Caregiver's Resource Guide

NOVEMBER 2013A special supplement to

A GUIDE FOR THOSE WHO

PROVIDE CARE AND SUPPORT TO ELDERLY FAMILY AND LOVED ONES.

NOVEMBER 2013Page 2 CAREGIVER’S RESOURCE GUIDE: An Advertising Supplement to the Ocala StarBanner

When You Become The Parent Of Your Parent Medical advancements have enabled

people to live longer. Though everyone wants to live longer, some people outlive their ability to care for themselves. In such instances, family members must make a decision regarding how best to care for an elderly relative.

According to “Aging in Place in America,” 63 percent of Baby Boomers are actively involved in providing some kind of help or assistance to their elderly parents. Whether this is due to the rising cost of elder care or simply a feeling of obligation on the part of the child, many middle-aged men and women are responsible for caring for aging parents and young children.

The emotions that might result from caring for an aging parent are often mixed. Some people are happy to do their part to help make life a little easier for a person who devoted so much of his or her energy to raising them. Others in the sandwich

generation can feel like this is a burden or guilty that they’re not doing enough for a parent.

Signs an Elder Needs HelpWhen an older relative stops driving, this

is often indicative that he or she needs assistance with daily living. There also may be signs that support and care is needed, such as if the house seems untidy, if he or she is having trouble maintaining personal hygiene, if the parent is getting hurt attempting to do things around the house

or if he or she seems malnourished due to the inability to cook meals. Limited mobility or loss of mental faculties also may be indicative that it is time for a loved one to receive care.

Questions to AskAlthough taking on the care of an aging

parent may seem like the best idea possible, particularly for a senior who is very afraid of losing his or her independence, it may not always be in either party’s best interest. Before anyone determines what will be done to help a relative, it’s best to answer a few questions as straightforwardly as possible.

▶ What type of care does my parent need?▶ How soon into the future is that type of care

bound to change?▶ Can care be handled by someone who comes

into the house, such as a visiting nurse?▶ Will my parent feel comfortable with an

outside person helping with day-to-day care?▶ What are my parent’s limitations?▶ Am I capable of handling this on my own?▶ Can I afford an adequate care facility?▶ What are my local facility options?▶ Will this type of care affect my own personal

well-being?▶ Can I handle this emotionally and physically?

Any person facing the prospect of caring for an aging parent can realize that there is help available, as well as many different people who can help guide a decision. The first resource is to ask siblings, aunts, uncles, and cousins to weigh in on the situation to help the family come to a consensus.

Caring for a loved one who can no longer care for themselves is something that many Baby Boomers are facing on a daily basis. Although it may be a touchy subject, it is worth exploring what you will do before the situation becomes urgent. h

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NOVEMBER 2013 Page 3CAREGIVER’S RESOURCE GUIDE: An Advertising Supplement to the Ocala StarBanner

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How do we view our role in taking care of our parents? Are we willing to help

them out financially? What about having them move in with us? And, what are our expectations for our own children when we need help?

A survey this past June, asked 751 adults age 18+ with at least one living parent or guardian.

The two most unsettling statistics: 1. 45% say their parents have

made no plans when they can no longer live independently

2. 26% have no clue what plans their parents have for latter life

Here are other insightful findings:78% of men and women with both

parents living say they will make a financial sacrifice to help with eldercare because it’s

the right thing to do, yet if there is only one living parent, just 69% feel that way

75% of all ages say they will make financial sacrifices to help Mom and Dad

81% agree to support their parents physically, emotionally and financially as they have done for us

Women are more willing to cut back on their day-to-day lifestyle, while men are more likely to tap their retirement savings or the value of their home

Twenty-one percent, evenly split between the genders, are unwilling to give up those or other options, including big-ticket items (vacations, cars, electronics) or their child’s education fund

Women age 55-plus are four times more worried than their male counterparts about some day having to chip in and help a parent pay his or her bills. What’s more, they’re less likely, they say, to be able to

help (37% women vs. 56% men)

And more: Among ethnic groups, 71% of Asians

agree that their kids should provide money if necessary (13% don’t), African Americans are split on a the issue, 43% of whites agree and 37% disagree, and 45% of Hispanics agree vs. 35% who disagree

63% think if you have enough room, your parent should move in with you. The biggest reason is “duty” (46%), while “love” just rated 26%.

According to the study, males ages 18-29 are nearly twice as likely as their counterpart females to live with their mothers, and men age 55-plus are six times more likely as females to live with Mom. Women ages 40-54 are twice as likely as guys the same age to have Dad move in.

Alert: Women say they want less emotional, physical and financial help from their kids than men. That breaks down as 61% of women and 67% of men think their kids should help care for them; 57% of men vs. 49% of women believe their kids should let them live with them.

The takeaway: Find out what your parents have in mind should/when they become dependent. If the answer is, “I haven’t thought about it” or “we’ll cross that bridge. . .” you’re all set to segue into a meaningful conversation.

Baby boomers, the same goes for you and your children. The key word is “expectations.” h

What Are We Willing to Do for Mom and Dad?

Article by Sally Abrahms, Specializing in Boomers and Aging with a Focus on Caregiving and Housing


The typical healthcare patient has changed in

recent years. No longer are individuals putting all of their healthcare decisions into the hands of nurses and doctors. Patients are more informed than ever before and are interested in taking a more active role in their own care.Thanks to the Internet,

people are able to access information that, in the past, was not easily available. A few decades ago, medical data may have been elusive and filled with confusing jargon the layperson might not have understood without a crash course in biology. However, today there are different Web sites that clearly spell out information about certain illnesses and diseases. This means that patients may no longer be walking blindly into appointments with doctors. Facing an illness is never

easy, and the decision-making abilities could be hampered by emotions and the desire to improve as quickly as possible. Patients who do not have all of the facts may have to rely solely on the expertise of caregivers and physicians when making important healthcare decisions. By knowing the avenues of information, a patient can find assistance with careful decision-making. While learning about an

ailment is important, there are some things to consider.

The internet isn’t foolproof.

Many online medical sites are very reliable and offer a wealth of pertinent information. They can be good starting points when seeking out information on a particular condition. It is in your best interest to visit sites that are well-known and monitored by respected medical affiliations. Other sites may be peppered with exaggerated claims or misinformation. Therefore, do not go by online

information alone.

Don’t self-diagnose.It can be easy to use the

Internet as a means to narrowing down symptoms and making assumptions about what ailments you may have. Instead of using the Internet to self-diagnose your condition, leave the diagnosis up to your doctor and rely on online information after you are diagnosed. This can improve your understanding of the condition and any potential treatment options.

Seek other avenues of information.

You should never hesitate to seek a second opinion or go to a published medical journal to find out more about a condition. You have rights as a patient to be comfortable with the advice doctors give and be as involved in your treatment as you want to be.

Online forums could be more harm

than help. Many people turn to

online forums and blogs to gain more insight into particular diseases. While these forums may be good sources of support, information published on these sites could be misleading, inaccurate or unsafe. Before trying any proposed treatment, it is best to consult with your doctor.Having a general

knowledge of a medical condition can enable healthcare consumers to make more informed decisions about their situations. h

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Start with a candid conversation.Talk with your parents about how

you will be helping them to meet their needs. Unless they are severely incapacitated, they should continue to make their own decisions and remain a central part of all discussions about their care. Encourage them to articulate their concerns: Most likely, your parents are worried about becoming a burden and losing control of their lives. Have an open conversation about what role your parents want you to play. Establish limits so they don’t form unrealistic expectations.

Set your priorities.Make a list of what needs to get done and how you plan to do it. An

organized approach puts you in control, reduces stress and ensures that your parents get the assistance they need. Be sure to create backup plans, and ask others to serve as reinforcements if necessary. Write down your plans and schedules, and give a copy to all involved family members. Consider using an online scheduling tool such as Lotsa Helping Hands to organize and keep track of who’s doing what, when.

Build a support network.In most families, one person assumes the role of primary

caregiver. But that doesn’t let others off the hook. Enlist the help of your siblings, of course, but also consider that cousins, nieces and nephews may be eager to help. Don’t forget to include your friends, distant relatives, neighbors and acquaintances, such as members of your parents’ civic or religious groups. Not all of these folks will volunteer to help, but many will get involved if you ask. Some, in fact, may feel hurt or left out if you don’t seek their assistance.

Don’t be afraid to delegate.Ask a friend to pick up groceries or

get books from the library, a neighbor’s child to adopt your parent as a grandparent,

or a local teenager to help with yard work for a manageable fee. Investigate whether a civic group can provide free home repair or transportation services. Ask the newspaper carrier, a barber or an apartment superintendent to keep an eye out for your parents and to call you if anything seems wrong.

Offer alternatives.With family members, don’t accept excuses for not helping without

offering alternatives. A sibling who lives far away, for example, can help with paying bills, contacting doctors’ offices or seeking support from local agencies. Siblings whohave young children can cook meals or bring kids along for visits and outings.

Hold family meetings.Schedule them regularly, and bring in distant family by phone. Choose

a neutral party to moderate if necessary. Draw up a clear agenda for each meeting, and agree on rules of conduct — for instance, don’t interrupt, stick to time limits, avoid argument and focus the discussion on how to care for your parents. If meetings

tend to be contentious, consider hiring a geriatric care manager to run the meeting.

Involve your children.When you have parents and children who need your time and

attention, you may feel pulled from both sides. Be honest with your children about the situation, and listen to their concerns. Encourage their questions, and answer them thoroughly. Carve out time for fun activities, and request your children’s help. Teenagers can drive Grandma to the store, and even a toddler can make her feel loved.

Talk to your spouse.Have a discussion with your partner about your caregiving

responsibilities.What role do you expect him or her to play? Suggest specific ways your spouse can help, and show appreciation for his or her efforts. Recognize that your responsibilities affect your spouse, and encourage him or her to talk about any frustrations. Your relationship is a priority — keep it that way. h

8 Rules for New Caregivers Determine housing options and preferences: With your parents, discuss whether they want to continue to care for their home or whether they have considered living elsewhere. Depending on their health and well-being, they can either stay in their home with some changes and additional help or consider other options such as an assisted living residence or a continuing care retirement community.

Research helpful services: Consider home care, adult day services, meal delivery and help with everyday activities such as preparing meals and doing laundry.

Learn medical history: Ask your parents about any medical conditions or health problems and get a list of their doctors and medications. If your parents are unclear about the details, ask if you can go with them on their next visit to the doctor.

Assemble contact list: Gather names and contact information for those in your parents’ personal support system. This should include close relatives and friends, neighbors, friends from their place of worship, clergy, housing managers or apartment front-desk staff, and even the local pharmacist.

Create a financial profile: While this information may be difficult to obtain, it is critical to have. Make a list of income sources such as Social Security and pensions, monthly and yearly income and expenses, bank accounts and investments, and a statement of net worth.

Review legal needs: Work with your parents to determine what relevant legal documents they have or want to have (wills, advance directives such as living wills, health care proxy forms, trusts and powers of attorney). Locate important documents, including their birth certificates, deed to home and insurance policies, and find out if they are up to date and express their current wishes.

Make a list of important accounts: Include Social Security numbers, bank accounts, credit cards, health and life insurance policies, and driver’s licenses.

Your To-Do List


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Moving Out of the Family Home: What to ExpectMoving out of a home —

regardless of where to — can be an incredibly emotional journey. This is especially true for those moving out of the family home after many years and in with their children, into a smaller place or to a care facility. Many see it as an end rather than a beginning and emotions can run high. What you, the caregiver, may not expect, though, is your own emotional reaction to the change — even though it’s not you who is moving. Be prepared emotionally for what to expect, both from your loved one and yourself.

UNANTICIPATED EMOTIONSDuring the flurry of activity leading

up to a move — finding a new residence, packing, and paring down —expect your loved one to experience emotional highs and lows. While they may show excitement as you tour potential new residences and shop for necessities for the new space, they will likely also have times of deep sadness while they recall the fond memories that fill their old residence.

Moving out of the family home is a big change on many levels. First, it’s a huge disruption, for a time, to daily routines and a major transition into new surroundings. For an older adult, these disruptions and transitions take much longer to adapt to than for the younger set. Secondly, a move at this stage of life may trigger concerns about loss of independence and what lies ahead. Losing any kind of independence is hard for those of us who have lived an independent life. So, it’s important to be sensitive to these moments with your loved one. Help them through the process simply by taking the time to listen and be empathetic.

PARING DOWN AND PACKING UPDuring the downsizing process and

subsequent packing phase of the move, memories will be triggered when old keepsakes and treasures are unearthed and heirlooms are passed on to family members. Activities like paging through a yearbook, reorganizing photos, sorting jewelry and finding old love letters can drum up old feelings and stories, which should not be rushed through. Allow plenty of time for packing so your loved one has ample opportunity to reminisce and pass on any family history to you.

LEAVING THE FAMILY HOME BEHIND

As the move nears, expect emotions to become heightened. With only days left in their home, your loved one may break down at the thought of leaving. While you will most likely be feeling the stress of all that needs to be taken care of, remember to comfort them. Check in with them often to see how they’re doing. Talking may be hard for those families who don’t communicate emotions with ease, but it’s necessary. Simply asking, “How are you holding up?” can provide a world of comfort to a parent or loved one leaving the home they’ve known for some time. It will let them know you’re in their corner and understand that this can’t be an easy situation for them.

Trivializing your loved one’s emotions is one of the worst things to do in this situation. With their entire world in upheaval, making them feel as though they’re overreacting can upset them even more. While you may not know exactly what they’re going through, try to put yourself in their shoes despite any chaos that may be going on around you.

On moving day it might be best to plan an outing for your loved one — lunch, a trip to the mall, a visit with friends — so they can avoid the trauma

of seeing their possessions moved out of their beloved home. This will mean, of course, that managing the move is up to you and any help you can gather. It may be worth it if it means that your loved one will feel a sense of normalcy during such a tumultuous time.

MOVING INAfter all the boxes are unloaded and

the furniture is in place, expect it to take a while before your loved one feels settled. Arranging their new space similarly to their former home will aid in the transition. A nice gesture to welcome them into their new space would be to stock their fridge with favorites or bring in their favorite takeout for dinner their first night there. Over time, they should ease back into their old routines and begin to see the advantages of their new home. Just be patient with them as they find their footing.

FOR THE CAREGIVERYou might be surprised and taken

aback by the emotions you experience when moving your parent or loved one out of the home — especially if you’ve shared that home with them in the past. Many caregivers get so caught up in what needs to be done for a move that they don’t take into account the emotional implications the move will have on them. Expect to be bombarded by fond — or not so fond — memories that deserve attention. Watching your loved one go through their emotional process around the move may also affect you greatly. Indulge in these emotions rather than holding them in. They are important and need to be expressed — whether in privacy or with your loved ones — in order to be the strong support system your loved one will need throughout the move process. h

AARP


The worried 60-year-old woman tells a familiar story: “My 84-year-old father

was always the boss at work and home and is used to being in charge,” she says. “Now, even though his mind and body don’t work so well, he still won’t listen to me or allow me to do anything for him.”

She is anxious to convince him to receive her loving care.

Many adult children tiptoe lightly around their parents’ dignity and right to lead their own lives. They hover on the sidelines until one of two things happens: Mom and Dad have the dawning realization they are getting older and could benefit from help; or there’s a sudden event — for example, a broken hip due to a fall or car accident — that makes aid necessary without further debate.

All daughters and sons pray for the first. When the second scenario occurs, many of them feel guilty that they didn’t press their parents to accept assistance earlier.

In the last two years, the 60-year-old daughter has pressed hard. Her stubborn father has pushed back harder, though. “When I tried to hire someone to cut his grass to keep him from suffering heatstroke, he was furious at me for trying to take away his pride in tidying his own yard,” she says. “When I offered to drive him to the doctor’s office because he doesn’t see well anymore, he refused, saying he doesn’t need me.”

They are at a standoff.

Out of a sense of urgency about his deteriorating capabilities, she makes increasingly frequent attempts to help him. Just as often, he squares his jaw and blocks her as if she — and not age — is the enemy.

These power struggles are frustrating and harm the quality of their parent-child relationship. Here are several strategies

the daughter could try to ensure her father’s safety, but also appeal to his pride.

Empowerment She can stress that receiving help can be

empowering, not disempowering, for an aging parent: It is crucial for the daughter to show her father that she is his ally, not adversary, and that she fully supports his desire to live independently as long as he can. But she should also raise the prospect with him that accepting some help would allow him to do more of what he wants and maintain his self-sufficiency.

If he would receive help with mowing his lawn, then he would conserve energy he could then use for trimming hedges, whacking weeds or pursuing some other goal of importance to him. With the boost of helping hands, we all achieve more and go further. We become more, not less.

Enablers of GrowthEmphasize the giving that is inherent in

receiving: Many adult children who take care of their parents mature personally and spiritually from the experience. When aging parents allow their daughters and sons to be their caregivers, they are intentionally giving them that opportunity to learn and grow.

In contrast, aging parents who protest that they don’t want to be a burden to their kids and therefore refuse to allow them to be helpful actually deprive their

children of this growth experience. In my opinion, they are taking an independent stance at their children’s expense.

The aforementioned daughter can make this point to her father by explaining how much it would mean to her if he would give her the chance to assist him. She could also remind him that he helped take care of his own parents when he was her age and, afterward, always felt pride in having done the right thing.

Role Model ReminderReceiving care graciously is equivalent

to getting old gracefully: As youngsters, adult children learned from observing their parents about how to prepare for and handle the challenges of the prime

of life. As middle-agers, they learn from observing their parents about preparing for and handling the many losses at the end of life.

The daughter should make explicit to her father that her eyes are still upon him. If he can display calm acceptance and resolve in receiving care, it would provide her with a model of graciousness in the face of physical and cognitive decline.

If he persists in practicing denial and refusal, the lesson she’ll learn is that old age is to be bitterly fought, rather than adapted to and embraced. His choice of grace would make a positive difference in her old age. h

When Aging Parents Won’t Receive Help Graciously by Barry J. Jacobs, PsyD., AARP, July 2, 2013

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The Healing Power of Negative Emotions For caregivers, ‘let it all hang out’ can be a therapeutic prescription

After his wife’s cardiac arrest, the 70-year-old man carefully avoided saying anything negative. He feared

upsetting her — and thereby inviting another heart attack.

Nor did his wife express her worries — her frustration, her sadness — for fear of upsetting him.

Through this mutually protective collusion, the pair accentuated the positive so avidly that their rapport became superficial and stilted. Like so many caregivers and care recipients, the couple subscribed to “the power of positive thinking.” What they missed out on was the healing power of sadness.

And that’s understandable: The best way to sustain each other’s morale through this medical crisis, they believed, was to cheer each other on. To accomplish that, the man and woman gave voice to almost exclusively upbeat thoughts and feelings. Venting negative emotions, in their view, could only harm their health, their psyches and possibly their relationship. But that needn’t be the only way, and it’s very likely not the best way.

Sharing what you’ve lost in the wake of a chronic illness or medical event, sometimes disparaged as “stinking thinking,” can actually bring couples and families closer together.

Like others struggling to cope with adversity, the couple profiled above is engaging in what psychologists call a conspiracy of silence. Perfectly normal fears and other emotions churned up by a life-changing condition — the wife’s fear of a second heart attack, the husband’s frustration at his wife’s slow recovery — are pooh-poohed or squelched.

Optimism counts; its effects are far more salutary than wallowing in misery. But when well-meaning family members start censoring what they say to one another, they stop sharing the full range of life’s joys and sorrows. The result: unintended distancing and isolation.

To make that point, I frequently ask couples, “Did you argue, or complain to one another, before this medical event occurred?”

“Of course,” comes the response.

I then ask, “Has this crisis made you less open with one another? Do you confide in each other less now than you did before?”

The reply to that is usually just an uncomfortable shrug.

A better way to bolster family cohesion and resilience

in situations like these is to balance — or try to balance — the positive and the negative: Keep hope and good humor alive, yes, but at the same time feel free to voice your doubts, disappointments and anxieties.

How can caregiving families put the (seemingly) negative to positive use? Here are three ways:

1. Put worries into wordsThroughout the caregiving years, all family members

worry to some degree or another. It’s a natural response to uncertainty; it’s also a proven means of preparing for the challenges ahead. When family members hesitate to speak up, however, they often start to internalize their angst. If only they would voice their concerns! Doing so enables relatives to gauge (and possibly correct) each other’s unrealistic anxieties, thereby gaining reassurance. In short, sharing worries can activate a family’s comfort and support systems.

2. Announce annoyancesThe irks and quirks of everyday living — finding dirty

dishes in the sink, for example, or missing another’s cue that he or she needs attention — don’t come to a halt with the onset of an illness. Instead, they multiply. Caregivers don’t want to compound the suffering of the afflicted, obviously, so they often keep their grievances

to themselves. Yet this robs family interactions of mutuality — the notion that loved ones have expectations of (and are committed to caring for) each other. Caregivers who refuse to say what’s bothering them may eventually brim over with resentment — a sure sign of impending burnout.

The healthier alternative? Caregivers should calmly and constructively express their annoyance to care recipients; just because someone is sick doesn’t mean they stop being a fully fledged member of the family. This is a better way to air and settle gripes, because it largely restores the give-and-take of family life before the illness. Caregivers who vent don’t resent.

3. Don’t suppress sadnessIf there’s one negative emotion that family caregivers

and care recipients seem to avoid the most, it’s sadness. Some people fret it’s the first step on the path to depression. Others tamp it down because they’re afraid it will be seen as a sign of defeat or resignation.

But as anyone who has ever attended a moving funeral service knows, expressing sadness can bring family members closer. Discussing their losses — both actual and anticipated — can bond caregivers and care recipients, giving each a sense that they will face whatever comes together. What’s left said, not unsaid, is the real silver lining of this dark cloud. h

by Barry J. Jacobs, PsyD., AARP, September, 2013


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OUR MISSION: “TO SERVE OUR RESIDENTS, THEIRFAMILIES AND OUR STAFF WITH COMPASSION FIRST.”

-CAMELOT CHATEAU

Camelot Chateau Assisted Living1831 SE Lake Weir Avenue | Ocala, 34471

Phone: (352) 629-6077 • www.camelotchateau.com • AL# 5429

Tax Tips for Family Caregivers

If you’re paying all or part of the cost of caring for a parent or another relative, you may qualify for some federal tax breaks. And who couldn’t use the extra money?

As the tax season approaches, here are six ways family caregivers can save money on their taxes.

1. How does a relative qualify to become a dependent on your tax return?

Relatives are eligible to become a dependent on a caregiver’s tax return if they earned less than $3,900 a year in 2013, excluding nontaxable Social Security and disability payments, and if the caregiver provided more than 50 percent of the relative’s support. If that criteria is met, caregivers can take a $3,800 tax exemption for each dependent. By the way, your relative doesn’t have to live in your home to be considered your dependent.

2. When can a caregiver claim a tax benefit for a dependent’s medical costs?

If you claim a relative (a parent, spouse, step-parent, grandparent, sister, cousin, aunt or in-law, for example) as your dependent, you can claim medical deductions if you’re providing more than 50 percent of their support and if these costs represented more than 7.5 percent of your adjusted gross income in 2012. You must meet the threshold on both counts. That 7.5 percent threshold rises to 10 percent in 2013 for caregivers under the age of 65. It will remain at 7.5 percent this year for those over 65.

3. Are caregiver tax deductions limited to just relatives?

No. Non-relatives could also qualify but only if they are part of the caregiver’s household for the entire tax year.

4. What other kinds of dependent expenses are deductible?

The cost for food, housing, medical care, clothing, transportation and even bathroom modifications all qualify for tax deductions. The IRS allows caregivers to deduct the costs not covered by a health care plan for a relative’s hospitalization or for out-of-pocket costs for prescription drugs, dental care, copays, deductibles, ambulances, bandages, eyeglasses and certain long-term care services. Keep all your records to prove these expenses in the event of a tax audit.

5. What happens when more than one sibling wants to take the parent as a dependent on their tax form?

You can file a multiple support agreement on form 2120 with your tax return if more than one sibling is sharing the cost of the parent’s upkeep. As an alternative, experts say, you may want to consider creating a written agreement with your sibling that would allow each of you to take the dependent deduction every other year.

6. Can caregivers use their flexible spending accounts to pay for a relative’s eligible medical expenses?

Yes, a caregiver’s tax-free flex account may be used to cover expenses for both dependent and independent relatives — as long as you’re responsible for at least 50 percent of their support. The FSA is a tax-advantaged account that allows an employee to set aside a portion of earnings to pay for qualified medical expenses. A $2,500 federal cap was put into place for 2013.

As more boomers take on caregiving responsibilities for their aging relatives, it’s important to understand the tax ramifications — and benefits — of their financial support. h

by Judi Hasson, AARP


Self-Care Key To Fighting Off Compassion Fatigue This compassion fatigue test

will help measure if you’re suffering from caregiver burnout. Compassion fatigue is a form of burnout where caregivers continue to give themselves fully to the person they are caring for, finding it difficult to maintain a healthy balance of being able to separate themselves from the patient (empathy and objectivity).

Answering “yes” or “no” to the following nine statements will help you assess your risk for compassion fatigue.

1 ) Personal concerns commonly intrude on my caregiving role.

2 ) Family members, friends, other caregivers seem to lack understanding.

3 ) I find even small changes enormously draining.

4 ) I can’t seem to recover quickly after association with daily trauma or a troubling event.

5 ) Association with any type of traumatic or troubling event affects me very deeply.

6 ) My patients’ stress (the person you care for) affects me deeply.

7 ) I have lost my sense of hopefulness.

8 ) I feel vulnerable all the time.

9 ) I feel overwhelmed by unfinished personal business.

Answering “yes” to four or more questions may indicate that you’re suffering from compassion fatigue. Remember, this is NOT a diagnosis. Only a doctor or qualified mental health professional can make a diagnosis and recommend treatments.

While a career in nursing can be both rewarding and fulfilling, it also comes

with its fair share of stress, particularly for nurses who work with patients suffering from acute chronic diseases, severe injuries or terminal illnesses. Among the most significant challenges for nurses and other caregivers is to provide personalized care without becoming overinvolved with or overly invested in their patients. However, when nurses work with people who have experienced extreme trauma or are facing

their final days, the stress can become exhausting and overwhelming.

“Compassion fatigue” is the term used to describe a range of symptoms that can arise when caregivers are traumatized as a result of helping others who are in physical or emotional distress. Nurses suffering from compassion fatigue display a range of psychological and physical symptoms, including irritability, anxiety, disrupted sleep, loss of self-esteem, changes in sexual desire, and an inability to stop thinking about work. In some cases, nurses lose empathy for

patients, have trouble connecting with them or begin to avoid particular patients. Compassion fatigue can cause nurses to

feel guilty about their treatment of patients, become dissatisfied with their jobs and

become addicted to alcohol, drugs or food.

Compassion fatigue not only affects nurses’ physical and

emotional states, but it can also jeopardize patient safety, cause

patients to receive substandard care and have a negative financial impact on medical institutions. Studies have

shown that compassion fatigue is linked to

decreased productivity, higher rates of

absenteeism and

increased turnover among nurses, all of which are costly and difficult to remedy.

Developing and implementing positive self-care strategies are critical for a person to both preventing and recovering from compassion fatigue. These strategies fall into three main categories.

Awareness and Education: Since compassion fatigue was not formally identified as a special problem for nurses until the early 1990s, some nurses may not have an adequate understanding of its roots, symptoms or management. Supervisors need to ensure that nurses are educated about the issue and can recognize the symptoms in themselves and others.

Relaxation and stress management: Nurses need to be encouraged to monitor their self-care and take steps to manage stress both on and off the job. Self-care begins with a commitment to having an adequate diet, staying hydrated, sleeping, and exercising and can be supplemented with stress-reducing activities, such as yoga, meditation, massage or tai chi. Some nursing units have even designated a comfortable space for relaxation, where nurses can close their eyes, meditate, stretch or listen to music or relaxation CDs.

Talking and sharing: Nurses -- particularly those who work with critically or terminally ill individuals -- need opportunities to talk about their experiences with colleagues and supervisors. Sharing stories and receiving support from coworkers is among the most effective ways for caregivers to relieve the stress associated with their jobs. And the more they can talk, the better. Research has found that people involved in traumatic events need to be able to tell their stories a minimum of eight times to counteract the physical and psychological impact of their experience. h AARP

Compassion Fatigue Test


Alzheimer’s Associationwww.alz.org800-272-3900Information and support for people with Alzheimer’s disease and their caregivers. Operates a 24/7 helpline and care navigator tools.

Alzheimer’s & Dementia Alliance for Education & Supportwww.adaesinc.org352-671-9600ADAES, Inc. is a non-profit corporation providing comprehensive education for caregivers and professionals on a variety of relevant subjects; communication, behaviors, activities, wandering, safety and others.

Alzheimers.govwww.alzheimers.govThe government’s free information resource about Alzheimer’s disease and related dementias.

ARCH Respite Networkwww.archrespite.orgFind programs and services that allow caregivers to get a break from caring for a loved one.

Eldercare Locatorwww.eldercare.gov800-677-1116Connects caregivers to local services and resources for older adults and adults with disabilities across the United States.

Family Caregiver Alliancewww.caregiver.org 800-445-8106Information, education and services for family caregivers, including the Family Care Navigator, a state-by-state list of services and assistance.

Florida Department of Elder Affairswww.elderaffairs.org 800-96-ELDERThe Department offers caregiver assistance services through various programs. You may call the Elder

Helpline to find out if you or your loved ones are eligible to receive benefits and services from one or more of our programs.

Medicarewww.medicare.gov/caregivers800-MedicareProvides information about the parts of Medicare, what’s new and how to find Medicare plans, facilities or providers.

National Alliance for Caregivingwww.caregivingnetwork.orgA coalition of national organizations focused on family caregiving issues.

National Family Caregivers Associationwww.caregiveraction.orgInformation and education for family caregivers; includes the Caregiver Community Action Network, a volunteer support network in over 40 states.

The National Clearinghouse for Long-term Care Informationwww.longtermcare.govInformation and tools to plan for future long-term care needs.

Social Security Administrationwww.socialsecurity.gov800-772-1213Information on retirement and disability benefits, including how to sign up.

State Health Insurance Assistance Programwww.shiptalk.orgA program that offers one-on-one insurance counseling and assistance to people with Medicare and their families.

Veterans Administrationwww.caregiver.va.gov855-260-3274Support and services for families caring for veterans. Maintains a VA caregiver support line.

12 Resources Every Caregiver Should Know AARP

When anyone faces an advancingillness, everyone in the family is affected- particularly the primary caregiver.Being a caregiver takes a toll, bothphysically and emotionally. That’s whereTransitions, a program offered at nocharge, can be a helping hand, anotherset of watchful eyes and a valuableresource for community contacts.

Transitions is a professionallymanaged volunteer-based supportsystem that includes:

• Care management andphone support

• Companionship• Transportation• Help with errands• Telemonitoring in the home(physician-referred)

Our team works closely with MarionCounty physicians. They know we are anadditional resource in the care of theirpatients. Ask your doctor about contactingus for services or learn more aboutTransitions at www.hospiceofmarion.com/transitions.html, where you can take ourconfidential self-assessment quiz to findout if Transitions is right for you, or call(352) 854-5200.

TRANSITIONS: CARE FOR THE CAREGIVER

Hospice of Marion County3231 SW 34th Avenue | Ocala, FL 34474

Phone: (352) 873-7400 • hospiceofmarion.com


MostPreferredHospital.BestQuality. BestDoctors. BestNurses. Best Image.

11years ina row!

MarionCounty’s ConsumerChoice.Again.

For 2013-14 alone, Munroe Regional has received more than 50 recognitions from the industry’s experts for quality,excellence, patient safety and many more.at’s more recognitions than any other hospital in North Central Florida. Butfor the 11th year in a row, the most important recognition we’ve received comes from you—the people of Marion County.We are proud to receive the Consumer Choice Award as Marion County’sMost Preferred Hospital for the 11th year in a row.

But there is more to it. For 115 years, Munroe Regional has beenMarion County’s hospital.We were the fourth hospitalcreated in the state, and we’re consistently rated as one of the best community hospitals in the country. Every day, more than3,000 doctors, nurses and other healthcare professionals, along with 1,700 volunteers, go to work with one thing in mind:to be the best hospital, with the best care, for the people who matter most: our friends and neighbors in Marion County.Because being namedMarion County’sMost Preferred Hospital 11 years in a row isn’t just an honor. It’s a responsibility.

Always has been. Always will be.

Learnmore about theConsumerChoiceAward atMunroeRegional.com/accolades.

OCALA, FL

www.MunroeRegional.com

It’s not just anhonor. It’s a responsibility.

Documents

Caregiver's Resource Guide