The ideal home caregivers are family members, neighbors, or friends

LB: Hello, I’m Larry Berkelhammer bringing you more information about living well with chronic illness. This is the first of a five-part text interview with Steve Olian. I’ll return to video interviews after this five-week series.

LB: Larry Berkelhammer

SO: Steve Olian

 LB: I have with me today Steve Olian, an MBA, who worked in practice management in the medical field. In addition to his professional background in medical practice management, he has personal experience. Steve’s spouse is disabled by MS and since their grown children are not living nearby, he has been the one to manage her care.  He also facilitates a group of about 15 to 20 seniors, many of whom are disabled at the largest senior center in Marin County, California.  I’m going to be asking Steve some questions based on his professional experience, and especially on his personal experience managing his spouse’s medical and home health care.

 LB: Lets jump right in. I have questions about how to manage home health care for a disabled family member when the job is too much for the well family member. I suppose the first thing is recognizing the need for outside help.  How can people know when the person they’re living with needs more help than they can give them?

 SO: I think you come to a point eventually when you find that too much of your life is being absorbed in the care process, and you have to really look at that realistically.  If you find yourself becoming very short-tempered, impatient, and burned out, then, if you can possibly afford it, then it is really appropriate to look for help on the outside.  Financial and other considerations are part of the decision-making process, and some people have limitations that prevent them from doing that.  Assuming you’re fortunate enough to be able to, that is what our conversation is about today.

 LB: I imagine one of the struggles in the beginning is that you may want to personally care for your loved one, and you try to, but you find that after a certain period of time it’s just too exhausting! Some people don’t have the resources to hire someone from the outside, so in that situation, I imagine then they call on family members.  Even if you are lucky enough to have a good-size family nearby, how do you decide on which family members will do which jobs and which one will oversee the whole plan?

 SO: It really kind of works the other way around. One would look around to their family resources and may find out that some people who are willing, turn out to be less competent than desired. Even in my facilitation of groups about home care—we see that there are people in families who are capable of doing this, psychologically and functionally, and there are others that cannot.  They are just not going to be appropriate for that, and that is another judgment call people have to make.  With family members as dispersed as they are these days, you may have children who are willing as well as capable, but they’re 3,000 miles away at a job that they can’t leave.  So I think more and more seniors are being thrown under their own resources.  It’s really ideal if you could have family members who know, and care, and love the person that is being cared for.  Unfortunately, that is not always available.

 LB: Let’s say you do have family members who are available, capable, and are willing to do it, I imagine they have different skills, like one family member may be very organized in his or her thinking and be a great manager, whereas a different family member may have medical knowledge and may even have worked as an RN, LVN, or CNA (certified nurse assistant).  That’s a very ideal situation.  Do you have anything to say about that?

 SO: Let’s use the term managing the care, because the spouse or the primary caregiver is going to have to exercise management skills. This includes trying to decide or judge which family member has the capability of doing various jobs that need to get done. Even though you’re either recruiting family members to help out or you’re going outside to hire people to do it, the primary caregiver is still the primary caregiver, that is, the one doing the management, and that is a big job that never ends!

In next week’s installment, Steve and I will discuss what to do when you want to hire help from the outside—where to go for that.