Taking Care of Elderly Parents and Working- The Caring Generation®
The Caring Generation® – Episode 64 November 18, 2020 On this caregiver radio program, Pamela D Wilson, caregiving expert shares tips for working and caring for family while Taking Care of Elderly Parents. Guest Dr. Aninda B. Acharya Professor of Neurology from Saint Louis University shares information about Anosognosia – a lack of insight into health concerns and safety for persons diagnosed with mental illness, stroke, dementia, or brain injuries.
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Taking Care of Elderly Parents
00:03 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation with host Pamela D. Wilson is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.
00:48 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, advocate, and speaker consultant. I’m your host on The Caring Generation radio program. Coming to you live from the BBM Global Network Channel 100 and TuneIn radio. The Caring Generation focuses on conversations about health, well-being, caring for ourselves and aging parents, all tied together with a little bit of humor and laughter essential to being a caregiver.
01:14 Pamela D. Wilson: The topic for this caregiving radio program is: surprises about taking care of elderly parents. How what you don’t know negatively impacts the lives of a working caregiver or a spousal caregiver. We will talk about caregiving challenges that result in the struggle to adapt to a new way of life for the caregiver, the aging parent, a spouse, or another family member. If you’re thick in the middle of the caregiving experience of working and caring for elderly parents, you all know what I’m talking about.
01:50 Pamela D. Wilson: Our special guest for this program is Dr. Ani Acharya, Professor of Neurology at St. Louis University School of Medicine, who joins us to talk about anosognosia. Yes, that is a tongue twister. And how anosognosia applies to your caregiving situation when an elderly parent lacks insight or forgets conversations. How many of you have that happen? You might think it’s you, it’s not.
02:18 Pamela D. Wilson: Dr. Acharya completed his undergraduate medical training and neurology residency at the University of Kansas, plus a two-year Stroke Fellowship at Washington University in St. Louis, Missouri. His main clinical and research interests include rehabilitation after stroke, traumatic brain injury, and treatment of migraine and other headache disorders. He has written many book chapters and articles regarding stroke, rehabilitation, and management of headaches.
02:51 Pamela D. Wilson: Let’s return to ten concerns and solutions for taking care of elderly parents, within the context of working and caring for elderly parents. These are areas where caregivers may not think through the long-term consequences of decisions, or you may be so frustrated and burned out that coping through the day without falling apart is the best that you can do. Only a caregiver understands another caregiver’s experiences. We talk about that all the time in my caregiving groups. You’re in the right place here with The Caring Generation and me.
03:30 Pamela D. Wilson: Number one on the list of concerns and considerations resulting from giving up a job and taking care of elderly parents is outdated job skills and being deemed unemployable. As many of us have experienced, it’s easier to change jobs when you are currently employed. The minute you decide to change your position of working and caring for elderly parents to only taking care of elderly parents, your status can quickly shift to being unemployable. Job skills, as you know, can become rapidly outdated because of all the technology updates and new workplace initiatives.
04:12 Pamela D. Wilson: If you previously worked in a fast-paced environment, it’s likely that your position requires you to be highly organized and efficient. While these skills definitely transfer to taking care of elderly parents, work skills quickly become rusty when we don’t practice them every day. The other issue that happens—but no one talks about it—is competition. The longer you are out of the workforce caring for elderly parents, the more difficult it is for you to remain competitive skill-wise with other people who are competing for the same job or the same type of work.
04:52 Pamela D. Wilson: While a couple of months out of the workforce may not make a significant difference, two years, five years or more, can make your skills appear outdated to employers. Know that your competition is candidates who have no gaps in their work experience. You might upload hundreds of resumes and not receive a single invitation to interview. Applying for jobs today—it happens over the internet. If you don’t know how to upload PDF documents or meet the submission requirements, you won’t even be considered. The programs that scan resumes for keywords and suitability might eliminate you as a great candidate because you have gaps in employment.
05:38 Pamela D. Wilson: Also, other information that you submit can stop you from being a great match on paper. While employers are not supposed to discriminate, choosing a candidate who has been steadily employed and who appears stable—instead of a candidate who left the workforce and is taking care of elderly parents may be their preference. The appearance of being unable to continue working and caring for elderly parents, even if you explain the reasoning, may be a deal-breaker for an employer who has no idea of the time and personal demands of taking care of elderly parents.
06:15 Pamela D. Wilson: Most companies today, they don’t even realize that they have employees who are working caregivers. Nor do many corporations offer any type of caregiving support programs to retain employees who want to stay working and caring for elderly parents. Elder care will remain a challenge for employers and employees, until corporations recognize the importance of offering elder care workplace programs. Programs for family care and child care—those already exist. Elder care is that next frontier for human resource managers to embrace.
06:50 Pamela D. Wilson: Number two for concerns and considerations for working and caring for elderly parents, and leaving a full-time job is the idea of re-entering the workforce if you are middle-aged or older or a younger caregiver. This challenge goes both ways, and it relates to age discrimination. If you are middle-aged or a soon-to-retire caregiver, you are competing in the area of skills, technology, physical energy, and endurance versus job seekers younger than you. If you are a younger caregiver who delayed completing college for taking care of elderly parents, you may not meet the education requirements of the position that you would like to have.
07:32 Pamela D. Wilson: Working and caring for elderly parents brings up so many life-affecting decisions. Be thoughtful in considering the short and the long-term consequences of keeping your full-time job and finding other ways for your elderly parents or a spouse to get all of that needed care. These are such important considerations for all caregivers. No matter if you are 20, 50, or 60, getting ready to retire, it’s important to think of the consequences of leaving a paying job to take care of elderly parents.
08:09 Pamela D. Wilson: Up next, we’re going to speak to Dr. Ani Acharya, Professor of Neurology at Saint Louis University School of Medicine. He’s going to join us to talk about anosognosia, a lack of insight into health concerns, and safety for persons diagnosed with mental illness, stroke, dementia, or brain injuries. This discussion will give you insights into why loved ones do what they do. Helpful tips for caregivers and aging adults are in my Caring for Aging Parents Caregiving Blog. I also invite you to follow me on Facebook at Pamela D. Wilson, caregiving expert, where you can join my online caregiving support group. It’s called the Caregiving Trap.
08:48 Pamela D. Wilson: I’m Pamela D. Wilson on The Caring Generation radio show, live on the BBM Global Network Channel 100 and TuneIn radio. Visit my website www.PamelaDWilson.com. On there are the podcasts of this weekly radio program, click on the Media tab, scroll down to The Caring Generation. Also, my free caregiving library, it is for family caregivers and for professional caregivers. Stay with me. We’ll be right back after this break.
11:31 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host on The Caring Generation radio show for caregivers, live from the BBM Global Network Channel 100 and TuneIn radio. With us is Dr. Ani Acharya. Doctor, thank you so much for joining us.
11:45 Dr. Aninda (Ari) B. Acharya: Yes, thank you for inviting me.
11:47 Pamela D. Wilson: So, a question for you. Caregivers in my support groups express frustration with elderly parents or spouses that they see as being stubborn, lacking insight, failing to follow through. How might anosognosia be the cause?
12:03 Dr. Aninda B. Acharya: Right, right. So actually, I see the same thing. I ran a stroke rehabilitation program for many years, and I would hear about how patients are not motivated to participate in the rehabilitation programs. And so what I would do at that point was I’d go talk to the patient. I’d examine them, and then I’d ask specific questions to kind of gauge their insight into their condition. And often, what I’d find, especially in the setting of stroke, is that they’re just not aware of their deficits at all. They may have a paralysis or cognitive deficits, but they just don’t recognize that deficit. And at times, they would just minimize the deficit or not see it as a significant problem.
12:46 Dr. Aninda B. Acharya: We neurologists have a name for everything, and the name for this is anosognosia, which is kind of a mouthful, as you said. Nosis has to do with knowing. And so the word literally means unawareness of one’s deficit. It’s a term that was coined about 100 years ago by a famous Neurologist, Joseph Babinski. And it’s actually something that we really should be aware of, and it’s important that the patients and the family be aware of it, as well as the caring team so the proper expectations can be developed and a proper treatment plan can be developed. So yes, it’s an important topic that’s worth talking about.
13:32 Pamela D. Wilson: And so you mentioned stroke, what other conditions can lead to this diagnosis?
13:38 Dr. Aninda B. Acharya: Yes, sure. So, psychiatric disorders and neurological disorders. They cause dysfunction in the brain. With neurological disorders, there might be an injury like a stroke or a brain tumor. In psychiatric disorders, there may be a chemical deficit or abnormality that leads to the condition. The other thing the brain is doing is it’s constantly updating its awareness of how well it’s functioning. And so when that process is not working properly, that leads to anosognosia. So we see this very commonly after stroke, but we also see it in the setting of Alzheimer’s dementia and certain mental health disorders where they just don’t recognize that they have some deficit that requires remediation or treatment.
14:31 Pamela D. Wilson: And so we have this skill gap in our brain, does it go in degrees? For some people, is it a little bit, or is it a lot, or does it progress? How does that work?
14:39 Dr. Aninda B. Acharya: Yes, I’ve seen the whole gamut in my practice. Sometimes somebody might come in with a paralysis of one side, and they just don’t recognize that they’re not moving. Usually, it’s the right side of the brain that’s affected, that leads to the left side being paralyzed. But they don’t recognize the fact that they’re not moving the left side. Sometimes it could be more subtle than that, and they just don’t recognize the significance of the deficit, or they minimize it. Basically, the brain, what it’s doing is it’s constantly trying to incorporate new information to update its self-image, and if that process is impaired because of neurological, psychiatric disorder, then they develop this condition, where they just don’t recognize that their brain is not working the way it’s supposed to work.
15:34 Pamela D. Wilson: And so if the caregiver is seeing these things and they don’t know what to do—do they go to a primary care doctor—who do they go see to get this diagnosed?
15:44 Dr. Aninda B. Acharya: It’s important to discuss this with the doctor. A primary care doctor is probably the good first choice. When a person first comes in with a serious neurological disorder, oftentimes, the first—what the treatment team is really most worried about is keeping the person alive, and they might be on a ventilator. They might need different kinds of treatment. It’s only later that people realize that the patient actually has this significant deficit where they don’t even recognize neurological or psychiatric symptoms that they’re having. So it’s a very good idea for them to talk to their family members, to talk to the doctor. Further work-up might be needed, and maybe getting some specialists involved, like a psychiatrist or a neurologist, could be useful in that situation, to just know what’s going on, so you can plan appropriately.
16:47 Pamela D. Wilson: And let’s say that it’s an older person and they don’t have kids. They don’t have any caregivers, and this happens and you’re seeing them or another doctor’s seeing them. What do you counsel that person to do if they don’t have any insight?
17:02 Dr. Aninda B. Acharya: Yes, I think that the first thing to do is first establish this is an issue. Oftentimes when a patient is brought in with dementia, one of the first things that’s lost is this ability to recognize deficits. They don’t think anything is wrong. It’s the family that thinks something is wrong. But when there’s no family around, it makes it much more difficult. What I try to do is get a team of people, including psychologists and psychiatrists, and their primary care doctor, to try to come up with a treatment plan that’s going to work for the patient.
17:43 Pamela D. Wilson: And with that, we’ve got about a minute left before we have to go out to a break. So what if the patient is in that state where they’re like, “Well, doctor, you’re crazy. There’s nothing wrong with me.” What you do? Do you have options? What do you do then? [chuckle]
17:58 Dr. Aninda B. Acharya: Yes, well, the most important thing is to develop a trusting relationship with the patient. You have to listen to what their perspective is, and then you have to explain to them that the injury that they’ve had to the brain or the disease process is affecting their ability to recognize what’s wrong with them, and you just have to work with the patient. Obviously, the patient can make their own decisions, but I think our job as treating physicians is to be honest with the patient and develop a trusting relationship and try the best we can to get the patient better based on the treatments that are available.
18:46 Pamela D. Wilson: Listeners, we are going to continue our conversation with Dr. Ani Acharya after this break. The podcast of this radio show for caregivers, including all of the show transcripts that you can read for all of The Caring Generation shows, are on my website at www.PamelaDWilson.com. Click on the Media tab, scroll down to The Caring Generation radio show, and everything is there. You can also share the podcast with your loved ones on Apple, Google, Spreaker, Spotify, all the top podcast shows. You can put a link on their cell phone and let them listen every week.
19:19 Pamela D. Wilson: This is Pamela D. Wilson on The Caring Generation. You’re with me live on the BBM Global Network Channel 100 and TuneIn Radio. Stay with us. We’ll be right back.
21:49 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. I’m your host for The Caring Generation on the BBM Global Network Channel 100 and TuneIn Radio. We’re back to continue our conversation with Dr. Aninda B. Acharya. So Dr., how is anosognosia diagnosed?
22:05 Dr. Aninda B. Acharya: Yes. So there’s no one test for it, and that makes it a little bit difficult for people to recognize. It’s really a bedside assessment of the patient’s knowledge of their deficits. And as we talked about, it can be subtle at times, and it may require a long conversation with the patient to see exactly what their insight is into how bad their deficit is and how it might affect performance in doing routine daily activities. So they may go anywhere from not acknowledging the deficit at all or to just minimizing the deficit. And especially in the situation of dementia, one of the first things that people lose is their ability to recognize that they’re having memory deficits, and that’s why it’s oftentimes the family or friends that notice the problems before the patient even notices them. In terms of mental health disease, oftentimes, the aberrant behavior, the patient just doesn’t recognize that that behavior represents symptoms of a disease. And so really, I think that the key is close observation of the patient and asking very pointed questions to figure out what their level of insight is, and I think that’s the best way to diagnose this condition.
23:36 Pamela D. Wilson: So when you say asking pointed questions, give me an example of one question that you would ask?
23:41 Dr. Aninda B. Acharya: So in the emergency room, you might see somebody that has a left-sided paralysis, and so you ask them if they’re able to move the left side, and they say, “sure, I can move my left side,” but you can see clearly that it’s paralyzed. So that’s an extreme example. I think that another example would be where somebody might—they’re spending a lot of money, and they don’t recognize that that’s detrimental to their situation. It might be because of dementia. And so you start asking them questions, and they can come up with all sorts of reasons why they’re making all these strange purchases, and then you realize that they don’t have any insight into the fact that the behavior that they’re displaying is actually abnormal. And so that’s what it comes down to, is developing a relationship with the patient and judging what they’re saying versus what they’re doing and seeing a discrepancy there.
24:52 Pamela D. Wilson: You know, I’ve worked in healthcare for 20 years as a care manager, I’ve been a Power of Attorney, a guardian. Very few physicians talk about anosognosia. Why don’t we talk about this? Why is this not more known?
25:05 Dr. Aninda B. Acharya: I think it should be more recognized, and part of the problem is that it’s not that obvious sometimes. When somebody’s paralyzed, it’s obvious. When they can’t speak, it’s obvious. But when they’re just minimizing their deficits or not aware of their deficits, it may not be quite as obvious. Also, I think it gets confused with denial, a lot of times, people say, “oh well, the patient is just in denial, that’s why they don’t recognize their deficits.” But denial is a specific psychological defense mechanism, where when you start talking about something, they get very stressed, it causes pain, and so then they quickly change the subject to something else. And so that’s different than anosognosia, where there’s actually a problem in the brain in updating one’s self-awareness when they have a disease so that they recognize that they’re having consequences of the disease, so it’s different from denial.
26:13 Pamela D. Wilson: And so, for caregivers who manage care for a spouse or an elderly parent, what should they know about anosognosia and how they should talk to doctors or should they always go to medical appointments, what happens if a parent goes to the emergency room? What do caregivers need to know about this?
26:28 Dr. Aninda B. Acharya: I think it’s really important to talk to the physicians about this. The problem is that if a person doesn’t recognize their limitations, their deficits, that their behavior is not appropriate, then that impairs any kind of remediation process, any kind of treatment that can help alleviate some of these symptoms. And it becomes dangerous when let’s say, they don’t recognize the fact that they have weakness on one side and they try to walk. Then that can lead to falls. And so it’s very important that one recognize the fact that they are not aware of their deficit so that proper safety measures can be put in place. In terms of psychiatric conditions and dementia, it might affect one’s compliance with medications. If you don’t think anything’s wrong, then why would you want to take a medication for it? And so that becomes an issue too. So I think it’s important to recognize this. In the emergency room setting, it becomes very important, because oftentimes, the doctors in the emergency room are trying to get the history from the patient, and if they’re not aware of their deficit, that they may not be able to give an accurate history. So in that situation, it’s really important for the physicians to contact caregivers to really get the true story about what’s going on with the patient.
28:08 Pamela D. Wilson: And earlier you mentioned that you established care team, so for caregivers, if they’re working with various people, who would be the most likely people on that care team for their parent or spouse?
28:23 Dr. Aninda B. Acharya: In the rehabilitation setting, there’s usually a rehabilitation doctor. I’ve always, throughout my practice, have worked in interpersonal multidisciplinary teams, and I think that works best because everyone brings their own insight into that, and it’s important in that situation for the caregiver family member to talk to each of the individual specialists because they have different insights into what’s going on. Often that will include a neurologist or a psychiatrist, or a primary care doctor or a psychologist. There’s no specific treatment for anosognosia. There are some experimental protocols that have been developed, but none of it’s ready for prime time. But I think that doing some cognitive therapy so that the patient can better understand what’s going on with them will help the patient compensate for their deficit.
29:19 Pamela D. Wilson: Doctor, thank you so much for joining us. I think you have put a lot of caregivers minds at rest who’ve been worrying about this for their elderly parents. Listeners invite your friends and family to join us every Wednesday evening for these thought-provoking conversations about caregiving, aging, health care, family relationships, and more. I’m Pamela D. Wilson, your host on The Caring Generation. Live on the BBM Global Network Channel 100 and TuneIn Radio. Stay with me. We’ll be right back.
32:03 Pamela D. Wilson: Is Pamela D. Wilson caregiving expert, author, and speaker consultant. I’m your host on The Caring Generation radio program for caregivers and aging adults, live from the BBM Global Network, Channel 100, and TuneIn Radio. The Caring Generation focuses on the conversation of caring, giving us permission to talk about aging, the challenges of caregiving, health, the patient experience, family relationships, and everything in between.
32:29 Pamela D. Wilson: Let’s return to the idea of taking care of elderly parents. If you are working and caring for elderly parents and thinking about giving up that job, the number third consideration is that your job may be your saving grace. What do I mean by that? A saving grace is a good thing that redeems or saves us from a negative experience. I know many caregivers who say that going to work gives them a break mental and physical from taking care of elderly parents during the day, or even several days a week or several days a month and that getting away makes a significant difference for them. Working and caring for elderly parents also allows caregivers to remain financially independent and have a life outside of taking care of elderly parents. Caregivers tell me that being a caregiver can be an isolating and lonely experience. Having an outlet, even if it’s going to work, can be that saving grace that you need to keep you going.
33:34 Pamela D. Wilson: Let’s talk for a few minutes about money. Social Security benefits and retirement income, related to working and caring for elderly parents. When caregivers think about giving up a job to care for elderly parents, the thinking is usually based on living in the present. Taking care of elderly parents is a marathon; it is not a sprint. Caregiving can go on year after year after year, more years than you can even imagine. The number four consideration is to think about planning for the future. One component of retirement income is Social Security, that’s based on your annual income and the length of time that you work. This length of time is called quarters. As you may know, there four quarters in a year. A person needs 40 quarters of work to be eligible for retirement benefits. That’s 10 years consistently. Other qualifications exist for people who might become physically disabled. Those Social Security credits that you earn also count toward being eligible for Medicare when you reach the age of 65. Not all types of work, though, count toward Social Security benefits and Medicare. Some federal employees, railroad employees, school systems, some people who work for state or local governments may not participate in the Social Security program.
34:58 Pamela D. Wilson: It’s important to know where you stand with earning Social Security quarters before you decide to end work and take care of elderly parents full-time. Because then you’re giving up income, and you’re giving up contributing to Social Security. You don’t want to find yourself in a position where you’re not eligible for Social Security, and you’re not eligible for Medicare. The number five consideration for working and caring for elderly parents is that remaining employed, as we talked about, allows you to contribute to Social Security. But also to save money in a 401K program or some type of other retirement program. A lot of caregivers are shocked that Medicare doesn’t pay for all of the care that elderly parents need. Those costs of taking elderly parents when care services are used, they can be really high. Sticker shock about care costs can leave caregivers to feel that you do have to quit a job to save your parents money, but then what happens to your income? What happens to your savings? That thought of protecting your elderly parents money might be admirable, but you want to consider the long-term effects on your retirement savings, on your ability to re-enter the workforce when caregiving jobs and to get a job. Let’s talk about other struggles that caregivers working and caring for elderly parents face when you choose to remain employed.
36:19 Pamela D. Wilson: Number six is frustration about things you don’t know. I like to paint a picture of an onion. How many of you have peeled an onion back layer after layer? Taking care of elderly parents is like peeling back an onion. One thing happens that reveals another issue and another. It seems like you get one problem under control, and then before you know it, something else happens. Another example could be that home improvement project you thought would be simple. As you start tearing out the walls of the floor, you realize, oh my gosh, there are issues like faulty wiring, insulation, plumbing problems, so many complications for getting that project done that totally increase the time and the budget that you set aside for it. That onion and the home improvement project represent examples of a person’s ability to see the obvious but not to know what’s going on under the surface or behind the scene. In caregiving, this is that idea that you don’t know what you don’t know. Recognizing that knowledge gap can make it challenging, sometimes even scary, for taking care of elderly parents. Many caregivers don’t want to do something wrong or make a mistake that could lead to different problems or complications, but many caregivers are not always sure how to move forward.
37:35 Pamela D. Wilson: As taking care of elderly parents progresses, you might find that more health complications mean spending more time at doctor appointments. If you’re employed, this might mean talking to your supervisor about time off and making up missed time. In situations where uncertainty exists about taking care of elderly parents, watching and waiting is not always the best plan to ensure that an elderly parent or a spouse receives the care they need. The number seven concern about taking care of elderly parents is the idea of coping or not coping. A simple explanation of coping means dealing with all the responsibilities, the problems or difficulties that arise in caregiving in a calm and reasonable manner, that can be difficult. Caregiving problems usually involve managing health concerns, which can be emotional, learning about medical diagnoses and conditions, which can be intimidating, and coordinating care with care providers, also organizing care, working with family members.
38:40 Pamela D. Wilson: Being a caregiver, it’s a lot of work, and it is not without complications. That manual on how to be a caregiver, planning, coordinating care is in my online caregiver course. It’s called Stay at Home Taking Care of Elderly Parents at Home and Beyond. More help for caregivers is also in my book, The Caregiving Trap, and on my website, www.PamelaDWilson.com. Make it easy for elderly parents to listen to this show each week, install your favorite podcast app on mom or dad’s cellphone, and I’ll start the conversations for you. This is Pamela D. Wilson, caregiving speaker consultant on The Caring Generation. Live from the BBM Global Network, Channel 100, and TuneIn Radio. Stay with me. We’ll be right back.
41:46 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, advocate, and speaker consultant on The Caring Generation, live from the BBM Global Network, Channel 100, and TuneIn Radio. If your company isn’t offering caregiver support programs, maybe it’s time to ask your human resources department to support working caregivers. Caregiver education and programs for corporations and groups, including on-site education, online webinars, video conferencing presentations, and creating a workplace where people matter, are on my website at www.PamelaDWilson.com.
42:18 Pamela D. Wilson: Before the break, we were talking about coping. As you work through taking care of elderly parents, do you know what coping style works best for you? Some caregivers work to identify the problem—to put in place solutions to address the concern. Sometimes though, as we discuss that problem, it’s not always obvious. You can’t figure it out. Another coping style for taking care of an elderly parent is emotion-focused. In this coping style, a caregiver works to reduce negative emotions like worry, frustration, fear or anger. Examples of emotion-focused coping might be choosing laughter or humor. I find that always helpful. Embracing prayer or religious activities could be another coping strategy, or even better, finding ways to accept and appreciate the situation, that is, meaning-focused coping, meaning that caregivers are looking for meaning behind that situation.
43:20 Pamela D. Wilson: This internal search could identify why the situation is happening. Taking care of elderly parents may have a more personal sense, like feeling that adult children should care for elderly parents and getting personal meaning and satisfaction from doing that. Social coping is another way to manage work and taking care of elderly parents. It’s partly the idea that we talked about before, that remaining employed while taking care of elderly parents can be that saving grace or that blessing in disguise. Through the activity of going to work every day, a caregiver can reduce stress. Seeking support from colleagues at work can relate to social coping. Exerting mental focus on non-caregiving projects each day while at work, it’s another way to cope because you are mentally distracted from all the things that relate to caregiving.
44:15 Pamela D. Wilson: Other coping methods exist that are not helpful and can make caregiving experiences feel more troublesome. By not taking a problem-solving approach, caregivers can feel more out of control. Feelings of hopelessness or helplessness can grow. Caregiving can harm your mental health and your physical health, that is well proven by all the research. And being disengaged from a care situation, it can place the care and the well-being of your elderly parent at risk, and sometimes you just can’t even see that happening. It’s like you’re very unaware. Holding emotions inside, while some caregivers think that that is a helpful strategy, that can ensure caregiver stress building up and blowing up. At one point, caregivers can become so exhausted and frustrating that you really just want to walk away from a caregiving situation, never to return. Not a good strategy.
45:13 Pamela D. Wilson: Avoidance. It’s another not so good strategy used by caregivers that can result in withdrawal, apathy, just not caring, and a lack of motivation to do anything. It’s the idea of just doing what it takes to barely get through that day without thinking about what’s going to happen tomorrow. Caregivers who have hope, those who are interested in making a plan to resolve the care issues of elderly parents, those people fair the best, no surprise.
45:43 Pamela D. Wilson: The number eight step to improve working and taking care of elderly parents is creating goal-directed behavior. When a caregiver can look at a situation from the outside without being emotionally attached, it can be easier to see which way you should go. Which path forward is going to help you make a goal to care for elderly parents? That activity is like when you set goals at work, or you’re on a work team, and your setting goals and what you want to accomplish. Ask yourself as a caregiver or as a family, what do we want to accomplish for a parent? That we is very important, because to achieve success, you have to, as a caregiver, obtain the agreement of your elderly parent to participate or the cooperation of your brothers and sisters or other family members. It’s not all or shouldn’t all be just you. I know sometimes it is.
46:34 Pamela D. Wilson: That lack of collaborating with other people and consensus building, is one reason that working and caring for elderly parents can feel so stressful or that it can fail, or that you feel like you have to do it alone and there is nobody else there to help you. That’s a worst-case scenario. So what you want to do is put together a care plan that could include focusing attention on parts of the situation that you think are the easiest to change and think about specific actions to do that. So it could be as simple as, how do I get a parent to take medications? Let me get a medication box. Put the pills in. Remind my parent to take them. When you’re interested in solving those problems, it makes it a little bit easier. But some caregiving, health, or relationships can be a little more difficult to learn how to solve if you don’t have a thorough—what we call process of elimination. Which is really a thoughtful way to work through health situations that could be complicated, especially if your parent has a lot of diagnosis. So like we talked with Dr. Ani earlier, you’re seeing that a parent is forgetful, but you don’t know why. So you go to a doctor to eliminate what you know that it isn’t, to try to figure out what it is, which could be in this case, anosognosia.
47:52 Pamela D. Wilson: Complicating factors for working and caring for elderly parents are relating one diagnosis to the next. Medication interactions can happen. One disease can speed along the process of another. It’s kind of like playing chess. Chess is that game of strategy that increases our concentration and our thinking. It’s definitely a game of discipline of focus, and responsibility. So all of these things that help us plan and help us be a little more future-oriented to say, “well, if this happens, what then?” can help us in caregiving situations. So that you don’t always feel so affected by all of these outside circumstances that can happen. A lot of caregivers feel compelled to swoop in and solve the problem. When really your elderly parents should be involved in helping you do that. Caregivers can be too helpful and make elderly parents and spouses more dependent on you for help. You definitely don’t want to do that.
48:47 Pamela D. Wilson: More information about taking care of elderly parents and how I help caregivers and corporations interested in elder care programs and solutions is on my website at www.PamelaDWilson.com. It’s in my online caregiver course called taking care of elderly parents. It’s in my Caring for Aging Parents Caregiving Blog and in all of these radio show podcasts that you can find on my website at www.PamelaDWilson.com.
49:15 Pamela D. Wilson: You can follow me on Facebook, at PamelaDWilsonCaregivingExpert. On Instagram, I am WilsonPamelaD; and on Twitter, I am Caregivingspeak. This is Pamela D. Wilson, caregiving author, expert and speaker, consultant on The Caring Generation. You’re with me live from the BBM Global Network Channel 100 and TuneIn Radio. Invite your elderly parents, your spouse, your family members, people at work to join us every Wednesday night for the show, and if you miss it, remember, you can catch it on my website at www.PamelaDWilson.com. Stay with me. We’ll be right back.
51:10 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, advocate, and speaker consultant. I’m your host, this is The Caring Generation radio program for caregivers and aging adults, live on the BBM Global Network Channel 100 and TuneIn Radio. Share The Caring Generation with your friends, family, co-workers, the companies where you work, your social groups, church everywhere. One in four people you know are caregivers, looking for hope, help, and support, that is here every week on The Caring Generation and on my website 24/7, at www.PamelaDWilson.com.
51:41 Pamela D. Wilson: Next week, we’ll be talking about why families don’t always get along. There are many reasons, as you know. My guest, Spencer Crona, is an elder law attorney who will share information about unexpected situations resulting in families taking care of elderly parents, who sometimes end up in court situations. Part of thinking two or three steps ahead in caregiving is the idea of being proactive. I know I sound like a broken record. Join a caregiving support group in person, online, take a caregiving course, ask your company for caregiver support programs. You have to ask and seek support if you hope to receive it. You don’t have to do all of this caregiving stuff alone unless you really want to be that lone caregiver.
52:25 Pamela D. Wilson: There’s a short podcast on my website, it’s called The Lone Cow. I’ll put a link in here, that talks about the benefits of having an open mind. What is it about having an open and non-judgmental mind that can be so difficult for us? Why do we become so attached to beliefs, habits, and routines or even belongings that we can’t see as detrimental to a solution? Number 10 in the idea of taking care of elderly parents is to avoid giving up. Giving up is a disease of our mind, not really of our body. Our thoughts hold a lot of control over our actions. And as we talked earlier, not coping to manage through taking care of elderly parents, it can result in a lot more problems for us and our parents. By not taking any action to change a caregiving experience, the caregiver can seek deeper into isolation, depression, and problems, and it’s like quicksand. So the deeper you sink, the more difficult it becomes, and the longer you allow it to go on, the more difficult it can be to change that situation or to improve it as a caregiver. Don’t let anything go that far so that you become so burned out that you can’t take action that you just don’t care anymore, and you feel powerless to change.
53:46 Pamela D. Wilson: I talk to a lot of caregivers in these situations. So if you’re in that situation, how do you get going? Believe it or not, the simple act of physical activity and a daily routine is one way to dig yourself out of that quicksand, out of just not caring anymore. It’s physical movement. Move, get up, go for a walk. Walk around your house 100 times—do something. How many elderly parents do nothing but sit all day? How many young and middle-aged adults sit all day at work or in other activities? Give your mind, give your body a boost, go take a walk. If you’re stuck at home, get out, take a shower, take a bath, brush your hair, shave, put a little make-up on. In these days of COVID, so many caregivers are staying at home and not even getting dressed because they know that nobody’s coming by—and a lot of people are working from home. Those little habits won’t help change your hopeless or helpless situation. But if you can get moving, that might be the spark you need to get yourself going. Change your thoughts, change your thinking to avoid giving up on life.
54:54 Pamela D. Wilson: Create a plan, set some goals, do something every day to work forward to that goal, whether it’s taking care of an elderly parent, changing jobs, any personal goal. Don’t give up. You have the power to make that happen. Start today. Ask for the help, the education that you need from your family and the workplace. A thank you to all the caregivers who continue to complete that caregiver stress assessment on my website. It’s at www.PamelaDWilson.com. To find it, you go to the Contact Me button, scroll down to find the Caregiver Survey. When you share your stories and your situations there, it helps me create this radio show for you each week. I also will, on occasion, create a video of the to answer a caregiving question. You are all amazing. Thank you so much. Invite your family and friends to join us every Wednesday night. This is Pamela D. Wilson, Caregiving Expert, Senior Care Advisor, and speaker consultant. God bless all of you caregivers, sleep well tonight, have a fabulous day tomorrow, and a great week until we are here again together.
55:56 Announcer: Tune in each week for The Caring Generation with host, Pamela D. Wilson. Come join the conversation, and see how Pamela can provide solutions and peace of mind for everyone. Here on Pamela D. Wilson’s The Caring Generation.