1. Alexandra Morris, Gerontologist Alzheimer’s Association Northern California & Northern Nevada 800-272-3900 Caregiving Support

3. Data: Caregiving for an Elder Caregiving for a frail or ill elder is a marathon: Ave 4-6 years Research shows that caring for a frail or ill elder creates physical, emotional and financial challenges for the caregiver Greater risk of developing or exacerbating stress related illnesses; i.e. heart disease, hypertension, depression & anxiety, ulcers and increased risk of injury or accidents Caregivers often ignore their own health conditions 30% of caregivers are still employed Caregivers are at higher risk of social isolation

4. Making the Most of Caregiving Education Support Respite

5. Education Investigate the disease or condition though on-line sources, books & journals www.alz.orgwww.alz.org Attend classes, seminars and conferences www.alz.org/norcal Click on Education or Professional Education www.alz.org/norcal Talk with professionals in the field DPOA- Health- Finances/ Trust / POLST Attend elders doctors appointments

6. Support Helpline 800-272-3900 Support Groups: www.alz.org/norcal Click on “Support Groups”www.alz.org/norcal Friends and Family Care Consultations at Alzheimer’s Association Offices On-Line Coordinated Care: www.alzheimersnavigator.org orwww.alzheimersnavigator.org www.Lotsahelpinghands.com Family Meetings at Alzheimer’s Association Offices Care Management Low income or other criteria for free, limited care management Geriatric Care Manager www.caremanager.orgwww.caremanager.org

7. Respite: In-Formal and Formal Family and Friends In-Home Care Adult Daycare Over-Night Care in a Facility Call us at 800-272-3900 or in Northern California/ Northern Nevada www.alz.org/norcal list is linked in middle of home page: Discover Community Resourceswww.alz.org/norcal

8. Options for In-Home Care Independent Contractors In Home Care or Nurse Registries In-Home Agencies Home Health Care Agencies IHSS: Low Asset Medicaid (Medi-Cal)Program

9. Cost and Other Considerations Independent Aides: They are your employees You set the pay, likely the most cost effective in-home care You screen and perform reference and background checks (Live Scan) Consider costs of payroll services, workmans comp and liability insurance Training & supervision is your responsibility What happens when they are sick? Or need to leave town? Or hurt themselves? Registries Check the fine print, not all registries are the same. Some provide “payroll” services and background checks, others do not Consider costs of payroll services, workmans comp and liability insurance Aides have expectations as to the hourly rate. Likely still less expensive than in-home agencies Training and supervision your responsibility In-Home Agencies Provide home health aides or CNA’s at modest cost If aide is ill, they can send another quickly Oversight and training by the agency Often task oriented and English a second language Minimum hours (3 or 4 hours) Home Health Care Agencies Provide skilled nursing or therapy level care at premium cost Oversight and training by agency Well-trained professionals IHSS No cost to client who qualifies under Medi-Cal Hours limited by an assessment of physical needs IHSS allows family or friends (after training) to provide the hours or they provide a list of aides

10. The Interview Prepare by writing down what your expectations are: Companionship, Supervision, Personal Care, Medical Care. Be specific, for example, light meal prep, taking PWD on walks, shopping and the number of daily or weekly hours expected and time of day/night needed. Training Consider paying for dementia training, body mechanic’s, infection control and recognizing illness training Temperament Ask “What would you do if” questions Be honest about your PWD behaviors and physical challenges

11. Reasonable Expectations The aide may not do things exactly as you do. Be reasonable. Choose your priorities. Punctuality and appropriate notice of changes in schedule a must. Alzheimer’s Association have lists of agencies. Call us at 800- 272-3900 or in Northern California/Northern Nevada www.alz.org/norcal list is linked in middle of home page: Discover Community Resources www.alz.org/norcal

12. Adult Daycare Social Day Programs Less expensive/ usually sliding fee schedules Hours typically from 9am to 3pm Social program, no health services Usually mixed elders (not dementia specific) Day Health Programs More expensive but Medi-Cal may cover limited days Longer hours Health Services: i.e. PT, OT, Speech Therapy Often have other services: i.e. Social worker, support groups, education

13. Overnight Care in a Long-Term Care Facility Residential Care Facilities for the Elderly (RCFE’S) AKA Assisted Living and Board and Care Homes Skilled Nursing Facilities (SNF) aka Convalescent Homes or Rehabs with respite stays Minimum stays Lots of paperwork and preparation Expensive: $200 day + Medi-Cal may cover for SNF VA Respite for those who qualify

14. Take Care of Yourself Honor yourself, your body and your role in another persons life by taking care of yourself Make a list of enjoyable activities and engage in at least one enjoyable activity a day Keep up on your own health: Doctors appts, Dentist appts, take medications and follow doctors recommendations Research shows that Yoga, Tia Chi, meditation or focused breathing (signal breath) can be very beneficial for stress reduction Exercise and eat nutritiously Drink alcohol in moderation or not at all and don’t smoke Socialize

15. Caregivers Doomsayers would preach that the world has been overtaken by rage, greed and resignation. I believe if you look into the private rooms of caregiving, you will find the true nature of things as they are. There you will find great kindness and devotion, a trust of life that surpasses doubt or pain. There you will find the highest expressions of who we are. Beth Witrogen McLeod