Home October 2014 Turning the Tide

Turning the Tide

Baby Boomers are getting older. Why is this important? Because, according to statistics, Boomers make up 24.3 percent of the total U.S. population of approximately 315,000,000; by 2030 one in five Americans will be older than 65. They are the largest generation of Americans born in the United States.
For those unfamiliar with the demographic classification, Baby Boomers are those individuals born between 1946 and 1964. The post-World War II birth explosion peaked in 1957 at 4.3 million and capitulated to Generation X in 1965. As people born after World War II and after the Korean War age, the younger Baby Boomers, Gen Xers and Gen Yers are preparing to care for those who need assistance. This is significant because many parents are moving back in with children and many children are taking on the caregiving role for loved ones.
The loved ones being cared for are not necessarily parents. They are grandparents, aunts, uncles, family friends and sometimes siblings. Regardless of the relationship, they are people who now must rely on the help of others. What does that involve? And how does one care for oneself while caring for a loved one? JLife  sought the input of seasoned social workers in the Orange County Jewish Community who provide support to families dealing with these very questions. It may seem to be a daunting task, but there are options.
One thing to remember, said Older Adult Care Manager Nadine Durbach, MSW, of Jewish Federation & Family Services (JFFS), is that “barring severe mental illness, chronic violence, and addiction, most parents do their best for their children. And as such, model for them how families hold each other up to the light and care for each other during good, but especially difficult times.” But not everyone is intended to care for an aging loved one; not everyone has the financial, social, or psychological means to make that commitment. However, there is a reciprocal responsibility one has to his or her parents or loved one that cannot be abandoned. Keeping in mind, of course, that this happens in a healthier family structure—it does not and may not happen for every family. And not every Baby Boomer is going to “allow” a child or loved one to take on that responsibility.
How does one approach the difficult topic of letting a loved one know there is concern that he or she can no longer live independently? It is not an easy topic to broach. The loss of independence and the realization that you are no longer able to care for yourself are developmental milestones that leave everyone involved confused, angry and afraid. But it is approachable, said Durbach. How does one approach the topic of being cared for? It is a conversation Durbach has often with an older adult: “Not in spite of the fact, but because you taught your children this—you modeled for your children how families wrap around each other and take care. Because you were such an excellent teacher and it is a natural cycle of life for your children to do this with you.” By having this conversation and by setting the framework, we allow our older loved ones to maintain dignity and independence.
The following is a Q&A with social workers Cally Clein and Nadine Durbach, both social workers with JFFS.
How do I know when it is time for my aging relative to have assistance?  First, with regard to choosing assistance, families should always focus on the loving, caring, and nurturing aspects and provide as much unconditional support and emotional support necessary to making this decision. The management aspect should be left to professionals who deal with elder care. The following red flags were put together by professionals at JFFS [in the document “When Do I need A Care Manager?”] to provide peace of mind:
•    If problems become more time-consuming than you can handle given the other demands in your life
•    If you notice a decline in physical health, increasing signs of confusion, and inability to handle routine tasks
•    If your family members cannot agree on how to care for your loved one
•    If you are uncomfortable leaving your loved one at home alone
•    If you live out of town
•    If you are worried that your loved one is at risk for fraud or is being taken advantage of
Why do I have to use a professional?  Using a professional will reduce the time it takes because the professional can make appropriate referrals much faster than the family member can on his or her own. It will reduce the tension inherent when adult children step in to manage affairs and reduce role reversal tensions and relationship stressors.
The following are some steps to using Care Management [as found in JFFS’s “How Does Care Management Work?” by Terry Moses, Cally Clein, LCSW, and Nadine Durbach, MSW]:
Step One: Personalized Assessment
A home visit is paid to personally evaluate all the areas in which you or your loved one may need assistance. Assessment fees include an evaluation of physical and emotional health, social activity, home safety and maintenance, need for transportation, housekeeping, meal preparation, errands, bathing, dressing, legal advisement and financial management. The JFFS Care Manager then outlines areas of concern with specific actions to address short- and long-term needs.
Step Two: Personalized Care Plan
The care plan is a roadmap for the future, with recommendations for how to proceed in every area; the recommendations can be implemented by family members, by the care manager, or by both. You decide how much or how little you want professionals to be involved depending on financial resources available.
Step Three: Implementation
Because care management is based on a personalized care plan, it looks different for every person. Here are some tasks you can expect the care manager to do:
•    Arrange and monitor in-home care, housekeeping, and other services provided in the home
•    Make arrangements and coordinate with physicians, caregivers, therapists, and other care professionals to optimize the quality and efficiency of care
•    Review financial and legal issues and offer referrals to qualified specialists
•    Provide education on alternative living options and make referrals to appropriate providers
•    Facilitate adjustment to a retirement community, assisted living facility or nursing home [Some options include Heritage Pointe, TrueNeighbors Village, Bubbe and Zayde’s Place, Laguna Woods Village, and other Jewish assisted living communities.]
•    Act as a liaison to families, providing regular progress calls, and quickly alerting family members to problems
•    Facilitate expedited delivery of health equipment
•    Advocate with service providers for quality, cost, and accessibility of care
•    Advocate for hospitalized client and family
•    Assess medication management system
•    Offer counseling and emotional support
There is no need to take on the task of caring for another by oneself: contact JFFS at (949) (435.3460. For additional information on this topic and available resources you can contact JLife Magazine at editorjlife@gmail.com.
This article is Part One of a two-part series focusing on caring for aging loved ones. This month focuses on how to know when it is time to seek help and what that assistance entails. Make sure to read next month’s issue to find out more about caring for aging loved ones, long-term care options, and handling the care of a geographically distant loved one.
Dr. Lisa Grajewski is a psychologist working toward licensure. She is a therapist with Jewish Federation Family Services and is a psychological assistant for a private practice in Tustin. Dr. Grajewski has been writing for JLife since 2004.

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