Prince George’s County Department of Family Services
FAMILY CAREGIVING GUIDE
A comprehensive guide of resources to make caring for your aging loved one easier.
This guide provides convenient and useful information to individuals and families caring for loved ones. It covers a wide range of topics, including the role of a caregiver, locating additional support, housing options, legal issues, healthcare options, and much more.
CONTENTS Letter from County Executive Angela Alsobrooks
2
Letter from Director of the Area Agency on Aging
4
The Caregiving Role
6
Caregiver’s Support Team
8
Caregiving at Home
10
Housing Options for Caregiving
12
Legal Issues & Resources
14
Financial Resources
16
Healthcare
18
Getting Around
21
Caring for the Caregiver
22
Glossary
24
LETTER FROM COUNTY EXECUTIVE
ANGELA ALSOBROOKS Dear Caregiver, Caring for loved ones who can no longer care for themselves can be both rewarding and challenging. The patience and love required to be a caregiver are the greatest gifts that you can give someone in their later years. Therefore, I am pleased to offer you the Prince George’s County Family Caregiving Guide, prepared by the Department of Family Services Area Agency on Aging. Prince George’s County is a caring and compassionate place to live, and this guide will assist with your caregiving needs while informing you of available options and resources. I encourage caregivers to read this guide and learn about the many longterm care options and services available, and the best way to use them. There are also resources to support you as a caregiver, because as you work hard to care for others, it is critically important that you care for yourself as well.
2
Prince George’s County’s seniors are the bedrock of our community. We will always care deeply about our seniors and their unique concerns. Our comprehensive services to seniors are available to assist people of different abilities, economic status, and needs. I appreciate the valuable service that older adults have given to the community and recognize their collective wisdom and experience. We hope this guide will be an invaluable resource to assist you in providing effective and compassionate care for your loved ones. Sincerely,
Angela Alsobrooks County Executive
Prince George’s County Area Agency on Aging | Family Caregiving Guide
Portrait or supporting photo
LETTER FROM DIRECTOR OF THE
AREA AGENCY ON AGING Welcome Caregivers, The Department of Family Services Area Agency on Aging is an excellent resource for those caring for older relatives who live in Prince George’s County. We provide an array of services to assist seniors, caregivers and individuals with disabilities to enjoy life to the fullest. Whether it’s meeting healthcare needs, providing nutritious meals or discussing longterm care options, the Area Agency on Aging is committed to assisting older adults with aging in place. The Prince George’s County Family Caregiving Guide was developed to inform caregivers about resources and help them maintain their loved ones in their homes and communities, where they desire to be. This guide is a valuable tool that provides information, assistance, and referrals to services that help with all aspects of caring for an older family member or friend.
4
The Area Agency on Aging respects an individuals’ right to self-determination and we embrace a consumer choice model. Once advised of all options, the consumer can then make an informed choice that works best for them. This Family Caregiving Guide is an example of the many ways that we hope to assist you and your family. If you need additional information, please contact our Family Caregiver’s Program at 301-265-8450. We hope you find the Family Caregiving Guide to be a valuable resource and we look forward to hearing from you. Sincerely,
Theresa M. Grant, Director Area Agency on Aging
Prince George’s County Area Agency on Aging | Family Caregiving Guide
“Whether it’s meeting healthcare needs, providing nutritious meals or discussing long-term care options, the Area Agency on Aging is committed to assisting older adults with aging in place.”
THE CAREGIVING ROLE
There is no work more important, more challenging, or more meaningful than caring for a loved one. A caregiver provides a broad range of assistance for an older adult or an adult with a chronic or disabling condition—typically without formal training. Depending on the needs of the person receiving care and the capabilities of the caregiver, care may be a live-in arrangement. In other instances, it may involve regular visits to provide assistance, as well as coordinating medical appointments, home healthcare, personal care, or housekeeping. For some, the role of the caregiver is given overnight. For others, it is a role taken on gradually over time. Caring for someone, no matter the relationship, can be physically and emotionally overwhelming. It is not unusual for caregivers to have other obligations such as employment, raising children, or family commitments. Recognizing these and other factors relevant to caregiving, the Area Agency on Aging wants to help you navigate your caregiving journey. The Older Americans Act (OAA) of 1965 was the first federal initiative aimed at providing comprehensive services for older adults. Under the OAA, our Prince George’s County office is considered the local Area Agency on Aging—a
6
central point for information, assistance, and referral services for a range of local, state, federal, private, and non-profit services and resources. Our staff helps individuals and their families with navigating a system that can, at times, be complex and overwhelming. We are here to provide support with accessing services such as meals, in-home services, transportation, legal assistance, elder abuse prevention, caregiver support, and other benefits. We are also able to assist long-distance caregivers with linkages to services where their loved ones live. The National Family Caregiver Support Program (NFCSP) is a federal OAA program established in 2000 to fund a range of supports such as counseling, training, information, assistance, and supplemental services to help caregivers in caring for their loved ones at home and other community settings for as long as possible. This guide is an effort to support Prince Georgians with their caregiving responsibilities. We recognize that each caregiving situation is different. Our trained staff is ready to meet with you and develop a plan tailored to your needs.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
THE PRINCE GEORGE’S COUNTY AREA AGENCY ON AGING’S PURPOSE IS TO SUPPORT:
OLDER ADULTS
INDIVIDUALS WITH DISABILITIES
CAREGIVERS
so they can maintain the highest quality of life with independence and dignity.
For more information, call 301-265-8450, or visit FamilyServices.MyPGC.us/Caregiving.
CAREGIVER’S SUPPORT TEAM The first steps of caregiving can be the most challenging. Like any new role, it requires learning. Your caregiving support team can include a mix of people (family and friends; medical, legal, financial professionals; and our agency) who can support you in your role as a caregiver. This guide is filled with resources to help you choose your team, regardless of income or needs. The table on the right is a breakdown of potential support teams and how they might assist you along your caregiving journey.
8
Prince George’s County Area Agency on Aging | Family Caregiving Guide
TEAM
TEAM MEMBERS
TEAM SUPPORT TASKS
Family Friends Clergy Faith-based organizations Neighborhood/community organizations
Provide assistance with care for your loved one Provide emotional, spiritual, and mental support
Primary care physician Nurse Medical specialists Physical or occupational therapist Nutritionist or dietician Mental health professional Case worker Social worker Options counselor Homecare aide
Maintain the mental and physical health of your loved one Diagnose medical problems, administer medications and treatments, or develop dietary plans Provide consultations and recommendations for care Provide assistance with activities of daily living (ADLs) Provide linkage to community based services
Attorney Accountant Financial planner
Financial planning and aid Estate planning End-of-life directives Tax help and planning
CAREGIVER’S SUPPORT
HEALTH PROFESSIONAL
FINANCIAL & LEGAL
CAREGIVING AT HOME
Caregiving at home doesn’t mean you’re alone on the journey. There are public and privately funded programs and services that can assist you. RESPITE CARE Respite care provides short-term relief for primary caregivers. It can be arranged for an afternoon, several days, or weeks. Care can be provided at home, in a healthcare facility, or at an adult day care center. Resources may include but are not limited to home health agencies, assisted living facilities, nursing homes, as well as family and friends. ADULT MEDICAL DAYCARE Adult medical daycare centers are daily non-residential facilities that offer a safe environment for functionally impaired adults who are unable to remain home alone. They are ideal for caregivers who work full time or need a break. They may also benefit older adults who desire companionship with people their age. In addition to socialization, adult daycare centers offer meals, recreational activities, nursing care, and various therapies. Centers can sometimes provide transportation to and from, offer care for individuals with dementia-related illnesses, and may even offer sponsorships to alleviate some of the financial burden.
10
ASSISTANCE IN THE HOME Home Healthcare (Skilled) Doctor’s orders are needed to begin skilled home care. Services are provided to patients in their homes, typically for up to 60 days, and often follow a hospital discharge. Skilled nursing is provided by a registered nurse (RN) and/or a licensed practical nurse (LPN). Rehabilitation services (such as physical therapy and speech therapy) are provided by licensed therapists. Home healthcare is convenient and usually covered by most health insurance plans. In-home Aide/Chore and Personal Care Services An in-home aide helps maintain independence in the home by providing personal care, light housekeeping, meal preparation, and companionship. TECHNOLOGY Assistive Technology Assistive technology promotes independence by enabling people to perform ADL tasks. The Area Agency on Aging can provide recommendations to specialists who will help you choose assistive, adaptive, and rehabilitative devices for older adults and individuals with disabilities that will support self-sufficiency with mobility and occupational activities.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
Individuals with long-term illnesses who need assistance with their activities of daily living (ADLs) often prefer to receive care at home.
Smart Home Technology Smart home technology (information-based technology) is used in homes to collect and share information about your loved one with the primary care provider and other family members to help keep them safe. Medical alert systems are among the most popular devices to keep aging adults safe in their homes. These systems can detect falls and alert the caregiver even when the user is unable to activate a button. Pill dispensing systems make it safer for older individuals to age in place. The devices can be programmed to dispense specific medications several times a day in varying doses. A caregiver is notified if the pills aren’t dispensed promptly. These dispensing systems lower the risk of accidental overdoses and help individuals maintain complicated pill schedules. MEALS Home-delivered Meals Caregivers can arrange to have nutritious prepared meals delivered regularly to their
family member who is unable to complete the task independently. Caregivers can contact their local Area Agency on Aging to discuss possible options. Congregate Meals Congregate meals are nutritious meals served in group settings to promote socialization with other older adults. The Area Agency on Aging Senior Nutrition Program provides meals and companionship at senior centers, apartment complexes, faith-based organizations, and more. Grocery Delivery Service Home delivered groceries is increasing in demand and may be a benefit to caregivers. If your loved one has limited physical mobility or access to transportation, grocery delivery services can spare you a trip to the store. You can also use the service if you are providing long-distance care. Caregivers can use mobile apps or websites to schedule store deliveries.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
11
HOUSING OPTIONS FOR CAREGIVING
Sometimes receiving care at home may not be possible for older adults who require specialized care. There are several residential options available depending on the needs and wants of your loved one and their financial situation. BEFORE CHOOSING A RESIDENTIAL COMMUNITY, IT IS IMPORTANT TO ASK: Who should I consult to help me make this decision? What services will my loved one need, and what services do they value? Where is a location that’s close to family or friends who can support the caregiving team? When should my family member or loved one make this move?
INDEPENDENT LIVING OR RETIREMENT LIVING COMMUNITIES Independent or retirement living communities are most appropriate for those who can manage their healthcare needs on their own. However, some residents may receive assistance from family or an aide. Independent living does not provide healthcare services or assistance, but may offer a monthly meal plan, housekeeping, social activities, and transportation. Active Adult Communities Active adult communities are neighborhoods or apartment complexes for adults 55 and older. Depending on the communities, they may provide meals, housekeeping, activities, and lawn services. Residents may also have the option to rent or own their homes. These communities offer independence and a sense of security and belonging. Independent Senior Apartments Senior apartment properties are designed to accommodate adults 62 and older and may be based on income. Independent senior apartments may also provide limited services.
Senior Villages Villages bring together volunteer-based services and support to help seniors live in their homes as active, valued members of the community for as long as possible. Across the country, the village movement is represented by community-based, peer-run organizations offering members a wide variety of practical services including arranging for social activities, assisting with ADLs and instrumental activities of daily living (IADLs) and providing information about useful resources. Village structures and services reflect the unique needs of their communities and embrace a not-for-profit ethic. Village operations may LONG-TERM CARE FACILITIES be sustained by a blend of membership fees, Nursing Homes donor support, and grant funding. Nursing residential facilities offer a full range of care—from daily tasks to specialized Continuing Care Retirement healthcare, depending on the facility. Nursing Communities (CCRCs) homes are ideal for individuals who need daily CCRCs provide three levels of professional care that is unmanageable in a accommodations: independent living, home setting. personal care/assisted living, and skilled nursing/rehab on one campus. These Palliative and Hospice Care communities offer long-term contracts to Palliative care provides emotional and accommodate older adults’ needs as they physical comfort for people with serious change over time. Most CCRCs require new illnesses who are pursuing treatment. Hospice residents to pay a one-time entrance fee, care provides end-of-life care to patients with and all require monthly or daily payments. a terminal illness and a life expectancy of less than six months. Because most people prefer Assisted Living Residences to stay at home, services are usually provided Assisted living residential facilities provide in the home setting as opposed to an inservices to individuals who need help with patient facility. These services also support daily tasks—such as dressing, eating, mobility, family members and caregivers. Services and medication management. The rooms or are provided by an interdisciplinary clinical suites are designed to meet personal and team including nurses, certified nursing healthcare needs. The facilities can be as assistants (CNAs), social workers, volunteers, small as a home with a few residents or as bereavement counselors, chaplains, and large as an apartment complex. medical directors. Prince George’s County Area Agency on Aging | Family Caregiving Guide
13
LEGAL ISSUES & RESOURCES Encourage your loved one to talk to an attorney about the following topics—it will help make your job easier for the road ahead. LIVING WILLS (or advanced directives) allow the recipient of care to direct who they want to make healthcare decisions if they are unable to do so themselves. They provide peace of mind for the caregiver and care recipient, and ensure the wishes of your loved one will be carried out. In Maryland, living wills must be in writing or doctors will defer to the next of kin for decision making. A POWER OF ATTORNEY is a legal document that lets your loved one appoint a person to represent them or manage their affairs if they are unable to do so. There are several types of power of attorney, and the legal or financial authority can be as broad or limited as the agreement dictates. A medical power of attorney (advance directive) allows any competent person to create a power of attorney to make healthcare decisions for them in case they become too sick to make a decision about their own care. Unless otherwise stated in the advance directive, the directive goes into effect when the individual becomes too sick to decide on their care. Financial power of attorney (limited or general) allows a person to make financial decisions (within limits) for another. In this form, the person receiving care is the principal and the person they give authority to is the agent. The agent can do anything with your property
14
that is stated in the power of attorney. This may include withdrawing money from bank accounts and selling property. Do-not-resuscitate (DNR) is a document in which a patient provides instructions indicating that they do not want to be resuscitated in the event of a cardiac or respiratory arrest. The document may be obtained from the patient’s doctor or upon entry to a hospital. Once completed, the DNR order is filed in the patient’s medical record. GUARDIANSHIP is a formal court process that is used to appoint someone (the guardian) to act on behalf of the court to manage a person’s care and/or property. A guardianship proceeding is necessary when a physician, psychologist, or certified clinical social worker determines that a person is unable to make responsible decisions concerning his or her medical care or financial matters, and there is no alternative to a guardianship available, such as a power of attorney. ESTATE PLANNING outlines how the person’s property and assets will be handled after their death. Good estate planning can avoid problems within the family, save on taxes, and ensure your loved one’s wishes regarding wills, trusts, charitable giving, or funeral services will be carried out. Estate planning should be done through an attorney.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
With good legal planning you can avoid problems with family, save on taxes, and know that your loved one’s wishes will be followed when they are no longer able to make decisions for themselves.
LEGAL AID RESOURCES
If you and your loved one are struggling to afford the services of an attorney, the Area Agency on Aging is here to help and may be able to link you to programs such as:
MARYLAND LEGAL AID BUREAU (MLA)
THE SIXTY PLUS LEGAL PROGRAM
The MLA is the largest provider of free, direct legal services in Maryland and the state’s third largest law firm. As a private, non-profit law firm, MLA provides a full range of free civil legal services to low-income people statewide. MLA handles civil cases involving a wide range of issues, including child custody, housing, public benefits, consumer law, and criminal record expungements to remove barriers to obtain child custody, housing, and employment. Visit mdlab.org or call 866-635-2948 for more information.
This program is a joint project of the Legal Aid Bureau and provides low-cost legal services to individuals at least 60 years old. The program works with private attorneys who care about you and your need for affordable legal assistance. Their services include help with wills, powers of attorney, advance healthcare directives, and living wills. In addition, they provide help with small estate administration and probate, and deed changes. Each client receives a free consultation visit with a program attorney, and further assistance may be provided by an attorney for a reduced fee. Call 410-951-7760 for more information.
FINANCIAL RESOURCES
There are options available to help pay for housing, medical, and support costs that come with caregiving. As an Area Agency on Aging, we have information on federal, state, and local programs to help your loved one with their financial needs. This guide covers several options, in addition, government agencies and other organizations frequently add new resources. HOMEOWNER/RENTER OPTIONS AND FEDERAL TAX CREDITS If your loved one is a homeowner, reverse mortgages specifically for older adults, home equity conversions, and tax credits can provide money for long-term care. There are also programs that can offset expenses for renters. Our office can help you determine which financial strategies will work best.
16
GOVERNMENT PROGRAMS AND ENTITLEMENTS From Medicaid and Medicare to the Supplemental Nutrition Assistance Program (SNAP) and Supplemental Security Income (SSI), government programs can help your loved one pay for healthcare and living expenses. The choices can be confusing, but your local Department of Social Services and Social Security offices, who administer the programs, can assess eligibility. You can also call the Area Agency on Aging to discuss various benefits your family member may be potentially qualified to receive.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
WE CAN HELP YOU determine which financial programs best fit the needs of you and your loved one. IF...
INQUIRE ABOUT
CONTACT
Your loved one is struggling to pay their mortgage or rent.
The Homeowners Tax Credit or Renters Tax Credit provides relief to homeowners or renters paying more than 30% of their salary on housing.
dat.maryland.gov/ realproperty 410-767-1184
Your loved one is struggling to pay utilities or heating.
The Maryland Energy Assistance Program is an income-based program for those having trouble paying their heating or utility bills. You don’t need a turn-off notice to qualify.
dhs.maryland.gov/office-ofhome-energy-programs 800-332-6347
Your loved one’s home is not up to code and/or is unsafe.
The Housing Rehabilitation Assistance Program (HRAP) is an income-based affordable loan to fix homes so they meet contemporary minimum property standards, including the elimination of housing code violations.
Hiphomes.org/wp 301-699-3835
Your loved one wishes to remain at home, or at a family member’s home, but the home is inaccessible.
The Accessible Homes Program provides zero-interest loans for eligible seniors to fund improvements like the installation of grab bars, railings, ramps and widening of doorways.
singlefamilyhousing.dhcd @maryland.gov 301-429-7821
Your loved one is unable to work due to a disability or is 65 years or older with limited income and resources.
Social Security Disability Income (SSDI) or Supplemental Security Income (SSI) provides older adults or those with disabilities with monthly payments.
ssa.gov 800-772-1213
Prince George’s County Area Agency on Aging | Family Caregiving Guide
17
HEALTHCARE
As a caregiver, it’s important to have an open dialogue with your loved one about health matters and their medical history. Issues related to healthcare often concern caregivers the most, whether it’s ensuring that your loved one is covered by insurance or being prepared for medical issues that may arise. This guide can help you start the conversation. TYPES OF CARE • Acute care refers to short-term treatment for a severe injury, illness, medical condition, or surgery from which the patient will recover fairly quickly. • Skilled care refers to rehabilitation services ordered by a doctor and performed by a licensed healthcare professional such as a nurse or physical therapist. • Chronic care refers to a pre-existing or long-term illness, where treatment will be for a significant duration of time. It is the opposite of acute care. • Ambulatory or outpatient care can include medical diagnosis, observation, consultation, treatment, intervention, and rehabilitation services, and does not require a hospital admission. ASKING THE RIGHT QUESTIONS It’s a good idea to gather all the health information you can about the person you are caring for. There may come a time when the person you are caring for is unable to answer these questions and you may have
18
to provide the information. With your loved one’s permission, you can also accompany them to medical appointments and have their medical records released to you. We recommend you ask your family member the following questions: • Who is your primary care physician/ dentist? • What other doctors or specialists do you see regularly? • What illnesses, health problems or injuries do you have? • What treatments has the doctor ordered for you? • What medications are you taking? If applicable, write down the names, dosages, and schedule for reference. • What medications are you allergic to, and what other allergies do you have? • What health insurance do you have, and where can I find your card? • Do you have an advance directive or living will? INSURANCE There are resources available that can assist you in navigating insurance options for your loved one. The Area Agency on Aging, State Health Insurance Program (SHIP), and Family Caregiver Program are happy to meet with you to discuss your options.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
PREPARING FOR EMERGENCIES Keep the following by the phone or in a prominent location so the person you’re caring for or emergency medical personnel can find it:
Emergency Number (911)
Poison Control Center of Maryland (800-222-1222)
List of current medications and allergies
Doctor’s name and phone number
Emergency Contacts
WHICH INSURANCE IS THE RIGHT CHOICE? Private Insurance
Your loved one may have an existing policy through a job or spouse. Additional health insurance can be purchased to supplement this.
Medicare
If your loved one is 65 or older, has certain disabilities, or end-stage renal disease, they might qualify for Medicare.
Medigap
If your loved one has conditions or needs not fully covered by Medicare, a Medigap plan will supplement the remaining balance on Medicare approved services.
Medicare Advantage Plans
A type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage and additional supplemental benefits like dental, vision, and hearing.
Medicaid
Medicaid provides coverage to low-income people, families and children, pregnant women, the elderly, and people with disabilities. To find out if your loved one is eligible for Medicaid, visit medicaid.gov. or contact your local Department of Social Services.
Affordable Care Act
Passed in 2010, the ACA (sometimes referred to as Obamacare) makes affordable health insurance available to more people by providing consumers with subsidies that lower costs for households with incomes between 100% and 400% of the federal poverty level. For more information visit healthcare.gov or marylandhealthconnection.gov.
Long-term Care Insurance
Long-term care insurance is an insurance product that helps pay for the costs associated with long-term care. Long-term care insurance covers care generally not covered by health insurance, Medicare, or Medicaid. Prince George’s County Area Agency on Aging | Family Caregiving Guide
19
THE STATE HEALTH INSURANCE PROGRAM (SHIP) SHIP offers insurance counseling to residents and caregivers at no cost—walking you through Medicare, Medicare supplements, Medicare Advantage Plans, pharmacy assistance benefits, and more. SHIP is not an insurance program; they are experts who will help you and your loved one navigate the system. Get started by calling 301-265-8471. VETERAN’S SERVICES If your loved one is a veteran, there’s a wealth of resources to support them. Veterans are eligible for many services such as pensions, insurance benefits, and more based on time served in the military. The Prince George’s County Office of Veteran’s Affairs is a one-stop-shop for federal, state, and county resources. The staff can walk you through benefits your loved one may be eligible for, such as healthcare coverage and pensions. They can also direct your loved one to local community-based veteran’s hospitals, mental health services, and veteran-specific long-term care and assisted living facilities . For more information, visit
20
princegeorgescountymd.gov/3023/ Veteran-Resources or call the Veterans Affairs Officer at 301-780-8260. You can also visit va.gov/health-care for more information, or contact the Maryland State Office of Veterans Affairs at 410-260-3838. DEMENTIA FRIENDLY PRINCE GEORGE’S The goal of the Prince George’s County Dementia Friendly Initiative is to leverage resources, both public and private, to create a community that supports those with dementia, their caregivers, and their families. Dementia Friendly Prince George’s is a volunteer-driven collaboration that prepares communities for the personal, social, and budgetary impacts of Alzheimer’s disease and other dementia-related disorders. “A dementia friendly community” is one in which people with dementia are empowered to have high aspirations and feel confident, knowing they can contribute and participate in activities that are meaningful to them. For more information about Dementia Friendly Prince George’s, call our Area Agency on Aging office at 301-265-8450.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
GETTING AROUND
Independence is very important for many older adults, and they may wish to continue traveling around the County by themselves. If you work, have other family obligations, or are limited on transportation yourself, you might not always be available to transport your loved one. County, state, and volunteer services are available to help your loved one maintain their mobility without needing to drive. METROBUS AND METRORAIL: Prince George’s County has 70 bus stops and 15 accessible Metrorail stations, and offers discounted rates to people 65 and older. Visit wmata.com or call 202-637-7000. MetroAccess is a shared-ride, door-to-door, paratransit service for people whose disability prevents them from using bus or rail. Visit wmata.com or call 301-562-5360. THE BUS offers 28 routes and covers more than 10,000 miles throughout Prince George’s County. Those 60 and older or with disabilities ride for free. Call 301-324-2877. CALL-A-BUS provides curb-to-curb service for seniors or those with disabilities whose homes are not serviced by public transportation. To reserve a trip, call 301-499-8603. SENIOR TRANSPORTATION SERVICES (STS) offers free rides to nutrition sites in Prince George’s County or for medical purposes such as dialysis. Call 301-499-8603 to reserve a trip.
CALL-A-CAB allows eligible residents to buy coupon books that can be used to pay for rides with participating cab companies when Metrobus, Metrorail, and/or Call-a-Bus are not available. Call 301-883-5656 to apply. MEDICAID TRANSPORTATION covers rides for eligible individuals to and from doctors’ offices and hospitals for non-emergency Medicaid-approved care. For more information or to schedule, call 301-856-9555. UBER AND LYFT are great options for immediate, door-to-door transportation around the County. Uber Assist is an option designed for anyone in need, especially seniors, expectant mothers, individuals with disabilities or going through rehabilitation, and those who may need additional assistance. With a telephone call, you can be matched with well-trained Uber Assist driver-partners. Learn more at uber.com/au/en/ride/assist. Lyft works with GreatCall, a Jitterbug medical alert and phone company, to offer a rideshare services for seniors. The process is simple, and seniors do not have to use the Lyft app to schedule a ride. Instead, they can go on their GreatCall phone, press the number zero, and an operator will schedule the Lyft.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
21
CARING FOR THE CAREGIVER
Caregiving can be an immense physical and mental burden. It’s important to frequently check in on your own emotional needs, stress levels, and physical comfort. You can’t be an effective caregiver if you don’t maintain your own health. TAKING LEAVE FROM WORK Accrued leave can allow you to take paid or unpaid time off, depending on your organization’s policy and the amount of vacation time you have saved. The Family Medical Leave Act (FMLA) allows for eligible employees to take unpaid, jobprotected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. This includes up to 12 workweeks off to care for a spouse, parent, or child who is struggling with a serious health condition. SUPPORT SYSTEMS AND SERVICES The Memory Cafe is a welcoming environment located in the County for caregivers and those with early-onset Alzheimer’s, dementia, or
22
other cognitive impairments. The Cafes offer refreshments, activities, and camaraderie, as well as a support system for you and your loved one. Support groups for caregivers foster the setting for sharing information, insight, advice and encouragement. They provide an opportunity to learn from others who face the same challenges and allow you to talk about your experiences. Faith-based support can be a great place to find strength and peace if you or your loved one are active in your faith community. Faith communities can provide camaraderie, counseling, and support. The Area Agency on Aging has resources to direct you to support groups and local organization that provide caregiver support. We can also recommend resources for professional mental health services.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
THE AMERICAN PSYCHOLOGICAL ASSOCIATION offers a method to take care of your mental health needs:
UNDERSTAND HOW YOU STRESS. Everyone “stresses” differently. What physical symptoms do you feel? How are your thoughts or behaviors different from times when you do not feel stressed? Identifying these patterns will help you determine when you need a break. IDENTIFY YOUR SOURCES OF STRESS. This is likely caregiving, but focus on what aspect of caregiving—is it financial, navigating the healthcare system, or coordinating care with family? Remember, the Area Agency on Aging is available to provide support. LEARN YOUR STRESS SIGNALS. You might have days when you have a hard time concentrating or making decisions, feel angry or sad, or experience headaches, muscle tension, or lack of energy. These are your “signals” and they clue you in on what is stressing you out. RECOGNIZE HOW YOU DEAL WITH STRESS. Are you using unhealthy behaviors such as smoking, drugs, or over/under-eating to cope? You may be using these as relief from stress—but unhealthy coping methods can pile on more problems in the long run. Don’t sacrifice your health. FIND HEALTHY WAYS TO MANAGE STRESS. There are lots of healthy, stress-reducing activities such as creating art, exercising, or spending time outdoors. Find a stress-reducing hobby that’s right for you. Prince George’s County Parks and Recreation has lots of events, classes, and beautiful places to explore. TAKE CARE OF YOURSELF. Caring for a loved one doesn’t mean you stop caring for yourself. Eat healthy, get regular sleep, and get moving. Like any job, caregiving requires a break—find respite care and take a vacation or staycation to focus on you. REACH OUT FOR SUPPORT. Caregiving doesn’t have to fall solely on your shoulders. Don’t be afraid to reach out and ask for help. Call regular family meetings to discuss who is willing and able to help you care for your loved one. As a caregiver, you need to take time to focus on yourself. Make a list of what your loved one needs—including chores, providing meals, rides to the doctor’s office, financial support—and then discuss with your family how they can support you. Prince George’s County Area Agency on Aging | Family Caregiving Guide
23
If you have questions or concerns about COVID-19, please contact the Prince George’s County Health Department at 301-883-7879.
GLOSSARY ACTIVITIES OF DAILY LIVING (ADLS) Routine activities people do every day without assistance. There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring, and continence. ALZHEIMER’S DISEASE It’s the most common form of dementia in adults. An irreversible, progressive brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks. DEMENTIA The loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. DURABLE MEDICAL EQUIPMENT Medical equipment used in the home to aid in a better quality of living. It is a benefit included in most health insurance plans. GERIATRIC EVALUATION A holistic assessment designed to evaluate an older person’s functional ability, physical
24
health, cognition, and mental health, and socio-environmental circumstances. INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADLS) Activities that allow an individual to live independently in their community. These activities include cooking, money management, grocery shopping or home maintenance. LONG-TERM CARE Medical and social care given to people who have severe chronic impairments. It may include care in the home by family members, volunteers, or paid assistants such as a home care agency. Long-term care can also be provided in an institution such as an assisted living facility or nursing home. LONG-TERM CARE OMBUDSMAN An advocate for residents living in nursing homes, assisted living facilities, and other similar adult care facilities.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
MEDICARE A federal health insurance plan for people who are 65 and older who have paid into Social Security; certain younger people with disabilities; and people with end-stage renal disease are also eligible. MEDICAID A joint federal and state program that helps with medical costs for people with limited income and resources. Medicaid programs vary from state to state, but most healthcare costs are covered if you qualify for both Medicare and Medicaid. MEMORY CARE Care designed to meet the specific needs of a person with Alzheimer’s disease, dementia, or other memory problems.
SANDWICH GENERATION Caregivers typically in their thirties or forties who are responsible for bringing up their children and caring for their aging parents. SPENDDOWN A financial term used when an individual’s assets are too high to qualify for Medicaid. As a result, the individual’s assets must be used or spent to ensure they are low enough to qualify for service. SUNDOWN SYNDROME A condition that includes symptoms such as agitation, confusion, anxiety, and aggressiveness in the late afternoon, evening, or at night, often in people with dementia.
Prince George’s County Area Agency on Aging | Family Caregiving Guide
25
Prince George’s County Department of Family Services Aging & Disabilities Services Division 301-265-8450 | TTY: 211 (Maryland Relay) FamilyServices.MyPGC.us/Caregiving