Adding up the cost of caregiving

Serving as a caregiver means understanding the financial implications for you.

This year, approximately 34.2 million Americans will provide unpaid care to an adult 50 years old or older, according to a June 2015 report by AARP and the National Alliance for Caregiving.

Caregiving isn’t just emotional — it’s financial. If you are taking care of an aging parent, spouse, or close relative, you’ll likely make a number of wealth-related decisions.

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November is National Family Caregivers Month

Tips and Resources for New Caregivers

Are you a caregiver to a loved one?

If you are, you are one of over 65 million caregivers that care for an adult child, parent or older family member.* Caregiving can be a tough job. It can be rewarding, too.

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November is Alzheimer's Disease Awareness National Diabetes Month

Assured Healthcare recognizes client and veteran, Fergal Patrick Gallagher, as we celebrate Veteran’s Day on November 11th.

Fergal at the Washington Monument

Fergal at the Washington Monument

Ask the Nurse - 'Holiday reality check' gives aging parents a safety net


Ask the Nurse: Christine Hammerlund, President of Assured Healthcare Staffing and Nurse

As Thanksgiving and Christmas approach, it is smart to be aware of changing roles with aging parents.

You have the full turkey dinner at your mom and dad's house. You do the cooking as you have for the last few years because mom is not quite up to pulling off such an event by herself as she did when she was your age.

So you get to do the honors. It it exhausting but satisfying. All your kids will be there. Aunts, uncles and cousins, too.

Mom and dad are getting older now, and you're always concerned about them because they are living on their own. In recent days, you have become very sensitive to the changes that age can impose. It's the price of being a caring adult child. But this was the first year you started to pay special attention to them this way.

These had been those years when your roles had shifted subtly, and you took pride by helping them in ways they used to help you.

One of these days you'll be the one who makes “the decision”. When will it be time for residential assisted living or in-home help to keep them safe? Or perhaps it's a more systematic method to organize their outings or regularly monitor their domestic needs.

You know it's no longer merely a question of chronological age to think of these issues. But life conditions change. Health changes. Fitness changes.

But how do you know when to pay special attention and what you should be looking for?

As it turns out, there are good tools to help you. Those of us who train in-home nurses use a checklist of symptoms and clues. Over the next few weeks as you ratchet up to the whirlwind of Christmas or Hanukah, I'll offer the “holiday reality check.”
If you are worrying about missing some basic signs, here are five categories from the “reality check.”

  1. Is your parent starting to have difficulty with basic tasks? Is walking and talking becoming a stressful chore? And does getting dressed every day seem difficult?
  2. If there are stairs in their home, do they have a problem getting up and down easily? Even on the main floor, do they find it more difficult every day to move from room to room? Is it harder for them to organize how they cook and eat?
  3. Is their personal hygiene becoming more unpredictable? Do they bathe as often as they once did or do they seem sloppy when they once were fastidious about personal appearance and dental hygiene? Perhaps they're not worrying about their hair being combed and washed.
  4. Check around the house to see if they are tending to basic household chores. If they have piles of unopened mail and unpaid bills, it's a sign. If they have regular medications, maybe they are managing it less effectively. Check for low food supplies; dents and scratches on their car. One telltale sign is a growing number of cigarette burns on furniture or carpets.
  5. Then there are significant changes in basic good health. Do you see weight loss, difficulty sleeping, hearing loss, bed-wetting, and bruises from falls, or skin burns from cooking accidents? Do they spill more items during cooking than seems explainable? (Some of us have always been clumsy.)

None of these signs by themselves mean your parent needs nursing help. Everyone has accidents and trends in their behaviors.

But it's equally important to know how to read signs that someone you love needs support and help.

If you are beginning to wonder if some level of private duty nursing help would make their lives better, be sure to review our Top 7 things to consider when choosing a Qualified Home Care Provider.

November is American Diabetes Month and National Alzheimer's Disease Awareness Month


Diabetes is one of the leading causes of disability and death in the United States. It can cause blindness, nerve damage, kidney disease, and other health problems if it’s not controlled. One in 11 Americans have diabetes – that’s more than 29 million people. And another 86 million adults in the United States are at high risk of developing type 2 diabetes.

To learn more, visit the American Diabetes Association website at

November is also National Alzheimer's Disease Awareness Month. To Learn more about the disease and how to support patients and their caregivers visit Dementia Day by Day at and The Alzheimers Reading Room websites at

Celebrating Spring and March | Ask the Nurse: forgetting the life you lived

The pain of forgetting the life you lived

by Christine Hammerlund, President of Assured Healthcare and "Mother"
Part two of a four part series about Christine Hammerlund and her Mom.

One of the obvious effects of even moderate dementia is that a person afflicted by it forgets.

Forgets events. Forgets faces. Forgets names. Forgets facts.

But the deepest fear for a thoughtful, independent person is to lose the memory of everything in life that mattered. To have all the rich events and experiences wiped away. It is a fundamental loss of humanity that dementia inflicts. It is a deep fearsome pain in the soul to confront that future.

There are a few things that really surprise me and continue to baffle me about Mom's dementia.

I can't always anticipate what she clearly remembers and what she forgets. She talks a lot about her life as a child, but can't remember her husband of 40-plus years or her children's names or when her birthday is.

She often asks me if I remember the neighbor down the street when she was growing up.

Most of the time she accepts that her memory is fading, but sometimes she cries because she realizes that she remembers less and less. Dementia is not painless.

Mom often asks me the same thing over and over again. I try to be patient and answer as if it were the first time she asked. I would advise those caregivers out there to never say, “remember you just asked that question and I answered you” because they don't remember. It is painful and depressing for seniors to realize they can't recall or retain new information.

Some of that missing information involves decisions that had been carefully considered and decided.

When she first moved in with me, she constantly talked about going home, and I had to explain to her that she would not be able to return home. She now suggests that infrequently.  She often tells me it is fine to leave her alone and that she'll be OK. But I have caregivers with her during the day, while I work; so she is never alone.  She hasn't totally accepted her functional limitations and often asks me what she can do to help me around the house. She wants to feel useful and helpful, and I struggle to give her small chores such as setting the table for dinner and folding the laundry. Because of her poor eyesight, she is unable to help with any of the cooking.

Look for Part 3 of this special series next month: They're losing enough; don't take their dignity too.

6 Healthy Reasons to Love Spring

Birds are chirping. Flowers are blooming. The good news is that all the things we love about spring are surprisingly good for us!

Extra daylight. Springing forward for daylight saving time feels rough the day after, but once you’re recovered from a night or two of sleep deprivation, the benefits are far-reaching. In addition to giving us more time to spend outdoors and serving as a natural mood booster, that extra hour of light may help reduce traffic accidents and fatalities.

A healthier home. During warmer weather, open your windows and let the sunshine in while you spring clean, declutter, and organize your home.

A spring-cleaned diet. Sweep the cobwebs about of your cold-weather diet with a dose of fresh spring produce.

Outdoor exercise. If winter is too cold and summer is too hot, spring is just right for outdoor exercise.

No more winter skin. Gone are the freezing temps and harsh winds that wreak havoc on your skin and hair.

Spring break! Have you taken a break yet? Whether at home or away a break from routine and daily stresses can reduce risks for diseases such as breast cancer and cardiovascular disease, as well as help manage stress long-term.

* Referenced 6 Healthy Reasons to Love Spring article by Annie Hauser

Celebrate St. Patrick’s Day with this healthy green Monster Veggie Burger

Veggie burgers often get a bad rap, but this wholesome recipe will change your mind. Made with chick peas, veggies, and just the right amount of seasoning, these patties are loaded with both flavor and good-for-you perks.

1 15-oz. can Progresso chick peas (garbanzo beans), drained, rinsed
1 egg
1 clove garlic, finely chopped
1 tsp. smoked paprika
1/2 tsp. ground coriander
1/2 tsp. ground cumin
1/2 tsp. coarse (kosher or sea) salt
1 c. chopped fresh spinach
1/2 c. shredded carrot
2 tbsp. chopped fresh cilantro
3/4 c. Progresso panko bread crumbs
2 tbsp. canola oil
Toppings, as desired (avocado halves, cilantro leaves, cucumber slices, tomato slices, sweet pepper strips, lettuce leaves)
Sauces, as desired (spicy mustard, Sriracha, ketchup, citrus vinaigrette)

In food processor bowl, place chick peas, egg, garlic, smoked paprika, coriander, cumin, and salt. Cover; process with on-and-off pulses about 45 seconds or until nearly smooth. Stir together bean mixture, spinach, carrot, and cilantro until well combined. Stir in bread crumbs. Shape mixture into 4 patties, about 3 1/2 in. in diameter and 1/2 in. thick. In 10-in. nonstick skillet, heat 2 tbsp. canola oil over medium heat until hot. Cook patties in oil 8 to 10 minutes, turning once, until brown and crisp. Serve veggie burgers stacked with toppings and drizzled with sauce. Makes 4 servings. Recipe provided by Betty Crocker

Post-holiday concerns about an aging loved one? Senior Care Reality Checklist can help.

Holidays bring families together to celebrate the season and enjoy sharing time together.  They also offer opportunities for us to spend lengthier periods of time with aging parents and loved ones — sometimes long enough to observe changes in habits or lifestyle that give rise to concerns about their health or well-being, especially when they live on their own. The changes can seem slight or innocuous:  a forgotten face, a mismatched outfit, a wrong turn on the way to the grocery store.  Or, they can be more alarming: 

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3 "Bright" Safety Tips for the Holidays

'Tis the season to be jolly - and it's also the season of lights and electricity.  Tree lights, exterior house and yard lights, and candle lights.  It's a very busy time of year when people get caught up in the excitement and can use a few helpful safety reminders:

  1. Be sure that all electrical decorations are in good working order:  no frayed wires or sparking plugs, or plugs that feel warm to the touch.  This is important both inside and outside the house.  If you're using older lights that have been in the family for years, be especially careful and consider replacing them with new lights that may also be more cost-effective and use less electricity.
  2. It may be tempting to add just one more string of lights before the big party, but first check to ensure that your electrical outlets are not maxed out or overloaded.  This is important both before the holiday and once the gifts have been opened.  Lots of electronic toys and gadgets will be plugged in and played with by children and grown-ups alike, so make sure that outlets are used sensibly and that younger children have assistance from adults.  When the use of extension cords becomes  tempting, be aware that they can also pose an overload hazard or cause dangerous trips and falls if not located safely.
  3. Candles are also a holiday favorite when it comes to decorating, especially as centerpieces or accents on a mantel or end table.  While they look lovely, they can also be a fire hazard, especially in combination with rambunctious children and pets.  Even if you're a holiday purist who prefers the warm glow of "real" candles, consider using the new cordless battery-powered candles instead.  They are realistic and some even provide that "natural" candle scent that we recall so fondly.

Article by Kim Washetas, contributing writer and enthusiastic whole health advocate.

How to Manage Prescription Programs Skillfully


Prescription programs are necessary for anyone who's taking medication. While medicated products and treatments are certainly one of the best ways to stay healthy, improper use can certainly produce the opposite results. If you care about your loved one then you should take every precaution necessary and that includes managing his medication schedule with the appropriate discretion. Consult the patient's doctor. If you have been tasked or you've taken it upon yourself to manage your loved one's medication then the first thing you should do is to consult the patient's physician. If he has more than one physician then you must speak with the physician who has prescribed the medications he is currently taking.

What your loved one has informed you regarding his medication may be detailed, but you can never be too sure, can you? This is your loved one's health at stake, after all. It's best to go directly to the source and consult the doctor about the medications he's prescribed.

Find out what he's taking and why. The first thing you should clarify is the generic and brand names of the medications he's taking. You've no doubt seen a prescription filled out by the doctor. Physicians are certainly one of the smartest people in the world, but their handwriting - if you can call it that - leaves a lot to be desired, doesn't it? And it's because of their chicken scrawl that some people end up buying the wrong brand. That's a mistake - in the worst case scenario - which could cost you your loved one's life.

It's critical that you understand why they've been prescribed as well. That way, you'll know what would happen if you do miss a dosage or what you should do if you're unable to access such medication for any reason.

Also, double-check the required dosages. People can easily overdose on prescribed drugs because they think that the more they drink, the quicker they'll be on their way to recovery. Sadly, it could be the reverse as well.

Be meticulous in your records. On the first page of your notebook, indicate the disease or condition of your loved one, the medications and dosages he's required to take as well as contact details of his physician and any other person that may be contacted in case of emergency.

On the succeeding pages, write down the date and time and place as well as the dosage of the medication you've administered. It may seem overly detailed, but that's better than lacking sufficient data when things suddenly go downhill. If there is more than one person who's assigned to keep track of your loved one's prescription programs, be sure that he is sufficiently trained for proper record keeping.

Keep track of appointments with doctors and other necessary schedules. Doctor's appointments, check-ups, lab tests, and schedules for any other procedure that would improve your loved one's condition should also be kept track of and is an integral part to his medical program. If you feel that you need to make an additional appointment with the doctor, go ahead and do so. It's better to be safe than sorry!

Edward Koop has written extensively on proper management of prescription programs as well as other essential subjects in quality healthcare.

Identifying Dementia Symptoms in an Aging Parent


Dealing with dementia symptoms in your own parent can stretch the limits of your sanity. Sometimes you may not even notice the first symptoms of dementia -- the slow decline of your aging parent's memory. The symptoms of dementia may continue until your aging parent starts exhibiting signs of other mental disorders, such as paranoia or delusions, which frequently piggyback on the effects of senile dementia. These symptoms may keep reappearing, until you can't ignore them and you're forced to take action like I was. Hopefully, this article will help you identify dementia and other mental problems in your aging parents and help you deal with the problem by getting their condition assessed by a professional. My own mom taught school most of her life. She was highly organized and extremely independent. She read constantly and became quite adept at oil painting. At the age of 76 she moved closer to my sister and I, but her canvases and brushes never seemed to make it out of the moving boxes. I bought her a VCR for Christmas, hoping that renting movies could help her shake her newly-found disinterest in life. But the new VCR was never turned on unless I happened to visit with a movie in hand. It became, like the microwave I had gotten her a year earlier, another piece of unused technology. It never dawned on me at the time that my mom had stopped wanting to learn new things, or that this could mean that her aging mind was showing early symptoms of dementia.

Believing that Mom's depression was a result of her unhappiness with her living situation, my sister and I began a search to find her senior housing. We placed our hopes on a retirement community that offered a full-time social director to rescue her from the depressed mood we were fighting. The retirement home helped her find new friends and subdued the paranoia, but only temporarily. Soon she insisted we change her banking accounts. She accused the banks of stealing money from her safety deposit box. She also became absurdly paranoid about my brother-in-law, who she suspected, had a master key to her apartment. All missing items were blamed on this poor fellow. We never suspected that paranoia could be a symptom of dementia.

The amazing part of all this is that my sister and I continued right on with our lives, denying Mom's odd behavior while helping her change bank accounts and get new locks for her apartment. We just figured it was normal for our aging parent to become strange when she turned 80 years old. We never suspected dementia was taking her away from us.

Symptoms of dementia are insidious, because they start so slowly. Often they are mixed with periods of what appears to be normal behavior. So just when we thought she was showing symptoms of dementia, she'd return with what appeared to be complete clarity, asking us about our spouses and giving the usual motherly advice we had grown up with and trusted. Looking back, I can clearly see the progression of the disorder. But at the time, senile dementia sneaked in and stole Mom from us without a clue. Because of our busy schedules, hectic lives, and maybe a little denial, we didn't see it until it was too late.

There was also a strong fear going on. I remember thinking that if my mother was showing symptoms of dementia, I must be showing symptoms of dementia too. She was so close to me that I had a lot of her same thinking patterns. She dictated reality to me when I was growing up. I worried about this a lot. I really wanted her to be "normal" so I could feel normal. I didn't want anyone to find out my mom was acting crazy. I could just imagine everyone at work hearing the news and moving their fingers in circles around their ear saying "Ah ha! That explains it!"

So we took Mom to doctor after doctor trying to find a cure for her symptoms. Was it low iron, low zinc, or low potassium? They drew countless pints of blood trying to rule out what could be causing her behavior. But eventually, most of the doctors proved worthless in offering real help. Not one seemed to be able to tell us what was wrong. None of her five doctors could give us any advice that would help her. They all seemed to deny there was any problem. Fortunately, we met a geriatric counselor who advised us to take her to a local hospital for a geriatric evaluation. I wish we had done this evaluation five years earlier.

If your parent is acting strange and you're not getting results or a concrete diagnoses from your doctor, consider a geriatric counselor. You can find them in the yellow pages or on the Web. The small amount of money you'll pay for their services will help you retain your sanity through the decisions you'll soon be facing. A geriatric counselor will also relieve you of a fair amount of guilt as you carry out the future decisions that become necessary when an aging parent develops dementia.

William J. Grote is the author of the book "Helping Your Aging Parent -- A Step-by-Step Guide". William cared for his aging mother and made plenty of discoveries along the way. Hopefully his book can help you down the road of care giving -- which for many of us who survived the 60's and 70's, may be a completely new experience.

You can download a free checklist "Warning Signs of Dementia and Mental Illness" to help you identify unusual behavior in aging parents at

Home Care for the Elderly or Ailing - 7 Tips for Choosing a Qualified Provider


As the nation's population ages, more Americans are being confronted with the need to seek assistance with in-home care of elderly or sick parents, or extended family. Couple that fact with the ever increasing trend toward same-day, out-patient surgical procedures, and assessing the qualifications of private duty home care for recovering patients of any age takes on an even greater urgency.  It's a difficult task for a lot of people. Because it is not pleasant to think about parents or family members becoming ill or needing medical help, many persons avoid planning in advance for those possibilities. When they suddenly have a need for home care, they don't know where to start in choosing a private duty provider. 

Given the rise in reports of elder abuse and the potential for unknowingly retaining illegal or unqualified workers, there is valid cause for concern. However, there are several key inquiries that can be made to help in selecting a qualified provider.  Be sure to ask the same questions of each prospective service. You can then compare responses "apples-to-apples", and that should help in making the right choice. The seven questions below address some of the most important areas of consideration:

  1. Experience of principals - Who owns the staffing service and what background does the owner or owners have in the healthcare or medical staffing field?
  2. Length of time in business - When was the service established?
  3. Licensing and professional associations or organizations - Is the service licensed in your state, and is it affiliated with any recognized healthcare, private duty or home care staffing organizations?
  4. Screening of employees - How are the service's employees screened for appropriate medical skills and certifications, and what type of background checks are conducted?
  5. Tenure of employees - On average, how long have its private duty workers been employed with the staffing service? Testimonials of private duty clients - Can the service provide testimonials or references attesting to the quality and level of service they have provided to other clients?
  6. Client intake process - How are the needs of the patient assessed and what type of care plan is prepared to record shift activities and make sure there is clear communication with patient and family throughout the term of care?

 These are important questions that any reputable service should be happy to answer - and during stressful times, it's important that you feel as comfortable as possible with the persons who are providing in-home care.

Copyright © Christine Hammerlund – 2008.  Christine Hammerlund is a registered nurse and the owner of Assured Healthcare, a healthcare staffing service headquartered in Gurnee, Illinois.