Wednesday, 20 January 2016

Care Partner Wednesday--The Sudden Care Partner

Meet Janice.

She has a family; two teenagers and a twelve-year old, a husband who travels, so is not home for the day-to-day running of the house, and a mother who helps out with the kids. Mom is a young eighty who walks every day, reads the paper, is conversant in politics and plays a mean game of Scrabble. Mom still drives,  so she comes and makes dinner a couple of nights a week when Janice is tied up with meetings at the office. It's busy, but it works.

Until the day it all falls apart. Mom steps off the sidewalk and misses the curb, falls and breaks her hip. She needs surgery to repair it, but as she is recovering, develops a heart arrhythmia. She can no longer drive and needs multiple medications. She becomes depressed, requiring more medication. Janice worries about her all the time, and wonders how she can look after her mother, her family and her job.

Janice has become a care partner.

Most of the family members I meet are far along in the care partner journey. They have moved their loved one into an apartment or life lease in our building, and many years later, down to the care sections. Or, the resident made the decision to move to a place where the care would be there when they needed it. Either way, it was a slow journey and family had time to learn their roles and adjust to what was needed. Not so with Janice. She became a care partner overnight, and is facing a lifestyle change, questions, fear, guilt...

If I had one piece of advice, this would be it: get help.

It's difficult to think clearly when it feels like your world is crumbling. Here are a few suggestions:

1. The first place to start is the doctors, nurses and social workers at the hospital. Before they release her, they will need to know that she has a place to recover where her needs can be met until she is healed. They may decide to send her to a rehab hospital, a place dedicated to getting her back on her feet and moving. She would get daily physiotherapy and encouragement to get back as much of her function as possible. This also gives you several more weeks to plan for what is needed next. If this isn't possible, talk with the medical staff about what the next steps should be. Be sure to include Mom in the conversation.

2. Ask, ask, ask. There may be supports available to you through government agencies, your insurance provider or other community services. Find out what help is available and how to access it.

3. Discover what Mom needs. Does she need an assistive device like a walker? Will she need a wheelchair for a period of time, and if so, could you rent it? Maybe you will need to think about buying a foldable wheelchair (called a transport chair) for when walking a longer distance is necessary. Will she need help getting in and out of the tub/shower? Can she put her socks on? Does her house have a lot of stairs that are going to be difficult? Make a list of what she needs, and another of what can be done to help.

4. Don't panic. It may be that some supports will need to be put in place for a period of time while she is healing, but this may not be the time for major permanent changes, such as moving. Make sure to get a proper assessment from your doctor. What is she going to need for now, and what will be needed in the future? Again, include her in all these conversations as you work out together a plan of care.

5. Think ahead. It may be that Mom heals well from her fracture, the arrhythmia is controlled by medication and the depression passes. However, given her age, it is the time to have several conversations. The "at some point you will need to move, Mom, and where do you think you'd like to live?" conversation will be the next one. You may be surprised to discover she's already thought this one through. If you haven't done it already, you should have the "powers of attorney" conversation, so that everything is legally in place when you need it. And at some point, perhaps connected to the legal work, you should have the "if you were to have a medical 'event' requiring CPR, would you want it? What kind of end-of-life care would you like?" conversation. Timing is everything for each of these, but don't put them off too long.

Janice, or anyone who suddenly becomes a care partner, has to make multiple decisions quickly. It can be frightening, overwhelming and make you weary. I go back to my original statement. Get help.

Because...there's no shame in asking for help.

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