3 Steps to Avoiding Caregiver Burnout during the Holidays

Being a caregiver for a loved one is often a selfless, thankless job. It can require extreme amounts of patience, determination and grace that many people do not have all of the time. During the holiday season, this difficult job can become even more arduous than usual.

An increase in unhealthy behavior like indulging in alcohol and a poor diet, or not getting enough sleep or exercise, can lower our defenses and magnify all of our experiences. Both the good ones and the bad ones can seem too big for us to control.


To avoid letting the holidays make the caregiving experience so hard that it burns you out, here are the steps that may help you get through this wonderful, yet emotionally and physically draining, period.

1) Know the signs of burnout
Caregivers may experience burnout at any time of the year, but the holidays can be particularly draining. If the caregiver is starting to feel apathetic, fatigued, has foggy thinking, or is dealing with emotional highs and lows, that person may be experiencing burnout. It is important to know the signs of being burned out so you can head it off at the pass before it takes over your psyche.

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What to Do if You Suspect Elder Abuse

We love to read heartwarming stories about devoted caregivers and thriving seniors. When we look at seniors who are well cared for, we think, “Of course – that’s the way it should be.”

Unfortunately, the good stories don’t tell the whole tale of senior care in the United States. According to the National Center on Elder Abuse (NCEA), 1 out of 10 seniors is a victim of abuse. What’s more, elder abuse is typically underreported. The National Elder Abuse Incidence Study estimates that only 1 in 14 cases of elder abuse ever comes to the attention of authorities.
Here, NCEA Deputy Director Julie Schoen offers tips on how to intervene in cases of suspected elder abuse.

What Is Elder Abuse?

“Elder abuse takes many forms,” says Schoen. The major categories of mistreatment include physical abuse, emotional abuse, sexual abuse, exploitation, neglect, and abandonment. Elder abuse can happen at the hands of a trusted friend or family member (domestic abuse), or it can be perpetrated by caregivers at a senior care facility (institutional abuse).

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8 Common HIPAA Violations You Must Avoid

Anybody who has worked in the medical field has encountered tricky situations when complying with the Health Insurance Portability and Accountability Act guidelines. HIPAA policies are vast in complexity, and they keep changing thanks to the updated Omnibus Rule, which was issued in 2013.

The maximum HIPAA fines have also increased to $50,000 per violation, capping at $1.5 million. This means abiding by the updated policies is more crucial than ever. To protect patients and hospitals alike, nurses, doctors and other medical staff need to ensure that security measures and employees are up-to-date on HIPAA’s changes. And one way to do that is by being aware of the most common HIPAA violations.

Common HIPAA Violations

Employee Dishonesty

It’s natural for us to innately trust our coworkers; after all, fellow nurses and doctors want what’s best for patients too, right? Sadly that isn’t always the case.

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Appetite Stimulants for the Elderly

Older adults sometimes experience a loss of appetite that may adversely affect their health. Even foods they once loved no longer seem appealing. Caregivers of seniors with this problem will certainly want to explore ways to stimulate their loved ones’ appetites and get them eating again.

Causes of Loss of Appetite

There are several causes for loss of appetite in the elderly. One may be a poorer sense of taste due to a diminishing number of taste buds as we age. Our sense of smell also diminishes, and with it, potentially, our enjoyment of food.
Disinterest in food also can be caused by physical or cognitive maladies. Those with multiple medical conditions may be particularly vulnerable to poor appetite. If they are taking medications, they may experience loss of appetite as a side effect.

Weight Loss in Elderly

Loss of appetite can lead to substantial weight loss, which is a major health concern.
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The 7 Deadly Emotions of Caregiving

Nobody would ever choose a smiley face as the perfect symbolic emoticon for a caregiver. Caregiving for an ailing loved one is just too stressful -- often triggering damaging emotions that can not only undermine your good work but harm your health, as well. Here's how to cope:

Caregiver emotion trap #1: Guilt

Guilt is virtually unavoidable as you try to "do it all."

What causes guilt: Guilt stems from doing or saying what you believe is the wrong thing, not doing what you perceive to be enough, or otherwise not behaving in the "right" way, whether or not your perceptions are accurate. Caregivers often burden themselves with a long list of self-imposed "oughts," "shoulds," and "musts." A few examples: I must avoid putting Mom in a nursing home. I ought to visit every day. I shouldn't lose my temper with someone who has dementia.

Risks of guilt: Caregiver guilt is an especially corrosive emotion because you're beating yourself up over faults that are imagined, unavoidable -- or simply human. That's counterproductive at a time when you need to be your own best advocate.

What you can do: Lower your standards from ideal to real; aim for a B+ in the many aspects of your life rather than an across-the-board A+.

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Bullying: A problem in Healthcare?

Like schoolyard bullying, workplace bullying involves a real or perceived imbalance of power and repetition of negative behavior. The behavior can be overt, such as yelling or threatening, or it can be more insidious and passive, like refusing to cooperate or perform necessary tasks. The American Nurses Association (ANA) reports that between 18 and 31% of nurses have experienced bullying behavior at work (ANA, 2012).

Whatever forms it takes, bullying is a serious, complex and ongoing problem in the health care workplace, which can lead to demoralization and decreased job satisfaction, as well as feelings of isolation, anxiety, sadness and depression.

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Is The U.S. Worried about Senior Population Growth?

There’s been much speculation about how the growing senior population numbers will affect us. Will there be enough economic resources to sustain this huge shift? Will there be sufficient services, like adequate healthcare, to accommodate a graying demographic with their special needs?


A recent Pew Research study examined the attitudes about the growth in aging populations in countries around the globe. Not surprisingly, the research showed the greatest concerns in countries that will have the largest percentage of older adults by 2050.


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When You Need More Help: Alzheimer's Care Options

When you care for someone with Alzheimer’s or dementia at home — either theirs or yours — a time when you need more help will almost surely come. Though you may not know when, be prepared by knowing your options in advance.

• First, reach out to family members and friends for support. Asking for help from people you know can be more difficult than hiring professionals who are total strangers, but when you can’t be there, there is nothing like knowing your loved one is being cared for by someone you know and trust. Read How to… Delegate Elder Care Tasks for advice on asking for help.
• Research and access respite care, which essentially provides a break for the caregiver on a short-term basis. Respite care is now more readily available in senior living communities via short-term stays. 

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A Cure for Dementia?

Advances in genetics and pharmaceuticals could lead to a cure for dementia by 2020, according to United Kingdom Secretary of Health Jeremy Hunt.

“Finding drugs that can halt or cure dementia may seem a distant prospect now but there are drugs companies that think they will have a cure for dementia by 2020,” Hunt said at the recent Local Government Association conference in Manchester, according to The Telegraph.

The United Kingdom's Alzheimer's Society expanded on Hunt's remarks commenting: “Studies we're funding show that drugs which are already licensed for other conditions may also treat dementia. If these are successful, we could have them doubling as treatments for dementia within 10 years.”
More than 5 million Americans have Alzheimer's disease, and the Alzheimer's Association foresees the number increasing to about 13.8 million by 2050.

As more of the population develops dementia and a cure remains elusive, providing effective care for residents with dementia becomes even more important. The Centers for Medicare & Medicaid Services held a webinar Wednesday to discuss the reduction of antipsychotics among residents with Alzheimer's or other forms of dementia. Facilities have achieved a 4% reduction in off-label use of antipsychotics among residents with dementia, but CMS is still aiming for a 15% average reduction.

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Spotting Eating Disorders in the ED

Eating Disorders can take months, even years, to treat effectively. But ED nurses who can identify patients with such a disorder can help get them on the right track to healing. A big challenge, however, is that patients with eating disorders often go to great lengths to conceal the problem.

Recognizing eating disorders in the ED, helping patients understand they are ill and steering them to ongoing mental and physical care requires preparation far in advance of the patient encounter, experts say. “For most eating disorders, recovery is a very long-term process,” said Bobbi O'Brien, RN, PhD, clinical psychologist at Eating Disorders Associates in Torrance, Calif. “You can get through the acute part, the medical part, pretty quick. But the rest — psychiatric issues, body image, self-esteem, co-occurring depression or anxiety disorders, family dynamics — that can take 10 years or more.”

Psychiatry’s diagnostic manual, the DSM-IV-TR, recognizes three main categories of eating disorders: anorexia nervosa, bulimia nervosa and eating disorders-not otherwise specified. Patients with anorexia have an obsessive fear of gaining weight, and so dangerously limit food intake. They might alternately “purge” nutrients by using laxatives or diuretics, or by inducing vomiting. Patients with bulimia, meanwhile, will eat in binges, followed by behaviors such as purging or fasting to compensate for the overeating.

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Aging Brain Makes it Difficult to Spot Scams

Do you remember a time when you had a gut feeling that someone was a bit shady? Two new studies suggest that as we age, our internal warning system seems to diminish, which could explain why older people are more often the victims of scams.

According to researchers at the University of California, Los Angeles, age-related brain changes may make us less able to recognize shifty, suspicious-looking facial expressions. The two studies, published last month in the Proceedings of the National Academy of Sciences, are the first to find that the aging brain sends out fewer warning signs about untrustworthy people than the brains of younger adults.

"There are cues [in facial expressions] associated with actual deceitful behavior," says study author Shelly Taylor, a professor of health psychology at UCLA. The studies she and her colleagues conducted found "quite a significant difference" in the abilities of older and younger adults to recognize devious expressions like an insincere smile or not making eye contact.

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Tips and Time Savers For CNA's

So, you’re brand new and a little nervous? Thats ok and natural. Being a CNA is a rewarding career, but there are LOTS to learn and lots of cover in those first few days at work! Don’t be surprised if you feel a bit overwhelmed and anxious. Someday–soon- you will be an “old pro” at this stuff. The first part of this is for the new CNA…

The Basics
I remember my first few weeks as a CNA- it was hard to get to know all the residents as well as staff as well as the facility policies and procedures. I was very overwhelmed and looking back now- there were certain things I should have done that would have made my life much easier then! Live and learn….

First, it is a good idea to bring a little notebook to work with you. In here you can write down info you need about everything from phone numbers to resident issues. Jotting down info is a way to remember it! At periodic times during the day check the little book to see if there are things you still need info about. When you think of questions and no one is around to answer them- write them down. Later you can refer back to the book.

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5 Simple Steps To Help A Lonely Resident

As we move into the holiday season, and the days grow shorter and grayer, many residents may find themselves feeling a bit down an lonely. Here are five simple things you can do to brighten a resident's day and keep the loneliness at bay.

1. Take the resident on an outing.
Something as simple as a trip to a coffee shop, going to see a matinee movie, or taking a short drive in the country can do so much to lift a person's mood. Ask questions and encourage your guest to share stories from his or her life. Be a good listener and you can really make someone's day. If a resident is not able to leave the facility, bring the outing to him or her. Get a take-out treat from a favorite local restaurant, or have a meal wrapped take-out style from your facility's cafeteria. Pick up a red and white checked tablecloth at the discount store to add a festive, picnic element. Brightly colored plates, cups, or utensils add a nice touch, too.

2. Be a friend.
As caregivers, we do the best we can for each of our residents, but some days a resident needs you to go above and beyond. There are those awful days when pain is worse than usual, or they're just feeling blue. Maybe personal issues are getting them down. See if you can free up a few moments in your schedule and sit down and visit with the resident. Let them know that, sure, you have other things you could be doing, but you choose to spend time with them. It could be as simple as chatting about the weather, or as involved as being a sounding board for whatever is worrying or bothering the resident. Think about a time when you were lonely, and how nice it would have been if someone had come along and said "I'm here for you." Schedule a regular visiting time, or give the resident a specific time when you'll be back to visit again. The lonely times go a lot faster if you've got something to look forward to.

3. Help your resident connect with others.
Arthritis and failing eyesight can make it hard for seniors to do things we take for granted, like writing a letter or making a phone call. Help a resident write a letter or email. Is your resident having trouble with a phone or cell phone? Offer to help w/ dialing, or write or type up a list of important phone numbers in large numbers.

4. Small gifts
Bring the resident a small gift like fresh flowers or a small potted plant. A little gesture can both brighten up their room and make their day. But--and this is important--Don't just gift and run. Take a few minutes to visit with the resident. Let them know you were thinking of them and that you genuinely care about them. Then, when they look up and see your gift, they'll remember your visit with a smile, and look forward to the next time you're able to stop by.

5. Make contact
This suggestion takes a little more care and effort than the previous ones. If you can do so without violating HIPPA or your resident's privacy, reach out to others on behalf of the resident, and see if you can arrange for friends or family to visit. Some residents are too proud to ask for help, or too upset or distracted to take the initiative on their own. Ask your facility's SSD to contact the resident's family or friends. Arrange a surprise visit. No family? Drum up a volunteer, pet visit, or something w/ local scouting troop or school. Sometimes it's not so important who is visiting, but that the resident has visitors, period.

Finally, If you have several residents who are dealing with loneliness, try arranging a group activity. A movie night (or ongoing movie club) is a great way to bring people together and get them talking. Invite family members and volunteers, if possible, too. Get the group together and watch a classic movie with an upbeat theme like Singin' in the Rain. Musicals are great because of the lively music and lavish dance scenes! Provide snacks, dim the lights, and let everyone enjoy a movie together. Afterward, lead a discussion about the movie. Encourage everyone to talk about their favorite songs or scenes, or reminisce about other favorite movies and actors from that time period. If the movie had dancing, bring in a volunteer to teach everyone a simple dance based on a song from the movie. Or lead a sing-a-long or karaoke with songs from famous movie musicals.

Sometimes the smallest gestures can have the biggest impact. If you see someone looking down, or who hasn't had visitors in a while, a little attention from you can make a huge difference.

How To Keep Your Cool When Dealing With a Difficult Resident

You don't have to work in long term care for long before you encounter a difficult person. Sometimes it's a resident, other times a coworker, or even someone outside the facility like a resident's family member or doctor. Beyond the golden rule, what can you, as a health worker, do to improve these encounters? To simplify things, I'm going to address issues with residents here. A lot of these tips are universal and can help with any difficult person, but some are very specific to long term care residents.

First off, no matter how difficult it is, keep your temper in check. It's easy to get your hackles up when people are being belligerent - moreso when you know you're right and they're wrong - but nothing will
ruin the encounter faster than a lost temper. If you need to leave the room or turn away to regain your composure, do so. Taking a deep breath and letting it out slowly, or counting to ten in your head,
really does help.

Composed and ready to face the situation now? Great. It's important to remember that many residents are adjusting to many changes in their lives. It is very rarely about you, and almost always about something
else that's bothering the resident, so don't take outbursts personally. The loss of health and independence can be very hard to face. Fear, anger, sadness, and pain can pervade almost every aspect of a person's life when they first transition to assisted care. Keep in mind that any of these things might be behind a resident's rudeness or inappropriate behavior. Instead of scolding the resident, or getting your feathers ruffled, use your empathy skills to gently encourage a resident to share what is bothering him or her. A leading question like, "I hear a lot of tension in your voice. Is your pain worse today?"  can give the resident the chance to tell his or her side of the story. Let your residents know that you're on their side
and will do everything in your power to help address their issues.

Now, with a belligerent resident, this might be an invitation to carry on about problems and pains, whether real or imagined. Do your best to get to the heart of their issues and offer solutions. Is Mr. Smith's wheelchair pad worn and causing discomfort? Is Ms. Jones' robe aggravating her skin condition? It's often the simple fix that can diffuse the litany of complaints. If fear is the root of the problem,
demonstrating empathy and sharing your knowledge might be all it takes to set a resident's mind at ease. Perhaps a resident is balking at taking medication because he or she doesn't fully understand why it is
necessary. Telling the resident to "take it because the doctor said so" won't help the situation. Use your knowledge to explain, as best you can, what a medication does or doesn't do, and set the resident's mind at ease. A resident might also lash out due to loneliness. Do whatever you can to be a friend to your residents. Sometimes all they need is someone to listen. Talk to your facility's Activity Director or Social Services representative and arrange for the resident to attend a group activity or have a volunteer stop by and visit with the resident.

Another issue that faces residents as they transition to a nursing facility is the feeling of a loss of  responsibility. Many resent going from being parents and caretakers to being dependent on others. Refusing to take medicine, or not wanting to attend meals in the dining room can point to a deeper issue. Residents are going from being in control of their own schedules to being forced into a facility's schedule, and that can be tough. You can help by offering residents choices and allowing them to exercise independence and judgment on their own. Instead of offering water with pills, let the resident chose between water, milk and juice (according to the diet plan). Ask residents what time they like to eat meals, and if the time is different from your facility's dining hours, see if it would be possible to arrange for an
in-room meal at a time more fitting for the resident.

In all encounters, focus on the positive. If you need to get through an awkward or unpleasant activity (like a sponge bath) chat about a TV show coming on later that day, or about the facility-wide Bingo game
that evening. If a resident is fighting you as you try to change a wound dressing, remind them that the sooner you finish, the sooner the resident can go back to doing something he or she enjoys. Let them see that by sitting quietly and letting you do your work, they can move on to more pleasant things more quickly.

Finally, be on the lookout for residents who suffer in silence. Most people are taught to keep a stiff upper lip, or to remain stoic in the face of troubles, so it can be very hard for your residents to admit they are hurting and need help. Use your skill at reading body language to help see beyond the surface behavior to what might be going on under the surface. Stiff posture or fidgeting might indicate a person is in pain. Staring into space or frequent sighing can clue you in that your resident's mind is on something other than the here and now. It might be too embarrassing for residents to discuss medical problems with you at first, but if you demonstrate an air of trust and make your residents feel safe, you can help them to express what's really behind "bad" behavior.

Want to read more on this topic? Check out these articles.
http://nursinglink.monster.com/careers/articles/5771-difficult-patients-why-theyre-that-way-and-how-to-handle-them

http://ezinearticles.com/?Elder-Care-Solutions---Dealing-With-Difficult-Aging-Parents&id=3901872

Elder Abuse and Neglect

Every year, tens of thousands of elderly Americans are abused in their own homes, in relatives’ homes, and even in  facilities responsible for their care. You may suspect that an elderly person you know is being harmed physically or emotionally by a neglectful or overwhelmed caregiver or being preyed upon financially. By learning the signs and symptoms of elder abuse and how to act on behalf of an elderly person who is being abused, you’ll not only be helping someone else but strengthening your own defenses against elder abuse in the future.

It’s difficult to take care of a senior when he or she has many different needs, and it’s difficult to be elderly when age brings with it infirmities and dependence. Both the demands of caregiving and the needs of the elder can create situations in which abuse is more likely to occur.

Many nonprofessional caregivers, spouses, adult children, other relatives and friends find taking care of an elder to be satisfying and enriching. But the responsibilities and demands of elder care giving, which escalate as the elder's condition deteriorates, can also be extremely stressful. The stress of elder care can lead to mental and physical health problems that make caregivers burned out, impatient, and unable to keep from lashing out against elders in their care.

Among caregivers, significant risk factors for elder abuse are

• Inability to cope with stress (lack of resilience)
• Depression, which is common among caregivers
• Lack of support from other potential caregivers
• The caregiver's perception that taking care of the elder is burdensome and without psychological reward

Substance abuse

Even caregivers in institutional settings can experience stress at levels that lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited to care giving, or work under poor conditions.

The elder's condition and history

Several factors concerning elders themselves, while they don't excuse abuse, influence whether they are at greater risk for abuse:

• The intensity of an elderly person's illness or dementia
• Social isolation; i.e., the elder and caregiver are alone together almost all the time
• The elder's role, at an earlier time, as an abusive parent or spouse
• A history of domestic violence in the home

The elder's own tendency toward verbal or physical aggression

In many cases, elder abuse, though real, is unintentional. Caregivers pushed beyond their capabilities or psychological resources may not mean to yell at, strike, or ignore the needs of the elders in their care. (The preceding is an excerpt from helpguide.org.  Click HERE for the full article.)

Below is  presentation with more information on Elder Abuse.