And how do you know?
Family caregivers struggle with knowing when to step in to help and when to leave well enough alone. But how do you know what to do and when? Maybe your 80-year-old mother is fine living alone right now with just some occasional assistance. But what additional help could she use now and what do you anticipate her needing in the future? Are there simple modifications that can be made now to avoid an injury or accident and is she able to recognize these as a need. What plan does she already have in place to help meet her changing needs and abilities? Are they realistic? What are the options available? How will you know when to make a change? Having the answers to these questions ahead of time will help you be prepared to respond to the inevitable changes.
Evaluating the Situation
As we continue our discussion of the essential steps to being a caregiver we address step two – Evaluating the Situation. It is necessary for caregivers to really know and understand the abilities and disabilities of their loved one. What can they do now and can you anticipate how this might change. It is also important to assess how aware or realistic your loved one’s assessment of their own abilities and disabilities. Can they anticipate what they might need and how they would like those needs to be met?
A “needs assessment” is the term professional caregivers use to determine what help is required in order to determine the services to be provided. From this assessment a plan of care is created. For those of you with family members in an assisted living facility the needs assessment determines the resident’s “level of care” which will directly relate to the cost of the care provided. You should have a clear understanding of your loved ones care needs so you can be sure that you are paying for and receiving the appropriate services.
As a family caregiver you can and should conduct your own needs assessment and you can and should create you own plan of care. This is especially important if your loved one lives alone so that you can put the appropriate services and resources in place. It is also a way to prepare as a person’s needs change over time and so your care plan can anticipate and adapt to these changes.
Three areas to evaluate
So what exactly is a needs assessment? It is an evaluation of a person’s level of functioning or ability in generally three areas – physical, mental, emotional. By applying a simple 3-point simple scale, with a 1 indicating no assistance needed, 2 if they need some assistance to a 3 indicating unable to do independently. From this assessment, a caregiver can have a clear understanding of what the needs are now but also plan for future needs as well. Caregiving can be full of some unexpected surprises that too often lead to making decisions in a crisis or changing plans more suddenly that expected. But the more you can anticipate and plan for a future need the less stressful these changes will be for all involved. Successful caregivers have a well thought out “Plan A” in place and a “Plan B” for when things change and a very important Plan “C” if a crisis occurs.
Physical ability is just that – how well someone is able to physically function walk, see, hear, drive, live alone etc. Many times someone can continue to live independently with only a few modifications to adjust to their physical limitations. Hand rails, emergency call buttons, and home delivered meals can significantly reduce accidents and injury allowing someone to remain in their own home for a longer period of time. In evaluating your loved ones physical ability some areas to focus on include
- Mobility, balance and stamina
- Vision & hearing
- Medical conditions, symptoms and medications
- Personal Care / Nutrition
- Housekeeping & home safety
Social & Emotional Needs
Emotional needs are those relating to mood and social interaction. Many elderly become increasingly homebound and this isolation can lead to anxiety and depression. Emotional issues can significantly impact a person’s sleep habits, cause a reduction in appetite and make them more susceptible to illness and injury. Evaluating your loved one’s emotional functioning includes addressing the quality of life issues such as:
- Family, friends, neighbors
- Hobbies or outside interests
- Community activities such as church and social groups
- Community support or services needed or available
Judgment & Reasoning
A mental or psychological assessment is important so that you have a clear understanding of your loved ones ability to think and reason, this is not just about memory but judgment and decision making ability. Is your loved one merely struggling with simple forgetfulness or episodes of confusion or is it more consistent and persistent problem. Is there judgment and reasoning ability impaired? Are they making merely foolish or poor decisions or is it an indication of being disoriented and not really aware of their circumstances?
All of these areas of functioning interact and influence the other and are important to understand the whole person. The inability to participate in outside activities due to pain or mobility issues will greatly affect a person’s mood and quality of life. Medications can cause changes in mood, behavior and thinking ability. And poor nutrition and infection can cause disorientation and confusion. So a thorough assessment will help uncover the issues and underlying causes so that a proper plan of action can be implemented.
The stress and burden of caregiving can be greatly alleviated when you have a clear understanding of what your job of caregiver entails. Once needs are identified then the caregiver and the cared for can work together to create a workable plan to provide the needed care. Open and honest communication will be an essential component in those next steps.
I hope you found this helpful. Please be sure to send me you comments and questions
So until next time – take care of yourself and know there is
…help for the journey