Expert Q & A:
Caring for Kupuna
Bed-to-wheelchair transfer? Emergency case management? A caregiving specialist gives advice for dealing with the expected as well as the unanticipated.
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AL: How do you begin to determine the level of care needed for an aging parent?
Hathaway: It starts with a conversation. Some people might want to have a one-on-one talk with Mom or Dad. Others may want to involve other family members. You might also want to bring in a professional to facilitate the discussion.
The ideal situation would be to hire a case manager to conduct an assessment and customize a care plan. They know about existing services and can come in and say, “OK, for your parent, these are the kinds of things that will work. These adult care centers are great, but your mom might be more comfortable at this center instead.”
A lot of people are reluctant to spend the money, but it’s worthwhile because a case manager can really cut the amount of time necessary to determine what’s needed and how to get it.
AL: Is it relatively easy for people to do this themselves?
Hathaway: Most people do it themselves, but it isn’t easy. Be prepared to spend a lot of time figuring things out. You may find a service that sounds great, but find out that your parent doesn’t qualify or will have to be put on a long waiting list. You’ll need to make a lot of phone calls and get on the Internet to learn about available resources.
The best place to start is with the county. Each county has an area agency on aging. In Honolulu you can call the Senior Help Line at 768-7700 or go to the county’s Elderly Affairs Division at www.elderlyaffairs.com, or the Aging and Disability Resource Center’s website at www.hawaiiadrc.org. The county also has case management programs that are run on a donation basis, but they usually have a waiting list.
AL: How do you find a good case manager?
Hathaway: Many private case managers belong to the Hawaii Association of Case Managers. Their website, www.hacm.net, has a lot of information about what case management is and what to look for in a case manager.
AL: If an elderly parent unexpectedly is hospitalized and becomes disabled, what’s the most important thing to do?
Hathaway: People are often thrown into that situation because an elder parent has a stroke or falls and breaks a hip. It’s going to be really difficult, so I recommend that as soon as the person is hospitalized, you contact the social worker and the discharge planner at the hospital and work on devising a care plan to use at home.
Unfortunately, these days people end up staying in the hospital for a very short time, so there’s little time to prepare. This is definitely a situation where a case manager could be very useful in helping figure out what’s needed and quickly getting support services in place.
AL: Where can people learn about the basics of family caregiving?
Hathaway: The best thing would be for them to contact us at Kapiolani Community College or the community college closest to them and sign up for a course. If they don’t have time for that right now, they can go to our website: www.kupunaeducation.com. We have quite a few resources.
The Red Cross also has a caregiver book that comes with a DVD called Family Caregiving. You can contact the Red Cross directly to obtain a copy. Also, there are lots of caregiver guides. The one I really like is called The Comfort of Home: A Complete Guide for Caregivers by Maria Meyer and Paula Derr.
AL: What’s important to keep in mind when caring for an elderly family member?
Hathaway: You need to remember that an elderly person is not a child, so let them do as much as they can themselves. Only assist them with those things they aren’t able to do. It’s very important that people maintain as much independence and ability as possible to uphold muscle strength and cognitive ability. Also, people are happier if they can do things for themselves.
AL: You’ve had first-hand experience in caring for loved ones in their final years. What were some important lessons you learned?
Hathaway: The most important thing I learned was that if you hire someone to assist, you really have to monitor the situation. People do a better job if they know you care and are on top of things. Home care is great, but for your own peace of mind, drop in occasionally and unexpectedly so the caregiver knows you are checking on how things are going. That should be the case whether a loved one is at home, a nursing home or a hospital.
AL: Any final thoughts?
Hathaway: Besides taking time out for yourself, try and make the task you are doing with the elder more enjoyable as opposed to something to be rushed through. If you need to assist with bathing, for example, slow down the process a little. My mom really likes a certain kind of bath gel because it makes bathing a more enjoyable experience. Little things like that help make the process of caregiving more gratifying for everyone involved.
