The story below is about Mary (name has been changed) who was told by a neighbor she needed someone to help her at home. Mary had some diminished capacity and hired the “friend” that the neighbor suggested.  Unfortunately, the circumstances’ surrounding this case are not unusual and demonstrates the necessity of hiring a home care company that provides care management, bonded, insured and supervised caregivers.

Mary’s primary care physician became concerned for her well-being after an appointment in July of 2012.  Mary’s privately-hired caregiver exhibited controlling behavior over Mary during the appointment.  The physician expressed his concerns to Mary’s Trust Administrator, and after a brief investigation the Administrator realized that the caregiver was financially and emotionally taking advantage of Mary.  Acting quickly the Administrator contacted Kansas City Home Care and requested we find a bonded, insured and supervised caregiver to assist Mary with her daily activities of living.

Kansas City Home Care (KCHC) responded quickly and did a complimentary assessment of Mary’s daily living needs.  A mature and experienced caregiver was assigned to Mary’s case.  At first, Mary was frightened by the changes in her routine and said repeatedly that she missed her old caregiver.  However, due to the patience and understanding of the staff at KCHC, Mary accepted a new caregiving team by the end of the first week.

Kansas City Home Care has been providing daily care to Mary for three months.  Mary no longer exhibits paranoid-like symptoms when our caregiver or others are in her home.  In fact, she now looks forward to a daily visit by our caregiving staff. Mary has a history of high blood pressure and needs to be on a low sodium diet. Unfortunately, her diet had mainly consisted of canned soups and frozen dinners which are high in sodium. Mary has now been eating balanced low sodium meals and feels better and has gained some much needed weight!

Mary’s dementia-like symptoms have also improved and instead of forgetting that our caregiver is coming, Mary eagerly awaits a visit from “her friend” and looks forward to the activities that she and the caregiver have planned each day. Her overall mood has changed dramatically and she appears much less frightened and agitated than she was before we began services.

Mary’s Trust Administrator has commented on the improvements she sees in Mary as a result of our care.  About a month after KCHC began caring for Mary, her Trust Administrator went to visit her home unannounced and was greeted by the smell of homemade beef stew cooking in the kitchen.  The Administrator told the caregiver on shift that she didn’t know the last time Mary had a home cooked meal. During Mary’s recent appointment with her physician he commented several times that KCHC was taking good care of Mary.  He was very pleased to see the improvement in her mood, memory retention, and overall health.

Mary recently visited our office with her caregiver and was in a very good mood. Her color was good and she had just returned from the beauty parlor.  She was laughing and talking the entire time she visited our offices.  Our staff was happy to see how much Mary’s mood has improved and how much better she seems to feel. Seeing Mary smile and engage in conversation is a testimony to our corporate philosophy of “Clients First.” Making a difference in a client’s quality of life is our goal and obviously we have met our goal with Mary!

The use of privately-hired caregivers is not uncommon and there are situations where the arrangement works well for those needing home care.  But, in order for the arrangement to work well there must be someone other than the client who supervises the caregiver–a family member, a trusted friend or a care manager.  There can be many pitfalls to hiring someone privately and consumers must be careful.  The National Private Duty Association has an excellent paper on “Consumer and Worker Risks from the Use of Nurse Registries and Independent Contractor Companies” that discusses the issues surrounding employing private caregivers.  The position paper can be located at

One of the hardest decisions family caregivers make is deciding to ask for help—first there are the guilt feelings, then the “who do I call or ask” and then the final step of taking action to get help. Caregiver burnout can be caused by a myriad of reasons that can diminish your ability to provide good care for your loved one. How do you know if you are on the path to caregiver burnout and what can you do about it?

Warning Signs of Burnout:

Lack of sleep and time for yourself
• Caring for another loved one can lead to constant worry and sleepless nights. The struggle between being a good parent, a spouse or caregiver can lead to thoughts of “What happens if I am not there and my mother falls?” or “Am I neglecting my spouse and children to take care of my Dad?” These thoughts and ones like it can come and go throughout the day but many also experience it during times they should be relaxing or sleeping. The lack of rest and doing fun activities can lead to exhaustion and depression.

Shortage of a Reliable Support Network
• If you are perceived as being the “strong” one in the family and you do not ask for help or voluntarily receive it from your siblings, spouse or other relatives you could experience caregiver burnout. Lack of support from family or friends can cause tension, anger, depression and additional stress. Make sure your support system fully understands what it costs you physically and emotionally to be the main caregiver.

Work and Caregiving
• Juggling work, home and caregiving can be exhausting, stressful and frustrating. It is more and more common for workers to take time off to care for their loved ones. It is also becoming more common for employers to understand their workforce might be caregivers to both their parents and their children. Do not hesitate to talk to your employer about your need for time off—talk to your employer about working remotely when necessary or changing your work hours to make your caregiving needs easier.

If these signs sound familiar then you need help. There are many options available to give you the relief you need. Here are some ways you can do so to make your caregiver duties easier and less stressful.

Community Resources
If your loved one has a medical condition, dementia or a chronic illness such as Parkinson’s seek out a support group. Being able to share your experience with others who are going through the same issues will help alleviate stress and allow you a safe place to vent your frustrations.
• Become familiar with the Family Medical Leave Act. Using the Leave Act can help alleviate the pressure of juggling work and caring for your loved one.
• Have an honest and open conversation with your employer. Ask about Flex time or working remotely if necessary.

Friends and Family
• Recharging is important if you are going to be a caregiver. Ask your spouse or another family member to go to the grocery store or sit with your loved one so you can take a nap or read a book. The smallest of tasks can make a huge difference to your level of energy and stress.
Private Duty Home Care
• Paying for an agency to provide you respite is not always inexpensive but it can make a huge difference to your quality of life. Something as simple as having a caregiver come in 4 hours a day or week can give you a much needed break.
• Although paying an agency is not inexpensive it is the best way to insure your loved one gets the appropriate care and is supervised. Hiring the neighbor or someone out of the newspaper is often an unsafe situation and will only add to your stress.
Geriatric Care Managers
• Even if you join a support group, take time off from work, have agency or family help so you get respite, you might also have a hard time dealing with the stress of knowing your loved one is declining. Although it might be difficult to admit you need someone to talk to about your feelings, a geriatric care manager can provide you with the support you need to reduce your stress, anxiety and depression.
• A care manager can also act as an advocate for your loved one in medical situations. As professionals they can help you navigate the health care maze.
Caregiving is difficult, stressful, frustrating and exhausting. But, as a caregiver you must take care of yourself or you will be too exhausted to take care of your loved one. Kansas City Home Care has been providing respite care for caregivers for almost 25 years. As geriatric professionals we can also provide you with counseling and advocacy if needed. Let us know if we can help by calling 913-341-4800.

Overland Park, KS – When you live many miles away from your loved one with dementia, the separation complicates  caregiving. Concerns about the person’s safety, nutrition and health can be overwhelming at times.Here are some strategies to manage long-distance caregiving.

Identify needed help

If the person with Alzheimer’s disease lives alone, he or she may have difficulty managing daily tasks.  Identify what kind of help he or she may need to remain independent in the home for as long as possible. When you visit you loved one, observe the following:

  • Is there food in the refrigerator? Is it spoiled? Is the person eating regular meals?
  • What is the condition of the inside and the outside of the home? Has it changed?
  • Are the bills paid? Are there piles of unopened mail?
  • Do friends and relatives visit regularly?
  • What is the person’s personal appearance? Is the person bathing and grooming?
  • Is the person still able to drive safely?

Establish support contacts

Building a list of contact people and resources can help you coordinate care from a distance.

  • Family, friends and neighbors. Make a list of their phone numbers and addresses. Ask if you can check in with them to find out how your loved one is doing. They may also be willing to stop by your loved one’s home for regular visits.
  • Your loved one’s doctor. Keep in contact with the person’s doctor. The doctor can call you if there are concerns about the person’s mental or physical well being.
  • Community organizations. Check with local churches, temples, neighborhood groups and volunteer organizations. They may provide meal delivery, transportation or companion services.
  • Home care services. You can hire home health care workers to help the person with bathing, personal care activities, preparing meals and taking medications.  Hiring a geriatric care manager can help you assess and monitor the overall needs of your loved one and communicate with you regularly about his or her well-being.

Make the most of visits

Few long-distance caregivers are able to spend as much time with their loved one as they would like. The key is to use your time wisely :

  • Make appointments with your loved one’s physician, lawyer and financial adviser during your visit to participate in any decision- making.
  • Meet with neighbors, friends and other relatives to hear how they think the person is doing. Ask if there have been any behavioral changes, health problems or safety issues.
  • Take time to reconnect with your loved one by talking, listening to music, going for a walk or participating in activities you enjoy together.

Considerations before moving a loved one into your home

There will come a time when your loved one will no longer be able to live alone. One of the decisions you might consider is moving the person into your home. Here are some things to think about:

  • Does he or she want to move? What about his or her spouse?
  • Is your home adapted to support the person?
  • Will someone be at home to care for the person?
  • How does the rest of the family feel about the move?
  • How will this move affect your job, family and finances?
  • What respite services are available in your community to assist you?

Moving a person with Alzheimer’s disease from familiar surroundings may cause increased agitation and confusion. Talk with your loved one’s physician or a social worker and call the Alzheimer’s Association for assistance before making a decision.  In some situations, an assisted living or a residential care setting may be a better option for the individual.

Resolving family conflicts

Caregiving issues can often ignite or magnify family conflicts, especially when people cope differently with caregiving responsibilities. Family members may deny what is happening, resent you for living far away or believe you are not helping enough. There may also be disagreement about financial and care decisions.

To reduce conflicts, acknowledge these feelings and work through them.

  • Have a family meeting. Talking about caregiving roles and responsibilities, problems and feelings can help ease tensions. You may want help from a professional counselor or clergy.
  • Recognize differences. Some family members may be hands-on caregivers, responding immediately to issues and organizing resources. Others may be more comfortable with being told to complete specific tasks.
  • Share caregiving responsibilities. Make a list of tasks and include how much time, money and effort may be involved to complete them. Divide tasks according to the family member’s preferences and abilities.
  • Continue to talk. Family meetings or conference calls keep the family up-to-date and involved. Discuss how things are working, reassess the needs of the person with Alzheimer’s, and decide if any changes in responsibilities are needed.