Two of 8,497 Caregiver Challenges

Caregivers, whether members of the family or professionals, face a wide variety of challenges.  Issues of identity, loss of friends, hobbies, careers, you name it, are often — but never too much — discussed.

There are two that I want to point out today, however, that do not always get enough attention.  They are serious challenges that make the job (paid or unpaid) of the caregiver even more difficult than it otherwise would be.

1.  “I don’t need any help.”

At Support For Home, we work with a lot of family caregivers, providing counseling and advice to them on how to be most effective and maintain their own health and well being.  We also, of course, provide home care through our professional Home Care Aide employees.  One of the most frequent and serious impediments to their ability to provide quality care is the client (or loved one) who insists that she, he or they do not need any help.  “I know I / we will someday, but not yet,” is an all to frequent refrain.

So, the caregiver is trying to provide homemaker, companion, concierge and personal care, as appropriate, while the loved one or client is trying to usher the caregiver out the door.  The skills of negotiation, redirection and persuasion needed would do a diplomat proud.  In the meantime, the caregiver is using great deal of energy just getting permission to provide the care.  No wonder it is an exhausting endeavor.

2. Home Care is not House Care.

In home care, we do perform homemaker services, such as light housekeeping, cooking, laundry and so forth.  For many loved ones or clients, support for the Instrumental Activities of Daily Living involved in maintaining a home are critical to the ability to live at home.

At the same time, in California, at least, the provision of care by a “personal attendant” under Wage Order 15 (labor code) restricts general care of the house to 20% of the time worked by the caregiver.  This is one of the distinctions between a home care agency, such as Support For Home and other members of the National Private Duty Association (NPDA), and housekeeping / maid services.  We take care of people. Housekeepers take care of houses.

Unfortunately, many loved ones and clients do not understand the distinction very well — sometimes intentionally.  If a family caregiver or professional Home Care Aide is focused on washing windows, they are not helping with transfers or personal care or perhaps a large-piece jigsaw puzzle with their loved one or client who is suffering from Alzheimer’s.

So, if you are a caregiver, I greatly respect and admire you.  You are doing work — for the family or a client — that the vast majority of us are not equipped to handle.  If you know a professional or family caregiver, give them a pat on the back and a smile.  They are exceptional people.

Best wishes.  Bert


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