Your Eldercare Compass
Helpful tips for family caregivers

Private pay services for care at home

Typically, it’s family members who fill in to perform the necessary tasks. But for many, perhaps including you, there are obstacles to helping on a regular basis. (Quitting your job to provide care is risky. Leaving work midcareer jeopardizes your retirement options and savings.)

Of course, you can hire people to support a loved one who isn’t able to live completely independently. For instance, if memory problems make handling money a challenge, you can hire a daily money manager. They are bonded professionals who can pay the bills, balance the checkbook, etc.

And you can have many things delivered (groceries and pharmacy goods, for instance). Since the pandemic, many stores are now offering this option for an extra fee. Or look for services in the “gig economy.” Maybe introduce ride-sharing for transportation, or errand runners. It’s not inexpensive. But if it enables you to keep working, it may be a very wise use of funds.

The biggest challenge, however, is home care. There may come a time when your relative needs assistance at home. At first it might be a few hours a day. Eventually it could be 24/7. Even when related to a health problem, this is not paid for by Medicare. It must be paid for privately, unless your loved one has coverage from Veterans Affairs (VA) or a long-term care insurance policy. Home care service providers do tasks and provide companionship. They are prepared to handle everything from transportation, cooking, and cleaning, to helping with bathing, dressing, and toileting.

A licensed and bonded home care agency can help you find professional caregivers who are a good match for your loved one. Agencies do background checks and training and furnish important insurance coverage. They will also send a replacement if your usual caregiver is sick.

Or you can hire helpers yourself. But then you also take on significant legal and financial responsibilities. (For instance, what if they get injured on the job?) You must also evaluate that the person is qualified and that your loved one will be safe. The IRS does require you to hire them as employees. Also, to withhold and file taxes, pay Social Security, etc. Even if the individual says they are an independent contractor, the IRS says they aren’t. (Hire a payroll service to handle the detailed bookkeeping.)

Hearing the TV better

Is your loved one having trouble hearing the television? Closed captioning isn’t helping enough? Check out these possible solutions.

Better sound from the TV. Check the TV for special audio settings that enhance dialogue and reduce background noise. Or purchase a “soundbar” to plug in to the TV. These improve audio volume and crispness.

Place an amplifier beside your relative. This simple box-like device takes in nearby sound and sends it through a cord to headphones your loved one wears.

Wireless headphones. Wireless headphones typically have two parts: A small broadcasting unit plugged into the TV, and the headphones themselves. Most headphones have deep ear cups that also block out room noise. Consider these issues when shopping:

• Frequency adjustments. If testing reveals that your relative hears best at higher (or lower) frequencies, look for a model that allows for specific adjustments.
• Type of connection. This is how the broadcast connects with the headphones. An optical connection requires staying within the line of sight of the broadcast box. No walking to the kitchen to get a snack. Bluetooth and RF technology eliminate this problem. Your loved one can roam and still hear the show.
• Latency issues. Is there a lag between the lips moving and when the audio gets to the headphones? Bluetooth technology used to have this problem. Newer models appear to have resolved it.
• Charging the battery. Headphones require electricity. Find out how long the unit’s battery lasts. Or consider headphones that are set on a dock when not in use, as these recharge automatically.

Connecting to existing hearing aids. If your relative has hearing aids that are Bluetooth-enabled, you can direct a TV’s Bluetooth signal to the hearing aids. Some TVs have a Bluetooth signal built in. For others you may need to add an accessory.

Writing the last chapter

If your loved one has health challenges, they may be feeling a loss of control. Add to that a terminal diagnosis and a sense of doom may prevail.

But recognizing that life is coming to a close does not have to mean one waits glumly for the end. There are many ways hospice patients have chosen to take action and purposefully write their own “last chapter.” Perhaps one of these might appeal to your loved one:

• Write or record a life review. Somewhere between a memoir and “lessons learned,” in a life review your relative can share pivotal moments and why they were important. Take dictation for typing later. Or go to StoryCorps.org for an app that helps families video-interview relatives.
• Finish a cherished project. Perhaps it’s a quilt that is not completed. Maybe it’s a piece of furniture still unfinished in the shop. Or perhaps your loved one would enjoy a show-like exhibition of their artwork. Is there a way to publicly acknowledge their creativity?
• Reconnect with estranged relatives or friends. Asking and bestowing forgiveness is a deeply meaningful activity. Old grudges usually melt away in the context of limited time.
• Write cards to family members. One way to be present even after death is to write cards or letters to be given at particular life passages.
• Have a celebration of life. Perhaps your relative is of the temperament to invite friends to gather and share stories before their passing rather than after.
• Leave a legacy to help others. This doesn’t have to be anything grand like a scholarship. It can be as simple as books for a library or sports gear to a young team. Perhaps donate organs for transplant.
• Actively enjoy the simple pleasures. If ever there was a time to slow down and smell the roses, this is it. Many find deep contentment in the gift of each day.