Tag: senior citizens

Caregiving for Seniors

Caregiving for seniors can be challenging. Know your options.
Retirement reality? Or wishful thinking?
Photo by Dominik Lange on Unsplash

I live in a senior community. Many of the realities of senior living are positive. But some of the realities of senior living are tough. A couple of stories about caregiving for seniors that I’ve heard in just the last few weeks. . .

My husband is driving me crazy. He’s been getting worse and worse. He follows me around the house from morning til night, repeating the same question that he asked 5 minutes ago. He’s making it hard for me to get anything done. And it’s impossible for me to leave him home alone!

Another story, overheard from another conversation:

Well, I finally have to do it. The pain is just too much. So I’ll be getting hip surgery – next week actually. The doc says I won’t be able to stand or get around very well for quite a while. I guess I’ll have to find somebody to take me to appointments. Oh, and I’ll need somebody to walk the dog. . .

When I heard this last story, I knew it was a recipe for real trouble!

Without some sort of plan, these neighbors may be heading straight into an emergency!

Amazingly, that very day I got a solid referral to a woman who runs an in-home care agency – right here in town. The timing was perfect. After I met with her, I knew I wanted to share some of what I learned about caregiving for seniors.

So a special shout-out to Kamara Viau,
owner of Acti-Kare of Irvine
She helped me jump confidently right into this new topic

Here are some of the questions I asked about home health care and caregiving for seniors at that first meeting. The answers come from Kamara and from my own follow-up research.

“What exactly does in-home care include?”

As you might expect, there are different levels of home care. The levels seem mostly related to the skills required of the caregiver.

  • For example, if you are recovering from surgery, you may need someone to instruct you about your therapy, and make it clear what you can or should not do. You may need help managing medicines. This level of care, typically called “recovery care,” requires skilled nursing training. . . and naturally, is often the most expensive. It may not last very long.
  • At the other end of the spectrum, as caregiver to an aging husband or wife, you yourself may need “respite care.” Just having a trusted health care worker to act as companion for your mate for a few hours could be a real godsend.

Many services lie in between these extremes. The home health caregiver may plan and prepare meals, do light housekeeping and laundry, help with bathing and dressing, etc.

“How do you decide what care YOU want, or need?”

The process starts with a consultation, or assessment. It should be handled by a specialist with medical background and experience in caregiving for seniors. (Ask about that background! Turns out Kamara is a trained dietician with years of experience in a nursing home setting.) The consultation will be based on two things: the medical and mental health of the person to be cared for, plus how much help he or she needs in performing the Activities of Daily Living, or ADLs.

There are standard industry lists of over 25 ADLs. They include things like bathing, preparing and eating meals, standing from sitting, using the telephone, managing medications, paying bills, etc. Get a head start on understanding ADLs by downloading a copy of a full list here.

For some programs, not being able to manage just 2 or 3 of the activities of daily living says you’re in jeopardy! (Wow. Most seniors I know have a problem with at least 1 ADL – like putting on socks!)

“What sort of contract can I expect?”

Following the consultation, you can expect a customized and comprehensive written plan of care. The plan of care is the contract.

It identifies exactly what the caregiver will do, how often, what days of the week, etc. (Most agencies have a minimum 4 hour shift.) Your plan of care should make it clear how visits are documented, what happens if you need a substitute caregiver, etc. It also includes how you will pay for the service.

Naturally, with earthquakes on my mind, I asked specifically about the responsibility of the caregiver in an emergency.

The plan of care should include specific instructions for the caregiver about what to do and whom to call in an emergency. Kamara said that her caregivers also receive special training preparing them for a widespread disaster like an earthquake. Included in that training: “Discuss ways to keep yourself and your clients safe in an emergency. Be prepared to accompany/guide the client away from areas that are no longer considered safe.”

If you are interviewing agencies (and you should interview several), slip in a question about emergencies that might be likely in your part of the country!

“So how much can I expect to be charged for caregiving services?”

The average hourly rate for a licensed caregiver can vary depending on your location, the skill level you require, how many hours per week you need the person, etc. A variety of sources agreed that the hourly rate for a home health aide in California ranges from $23 to $36 per hour.

“Where can I get help paying the bill?”

  • Medicare. Medicare may cover care if a doctor certifies that the patient requires skilled nursing care, physical therapy or other professional therapy, and the care is provided by properly licensed professionals. Assistance with ADLs, however, probably will NOT be covered.
  • Medicaid. At the same time, low-income programs such as Medicaid may cover skilled nursing as well as personal care or homemaker services – again, as long as they are “medically needed” and “provided by a licensed agency.” State income requirements differ, so start on homework now if you think you may be able to take advantage of Medicaid. And be aware that some states may have waiting lists for this care. The sooner you get on the list, the better.  
  • Private long-term health care insurance. Do you have a long-term health care policy? Dig in to see just what in-home caregiving services will be covered. LTC policies typically are designed to cover care in a facility, but they often will cover in-home care support based on factors such as not being able to perform a specified number of ADLs. Everything is based on how each policy is written! 
  • Your own savings. Many people will recoil when they think of a $30 hourly cost with a weekly minimum. “Just can’t afford it.” However, if you want to stay independent and in your own home, planning for the cost of home care may be exactly what you want to do.

“What if the caregiver isn’t a good fit?”

If the consultation was thorough, your caregiver should start off with the skills and understanding you’re looking for. You should have the opportunity to give regular feedback, too, on how everything is going.

The feedback process and options for changing caregivers should be included as part of that initial consultation. Remember, you’re the customer here so you should have the final say.

Final thoughts for people caring for a loved one at home.

Is your current home situation causing you anxiety or stress? Are you are feeling trapped? Perhaps guilty that you aren’t doing enough? Is caring for someone else impacting your OWN mental and physical health?

Would help from a professional caregiver lessen that tension? You may only need a little help now. But you’re likely to need more help later. The more you know about in-home care and caregivers, the more choices you’ll have.

I hope this Advisory will help. It doesn’t have all the answers, but it can get you started.

Your Emergency Plan Guide Team

P.S. Don’t forget my checklist of the Activities of Daily Living. Discuss it with family and with a potential caregiver. Click here to download the list of ADLs for free.

The Joy of Giving — to Senior Citizens


As a senior citizen, you can give others the chance to experience the joy of giving to YOU. Here’s how . . .

When we get to November, we know that “holiday season” is just around the corner. So every year here at Emergency Plan Guide we remind you that preparedness items make good stocking stuffers for kids as well as smart “thank-you gifts” for employees.

This year, though, we are turning things around. We’re not suggesting that you experience the joy of giving to others.

This year, we want to help others get the joy of giving . . . to you!

This is an idea that came up at a recent neighborhood meeting, here in our senior community. (Since everyone at the meeting was a senior citizen, they agreed it was a GREAT idea.) It was such a good idea that we turned it into a newsletter article to share with all!

So here’s what our group will be publishing the first week of December, in time for Hanukkah and Christmas. Today, though, as a reader of Emergency Plan Guide, you’re getting this good idea early.

The Holiday List for Seniors . . .

My Neighbors Helped Me Make this List!

  • Show me how to QUICKLY call 911 using my cellphone.
  • Make sure my doors aren’t blocked with furniture, boxes, etc.
  • Help me get rid of trip hazards — throw rugs, pet dishes, etc.
  • Can you bring me some half-gallon bottles of water?
  • Do all my windows open? Do all my lights work?
  • Grab a towel (to muffle the sound) and test my smoke alarms.
  • Be sure I have a working flashlight in every room.
  • Help me pack an “Under the bed” kit in case a disaster hits at night: flashlight, shoes, sweater or jacket, whistle, gloves, list of emergency contact names, and some water.

This checklist is a great preparedness exercise for an older friend or family member.

Here’s the step-by-step . . .

  1. Are you, or do you know, someone who could use a helping hand to make sure their home is as safe as it ought to be? Cut out this list and hand it to them.
  2. Tell them to check off small safety or preparedness jobs that just aren’t getting done around the house.
  3. Finally, mail or hand the list to younger friends or family members who are planning a holiday visit. If they arrive with list in hand, they will easily get these simple jobs done!

I guarantee that this list has the chance to produce a big WIN-WIN!

Your Emergency Plan Guide team

P.S. In this case, the joy of giving is actually a 3-way win!

  • If you’re the one receiving these small gifts, you’ll be so much more comfortable and more confident as you head into a new year.
  • If it’s your mother or father or another older relative that gets these small safety gifts, you can feel satisfied that you have done a good turn – or two.
  • If it’s a neighbor who receives these gifts – your whole neighborhood will be safer in the future.

Take advantage of this simple giving opportunity. Such opportunities don’t come along every day.

Preparedness for Older Adults

How well will they fare in an emergency?

I expect you are in much the same boat as I am. That is, as older adults, when it comes to preparedness much of what we learn about is theoretical or purely academic. Even with lifetimes behind us, few of us have ever personally had to give someone CPR, or run from a tsunami, or forage in the woods for food.

Over the past three weeks, though, we’ve been witnessing a situation in Ukraine that, while unfamiliar to most of us here, has entered our consciousness with exceptionally strong and vivid emotion.

As a senior citizen, I find my eyes drawn to the older people in all the pictures.

Unsteady on their feet, needing a hand to keep upright on a slippery bridge. Lying against a wall, exhausted. Struggling to carry their one bag of possessions while holding on to a hand or arm or a railing.

I can’t help but think about what would happen to my neighbors here in our community if we were forced to endure such conditions. And, naturally, my thoughts and observations lead into an Advisory.

What can older adults do to be better prepared for emergencies?

First, we can try to be in better physical shape!

Being isolated at home during Covid hasn’t helped. But many of my neighbors have pretty much stopped working or even walking – unless they have pets!

I am lucky to serve as an elementary school crossing guard. I get in at least two solid hours of standing and walking every day! At the same time, I know my balance isn’t as good as it once was. And at home I certainly have trouble getting up off the floor.

Do these limitations fit anyone YOU know?

Muscle is important. In the 2017 fires in Santa Rosa, CA, seniors died because they didn’t have the strength to open their garage doors when the electricity failed! And we’ve seen images of people on their roofs in Texas, escaping from flooding. Could you climb up to your roof?

I have discovered what I think is an excellent series of exercise videos for seniors. Prepare to meet Bob and Brad! They are somewhat goofy but their advice works! Here’s their 13 minute video from YouTube:

Second, we can think through what it would take for us to walk any real distance or wait in line for hours.

Obviously, if you have difficulty walking, part of preparing for emergencies is to have already made plans for assistance. For everyone, here are some aids to consider.

I would need a pair of really sturdy shoes. (I already know this because of my crossing guard duties.) Every one of my emergency kits – my Go-Bag and my car emergency kits – has shoes and socks among the very first items to be packed.

Older adult taking a drink of water while resting on bucket seat.

What about a way to rest, without having to sit or lie on cold or wet ground? This week our neighborhood group is looking at the value of using ordinary 5-gallon buckets as containers for emergency supplies. With the addition of a simple cushion, a bucket can become a seat, giving you a chance to take a rest, manage a drink of water — without having to struggle to your feet when the rest is over. (Foldable golf stools are great, too, though awkward if you’re boarding a vehicle.)

A back-pack allows you to carry your stuff and have both hands free, to reach for help or to offer it. A rolling cart may tie up one hand and arm, but you wouldn’t have to actually carry anything. As for a suitcase? Most seniors can’t carry one!

Third, we must rethink. What is the absolute minimum we want to carry with us in an emergency evacuation?

This is the most difficult list to come up with because each of us is so very different.

Here are some general ideas to consider.

  • Prescription medicines – as much as you can carry. In turbulent times you’ll have no way to get a refill. (We’ve talked before about pressuring your doctor for extra pills.)
  • Extra eyeglasses and/or hearing aids. Your safety and certainly your comfort depend on these aids. Again, in an evacuation setting there will be no way to get replacements.
  • Phone and power bank. Who knows where you’ll find a free electrical outlet with electricity? The power bank will recharge your phone at least 3 or 4 times.
  • Flashlight and/or headlamp for moving about in the dark. If you are in a strange place, or even a familiar place that has been damaged, moving without being able to see is a recipe for injury.
  • Small emergency radio (with batteries) to have a chance of knowing what’s going on.

All the items mentioned above so small they would probably fit into just one or two Ziploc bags. So what will you do with the rest of the room in your carrier?

Here are specifics that may be more important for older adults.

  • Important original documents THAT ARE NOT REPLACEABLE. Think again. Most documents these days can be replaced with time and effort so don’t stuff you evacuation bag with paper. The best way to handle all important documents is to scan them onto a flash drive. Easy to carry, easy to access when you are settled again. Has to be prepared in advance, of course.
  • Items to keep you warm. Have you used chemical hand warmers? They are about the size of a tea bag. They last for hours. We have several boxes around the house.
  • Extra socks and underwear. What YOU need to feel presentable and confident.
  • Items for personal hygiene: baby wipes, toothbrush and toothpaste. I always carry lip balm. Joe and I always carry toilet paper (partial rolls, flattened for more efficient packing). Plastic bags of different sizes for trash, to sit on, to separate dirty from clean.

Even adding all the above, you will still have room to spare. It’s at this point you may want to pack something you love, for comfort – a photo, a stuffed animal, a favorite book.

If you’d like a copy of our Evacuation Go-Bag list for older adults, drop me an email and I’ll send the list along. We updated it in 2020 after our close call with a wildfire.

Finally, take responsibility for yourself.

Some years ago the American Red Cross published “Disaster Preparedness for Seniors by Seniors.” If you’ve been reading our Advisories, you will already have been exposed to nearly everything in that booklet.

What I like best about this booklet, though, is the very first chapter. It is entitled, “Take Responsibility.” Its last sentence sums up how we approach preparedness for older adults:

“Knowing what to do is your best protection and your responsibility.”

I trust you agree!

Your Emergency Plan Guide team

P.S. More about buckets coming soon. . .along with another meeting idea that your neighborhood group will enjoy!

P.P.S. You will notice that I’ve included quite a few links in this Advisory — more than usual. That’s because these are items that I think you absolutely must have ready in your emergency kits.