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“It’s My Duty, Isn’t It?”: The Rewards and Challenges of Caring for a Parent at Home | Cityview Magazine


As our parents and loved ones age and grow older, they are often no longer able to care for themselves or live alone. As the day approaches when additional care is needed, there are many difficult decisions to be made. Depending on a senior’s relative health and fitness, there are a number of different levels of care available, ranging from occasional visitation to full-time care. But in this difficult economy, many Americans are choosing to bring their parents home. | By Sarah H. Clark
November is National Family Caregivers Month

President Obama released a presidential proclamation in 2011 recognizing those people who serve as caregivers for their loved ones. The proclamation began, “Across our country, millions of family members, neighbors, and friends provide care and support for their loved ones during times of need. With profound compassion and selflessness, these caregivers sustain American men, women, and children at their most vulnerable moments, and through their devoted acts, they exemplify the best of the American spirit. During National Family Caregivers Month, we pay tribute to the individuals throughout America who ensure the health and well-being of their relatives and loved ones.”

The president gave special recognition to caregivers who assist their parents and other seniors, writing, “Many of our Nation’s family caregivers assist seniors and people with disabilities to help improve their quality of life. Their efforts help deliver short term comfort and security, facilitate social engagement, and help individuals stay in their homes and communities as long as possible. This heroic work is often done while caregivers balance other commitments to their families, jobs, and communities. As these remarkable individuals put their own lives on hold to tend to their family members, it is our responsibility to ensure they do not have to do it alone.”

In November 2012, the nation will once again recognize family caregivers and the sacrifices that they make to care for senior citizens and other family members.

Speaking from Personal Experience

In honor of National Family Caregivers Month, Cityview spoke with a local family that has had reason to be grateful for the support of both a family caregiver and a home healthcare service. About three years ago, Robby† was ill with pneumonia and had to be hospitalized. Prior to the incident, she had been living alone, but her illness weakened her so much that it was impossible for her to go back home after being released from the hospital. Instead, she moved in with her daughter JoAne† and her family.

“I had to come down here—I didn’t have anywhere else to go—and they wanted me to stay with them. They’ve taken care of me for nearly three years now,” says Robby of her daughter’s family. JoAne asserts that caring for her mother is “not too hard.” Though Robby is weak enough that she cannot walk or move on her own, their hospice service has provided a wheelchair and the oxygen that she needs for her weak lungs.

In addition to being cared for by her daughter, Robby has a caregiver from Smoky Mountain Home Health and Hospice (SMHHH), Nina Carter. “Nina comes three times a week and gives her a bath, and that really helps me. The nurse is also here three times a week to check on her, and I can call anytime and a nurse is always on duty if I need anything—they’re always here before long to help Mama, whatever the problem is,” says JoAne. When the nurse or caregiver is there, she can also take the time to go grocery shopping or run other errands, confident that Robby is still being well cared for at home.

Carter herself is nearly 60 years old and has been caring for elderly people since she was in her 20s. “I helped to take care of my grandmother,” she says. “She was bedridden for nearly 20 years when I was young.” After that experience, Carter never stopped caring for senior citizens. She has been with SMHHH for 13 years, and she hopes to continue working there until she has to be cared for herself.

Hospice care has been a wonderful resource for JoAne and Robby’s family. “I’d recommend that anyone with an elderly parent use this service,” says JoAne.

Adjusting to Having a Caregiver

Though JoAne and Robby know and trust Carter to care for Robby as she would for her own parent, for many people it is difficult to adjust to having a stranger in the house—particularly for seniors who live alone while receiving home healthcare. “It’s a normal thing for people to be worried. Especially if someone is going to come to your house and, for example, take your clothes off to help you bathe,” says Carter.

So on her first visit to a new client, Carter always takes things slowly. “I let them know that they are the ones who are making decisions about how much help they want or need,” she says. There’s never any pressure to adjust to having a caregiver, but rather she makes every effort she can to make them feel comfortable with her. As she develops a relationship with her clients, they adjust to having her help them with their basic needs.

Carter also emphasizes that even though patients are often referred to her company by their doctors, families always have a choice of what home health agency to work with. “Sometimes people don’t know that they can make a personal choice,” she says. “We always make sure that they’re aware of that.” Making that choice is another way that seniors and families can feel safe and comfortable with adding a professional caregiver to their lives.

Caring for Caregivers

Sometimes, a family caregiver simply needs a break. Caring for others, and the elderly in particular, can be a valuable, affirming experience, but caregivers can often become tired or even frustrated if they do not take appropriate time for themselves. At other times, a caregiver needs to travel for business or to visit other family members, requiring them to leave behind a senior whose health does not allow them to travel. If no one is able to stay at home with the senior, respite care can often be a good solution.

Respite care is an option that is not as widely known as some other services for seniors. It allows a caregiver to leave a senior at an assisted living or nursing home facility for a few days at a time. There are some requirements that must be taken care of ahead of time, such as getting the senior checked by a doctor and filling out paperwork, but after these requirements are fulfilled, the process is relatively easy. The typical stay in respite care is about five days, and there are several facilities in Knoxville that offer this service.

Understanding Hospice

Hospice is a form of palliative care that focuses on caring for patients who have a life expectancy of six months or less. Hospice care does not involve any acute or aggressive curative care, but rather concentrates on treating a dying patient’s symptoms and making him or her as comfortable as possible in the last few weeks or months of life.

The modern-day hospice care movement was started by Cicely Sanders, a British RN, who was inspired to provide palliative care for the dying through her volunteer work at St. Luke’s Home for the Dying Poor. In 1963, she began a tour of the United States, giving lectures and raising awareness about the needs of the terminally ill. She returned to Great Britain and opened the first modern hospice, St. Christopher’s Hospice, in 1967. The 1969 bestseller, On Death and Dying, by Elisabeth Kübler-Ross, helped to raise further awareness of the need for compassionate end-of-life care.

Inspired by Saunders’s work, Florence Wald opened the first hospice in the United States, called Hospice, Inc., in 1971. The first hospice program in the state of Tennessee, Covenant Hospice, was founded a few years later in 1978 and was among the earliest hospice programs in the country. By 2008, more than a third of dying Americans were using hospice care, with around 900,000 enrolled in hospice programs that year. Hospice care has continued to grow and improve over the years. “The future of hospice is for a good deal of growth, because we have an aging population and a lot of folks with chronic illnesses,” says Dr. David Wooten, the Palliative Care Director at Covenant Health in Knoxville.

Wooten emphasizes the team approach that characterizes hospice care, which usually takes place in a patient’s home. “Hospice has doctors, nurses, social workers, chaplains, and home health aides,” he says. “There is always something else we can do to make sure a patient is comfortable.” Hospice also does not stop simply with the patient, but rather includes his or her entire family. “We have a focus on bereavement, on following up with the family and loved ones, trying to help them through that process,” says Wooten. The holistic nature of hospice care allows patients to end their lives as comfortably as possible—and, even more importantly, at home with their families and loved ones around them.

Quick Guide to Senior Care

By Connor Sears

The different levels of senior care can often be a little confusing. Here is a guide to the common types of care that are available.

Hospice Care

Routine Home Care

The loved one remains at home, and a hospice provider visits a couple of times a week (depending on the condition and needs of the patient). All sorts of services are offered, including medical, religious, home health aid, and counseling for both the patient and the family. 24-hour on-call service is available.

Continuing Nursing Care

Care is still provided at the loved one’s home, but around the clock. This is usually offered temporarily if a patient’s condition worsens and needs constant attention until the condition stabilizes. This method may not be an option if the hospice provider doesn’t have the resources to provide permanent care.

Inpatient Care

Similar to Continued Nursing Care, except it takes place in a health facility away from the patient’s house, sometimes even in a local nursing home that has an agreement with the hospice provider. Again, this is primarily a temporary measure until the patient’s condition is stabilized enough to resume Routine Home Care.

Respite Care

The loved one receives the same care as they do at home, but in a special respite facility. This is for family members who act as caretakers to be able to take a break from caretaking. This is usually for a period of five days.

Assisted Living

Assisted Living Residence

A live-in facility for elderly people who don’t require constant or intensive medical attention, but who do require help with activities of daily living (ADLs) like bathing or eating.

Nursing Home

Similar to an Assisted Living Residence, but with a trained, 24-hour nursing staff for loved ones who need persistent medical care.

Active Living Homes

For healthy and socially active seniors who are able to live relatively independently. Facilities and activities are designed to cater to the elderly, and simple tasks like trash collection and lawn care are often provided.

Retirement Community

A community that incorporates all of the above types of facilities for seniors who want to live with each other but have different needs.

Senior Daycare

A daytime facility with a trained staff that offers prepared food and activities for relatively independent seniors, primarily as a means of continued socialization.

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~ by Butch on November 24, 2012.

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