Caregiving for Your Senior Family Member

Overview

A caregiver is responsible for a person who can’t take care of themselves. The person may be elderly and frail, ill or disabled, or have dementia. The caregiver can manage:

  • Daily life needs
  • Medical care coordination
  • Finances, if appropriate

 A caregiver can be:

  • A family member or close friend
  • Someone hired by your family to be or assist the main caregiver

On average, caregivers spend 4 years in their role. The timeframe can vary widely, though. People with Parkinson’s or Alzheimer’s may need care for years. A senior with a short-term injury may only need help for a month.

In the United States 80 percent of long-term care is done in the home. More than 44 million people are unpaid caregivers.

Caregiving can be emotionally rewarding, and difficult. Often, caregivers feel overwhelmed, resentful, or depressed. It helps to learn coping skills and to use support services.

Before hiring a caregiver, decide what your family member needs, and review the services that several types of caregivers can provide. When interviewing applicants:

  • Consider their personal qualities and communication skills
  • Check their references
  • Start with a trial period before hiring permanently

Working with Health Care Professionals

Most family caregivers communicate often with health care professionals on behalf of their loved ones. This can include:

  • Arranging and attending medical appointments.
  • Assisting with medications.
  • Staying informed about their medical conditions.
  • Planning medical care with clinicians.

These guidelines can help caregivers have respectful, productive relationships with your family member’s health care team. Be sure that the caregiver you select:

  • Introduces themselves to all members of the care team. The caregiver can tell them about their relationship to the patient, role in planning care, and how to be contacted.
  • Makes a consultation appointment, if they have any questions. This allows time for them to discuss any concerns with the doctor.
  • Always asks their questions in a private space. Caregivers shouldn't ask for quick answers in a waiting room or hospital corridor.
  • Is appreciative of clinicians’ care. Make sure they say "thank you" often.

Alternatives to in-person visits include phone or video visits and email consultations. The caregiver may need to register through the Act for a Family Member feature to access some options. Learn about this on My Doctor Online, on Manage Your Family’s Health. The caregiver will need the family member’s permission.

Caregivers can also request a second opinion if they're uncertain about a doctor’s diagnosis or recommendations.

Acting as a Patient Advocate

A professional patient advocate may be available to you through the patient’s health insurance or a government program. Take advantage of this service, if available. But you don’t need training to be a good advocate for your loved one.

An effective patient advocate needs to:

  • Communicate well with clinicians and support staff.
  • Understand the patient's condition. Know how to find information, including online research.
  • Respectfully stand up for the patient's needs.
  • Respond flexibly and creatively to problems.
  • Track questions and concerns about the patient. Make sure these are covered during appointments.
  • Be well organized and manage time effectively.

Family caregivers can give clinicians valuable information. It’s vital to keep a written record of your loved one’s:

  • Eating and sleeping habits.
  • Emotional changes, such as weeping or angry outbursts.
  • Symptoms, such as fever, cough, or abdominal pain.
  • Ability to follow (or resist) doctors' instructions and take medications as prescribed.
  • Use of over-the-counter or alternative remedies, if any.
  • Side effects from medication.

Selecting a Health Care Agent

Family members can choose a health care agent to make medical care decisions on their behalf. They identify the agent by completing an Advance Health Care Directive. Learn more at the Life Care Planning website. 

Hiring a Caregiver

Decide on the type of caregiver to hire based on the services your family member will need.

Personal care assistant or companion. No certification or licensing is required. The assistant or companion may provide:

  • Grocery shopping, meal preparation, and housecleaning
  • Company and conversation
  • Assistance with dressing, bathing, and toileting if needed

Certified nursing assistant (CNA) or home health aide. These caregivers can help with daily activities and hygiene. They can also provide basic health care. Their training includes:

  • Checking vital signs such as pulse and blood pressure.
  • Turning and positioning a person in bed.
  • Ensuring medications are taken on time.
  • Providing wound care (nonsterile).
  • Assisting with gentle range-of-motion exercises or walking.

Licensed nurse. A nurse can care for your bedridden family member at home instead of moving them to nursing home. A registered nurse (RN), licensed vocational nurse (LVN), or licensed practical nurse (LPN) can provide the same care as a CNA, such as assistance with:

  • Medical equipment
  • Sterile wound care
  • Vital signs monitoring

Choosing the Right Caregiver

Hiring your family member’s main or assistant caretaker takes careful planning. The steps include:

  • Assessing your family member’s needs and listing chores and responsibilities.
  • Making a job description.
  • Developing a contract, if long-term care will be needed.

Tips for finding the right caregiver include:

  • Asking for referrals from friends, neighbors, your doctor, church groups, or work colleagues.
  • Working with a licensed agency that offers qualified applicants who are bonded and insured.
  • Checking potential caregivers’ references.

When interviewing applicants:

  • Include more than one family member or close friend. Compare thoughts after each interview.
  • Trust your instincts. Ask yourself whether the candidate seems responsible and communicates well. Will they get along with your loved one?

Start with a trial period. Spend time with the caregiver and your family member. Does your loved one seem comfortable? Does the caregiver perform their duties responsibly?

Expect a good caregiver to:

  • Know about your family member’s condition.
  • Allow them to be as independent as possible.
  • Know what to do in an emergency.
  • Communicate well with you and your family member.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following:
(1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.