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Thursday, June 29, 2017

Simple Tips for Better Balance

Balance Exercises for Older Adults

As we age, our balance and coordination begin to diminish, leading to a higher risk of falls.

As professionals and, in many cases, as caregivers ourselves, many of us have known someone whose balance is impaired. Difficulties with balance stem from injury, joint replacements, or a slip and fall, to name just a few causes. The balance impairment could be long-term in nature and associated with a disease state such as Parkinson’s, a neurological disorder involving the nervous system that causes movement impairments. Whatever the case, balance can be improved, albeit on a relative level for each person.

Good balance is essential. Recent studies point to balance as an indicator for longevity. As we age, our balance and coordination begin to diminish, leading to a higher risk of falls. In fact, falls are the leading cause of injury among Americans over age 65. In 2014, the CDC cited fall-related injuries were responsible for $31 billion in Medicare costs.

More recently, the National Safety Council’s 2017 Injury Facts publication indicates in the 65-and-older population there has been a 182% increase in slip, trip, and fall deaths since 1999. This trends with aging populations, where the faster growing age segment in the United States is 90 years of age and older. The following chart depicts fall trends.

Balance Exercises for Older Adults

What is Balance?

Simply put, balance is the ability to maintain our position in space, otherwise known as equilibrium, as forces (internal and external) act upon us. Gravity is a common external force, while low blood pressure (i.e. hypotension) can cause acute bouts of dizziness stemming from internal changes. Performing balance-centric exercises daily, even in small amounts, improves the body’s ability to maintain a sense of equilibrium, thus preventing a fall or similar balance-related accident.

However, balance is more than equilibrium. Balance training needs to be “functional”, meaning the benefits can be easily transferred to your activities of daily living (known as ADLs). For example, home health professionals can observe their clients and customers in their home, work, and social settings to see if balance training strategies are improving balance. Exercises should combine elements of mobility and stability. Mobility is associated with flexibility and pain-free range of motion, for example through a joint. Stability is thought of in terms of strength. Exercises that combine mobility and stability, coupled with a baseline sense of equilibrium, form the foundation of a great balance enhancement program.

Physical Factors That Affect Balance

We control many physical factors affecting our balance, some of which are more obvious than others. Below is a Better Balance Checklist highlighting pertinent factors to consider related to balance:

  • Lack of physical activity: Are you getting daily movement?

  • Medications: Have you started a new medication and experienced any dizziness or lethargy? These symptoms can decrease reflexes and response time.

  • Impaired vision

  • Dehydration

  • Ear problems

  • Insufficient sleep

  • Surgical procedures

  • Diseases

Taking a holistic view of movement quality as it relates to balance can provide insight not seen upon first glance!

Functional Assessment: Assessing Your Balance

Advances in the ability to assess balance have come a long way. The Johns Hopkins Fall Risk Assessment tool is one approach. The assessment affords a scoring system based upon various categories. For more practical movement=based approaches, the Functional Movement Screen (FMS) has become popular in recent years and is practical for community-based settings. While the FMS was originally used with athletic populations, various components such as the hurdle step and inline lunge represent movements similar to those performed during activities of daily living.

For the purposes of a simple movement assessment that requires no equipment or special apparatus, perform the following body weight assessments and see where you have difficulties:

  • Standing Calf Raise: Screens balance and ankle flexibility.

  • Stair Walking (up and down a set of stairs, with and without a railing): Tests lower body strength and balance.

  • Sitting to Standing from a Chair (with eyes open and with eyes closed, with a partner if needed): Screens ability to transfer weight from a sitting to standing position. Strength in your hips and legs is challenged during this assessment.

  • Weight Shifting (moving side to side, pause on one leg and shift to the opposite side): Assesses lateral weight transfer, similar to sitting and standing, yet through a different plane of movement. Core and hip control are challenged as well.

  • Heel to Toe Walking (forward and backwards): Assesses balance and coordination by decreasing your base of support (with your feet closer together). Core muscles including those in the torso and lower back are recruited at an increased level.

Note: It’s always a good idea to perform these assessments with help from a spotter.

If you can complete the above self-assessments with little or no difficulty, that’s great! A good sense of balance is indicative of strong core muscles, responsive reflexes, and the ability to perform activities of daily living with relative ease.

Your Better Balance Routine: 4 Simple Exercises

First off, you will find a million different opinions from health experts on best approaches to balance training. No one person is wrong or right, yet there is general logic that fitness experts utilize. For example, if you cannot perform a standard squat without pain, why would you attempt to perform such an exercise on an unstable surface such as a balance ball? Furthermore, is a squat on a balance ball (also known as a Bosu Ball) truly functional if you spend most of your time on stable surfaces? These are questions to answer with your care providers.

With that said, let’s move on to four exercises that I’ve seen provide great benefit to numerous clients over the years.

Exercise #1: Alphabet W’s

Set-up: Sit upright on a sturdy surface. Squeeze your shoulder blades black and down. Draw your elbows down and back into your middle spine. Hold, then release.

Feel it Here: Middle Back

Benefit: Strengthens the posture muscles that keep the body upright during static positions (such as standing) and dynamic positions (such as walking). These muscles work collaboratively with the shoulders and hips to assist in balance, respiration/breathing, and decreased incidence of chronic musculoskeletal conditions including back pain.

Exercise #2: Weight Shifting

Set-up: It is recommended to perform this exercise with a partner or while standing near a wall for added stability. Begin in a normal standing position. As you walk forward, your partner should spot from the left to the right leg, as you balance momentarily on each leg. You should feel the hips and legs working to stabilize your body during the momentary pause phase.

Feel it Here: Hips, Legs

Benefit: During movements such as walking and stair climbing (two very common daily activities), weight shifting is a crucial part of keeping your balance. Distributing your weight back and forth between the left and right sides occurs hundreds of times per day.

Exercise #3: Single Leg Deadlift

Set-up: Draw one leg straight back while keeping your hips square. Perform the deadlift while keeping the leg off the floor. Use a wall or chair for assistance in balancing.

Feel it Here: Glutes, Hamstrings

Benefit: This exercise accomplishes two primary objectives: it strengthens the back of your lower body and teaches hip hinging. The latter benefit trains the body to hinge at the hips, not the lower back.

Exercise #4: Toe Taps

Set-up: Sit comfortably on the front of a chair. Make fists and keep them over your knees. Begin to tap you toes together at a rapid rate for 20-30 seconds.

Feel it Here: Shins, Top of Feet

Benefit: This exercise strengthens the front of the shins, specifically a muscle call the Anterior Tibialis. This area of the shin works with the foot, knee, and hip during walking and hip lifting. Improved awareness of lifting the foot may occur, enhancing proprioception during walking.

Fitness Equipment: Common Tools of the Trade

All the fancy equipment won’t make a difference unless applied in a logical, systematic method with regular assessment along the way. Thus, the goal should not only be to get the client well, but to also teach them skills to facilitate a level of post-care independent maintenance. The following are common tools of the trade that may help in improving balance.

Foam rollers are commonly seen in most therapeutic and fitness-based centers. The rollers come in a variety of presentations including soft to dense, or long to half length. They are generally used as a method to release trigger points or tight points in fascial or connective tissue, which is the most common substance in the human body. Connective tissue is found in cartilage, blood, and nerves. A less common benefit (and arguably more important) is that foam rollers can re-hydrate tissue by bringing fluid to dry, restricted tissue such as the IT band on the outside of your hip. You can easily find examples of foam roller use on the internet, with the best source of education being

Therabands are great training tools. They are portable, easy to transport, and have multi-functional capabilities. The darker colored bands represent greater resistance while the lighter colored bands offer less resistance, yet the inherent stretch properties of the band can make any color challenging. The body can perform all kinds of movements with bands including pulling, pushing, pressing, rotating, and extending. Multiple joints and muscles are worked without having to change weight plates or seat positions as is common with selectorized machines. You can find examples of band exercises on websites such as YouTube.

Tennis balls are a cost-effective tool to use on the feet. Why the feet? The feet, specifically the arch and big toe, are vital to stability during walking. In fact, it can be argued that the big toe is the most important joint in the body when it comes to balance. You can roll the ball on the arch or squeeze the ball between the toe mounds.


The good news is that balance can be worked on with daily exercises in short bouts designed to improve stability and mobility. For those lacking adequate balance capabilities, their quality of life can be negatively affected due to the lack of independence that comes with freedom of pain-free movement. By performing the exercises listed in this article, my hope is that you will see improvements over time in your daily functions.

Additional Resources:

Author -  William Smith

- By William Smith, MS, NSCA-CSCS, MEPD

William Smith, MS, NSCA-CSCS, MEPD, currently works for a nationally recognized healthcare system in the New York metropolitan area providing health and wellness services to the community. His interest is in special populations, and how healthcare providers and fitness professionals can work more closely together.

Having lost a grandparent to a fall, Will became interested in using movement training and lifestyle modification to help mitigate falls.

Will is an author with Hatherleigh Press having published 14 books. Contact Will at


Distracted Driving, Falls, Opioids Cause Spike in Unintentional Death Rate,” National Safety Council.

"Simple Tips to Better Balance," Homecare Magazine: excerpts from William Smith’s Balance Article, November 2015

Wednesday, June 28, 2017

Demand Increasing for Private Employment in High-Hour Senior Care Cases

privately employed caregiver solution

According to research by the AARP, about 90 percent of our rapidly-growing senior population would like to stay in their own home as they age. Furthermore, 82 percent maintain their desire to age at home – even if they require day-to-day assistance with activities of daily living. With a rapidly increasing senior population, demand for quality in-home care is beginning to skyrocket.

For the past 40 years, in-home care has been delivered predominantly by home care agencies who employ caregivers and dispatch them to homes. However, recent regulations are changing the cost structure for home care agencies, especially for certain types of cases like Alzheimer’s disease and other conditions involving cognitive decline.

These types of cases call for care continuity – one or two caregivers who work with the patient every day and fully understand the complex and unique needs of the patient. Importantly, this also serves to calm the patient as a revolving door of new faces can be very upsetting to those with cognitive decline.

These types of cases invariably have high hours (more than 40 in a week), which, under the new regulations, now triggers overtime requirements for home care agencies. In most states, first-party employers (families), are exempt from overtime requirements if the caregiver is a live-in employee or qualifies as a companion. This allows them to get the care continuity they need without the additional cost. Given that most memory disorder cases progress toward around-the-clock care, this overtime exemption can reduce the cost by as much as 50%, or tens of thousands of dollars per year. This radical cost disparity is creating a gravitational pull toward private employment.

What Exactly Has Changed?

At the end of 2015, the Department of Labor (DOL) repealed two Wage & Hour Law exemptions that had been in place since 1974 – the Companion Care exemption and the Live-In exemption. The repeals impacted only third-party employers of direct care workers (i.e. staffing agencies), no longer allowing them to pay workers less than minimum wage and forcing them to adhere to overtime standards.

As a result, many home care agencies now handle high-hour cases differently. They either get the family to accept a rotation of many different caregivers or pay for the associated overtime with a major increase in their hourly rate.

The Private Employment Solution

Private employers are still exempt under federal law and most state law. These exemptions make private (direct) employment a much more affordable alternative to the traditional home care agency model – especially for cases that are chronic, high hour and require care continuity.

Even after adding in payroll taxes, insurance and all other employer-related expenses, the savings can be staggering.

A Simple Budget Scenario

A family needs care for a loved one suffering from dementia. Family members are able to provide care on the weekends, but during the work week, they need around-the-clock caregivers. The local home care agency had recently increased their hourly rate to $25 per hour, which meant they would need to budget for $2,000 per week ($25/hr X 16 hrs/day X 5 days/wk).

Note: This takes into account the federal sleep time exemption where employers may deduct up to 8 hours of sleep time if an employee works a shift of 24 hours or more.

With this information in hand, the family decided to compare the cost to employing privately and found several caregivers with similar qualifications that would work for around $12 per hour. Because the caregiver was required to be on-site for 120 hours per week, this qualified as a live-in employment situation in the eyes of the law, meaning the family would not be responsible for overtime – on top of the savings they’d receive from taking the sleep time exemption.

The all-in hourly cost for private employment (taxes, insurance and payroll service) ended up being $13.45. As you can see in the illustration below, this saved the family more than $48,000 - nearly half the cost of going through their local staffing agency.

Agency Costs $25 per hour x 80 hours x 52 weeks $104,000
Private Employment $13.45 per hour x 80 hours x 52 weeks $55,952
Savings Per Year $48,048

It’s important to note that cost is not the only factor to consider when deciding on a care solution. Home care agencies charge more because they manage several important aspects of the hiring process as well as the employer responsibilities. Some families will want to retain an agency for all those tasks, while others will opt for the consistency and savings of a private caregiver. For those who opt for private employment, here’s what they need to know.

privately employment vs staffing agency cost comparison

Household Employment Basics

Hiring a senior caregiver privately means the worker is now a household employee. And just like any other employment situation, payroll, tax and labor laws must be followed. There are three primary wage reporting responsibilities families have for their caregiver:

1) Withhold payroll taxes from the caregiver each pay period. Normally, this includes Social Security & Medicare (FICA) taxes, as well as federal and state income taxes. Some states are different and you can consult this state-by-state guide for more information.

2) Remit household employment taxes. These generally consist of FICA taxes as well as federal and state unemployment insurance taxes. Again, some states have additional taxes, so it’s important to consult the state-by-state guide beforehand.

3) File federal and state employment tax returns. These are due throughout the year – rather than just at tax time – and go to the IRS and state tax agencies.

In addition, there are a number of employment law matters that need to be handled at the time of hire. Depending on the state, a family may be responsible for providing things like a written employment agreement/contract, detailed pay stubs, paid time off/paid sick leave, workers’ comp insurance, etc.

The good news is there are household employment specialists, like HomePay, that take full accountability for all of the employer responsibilities so families are free of paperwork and risk – enabling them to focus on caring for their loved one.

In Conclusion

There is no one size fits all solution to caring for our older adult population. Home care agencies, assisted living facilities, independent living facilities and skilled nursing facilities all have a role to play. And, now with the recent regulatory changes, so does privately-employed in-home care – especially for those patients suffering from cognitive conditions who need many hours of consistent care.

When this type of case arises in your practice, please feel free to contact us for a free budget consultation so you can present your client with all their care options.

Author -  Carol Marak

- By Tom Breedlove, Director of HomePay

Tom brings more than 30 years of business experience, including more than a decade as Director at Breedlove & Associates – now known as HomePay – the nation's leading household employment specialist. Co-author of The Household Employer’s Financial, Legal & HR Guide, Tom has led the firm’s education and outreach efforts on this complex topic. His work has helped HomePay become the featured expert on dozens of TV and radio shows as well as countless business, consumer and trade publications.


Publication 926 (2017), Household Employer's Tax Guide,” 2017, IRS.

Fact Sheet: Application of the Fair Labor Standards Act to Domestic Service, Final Rule,” Sept. 2013, Department of Labor, Wage & Hour Division.

The United States of Aging Survey” 2012, AARP.

The United States of Aging Survey” May, 2016, Bureau of Labor Statistics.

Cost of Care Survey 2016” 2016, Genworth.

Monday, June 26, 2017

How to Have Crucial Conversations When Your Aging Loved One Is Resistant

crucial conversations when someone is resistent

If you are concerned about your loved one being resistant to having crucial conversations with you about end-of-life issues, you might hesitate to bring up the subject.

Talking about aging and end-of-life issues with an ailing loved one is not easy for most of us. Many of us avoid this conversation altogether until we actually face difficult end-of-life issues and decisions for a loved one need to be made. Having crucial conversations now, while your loved one is relatively healthy, will make it easier if and when you or your loved one is faced with a sudden and unexpected health emergency. The way in which you approach having these conversations is crucial to creating a plan that spells out clearly how matters will be handled in the future. Such a plan is empowering for all involved.

In many aspects of caregiving, resistance often comes into play, and you will need to address this resistance when fulfilling the role of a caregiver. When I cared for my dad, one of the toughest challenges I faced was his resistance to care. How do you help a loved one who doesn’t want or resists your help? I had to learn and understand why my dad was resistant and develop new strategies to gain his cooperation.

This article will provide you with the necessary tools to have crucial conversations with a resistant loved one, and it will also provide tips to help you deal with resistance that comes from either your loved one or other family members.

When Your Loved One Is Resistant

Have you ever thought about why your loved one is resistant to receiving care or having crucial conversations with you and other family members? It could be due to the fact that he or she may be dealing with a personal loss, such as a spouse, physical loss, mental loss and/ or the fear of losing his or her independence. It could be that your loved one may feel that having a crucial conversation about end-of-life with you might signal he or she has to relinquish their privacy and adjust to new routines. Or it could be that your loved one doesn’t have a solid relationship with you and/or other family members. Or maybe it’s connected in some way to the fact that your loved one’s friends have all passed away. Or your loved one could be in the early stages of dementia. Or perhaps your loved one doesn’t want you to know about a chronic condition he or she is suffering from. And it could very well be because he or she is afraid of:

  • You taking away his or her car keys

  • Losing his or her way of life

  • Getting old

  • Not having any financial assets to help you

  • Being a burden on you

  • You taking all his or her financial assets

  • Having you as a caregiver

  • Being thrown into a nursing home

  • Dying

How to Help Your Loved One Overcome Resistance

To help your loved one overcome his or her resistance to engaging in crucial conversations about aging and end-of-life issues, illustrate for him or her the importance of planning ahead by asking these questions:

  • If you suddenly and unexpectedly get ill, who is going to take you to the hospital?

  • What kind of care do you want in the future?

  • Where is the money for hospital care and long-term care going to come from?

  • And finally, what are your desires regarding your funeral?

  • Who is going to pay for it?

Aging loved ones should be reminded that if they don’t have these crucial conversations with adult family members while they are still well, all hell can break loose when they are too ill to intervene, as family members may express different desires and stress each other out. As a concerned family member, keep in mind that you must be very patient and gentle with your loved one in the early stages of discussion, when they need your help the most. Trust is a major factor for your loved one—after all, your loved one is putting his or her life in your hands—and so his or her resistance may very well dissolve as trust in you grows.

Another strategy for bringing your loved one on board is to share with him or her what your wishes are for your own end of life, and to explain that you have started thinking about how your own final wishes can be realized when the time comes. After all, you should not expect your loved one to do something you have not done for yourself. You will find that the crucial conversations are much easier when you have actually contemplated your own end-of-life stage and described it to someone else.

Strategies for Effective Crucial Conversations With a Resistant Loved One

The following strategies will help you enter into that first conversation about aging and end-of-life matters with a resistant loved one and make it productive. First, tell your loved one that you would like to set a time for the two of you, plus other members of your family, to have a crucial conversation about how you are all going to prepare yourselves emotionally, financially and legally to avoid sticky end-of-life issues. Once you have agreed upon a time for the conversation, schedule a family meeting.

Remember never to hold this type of meeting on or around a holiday. This subject is too heavy for a holiday. Next, select two or three family members who are confident and qualified to lead the conversation. (Remember, this is not an easy conversation, and not everyone is equipped to do this.) Remind family members beforehand that they must have only your loved one’s best interests at heart.

Once the meeting gets under way, ask your loved one this question: “If I had to handle a sudden and unexpected health emergency for you, what is the most important concern you would have?” Allow your loved one to articulate his or her biggest concern, and then ask why this concern in particular is so important. Next, ask your loved one to relate his or her wishes for end-of-life care. Then share what your wishes are for your loved one’s end-of-life care, and allow your family members to air their wishes for your loved one, as well. The point is to allow everyone to feel that they have a say-so regarding the issues that might arise during end of life. This approach will help your loved one feel that he or she is not being pushed around by family members, and that he or she has a say regarding the care received. Making this initial crucial conversation a family affair will foster greater participation in future and will set the stage for a better outcome. And it will steer your aging loved one away from the notion that “it’s all about him or her” and toward the realization that “it’s a family affair.”

Before the meeting ends, be sure to share with your loved one and other family members what might happen if you do not come together and preplan. Share only facts, and don’t resort to scare tactics. (Do not ever threaten or use scare tactics when talking with a loved one about end-of-life issues or decisions.) These are some potential pitfalls of a lack of preplanning:

  • Family rivalries and dissension could reach an all-time high as each person tries to have his or her wishes for the loved one carried out.

  • If problems between family members exist, those relationships could go from bad to horrid.

If you or your family members are uncomfortable about having this crucial conversation, an alternative is to enlist the aid of a geriatric mediator or a geriatric attorney. Have them come to your home, meet with your family and provide everyone with the necessary tools and resources to help in the decision-making process. A geriatric attorney can also ensure that you have the necessary legal documents in place to protect both you and your loved one. Keep the following points in mind:

  • If there are family members who are unsupportive and who will not cooperate, definitely seek legal counsel.

  • Hire only professionals who are experts in geriatric care to assist with the emotional, financial and legal matters surrounding your loved one’s end of life

  • Caregiving Empowerment Strategy Training Courses are available online. You can get the help you need at

Other Strategies for Effective Crucial Conversations With a Resistant Loved One

  • If your loved one refuses to accept that he or she is in poor health, and thus sees no need for crucial conversations, make a dramatic case. When approaching your loved one, it is best practice to have some proof substantiating your concerns, such as pictures, letters or other documents, for your loved one to review. An example would be showing your loved one a photograph of himself or herself taken a month earlier, and then showing him or her a photograph that was taken that week or that day. Your loved one will clearly see how much thinner or unhealthy he or she appears to be in the recently taken photograph. Remember, a picture is worth a thousand words. When you use show-and-tell to convey your concerns, your loved will eventually trust you, knowing you have his or her best interests at heart.

  • Describe “caring” in a positive way. You may consider describing respite care as an activity your loved one likes. Talk about a home-care provider as a good friend. Also you might describe elder care as a seniors’ country club, or refer to your loved one as a volunteer or helper at the country club.

  • Never give up on your loved one. If he or she doesn’t want to discuss the topic the first time you bring it up, try again later.

  • When your loved one acknowledges his or her medical conditions but still refuses to tell you about them, be patient. Voice your concern and off er your help. Know that your loved one will eventually come around.

  • Enlist the help of family members. Family and friends might be able to help you persuade your loved one to accept help.

What should you do if your loved one refuses to tell you if he or she is being abused or if he or she refuses to tell you if he or she does not like his or her doctor, assisted living or long-term care facility?

  • Listen, listen and listen to your loved one. When your loved one tells you that he or she does not like a particular doctor or a staff member at a long-term care residence, make certain to ask him or her why, as abuse could be the root cause. Also, make sure you are aware of any bruises or cuts on your loved one for which there is no explanation. These could very well be telltale signs of abuse. If you believe that a doctor has abused your loved one, contact your state medical board. If you believe your loved one has encountered abuse at a long-term care facility, report, report, report your findings and concerns to the facility’s higher-ups, your state’s long-term care ombudsman and/or adult protective services. They will conduct an investigation to get to the bottom of your concerns.

Question Checklist

Reasons for your loved one’s resistance Is your loved one resistant because:

  • Your loved one is dealing with a personal loss, such as a spouse, physical loss, mental loss and/or fear of losing his or her independence?

  • He or she does not want to relinquish his privacy?

  • Your loved one does not want to adjust to new routines?

  • Is your loved one in the early stages of dementia?

  • Your loved one wants to keep his or her chronic condition a secret?

  • Is your loved one afraid of you taking away his or her car keys, losing his or her way of life, getting old, not having any financial assets to help you, being a burden on you, you taking all his financial assets, being thrown into a nursing home, dying?

Strategies to Overcome Resistance

  • Have you scheduled a family meeting?

  • Has your loved one been included in the family meeting?

  • Are you holding the meeting during a neutral time of the year (not around the holidays)?

  • Have you given your loved one an opportunity to voice what he or she believes is his or her biggest health concern?

  • Have you made your loved feel like his or her opinions matter?

  • Are you honest with your loved one?

  • Have you refused to use scare tactics to facilitate your loved one’s cooperation?

Strategies to Overcome a Refusal to Communicate

  • Have you made a dramatic case to your loved for why he or she should communicate his or her health concerns?

  • Have you described the idea of “caring” to your loved one in a positive way?

  • Have you made it clear to your loved one that you will not give up on him or her?

  • Are you patient with your loved one?

  • Have you enlisted the help of family members to persuade your loved one to accept help?

  • Have you listened to your loved one’s concerns?

Author - Carolyn  A. Brent, MBA

- By Carolyn A. Brent, MBA
Author of The Caregiver’s Companion

Carolyn A. Brent is an award-winning and bestselling American author and eldercare legislation advocate. Designated as an Editor's Choice, she was reviewed by the Library Journal as well. Verdict: excellent!

Brent is also known as a bodybuilder and Health & Wellness Guru. She is the founder of Across All Ages and two nonprofit organizations, CareGiverStory Inc. and Grandpa’s Dream. Visit:

Excerpt. © Reprinted with permission. All rights reserved.

Monday, June 19, 2017

How to Recover From Congestive Heart Failure

How to Recover From Congestive Heart Failure

Congestive heart failure (CHF) affects nearly five million adults in the United States, most of whom are older than 65, and is a leading cause of hospitalization and re-hospitalization amongst seniors.

There are several underlying conditions that lead to CHF, including coronary artery disease, which weakens and damages the heart. What happens is the heart is no longer able to pump enough blood to the rest of the body, and that negatively affects many other bodily functions. Fluid begins to back up in the lungs causing a loss of oxygen. The kidneys can’t remove excess fluid and it starts to accumulate primarily in the feet or lower legs. As a result, CHF causes difficulty in breathing, mobility, and extreme fatigue.

Congestive Heart Failure is one of the leading reasons for re-hospitalization and about 12% of CHF patients return to the hospital within 15 days of being discharged. CHF is considered a chronic illness. It can’t be cured, but the symptoms can be managed. Having the information and support to manage CHF as you transition home makes the chance of ending up back in the hospital less likely.

Some of this preparation happens during discharge planning. While good discharge planning includes scheduling follow-up appointments and education about managing your illness, it’s not unusual for patients and family members to forget much of what they are told in the chaotic and stressful hospital setting.

Transitional care programs that involve visits to your home by a social worker or nurse can reinforce what you learn at discharge and have been found to effectively reduce re-hospitalization. It may also mean hiring private duty in-home care to assist with activities of daily living at home. Short-term respite stays in senior living communities is another great options.

Unmanaged CHF can greatly limit your ability to take care of even your most simple daily needs, and changes in symptoms can occur quickly and go unnoticed at home. Residential transitional care gives you time to recover, build strength and learn to manage and monitor CHF symptoms in a safe and comfortable environment.

Lifestyle changes are a key part of managing CHF. Assisted living staff can help you learn how to track your medications and develop and maintain an appropriate diet and exercise routine to support a speedy recovery. They can help you schedule follow-up appointments and provide transportation or make transportation arrangements for you. They can also help monitor important symptoms such as weight gain, breathing problems, swelling in the extremities, as well as teach you how to tell when a change in symptoms requires a call to the doctor.

Author -  Amanda Toler Woodward, PhD

- By Amanda Toler Woodward, PhD

Amanda Toler Woodward, PhD is an Associate Professor in the School of Social Work at Michigan State University. She does research on services and supports for older adults including racial and ethnic disparities in access to services and international comparisons of service systems.


Congestive Heart Failure (CHF),” Healthline Media.

When Short-Term Care Is Needed,” Seniorly.

Hospital Discharge Planning for Elders,” Seniorly.

What is Assisted Living?” Seniorly.

What is Respite Care?” Seniorly.

A version of this article, Recovery Care for Congestive Heart Failure written by Amanda Woodward appeared in Seniorly’s Senior Living Resource Center.

Wednesday, June 7, 2017

Can Fasts and Fad Diets Be Good for You?

Can Fasts and Fad Diets Be Good for You?

Lose weight! Try this pill! Eat this single food! Are timeworn diet gimmicks now actually safe to use?

Many might remember the dieting fads of the 1950s and later, as women attempted to cinch in ever-thinner waistlines. Of course, dieting isn’t always about weight loss. It can also be about chronic disease management to help people fight obesity, diabetes, heart disease and more.

Even today, there is always something new to learn about health and diet. Sometimes, diets and fasting seem to work—scientists even plan to use fasting to fight cancer. Here’s your update on what works, and what doesn’t.

Five Fad Diets To Steer Clear Of says some diets are not just impractical, they are downright dangerous. Here’s a look at a few that nutritionists deem completely unsafe:

  • The blood-type diet:
    There is absolutely no scientific proof that your blood type affects your body’s ability to process fat and calories. Because of this diet’s extreme restrictions, experts give it a thumbs down.

  • The werewolf diet:
    Sometimes known as the lunar diet, this involves a day of fasting with only water and juice during a full or new moon. You might lose water weight for a short time, but you could also cause serious issues with any medications you might be taking.

  • The master cleanse / lemonade diet:
    This plan expects you to subsist for days on lemon juice, cayenne pepper and maple syrup. In other words, you’re just drinking a diuretic for days. You’ll lose water weight, sure. You’ll also lose muscle weight. Then you’ll gain it all back when you start eating normally again. Plus, side effects can be particularly devastating for those on blood pressure or diabetic medications: fatigue, nausea, dizziness and dehydration are just a few.

  • The baby food diet:
    Really? You’re not a baby; you need way more calories than that!

  • The cotton ball diet:
    This diet consists of soaking cotton balls in orange juice—and then eating them. Not only are there nearly zero nutrients with this diet, but the potential intestinal blockages are mind-boggling. No. Just . . . no.

Famous Fad Diets

In the 1950s, the grapefruit diet had everyone rushing to the fruit section of the grocery store because it seemed to work so well for stars like Marilyn Monroe. Eating half a grapefruit three times a day pre-meals with no change to the actual meal was a pretty simple thing to do, after all.

Research over the past 70 years has confirmed the good news about a diet along these lines: Eating soups, salads and fruit prior to a meal does help a person eat less during the final course and lower overall calorie intake. The bad news? After a while, grapefruit gets monotonous, it doesn’t contain any “fat-busting enzymes” as some believe, and the overall diet calls for an extreme limit on calories.

Switch it up with other fruits or healthy items while eating portion-controlled, balanced meals, say experts, and the infamous “grapefruit diet” could be a great way to control your weight. The trick to turn this fad diet into a healthy way of life is to include more balanced foods you enjoy, add in exercise and sneak in a few more healthy habits (like ensuring you have enough calories for your body). Otherwise, sheer boredom will cause you to toss grapefruits in the trash and go searching for the chocolate in the back of the pantry.

In the 1970s, diet fads narrowed the focus from balanced meals to low calorie meals. Researchers discovered that while the concept of eating fewer calories than your body required did indeed drop pounds, the body still requires the right combination of calories and nutrients to keep muscles healthy. Plus, too few calories can wreak havoc on the body’s immune system. Later, the high-protein, low-carb diets proved similar: They can work, but when the body doesn’t have the right nutrition blend, it can backfire into weight gain or, worse, serious health issues.

The worst news? Foods packaged and marketed as low calorie are often artificial and processed, and typically high in unhealthy preservatives and flavorings. Fad diets go on and on (remember the chocolate diet or the cabbage soup diet?), but the key point is to consider science and what we now know about how the body works.

Why Fad Diets Don’t Work

Today’s fad diets often add in another element: the “magic” powder. Eat a little bit of this food, a little of that food, lots of water and THIS powdered or premixed drink so you can lose weight. Again, you will lose weight for a while. Once you try to get back into real-world eating, however, the pounds will creep back on. Why? Because the diet never teaches you how to make healthy eating a way of life. nutritional experts say that before starting any weight-loss plan, you should take stock of your current health status. Meet with your doctor, for example, to check weight and manage any health issues you might have. Do you need more of a certain nutrient, for instance?

Keep a food diary to understand what you’re currently eating. Locate a support group that can help you get through those days when all you want is cake for breakfast, lunch and dinner.

Next, set a goal to move more. You don’t need to start with a big workout plan at a senior center. If you currently only walk to the next-door neighbor’s house, walk a house farther today. And one house farther the next day. Take baby steps, at your own speed, when it comes to movement. Just move.

Once you’re moving a bit more, it’s finally time to upgrade your eating. Become aware of how much unhealthy food you eat and what you reach for as a comfort food. Replace “I should” with “I choose” or “I choose not to” when selecting foods to eat.

Those simple words put you in control and quickly strip away the guilt. Choose, for instance, to stock your pantry with healthy fare. Choose to add flavor to foods with spices and herbs instead of salt. Choose to bring healthy snacks when you go out. Choose to savor each bite you eat. Choose a rainbow of fruit and vegetables to help you get a good mix of nutrients. Or choose not to — it’s your decision.

The bottom line is that while fad diets — including fasting — can indeed show short-term improvements, the only sure way to long-term weight loss is to make healthy choices day in and day out.


Dieting Through the Decades: What We’ve Learned from Fads,”

Study finds fasting may help reduce negative side effects of chemotherapy,” July, 2011, National Institute on Aging.

Losing Weight Without Fad Diets,”

14 Fad Diets You Shouldn't Try,”

Fasting and less-toxic cancer drug could be alternative to chemotherapy,” Mar. 30, 2015, Robert Perkins, USCNews.

Blog posting provided by Society of Certified Senior Advisors

Tuesday, June 6, 2017

Starting Your Own Business After 55

Starting Your Own Business After 55

For many, starting a business later in life makes sense as long as you understand and manage the risks involved.

The concept of entrepreneurial spirit has long been reserved for 20- and 30-somethings. It’s believed that the younger generation has more of an appetite for risk. However, research now proves that’s not true. According to the Kauffman Index, people between the ages of 55 and 64 start small businesses at a higher rate than younger generations.

Today’s work climate may contribute to this change. As more millennials move into the workforce, older workers are being replaced by automation, shrinking bottom lines and workers willing to accept less pay for the same job. As a result, those being pushed out of the workforce are turning to business ownership as a means of security for the future.

Why and How Entrepreneurship Makes Sense

For some, the idea of owning a business just makes sense. You understand that being your own boss allows you to control your destiny. For others, being solely responsible for your future is a terrifying thought. The thing to remember, however, is that there is more to business ownership than just making money.

  • Pursuit of passion: Many older adults choose to open a new business to pursue their passion. After years, sometimes even decades, working for someone else, the idea that you can spend your days working on something that matters to you is exciting.

  • Personal value: The fact is, baby boomers and Gen Xers have spent years working in their chosen fields. During that time, they’ve gained a wealth of knowledge that, no matter how hard organizations try, cannot be captured. Starting a business can be a means of sharing knowledge and creating personal value that exceeds the feelings of worth working for an organization.

  • The American dream: Many older Americans want what their parents wanted—to leave their children and grandchildren with a better life. That can mean everything from a greener planet to a better bank account. Some realize they won’t achieve this desire working for someone else. Instead, starting a business based on passion can help build and change the world and the legacy they’ll leave.

“One piece of advice I would give to those looking at starting their own business would be to do MORE research into the field they are looking at then they ever thought necessary,” says Steve Garrett, RPh, CSA.

Garrett, who launched a CarePatrol franchise in the Pacific Northwest, used multiple programs available to older populations to help with financing his second career. In particular, he took advantage of his local SBA-SCORE program, which is made up of retired business executives who offer mentorship, classes and templates and programs that participants can use in developing business plans and other business-related issues.

Regardless of the reason you choose to start a business—passion, value, legacy or something entirely different—starting a business after the age of 55 can make a lot of sense from both a personal and a financial perspective.

Financially, there are many programs in place to help older entrepreneurs begin and grow a business. Programs like the Small Business Association’s (SBA’s) Encore Entrepreneur are designed to help those over 55 choose, start and build small businesses. And investors are more likely to invest in companies that people over the age of 55 started because you not only have the knowledge to run the business, but you also have the financial means.

Older business owners usually have more financial means for starting a business. They can use assets and savings accounts to fund a new venture. They also have retirement accounts, and various ways to tap into those accounts. For example, the Roll Over for Business Startups (ROBS) program allows entrepreneurs to roll their retirement account, 401(k) or IRA into a new business. In addition, some retirement accounts allow business owners to take early withdrawals or retirement account loans.

The caveat is that using retirement funds to bankroll a new business can be risky. Before cashing in your retirement account, investigate your chosen business to ensure it’s a good match for your personality and work ethic, and that you’re taking the appropriate level of risk. Some risk is required, but too much risk can leave you without an alternative for your future.

Businesses for Senior Entrepreneurs

Probably the easiest part of starting a business is deciding what type of business you want to start. If you don’t already have some ideas based on personal passions, then a quick study of what your area needs can generate dozens of ideas. Some of the top business picks for senior adults include:

  • Consulting: Consulting is a good way to share your expertise while maintaining the freedom to choose who you want to work with.

  • Accounting and bookkeeping functions: If numbers are your passion, accounting, bookkeeping and tax-related businesses are easy to start and have a relatively low overhead.

  • Life services: People always need help with something, whether it’s older adults who want assistance with transportation or household services, or middle-aged people who need advice about gardening, pets or childcare. Most life services businesses have inexpensive startup costs and low overheads, and you can build the business around the hours you are available.

  • Franchises: Franchises are popular business options because someone else has already done the work to put the business system in place. Your job is to invest in the franchise and then follow the system. Most franchises are stable and good investments, though you should do your research, because they can also be a lot of work.

Opening a new business is no longer just a young person’s game. Today’s senior adults have more knowledge and better financing options for entrepreneurial endeavors. Just be sure that you’re investing the appropriate level of risk to achieve your end goal.

*Disclaimer: The Society of Certified Senior Advisors does not provide financial advice and this article should not be construed as such. If you are seeking financial advice, please contact a financial professional.


5 Small Businesses to Start after 50,” May 2016, USA Today.

The Pros and Cons of Starting a Business Over 55,” June 2014, SCORE Association.

How Older Entrepreneurs Can Turn Age to Their Advantage,” Roger St. Pierre, May 2017, Entrepreneur.

Self-Employment in the US,” March 2016, Bureau of Labor Statistics.

Roll Over for Business Startups (ROBS) – The Ultimate Guides,” Jeff White, April 2017,

What You Need to Know About Using Retirement Money for Business Funding,” Adam Bergman, July 2015, Forbes.

Blog posting provided by Society of Certified Senior Advisors

Monday, June 5, 2017

Intergenerational Learning via The Grandfriend

Intergenerational Learning via The Grandfriend

Many cultures have long understood that a community’s oldest members can provide experience and wisdom to younger members. In the U.S., however, extended families with intergenerational support are declining. After many years of work, various programs are beginning to change this downward trend.

From school pen-pal programs that pair sixth graders with seniors to intergenerational facilities that let older adults and toddlers spend time together, the “grandfriend” concept is expanding worldwide. The Healthy Aging Partnership, a coalition of 40 not-for-profit organizations in the Puget Sound area of Washington state, says that interactions among young people and older adults are crucial to reducing depression, relieving boredom and improving health—for both generations.

The Intergenerational Learning Center at Providence Mount St. Vincent in West Seattle, for example, offers daycare for children 6 weeks to 5 years old. Four program areas offer children the opportunity to visit with nursing home residents, and the Intergenerational Family Room provides a shared space for residents and children to participate in special activities and form relationships. In Washington, D.C., the DC Office on Aging and the DC Public Schools Office of Early Childhood Education have a joint partnership designed to bring together senior citizens and early childhood students.

If you’re interested in connecting with children in your area, there are many different ways to do it. You can become involved with an organization like Big Brothers Big Sisters of America; contact your local school district, grandparent networks, or nursing homes to determine which programs exist in your area; or even take the Gen2Gen Summer Challenge to help nurture a young person.

Experience matters. Grandfriends can make a difference—and you can become one today.


'Grandfriend' pen-pal program joins Colman-Egan 6th graders with area seniors,” KSFY staff,, May 5, 2017.

Blog posting provided by Society of Certified Senior Advisors

How to Avoid Online Shopping Scams

How to Avoid Online Shopping Scams

The internet offers great bargains and fast delivery. Know what to watch for so you can shop safely and securely.

Grabbing great deals on the internet is almost as fun as finding a bargain in person at a local store. Plus, the convenience of online shopping can’t be beat: Shop, order and pay from the comfort of your home, sit back and wait for delivery. What’s not to like?

Sneaky Shopping Scams

Other online shopping scams include:

  • Fake ads on classified-ad websites such as Always insist on meeting in person to inspect the item before you pay in cash.

  • Surveys that promise a payoff of any kind (a free product, for example) once completed.

  • Retailers that do not allow payment through secure services such as credit card transactions or PayPal. If one insists on a wire payment, your bank account information, a prepaid money card or a money order, don’t finalize the purchase.

  • Websites that don’t offer information about privacy, terms and conditions of use, dispute resolution, refund policies, or contact details.

  • Sites with poor-quality images or that have another company’s logo or watermark.

Statistics show that more people than ever are shopping online. The share of U.S. consumers who shopped online on Cyber Monday (the Monday after Thanksgiving) in 2016 increased to 73 percent, while a solid 40 percent of consumers now shop several times per month online. At the same time, a Forbes Magazine survey of 125 retailers showed online fraud attempts were expected to rise more than 40 percent.

Bob Schulties is a content manager for, a technology advice site. He loves to shop online just like anyone else. He’s learned a few secrets, however, that he wants Senior Spirit readers to know.

“One of the things to keep in mind when you shop anywhere is that people have been scamming other people since the dawn of time,” Schulties says. “The Romans coined a phrase: ‘Caveat emptor’ means ‘buyer beware’—and that’s what every shopper should remember when purchasing items online.”

Schulties says online shopping scams are always changing, but the basics remain the same.

“If you see a deal that’s too good to be true, it probably is,” he says. “Think of the $75 off fake coupon supposedly from Bed, Bath and Beyond that recently went around the internet. And one of the most common scams I warn readers about are penny auction sites where you buy credits in order to purchase an item for a few dollars. You will spend more in purchasing credits than any product is ever worth!”

He adds that fake shopping sites will mimic legitimate retailers by stealing logos, advertising the same products at lower prices or using pop-up ads for “terrific deals.”

Bed Bath and Beyond Fake $75 Coupon

Seven Online Shopping Safety Tips

Schulties and other experts advise online shoppers to remember these tips:

  • Use a site you or a friend are familiar with and have used before with success.

  • Ensure you are truly on that site by checking the URL at the top of your web browser. It should not be missing letters ( or have extra letters or numbers tacked onto it (

  • Confirm the site is secure by checking for the lock to the right of the URL or an ‘s’ after the http. A secure site will have at least one and usually both. For example, the official Amazon link will look like this: Https:// secure website

  • Never follow a link to a site. If you receive an email from Kohl’s, for instance, don’t just click the link to get to the deal. Go to the retailer using the URL you already know. The deal will still be available. If you follow a link in an email, you could be setting yourself up to provide credit card information, passwords and your personal information to a fake site.

  • Use a credit card for purchases. You can use a debit card, of course, but that instantly withdraws cash from your account. Credit cards have a stronger layer of protection that keeps your cash in hand as you work out any problems with a retailer, whether it’s fraud or not.

  • Never give a site your Social Security number. If a site wants that information, just leave it. There is never a reason, say experts, for a site to require your Social Security number to make a purchase.

  • Always change your passwords. Even if you change it up slightly, use a different password for every site you shop. It’s a pain, but it’s a far bigger pain to have your information stolen from one legitimate site and then used on multiple sites to make purchases before you even know anything is happening.

Schulties recommends password manager program 1Password to keep your passwords organized. This program is simple to use, remembers all passwords for you and keeps each site’s password secure.

“These guys are the real deal and have been around a long time—I use them,” he says. “When you sign up through them, it will remember all your passwords from all your sites. You simply sign in using a single, master password with them; 1Password remembers the rest of your passwords for the sites you visit.”

Above all, he says, just stay vigilant. “Most sites are great—if you keep your eyes open, you’ll be just fine.”


Statistics and Facts about Online Shopping Behavior in the United States,” Feb. 2017, Statista.

Shopping Online,” Sept. 2011, Federal Trade Commission, Consumer Information, Shopping Online.

Top 10 Scams - 2017,” Feb. 14, 2017, Better Business Bureau.

Online Safety,” May 10, 2017,, Online Safety.

Why Online Shopping Fraud is Expected to Jump 43% This Holiday Season And How To Protect Yourself,” Laura Shin, Nov. 23, 2016, Forbes Magazine.

Blog posting provided by Society of Certified Senior Advisors

Friday, June 2, 2017

Famous & 65

Look Who’s Turning 65

June 7—Liam Neeson

June 7—Liam Neeson

Irish actor Liam John Neeson, who began acting on stage at the tender age of 11, made his professional acting debut with the Belfast Lyric Players’ Theater in the play The Risen People. That led to a variety of roles in with Dublin’s Abbey Theater and, eventually, to Hollywood. In the early 1980s, he and actress Helen Mirren lived together. She convinced him to find an agent, which helped him garner meatier roles in the States.

A nomination for Best Actor from the Academy of Science Fiction, Fantasy & Horror Films in 1991 for Darkman, along with a 1992 win for Best Actor in the movie Under Suspicion from Cognac Festival du Film Policier cemented his reputation as a leading man. He was selected to play Oskar Schindler in Schindler’s List (1993), a role that finally catapulted him to A-List stardom with his first nominations in best actor categories with the Motion Picture Academy of Arts and Sciences (the Oscars), the Golden Globe Awards and the British Academy of Film and Television Arts (BAFTA). Although he never has won any of those awards, he has won 19 other awards and been nominated for a total of 38 acting awards.

Neeson, who became an action star in his fifties with movies like Taken, currently commands $20 million per film. He says that Ralph Fiennes is one of his closest friends. “He’s very into yoga and I do bits of that with him. We hike and walk and talk a lot.”

June 18—Miriam Flynn

June 18—Miriam Flynn

Voice actress Miriam Flynn, born in Cleveland, Ohio, is also a beloved character actress. Perhaps best-known for her roles in two well-loved franchises (National Lampoon’s Vacation flicks, in which she played Cousin Catherine, and The Land Before Time movies, in which she stars as Grandma Longneck), Flynn was initially a member of The Second City improv troupe alongside James Belushi, Shelley Long, and George Wendt.

She was a cast member in and writer for The Tim Conway Show, which aired for a single season in the early 1980s. In 1995, she voiced the character of Maa, an aging ewe, in the surprise smash movie Babe, the story of a pig who learns to herd sheep. Flynn has also guested on numerous television series (Cheers, L.A. Law, Scandal, and The Middle, to name just a few.) Overall, she has 143 film, writing and television credits to her name.

Married and the mother of two children, Flynn lives a private, quiet life in Pacific Palisades, California.

June 20—John Goodman

June 20—John Goodman

St. Louis native John Goodman started out adult life as a professional bouncer and earned a bachelor’s degree in Fine Arts from Southwest Missouri State University in 1975. He studied there with actors Kathleen Turner and Tess Harper. He started down the fast lane to stardom in New York City with an appearance in a Burger King commercial (he spoke no lines.) During his struggling-actor days in NYC, he befriended Bruce Willis, Dennis Quaid, and Kevin Kline while working off-Broadway. He also worked as a waiter and bartender to pay the bills on his apartment in Hell’s Kitchen.

Some says Goodman is best known for his role as Dan Conner on the television series Roseanne, which aired from 1988 until 1997 and earned him a Best Actor Golden Globe award. But for the past 20 years, Goodman has built a movie career that few can rival. His appearances in Coen brothers movies, such as Raising Arizona, Barton Fink, The Big Lebowski, and O Brother, Where Are Thou? have earned him a cult following of sorts, plus led to work in more than 50 other films. He is known for voicing roles in more animated films than any other actor in history.

Saturday Night Live fans know him from 14 gigs hosting the show (one more than the show record previously held by comedian Steve Martin). Dart gaming fans recognize Goodman for his unique style of throwing darts: He holds the pointed tip with his thumb and index finger, then throws the dart with the opposite end pointing to the board so that the dart turns 180-degrees in mid-air. Watch movies like King Ralph to catch him displaying this distinctive style.

Source: Wikipedia

FAMOUS & 65 is a featured article in the Senior Spirit newsletter.

Blog posting provided by Society of Certified Senior Advisors

Thursday, June 1, 2017

Caregiver Burnout: Do You (or a Friend) Suffer From It?

Caregiver Burnout

As much as it is rewarding, providing care to an aging or disabled loved one can be a demanding and thankless job. We’ve rounded up some tips to help you reduce some of the stress.

It’s no secret that many adults care for other adults these days. In fact, according to the Family Caregiver Alliance, approximately 30 percent of U.S. households involve a relative, partner, friend or neighbor who provides a broad range of assistance for an older person or another adult with a chronic or disabling condition.

When you love someone, you want the best for them. Providing care—whether long-distance, in-home or through a nursing home or assisted living facility—often seems like the natural thing to do. At some point, however, negative emotions and stress will come into play, no matter how much love is involved. The demands on a caregiver's body, mind and emotions can easily seem overwhelming, leading to fatigue and hopelessness and, ultimately, burnout.

It’s important to identify and address the often hard-to-admit feelings that you might experience during the caregiving process.

Beyond Stress: Caregivers Continue to Work Past Breaking Points

Bonnie Wells, 70, of Las Vegas, Nev., cared for both her mother and father during the last decade of their lives. Her mother, who died at 89 years old, was non-ambulatory. Her father, who died three years after her mother at the age of 95, was ambulatory and driving until the last day of his life. The caregiving crept up on her in ways she didn’t even realize—she was taking her mother to thrift stores to give her dad a break for a few hours or changing sheets for her father when his arthritis grew too painful.

Where to Get Help

When you need help, ask. If you take care of yourself, you’ll have more energy and ability to do the great job you want to for your loved ones.

There are organizations like the Family Caregiver Alliance that offer state-by-state help for family caregivers, provide caregiver tips and legal information, and supply various other tools. Local senior centers often have valuable resources and even staff that can help caregivers manage others’ needs. Also, a quick Google search for “area agencies on aging” can reveal additional options.

If you’re unsure how caregiver stress is impacting you right now, take this Family Caregiver Distress Assessment. You might be surprised at your results. But above all, know that there are millions of caregivers just like you. Don’t feel guilty when you need a break—and keep searching until you find a way to get one.

Wells was the only child out of eight who lived in the same town with her parents, so siblings expected her to ensure both parents were cared for. A sister provided some long-distance care via frequent Skype conversations with both parents, and a brother would drive in twice a year to check on the car’s performance and manage household plumbing, electrical and exterior issues. But the day-to-day, face-to-face problems were Wells’ to deal with—even as her own long-term career came to a screeching halt with her employer’s bankruptcy.

“Stress is not even close to the word I would use to describe the experience,” she says. “Overwhelmed, exhausted, angry, frustrated, embarrassed, impatient—those fit better. I had days where I just couldn’t go to their house one more time, frankly. Then I would feel guilty about not checking on them for a day and the cycle of negative feelings would just start up all over again.”

Experts say Wells is not alone in her feelings. Meredith Collins, MS, PCHA, ALA, CDP, CSA, explains that caregivers often feel isolated and so stressed out that their immune systems can erode, which then increases the likelihood of disease, depression or hospitalization. Others in Wells’ shoes also belong to a growing group of individuals still caring for children while caring for aging parents, says Jerome M. Avner, CSA and Wealth Advisor.

“Adults in this sandwich generation annually spend approximately $10,000 and 1,350 hours on parents and children combined,” Avner says. Add the caregiver’s financial challenges, loss of personal time and personal health concerns into the mix, and it’s easy to see where the stress comes in.

Caregivers: Get the Basics in Place

Wells reminds other caregivers of something critical: “A lot of the decisions you’ll make as a caregiver will involve the temperament of the people involved. Remember, you are doing the best you can—even when you don’t feel you are, you’re doing what you can. Give yourself time to breathe, time to think and time to get away. It’s okay. Truly.”

Here are tips to help you manage the stress.

  • Get at least 10 minutes of physical activity. Make this a priority. Even that short amount of time makes a key difference to health.

  • Get enough sleep for your body.

  • Hydrate and eat a balanced diet. Don’t just pick from plates or eat on the run.

  • See a doctor regularly who can help monitor your stress levels and health conditions.

  • Accept support. Let the neighbor bring in the mail, hire a housekeeper and use sites like to help you find assistance with everything from on-site car repairs to putting up shelves.

  • Schedule time away. Yoga, walks, coffee with a friend or even time alone can be a huge boost for you.

  • Find a support group. Whether online or in-person, talking to others in similar shoes can help reduce your stress and remind you that you’re giving great care.

Friends of Caregivers: What You Can Do

  • Be a shoulder to lean on. Many caregivers have no one to talk to about their frustrations and feelings; your open ear could make all the difference for someone who just needs to vent.

  • Offer to help. Take a friend’s mother to the salon for a nail appointment. Bring a friend’s father to a store so he can shop while you do. Ask the caregiver for ideas, and tell them which day each week or month you can assist for a few hours.

  • Step in to care for pets. A caregiver with pets can often feel guilt and worry that they are neglecting their own animals while they spend time away from home. Take a day of dog walking off their hands or offer to take the pet to a grooming or vet appointment.

  • Regularly cook for one more. Take the extra food to the person who needs care. (Ask the caregiver for any dietary instructions.)

  • Volunteer to be a “check in point” for the caregiver. Check on shut-ins, for example, and let your caregiving friend have a break one afternoon a week.


Caregiving for the Caregiver,” Meredith Collins, Mar. 29, 2017, NorthShore Blog.

“The Sandwich Generation,” Jerome M. Avner, Oct. 2016 – Mar. 2017, SeniorsBluebook.

Caregivers Need Care Too: Tips on Managing Caregiver Stress,” Apr. 11, 2010,

What is Caregiver Burnout,” WebMD staff,

What is Caregiver Burnout,” Staff writer, American Heart Association.

Blog posting provided by Society of Certified Senior Advisors