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December 30, 2009 > Care of the Older Adult:

Care of the Older Adult:

Taking care of an elderly relative or friend can be a difficult job, especially if the person is ill, disabled or suffering from dementia. In addition to the physical strain, which can be significant, caregivers also often face financial, legal, emotional and even spiritual stresses.

To help caregivers of older adults learn about resources to help them with their daunting responsibilities, Washington Hospital is hosting a special seminar, "Care of the Older Adult," on Tuesday, January 12 from 1 to 3 p.m. The seminar will feature Nancy Rothschild, a licensed marriage and family counselor who is the Coordinator of the Family Caregiver Support Program for the City of Fremont, and Ellen Cuozzo, R.N., who is Manager of East Bay Community Relations for Pathways Hospice. The seminar will take place in the Conrad E. Anderson, M.D. Auditoriums in the Washington West building at 2500 Mowry Avenue in Fremont.

"People who are caregivers need to care for themselves, too," says Rothschild. "So many caregivers don't have the time to care for themselves. They often don't receive any expression of gratitude from their patients, so they don't see themselves as worthy of care. This can lead to depression and even despair. That's why it is important for caregivers to take advantage of resources available in the community to make their burden lighter so they don't suffer from 'compassion burnout' or actual physical illness."

Rothschild notes that the Family Caregiver Support Program can provide caregivers with referrals to attorneys and financial experts to help them deal with pressing legal and financial concerns.

"It's important for caregivers to make sure their loved ones have all their legal documents in order, such as power of attorney for financial and medical decisions, including advanced directives, do-not-resuscitate orders, wills and estate planning," she explains. "You don't want to have to sort through complex legal and financial matters with a patient who is terminally ill or incompetent. You also should discuss your loved one's wishes for things like memorial services and burial arrangements. As painful as those discussions might be, the more you have talked about these topics, the easier it becomes."

Rothschild recommends that caregivers look into various options for gaining some time for themselves. "If you are financially able, hire people to take over various aspects of your responsibilities, such as housekeeping, cooking, running errands and caring for your loved one to gain some 'downtime' for yourself," she says. "If you don't have the financial resources to hire assistants, reach out to other resources in your family, church and surrounding community. You deserve some time off to restore yourself."

The Family Caregiver Support Program can provide referrals to a variety of resources, such as a class in February on "Communicating with People with Dementia." Rothschild herself teaches "Mindfulness-Based Stress Reduction" classes that teach caregivers about meditation, yoga, breathing practices and other methods to help them deal with stress. The classes are generally held a couple of times each year. There also is a weekly yoga session on Mondays, and support groups for caregivers that meet twice a month.

In addition to taking advantage of the services of the Family Caregiver Support Program, Rothschild suggests that caregivers consider services such as adult day-care facilities. Two such facilities are located in the Tri-City area:
* Bay Area Community Services in Fremont offers day-care programs for people with dementia or physical limitations.
* Alzheimer's Services of the East Bay, located in Hayward, offers care for seniors with Alzheimer's disease or other forms of dementia.

"Both of these facilities offer pick-up and drop-off services," Rothschild says. "Also Medicare, MediCal and some private insurance policies may pay a portion of the fees."

Another vital community resource for caregivers is the Pathways Hospice program that provides compassionate care for people who are nearing the end of life. This comprehensive program offers physical, emotional and spiritual support for dying patients and their support network of family and friends.

"We are there to hold patients' and caregivers' hands through this process," explains Cuozzo. "Hospice can be a great source of comfort to patients and their families. People often comment that they don't know how they would have coped without hospice care."

Pathways Hospice offers a comprehensive program that can involve a team of nurses, social workers, home health aids, spiritual care counselors and volunteers. "All our hospice staff and volunteers are screened and trained to be present at the patient's bedside," Cuozzo notes. "They can be a supportive presence that allows family members to take time for other outside responsibilities. Everyone who comes to the patient's bedside has just one goal in mind - to make the patient's quality of life the best it can be."

The criteria for qualifying for hospice care includes anyone with a life-limiting illness, generally with a life expectancy of six months or less, who no longer has any life-saving treatment options less or who no longer desires life-extending options.

"Ordinarily, anyone can call us and ask for hospice care, but we need to have a physician's confirmation of a terminal prognosis," Cuozzo says. "The patient's own doctor continues to direct the medical care, and input from the patient and family helps guide the hospice team's efforts. We encourage people to seek our services early, when we can make a substantial difference in the quality of their loved one's remaining life. Don't wait until the last couple of days."

Like Rothschild, Cuozzo also stresses the importance of end-of-life planning. "We can help families have conversations with their dying patients about legal issues, memorial service preparations, durable power of attorney and estate planning," Cuozzo says. "If people have already prepared these documents earlier in life, we suggest that they and their families review them to see if any of the patient's preference or decisions have changed."

For more information about the upcoming seminar at Washington Hospital, or to register to attend, please register online at For information about services and classes offered through the Family Caregiver Support Program, call (510) 574-2035 or email More information regarding Pathways Hospice services is available by calling (1-888) 755-7855 or by visiting

Washington Hospital
Tri-City Voice article re: elder care

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