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

“Gloves make me brave” – remark made by a Greenville Memorial Hospital Nurse.

You’re taking care of a life form, and life and metabolism require inputs and generate outputs. This is as true of yourself as it is of the one you’re caring for. In fact, the processes are basically the same between you and your cared-for (unless maybe you’re caring for an alien from another planet). So, if you need to help your charge with these functions, inputs or, yes, outputs, just put on a pair of gloves (where warranted) and get it done. Caregivers (professional and amateur, and parents) do that sort of thing all the time. Don’t make it a bigger deal than it is.

I will never take going to the bathroom for granted ever again.

Control expectations, and be flexible.

If you’re caring for someone who’s recovering, you want to convey optimism, but things proceed on their own schedules, and progress is not always linear. Some days it’s two steps forward, some days it’s a step back, some days you just fight it to a standstill.

It’s ok to make plans, but be prepared if your cared-for can’t attend that event, or progress isn’t “on schedule”, or even if you have to change your own plans because your cared-for needs you. Do not get so enamored with a plan that you get all in knots if it has to change. That becomes just a bunch of stress you don’t need and wastes mental bandwidth.

Options are a good thing. If your job permits, keep your laptop handy so you can do work when you’re sitting around the hospital. Know where the grocery stores are so you can make a quick stop on the way between places. Have a friend who can mow the grass and look after the cat if you get tied up. Carry durable snacks (preferably something healthy, like trail mix) in case you have to miss a meal. Know places where you can get a healthy meal if you don’t have time to fix something (I like Subway). Carry your most important medications with you (tip: a small re-sealable bag takes up a lot less room in a backpack than a pharmacy bottle – just make sure it’s properly labeled). Having options like these in your back pocket will help reduce the stress when the situation changes.

Be flexible, and know your priorities. If you’re called away from work, know that you’re taking care of the Most Important thing (your cared-for), and don’t worry about work. That’s what FMLA is for (for my US reader, anyway). Remember to keep your own self a spot on the priority list (see Caregiver thoughts #1) and, if your cared-for is in a good situation, go run or do some gardening or whatever you like to do to unwind.

It is what it is, and what will be will be (I think that’s from a song).

My role as a caregiver for a cherished loved one had been gradually increasing over the years, but recently, due to medical issues, that role has taken a very large leap. That’s why I haven’t been posting much here lately.

Remembering that I have a blog, I thought I’d post some thoughts on being a caregiver. I’m a practical sort, so I’ll concentrate on the nuts&bolts (so to speak) of being a caregiver and leave the deep philosophical/spiritual/psychological aspects to others who are far more qualified than I am to comment on such matters.

Rule #1: take care of yourself.

Everyone I’ve talked to places this first, and I understand the reasoning. It’s like when they tell you to put on your own oxygen mask before assisting others should there be a sudden loss of pressurization on the airliner. If you’re passed out gasping for O2, you’re of no use to anyone. My Sister put it quite nicely: “If you [as the caregiver] go down, he’s [the one cared for] in Trouble.“.

I’m posting this one first, not just because it’s Very Important, but because I’m finding it very difficult to adhere to. It’s very difficult to leave your loved one in professional hands, no matter how good, and walk away to even do “necessary” things like get groceries, but even more so to just unwind and do something recreational. Or maybe you think it’s not necessary to buy groceries. After all, there’s a food court in the hospital, and plenty of drive-thrus. IMHO, relying on those food sources would be a Big Mistake.

But it’s important to maintain yourself with adequate rest, food, exercise, and yes, just plain downtime. You need to operate in a way that’s sustainable.

Now that I’ve said it publicly, I have to stick to it, otherwise someone will hit me over the head with this post.