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Doctor: Caregivers Need More Control

Advice includes taking care of yourself, going out and feedback.
The Ledger

Caregiving is never effortless, but there are several steps we can take to make it less burdensome and more rewarding. So says Marion Somers, Ph.D. author of "Elder Care Made Easier."

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MARION SOMERS, known as Dr. Marion, advises caregivers to take care of themselves and take better control of their situation.

Somers, better known as Dr. Marion, is a geriatric care manager with 40 years experience under her belt. She's big on planning and paying attention to the small stuff. Minding the details takes a little extra effort, but pays off big rewards in helping the harried caregiver get his or her life under control. Here's her best advice:

1. Accept your role. A lot of us are caregivers and don't know it. Or rather, we may know it somewhere deep down, but we'd rather not think about it, according to Dr. Marion. If anyone asks, we'll say, "Well, yes, I'm kind of responsible for my aunt Zelda," but we don't quite want to take the mental leap and say, "Yes, I'm her primary caregiver."

"People need to wake up to the facts. Only then can you take charge of the situation," says Dr. Marion.

What are the facts? Back to Aunt Zelda for a moment. Is it the same Zelda who lives three states away, but whose doctors' appointments you schedule, whose neighbors you've organized into a support brigade, and who calls you every day when she wakes up (at 6:38 a.m.)? Do you have responsibility for her finances? For seeing that her house gets cleaned? Look in the mirror. You're her primary caregiver.

What does acceptance of your role do? For starters, it helps you get results. "In a crisis, professionals in the field will defer to someone who identifies themselves as the primary caregiver," says Dr. Marion. "They'll listen to you. That's a term that has meaning in the healthcare profession. Calling yourself the neighbor, the friend, even the relative, won't get you the same treatment or the same access."

2. Don't neglect your own needs. Caregivers have a higher rate of illness, depression and dementia than the population at large. "Before they took on this responsibility, caregivers had full lives," says Dr. Marion. "Maybe they had a book club, maybe they

exercised regularly. But now, they stop doing the things that support them. With all that energy going out, they're not replenishing themselves. And, if they get sick, that's a double whammy for the person they're caring for."

The solution is to find some backup help so you can schedule regular breaks for yourself. Rejoin that book club; take a vacation; join a card game. The person you're caring for will be better off for it.

3. Get regular feedback. "It's essential that whenever you make suggestions, you check in first and ask, 'What do you think? How do you feel about this?'" says Dr. Marion.

A classic example of not getting feedback: A caregiver who lives two hours away from the person she's caring for knows the person is running low on groceries. So she drives two hours to the supermarket, takes them to the person's house and loads up the refrigerator. Then, pressed for time, she jumps back in the car and drives two hours home. Now she's spent four-plus hours getting groceries and the person she's bought them for is acting resentful. What went wrong?

"Sure, you did a wonderful deed," says Dr. Marion. "But maybe you bought the wrong brand of cereal. Maybe you put the milk on the top shelf and she always puts it on the bottom shelf."

This common conundrum is easy to prevent. All it takes is asking some questions before you do the shopping. "If you simply barge in and stack the groceries willy nilly in the 'fridge, the person is not going to be grateful to you for devoting the better part of a day to helping them. Instead, they're going to think you aren't very considerate."

4. Use the "I" word. When important decisions are being made, it's critical to get the person's buy-in. "Never just tell someone that you've decided to do something, whether it's hiring an aide or making a doctor's appointment," says Dr. Marion. "Ask them what they think. Then be sure to say how you feel as you explain your point of view. For example, 'I'm really worried about you and I'd like you to consider having someone come in to help with the washing/cooking/cleaning.' The 'I' word is vital to expressing empathy and getting buy-in."

5. Maintain a familiar routine. Similarly, should you need to hire a caregiver or a health aide, make sure you tell them the routines the person likes to follow. Does she like to shower at night or take a bath in the morning? What does she like to eat for breakfast? "If you ignore these basic preferences, and let outsiders set up their own schedules, the person feels diminished," says Dr. Marion

6. Encourage outings. As people get older, they start limiting social activities, because they feel it's too exhausting. But once they get out of the house, they interact with other people. "That's very important. It keeps them intellectually and emotionally stimulated," says Dr. Marion.

Yes, it's complicated to help them out of the house, but worth the effort. "Their social life can't be just doctor visits," says Dr. Marion. "Take them to the senior center. There are games, conversation, snacks, plus they have to dress up a bit."

7. Don't try to "parent." This is a big one, and it flies in the face of instinct. Here you are, taking responsibility for a person's life. It feels a little like the parenting you did when your children were small. But there's a big difference. "These are adults. They have lives," says Dr. Marion. "You cannot go in and take over another person's life. Even when what you're trying to do is for their benefit, they're going to look at you as a busybody, and they'll resent it."

What it all boils down to is respecting a person's needs, life experience and habits. Taking a little extra time to make sure the person you're caring for feels engaged and in control of his or her life will pay back rewards many times over in terms of cooperation and positive feeling.

Dr. Marion has created a suite of free iPhone apps loaded with helpful resources for caregivers. You can find them at http://elder911.net/.

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