‘We are taking Gran to the hospital’: Elder care unpredictable, exhausting

The call came very early one morning. It was hot and hazy just before the July long weekend. The ringing phone woke me from a deep sleep and the rushed voice on the other end said, “The ambulance is on the way — we are taking Gran to the hospital — can you please meet us there.” I got dressed and was out the door before I was fully awake.

I was joining thousands of other working Canadians providing acute elder care. Other entrepreneurs, employees, managers and executives face similar situations every day; a spouse has a heart attack, a parent falls and breaks a hip or an in-law becomes increasingly disoriented and confused.

I recently talked with three executives about this subject and their stories were remarkably similar. Each one described how they took a week off to visit their mother, expecting to finalize plans for selling the family home and moving mom into a supportive environment. And each returned home disappointed and no further ahead than when they left. Mom’s home is not up for sale and there are no plans to put it on the market any time soon.

For executives and managers accustomed to being in charge, dealing with a long and complex set of issues associated with caring for an aging parent can be very frustrating.

Elder care defined

Elder care is complex, unpredictable and exhausting. It can take time, drain your energy and consume resources. It is often episodic, requiring minimal effort one day and intense effort the next. Elder care tends to become more complex over time. It can start simply with shopping, driving or snow shovelling and expand into intimate personal care.

Elder care is unforgiving and does not have a happy ending, unlike child care where the end of daily parenting means you get to stand back and watch your children grow into adulthood, independence and success. The end of elder care means loss and grief.

Parenting is more forgiving — if you miss dinner with your family to attend a meeting you can make it up the next day. But if you miss the last few days of your parent’s life — there is no way to ever make it up.

Elder care is also unpredictable. The doctors told us that my grandmother would not likely live more than a few days — ten weeks later she died peacefully with my mother and me at her side.

The toll it takes

Providing elder care is physically, emotionally and intellectually exhausting and it touches many people directly and indirectly. When I was unavailable this summer colleagues stepped in to take my place at the last minute, make presentations to hundreds of people, prepare reports, renegotiate deadlines with clients and postpone or cancel events. Their stress levels increased as they tried to both pick up my workload and provide me with personal and emotional support.

My clients experienced heightened stress as they had to adjust to the changes we were forced to make.

My immediate family had to drastically change vacation plans. My son moved back home to help manage the household, while my husband took care of our daughter and I moved in with my grandmother to provide her with the care she required and the help my mother needed.

Evolution of employer supported elder care

Over the past decade employers have changed their approach to elder care. Historically, employers provided some unpaid family or caring leaves, resource and referral programs (access to community services contact information) and limited counselling and consultation on managing elder care. But these quick-fix solutions fail to recognize the complexity of the issue.

There are two aspects to elder care: the internal and external. Internal is the physical, emotional, and spiritual side of the relationship.

The external is the logistical or management side of the relationship. This includes care-management issues such as housing and home supports, health care, home care, transportation, nutrition and so on, and financial management and legal issues such as power of attorney.

Personal and professional need for support

To address the internal aspects of elder care, employers must recognize elder care’s challenges. Employees need respect, understanding and support. They need workplace flexibility, the ability to adjust work hours and the option to leave the workforce temporarily with the option to easily return when they are ready.

Managers should be trained to effectively manage flexibility, redistribute workload and work assignments, and not consciously or sub-consciously penalize employees for missing work.

There’s a need for better counselling from employee assistance plans. A few sessions are often not enough to deal with the range of issues employees are dealing with. Employees should be given access to elder care networks, groups of people who are either providing elder care or have recently been through the experience. Meeting online or in person, these networks offer a source of support and help employees navigate the services systems and plan the next stages of elder care.

To address the external or logistical side of elder care, employees need time to manage a network of care providers or time to provide that care. They need help understanding that the few community services that exist (hospital care, home care, respite care) are often under enormous pressure and not always able to assist.

This summer I was able to purchase services from the community to enhance the care we were providing for my grandmother at home. However, despite being well connected to the community agencies and despite their efforts to find suitable staff, they were not able to fulfill our request. The agencies are facing the same labour squeeze and recruitment and retention challenges as the rest of the medical and community services communities. We were able to get help for two half days a week and one night a week, but we needed to provide care 24 hours a day seven days a week for almost 10 weeks.

When employees are successful in getting services, they may need help to pay for them. When we could get help for the overnight shift this summer, we paid $160 a night and $280 on holidays. Including elder care in a flexible spending account can help reduce an employee’s stress.

Elder care: A gift

I love my work and it has always been a very important part of my life. But as I held my grandmother’s hand, watching her breathe, or helping her sip a little water in the middle of the night, I seldom thought about work. When I did it was generally “work will be there tomorrow, my Gran may not be.”

My colleagues know how much I appreciate their help and support. My clients have forgiven me for not being available for a short period of time, events have been rescheduled for 2003 and family bonds have been strengthened.

My grandmother lived a long, healthy and happy life. Her grace, elegance and gentleness touched many lives. She taught me many things, including the value of family. We were able to fulfil her dying wish to live out her life, in her own home, with dignity, surrounded by family.

Nora Spinks, is president of Work-Life Harmony Enterprises, an organization providing international leadership in the work-life field. She is the founder of the Executive Work-Life Roundtable, a national forum for HR professionals interested in work-life and well-being. She can be reached at [email protected] or 1-800-965-2414.

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