Any advice for a new full-time caregiver moving into position this week?

Take care, Catherine. You've had a lot of change and are very understanding. You'll be there for your friend.
Carol

Hi Everyone, I wanted to drop in and let you know that Vivians husband Bob passed away Friday night about 9pm. Vivian and thier son Jeff were by his side. He went very quickly. He had only been home for 4 days from the nursing care facility. He went so fast. I sort of figured he would... somehow I knew deep down that he wouldn't last a week once he got home. He just came home to die.

The family has asked me to stay with Vivian until later this summer (at least) when they want to try to get Viv moved closer to Jeff, about 3 hours from here. They want to give her time grieve in the home she shared with Bob for 20 years, and to adjust to the changes in her life. Then, sometime this summer, they'll be putting the house up for sale. I won't be recieving an income every two weeks as planned, due to Bobs passing so quickly, however, they will pay me for the first 2 weeks, and the family does want to honor Vivians promise to me that I will have a home for 6 months at least, and if the house sells before that they said "you will have some kind of nest egg to go on".
I ask that you don't advise me beyond what I am telling you here, because things change so fast that I have choosen to just stay with Viv and be grateful that I don't have to pay rent or utilities or food, and that her family wants to "gift" me some extra support when the time comes. I am keeping my current house cleaning jobs, and thinking of getting certified as a nursing assistant. I'll be saving my money, working on my art (I do graphics and have an online site at zazzle.com/ranchlady) and I am hoping that will take off for me too. I also paint and am an aspiring writer. We'll see what happens.
For now, Vivian seems to be keeping herself busy with memorial plans, and Easter. I have not seen her cry since Bob passed Friday evening and I am a little concerned about that, but I think once the memorial is over and life slows back to a normal pace she will need a shoulder to cry on, so I will be here.

Thanks for being here for me. :)

~ Blessings,
Catherine

Catherine, you say hospice is involved, so you have a great resource there. If you are concerned about Viv's stress level, mention it to the hospice nurse. They have seen so many different families go through a crisis of illness, they are pretty well experienced in how people can react to it. They probably can come up with some interventions to help ease her stress level. I'm sure they talk to the son,too, so they can work with everyone. Good luck. Lauren

Thank you to everyone who is responding. :) Hospice care is involved, and the local organization that handles all that happens to be managed by the former rector of Vivian and Bob's Church, so they love and trust him. And yes, the adjustable bed and comode and a wheel chair are all here, though Vivian has not yet tried to get Bob into the chair or on the potty. Here's the update:

Bob had been recovering fairly well from his hip replacement surgery, and aside from the fact that he continued to loose wieght, declined in his eating habits, has second stage alzhiemers, and a tumor that they are pretty sure is Lung Cancer, he had been doing his excersizes while at the nursing center, and was getting around on a walker.
Then, On Monday, the day Bob was due home from the Nursing center, he got out of bed at 4 am, and fell, cutting the back of his head. He was rushed to emergency where they ran a cat scan and stiched him up. He'd had another stroke (he had a severe one 4 years ago, and small ones periodically since then, and it was a stroke that attributed to the fall in the bathroom 7 weeks ago that required the hip replacement, and the chest exray that had revealed the tumor). After thoroughly checking him over and determining they were not dealing with concussion or worse, they went ahead and released him to go home, so he has been here since Monday, but is now bedridden, and cannot walk at all. Vivian has decided not to expect him to do any further excersizes at this point, so he is daily getting weaker, and yesterday I helped her sit him up so she could get a clean sweatshirt on him.

I am concerned about his skin deteriorating since he seems to spend all his time on his back, and today when I had a brief chat with him , he was very disoriented, talking about waiting for a plane, thought he was at an airport.

I am concerned that Vivian is very fiercely independant, protective, and is havng a very hard time reliquishing ANY responsibility for caring for him. So far this week has slept in the den on the couch rather than her own room, so that she can be right next to Bob if he wakes up and wants or needs anything. She was up every 2 hours the night before last, changing him. Hospice came in and bathed him yesterday and helped her change his bedding.

She has left me with him alone three times while she quickly ran to the mail box or to the store, but both times were under an hour, and her original plan to get out of the house twice a week is now a mute point as she refuses to take any time for herself, unless Bob is sleeping, then she will sit by him and quietly read or watch TV.

I have a baby monitor in my office and in my bedroom so all she has to do is turn it on and ask for me or I'd wake up during the night and go help her, but she has yet to use it. She closes the door to the den when she changes him.

I am working outside of the home during the day 3-4 days a week, so I am not here every moment. She tries to have hospice come in when I am out of the house, which is good.

Vivians entire exsistance is cenered around Bob, always has been. I know she is more stubborn now because she feels she is loosing control of her whole world, and so there is little I can do besides wait for her to ask me to help her with something, because if I suggest that I help or try to, she usually refuses, and says she can handle it. She says "If I need you I'll ask". She's very kind about it, it's not mean spirited...but she is very firmly stubborn in her will to be Bobs primary, if ONLY, care provider. It's almost like my trying to help is threatening to her feelings of adaquacy. So, I am backing off, because if I push or try to convince, she gets irritable, and her stress level is a primary concern of mine.

I am concerned she will wear herself out, and if she collapses, will her family be angry with me, saying "Where were you?"... but I have been reassured by a close family friend, that her family knows exactly how stubborn and protective and do-it-myself she is, and they will not blame me, and that they are just happy knowing I am here in the event of a real emergency.

I am about to send my first report eMail to her eldest son, letting him know what I am seeing. I will be careful just to stick to the facts... not to make suggestions or give my opinion, as I know they will be protective of her stress level too. If we try to make her change her ways to quickly, she will feel like the life she is trying to hang onto so desperately is being yanked away by the people she should be able to trust most, her family and me.

As far as the original tension in the house, my backing off a bit seems to have calmed Viv down and she has asked for a lttle more help in the last day or two, so I think this probably is the way to handle it until I speak with her son and see what he has to say.

I am tired though, probably due to my worrying about her, and my move last week, and the tension and stress from our first couple of days.

One other thing, we seem to have remedied, her dog does not want to accept mine and keeps attacking mine, so we have put up a baby gate on the back hall to my private rooms. There is private entrance at the end of that Hall to the back yard, and from the yard through the garage, so we can and do keep the dogs seperate at this point. Which means we have to check with each other to make sure one dog is not in the yard when the other wants out.

As far as putting everything in writing...I have no idea how to broach that subject. Like I said, I agreed to do this for no pay at first so long as I could keep my cleaning jobs, which so far I can, but I can also see that Viv is going to get tired real fast and need me more (if she'll allow herself to)... and her family decided last week that they ARE going to pay me, and when they were here and told me that I thanked them but did not ask how much. (it was almost like a gift) Her son just said "You WILL be recieving a check on the first and fifteenth of every month. It won't be much at first until we get dad home and see how much mom can do and how much she'll need you, but we want to pay you something, we think it's only fair".

I did mention briefly to Viv that maybe we should put this all in writing and her response was "Do you want to call the whole thing off?" (Again, she was not mean spirited about it). I told her no, I wanted to help her, but since her son was insistant that we keep our mail seperate, I thought he might want a contract of sorts with me. She suggested we stick with the original suggestion her son made when I accepted the offer, and that was to wait and get dad home and see how it goes.

It has been less than a week since Bob came home, and Viv's son will be here Saturday.

I will try to address this if I get a chance to, but Saturday is one of my days to work outside the house. I will be gone half the day and may miss him.

So, like I said, I'll be writing him an email tonight, and will begin my communications with him about all our concerns at that time.

I thank you all for your replies and support. I'm sorry for the length of this post but I wanted thngs as clear as possible so your replies could be well informed.

Catherine

Hi Cathi,
Cat is right on.Get everything in writing. This is not to say you don't trust people, but it is to protect yourself. The family may be very nice, but they won't want to spend more of Mom's money than they have to. The burden of proof will be up to you. Also, if you can, keep a place to move back to in case this is just too much. You are a kind soul, and that is good. But you need to take care of yourself, too.

Please keep checking in.
Carol

Hi Catherine-I'm sorry I didn't read my mail and see this yesterday. I hope they purchased (or rented) an electric bed (push the button, the head/foot/or both are adjustable) with pressure relieving mattress, and if they didn't, request one. Also ask about a bedside commode, so the husband won't have to travel far from bed to bathroom.An over bed table,and it sounds like a wheel chair would be in order, so he can have a change of scene. Setting him up like that will make it alot easier to care for , for everyone, including him. The local health care equipment store would have those items. A good cushion for whatever chair he will sit in would be a great plus, too. If he is in pain, contacting a hospice will help everyone, and ease his wife's mind. Good luck, and I think it's a wonderful thing you are doing. Lauren

Hey Catherine,

I hope it all works out for you and eveyone. Hang onto the list. A good rule of thumb is that if you didn't write it down - it didn't happen.

I am not saying this to scare you, but to empower you. During good times when everyone agrees, things may seem petty, or like they would be 'too much' - but if there is a rough patch ahead it can keep emotions from getting in the way of facts.

Blessings to you & the lady you are taking care of. Many of of wish that we had someone like you to help us with our own loved ones. Take care & let us know how you are doing.

Cat, thank you for your reply. I am finding there are things to work through, but her family has set up a scheduel for me and will be paying me, and I am not sure how to address extensive suggestions you have made. I will take all these things into consideration, though, and I appreciate your input. Right now, I am moved in, and Vivians husband is due to come home tomorrow. There are things that I have had to bring up with Viv, as she is a very set-in-her-ways woman, who is frail, but determined to do as much as she can. I am a very strong Christian, and so is this family, so we are all leaning on the Lord and taking this one day at a time. Also, I so appreciate being able to come to a forum where I can talk with others who are doing this full time, and can help me along. Blessings, ~ Catherine

Dear Cathi,

Since you are not family, I think you should give it a trial run before you give up your current place to live. Secondly, you will have to reconcile that as soon as you do move it, you have an employer that has access to you 24/7 and family as well. Have you made an employment contract and put it in writing?

Reading between the lines, I think that you may not be ready for this step until you determine what you will be paid, how you will be covered if you should happen to be injured on the job. Are you a direct employee, or an independant contractor. If you are an independant contractor, you will have to consider the tax implications of accepting rent in lieu of direct payment. THere are many issues to consider.

As far as your duties - you will also need to get what you are and aren't responsible for. You didn't say if you have any certifications, or training. I hope that you will seriously evaluate how you are going into this arrangement before you start.

You can find out going rates in your town if you call several home health agencies and ask employment questions. You might also want to talk to someone at the area agency for aging in your community about steps to take. I don't mean to be a naysayer, but it seems that there is alot to deal with before you ask a single caregiving question.

As far as the dear lady's personality - you already know her. She will not change, so anticipate how you will handle it when she becomes more difficult - or what you would do if there was an emergency, or conversely if she declined and her family decided on different living arrangements.

You sound as if you have a kind heart - please be a bit cautious before jumping into this situation.

Cat

Dear Catherine, sounds like you are taking on a huge responsibility, I don't know anything about what the pay should be. It would be nice if you could seek some legal advice on the best way to handle some of the issues, or have some sort of contract. I don't know, others here are certainly more educated on this issue. I'm just a newbie up late, catching up on reading posts. Good Luck to you, you are giving up a lot to take on this job. God Bless You! Nauseated