#56: Supporting Families of Home Care Recipients

Show notes: Special edition

CASE STUDIES

Supporting families of home care recipients

In this series of podcasts, we are exploring varies topics through case studies – and today we are looking at supporting families of home care recipients.

In this episode you will learn:

• The advantages of working closely with families of home care recipients
• Difficulties in detecting memory changes in the home environment
• Ongoing care needs and management of a declining elder
• Additional support needs for families.

In this episode we’ll look at the role of families in terms of their acceptance of their loved one’s health in late life. We’ll also talk about families and the important role they play in noticing things or trends that are happening with their loved ones.

Today’s case study involves Rose, a lovely lady supported by her children to live in a retirement village. She has been diagnosed with dementia, and her husband who lived in a nursing home also had dementia. Rose is doing well in the retirement village, and there is no talk about the need to move her into residential care anytime soon. Although in her late 70s or early 80s, Rose remained very creative and young at heart.

Rose was well supported by the village she was living in. She had a limit on her licence which she adhered to and her dementia was quite mild. Her declarative memory was very good, but recalling the specific details was difficult and this was very frustrating for her.

I was seeing Rose as she had depression, and my role was to work through some cognitive behaviour therapy to help her within the home care setting. Rose was very good in her home environment, but once outside it was difficult for her to engage with others and that was causing her anxiety. We worked together on strategies to address her depression and anxiety. Between sessions she worked on goals we had set, and she made good progress.

Her two daughters were very caring and involved, and wanted to know what Rose and I discussed and what they could do. As a psychologist, we are bound by privacy and while there is a place for families to provide some background on their loved one, I needed to explain the boundaries concerning what I was able to disclose. I also highlighted to one of the daughters that she might need help herself, with some personal struggles she had outside of her carer responsibilities. She sought help and was grateful. Getting help herself also allowed her to more easily notice signs that showed that her mum’s anxiety and depressions was exacerbated.

‘Families provide a window of opportunity to elder background, and can also be the first to notice change in an elder and their wellbeing.’

Talking to families of home care recipients, you realise the struggles they have with the worry of not knowing if they are doing the right thing. For example, wondering if their loved one with dementia needs to move into care. This is not necessary for elders like Rose who have been diagnosed with dementia but are doing quite well; we don’t need to swiftly act because they are diagnosed. Instead, we can look for signs down the track that show that they might need to move into residential care, for example when the risks of harm increase.

In a different case, a client of mine lived alone on a busy road in a unit. She had no awareness of the traffic, and would wander out leaving the house open, or the stove on. She started burning her food, when once she was a wonderful cook. These are all clear signs that the impact of dementia is putting her at risk, and as a result, she needed to move into residential care. She presented really well, but when you spoke with her it became evident that there was a risk to her safety.

Burnout is common amongst carers, and when you consider they might have long hours of care, financial strain, isolation and stress, it’s easy to see why. There are different levels depending on where their loved one is currently at, and it is helpful to be aware of where you can direct families for support when they need it, so carers are looked after and can provide the best care. Coming to terms with the way our relationships change is also difficult, as we can transition from being the child to parenting our parent. Going back to Rose, she got better when her daughter addressed her own stressors in her own life as she was then able to provide better care to Rose, who was able to live happily in the village for years to come.

Carers forums are a safe space to connect with others in a similar situation, and Dementia Australia offers support to those with dementia to continue living at home, enjoying activities and learning about dementia. Often a diagnosis is met with fear, but there are strategies that can help those suffering to limit the impact. Find a Psychologist can also be very helpful. Or if delving into this seems all too much, simply recommending the family member has a chat with their GP is a great starting point.

Resources:

Carers Australia – SANE Forums: https://www.carersaustralia.com.au/support-for-carers/sane-forums/

Dementia Australia: https://www.dementia.org.au/  

Find a Psychologist: https://psychology.org.au/find-a-psychologist