Perhaps your loved one has just gotten out of the hospital and needs some meals for a few weeks while recuperating. Or maybe Mom has dementia and it’s become too much for Dad to have to cook on top of caring for her.

Meals on Wheels America serves communities most everywhere in the country, but there are requirements for eligibility. And the choices are limited to what is being served that day.

If you decide to look into private meal services, consider the following:

• Special diets. If your loved one requires it, can the service accommodate low-sodium, diabetic, or other special diets?
• Frozen or fresh. If frozen, is there room in your loved one’s freezer for the minimum order? If fresh, what is the shelf life?
• Preparation. Are heating instructions within your relative’s capabilities?
• Payment. Most services are private pay, but some may participate in a Medicaid waiver program.Or does your loved one’s insurance cover meals for special diets?
• Shipping fee. What is the shipping or delivery charge? Flat rate or per meal? Shipping is expensive, thus larger orders are more efficient.
• Minimum orders. Some services require bulk orders of five, ten, fifteen, or twenty meals at a time.
• Weight of the package. Large orders may be difficult for your relative to lift and carry into the house.
• Scheduling. Can you determine delivery days and times, or do they have a fixed schedule? What if your loved one is out when the meals arrive?

If you are looking for a long-term solution, it is wise to try a few services. Perhaps order for yourself first to get a sense of the process and the quality of the food from each vendor. Also, look for discounts. Many regularly offer coupons for 10%–20% off. They add up!

Are you worried about meals?
Food is so basic to health and giving/receiving love. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how distressing it can be when you are worried about a loved one’s nutrition. Let us help. Give us a call at (415) 921-5038. You don’t have to do this alone.

If you care for a loved one with moderate to advanced dementia, it’s likely the idea of placement in memory care has come up. Maybe a friend has nudged you. Or it’s been suggested by your relative’s doctor or care manager. Perhaps you know you are exhausted. Most families eventually investigate this option because it’s staffed 24/7 by people trained in dementia strategies.

The most common reasons families make the shift

• The person is in danger of harming themselves or others (for instance, wandering, or aggressive outbursts).
• The family caregiver’s mental or physical health is going downhill.
• The person is incontinent.

Your feelings may cloud wise judgment. People with dementia don’t recognize their need for help. It is up to you to make a wise decision for them. But strong feelings may hold you back:

• Guilt or betrayal. You promised you’d never send them to a nursing home. Sometimes we can’t keep every promise. Who knew dementia care could be so hard? Visit a few memory care communities. Given their focus on keeping residents happily engaged in activities, they are generally much sunnier than a nursing home.
• Shame or embarrassment. Others may judge you. None of them have walked in your shoes. Go to a support group of family caregivers and hear their feedback. Your decision addresses the need for safety and good health for everyone involved.
• Worry your relative will get worse. No one can care for them as attentively as you can. That’s true. And an uptick in confusion and disorientation is common at first. About six weeks in, however, you’ll likely see them more engaged as they join others in activities.

If you are struggling with this decision, consult with a care manager or social worker. They can even facilitate a family meeting to get everyone on the same page.

Can you really keep up the current level of care?
As the San Francisco experts in family caregiving, we at Compassionate Community Care frequently see a family member’s health plummeting as they care for a loved one with dementia. You can’t stop your relative’s decline. But you don’t have to be a casualty to it. Let us help you make some changes. Give us a call at (415) 921-5038.

If someone else in your family has primary responsibility for the care of your loved one, that doesn’t mean you don’t have anything to contribute. Far from it! Caring for an older adult is more than one person can do alone. There are many ways to lend a hand (even if you don’t live nearby).

Consider:

• Managing finances, talking with the doctors, doing yardwork, running errands. If direct care isn’t your thing, address other needs. Anything you can take off the plate of the primary is a help.
• Contributing money. If you live far away and have the means, pay for outside help to give your sibling some relief.
• Providing emotional support. It’s often very lonely to be the primary caregiver. Having a good listener to talk to for safely blowing off steam can ease the load.
• Giving them a break. Gift them a “spa day” where you make all the arrangements and they just enjoy. Spend some of your vacation time caring for mom or dad so the primary can have an extended rest.

“My sister would never go for that!” The biggest complaint in many families is that the primary caregiver is so particular, it’s impossible to help. True. They may have trouble letting go of control. As long as there is nothing medically dangerous about what you propose, however, you may need to assert yourself and express your right to participate in your parent’s care in your own style.

If you get resistance, consider a facilitated family meeting. Family dynamics are decades old. A counselor, social worker, or Care Manager can guide a conversation constructively. Families are an ecosystem and each member inhabits a niche. It will be better for your loved one, and for you and your siblings, if everyone has a chance to contribute, each in their own way.

Do your family roles seem locked in place?
They have been finely honed since childhood. But that doesn’t mean things can’t shift to be more appropriate to family needs when mom and dad require help in their older years. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you rebalance the roles. Give us a call at (415) 921-5038.

People with heart failure (HF) often tire easily, especially if they exert themselves. In HF, the heart is swollen with fluids and cannot beat efficiently. The body’s cells then become hungry for oxygen. If your loved one has HF, you witness this in his or her fatigue, shortness of breath, and frequent naps.

Even with HF, however, your relative needs to be physically active. Physical activity helps the heart muscle gain strength. It improves circulation. It helps with weight control, and, oddly, with reducing fatigue. Exercise also helps with depression, which is common in HF.

Pacing is the key. Talk with the doctor about optimal forms of physical activity. Initially, walking, swimming, or biking may be recommended. As HF progresses, simple tasks, such as taking a shower or cooking a meal, may qualify as exercise. Ask the doctor for a prescription to work with a cardiac rehab team to create an activity plan tailored to your loved one’s needs.

Conserving energy. Think of personal energy as a tank of gas. With HF, your relative has a small tank and needs to be “fuel efficient.” Conserving energy when doing chores leaves more “in the tank” for doing things that bring joy and meaning.

• Alternate periods of activity with periods of rest. Divide large chores into smaller tasks throughout the day or across the week.
• Avoid rushing. It wastes energy.
• Work smarter. Minimize trips up or down stairs. Cook large quantities of food and freeze for heating later. Instead of towel drying, slip on a terry cloth bathrobe after bathing.
• Get help for mundane tasks. Have groceries and prescriptions delivered.
• Create workstations that permit cooking, grooming, dressing, bathing while seated.
• Use a cart or walker with a basket for carrying things from place to place.
• Avoid bending or reaching. Use extenders.

Looking for ways to ease fatigue?
Give us a call at (415) 921-5038. As the San Francisco experts in family caregiving, we at Compassionate Community Care understand that quality of life is based on how much time your loved one can spend doing things they truly enjoy. Let us help you identify ways to conserve on chores so your relative can go full throttle on pleasant activities.

If the person you care for has a low vision diagnosis, three types of modifications to the home can make life easier: Lighting, glare control, and the use of color contrast. Fortunately, these strategies are relatively inexpensive.

Lighting. Sunlight is the best. It’s full-spectrum light. But it fluctuates depending on the time of day and the weather. Fluorescent bulbs are advised for general room lighting, although they cannot be dimmed. Incandescent lights can be dimmed, but they tend to produce visual “hot spots” or glare. Their best application is in a gooseneck lamp for close-up tasks. Lights recessed into the ceiling are optimal for spotlighting dark areas without creating glare (for example, a closet, hallway, stairs). Track lighting is lower cost, but it sometimes creates glare.

Glare control. Glare arises when reflected light creates too bright a hot spot relative to the rest of the room making it difficult for the eyes to adjust. Strive to reduce shiny surfaces. Also, to control surrounding light.

• Choose mini blinds or vertical blinds for maximum control of glare from the sun.
• Install dimmer switches to even out lighting brightness.
• Avoid using glossy paints or polishing furniture or floors to a shiny finish.
• Have tablecloths or other throw-ons available to cover bright surfaces as needed.

Color contrast. Light colors used in contrast to dark or bright colors instantly make it easier for your loved one to locate important items or get oriented in a room. For instance:

• When walls are white, paint doors, doorjambs, and baseboards with bright colors to highlight the boundaries of a room. Use a dark switch plate around light switches and outlets.
• Choose solid floor coverings (carpet, wood, tile) instead of those with patterns.
• Provide a dark desktop for tasks involving paper or a white plate for dining on a dark table top (or cloth).
• Place a dark armchair against a white wall and/or a light-colored floor or rug.
• Place brightly colored tape on the edges of cupboards and drawers to help your relative know when these are open, safeguarding against bumps, cuts, and falls.
• Red, orange and yellow—solid, bright colors—are more visible than pastels and/or dark colors.

Does the person you care for have low vision?
The older we get, the greater the chance of visual impairment. Cataracts, glaucoma, macular degeneration, and diabetes are the most common causes. As the San Francisco experts in family caregiving, we at Compassionate Community Care have worked with many families needing to make adjustments for their loved one’s low vision. You don’t need to do this alone. Give us a call at (415) 921-5038.

Frustrated in your search for a paid caregiver? You are not alone. There is an extreme shortage of helpers right now. Even before COVID, the demand for aides was greater than the supply. The “Great Resignation” hit the caring professions hard. Caregivers close to retirement left early. And many younger workers decided to opt for safer, less demanding jobs. In some states, as many as 38% of direct-care workers chose other occupations last year.

Caregiving is strenuous work, usually for very low pay. And there’s little societal respect for the career. The work can involve unpleasant personal care tasks. As well, clients with dementia may behave unkindly. Even clients without memory and thinking problems have been known to take out frustrations on paid helpers.

Adding to those realities, there is little growth opportunity for direct-care workers. Even jobs at fast-food chains pay better. Corporate employers can also provide more-flexible schedules so parents can be home after school. All these factors make direct care a less appealing career choice. Nearly half of paid caregivers quit within their first year.

By 2030 we will have twice as many people over 65 as we had in 2011. And we will have fewer young people in the population, so fewer potential helpers.

Yikes! As a family in need of help, this can be distressing news. As many as 85% of home-care companies reported having to turn away new clients at least once because they didn’t have the staff.

If you are lucky enough to get help, strive to make it a lasting relationship. Don’t tolerate poor work, but make an effort to thank and treat with respect those aides who do good work. It will be in your best interest, and in your loved one’s. The shortage is very real.

Are you having trouble finding help?
It can be daunting. As the San Francisco experts in family caregiving, we at Compassionate Community Care are actively strategizing about this problem every day. It’s a challenge throughout the nation. Give us a call at (415) 921-5038. Let’s see what we can do together.

Distance makes caregiving more challenging, from knowing what’s needed, to getting tasks accomplished. Here are some tips:

Stay in touch. This is a win–win. You stay current on issues, and your relative gets the emotional boost.

• Use the phone, email, and/or Web-based video calls. Connect at different times of day to see what’s up. Is mom sleeping a lot? What’s on the table at dinnertime?
• Ask about any injuries or falls. This information is important but may not be volunteered.
• If your relative lives alone, consider having them give you an “I’m up!” call or text by a preset hour.

Plan ahead. When visiting, use your time wisely. Do things with your family member that are just plain enjoyable. But also

• go to medical appointments. Get to know the providers. Ensure that releases are signed so you can talk with the doctors as needed.
• address housekeeping issues. Fix potential hazards, such as loose rugs, rickety stairs, and burned-out light bulbs. Check for signs that regular help is needed, such as garbage or laundry piling up.
• get into the kitchen. What is in the refrigerator? In the cupboards? Scorched pans may indicate your relative is forgetting to turn off the stove, a common sign of memory problems.
• check the desk. And ideally, scan the checkbook. Is the register in order? Any overdue notices?
• connect with the neighbors. And/or nearby close friends. Give them your contact information.

Stay organized. At your home, keep a binder up to date with documents essential to healthcare and money management.

Are you a long-distance caregiver?
As the San Francisco experts in family caregiving, we at Compassionate Community Care understand how precious your time is and how difficult it is to get everything accomplished from afar. You don’t have to do this alone. Give us a call at (415) 921-5038.

Catching things early is big with Medicare. Every year, all Medicare enrollees are eligible for a free “Wellness Visit” with their primary care doctor.

This is NOT an annual physical, so don’t use that term when making the appointment. Beyond basic vitals—height, weight, blood pressure, and pulse—there is no physical examination. If a physical exam is done, your loved one may have to foot the bill.

The yearly Wellness Visit is more of a conversation. The goal is to look at ways to avoid health problems or identify them early. The visit includes

• a review of medications and medical history
• a health risk questionnaire. This survey addresses lifestyle issues such as smoking, alcohol, and exercise
• other questionnaires assess memory and thinking problems, depression, anger, and social isolation

Based on your relative’s responses, the doctor may recommend screening tests. The idea is to nip any problems in the bud. It is also a time for your loved one to discuss preferences for end-of-life care. (This is called “advanced care planning.”)

Important to note, this visit does NOT include treatment or management of your relative’s chronic conditions. Diabetes, high cholesterol, and high blood pressure certainly threaten wellness. But they are addressed separately. And tempting as it is to say, “While I’m here, doc, what about this pain in my knee,” that is also outside the bounds. Best to make another appointment or your loved one may be charged for the visit.

Different from the “Welcome to Medicare” visit
If this is your relative’s very first year on Medicare, they are entitled to a free “Welcome Visit.” This is similar to the Wellness Visit but includes other assessments. One for fall risks. Another to identify weight problems. The appointment may also address hearing and vision. These additional assessments are not part of the yearly Wellness Visit.

Are you concerned about Medicare coverage?
Give us a call at (415) 921-5038. As the San Francisco experts in family caregiving, we at Compassionate Community Care can help you unravel the myriad complexities.

In most families, there is one person who takes on the lion’s share of caring for an aging loved one. Perhaps it’s the oldest daughter. Or the emotionally closest child. Or maybe it’s the geographically closest relative. And when there are no siblings, it’s usually the only child.

Being primary can be quite a job. In many cases it involves driving to the doctor and managing medications, handling finances, providing for daily needs, coordinating care services, and keeping the elder’s spirits up. If you are that person, don’t try to do it alone—even if it seems like that’s the only choice.

Here is advice from family caregivers who have been through this journey:

• Take breaks. It may not feel possible, but there are ways. If you forgo breaks, you risk burning out—which has negative consequences for everyone, not just you.
• Call a family meeting to discuss sharing responsibilities. Old family dynamics often resurface in this context. Consider getting the services of a social worker or care manager to facilitate a discussion.
• Be open to receiving help. Some families complain that the primary caregiver is so particular, there isn’t a realistic way to pitch in. Does that ring even a small bell with you? You may feel that you are the only one who can do it right or that you have to do it all. Now is a time to challenge that belief about yourself, even if you are an only child.
• What if it isn’t perfect? Of course, you want the best for your loved one. But consider for a moment: What is the worst that could happen if things weren’t done exactly up to the standard that you set? Perhaps there would be some discomfort for you and your relative, but nothing compared to how bad it would be if you burned out or ended up with a health crisis of your own (not uncommon among primary caregivers).
• Be clear about the costs and the rewards. What are you sacrificing as you carry out this role? (Social life? Career advancement? Your own retirement security?) What do you realistically enjoy or gain? Identifying the pluses and minuses can help you focus on what needs changing and what you want to emphasize.
• Family patterns die hard. Guilt or the perennial desire for parental approval can wear you down quickly! Plus, it’s common for siblings to revert to old resentments and rivalry during the eldercare years. Don’t get hijacked by the past! From your adult self, acknowledge what you realistically can and can’t do. Get professional help if it’s proving too difficult to reset internally.

Do you shoulder most of the eldercare responsibilities?
As the San Francisco experts in family caregiving, we at Compassionate Community Care understand the unique challenges you face. You may feel like you have to do it all, but you don’t. Give us a call at (415) 921-5038. Let’s share the load.

Our eyes show us the world. If something goes wrong with them, it can affect our total well-being. Dry eye syndrome makes eyes feel gritty, burning, itchy, and sensitive—discomforts that are hard to ignore! It typically manifests with age and affects as many as 30% of older adults.

What to do if your loved one has these symptoms: First, visit the eye doctor to understand the exact cause and identify any medications that are contributing to the problem. Then, try some proven soothing remedies:

• Warm compresses. Place a warm washcloth over your relative’s eyes for five minutes twice a day, pressing gently at the base of the eyelashes. Reheat the washcloth whenever it gets cold. The water hydrates the eyes and the heat loosens oils in the eyelashes that can build up and interfere with tears.
• Baby shampoo. The doctor may recommend massaging baby shampoo gently along the eye lashes to cleanse them more thoroughly.
• Eye drops. Over-the-counter “artificial tears” can help, but avoid those designed to eliminate redness. Better are eye drops that come in small individual-dose containers. These drops lack preservatives and can be used five times a day or more.
• Eye ointments. Ointments last longer than drops in terms of lubrication, but they make vision blurry. Save ointments for nighttime use.
• More fluids. More water consumed means more moisture for the eyes.
• Humidifiers. Adding moisture to the air, especially in winter, reducesthe likelihood of the eyes drying out.
• Change contacts. Daily disposables may be less irritating to the eyes. Or change to glasses now and then.
• Wraparound sunglasses. These can help reduce the evaporation of tears if your loved one spends time outdoors in wind and sun.
• Less screen time. Try the 20/20/20 rule. Have your loved one get up every 20 minutes for 20 seconds, stretch, and focus on something at least 20 feet away.

Are dry eyes a problem?
Sometimes it’s the little things that make quality of life so difficult. As the San Francisco experts in family caregiving, we at Compassionate Community Care know how important something like eye comfort can be. If the person you care for is struggling with daily life issues, give us a call at (415) 921-5038. You don’t have to do this alone.