Archive for April, 2014

Avoiding Caregiver Burnout

Monday, April 21st, 2014

By Bernard A. Krooks, Certified Elder Law Attorney®

Being a caregiver for an elderly family member can be very demanding, both physically and emotionally. It is no surprise that many caregivers experience burnout. Caregivers often feel pressure to assume additional responsibility as time passes and neglect to take time out for themselves. Here are a few key tips to avoid burnout:

Ask Family Members for Help

When an aging parent needs care, one adult child may assume a greater share of the work than their adult siblings. This may be intentional or unavoidable, if other siblings work full-time or live farther away from the parent. Often, the imbalance is not acknowledged or even understood. It may be that those siblings who are not the primary caregivers simply do not know how much work is involved. In this situation, it can be important to have a family meeting.  The primary caregiver can use such a gathering to inform other family members of the details of their parent’s condition, and what is needed in terms of care. Once the caregiver explains in detail the amount of work that is involved, a perfect opportunity arises to ask other family members to contribute and help.

Try a Support Group

Being a caregiver can be very isolating. One may spend a great deal of time alone with the elderly parent.  Other relatives and friends, who are not caregivers, may not appreciate the amount of work involved and may not understand the caregiver’s frustration or exhaustion. Getting together in a support group is an excellent way to share resources and talk about day-to-day experiences with other caregivers in similar circumstances. Caregivers may be reluctant to attend a support group because of time constraints or because they downplay the significance of their work. However, most people have a positive experience when they attend support groups.                                                                                                   

Use Respite Care

Many people are working as unpaid caregivers for an elderly family member in part because professional in-home assistance can be unaffordable. Respite care can be a good alternative to full- or part-time help, providing planned, short-term breaks for the caregiver. For example, a break of a few hours once a week can have a beneficial effect on the caregiver’s emotional well-being. When making choices about care, families sometimes look at the option of hiring in-home care as an “all or nothing” undertaking, but respite care can be the perfect in-between alternative, allowing a family member to provide primary care, but take necessary breaks.

These tips have a common theme: one should not face these challenges alone. Instead, get help from family members and from community resources.

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Emergency Rooms and the Elderly Patient

Thursday, April 17th, 2014

Emergency rooms are designed for fast treatment of serious or life-threatening conditions.  Elderly patients suffering from chronic illnesses may not always be able to convey important medical information to treating professionals.  This is particularly true of those suffering from Alzheimer’s disease or dementia. Additionally, elderly patients may not be able to properly communicate information about their prescribed medications. These factors mean that quick treatment is not always the most effective treatment.

hospitalPatients coming to hospital emergency rooms receive treatment and are sent home with detailed instructions about arranging their own follow-up care. This approach is grounded in the efficient use of limited resources. For many elderly patients, this approach may not be ideal because more thorough evaluation is necessary.

Specialists in geriatric medicine and emergency room care have taken steps to address the problem. Recently, the Society for Academic Emergency Medicine (SAEM) published a set of guidelines to help emergency departments provide better care for elderly patients.

The purpose is to “provide a standardized set of guidelines that can effectively improve the care of the geriatric population and which is feasible to implement in the ED. These guidelines create a template for staffing, equipment, education, policies and procedures, follow-up care, and performance improvement measures.”  (Society for Academic Emergency Medicine, 2014)

Elderly-Man-With Doctor

The guidelines include better training for hospital staff to recognize certain factors that play a role in providing care to the elderly. For instance, older patients may need more assistance getting prescriptions filled, and may need for transportation to be arranged for follow-up medical visits. The guidelines also recommend sound-absorbing materials and non-slip flooring in emergency rooms to reduce noise and prevent accidents.

Recommended changes also include printing discharge instructions in a large font size, and making sure that emergency rooms communicate important information to the patient’s family and any outpatient caregivers, including nursing homes. Emergency departments should also develop relationships with providers of resources that patients can use for follow-up care regarding mobility, safety assessments, prescription assistance and education, and home health care assistance. The guidelines stress that much depends on educating hospital staff about the needs of elderly patients.

Similar changes have been made in regard to pediatric and cardiac emergency care, but changes to help the elderly have not come as quickly. Nevertheless, progress is being made. Today over 50 medical centers have made such improvements, as opposed to ten years ago, when there were no such features.

 

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Society for Academic Emergency Medicine. (2014). Geriatric Emergency Department Guidelines. Retrieved from saem.org: http://www.saem.org/education/geriatric-ed-guidelines

 

Glossary of New York Estate Administration Terms

Tuesday, April 8th, 2014

If you are preparing your will, or if you have been named as executor in a will, you may be encountering some unfamiliar terminology. It is important to know the meaning of the terms used in the administration of estates, so that you can begin to understand how wills are probated and what the responsibilities of a fiduciary are. This glossary defines some of the terms that are used in the administration of estates in New York State. More information can be found at the website of the Public Administrator of New York County.

 

  • Administrator: A fiduciary appointed to administer the estate of a decedent who died without a will.
  • Decedent: A person who has died.
  • Distributee: A person entitled to take some or all of the property of a decedent who died intestate. Also called an heir.
  • Domicile: The permanent place where a decedent lived. If a decedent lived in more than one place, then the domicile is where the person intended to return.
  • Estate: The total property of a decedent.
  • Executor: A fiduciary who is named in a will to administer the estate of a decedent.
  • Fiduciary: Also called a personal representative, a person appointed by the Surrogate’s Court to administer or manage the estate of a decedent. A fiduciary may be an executor if named to that position in a will, or an administrator if appointed to administer the estate of a decedent who died intestate.
  • Intestate: Describes a person who died without a will.
  • Personal Representative: Another term for a fiduciary.
  • Probate: The process by which the Surrogate’s Court recognizes the validity of a will. When a will is recognized as valid, it is admitted to probate, and the executor is usually appointed to administer the estate.
  • Public Administrator: The Office of the Public Administrator administers estates in each New York county, and is the default fiduciary, administering estates when no one else is available, such as when a decedent dies intestate and there are no distributees, or the distributees are ineligible to serve as administrator.
  • Surrogate’s Court: The New York county courts that oversee the estates of decedents. In other states, these may be called probate courts.

 

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