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There comes a point when you are caring for a loved one, when you have to ask yourself what is the best decision for me as well as for the person I am caring for. Whether you decide to continue to care for your loved one or start to explore other options such as a professional care home, take the time to insure your own personal health and well being. There is a reason that during the safety briefing on a plane they tell you to put your oxygen mask on first, then help your love ones. If you don’t take care of yourself you have no way to care for someone else. “There is a cost to caring,” states Charles Figley, an expert in trauma and researcher in the field of burnout; he comments that compassion fatigue is something that can occur when caring for someone long term. Take a moment to examine how you feel and see if you may be experiencing any level of burnout or even compassion fatigue and then take the time to explore ways to best care for yourself as well as those you love.

Before we go much further, let’s briefly explore the difference between burnout vs. compassion fatigue.  Figley describes burnout as the end result of a gradual process of wearing down.  It is the long-term consequences of unaddressed compassion fatigue, resulting in emotional exhaustion and a diminished sense of personal accomplishment and achievement.  Recovering from burnout is often a more lengthy process.

Compassion fatigue is often a result of the daily care we do, and is a more immediate specific response.   It is often characterized by emotional and physical exhaustion; symptoms resembling depression; and usually a shift in a person’s sense of hope and optimism about the future value of the care they are offering.  This may not be a constant feeling, but it something that comes and goes.  The recovery from compassion fatigue is often less lengthy then burnout.

Are you isolating yourself, bottling up your emotions, having nightmares or even physical ailments? Do you suffer from compulsive behaviors such as over eating or over spending or have difficulty concentrating. Do you feel stressed out or depressed? These are symptoms of compassion fatigue. There is no cure for compassion fatigue but by practicing good self care techniques daily can help you to be physically and emotionally healthy and decrease these symptoms.

A self-care plan begins with you.  It begins with being kind to yourself, becoming aware of how things are effecting you (both physically and emotionally), setting boundaries, expressing your needs, taking actions to aide yourself, surrounding yourself with individuals that listen and support you and being able to listen and support others around you.  Although when you care for someone it seems like you have no time, you need to take the time to have healthy eating and exercise habits. Get plenty of rest and hydrate yourself. Develop good time and self management skills even if it means saying no.  Have a support system, take breaks and try to enjoy a balance in your life. Do not give up all of your friends and hobbies.  Pick your battles and even though it is hard, consider professional care givers, if not on a regular basis then consider short term help.  You can sometimes schedule breaks, where you use a professional care giver in the home or facility for a few weeks a year, allowing yourself to have time to decompress and feel better before you can no longer care for your loved one.
Hospice is not a place. Hospice is a “concept of care” designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.1 The goal of hospice care is to provide patients with comfort and dignity at the end of life with a special emphasis on controlling pain and discomfort and managing symptoms. The focus is on compassionate caring not curing. Hospice care neither hastens nor prolongs life, but this specialized service has been shown to increase quality of life. Hospice is covered by Medicare and Medicaid and most private insurance companies to eligible patients referred by a physician. Hospice services include care by professionals and volunteers and medication, equipment, and medical supplies. Families have no out-of-pocket expenses other than the cost of room and board. The patient and family are at the center of hospice care. The hospice team works with the patient and family to develop a personalized plan of care that respects the individual’s end-of-life wishes. A multi-disciplinary team of physicians, nurses, home health aides, social workers, therapists, spiritual counselors, bereavement counselors, and volunteers provides expert and compassionate care that is available 24 hours a day, 7 days a week. Physicians and nurses are specially trained to address pain and manage symptoms. The team works closely with family members to provide feeding, bathing, turning, administering medications, and monitoring changes in a patient’s condition. Some hospice providers provide alternative therapies such as Pet Therapy or Music Therapy. Spiritual counselors, therapists, and social workers help patients and families with emotional and spiritual concerns and provide bereavement support to family members after a loved one has died. Most people choose hospice care in their own homes, but hospice care is also available in hospitals, nursing homes, and residential care communities for the elderly such as assisted living communities and board and care homes. In 2011, 66.0% of hospice patients received care in the place they call “home,” including private residences (41.5%), skilled nursing facilities (17.2%), and residential communities (7.3%).2 When hospice care is not an option at home, nursing homes, freestanding hospice facilities, and residential care communities like board and care homes are places for families to turn for short-term respite or longer term care at the end of life. The Board and Care model, which provides residential care for fewer residents in a private home, offers a home-away-from-home in an intimate environment that provides a home-like routine and a place for family to gather. Board and Care homes can offer temporary hospice to residents and families who request it. These homes typically work with a number of hospice organizations to provide families with choice for high quality care. The board and care staff coordinate care with the hospice staff and they may provide bedside comfort tailored to the resident’s needs and preferences, such as soft music, reading, and aromatherapy. “Choosing a hospice to care for yourself or a loved one in the final months or even days of life is an important and stressful process,” said J. Donald Schumacher NHPCO president and CEO. “Each hospice offers unique services and partners with specific community providers – so it’s important to contact the hospices in your area and ask them questions to find the one with the services and support that are right for you.”3 For additional information on hospice and how to select a quality hospice provider, families may turn to online resources found at the National Hospice and Palliative Care Organization (www.nhpco.org) and the Hospice Foundation of America (www.hospicefoundation.org). References: 1Hospice Foundation of America. www.hospicefoundation.org. 2Facts and Figures: Hospice Care in America. 2013 Edition. National Hospice and Palliative Care Organization. www.nhpco.org. 3Choosing a Quality Hospice. National Hospice and Palliative Care Organization. www.nhpco.org.   Trina Duke, Master of Science in Gerontology Concierge Gerontology Services
A study in ‘The Gerontologist’ states that, “approximately one-third of 65-year-olds are single.” That’s a 50% increase since 1980 according to the U.S. Census. Aging with family and friends has been shown to result in improved health of seniors, including lower chances of cognitive impairment, and hospitalization. Research shows that socialization, companionship and hobby-building has great benefits for seniors: older adults who are surrounded by others are at a decreased risk of both cardiovascular and cognitive decline. For some seniors, moving into an Assisted Living Community is the first step they can take to help maintain or increase the quality of life as they grow older. In reputable communities, experts in the field of long-term care help coordinate between activities to create communities where older adults are able to create new memories with one another. Residents take on scheduled group hobbies such as yoga, cooking, and artistry while pursing passions both new and old. Assisted Living Communities can act as a hub for seniors to connect and make new friends. Our advice for making friends in a community? Participate and try out all the opportunities that are available. The goal is to foster an natural feeling of community with residents similar in age and circumstances.
Dementias are degenerative disorders that develop primarily in the nervous system and selectively damage particular areas of the brain. Some dementias, like Alzheimer’s disease affect all areas of the brain simultaneously, while others, such as frontotemporal dementia, affect the parts of the brain involved in controlling one’s communications and emotions. Still others are caused by vascular disease, brain trauma, or chronic alcohol abuse (Korsakoff’s syndrome) By 2030, 20% of U.S. population will be older than 65 years of age – about 50 million people. Dementia affects 1% to 6% of those older than 65, and between 10% and 20% of those older than 80 years of age. In the next 30 years, estimated 10-20 million seniors in U.S. will have mild to severe forms of dementia. Seniors with history of moderate traumatic brain injury (TBI) have a 2-3 times greater risk of developing Alzheimer’s disease – those with a severe TBI have a 4-5 times greater risk. Even healthy seniors are at risk for falls and head trauma, so any fall to the head, however minor, should be seen by a medical professional and documented. Alzheimer’s disease accounts for 65% of all dementias. There is no direct diagnosis of Alzheimer’s – and while PET scans and other imaging techniques are being studied, none have yet been able to show the presence of Alzheimer’s disease. Alzheimer’s onset often surprises families because vision, movement, and sensation remain untouched while a senior’s memories begin to slowly decrease. Recent memories are affected first, leading to “senior moments” that appear innocent because all other memories, including those from decades ago, remain intact. Eventually those remote memories begin to fade, and lastly the senior’s “crystallized” memories, such as family member’s names and faces, are compromised.   By David L. Raffle, PhD Clinical and Forensic Neuropsychologist www.RaffleBrainInstitute.com
Several blogs and news outlets, including the LA Times took interest in and covered our proposal for Sierra Bonita: Follow the links below to read these articles at their sources: Curbed LA: Senior Living Facility On Sierra Bonita Still Breathing Curbed LA: No Mega Senior Living for Sierra Bonita Melrose Village Blog: Mega Senior Living Facility Turned Down Melrose Village Blog: Residents Concerned About Zoning Variance for Proposed Nursing Home Melrose Village Blog: Proposed Facility on Sierra Bonita Draws Controversy
Happy New Years from all of us at Raya’s Paradise Board & Care facilities. Raya’s Paradise in implementing a new medication management system that will provide a safer and more accurate medication distribution. In addition, we will also increase the activities level for our residents which will include outings.