There are a lot of reasons one might need someone to care for them, and varying degrees of all of them. Someone might have a disability (permanent or temporary). They may be ill (temporarily, chronically, or terminally). They may be at one extreme or the other of age (very, or somewhat, young, or old). So. I should mention that the reason my cared-for needs a caregiver is because of “advanced age”

What do you call someone in that condition? Many of the terms that get thrown around carry connotations that fail to appreciate the variety and complexity of things that condition entails. “Elderly”. “Senior Citizen”. “Aged”. “Geezer”. Just plain “old”. They all carry stereotypes that over-simplify the needs and problems of these folks. So, maybe I’ll use “advanced age”, or “one of many seasons”, just to have a term with minimal baggage.

Lest we lose perspective, it’s not all needs and problems. These people have unique capabilities too. Wisdom is something that tends to come with advancing age. Providing an anchor for the family. Giving witness to history that the rest of us never experienced (your orders: go talk to the advanced-age people around you and learn and record history first-hand). Or just being around to sign for that package at the house or meet the cable guy.

It’s often made into a joke that people of many seasons seem obsessed with things like digestion and bowel movements and even just getting up. There’s a good reason for this. When you’re younger, these things are pretty much automatic. You don’t give them any thought. Later on, these things become difficult and require attention and conscious effort. Something like walking is done with great care and planning to ensure a safe transit. Medications become necessary and require careful management. And, if you live long enough, you will have had enough problems with these things that you no longer take them for granted.

I came across this article, which talks about what sort of parameters or values we might impose on robotic caregivers as that technology develops:
http://www2.warwick.ac.uk/newsandevents/pressreleases/asimov146s_three_laws/

The 6 values developed by Professor Tom Sorell are:
· Autonomy – being able to set goals in life and choose means;
· Independence – being able to implement one’s goals without the permission, assistance or material resources of others;
· Enablement – having, or having access to, the means of realizing goals and choices;
· Safety – being able readily to avoid pain or harm;
· Privacy – being able to pursue and realize one’s goals and implement one’s choices unobserved
· Social Connectedness – having regular contact with friends and loved ones and safe access to strangers one can choose to meet.

I think it might be useful for us more biological caregivers to keep these things in mind as well.

For my part, I’ve prioritized things as keeping my cared-for a) safe, b) comfortable, and c) happy, which kind of play into the proposed 6 values.

My “Safe” and Professor Sorell’s “Safety” are pretty much the same, with maybe an element of “Privacy” thrown in. How safe do you feel when everyone is watching your every move (the NSA not withstanding)? Safety includes things like removing hazards from the environment (loose rugs that can cause a fall), providing assistive devices, overseeing medications, and not just providing transport to the doctor’s office, but being there to discuss issues with the doctor and make sure instructions are understood. It can also include instruction and advice, like what to do with those funny looking Emails or the various scams that come around regularly (“answering the door does not mean opening the door”).

I think everything else elaborates on my “comfortable” and “happy”. I want my cared-for to be as independent as he’s capable of (and I have my own selfish reasons for that), so he can do the things he wants to do. For those things that he wants to do but can’t, I try to provide the “enablement” so they can happen anyway, whether that’s providing transportation, arranging tickets, or just putting up grab bars on the wall so he can get around – safely.

Independence, autonomy, and privacy can be a tricky thing when dealing with someone who’s aging. At some point, if we live long enough, we’ll all become less independent, autonomous, and have to give up some privacy. The trick is to have this happen gracefully, and only as required. If your cared-for is legally competent, you have to respect that and let them make their own decisions, be they financial, social, or medical. You’re there to advise and make sure all the information is communicated and understood. For example, make sure the doctor has heard all the complaints, and your cared-for understands their options. Then enable that chosen option. The question of competence has to be evaluated on a regular basis. If your cared-for decided to buy a swimming pool that just won’t fit in the yard, or, heaven forbid, starts getting into auto wrecks, you may have to make changes. But this needs to be done with great care, and not just because you don’t like that new friend they made.

I have to give a pat on the back to my cared-for. He made his own decision to not drive any more, and for this I am Eternally Grateful. This is a Huge step away from independence in our society, and that he did it on his own and before anything bad happened is worth the highest praise.

Humans are social creatures. Try to make sure your cared-for is not trapped in the four walls any more than necessary by providing every possible opportunity to “get out”. Take them along on errands. Look for shows they might enjoy. While in the four walls, I try to find ways to get people in touch with him, provide things to do (which can be a challenge for someone who has trouble hearing and seeing), make sure they have music, and I stay in touch myself while I’m away. And don’t squander the time you’re home with your cared-for: find things to do together, whether that’s playing a game. cooking, or watching a TV show together; don’t hide away somewhere behind a computer writing blog postings or some such nonsense. Hmmmm….

[I’ve collected all these caregiver thoughts under the category Caregiving for easy reference. You can follow the link here or on the lower right side.]

Time is a precious comodity (paid-time-off doubly so), so practice good time management.

Organize your to-do’s so you can get them done in the most efficient manner, such as stopping at the pharmacy, supermarket, and post office all in one trip (saves gas too). If you need to take a day off from work for some activity on the house, see what other things you can line up for that same day.

Write things down so they’ll be handy when you need to look them up, and refer to your notes often. This will help with time management by making sure things get done in a timely fashion and when it’s most convenient to do them. Doesn’t matter if you use a notepad, notebook, or something in “the cloud”, so long as you keep track of things.

Simplify things when you can. For example, get a transponder tag for that toll road on the way to the hospital so you don’t need to keep track of change. Use your credit card (just remember to pay it off promptly when the bill shows up) so you don’t have to make trips to the ATM/bank.

It’s ok to multitask in some situations; I learned to pet the cat with one hand while eating with the other, while reading the newspaper.

Use checklists to ensure that critical tasks (like dispensing medications) are done correctly. While this isn’t a time management thing per se, it will help avoid a time-eating “oh shoot”. It’s actually surprising to me that the use of checklists is so recent a thing in health care; pilots have been using checklists practically since the beginning of time, and to good effect, but I digress…

Utilize professional services where appropriate. If your cared-for is at home, there are home health care services that can provide wide variety of helpful services, from in-depth nursing care to just someone who can look after things and give you a break. One such organization is BrightStar Care. A close family member made extensive use of their services in 2013, and I’m using them as well now. I’ll probably write more about them when I have more experience with their services and operation, but so far, I’m quite satisfied.

Being careful with your time will help you adhere to rule #1