What it is:

     Respite services are amongst the most valuable, and under-utilized, services in the caregivers tool box. The truth be told, many people really do not know what it is. Respite is a break for the full time caregiver who receives no pay. It is a way for a spouse, sibling, child or friend, who provides care, to take a break and address personal issues. It should not be confused with the taking on of a full or part time health aide or caregiver. Rather, it is the utilization of a trusted person or agency for a few hours that can allow the primary caregiver to run errands, address personal issues, or just plain take a break.

     This service is under-utilized for a variety of reasons. A lack of awareness is one. Not knowing that this valuable (and actually common) service is available for caregivers. A lack of the facts is another common reason. As a caregiver, you are more likely than not focused on the condition and needs of the person you are providing care to. However, caregivers also suffer from an array of health ailments related to providing care. Did you know:

• Family caregivers who provide over 30 hours of care weekly are more likely to experience symptoms of depression or anxiety than non-caregivers. For those caring for a spouse the rate is six times higher; for adult children caring for a parent the rate is twice as high.
  
• Family caregivers suffer a chronic condition at more than twice the rate as non-caregivers.
  
• Stress from providing care can take as much as ten years off a family caregiver’s life.
  
• Elderly spousal caregivers with their own history of illness, and who are experiencing care-related stress, have a 63 percent higher mortality rate than non-caregiving peers.

     Finally, one of the reasons that this valuable service is often overlooked is that as good people, we tend to blend our roles. We do not separate spouse and caregiver, or child and caregiver, or friend and caregiver. We tend to feel obligated as a spouse, child, or friend to also be the caregiver. In turn, we often do not recognize that we need a break from time to time to refresh ourselves or re-charge our “batteries”. As a spouse, child or friend we do not feel entitled to a break, even though we are most definitely in need of a break! Respite is an opportunity to step away, take a deep breath and take a little bit of your life back.

Why it is important:

     The importance of Respite both as a service and as a concept cannot be understated. Respite services allow the primary caregiver to rest, re-charge, and re-establish themselves. These breaks allow the caregiver to reduce stress levels, and therefore, provide better care. Furthermore, by taking a break and reducing their stress levels, the caregiver is giving their own immune system a boost, which can help alleviate ailments related to caregiver stress. Respite allows the caregiver to re-establish their patience. This re-establishment is therapeutic for both the caregiver, and the person who is receiving care. It is also an important preventive measure to help protect against unintentional dependent adult abuse. A couple of weekly hours costs very little, and in terms of preventing caregiver burnout, or dependent adult abuse, it is absolutely priceless.

How to start with loved one:

     To provide the best care, plan ahead. The best course of action when considering providing care for a loved one is to begin discussing the individuals wants and needs before they actually need care to be provided. While it may feel uncomfortable, a conversation about the persons’ needs and what you have observed about the persons’ physical or mental condition as a spouse, child or friend, will help ensure that the best course of action for both of you will be taken. 

     Be sensitive about your spouse, parent, or friend’s pride. It is not easy for any person in any stage of their life to admit that they need help in any way, shape, or form. Have an honest adult discussion about what you observe as a need, and what they perceive as a need. Speak with the other person as an adult and avoid baby-talk. Look for ways to preserve the independence and skills that they are currently maintaining. Do not complete tasks for them if they can independently do it themselves. Part of being a caregiver is helping the person you are providing care for feel good about themselves. Finally, after the caregiving process has begun, observe what you see and note it. Seeing someone you care about change can be scary. Seeing these changes and not addressing them can be dangerous.

     Finally, make Respite a part of the plan. Develop a partnership with a respite provider that can not only meet the basic needs of the individual, but provide even more than you. The Adult Day Center (A.D.C.) of Senior Resources is also a respite provider. Attending an A.D.C. will not only give you a break, but it will provide your loved one with an opportunity for friendship, fun and games, and a new environment. One half day (4 hours or less) at our A.D.C. can cost as much, and sometimes even less, than one hour with a home health aide. Eliminating stress, financial or otherwise, should be a part of your plan of care for your loved one.

Before and After Day One:

     Prior to using respite, meet with the provider, or tour the facility with your loved one. New experiences can be challenging and sometimes scary. Allow time to meet people and share information. Understand that providers themselves have paperwork requirements to ensure that they are doing everything that they can (and should) be doing. Have a list ready. Let the Respite provider know exactly what needs to be done for your loved one to make them as comfortable as possible. Ask questions and be honest. If your spouse, parent, or friend has special needs, or otherwise requires special attention, make sure that the Respite provider can meet those needs. Be as detailed as possible. List medications, food likes/dislikes, hygienic needs, anything that can help the respite provider provide the best care.

     Finally, give it some time. It is not always easy to break from a routine. It is also never easy to transition from a familiar caregiver to a new one. Expect to hear some complaints. Be supportive and encouraging. Encourage your loved one to give the process some time. If in time they are still dissatisfied, talk it out and see if a compromise can’t be reached. If a resolution cannot be found, then perhaps seeking another provider is in order. Remember, a transitional period is not uncommon at all. More often, after a few days, we find that our spouse, parent, or friend has come to love their new provider and environment.

     Some of the more common skin conditions afflicting seniors are:

 ·        Cancerous and non-cancerous growths.

·        Senile Purpura. This condition is characterized by purple spots appearing on the extremities due to thinness of the elder person’s skin and frailty of the capillaries and blood vessels below the surface of the skin.

·        Stasis Dermatitis. This is dry, itchy skin.

·        Exfoliative Dermatitis. This is a more severe version of the above. However, Exfoliative Dermatitis can result in excessive peeling and shedding of the skin. This can extremely dangerous for seniors, as the severe itching can lead to skin infection.

     Addressing the skin care needs of seniors can be a low maintenance affair with a few simple lifestyle adjustments. Changing a daily routine can pay big dividends.

 ·        Quit smoking. Beside the damage done to your cardiovascular system, smoking also damages your skin, and minimizes its’ ability to repair itself.

·        Take extra care to avoid developing bedsores, particularly for those who are incontinent or bed ridden. These individuals need to be turned frequently to avoid pressure sensitive ulcers. It is very important that absorbent products and catheters are changed frequently.

·        Stay out of the sun if you are not using sun block. As seniors are more susceptible to cancerous and non-cancerous growths, it is imperative that they use sun block whenever they will be out in the sun.

·        Use a room humidifier during the winter months. Keeping moisture in the air will help a senior’s skin keep some suppleness and reduce the effects of dry skin conditions.

·        Stay hydrated. Fluid intake impacts our skins’ condition. Seniors should make sure that they are getting at least a couple of glasses of water daily to help keep moisture in their skin.

     In addition to lifestyle changes, seniors can benefit from adding a couple of steps to their body care regimen. Seniors can “spoil themselves rotten” while ensuring that they do all they can to take care of their skin. By taking an extra couple of minutes daily, seniors can have their skin look and feel much better.

·        Take care of your home. Keeping your home and bedding clean can lead to healthier skin. Avoid hot water as this can dry out skin very rapidly. Avoid using chemicals such as chlorine, as chlorine irritates dry skin. When you clean wear gloves to lower your risk of exposure to irritants. Wash bedding and vacuum at least weekly. Dust mites have been found to irritate skin, making irritated skin harder to heal.

·        Reduce baths/showers. If a senior does not have specialized care needs related to incontinence, they should skip daily showers or baths, especially hot showers or baths. When bathing, make sure that extra moisturizing products are used. Generally speaking, emollient preparations lubricate and moisturize the skin, counteracting dryness and itching.

·        Lubricate. Use lotions appropriate for senior needs. Become a label reader and make sure that the skin product that is being used for the senior is meant for the senior. Some skin care products contain astringents which reduce oil in the skin. These products are good if you are a senior in high school, not so good if you are a senior citizen. Keep a small container by your sink and use it after every hand wash or bath/shower. Apply lotions to the skin when the skin is still moist from bathing. Try to apply lotions to the skin within three minutes of bathing or hand washing for maximum prevention of dryness. If you suffer from very dry skin and want to be sure the lotion you are using is thick enough to help, turn the container over and see if it drips or runs out. Thicker moisturizers and moisture barriers are your best bet.

     Finally, when in doubt, ask the professionals. Skin conditions can be a result or side effect from prescription medications. Rashes related to medications can take weeks to appear. When beginning a new medication, keep a journal and note any changes coming after the medication has started. Some skin conditions can result from combining certain drugs and certain foods. If skin problems are noted and seemingly cannot be addressed by any of the above recommendations, see a medical provider for an evaluation of over the counter, prescription, and holistic treatments.

     An online search for “moai” will take you to many an interesting place.  Spell the word wrong, and you will have the opportunity to learn about monoamine oxidase inhibitors.  Spell the word correctly, and you may learn about the giant stone faces on Easter Island that were carved between 1250 and 1500 A.D.  The definition we are seeking however has nothing to do with pharmaceutical drugs or giant stone sculptures.  The moai we are talking about is quite different.

     Moai is a term from Okinawa that refers to a small social group that meets regularly.  The members resolve to be lifelong friends, and form a very strong social bond.  Consequently, the Moai help reinforce the healthy behaviors of its members.  This makes perfect sense.  Surrounding yourself with people who make health a priority creates a subtle but powerful effect on your own behaviors.  Studies have shown that if an individual’s friends are obese, that individual is twice as likely to be obese.

     Health is a subjective term.  When most of us hear the word “health”, we immediately think of physical health.  The Blue Zones project have used the concept of the Moai in conjunction with people forming walking clubs that will help people build social connections.  Walking is a great form of exercise that builds our cardiovascular system.  Healthy socialization amongst peers is also healthy, leading to better mental health and an increased sense of well-being.

     In what other ways could we apply the concept of “moai” in our lives?  Remember that our definition is basically a group of friends whose interactions lead to healthier outcomes for each individual.  In short, what other types of groups or interactions could we apply the “moai” concept?  The answer is only as limited as your imagination!

     The holidays can be a challenging time for some people.  People who are alone, or are with limited friends and family may disdain the prospect of facing the holidays.  Another Thanksgiving or Christmas alone can be a very depressing concept to face.  Is this not a place where the moai concept can be applied?  Rather than be alone during the holidays, couldn’t people short on local family and friends form a “Holiday Moai”, a group of individuals that celebrate holidays together?  The same could be said about birthdays.  How many times have you heard someone refer to their birthday as “just another day”?  Couldn’t a group of individuals resolve to form a friendship bond centered on celebrating birthdays, a “Birthday Moai”?  Why not a hybrid concept, form a walking club that celebrates holidays together?  The sky is the limit!

     A well-known Chinese proverb states that “A thousand mile journey begins with a single step”.  Take that first step and embrace the moai!  Find ways to make new friends dedicated to not only their well-being, but yours as well.  Remember, there is not only strength, but also health, in numbers!

Diana Gradert and Neva Baker

Senior Resources would also like to welcome Kim Sojka, Scott Brooke and Michelle Hutton to our Board of Directors. We look forward to working with you.