living longer, and "projected to nearly double from 52 million in 2018 to 95 million by 2060". Increases in Illinois' aging population were also noted by the Illinois Department of Aging's Director, Paula Basta, in the state's 2021 Older Americans Month Press Release. She stated, "Today in Illinois, people 85 years of age and older are the fastest growing segment of the older population, and by 2030, individuals 65 years of age and older will represent 25% of Illinois's population".

What do we know about aging in Northern Lake County? According to the HFNLC 2022 Community Needs Assessment, adults 65 and older make up only 11 percent of the service area, compared to 14 percent in Lake County and 15 percent in Illinois. Despite being a younger population overall, some qualitative findings suggest a need for more services for older adults. Of the 15 interviews and focus groups conducted, three highlighted that the county is an aging population, and the needs of this population may be overlooked. Among community survey respondents, 59 percent (100/169) selected older adults as one of the top three groups in the community that needs more services available. In comparison, 15 percent (26/169) selected children or teens as a group that needs more services. When asked what type of health professionals or services does your community need more? Among survey respondents, some wanted to see more services for older adults (17% or approximately 29 of 174). In addition, due to structural inequities, many residents, including people of color, immigrants, people with disabilities, LGBTQI+ individuals, and older adults, face additional access barriers around language, insurance, cost, transportation, and provider availability.

What can we do to promote healthy aging? According to the Blue Zones, author, and researcher Dan Buettner, there are nine health habits gleaned from his study of centenarians from the U.S. and abroad. These include "moving naturally", "having purpose", "downshift", or stress management routines, "the 80% rule" to stop eating when the stomach is 80% full, consuming largely plant-based diets, drinking red wine in moderation, having a sense of spirituality, and belonging, "loved ones first" or strong familial connections, and social connectedness/social support/sense of community.

Thanks to our grantees and community partners who provide mental health and older adult services, and I wish all who celebrate AAPI and Jewish American Heritage Month abundant blessings. Whether you celebrate Mother’s Day, Memorial Day, or any other observance this month, enjoy!

Sincerely,

Venoncia M. Baté-Ambrus, PhD, MS, MA

Executive Director, Healthcare Foundation of Northern Lake County

Top 3 Fears Seniors Have About Aging

submitted by Harry Cline

For many family caregivers, caring for aging parents is a labor of love. Elderly parents may act out, lash out, and refuse to cooperate with the very people who care for them. But while these may seem like signs of a fracturing parent-child relationship, more often they’re symptoms of a senior’s stress and fears about aging.

Growing older can be scary. From a loss of independence to the loss of family and friends, aging comes with a lot of challenges. While some seniors manage to take those challenges in stride, many develop mental health concerns and exhibit difficult behavior.

This can be hard for family caregivers to deal with, but it’s important to empathize and respond constructively to senior misbehavior. Here are some tips from ElderCARE to help you get started.

Having to Leave Their Home

Odds are, your parents don’t mind an extra hand around the house. But if they shut down when you suggest downsizing or moving to assisted living, it’s time to change your tactic. The truth is, seniors aren’t just attached to their homes. They’re attached to their independence. Having to leave home is a sign that they’re not as able as they used to be, and that can be hard to come to terms with. Rather than suggesting assisted living from the outset, talk to your parents about their challenges at home and brainstorm solutions together.

Another option worth considering is renting, since that comes with less responsibilities. Luckily, there are plenty of options out there, including over 40 available apartments in Waukegan alone, so you can search by price as well as amenities. If you decide to live closer, you can also be of greater assistance as you help your beloved seniors plan their next move.

Giving senior parents a sense of control over the decision makes the transition easier. Many caregivers find it helpful to set up tours of assisted living facilities so elderly parents can see that modern senior communities are vibrant, social places and not the isolating facilities they’re imagining. That’s especially important for seniors who are starting to face loneliness at home, as isolation has been proven to be detrimental to senior health.

Developing Dementia

Is your senior parent stubborn about doing things themselves? Many seniors see dementia as a life-ending diagnosis. As a result, they hide any sign that they’re struggling to get by alone. Not only does a reluctance to admit they need help increase frustration in seniors’ daily lives, it’s also dangerous. A senior who is afraid to admit cognitive decline could end up lost, in a car accident, or a victim of financial fraud.

Since struggling with everyday tasks can make seniors anxious and defensive, avoid commenting in the moment and instead, offer help and bring up your concerns another time. Discuss the changes you’ve noticed but avoid judgmental language. Consider timing the conversation shortly before a doctor’s appointment so you can follow up with your loved one’s primary care doctor soon after.

Losing Their Spouse

For many senior couples, their spouse is their primary form of companionship. A husband or wife is a source of company in the senior years and someone to share the duties and expenses of the home. When that spouse dies, Psychology Today notes that it can mark a significant change in a senior’s financial, mental, and physical well-being. In some cases, seniors stop caring for themselves or lose motivation to leave the house.

The best way to make grief easier on senior widows and caregivers alike is to prepare for a death before it arrives. Completing senior loved ones’ estate plans, pre-planning funerals, and getting financial matters in order while both parents are living alleviates several sources of stress after a spouse passes. Some seniors choose to purchase final expense insurance to help cover the costs of their funeral (and other expenses like unpaid medical bills).

Worthy points out that caregivers should also increase the amount of support an aging parent receives after the death of a spouse. By surrounding seniors with a strong support network, families can encourage seniors to stay engaged after widowhood.

It’s not easy to be patient and understanding when a senior loved one makes caregiving difficult. However, responding to the fears of aging with kindness and understanding – including finding an accessible home – helps both seniors and their caregivers address challenges with grace. While aging may not be easy, the support of loving family members makes all the difference in a senior’s journey.

Core services at ElderCARE included friendly visits, grocery shopping, and escorted transportation to medical appointments. Give us a call today to learn more! (847) 406-4683

Honoring Black History Month: Representation Matters!

by Venoncia M. Baté-Ambrus, PhD, MS, MA

As I continue my journey to engage new stakeholders throughout northern Lake County, and the surrounding areas, I have accepted multiple invitations to address health inequities in the northern suburbs. I was particularly honored to speak about the social determinants of health in events honoring the legacy of Rev. Dr. Martin Luther King Jr. These events include serving as the keynote speaker for the 13th Annual MLK Interfaith Breakfast in Crystal Lake, a reader for Voices United, A Celebration of MLK Jr. Reading Event at McCall School in Waukegan, and an impromptu panelist at Supporting People and Strengthening Communities: A Tribute to Dick Hutson in Lake Forest. In preparing for these events, I was reminded of MLK’s famous quote, “Of all the forms of inequality, injustice in healthcare is the most shocking and inhuman.”

As I dig deeper to reflect upon the root causes of injustice in healthcare, systemic, institutional, and interpersonal racism rises to the fore, causing me to consider representation as one of many important strategies to dismantle racism and injustice in healthcare. While this discussion is topical for Black History Month, it is one that needs to occur in conjunction with action to diversify the healthcare workforce twelve months of the year until health equity and parity in workforce representation is a reality rather than a lofty goal.

Ponder this: What do Mary Eliza Mahoney, James McCune Smith, Otis Boykin, Solomon Carter Fuller, E. Kitch Childs, Thyra J. Edwards, Mary Beatrice Davison Kenner, George F. Grant, Daniel Hale Williams, and Mae Jemison have in common? If you do not immediately know the answer, you are not alone. The answer is that they are all pioneers in their respective disciplines in research, medicine, psychology, social work, dentistry, and allied fields. Their accomplishments have changed the face (pun intended) of health, human services, research, advocacy, and education.

Why is this knowledge important?

Quite frankly, if you cannot see your face, language, culture, and community represented among those who educate you, those you learn about, and those who provide your health and human services, it is exceedingly difficult to imagine yourself becoming one of those professionals. Therefore, representation matters!

According to Sex, Race and Ethnic Diversity of U.S. Health Occupations (2011-2015) African Americans or Blacks are underrepresented in several healthcare professions, comprising 4.8 % of Physicians, 4.9% of Psychologists, 3.0% of Dentists, 5.9% of Pharmacists, 1.8% of Optometrists, 10.4% of Registered Nurses, 4.4% of Occupational and Physical Therapists, and 6.3% or EMTs and Paramedics. Similar findings from a 2021 JAMA Open Network article stated, “Compared with the representation of Black individuals in the current health care workforce, the representation of recent Black graduates was lower for 5 of the ten occupations included” in the study. These findings have serious implications for the current and future status of the healthcare workforce. This lack of diversity in healthcare professions profoundly and deleteriously impacts health outcomes, particularly those associated with communities of color.

However, diversity benefits not only patients but also organizations as well according to a 2023 article in Circulation: Cardiovascular Quality and Outcomes, which reports that “data show that organizations with inclusive cultures are more likely to meet or exceed financial targets, improve performance, innovate, demonstrate agility, and achieve better business outcomes than those without inclusive cultures.”

So how will we achieve more healthcare workforce equity?

Nurturing Diverse Generations of the Medical Workforce for Success with Authenticity: An Association of Black Cardiologists’ Roundtable recommends the following overall strategies for addressing inequities in healthcare:

1. Create a robust healthcare workforce pipeline. Focus on how future doctors are groomed and recruited, including who has access to the field and removing barriers to entry.

2. Address diversity among research investigators and grant funding awardees.

3. Improve access to equitable and quality healthcare.

4. Advocate for policy and institutional initiatives that eliminate educational and economic disparities.

5. Recognize URM (under-represented minority) professionals for their leadership and talents and address inequality in promotion, advancement, and endowed chairs.

A 2021 editorial entitled Health Workforce for Health Equity in Medical Care, the official journal of the medical care section of the American Public Health Association, provides a health workforce equity framework with the following interconnected goal-oriented domains: (1) a diverse composition of the health workforce; (2) the social mission of health professions education; (3) provider distribution according to population need; (4) high-need patients being served; (5) practice patterns that are oriented to addressing root causes of disparities; and (6) safe and fair working conditions for all members of the health workforce. This framework is helpful in understanding and addressing shortages in culturally and linguistically diverse healthcare providers.

Representation: A Matter of Local Importance:

Representation also matters because it directly impacts if, where, and how often you access healthcare. Consider these highlights from the Live Well Lake County Community Health Needs Assessment (2016-2021): African American residents from a Waukegan focus group at the Family First Center discussed the lack of cultural sensitivity in the workforce as an area of improvement stating that “Professionals, who provide services such as education, safety, health care, etc., are not familiar with the culture of their customers or passionate about the community they work in.” Mental health, older adult health, trauma, and poverty are additional concerns from the focus group. Each of these areas could be improved by developing robust healthcare workforce pipelines.

Many of the top five opportunities for improvement reported by African American residents who participated in the Live Well Lake County survey were similar to those of focus group participants, including more jobs and a healthier economy (52%) ranked 1st, more programs and support for youth outside of school 39% ranked 3rd, and improved education (34%) ranked 5th. These findings also align with the recommendations of the Healthcare Foundation of Northern Lake County 2022 Community Health Needs Assessment. Respondents for education and workforce pipelines, need for a “competent and culturally-sensitive workforce,” “financial support and workforce development,” “mental health,” “older adult health,” and “healthcare.”

In closing, as we celebrate Black History Month, let us not forget the pioneers mentioned in this column and many more who have dedicated their lives to eliminating inequities in medicine, behavioral health, research, human services, advocacy, and education. While much work has been done, there is much left to do to promote Justice, Equity, Diversity, and Inclusion and address the Social Determinants of Health.

Six Financial Considerations for Senior Newlyweds

submitted by Harry Cline

Finding love isn’t just for young people. Romance can arise at any time in your life, and according to statistics, marriage rates among seniors are on the rise. Marriage is about more than just love and companionship, though — it’s also about sharing your life with somebody and building a future with them. Finances are an important consideration in this process, and senior newlyweds should take the following six expenses into account.

 1. Home Ownership

Most seniors in the U.S. are homeowners. If you own a home and your new spouse also owns a home, this prompts the question of where you both will live. This can be a tricky situation, but if you choose to go house hunting, there are some important features to look for. Many seniors prefer single-level homes, for example, with amenities such as walk-in tubs.

 2. Combining Bank Accounts

You will also need to consider the extent to which you will combine your finances with your new spouse. Some senior couples prefer to completely combine finances, which can certainly have its benefits — but others prefer to retain their financial independence and only share certain expenses. Decide whether you’ll share a checking account or maintain separate accounts.

 3. Insurance and Medicare

Senior newlyweds must navigate the requirements of their insurance plan or Medicare after marriage, too. Research how Medicare covers spouses and whether or not marriage may improve either spouse’s insurance coverage. You should also contact your insurer to see whether marriage will have any impact on your rates — especially if you add your partner to your policy.

 4. Tax Filing Status

After your wedding, you should tend to important legal obligations regarding your tax status and your eligibility for Social Security benefits. You can do this by filing an amended tax return that indicates your new marital status. You can also file Form SS-5 to update your name — if it has changed — with the Social Security Administration.

 5. Long-Term Care Costs

Many people avoid discussing the possibility of long-term care, but it’s a crucial topic to address — especially with regard to the cost. Planning for the expenses of long-term care can help you and your spouse avoid unnecessary stress later in life. You should develop a plan that you agree on, estimate your budget for the expenses, and determine how you will cover the cost.

 6. Source of Income

Some senior couples find that their retirement savings are not enough to keep them afloat. As you strategize potential sources of income with your spouse, you might consider starting a new business. In addition to the financial boost, running a business with your spouse is a fantastic way to spend time with them and avoid returning to a 9-to-5. Write a business plan with your spouse that details your plans for the company, its structure, how you’ll market to clients, and how much income you hope to earn. This step makes starting a new company so much easier!

 Financial Planning Helps Senior Couples Thrive

A solid plan is the best defense you can have against all of life’s unexpected events. When you get married later in life, it’s more important than ever to identify potential expenses and ensure that you are financially equipped for the future. Write a business plan and start a company to earn extra income and enjoy quality time with your spouse.

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Harry Cline is creator of NewCaregiver.org and author of the upcoming book, The A-Z Home Care Handbook: Health Management How-Tos for Senior Caregivers. As a retired nursing home administrator, father of three, and caregiver to his ninety-year-old uncle, Harry knows how challenging and rewarding caregiving can be. He also understands that caregiving is often overwhelming for those just starting out. He created his website and is writing his new book to offer new caregivers everywhere help and support.

Elder Care Not A Solo Act

When I was 16 and applying for a driver’s license, I studied rules of the road, probably my first challenge to understanding unfamiliar facts. After that came the SATs. The GRE and the LSAT. Each time, I studied, finally figured it out and passed. But now that I'm in midlife I'm facing a much bigger challenge: understanding Medicare

Believe me, it is the most complex test yet. But I am forging ahead because this is part of my professional life and also I am a caregiver in my personal life, Believe me, it is not easy.  Sitting in front of me right now is the 130-page handbook, Medicare and You 2022. Sent to all beneficiaries by the U.S. Department of Health and Human Services, it's a confusing read.

First off, let me assure you that if you find Medicare confusing, you and I belong to a very large club. It includes not only the almost 55 million in the U.S. who are now over 65, but also those who love them.

By 2040 the population of American adults who will be 65 and older will nearly double and that of adults age 85 and older will quadruple during the same period. As our aging population grows, the need for elder care will also increase --yet there are not enough workers and programs that are  fully capable of handling this burden.

Medicare is an important benefit, but our country lacks a single national health insurance program -- or even standard medical insurance policies --so most issues are confusing. Do not try to do this alone. There are resources, both public and private, and I urge you to use them-- because failure to do so can be financially and emotionally costly, even ruinous, to you and your family.

Elder care is not a single act. Rather, it is a long process, usually taking years of big and small decisions and acts, each based on unique needs.

The only single rule is this: do not try to go it alone. Clearly, caregivers and care recipients should work together, listening together to advice from trusted medical, social service and financial experts – and then sharing their separate impressions.

A question I am asked often: Who can help me enroll in a Medicare Plan?

It’s fine for friends and family to help you work through the Medicare plan selection process, as long as you follow a few basic guidelines.

• An agent or broker will need information about you and your providers to help you choose a Medicare plan.

• A friend or family member can be present while you discuss your Medicare coverage options with an agent or broker.

• If you want Medicare to share your personal information with someone else, you’ll need to complete an authorization form.

• Someone can act on your behalf if you’ve created power of attorney.

• Private Medicare carriers require a disclosure authorization in order to discuss your coverage with a loved one or friend.

But please remember to talk this through.  Communication is key in this new world of elderhood. Learn to speak the language. And do not be afraid to say, “This is new to me, please explain.”

Need more info? Contact Curtis Smith: curtis.smith@thrivent.com