Long-Distance Caregiving: 4 Ways to Stay in Touch from a Distance

Long-Distance Caregiving: 4 Ways to Stay in Touch from a Distance

Long-distance caregiving comes with a unique set of challenges, but it’s important for families to stay connected – no matter how many miles separate them. With technology and consistent communication, it’s possible to be intimately involved in your loved one’s care when he or she moves to assisted living or needs skilled nursing care.
“It’s really important for our population that families stay involved,” says Sarah Sjaaheim, Director of Social Services and Admissions at Eventide Senior Living Communities. “Nobody has to feel excluded because of distance.”
The National Institute on Aging defines a long-distance caregiver as anyone who lives an hour or more away from the person who needs assistance. These caregivers can take on any number of caregiving roles ranging from money management to clarifying insurance benefits to arranging care in a senior living community.
Here are some tips and tools for staying involved with your loved one’s care no matter where you live.
Technology
Even residents needing skilled nursing care are more tech savvy than ever, Sjaaheim says. Many residents are comfortable using smartphones and tablets, allowing families to keep in touch via video chat services like Facetime or Skype. Family members might text back and forth throughout the day. These tools are valuable whether you live across town or across the country.
Technology also plays an important role when family members want to be part of healthcare decisions. Electronic medical records mean that, in some cases, family members can access test results and physician notes even before Eventide staff receive them, Sjaaheim says.
Phone
Even with technology available, families who want to stay close to loved ones shouldn’t dismiss the phone. Some families choose a regular time to call: for example, 7 each evening or 4 p.m. on Sundays. If staff know about this routine, they can help to make sure your loved one is available for the call, Sjaaheim says. If dementia has taken away a loved one’s ability to recognize family members by face, he or she may still be able to recognize and find comfort in familiar voices.
“If someone has regressed and is seeking you as a child or young adult, you won’t look familiar but your voice will be,” Sjaaheim says. Even a one-sided conversation can bring comfort to someone with memory loss.
The phone is also a great way to stay involved with care and daily activities. At Eventide, conference calls are a common way to keep out-of-state family members in the loop during quarterly care conferences. Everyone who wants to be involved can get up-to-date information about a relative’s health, progress and interest in activities. In between conferences, family members are encouraged to call the nursing station for information. These regular connections build trust between staff and family members, Sjaaheim says. It makes it easier to converse when a health crisis or decline happens.
Mail
Everybody loves to get mail. The message doesn’t need to be long; the touch point is what matters. Send a postcard from a place that your loved one once visited. Send a card with a sentence of two about something happening in your life. You could even mail a photo book or calendar filled with images from your loved one’s past. These photos can be of family members or past events.
“Anything that prompts dialogue or conversation is helpful,” Sjaaheim says. “Family is vital for bridging gaps and helping staff to understand what is important to an individual.”
In-Person Visits
Even with other options available, be sure to schedule in-person visits and to set priorities for those times. For example, do you want to accompany your mom to a medical appointment? Family members who don’t see a loved one regularly can provide helpful observations on how a loved one is adjusting and progressing. Sometimes it takes someone from out of town to notice decline, Sjaaheim says.
While much of the visit may be focused on caregiving duties, don’t forget to spend time relaxing and enjoying each others’ company. Above all, don’t let guilt for not being there every day get in the way of enjoying time with your loved one.
“If phone is the best we can do, you can still play a valuable role,” Sjaaheim says. “The important thing is that you stay involved. Time goes so quickly. Don’t waste it on guilt.”

Music Improves Resident Quality of Life

For music therapist Danielle Ambuehl, some of the most powerful tools are a guitar, rhythmic instruments and the human voice.
Shortly before lunch on a mid-May Monday, she gently quizzes a handful of residents at Eventide’s Moorhead campus who participate in one of her weekly music groups.

“Mothers are often known for giving us words of wisdom. Can you help finish these phrases?” she asks.

“The early bird …”

“… gets the worm,” says one woman.

“Actions speak louder …”

“… than words,” several interject.

Ambuehl walks around and hands out jingle bells, tambourines and shakers as she introduces the next musical activity. It is based on a song with its own words of wisdom: “Accentuate the Positive.”

“That’s a good one,” says one resident as group members begin to shake their instruments and sing along to a recording by Bing Crosby and The Andrews Sisters.

The half hour session looks like a simple sing-a-long, but, in actuality, the music disguises therapy at work. The residents in long-term care work on range of motion as they shake instruments. Cognitive skills are strengthened as they remember song lyrics and common phrases. And it’s all done as they socialize and build community through song.

“Music is so motivating,” Ambuehl says. “I believe that it has the power to create instant change.”

Ambuehl is a board-certified and licensed music therapist who offers services to groups and individuals at all three
Eventide locations. The fulltime staff member designs activities that use music to address physical, emotional, cognitive and social needs.
For some residents, that means socializing as a member of Eventones, a choir that meets weekly. For other residents, that means a one-on-one session with Ambuehl who will play guitar chords to reduce anxiety. She’ll even create a personalized playlist for residents who may use music as an incentive to complete tasks.

“This gives Eventide residents something that a lot of facilities don’t offer,” she says.
Music is increasingly used to help seniors increase or maintain their level of physical, mental and social-emotional functioning, according to the American Music Therapy Association. Research shows that the intentional incorporation of music in a therapeutic setting can help a person maintain a quality of life. Ambuehl strives to identify the strengths and gifts of Eventide’s residents and enhance them. She also tries to match musical genres and time periods to the residents’ interests.

“I want them to be empowered,” she says. “What instruments do they want to play? What kind of songs do they want to sing or listen to? Everyone can participate no matter what abilities they’ve lost.”

One of her favorite stories is about a resident with anxiety who hollered at inappropriate times. He also tapped his foot vigorously. Ambuehl entered his room and started strumming guitar chords to the rhythm of his foot-tapping. Gradually, she was able to slow down the tapping and soothe the resident.

“He was more comfortable. And when residents are calmer and more comfortable, it’s also a safer environment for nurses, CNAs and other staff,” she says. “Music is powerful.”

Music also challenges residents and give them an opportunity to process their experiences. Ambuehl asked one of her groups to rewrite lyrics to the tune of Johnny Cash’s “Folsom Prison Blues.” The title of the new song? “Restless Leg Syndrome Blues.”

At the weekly gathering in the long-term care unit at the Moorhead campus, Ambuehl’s group ranges from six to a dozen residents.

They open with “Hail, Hail, the Gang’s All Here,” and they all are, singing and quietly clapping along.

Eventidings Newsletter | Spring 2017

Our Spring 2017 newsletter is now available! In it you’ll find:

  • How our Music Therapist is improving resident quality of life through music
  • Your Gifts in Action – Find out what the Eventide Foundation has been up to
  • Leaders in Living – Information about our upcoming Annual Community Education Series

Staying Connected with a Loved One Who Has Dementia

Maintaining a relationship with someone who has dementia or Alzheimer’s disease can be challenging.

Not only do these illnesses rob a person of memory, but they eventually impair a person’s ability to understand and speak words. Conversation and visits can become difficult.

But your loved one needs regular contact with family and friends.

“People with dementia or Alzheimer’s can pick up on how you make them feel,” says Stephanie Doppler, resident care manager at Eventide Sheyenne Crossings in West Fargo, N.D. “Even if they don’t remember your name or who you are, you can still leave them with a positive, good feeling.”

As the relationship changes, there are some important ways to stay connected with those who have dementia or Alzheimer’s.

Tips for Interaction

  1. Listen for clues as to where a loved one’s reality is. As these diseases progress, mom or dad’s memory regresses. They might believe that they are in their 40s, working on the railroad, or in their 20s, raising small children. “Ask them to tell you what’s happening,” Doppler says. Help them reminisce rather than bring them back to the present.
  2. Be agreeable and find ways to offer comfort and reassurance. Don’t argue with your grandmother when she calls you the wrong name or says she doesn’t recognize you. Just be there as a friendly and comforting presence.
  3. Share musical experiences. Music memories do not fade as an individual’s disease progresses, Doppler says. Sing hymns together. Encourage your dad to play piano, if that’s something he’s done in the past. Listen to favorite songs. “Music is an important, useful tool,” Doppler says.
  4. Share memories. If your loved one no longer uses words to communicate, feed them memories. Tell your mom how much you enjoyed the chocolate chip cookies she used to bake or how much you enjoyed your dad’s woodworking projects. Find old photos and look at them together. Bring a quilt your grandma made and talk about it as she holds it. Read a short story or poem aloud. If faith was important to your loved one, pray together.
  5. Bring your kids or pets. If your loved one raised children or loved animals, bring small children or a well-behaved pet to the visit.
  6. Promote touch. Even if verbal communication is gone, human contact can speak volumes. Gently rub your mom’s hand or shoulders. Hold your grandpa’s hand. Be sure to read their signals so you can stop if they start getting agitated or upset.
  7. Find an activity for success. Search for activities that your loved one can still do. Giving them a purpose is important. Sweeping, setting the table, even blowing bubbles can provide a sense of accomplishment and value.

Staying Connected Long-Distance

If you don’t live close enough for regular in-person visits, staying in touch with a loved one with dementia can be even more difficult. Here are some ways to stay connected:

  • If a phone conversation is no longer possible, send cards or short notes. Everybody likes to receive mail. It’s another way of cultivating that feeling of closeness and comfort, that understanding that someone cares.
  • Check in regularly with staff to stay up-to-date on your mom’s health and well-being. This should eliminate any surprises when you do visit.
  • When you visit, try to not have certain expectations in mind. It can be difficult to see in-person how your loved one’s disease has progressed. Stay positive and accept your dad where he is at.

Above all, recognize that while the relationship has changed, maintaining connections with someone who has dementia is valuable.

The Importance of Respite Care

Keeping an elderly loved one in their home as long as possible is desirable, but it also can be an exhausting labor of love for family caregivers.

If your loved one needs 24-hour support, it can be challenging to find time for a vacation, a doctor’s appointment or even a trip to the grocery store. Burnout, exhaustion and frustration can quickly settle in.

Respite care can help to alleviate some of the physical and mental demands of caregiving.

“Taking care of a loved one is important,” says Genn Bervig, director of admissions and social services at Eventide. “It’s also important to take care of yourself if you’re the caregiver. That’s the best way you can continue to provide care for your loved one.”

Bervig regularly receives calls from family members looking for assistance.

“I’ve heard from caregivers who need surgery themselves and they’re wondering: ‘who’s going to take care of my loved one while I’m recuperating?’” she says.

Eventide doesn’t provide respite services for the general public. It does provide respite services for hospice patients through Hospice of the Red River Valley.

But there are formal and informal, in-home and out-of-home respite options available.

Ideally, caregivers can find another family member or a friend who can step in for a short period of time, whether it’s an hour or two each day or for a full week of vacation. This may be a good option if the senior doesn’t need special medical care but needs to have somebody around.

When a family member or friend isn’t an option:

· Ask a parish nurse for ideas. If your loved one is a member of a church or faith community, there may be a volunteer who could stop by for a couple hours each week.

· Search for a respite service. If you are looking in Cass County (North Dakota) or Clay County (Minnesota), visit www.CassClaySeniorResources.com. This website provides a list of area service providers who provide day or overnight relief care for seniors needing supervision.

· Consider adult day care. Again, www.CassClaySeniorResources.com provides a list of options. An adult day care center provides meals, socialization, games and educational activities. Caregivers then have the freedom to work or take care of other household needs during the day.

Paying for respite care can be difficult. Insurance may cover if the care providers are licensed medical professionals. Long-term care policies may pay for some services. Some states provide Medicaid waivers to offset costs. Some state agencies have funds set aside to help in certain cases.

You can find information on respite care funding in North Dakota here. https://archrespite.org/respite-locator-service-state-information/166-north-dakota-info

You can find information on respite care funding in Minnesota here. https://archrespite.org/respitelocator/respite-locator-service-state-information/155-minnesota-info

The important thing is to recognize that family caregivers need sufficient and regular amounts of time away. It’s not only okay, it’s healthy to take a break.

Moving Day: Tips for What to Bring

Moving into a new home always comes with some stress. That stress may be magnified once you’ve decided to move yourself or a loved one into a facility where they can receive more assistance and care.

That said, moving into an assisted living or long-term care facility doesn’t mean giving up the comforts of home. But the move likely will require you to make some decisions as you relocate into a different, and possibly, smaller space.

“It’s a transition, just like any move is,” says Sarah Sjaaheim, director of social services and admissions at Eventide Fargo. “Even if everyone is positive and excited about the move, there will be an adjustment.”

She encourages residents moving into assisted living or a long-term care facility to take their time in determining what they want to bring with them.

“Decisions don’t need to be made overnight,” she says. “You can live in the space for a while and make decisions from there.”

Moving into Assisted Living

Eventide’s assisted living residences are unfurnished apartments, meaning new residents bring their own furniture, furnishings and personal items.

Space for those items depends on the square footage and layout of each apartment. (There are one-, two- and three-bedroom units plus 14 different floor plans).

Before you move into assisted living, consider:

  • If you or your loved one uses a scooter or walker, make sure that there is enough space to store it and to maneuver around the apartment. You may have to limit furniture to make sure there are clear pathways.
  • Some bedrooms may accommodate queen- and king-sized beds while others are better suited for a full-sized one. If you’re not sure, ask the facility. If you want a dresser in the bedroom, ask if there will be room for it.
  • Bring your favorite rocking chair or recliner. If you prefer to use an electric lift chair, be sure you know how to use it safely.
  • Bring small tables, decorations and blankets to make it feel like your space.
  • Area rugs may make an apartment more homey, but they can also be a tripping hazard. Consider leaving these behind. If you’re determined to bring one, make sure it lays flat and the edges are taped down.
  • Take into consideration space needed for medical equipment. Be sure that oxygen tubing is secured or placed where it isn’t a tripping hazard.
  • Ask yourself what services will I (or my parent) need in six months? Planning for these needs when you first move in can make things easier down the road.

Moving into Long-Term Care

Tougher decisions need to be made when you or a loved one move into a long-term care community. The rooms are smaller and more space is needed for caregivers and medical equipment.

Everything in these rooms is provided except clothing and decorations, but there are still ample opportunities to personalize the space.

“We encourage our residents to get settled and then decide what they want to bring,” Sjaaheim says. “The only restriction is that staff need to be able to maneuver safely around the bed and chairs.”

Some items that can help you or your loved one feel more at home :

  • While toiletries are provided in long-term care, some residents prefer to bring their own.
  • A CD player or small radio.
  • Clothing.
  • Photos of family, friends or treasured memories.
  • Plants.
  • A Chair. Recliners are provided in Eventide’s rooms, but some residents prefer to use their own.
  • Items that reflect one’s hobbies or interests. Residents often decorate their doors with flowers or sports memorabilia so they can easily identify their room. One resident displayed a model ship outside his room.

“We encourage residents to bring something that says, ‘This is my spot. This is just for me,’” Sjaaheim says.

Verdie and Norma: A Love Story

Verdie Ellingson has always loved Valentine’s Day. In fact, he has a frame holding eight valentines he received as a child at his country school in Chippewa County, Minnesota.

Later in life, Valentine’s Day would be when he proposed to his future wife Norma. And today, he still celebrates by sending valentines to family and friends and decorating the drift wood Valentine’s tree that Norma saw in a store and had to have.

Verdie and Norma’s romance started long before it became official. In 1944, Verdie attended a “basket social” at the country school where his sister Sylvia was a teacher. At a basket social, the girls would bring a basket containing a picnic lunch. The baskets were auctioned to raise money for the school. Sylvia tipped Verdie off as to which basket was Norma’s. He bid on it, won and had the privilege of having lunch with Norma that day. He went as far as to ask if he could give her a ride home, but her mother refused, being Norma was only 14 and Verdie was 20.

A couple of years later, Verdie was home on leave from his military service and went to a dance where he saw Norma. The two danced and visited and this time Verdie did give Norma a ride home. After that, Verdie went back to serving in World War II. Norma regularly sent him letters while he was gone.

Upon his return, Verdie was determined to finish college. After graduation, he took at teaching job in southern Minnesota. During Thanksgiving break, Sylvia once again played a role in Verdie and Norma connecting. Sylvia was married to Norma’s brother and wanted Norma to come home for Thanksgiving. She asked Verdie if he could pick up Norma in the Twin Cities where she was attending nursing school. He agreed. That ride sealed their fate. The two started seriously dating and on Valentine’s Day of 1952, Verdie proposed and Norma accepted, and as Verdie says, they “lived happily ever after.”

The two would spend almost 50 years together, Verdie always in love with Norma, just like a fairytale love story. “She was easy to love and she made it so I was easy to love, too,” says Verdie.

Verdie worked as a teacher, then an administrator and then a school superintendent. Norma worked as a nurse. Together they had four children and 10 grandchildren. When the couple retired, they moved to Moorhead to be close to their son.

When Norma needed more care due to her rheumatoid arthritis, the couple moved to Eventide on Eighth, where Verdie continues to live today, still celebrating Valentine’s Day.

Consider Eventide Foundation on Giving Hearts Day – Feb. 9!

You make a difference in the lives of our residents! Your gifts help us to enhance resident programming and activities so that every resident can continue to live their lives to the fullest! Please remember Eventide Foundation on Giving Hearts Day. Match funding multiplies the impact of your giving. Your gift of $10 or more will be matched up to $11,000. Make your gift count! Donate at givingheartsday.org on Feb. 9th.

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Learn more about the difference you can make through donating to our foundation!

 

 

Paying for Long-Term Care

If you’re fortunate enough to reach the age of 65, the question is “when” and not “if” you will need long-term care services or support. About 70 percent of us who reach that milestone will need care in their remaining years. On average, women will need care longer than men.

This trend leads to the second most popular question that Genn Bervig, director of Admissions and Social Services at Eventide, hears from families who call: what will this care cost?

The short answer: it depends.

There are a variety of services and support and, likewise, a wide range of costs. No matter what kind of long-term care you will need, researching options and planning ahead financially will benefit you and your family.

Costs

Long-term care is expensive. According to the U.S. Department of Health and Human Services, the average cost for nursing home care can range from $200-$300 per day, depending on services needed and whether the resident has a shared or private room. Personal items like phone and television are extra.

Assisted living can cost more than $3,000 per month. A home health aid costs about $150/day. And homemaker services like preparing meals and light cleaning can run about $130/day.

More people use long-term care services at home than in facilities like nursing homes, according to the U.S. Department of Health and Human Services. On average, women need support for 3.7 years; men for 2.2 years.  

Ways to Pay

Some individuals qualify for public health programs like Medicaid that will pay for long-term care either in a facility or at home. To be eligible, you must meet certain financial and health requirements. Because nursing homes cost so much, residents may pay first with their own money and “spend down” resources until they qualify for Medicaid. There are rules about this.

To the surprise of many families, Medicare rarely covers long-term care, Bervig says. It will pay for a short stay in a skilled nursing home or home health care if you’ve had a three-day hospital stay prior and need skilled nursing services or therapy.

This means that most families cover these costs themselves, usually through a combination of these methods:

1.   If you have long-term care insurance, research what services are covered. Some policies cover home care and assisted living services. Others cover only nursing home stays. The cost of the policy depends greatly on your age when you purchase it and the coverage desired.

2.  Most people don’t have enough money to pay for long-term costs out of savings and retirement funding. By planning ahead, they can determine the best private payment options for them. For example, reverse mortgages, certain life insurance policies, annuities and trusts are just a few ways to help cover the costs.

Since each situation is different, it may be wise to consult with an attorney or financial planner who can help you plan for these costs, Bervig says. Be sure this expert specializes in elder law or has significant experience with the needs of aging seniors.

Also, keep researching and stay up-to-date with the best ways to pay for long-term care. As the population ages, additional ways to cover these costs are being developed.