Care-giving After Hospital Stay

Many people experience hospital visits in their golden years. Bodies begin wearing out and the struggle against certain ailments or diseases can be grueling.  It is common for people in older age to go in because they've broken a bone, or had a stroke, or ended up with pneumonia that needed to be treated in hospital instead of at home.  There are also a number of scheduled surgeries and procedures that can cause elderly people to need extra care at home after they've returned, such as bypasses and a host of others.  The release from a hospital does not mean that they are clear to go back to normal activity, but simply that they are okay to go home as long as someone is there to care from them.  So with great love, many people take it upon themselves to offer care to the person who is being released.  They themselves will take care of this person who needs extra care and see to it that nothing else bad befalls them.  But often, the level of care-giving and the length of time that it takes for recovery is an unforeseeable part of the equation. They are signing up to have their lives turned upside down for an unknown period of time.  That can be exhausting and discouraging.  So whether you are a caregiver, or if you know someone who is, here are a few things to do to help avoid burnout and to ensure that the caregiver has the strength and energy they need to do their job well.

  1. Adequate rest. You'll need plenty of rest, but how can you come by this if you need to be up all night, every night watching someone?  Call on backup!  Whether it is extended family or friends that you need to call in, or even putting a call out at church, you need sleep.  You'll not be able to adequately function if you do not have rest.  Ask them to come and sit with the person during the day so that you can go and get a nap.  Lack of sleep can have symptoms similar to drunkenness and your cognitive abilities really do decline.  Remember that you are responsible for another person's well-being, so if you won't do it for yourself, then do it for the person you're caring for.   If you know of someone who is a caregiver, offer a few hours of time that you can sit with their loved one so they can get a nap.  If you're a close friend, offer it more than once a week.
  2. Time away. If you feel you're getting enough rest, then also plan in some time away each day. It's important, especially if the care you are offering is for a very lengthy period of time, that you have some space from the situation and the individual.  It doesn't matter how much you care for one another, if you're cooped up in the same house with someone for weeks on end, you can get a little abrasive toward one another.  So take some time to go and re-charge, do something that interests you and energizes you and then come back to the situation.  If nothing else, you'll have something new to talk about!
  3. Eat well. It can be tempting in these situations to feed your loved one what they need and forget almost entirely about what your own body needs.  Keep up with your nutrition and also with your vitamins.  Make sure you're having adequate amounts of vegetables.  It is amazing how these simple things can fly out the window in times of stress, when our bodies need them the most.  We tend toward comfort food when times are hard and also when we're exhausted. So keep pumping in those veggies and notice an improvement in energy levels and mood.  If you're a friend, bring meals high in vegetable content so that you know they are getting some good vitamins and minerals at least occasionally.
  4. Hydrate! This is one of the top items that people forget in times of long-term stress.  Drink plenty of water!  Ask someone to pick up lemons or limes from the store so you can have fruit juice in your water for an extra treat.  Get some herbal teas if it's cold outside so that you can warm up and hydrate at the same time.  You'll not only have more spunk, you'll also sleep better when you are able to sleep because of the hydration.
  5. Know when to say 'no more'. This care giving is one of the most daunting tasks you'll likely ever have to perform.  If it is getting to be way too much for you to handle, admit it.  You can't endure it forever.  If you need support from other family members, ask for it.  If there aren't family  or other professionals to call on for back-up, seek help from either an assisted living facility or a nursing home facility.  There is no shame in this.  Even if your loved one is not happy about it, there comes a time when this may be necessary in order to preserve your own health.  Do not allow yourself to get so depleted that you'll be unable to make adequate care decisions for them and for yourself. It's imperative that you keep evaluating throughout your process of care giving to see whether they are genuinely improving to the point that they can be on their own or whether you need help.

Remember, as a care giver, you are arranging a huge portion of your life to accommodate the needs of the one you love.  This is admirable.  It is also grueling.  Do your best to take care of yourself  so that you can care adequately for the one you love.

Making the Decision to Move to a Nursing Home

Nursing homes across the country have gotten a bad rap over the past decade.  Some have been found guilty of negligence and have had people within that are malicious and cruel.  That is absolutely inexcusable and they've been prosecuted.  By and large, however, nursing homes provide care for our very aged or infirm loved ones when they cannot care for themselves any longer & when it is not even advisable for those who love them to care for them at home.  An assisted living facility is a natural progressive step between living on their own and a fuller care facility, but some people must transition straight to increased care because of extreme health circumstances. In many circumstances, the decisions for these things are made by the facts of living situations.  Assisted living facilities can only go so far with care, as they are not as fully staffed as nursing care facilities.  They can check in with your loved one several times throughout the day and be there when necessary, but they cannot keep them safe if they have Alzheimer's or dementia.  They can not do toileting duties or bedside care.  So, how do you help a family member make a decision to go into care, or if they're not themselves, how do you decide for them?

  1. Assess the facts.  Is the person safe?  This should be the first priority in any situation.  I've seen countless families struggle with the decision of a beloved family member going into care because they cannot afford a facility, or because they think it is more honorable to keep them at home.  If however, that person is in danger because they have lost touch with reality and especially if they are prone to wander away from the home or engage in other dangerous activities (ie. Leaving the gas stove on or lighting fires) it is no longer safe for them to be at home.  They need 24 hour care.  And the last time I checked, there is not one person who can give 24 hour care, because you are not able to stay up continuously for 24 hrs a day, 7 days a week!  You need a whole team of individuals to give that extent of care in order for everyone to be well rested, alert and safe.
  2. Take stock of whether they or their caretakes are able to take care of their physical needs.  If they are able to feed themselves, bathe & toilet themselves without difficulty, they are probably fine to stay where they are.  If there comes a day when they are unable to do these things without extensive help, it is time to consider a nursing home.  If their abilities are lost because of a surgery or an injury, a nursing or rehab facility might only be temporary. 
  3. Consider their quality of life.  Sometimes the best way to make the decision is to look at the place where they will receive the best care.  If you are the caretaker, for instance, and you are able to take care of the daily physical needs that they have, but are unable to get them out and about for any social interaction or activities because you also need to work from home in order to pay the bills, it might be time for a change.  Their end of life should not consist in simply watching television.
  4. Be compassionate.  When I encourage compassion, I am telling you to have compassion for the      current caretakers in the situation they're in.  If that is yourself, have compassion on yourself.  If it is staff at an assisted living or rehab facility, have compassion on them.  And finally, have compassion on the person who needs care.  It is necessary to have a balanced view of compassion in this situation, because oftentimes people place all their care & compassion on the individual that needs extra care to the exclusion of their own health and well-being or to the exclusion of listening to another caretaker.  This is a recipe for burnout and bitterness.  Our loved ones would never want their care to become such that it affects the health and well-being of their caretakers.  So, practice compassion.  And if you determine that it is time for a change, begin the process. Do expect that there may be some difficult times ahead when you are discussing this with your loved one.  There may be anger, feelings of abandonment and betrayal.  You would probably feel the same in those circumstances.  

  This decision is stressful for family, and might be devastating to the individual that needs to enter care.  If they are not fully in their right mind, it can be even more difficult for them to accept or understand.  It is especially important to maintain contact with them during the transitional time, whether they are angry or not.  Once they are settled, re-establish a routine so that they know you'll still be involved in their lives, that you love and care for them and that you're not abandoning them to go off and enjoy a worry-free life. 

  Above all, keep your head throughout the process.  It's difficult, but it is just that, it is a transition and it is not the end of the road.  Encourage them, encourage the rest of your family.  You'll need a team of positive people to get through the next stretch of the journey, so be one of those people yourself!


According to one survey, 16% of Americans have been caregivers to another person in the past year.  That may not seem like a lot, but consider that this is only one year, and that most people have become an unpaid caregiver to someone at least for a short while throughout their lifetime.  Senior care giving can be incredibly challenging, both for the one offering and for the one receiving care.  Those who undertake this task need to go into it with their eyes wide open, with a well thought-out plan and with an excellent support team.

The caregivers that I'm specifically writing about in this article are those who are providing care for  elderly or disabled adults without monetary compensation for themselves.  In other words, they are working many long hours without pay.  This may seem like a small thing, but the numbers listed on suggest otherwise.  “The value of the services family caregivers provide for "free," when caring for older adults, is estimated to be $375 billion a year.”   $375 billion per year!  Their work certainly is not without value, they are simply not getting paid for it.  The work of a caregiver is grueling at times, even while being incredibly rewarding.  But, because of our culture's emphasis on all things monetary, these people who are giving of their lives, time & energy, may not be getting the acknowledgment or support that they need.  Below I will list a few things to be aware of and some ways to help avoid burnout for those who find themselves in a care-giving position currently.

First, remember who you are.  Sometimes in the daily grind of caring for others,  it is easy to forget who we are apart from that.  This type of work is physically demanding and terribly exhausting.  At times it may seem that there is not time to shower, let alone do something that we once enjoyed.  It is, however, terribly important that you hang on to little bits of time with which you can do this.  Even if it is 30 minutes that you look forward to to read a book you've been looking forward to or a bit of time to do some baking or painting.  Maybe you enjoy nature & could take regular walks to clear your head and breathe again.  Whatever it is, be sure that you are taking time to remember what it is that you enjoy and continue doing it & advancing in it.  You are filling the roll of a caretaker, but that is not the only part of you.  You need to remember who you are apart from that, because that task will not always be before you.

Second, remember to rest.  Getting adequate sleep can be challenging if you are caring for someone who does not rest well or is in severe pain.  Try as you might, rest might not be an option on a regular basis.  So, practice something that new mothers are always told since their newborns will not sleep regularly either.  Sleep when they sleep.  You may think, “this is impossible, I cannot sleep during the day” or “I have so many other things to get done, there is no way I can do that!”   But consider what your temperament and care is after you've gone for a substantial amount of time without sleep.  Are you as compassionate and kind?  Do your words come out sharp and biting?  Rest is fully necessary for each of us, whether we like it or not.  You can find someone to do laundry or cook a few freezer meals much more easily than you can find someone to take on the care of you or your loved one.  Admit when you are spent and need sleep.  Ask for help with other tasks from someone in your support group.  Then, go take a nap!

Third, be sure to have adequate support.  This is easier said than done, but you cannot do this alone.  If you are part of a church or synagogue, it is a good place to start looking for support.  If not, find a community of people that care & might be willing to help.  Oftentimes in putting yourself out there & talking about what is going on, you will come across others who have already walked that road & who have been caregivers themselves.  They are the ones who are most likely to remember and to offer real help in your time of need.  If they offer to help, take them up on it!  Ask if they could make a meal so that you have a little time to rest or accomplish some other task that only you can do.  Ask if they'd be willing to sit with your loved one for a couple of hours so that you can run errands. No matter how stoic and hardworking you are, you need to have a good support system to remain healthy while you are caring or others.  Take the help that is offered to you during this time.  I promise, you'll have opportunity in the future to “pass it on” wit someone else who needs a bit of support in their care-giving journey.

Last, don't lose heart.  The season that you're walking through right now is just that, a season.  It had a beginning and it will have an end.  Do your best to enjoy the current season, even while looking forward to the next one.  Allow yourself to have the feelings that you have, but be careful not to let them rule you, especially in times of weariness.  Things always seem to have a brighter outlook after a good cry and a long rest.  The one for whom you are caring for is most likely also very weary of their journey.  Try to guard against “compassion fatigue” just because you're both walking on a difficult path right now.  There is much to hope for, much to be grateful for and many people who are willing to shoulder the load with you.  They may not t know specifically how to offer what you need, but sometimes even having someone to talk it out with helps tremendously. Don't lose hope that things will improve.  Don't let your love grow cold in the process of caring for others.  Rest, ask for help, take a break.  Then come back to what you need to do with renewed vigor and purpose!