Solutions
To Your Caregiving Situations
Throughout Your Caregiving Years
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Managing The Stress ~ Making The Decisions ~ Discovering The Meaning |
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Solutions To Your Caregiving Situations Throughout Your Caregiving Years |
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Family Caregiver Case Study Managing the care--and the relationship--in difficult times (Editor's Note: This is the first in a four-part series featuring a family caregiver case study, originally published in our monthly print publication, Caregiving. Our case study explores the issues of caregiving and how a professional, such as a geriatric case manager, can help the family caregiver and care recipient weave their way through difficult care needs and a demanding relationship.) For Irena, her struggle to care for her mother took root before her birth, during World War II. Her parents, born and raised in Ukraine, saw first-hand the terror of war. In 1939, her father was drafted into a forced labor camp by the Germans and sent to Berlin where he worked until the end of the War. Since he learned German and had valuable skills (he was a master blacksmith and locksmith in Ukraine), he received "papers" that allowed him to travel. He went back to Ukraine, married Irena's mother, Mary. But because Mary did not have papers, he smuggled her to Berlin. Irena was born in a Displaced Persons Camp. Her parents eventually immigrated to the United States, setting in the Midwest. Irena, the oldest of three children, felt the pressure to confirm to her parents' Old World Ways. Irena longed to learn and travel; when she chose to enroll in a university 90 minutes from home, her parents expressed outrage and heartache at her decision. When she ultimately settled on the East Coast, her parents made very clear their position: As the oldest daughter, Irena was a reflection of her family's honor. She had dishonored the family's name by moving away. Her parents may have moved to the United States, but they lived their life as if still in Ukraine. "My mother never learned to read or write English," Irena says. "My parents were traumatized by experiences in the War and never seemed to move beyond that experience." But, for Irena, her survival depended on moving away; just as her parent's survival depended on leaving Europe. "If I had stayed, I would have known spiritual death," Irena says. "I had to keep myself by moving away." Irena visited her folks twice a year, making the commitment to maintain a relationship with her parents. After her father's death in 1994, Irena's commitment was truly tested. Her mother, Mary, continued to live in the home she and her husband bought in 1955; the house still stood, but the neighborhood had deteriorated and become unsafe. After suffering a mild stroke in 1997, her mother moved in with Irena's brother and his girlfriend. But, Mary was not safe with her son; he stole from her (Mary and her husband kept their savings in their house rather than in a bank), and isolated her from family and friends (Mary was not allowed to see or speak to Irena). When Mary was hospitalized as a result of poor care, the doctor refused to release Mary back into her son's care. Irena stepped in; her options were to move Mary back home or move Mary to her home on the East Coast. Mary's care needs were too extensive for her to live alone. So, Irena brought Mary back to her home. "I was a basket case," Irena says of this decision. "I was working a full-time job at the time so I called my Employee Assistance Program. The EAP referred me to a therapist and suggested I look to hire a geriatric care manager to help oversee my mother's care." Irena brought Mary home to live with her. She continued to work, hiring caregivers in the morning and the afternoon to care for her mother. But, money was a tight; since her brother had absconded with the savings, Mary had only her small social security and pension as well as minimal income generated from rental property she owned. Irena provided for Mary in her home for a year, but Mary wanted to return to her home. While Irena's friends would marvel at her decision to care for her mother in her home, Mary continually requested that she return home. "I did the best I could for my mother while she was here, but it never seemed to be enough," Irena said. "It seemed the only option was for Mom to return to her home." Mary returned home; Irena arranged for in-home care. But, the pressure to return to her hometown intensified, and the stress of trying to manage her mother's care from a distance was almost overwhelming. "The caregivers I hired didn't show up, or had they had personality problems with my mom," Irena explained. "My mother wasn't taking her medications, she wasn't eating right." Irena again was referred to a geriatric case manager, a professional who can manage, oversee and monitor the care of an aging relative. This time, Irena contacted the care manager referred to her: Miriam Oliensis-Torres, MSW, and co-owner, Geriatric Support Associates, Milwaukee, Wisc. She contacted Miriam to help her with her goal: Keeping her mom safe in her home. Miriam, who started her business in 1986 on a part-time basis, incorporating as a full-time business in 1988, often steps in to help families with just this goal. "We can help families balance the needs and wants of the adult children and the needs and wants of the older adults," Miriam explains. These needs are often in contrast. But for Irena, she wanted the same goal for herself as for her mother: For them both to remain safe in their own homes. Families turn to a geriatric case manager, such as Miriam, when the immediate family lives out-of-town, when the family has concerns but is unsure where to turn for help, or when a conflict arises among the family as to how best meet the needs of an aging relative. A care manager can assess the older adult's needs, educate the family and older adult about available services, and help the family and older adult make decisions about care needs. A care manager can stay as involved as the family and older adult deem necessary--from simply referring and recommending, to implementing and overseeing a long-term care plan. Irena and Miriam set to work on a care plan for Mary on Mary's tight budget. Next Time: Irena and Miriam face another challenge: A fire destroys Mary's house; they must find Mary temporary housing. Read Part II. |
The
Caregiving Years: |
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© Tad
Publishing Co. 2000 |
