Dr. Cheryl Woodson
DrCherylWoodson.com
Are you one of the many caregivers who struggle with eldercare and reach the end of their ropes? You may have family, but no one helps. You may have a job, children, and maybe grandchildren, or you have your own health issues. Maybe she wasn't such a good mother. How do you get off the hot seat?
You're right. You do not have to give care. Most caregivers are not legal guardians, but you can't just walk away. Having been in the caregiving role, you are at risk for charges of abandonment under elder abuse and neglect laws. Most states will bring these charges against adults who are in a position to be aware of the elder's needs, even if they don't consider themselves caregivers, and even if they don't live in the home.
One of my patients lived with his equally elderly wife. She could no longer give good care, and though their adult children visited frequently, they did not find a way to relieve her. Adult Protective Services involved the children in the investigation because they were aware of the needs, but did not intervene.
If you decide that your caregiving days should be over, I commend your integrity. Many overwhelmed caregivers toil on until they become ill and can no longer meet the senior's needs. Even though they don't mean to, these caregivers commit passive neglect. In the saddest cases, caregivers intentionally endanger seniors, or commit abuse.
Others depend on the elder for financial resources. Refusing to see beyond their own needs, these selfish people keep using the senior, committing elder abuse in the category of financial exploitation.
Your honesty and courage will make a difficult transition safer for everyone if you follow these steps:
- Contact a social worker at the hospital, or clinic, the Department on Aging (DOA), or Adult Protective Services (APS,) to help you develop another care plan. These services are free, but they may have limited resources, or take several weeks to become involved. The National Association of Professional Geriatric Care Managers is usually more responsive, but they will charge a fee. Their website (www.caremanger.org) provides a list of all certified care managers near the elder's zip code. Ask about fees when you make the appointment.
- Contact the elder's doctor to learn the senior's specific health care needs and decision-making ability. The Health Information Portability and Accountability Act (HIPAA) does not allow doctors to release information without elders' written permission, but you can always send a letter, describing the situation and asking for help. Doctors can also refer to DOA, or APS. The doctor and social service professionals can recommend the most appropriate care site, based on the seniors wishes (if there is not an incapacitating mental disorder,) the medical needs, financial resources, and any other family members' involvement. Can the senior live at home with services? Would assisted-living, or nursing home be more appropriate?
- If you're afraid of arguments, inform the elder and other family members AFTER you have a game plan. This decreases the risk of confrontations and guilt, forcing you to stay in a situation that's no longer good for anyone. Care managers and/or doctors can mediate by inviting everyone to a family conference, relaying the information, and helping develop a strategy. Ongoing personal and family counseling is essential for making a smooth transition and maintaining family relationships.
There is no way to make this situation painless, but you have to make it safe for the elder and yourself.
Dr. Cheryl Woodson is an author who specialized in Geriatric Medicine for more than thirty years, and also navigated her mother's ten-year journey with Alzheimer's disease. She taught Geriatrics in medical schools, founded community-based care-coordinating Geriatrics programs, and served on the White House Conference on Aging. Shooting from the hip and from the heart, Dr. Woodson brings a unique perspective to professional and family caregivers, community activists, and policy-makers. For more information and resources visit DrCherylWoodson.com. Permission granted for use on DrLaura.com.
