A Reminder in Nature

My mother passed away on August 27, 2013. I had been with her all day, rarely leaving her side or hospital room. At about 6 PM, a good friend stopped by. My mother had lost consciousness earlier in the day, but I still spoke to her and told her I was going down to the chapel with the friend for a few minutes. I left her in the good company of one of her nieces and a long-time friend of hers.

I guess I just didn’t have any prayers left at that point, because we went instead to a peaceful garden outside the chapel and talked – about nothing. No ravaging illness, no impending death. Just normal friend talk for five or ten minutes. I even laughed. While we were sitting there, a brilliant red cardinal landed on this massive black stone fountain in front of us. At that moment, I knew I had to leave. When I stood up, my mother’s friend was racing through the chapel. They had been paging me on the hospital system. The cell phone that had been glued to my side and my nightstand for the past two years was upstairs in my purse. I had inexplicably forgotten to take it with me.

And while I was sitting on that garden bench, my mother passed away…

It took me a long time to forgive myself and to get over the guilt of not being with her when she died. I felt like I should have held her hand when she took her last breath, told her I loved her one last time, prayed for her at the end. Instead, I was downstairs laughing with a friend.

The reality is that a seasoned hospice care professional could have told me that this is quite common – that people in transition often need quiet and that they sometimes do better when their loved ones are not in the room. A counselor later said to me, “Lisa, maybe your mother knew you needed to be out of the room or maybe she just wanted that for you.” In other words, maybe that was her last act of care as my mother – to spare me from seeing her die. It’s a heartbreaking, but beautiful, notion, if true.

Later when I was going through her things, I found a porcelain cardinal figurine. I’m not sure what significance it held for her – something she chose or if it was a gift. I now keep it in my home office as a sort of reminder of her.

I moved into a new house that I had been building at the time she died. I was sitting in my living room in the middle of what we consider winter in Texas (grass turns brown, few leaves on the trees). The season aptly matched my grief. Suddenly, out of the corner of my eye, something flashed by my back window. Perching on one of the young wax myrtle bushes was a beautiful red cardinal. Although cardinals are native to this area, I had never attracted one to any home where I lived. I had never really been a “bird person” before or had just not paid attention. I watch birds now and feed his little family all year long.

I know there is a lot of lore out there about cardinals. For the record, I believe that my mother went to Heaven the second she took her last breath. I do not believe her spirit is lingering on this earth – in a bird or elsewhere. However, the little red bird (or succession of birds) in my backyard has given me such comfort over the years. I do not have children to remind me of her smile or mannerisms or to carry on her legacy, but I have this sweet little bird that watches over my backyard and occasionally reminds me of her.

It’s enough – for now.

“It took me years to be the woman my mother raised. It took me four years, seven months and three days to do it – without her. After I lost myself in the wilderness of grief, I found my own way out of the woods. And I didn’t know where I was going until I got there on the last day back…It was my life–like all lives, mysterious and irrevocable and sacred….How wild it was, to let it be.”

Cheryl Strayed, Wild

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What if You Could Put Your Caregiver Experience on a Resume?

I have yet to see someone list parenting or caregiving experience on a resume or LinkedIn profile, and there are valid reasons for that. Some of the topics those might open up in an interview could get into uncomfortable areas for a hiring manager who is trying to steer clear of asking a candidate about marriage, children, health issues, etc. in an interview. However, whether you are working full-time, part-time or have taken a voluntary or involuntary leave of absence to care for your loved one, you are likely developing skills that can be invaluable in the workplace. Even if you already have some of these responsibilities at work, the caregiver experience may have enhanced your abilities because you are performing in a different (healthcare) setting or at a higher level than you normally do at work.

If I had been able to highlight my caregiver experience on a resume, the following five skills or competencies are the ones that most resonated with me. I’m sure you can think of others.

1. Ability to make quick decisions with little information. If you are caring for someone with a serious illness, you have probably made at least one decision that had a life-or-death consequence. At some point, you lose the ability and luxury to do exhaustive research on diseases and procedures. You just have to go with the information at hand and do the best you can. Truthfully, this is what most executives do. They tamp down on their emotions, sift through as many facts as they have and make the best decision available. If they have to “pivot” after that, they do it quickly.

2. Ability to manage a 6-figure (or 7-figure) budget. In the corporate world, the budget generally gets replenished every year. In the caregiver world, that is not usually the case. If you coordinated insurance coverage, getting additional assistance through government or private programs and/or found other ways to legally preserve the assets of your loved one so that your loved one had quality care during his or her life, your asset management and organizational skills would be impressive to a company.

3. Ability to communicate within multiple layers of an organization. Caregivers come in contact with many different types of healthcare professionals and personalities. Showing that you can effectively communicate with everyone from the receptionist at your father’s primary care doctor to your wife’s cardio-thoracic surgeon demonstrates your ability to match your communicative style to the audience at hand. It may also indicate that you are polite (but firm) under pressure and come prepared to appointments or procedures. These are good qualities in a company as well.

4. Ability to speak concisely. I once had a colleague say, “Lisa, if you can’t say it in 12 words or less, it doesn’t need to be said!” He was joking, of course, but not really. In the corporate arena, as in the healthcare setting, there are times when the person you are speaking to simply does not want to hear the full back story of how you got from Point A to Point B. As you probably know, many healthcare professionals these days don’t have a lot of time to spend with their patients. You have to get to the point – quickly. If you have learned how to state a problem concisely and can ask appropriate follow-up questions, that is an invaluable skill in the business setting, too.

5. Ability to manage multiple workflows to achieve a common goal or objective. This is essentially project management. For a caregiver, it may mean managing home health workers, volunteers, communications to family and friends, coordinating appointments and procedures, cash flow, property (where your loved one lives), medication changes, procuring medical equipment, legal issues, etc. Similarly, an acquisition of a company would have legal, accounting, treasury, people and asset issues, just to name a few of the sections of an acquisition workplan. While caring for a loved one does not necessarily qualify you to handle a corporate acquisition, it does indicate your ability to organize and keep track of multiple details and people. Don’t hesitate to highlight that ability in your job.

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The melding of personal and professional lives in the workplace has been a consistent trend for most of the 2010s. Whether parenting or caregiving experiences will spill over into future resumes remains to be seen. As a hiring manager myself, I have had a few job candidates reveal that gaps in employment were related to caregiving. I was able to ask them about their experiences without getting into some of the off-limit areas for hiring mainly, I think, because of my own experience as a caregiver.

If you bring up caregiving (or it comes up) in an interview, I would encourage you to be prepared with the skills you might have used or learned during that time and how those skills would relate to the job for which you are applying. That should steer the conversation away from any areas that are not appropriate to discuss in a hiring situation (age, reproductive plans, health, marital status, etc.). If not, a good hiring manager will move the interview in another direction.

If you can think of other caregiving skills that transfer to the workplace, please share with your fellow caregivers in the comments section or send me a message. I’d love to hear your feedback.

How to Unscramble a Loved One’s Finances

While some people might relish the idea of spending someone else’s money, taking over the financial affairs of a loved one can be one of the most difficult caregiver responsibilities for a variety of reasons. If you find yourself suddenly faced with this duty, I’ve put together a few things to consider to help you get organized.

Are you authorized to act on your loved one’s behalf? If your loved one is not your spouse or minor child, you will likely need to be named in a Durable Power of Attorney for Finances. A Durable Power of Attorney is a legal document that details who and how your loved one wants to handle their financial affairs either when the document is signed or when a specific event occurs (e.g, the person becomes disabled, incapacitated or dies). If a power of attorney does not exist, a lawyer can guide you on how to best proceed. You will need a copy of this document if you do not already have one.

Identify and access bank accounts. If you loved one is able to tell you, identify all cash, investment and credit accounts. Contact these institutions as soon as possible so that you can access the accounts and review the statements.

Review account statements. When reviewing the statements, look for and make note of:

• EFT deductions (monthly bills) or transfers to other accounts
• EFT deposits such as interest, social security, pension
• Ending balances of accounts
• Due dates for monthly credit/loan payments and amounts
• Charges since your loved one was ill. Does someone else have access to the bank account or credit card?

Review mail. Review your loved one’s mail for bills not automatically drafted from their bank account. You may want to consider having their mail temporarily forwarded to yours or a trusted family member’s home or getting a P.O. box if someone is not able to collect the mail regularly.

Consider a budgeting app/software. If you have the time to set up and have gotten access to accounts online, using an app like Mint or Personal Capital, or a software such as Quicken may help you keep everything organized and available to provide tracking for your loved one and other family members who may be interested in monitoring your progress or the accounts.

Consider a bill paying service. Many banks already have a bill-paying feature; however, these services actually retrieve the bills for you. The two that looked most interesting were PayTrust ($10/mo) and MyCheckFree (free).

Consider delegating this responsibility. If you are able to delegate this responsibility to a trusted sibling or family member, it can considerably relieve you to focus on the other responsibilities on your caregiver to-do list. The two of you can then check in on a regular basis to keep each other informed of the financial circumstances, or the person you delegated to can meet directly with your loved one. As primary caregiver, however, you may be incurring expenses on behalf of your loved one or making decisions about current or future care, so knowing about the loved one’s financial position can be helpful.

Before you delegate this responsibility, you must have the legal right to do so. If you are uncertain, an attorney can provide the appropriate guidance. Some tips for delegating:

1. Choosing someone nice or responsible are not the main qualities for this job. The person needs to be organized, have integrity and be good with finances.
2. Ask for regular updates of the accounts and the supporting documentation (for example, statements, a balance sheet or income statement from their financial app). A person with an accounting or financial background (family member or otherwise) will not be offended by this request and will do so without prompting. If they are upset by your request, find someone else. Seriously!

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Your loved one’s financial affairs will never be something that can be set up and set aside, but you can do some relatively quick planning that will alleviate a little of the daily work and stress by reviewing accounts regularly and looking into setting up financial apps, bill paying services and perhaps enlisting the help of a trusted family member.

Even Caregivers Need a Break

When I saw this sign in my neighborhood, it reminded me a little bit of the caregiver journey. Monarch butterflies travel up to 3,000 miles to reach their summer or winter homes – and they only do it once. A tiny butterfly cannot travel that far without stopping to rest and refuel during such a long trip. As a caregiver, you may have, or are already experiencing, a long journey ahead. To maintain your physical, mental, and emotional health, it helps to plan periodic rest breaks along the way. What that looks like can take on different forms.

Acceptance

If you aren’t already dashing off a text to someone to help or scheduling a quick getaway, then you may be struggling with the idea of letting another person take over for you. I know I did. I had lots of reasons for staying “in the game.” Here are some possible concerns you may have:

• Guilt and/or Fear. Maybe you feel like this is your responsibility, and, to delegate your caregiving responsibilities to someone else, even for an hour, would be wrong. Your visits may elevate your loved one’s mood or improve his or her vital signs. There could also be the fear that something could happen while someone else is there (a medication mistake, a fall or even death), and it would have occurred because you chose not to be, or were not, there.
• Fatigue. You would like to take a break, but you are too tired to find resources or to ask for help. It is true that our brains do not work as well when we are tired or exhausted. In this case, you seem to be fighting a vicious cycle of needing rest to find someone to help you get rest.
• Isolation. If this is a long-term illness, your friends’ and family’s eagerness to help may have lessened with time or you may have lost touch. A long absence may make it seem difficult to suddenly approach them for assistance.
• Needing to be in control. This was one of mine. There were so many things beyond my control, I just wanted to hold onto the things I could manage. Looking back now, I realize I overlooked some prime opportunities to allow others to help and to give myself a break.
• Lack of Boundaries. Some loved ones can be overly demanding – even in ill health. If you are not sure about what your limits are, a persistent loved one can take over a good part of your life for you.
• Lack of Resources. Resources could include financial, community or medical.

The Case for Scheduling Breaks

Caregiver burnout is a state of physical, emotional and mental exhaustion. It may be accompanied by a change in attitude, from positive and caring to negative and unconcerned. Burnout can occur when caregivers don’t get the help they need, or if they try to do more than they are able, physically or financially.

The Cleveland Clinic

Caregivers are amazing creatures, but we are not invincible. Caregiver burnout is real and manifests itself with mental, emotional and physical symptoms, such as depression, irritability or getting sick more often.

I recently read an article where a woman, who was caring for her mother, said she hated it when people told her to take care of herself so she could be there for her mother. Perhaps what she needed most was someone to offer to help.

A Simple Exercise

I believe most people genuinely want to help, but often don’t know what to do or don’t want to impose. Here is a simple exercise to get you started to connect sincere “helpers” with you as the caregiver.

Take a sheet of paper or a blank page on your computer or notes app on your phone. Title it, “Ways Friends/Family Can Help.” Begin listing tasks or treats that could help you. Here are some ideas to get you started:

• Bring a meal for the freezer
• Drive Mom to physical therapy on Tuesdays (or one Tuesday)
• Purchase a bag of sugar-free candy for Dad
• Invite child for an outing or sleepover
• Take/pick up dry cleaning
• Wrap birthday/holiday present(s)
• Bring snack or drink and sit with me for 30 minutes
• Call me every Wednesday for 10-15 minutes
• Check loved one’s house to ensure it is secure and looks lived-in
• Take pet(s) for annual exams

Keep this list with you (on your phone, in your purse, in your car). The next time someone offers to help, briefly scan the list and see if there is something you would be willing to let them do – or let them choose an item on the list.

Future posts will discuss apps for organizing friends and family helpers as well as developing a respite care plan and finding respite care resources. Until then, if you need additional ideas for your Helper List above, the Alzheimer’s Association has a really good list of ways to support caregivers that might help you along.

A Free App for Caregivers – Caring Village

In 1996, Hillary Clinton published a book called, It Takes a Village: And Other Lessons Children Teach Us. If you were alive then, you know that the book was about how it takes an entire community to raise children, not just the parents or grandparents, guardians, teachers, caregivers, etc. I would also argue that it takes a village to manage a chronic or serious illness. While the primary responsibilities seem to fall on one person, the journey wasn’t meant to be traveled alone. It includes doctors, nurses, aides, therapists of all kinds, family members, friends, clergy and many others you may never meet.

Technological advances give caregivers options to communicate and coordinate with family and friends about care needs. Although there really doesn’t appear to be a one-size-fits-all app out there, in the coming months, I’ll profile several that you can use in tandem or alone to fit your needs.

The first app I wanted to mention is Caring Village. It is free and available for both Apple and Android phones. It also has an online dashboard if you prefer working from a computer.

The application allows you to set up a community, or “village,” for your loved one that includes calendars, to-do lists, a journal, a medication list, a secure messaging feature and a place for documents. As the administrator, you can assign different roles for people you allow to join, which determines their level of access to the information.

Here are some things I thought that were interesting about the app:

• Members – Members can add a photo to their profile, so you know who they are. You may not know what your father’s colleague at work looks like. The first time he offers to drive him to the doctor, you can take a quick pic or ask him to upload his photo.
• Wellness Journal – The journal section allows you or others to add a few notes each day (or whenever) about how your loved one is doing. It also allows photographs. When your loved one’s health changes constantly, the journal could be a helpful tool to keep things accurate.
• Medication List – The list would be especially useful when medications are changing or your loved one moves between care facilities. You need to keep track of inventory and expiration dates. Photos are allowed here as well.
• Calendar and To Do Lists. The calendar is nice for the “village” to know of upcoming doctor appointments or procedures or if volunteer items are needed. The To Do Lists have reminder alerts for you and can be delegated to others (ask for a volunteer) for assistance.

Before using the app, you should consider overall how you intend to use the dashboard/app. Even with the most restricted level of membership (“Friends”), there is a great deal of access to the app’s information. For example, if you plan to load sensitive documents to the site (e.g., doctor’s notes from a recent appointment, Durable Power of Attorney, etc.), you may not want a neighbor who offered to drive your husband to the pharmacy to see that information. You either have to choose not to use the document feature or restrict who becomes a member. There is helpful chart in the Help Center about Role Access.

Have you used the Caring Village app? If so, what was your experience?

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Caring Village, LLC does not sponsor You Don’t Have to Join the Circus and was not aware of this post prior to today.