SA/NT Spring 2021 by Australian Carers Guide

A MUST HAVE SURVIVAL GUIDE FOR TODAY’S FAMILY CARERS SPRING 2021 | Issue 1 SA/NT

A New Age

Aged Care

RADICAL changes coming and how they affect you

Learn how to on

SAVE

Aged Care

DEMENTIA V ALZHEIMER’S DISEASE

ways to provide

better

ISSN 2652-8282

9 772652 828004 >

care

REDUCING ANXIETY

Expert advice to help you feel calm straight away

TIME OU Puzzles, Brain Games, Reader Stories, Word Games, Riddles, Quizzes

Maree McCabe AM explains what the differences are and what behaviours to look out for

Rachel Lane explains how residential living costs work and how you can make significant savings

& More

I’m not a

CARER!

We offer a new perspective that allows carers to accept society’s label as a carer & reap the benefits

SHOWCASING A FULL RANGE OF QUALITY AGED CARE AND HOME CARE PROVIDERS australiancarersguide.com.au

Our OurServices Services ✓ Home ✓ Home HelpHelp

✓ Respite ✓ Respite CareCare

✓ Companionship ✓ Companionship

✓ Personal ✓ Personal CareCare

✓ 24 ✓ Hour 24 Hour CareCare

✓ Transport ✓ Transport

✓ Palliative ✓ Palliative CareCare

✓ Dementia ✓ Dementia CareCare

✓ Care ✓ Care Management Management ✓ Hospital ✓ Hospital to Home to Home

SUPPORTING SENIORS TO LIVE INDEPENDENTLY AT HOME WITH

Confidence gG

over

nmen tS u

e idis

Delive rin

HOME CARE PACKAGES

Ask us about government funded in-home care

nmen tS u

Delive rin

e idis

funded in-home care

over

HOME CARE PACKAGES

• Ask us about government

Call 1300 008 018 | HomeInstead.com.au Each Home Instead® franchise is independently owned and operated. ©M&S Warner 2021.

PAUL KOURY – PUBLISHER

This Issue’s Contributors Rachel Lane Principal - Aged Care Gurus and Co Author of Aged Care, Who Cares

Maree McCabe AM Chief Executive Officer Dementia Australia

Dr Mark Frankel Founder/CEO of TakingCare Inc.

Mary Bart Chair of Caregiving Matters

Caroline Tapp-McDougall Author The Complete Guide for Family Caregivers

Paul Koury Founder - Publisher Australian Carers Guide

Rick Lauber Published author and freelance writer The Successful Cares Guide (Self-Counsel Press)

Michael Clohesy Wills and Estates at Gathered Here National Head of Legal Services

Raelene Wilding Associate Professor of Sociology at La Trobe University

publisher s message H

ello and welcome to the first edition of the Australian Carers Guide. We have created this guide specifically for our 2.7 million primary carers who are currently caring for their aging parent, spouse or an elderly loved one. We know that being a primary carer today in Australia’s busy and complex world is by no means easy. All too often, your needs are being overshadowed by the needs of the person you are caring for. Most of the helpful information that’s available, is geared towards the elderly and frail, but very little, if any, focuses directly on the carer’s needs and wellbeing. The arrival of the Australian Carers Guide has now changed that. We focus on you. We are your cheerleaders and commit to delivering content that speaks to your physical, financial, mental, spiritual, and emotional wellbeing. Having all been carers ourselves, we understand the issues that you will most likely confront and therefore commit to always delivering helpful and practical content to you. Our collaboration with the majority of states from within Carers Australia means that we can introduce

Australian Carers Guide | SPRING 2021

you to helpful resources and services they provide, including the Carers Gateway network. We are very proud of our range of professional and experienced contributors who offer you unique insights, positive perspectives, and creative solutions to the most common issues you face. This includes practical howtos, proven strategies, and expert advice, all intentionally designed to make a real difference in your daily lives.

Whether you’re new to caring or have been providing care for many years, you will find something meaningful, valuable, and entertaining in every edition. In this edition, we feature articles such as “I’m not a carer” and address the issue of why some carers don’t see themselves as carers.

“

Whether you’re new to caring or have been providing care for many years, you will find something interesting, meaningful, and entertaining in every edition.

”

We also explain the radical changes being made to the Aged Care Sector and why the $17.7 billion announced in this year’s federal budget will trigger a new age in Aged Care and how it will affect you. Other helpful articles include “Self-Care is not Selfish”, about empowering carers to prioritise their wellbeing without any guilt. Learn how to “Manage your Emotions before they Manage you”. Rachel Lane from Aged Care Gurus explains “How to Save on Aged Care”. Maree McCabe from Dementia Australia explains the difference between Dementia and Alzheimer’s disease and how to spot the difference. Our regular sections include Technology, Finance,

When you need to take some time out, we have specially created a Time Out section towards the back of the guide where you’ll find a special place full of fun things for you to do. We have put together fun Puzzles, Brain games, Word Searches, Crosswords, and much more, for your enjoyment. Don’t worry, we also provide solutions for everything on offer here. We ensure providers in our guide are reputable, have a demonstrated record of excellence and do genuinely care for you and your elderly loved ones. Primary carers are the ones who most often make the longterm care decisions for their elderly, so we pride ourselves on being able to Connect carers with providers that Care.

ISSUE 1 Spring 2021

Also be sure to visit our website which contains further practical resources, including videos, podcasts, and other carer stories for you to enjoy. The Australian Carers Guide is produced four times per year in Print, Digital and Online formats. We had a lot of fun putting this edition together for you and hope you enjoy reading it. Paul Koury – Publisher Publisher@acguide.com.au

Law and Estate Planning, Personal Stories, Meals that Heal, Expert Advice, Your Feedback, QnA and Editor’s Choice where wonderful carer groups list themselves and welcome all carers to

JOIN US ONLINE Please be part of our community and stay in touch with us on Facebook. australiancarersguide.com.au facebook.com/Australiancarersguide

join, especially those who feel isolated and alone.

General Enquiries: info@acguide.com.au

Free Call: 1300 717 515 SPRING 2021 | Australian Carers Guide

Caring for someone with a Home Care Package? By choosing to self-manage, they can join the many thousands of older Aussies using the Mable website to connect directly with independent support workers. With Mable, they’ll be able to:

Choose their independent support workers

so they’ll always know who’s coming into their home.

Choose which services they need

from the wide range people offer through the website.

Choose when they receive those services so they can fit support around their schedule.

Choose with confidence

knowing all workers have the relevant Police and reference checks. Better still, they could get up to double the hours of care by self-managing.

Scan the QR code to find out more, or visit mable.com.au

Featured Contents 13

A NEW AGE IN AGED CARE

We explain the Royal Commission’s recommendations, the Fed’s $17.7 billion response and how it affects you. BY PAUL KOURY

I’M NOT A CARER

Recognising we have internal and external identities, helps carers to accept both. BY PAUL KOURY AND RAELENE WILDING

DEMENTIA V ALZHEIMER’S DISEASE

SELF-CARE IS NOT SELFISH

LEARN HOW TO SAVE ON AGED CARE

MANAGING YOUR EMOTIONS

SELF-MANAGED HOME CARE PACKAGES

ADVOCATING FOR YOUR LOVED ONE

10 WAYS TO PROVIDE BETTER CARE

CEO Maree McCabe AM explains the difference and what behaviours to look out for. Without the oxygen mask on yourself ‘first’ you will be unable to provide quality care to your loved one. And yes, it’s guilt free. Rachel Lane explains how residential costs work and how you can make significant savings.

It’s not what you’re eating but what’s eating you. Suppressed toxic emotions affect well-being. We show you how to live by values, not your feelings or emotions. We explain what Self-Managed Home Care Packages are and their benefits.

Tips and advice on what you need to know. We unpack the best practices and those to avoid in the role of a carer.

ABOUT AUSTRALIAN CARERS GUIDE Australian Carers Guide is a must-have survival guide for today’s family carer. Our guide is packed full of useful, practical, and entertaining information all geared toward the carer and their well-being. Until now, there has never been anything available in the mainstream market specifically for our 2.7 million family carers. We would love your feedback and ideas for articles you would like to read in our upcoming issues. Please send us your feed back and ideas to.

Publication Mail Sales Product Agreement No. 72365477 Australian Carers Guide is published by PAK Allied Media on a quarterly basis. All rights reserved. Contents may not be reproduced without written permission of the publisher. Printed in Australia.

Editor@acguide.com.au SPRING 2021 | Australian Carers Guide

Regular Contents 10

Production Assistant KRISTY HATTON production@acguide.com.au Graphic Designer VIVIEN TIMMERS vtmmrs@gmail.com Creative/Branding Director Georgina Pettifer Wild Wolf Designs Distribution/Circulation Vicki Day GORDAN & GOTCH Pty Ltd Publication Office PAK Allied Media 13 Elm Street Suite 3, Bayswater Victoria 3153 Tel: 1300 717 515 info@acguide.com.au

An area where you will find useful tips, wise advice and helpful updates.

YOUR FEEDBACK

PERSONAL STORIES

MENTAL HEALTH - REDUCING ANXIETY

Sub Editor JULIE SPICE julie@acguide.com.au Advertising Sales NATHAN ANDERSON nathan@acguide.com.au

THE SCOOP

Publisher PAUL KOURY paul@acguide.com.au

Departments A place where you can interact and share your thoughts with us.

Peek into the lives of other carers and discover how they are managing their personal life and caring role.

Steps you can take to help begin reducing your anxiety levels straight away.

TECHNOLOGY We look inside the wonder filled world of VR Virtual Reality and explain why Aged Care facilities are embracing it. BY COLIN PUDSEY

RECIPES We offer you a variety of ‘Meals that Heal’ that are quick to make and good for your body. BY KARA O’ROUKE

TIME-OUT This section has 6 pages full of crossword puzzles, games and quizzes to enjoy. BY WILL RICHARDSON

102

EXPERT ADVICE

103

QnA

104

EDITOR’S CHOICE

We offer a variety of advice from protecting yourself from scammers to infusion therapy and everything in between. Ask us whatever is on your mind and we will answer you or get one of our resident experts to. We review Facebook Community groups, Books, Apps and other helpful products.

SPRING 2021 | Australian Carers Guide

Scoop

THE

TIPS, WISE ADVICE AND HELPFUL UPDATES

Mediterranean DIET 101

Based on traditional food from countries like Greece and Italy, this diet is considered as an option for weight loss and to help prevent heart attacks, stroke and type 2 diabetes. Here are the basics:

MIND FULL OR MINDFUL We can’t control what thoughts come into our minds, but we can control how long they stay. 1. Be aware – Try and be conscious and alert when a heavy thought has popped into your mind. 2. The only way to remove it is to replace it by thinking about a more pleasant and positive thought. 3. When your mind is full of the cares of the day, replace it by being or mindful of your beautiful surrounding and grateful for them. 4. If the heavy thought returns, repeat the process. 5. As you train your brain, it becomes easier. You can’t hold 2 thoughts at the same time.

Photos: CanStock

HOW TO COMFORT SOMEONE EXPERIENCING deep grief

The ministry of presence 1. The deeper the pain, the fewer the words. 2. Show up and shut up. 3. Remain close and silent. 4. Just knowing they are not alone is healing. 5. They just need skin.

10 Australian Carers Guide | SPRING 2021

✔ Eat dairy in moderation. ✔ Rarely eat red meat. ✔ Avoid processed foods and added sugars. ✔ Fill up on veggies, fruits, nuts, seafood, whole grains and seeds.

Experts suggest having a glass a day of red wine and making water your go-to beverage. Sounds fabulous!

SKIP the

Shingles

With one in three people experiencing shingles in their lifetime (known as chickenpox when you’re a kid), it’s important to recognize the risk of re-activation of the varicella zoster virus in later life. If you’re up-to-date on vaccines, related complications such as skin infections, nerve pain, vision loss and even neurological complications can be avoided. Ask your health provider for more information.

Beat BRAIN FOG

SMILE Not only is smiling contagious, but it’s been proven to A) Improve your mood B) Relieve stress C) Boost your immune system

LISTENING Ever thought why we have 2 ears and only 1 mouth? I think it nature’s way of letting us know we should listen twice as much as we speak. When you choose to stop what you’re doing and listen to another person, it unconsciously says that you value them at that moment more than anything or any task. In today’s fast paced world, taking the time to stop and listen to someone is one of the most important gifts you can give. It also pays to remember, that if you’re too busy to stop and listen to people,don’tbesurprisedifyoufindyourself surrounded by people who have nothing to say.

I WANT TO GO home

When an adult asks to leave an assisted living residence, stay calm and approach them in a relaxed manner.

1. Avoid reasoning and explanation. 2. Redirect their attention by starting a shared activity . 3. Look out the window together. 4. Discuss memories of home. 5. Provide a gesture of comfort, like hugging or stroking their arm.

THE SCIENCE OF crying

We cry at sad movies, at weddings, and we cry when we stub our toes. Happy tears and sad tears are basically the same. In case you were wondering it’s all because tears contain a natural pain killer which reduces the pain and improves your mood. It’s actually an endorphin, which is why you tend to feel better after a good a cry. Photos: CanStock

These tried-and-true memory boosters can help you remember more. Concentrate: Studies show that it takes at least eight seconds for information to move from your short-to long-term memory. Use crazy fonts: The harder to read, the better. When something is unfamiliar and difficult to read, you exert more effort and thereby remember more. Chew gum: Studies have shown that the act of chewing seems to keep people more focused and improves their concentration. Visualise: Associate a picture with whatever it is you’d like to remember.

SPRING 2021 | Australian Carers Guide 11

YOUR FEEDBACK

We’ve got mail Hello fellow carers, Our mail section is for you to write to us and share your experiences or comment on our articles. We welcome your feedback and comments. If you have your own personal story that you think our readers will enjoy, then please send them to us at editor@acguide.com.au or for the traditional, send to: Australian Carers Guide, P O Box 6155 Wantirna , 3152. You may remain anonymous if you wish. We look forward to hearing from you. MUM’S APPOINTMENTS

LOST AND FOUND

OLD FLAME

My parent‘s family doctor calls me regularly to check on them. It’s wonderful and also much more convenient. Is this something I can request from specialists as well?

When my husband died, I decided to try to reconnect with some of my old girl friends that I’d lost track of. Glory be, we still had many of the same things in common that we did years ago. One lives close by so it‘s easy to get together, but with the others I’m hoping to get together for a weekend this summer (or when COVID-19 social distancing is over). Once a friend, always a friend.

I ran into an old lover a couple of months ago. We are both footloose and fancy-free after raising kids and getting divorced. We’ve rekindled our relationship and although our kids are quite concerned, Sally and I are hoping to make a go of a new life together. Yes, we’re talking to our lawyers and financial advisors. Never fear.

Sometimes it takes me almost a day to get to their house, back and forth to the hospital ana then back to my house when waiting times are factored in. Rosie Osman, QLD

Tracey Hamilton, VIC

Rubin Kelowna, NSW Editor’s Note: Thanks for sharing. These are both lovely stories that give the rest of us hope, advice and even some good ideas.

TIPS When you or a family member is recovering from, or living with an illness, conserving precious energy is a serious matter. Here are some tactics recommended by occupational therapists to make day-to-day activities more manageable: Leave your most used items out or store them at waist level rather than putting them away. Prioritise the most important activities. Be ready to let some things go and ask for help to share the load.

Use tricks such as wearing a bathrobe instead of towel- drying. Or, let dishes air dry on the kitchen counter. 12 Australian Carers Guide | SPRING 2021

Photos: CanStock

Pace yourself by taking regular breaks. This will help you to balance your energy levels and complete the whole task.

A New Age in Aged Care WHAT YOU NEED

TO KNOW

don’t think anyone would disagree that our Aged Care Sector has received an incredible amount of media attention over the last 18 months. There have been many reasons for this, the first being the devastating Coronavirus (Covid-19) pandemic which swept through our residential aged care facilities in March 2020. This unexpected virus caused serious illness and over 685 deaths in our elderly communities.

The commission said that the “Aged care system fails to meet the needs of its older, vulnerable, citizens. It does not deliver uniformly safe and quality care, is unkind and uncaring towards older people and, in too many instances, it neglects them.”

Photos: CanStock

Then, if that wasn’t bad enough, the Royal Commission into Aged Care Quality and Safety* released their final report from the 2018 enquiry into the quality of aged care in Australia.

SPRING 2021 | Australian Carers Guide 13

AGED CARE $6.5

$630.2

$798.3

for 80,000 Home

to connect people living in regional areas with aged care services

to support informal

billion

Care packages

to support older Australians staying at home for longer

million

and family carers looking after senior Australians

$10

per day

Photos: CanStock

per resident for aged care providers to provide better care, as part of a $3.2 billion support package

It didn’t take too much to convince the Australian public of the failure in the aged care system as these failures made it to the news on television almost nightly and were covered extensively on other media channels. As the effects of the pandemic on our older Australians began to emerge, revelations began to surface of the abuse and mistreatment of some of our most vulnerable elderly citizens. Who can forget the images taken from within aged care facilities of residents whose sanitation had been neglected for days? We even saw footage of nursing staff physically abusing residents in their own rooms.

14 Australian Carers Guide | SPRING 2021

Of course, there were many facilities still taking wonderful care of their elderly residents and as usual, those providers are commended. The discovery that some of our residential aged care facilities and home care providers were treating our most vulnerable citizens in unacceptable ways compelled the Honourable Tony Pagone QC (Chair of the Royal Commission) and Ms Lynelle Briggs to take a deep dive into the reasons why our Aged Care system had deteriorated to the point of crisis and go completely unnoticed.

Over the last three years, the Royal Commission waded through more than 10,500 submissions and 600 witnesses to confirm the deterioration of the aged care system. In February 2021, the “Final Report Care Dignity Respect” was released by the Royal Commission and tabled in parliament. The paper was designed to usher in a “New Aged in Aged Care” with the focus shifting to the individual needs and preferences of the elderly in aged care. The report called for a new system underpinned by a rights-based Act with aged care funding based on need, in conjunction with stronger regulation and transparency of the system. This was the beginning of what was to trigger a major overhaul of our Aged Care system which was long overdue. In May 2021, at the same time the Royal Commission’s recommendations were announced, all eyes were on the Federal Government’s response which came via the Federal Budget. A massive funding budget of $17.7 was announced for aged care with a five-year, “five-pillar plan.” The plan detailed how the funding billions would be spent to address 126 of the 148 commission’s recommendations which were accepted. All but six of them were subject to further consideration. The 17.7 billion will be spent over the next four years to address the 126 recommendations. While the record funding was welcomed, some industry players say it is cash being thrown around to bolster the current system rather than genuine, structural aged-care reform which only time will tell.

LET’S BREAKDOWN WHAT THIS FUNDING MEANS TO YOU AND YOUR ELDERLY LOVED ONE: $6.5 billion will be spent funding an additional, 80,000 home care packages over the next two years, which are well needed and will assist loved ones to stay independent longer.

$798 million will be spent in funding support to 1.6 million informal carers. This will enable carers to access and equip them with the services and support they need. There will be more targeted support for carers looking after people with dementia. $3.9 billion will go towards increasing the amount of care received by residents of aged care homes. The mandate means that each resident will receive 200 minutes of direct care per day, including 40 minutes with a registered nurse. $102 million has been assigned to residential aged care places directly to senior Australians, instead of residential aged care homes. $200 million for a star rating system to better inform seniors and their families about quality of care provided by residential aged care places. $652 million investment will made into the aged care workforce, to increase the number of personal care workers and an increase to the number of training places for them. $698 million is being provided towards governance of the aged care industry to ensure improved care outcomes and a newvalues based Aged Care Act. By 2024, the aim is to have a new Aged Care Act in place to replace the untouched 1997 act. It may have taken us 24 years to arrive at this point, but the good news for carers and their elderly loved ones, is that Aged Care repair is on the way. For primary carers this means: An increase in support for informal and family carers especially for those caring for people living with dementia. The aim is to reduce carer stress and improve carer wellbeing by funding more flexible and centre-based respite places. Funding will also be given to support people living with dementia to remain at home and provide more help with the management of treatment and care and medication management. Carers will benefit from increased support and education to improve the quality of life for both the person they are caring for and for themselves. The budget will also be funding early access to Carer’s Gateway to help carers get support through counselling, coaching, peer support and skills training. SPRING 2021 | Australian Carers Guide 15

RESULTS OF THE COMMISSION AND THE ALLOCATED FUNDING THE FIVE PILLARS 1 Home care – Supporting older Australians who chose to remain in their own home 2 Residential aged care services and sustainability – Improving and simplifying residential aged care services and access to those services 3 Residential aged care quality and safety – Improving the quality and safety in residential aged care 4 Workforce – Supporting and growing a better skilled aged care workforce 5 Governance – New legislation and stronger workforce

Improved Aged Care AUSTRALIA NEEDS A RIGHTS-BASED AGED CARE SYSTEM Practically, this would mean that the number of people in the system would no longer be capped, and the long waiting lists for care would disappear over time. Now all older Australians in need of support would be independently assessed, and allocated care according to their personal needs and preferences, whether at home or in residential aged care. This is a huge step forward and, with the right support, would enable older Australians more choice and control over their care.

IMPROVED WORKFORCE CONDITIONS AND CAPABILITY Residential care facilities would need to ensure minimum staff time with residents. By July 1, 2022, this would be at least 200 minutes per resident per day for the average resident, with at least 40 minutes of that time with a registered nurse.

Photos: CanStock

It also calls for a new national registration scheme for all personal care workers, who would be required to have a minimum Certificate III training.

16 Australian Carers Guide | SPRING 2021

The proposed new funding model would provide universal funding for care services, such as nursing. This means there would be no requirement for aged care

recipients to pay a co-contribution, like public patients in public hospitals. Instead, the expectation is people pay for their ordinary costs of living, such as cleaning, subject to a means test and up to a maximum amount in residential care. These changes would coincide with the phase-out of the burdensome refundable accommodation deposits, which some residents currently pay as a lump sum to providers when they enter residential care. This approach is a shift away from the current muddled set of means-tested arrangements, and may help offset some of the additional spending needed to pay for a rights-based system.

Governance In essence, what this means is that there will be people whose sole responsibility is to monitor our aged Care system making sure the horrible treatment of our elderly loved ones never happens again. This involves ensuring that every elderly in our Aged Care system is treated with Care Dignity and Respect. This will happen by establishing a new Governance and Advisory structures, including a National Aged Care Advisory Council and a Council of Elders.

A better system will cost more The proposed new funding model would provide universal funding for care services, such as nursing. This means there would be no requirement for aged care recipients to pay a co-contribution, like public patients in public hospitals. Instead, the expectation is people pay for their ordinary costs of living, such as cleaning, subject to a means test and up to a maximum amount in residential care. These changes would coincide with the phase-out of the burdensome refundable accommodation deposits, which some residents currently pay as a lump sum to providers when they enter residential care. This approach is a shift away from the current muddled set of means-tested arrangements, and may help offset some of the additional spending needed. to pay for a rights-based system

CONCLUSION

Photos: CanStock

Caring longer. One of the main reasons we created the Australian Carers Guide was to assist the growing number of primary carers, who may find themselves needing to provide care for their elderly loved ones. Make sure you get every edition to keep up with the latest changes to our Aged Care sector and informed on how the changes will affect you. ACG

*A Royal Commission is an independent investigation process which has tremendous power to access information including private documentation or witnesses. However, it can only deliver it’s finding to the government and make appropriate recommendations. SPRING 2021 | Australian Carers Guide 17

amily caring

2.7 million

In Australia today, there are around

ST AT

the

family carers

looking after someone with a disability, medical condition, mental illness, or frailty due to age. ABS:2018

I’m not a

carer Photos: CanStock

BY PAUL KOURY AND RAELENE WILDING

18 Australian Carers Guide | SPRING 2021

n Australia today, there are around 2.7 million people looking after a family member with a disability, medical condition, mental illness, or frailty due to age. Most do not see themselves as carers. Instead, they think of themselves as children, parents, partners, relatives or friends who are caring for someone close to them. Those with a more sensitive nature can even feel insulted at the thought of someone trying to label them as a carer. Why would it matter if people identify as carers or not?

It matters because carers have specific needs. It matters because the staggering number of people who do not see themselves as carers do not realise that as carers they can access a wide range of supports and resources. Taking on the label of carer is a proactive choice. It is about being open to the available resources. It is about being empowered to access and use the supports available to them. CARE IN THE PAST Before the Aged Care sector existed, people relied on their families and communities for all of their care needs. The need to care for others was an unquestioned duty and an obligation. Family households would often have multiple generations living together and caring for each other. Women took on most of this unpaid work. As good women, they were expected to care for children, the elderly, and people who were sick or disabled. This expectation was deeply embedded in their sense of self as good and moral people. They were assumed to provide care from a sense of gratitude, love and respect for their families, neighbours and friends. In the past, it would never have entered anyone’s mind to label themselves as a carer. Governments didn’t provide social

support because it was assumed that there was no need. Women were expected to perform their ‘natural’ role and provide any care that was needed, with occasional contributions from some men and children in exceptional circumstances. There was no need or reason to count or categorise people Why would it as carers. matter if people identify as carers WE LIVE IN or not?

DIFFERENT TIMES

The world today, however, looks very different. We are less likely to live in extended family households. More commonly, we live in nuclear families. In fact, most people have siblings, parents and children who are living and working far from us, including interstate or overseas. Perhaps more importantly, women can now access education and employment. While this has helped everyone to live a much more independent life, it has also created a so-called ‘care crisis’. While women now participate more often in paid work, we are not seeing an equal shift in the number of men taking on family care responsibilities. Indeed, both men and women struggle to balance paid work and care, because most workplaces don’t make it easy to maintain this balance. Employers expect their workers to be available at all times. This is not a good match with the life and work of a carer, who also needs to give care around the clock. Sometimes, it seems that a person has to decide whether to be a paid worker or to give care to their loved ones – it is difficult to be both at the same time. When we make that difficult decision to reduce our hours of paid work, or give up paid work altogether, we tell ourselves that this is so we can ‘spend more time’ with our loved ones, be a good husband or wife, be a good parent, or be a good son or daughter. We don’t tell ourselves that we are giving up paid work to become a carer. SPRING 2021 | Australian Carers Guide 19

However, the carer label is actually quite Some carers might feel that accepting the label of carer is a symbol that they are giving helpful. By identifying as a carer, we can find other people in similar situations as our own up, or selling out. They might feel that a carer is different to a family member, that the label – other carers. This allows carers to become diminishes or denies their heart-felt desire to more visible and share with other carers the care from a position of love and honour. This tips and tricks that they use to navigate can place a carer in a very awkward their lives. It also allows carers to and uncomfortable position. be counted and to become a Accepting stronger collective voice. By identifying as a carer in surveys What has helped many people that we all and the Census, it is possible alter their thinking is a very have an internal effective mind shift. It is to tell the government and other organisations just how possible to accept the external identity and label of carer, while also many carers there are in external identity retaining our internal label of the country. This can help to husband, wife, son, daughter draw attention to the needs is the key that and so on. What is needed is of carers, which might then removes the for carers to accept that they lead to more resources to can have both external and struggle. support carers. internal identities, and that these can coexist in harmony. It is possible Unfortunately, many people refuse to accept an external identity as a carer, to take on the label of carer. Many whilst still retaining the most important strategies have been used to try and help internal identity, with heartfelt motives intact. children, parents, partners, relatives, or friends who care for someone to identify as a carer, but with very little success. Perhaps this is because the carer role is seen as less valuable or valid. After all, our society rewards the things we value with money, and carers are often unpaid or underpaid. Perhaps it is also because we don’t see ourselves as carers. We often prefer to call ourselves by other labels – worker, husband, wife, son, daughter, sibling, friend.

Accepting that we all have both an internal identity and external identities is the key to removing the struggle that many carers have in seeing themselves as either a loving family member or a carer. Once understood, this agility of thought towards identity removes any resistance to the carer label. It could be the mindset carers need to be able to embrace their identity as a carer.

SO WHY DON’T CARERS JUST ACCEPT THE LABEL?

WHAT DOES IT MEAN TO HAVE MULTIPLE IDENTITIES?

Whilst remaining sensitive to the complex dynamics of caring, identifying as a carer is important. It in no way diminishes the relationship between those being cared for and those providing care. But, identifying as a carer is a key factor in opening doors to a plethora of resources. It helps people to access practical, emotional and financial support for themselves and those they care for; the cared. By not accepting the label of carer, we are missing out on opportunities to be better carers, and better friends and family members to those we care for.

We like to think that we have one true identity, one true sense of self. However, this is not entirely true. Sociologist Dr Raelene Wilding, from La Trobe University, explains that our identities are actually made up of two key parts. “The truth is, our identities are made up of two parts. One is that inner sense of who we are, that sense of a core truth about ourselves. The other part is the many external categories and roles that our society uses to define us. Our identity is actually somewhere between these two parts – our identity is both of these, and neither of these, at the same time”.

20 Australian Carers Guide | SPRING 2021

For Dr Wilding, the carer is one of those external categories or labels that our society provides, to help organise the social world and share out resources. “Nobody is ever just a carer”, she explains. “Taking on the label of carer can be useful as one of our external identity categories or roles. When we take on this role or this label, we are letting governments and other organisations know that we might have specific needs, or we might benefit from particular types of help that are typically useful for carers and available to carers”.

Dr Wilding adds that “This external part of our identity is visible in the shared social and cultural labels that we use to navigate our lives. They can have both advantages and disadvantages. On the plus side, carrying these labels means we don’t have to ask everything about another person every time we meet them. This is because we use these labels to attribute certain expectations to everyone we meet. On the minus side, this can mean that we can bring assumptions to our encounters and our interactions with other people that are not always correct. Once we are aware of this, we can start to embrace the parts of the label that work for us, that we accept as part of our inner sense of self and reject the parts that don’t work for us. We can be clearer with others about the assumptions they can and can’t make about us”.

CONCLUSION With acknowledgement of this understanding, we hope you come to know and embrace the many institutions, both public and private, offering help for carers in Australia. You just have to reach out and say, ‘yes, I’m a carer’, then welcome and receive all the resources and support made available to you. A good place to start is by contacting the Carers Association in your state or call Carers Gateway on 1800 422 737. The reality is, if you, the carer, are better resourced and supported, it will always filter through to better support and care for the ones you care for. Everyone wins. Our magazine is committed to delivering carers with unique insights, practical solutions, and helpful perspectives. We also aim to provide fresh and valuable information designed to make a real difference in your daily lives. Not only are we your new cheerleaders dedicated to help support, encourage and enhance your role, we are also committed to disseminating information about fantastic services that exist for the sole purpose of championing carers. AGC

Written by Paul Koury – Publisher of the Australian Carers Guide with 12 years caring experience Dr Raelene Wilding is Associate Professor of Sociology at La Trobe University

Photos: CanStock

Importantly, this does not diminish from the internal part of our sense of self. In fact, it can sometimes help people to better fulfil or nurture that inner, core identity. As Dr Wilding explains, “While it’s helpful to see the two parts as separate, we can’t lose sight of the fact that they are always interacting with each other and are always shaping each other. So, if we can identify externally as a carer, then we help our societies to count us and value us as carers. This could lead to more resources and support, which can then help us to better nurture our inner sense of self as a person who cares for and cares about a particular person. It helps us to be a better parent, or a better son or daughter, or a better friend to the person we care for”.

SPRING 2021 | Australian Carers Guide 21

C arers

dos AND don’ts THE

Photos: CanStock

BY MARY BART

of a Carer

Have you ever spent an afternoon engaged in lively, spirited and inspiring conversation with a group of experienced family carers? They really do talk about everything, including how complicated, demanding and—yes—rewarding caring can be.

22 Australian Carers Guide | SPRING 2021

At a recent carer retreat I attended, most carers had been caring for a parent, spouse, sibling or friend for more than five years. They eagerly and enthusiastically shared their stories and talked at great length about some of the “dos and don’ts” that they had discovered in their caring journeys. The result of much laughter, a few tears and many hugs, here is a fresh-off-the-press summary of our very own top 30 dos and don’ts of caring that we’re pleased to share.

DO:

✔ Take care of your own health. Know

✔ Be honest and proud. Your work and

your boundaries. Life is all about setting expectations. Let your family know your limits. This will help create respectful conversations and situations. Stay up to date with medical and dental appointments, and keep up with your own treatments and prescription renewals.

efforts matter. Don’t be shy to tell people about the valued work that you do. Be truthful with your family about your caring role, your abilities and how providing care is impacting your life (emotionally, physically and financially).

✔ Stay connected with your friends.

constant in providing care. What worked last week or even this morning may no longer be relevant. How well you accept What worked and embrace last week or even change is key this morning may no to staying stress longer be relevant. free and being an effective carer.

Even a short phone call, connecting over the internet or meeting for lunch will help you feel engaged and balanced, and will keep things in perspective.

✔ Exercise as often as you can. Try a

regular walk around the block or join an aqua-fitness class at your local pool. Ask yourself this difficult question: “How is my health since becoming a carer?” Feed your spirit. Learn and practice stress-reducing techniques such as tai chi, yoga or mindful meditation.

✔ Laugh and keep your sense of humour. Sometimes the funniest things happen while providing care. Acknowledge and cherish those moments.

✔ Keep track of the money. Record both

what you spend yourself and all financial transactions that you conduct on behalf your loved one.

✔ Value your sleep. Always get a good

night’s sleep and, if possible, treat yourself to a short break during your day. This will give you the physical and emotional energy you need to get through your day.

✔ Know the signs of carer burnout. If you find yourself having limited time or energy, it might be time to take a step back.

✔ Embrace change. Change is

✔ Enjoy the good times.

Escape when you can and cherish time for yourself. Take lots of pictures to share and keep a journal to remember the things you did together.

✔ Seek and accept help from others.

Going it alone is not sustainable. Having the help of others will keep you sane and decrease your chances of resentment, depression and isolation.

✔ Limit contact with negative, critical people. If people don’t add value, don’t include them in your day.

✔ Learn. Get educated about your loved

one’s disability or illness so that you know how best to support them today and what to expect in the future.

✔ Take advantage of community

services. Numerous community and private SPRING 2021 | Australian Carers Guide 23

TRY THIS TO:

BE A REAL FRIEND TO A FAMILY CARER

Here are a few suggestions to support the carers in your life Keep in touch. Caring can be very lonely and isolating. Make sure to keep in regular contact with your friends that are carers. Don’t think that they are too busy to hear from you or that you are connecting with them at the wrong time. Phoning, emailing or sending a funny card will let them know they are not alone and that there are people who care about them.

Photos: CanStock

Be a good listener. Sometimes carers just want to be heard. Listening is a skill and often requires little conversation. Allow carers to vent, babble and let off some steam. Once they have gotten what

24 Australian Carers Guide | SPRING 2021

has been bothering them off their chests or what the current crisis is all about, a final hug is really all that’s required.

Show empathy. Empathy is the capacity to understand or feel what another person is experiencing from within their frame of reference. Take the time to imagine what your friend’s life is like and what their challenges are, and then imagine how you would deal with these same issues. Your comments will become more respectful and kinder.

Surprise your friend. Carers rarely think of themselves. The last thing

they expect is a happy surprise. Good surprises can be as simple as a voucher for a local coffee shop, taking over a cooked, ready-toserve dinner or the gift of a pedicure at the local spa.

Say kind and comforting sentences. “Thank you for doing all you do.” “I’m coming over on Thursday afternoon to watch your mother while you have a nap.” “I can’t imagine how hard it is for you to watch your dad in so much pain.” “I wish I were there to give you a big hug.” “How is your loved one doing? How are you doing?”

services are available, such as adult-care day programs, meal programs, homecare support and respite care for both you and your loved one.

✔ Know what you can change and what

you cannot change. All we can really change is ourselves and how we react to others and to different situations.

✗ Lose hope, hide from grief or be angry.

Hope gives us a reason to get out of bed. It gives us a purpose. Be realistic but positive in your approach. “Anticipatory grief” is the realisation that a part of a loved one is gone forever. Acknowledge it and seek professional help if needed. Don’t let selfpity and resentment control you.

✗ Stop doing what you love. Keep

DON’T: ✗ Let guilt overwhelm you. If you can

honestly say that, based on the resources available, you are doing the best you can then your feelings of guilt may decrease. And don’t be afraid to say “no.” It is freeing and gives you more control over your life.

gardening, reading or going to garage sales. Your favourite activities will take you away to your “happy place.” But don’t overindulge. Eating too much (especially unhealthy foods) or using tobacco, alcohol and other drugs excessively will not only affect your health, but also your ability to cope.

✗ Try to be perfect. Don’t fuss if some

things slide and don’t feel guilty to let them.

AVAOID THIS TO:

BE A REAL FRIEND TO A FAMILY CARER

Here are a few suggestions to support the carers in your life Trying to fix the situation. Supporting your caring friends does not mean that you are responsible for solving their problems. These issues are out of your hands and may actually not be solvable. Be aware that when you try and change situations, you might actually complicate them.

Offering unsolicited advice or criticism. Don’t think that you add value to a carer by being critical or saying that you have a better way of doing things. Keep your comments to yourself about how they are managing care. You are

not their boss or even their peer. A “know-it-all” attitude might well be met with resistance and even drive a wedge between you and the carer. Instead, praise the carer for something that you genuinely think they are doing well.

Adding guilt. Carers live with mountains of guilt. Don’t make it worse by piling on more. Nagging a carer is not only unproductive but highly unsupportive.

Saying unhelpful things. “You have gained a little weight and what’s with those bags under your eyes?” “What do you do all day? You should get out more and

take better care of yourself.” Say kind and comforting sentences. “Thank you for doing all you do.” “I’m coming over on Thursday afternoon to watch your mother while you have a nap.” “I can’t image how hard it is for you to watch your dad in so much pain.” “I wish I were there to give you a big hug.”

Being a stranger. Don’t think that you are bothering a carer by phoning or dropping in. Such social interactions are absolutely critical to their well-being. If you call at an inconvenient time and are asked to phone back later, don’t take it personally.

SPRING 2021 | Australian Carers Guide 25

Pace yourself and prioritize. Managing your responsibilities will allow you to be organized and in control.

✗ Ignore the signs of carer burnout.

If you know you are on the verge of burning out or have actually fallen off the cliff then you need to stop, reassess what’s happening and change what’s not working.

✗ “Wing it.”

Successful caring means being organized, planning and being prepared for doctor’s appointments and meetings at the bank, and creating a dynamic schedule that suits both you and your loved one. “Winging it” is a sure-fire way to fail.

✗ Think you

have control over everything and everyone. Although you will be the decision-maker in many situations, you can’t control the health of your loved one, whether your family will offer support or the expense of care. Being realistic will help you stay grounded.

✗ Expect people to read your mind.

Being able to clearly communicate your issues and needs will help others better understand and respond.

✗ Stop being an advocate. Defend your

loved one’s rights and needs. Challenge what seems wrong, does not make sense or will not work. You need to your loved one’s voice.

✗ Make your care recipient feel guilty. Regardless of how much time and energy you give to your loved one, don’t play the “guilt game” with them.

✗ Expect your family to pitch in and help. Just because you need and want their help,

26 Australian Carers Guide | SPRING 2021

doesn’t mean you will get it. Life and caring are rarely fair.

✗ Think that caring responsibilities are equally shared within a family. Assume that one person will do the most, while others will give what they are able.

✗ Abuse your loved one. Abuse can be

physical, emotional and financial. Know the signs of abuse and how to control your anger. Seek professional help and if you’re resentful or frustrated.

✗ Forget the

paperwork. Paying bills, filing annual tax returns and insurance claims, and keeping cards/ driving licenses current can be time-consuming, frustrating and expensive if neglected.

✗ Share everything. Be guarded with what

you share with your friends. Understand that most people don’t want to hear or know it all. Giving too much information is not a good thing. ACG

Escape when you can and cherish time for yourself. Take lots of pictures to share and keep a journal to remember the things you did together. Mary Bart is the chair of Caregiving Matters, an Internet-based charity that offers education and support to family carers.

P ersonal stories

What other

carers get up to? BY MARY BART

ho doesn’t want to enjoy their freedom and the ability to maintain their lifestyle and independence? Yet, with age and declining health, we often need a reality check to ensure that the inherent dangers and risks of living alone are mitigated as much as possible.

Let’s take a look at some smart seniors who have boldly taken things into their own hands to prevent unwanted surprises.

Ruth and Bev Ruth is 78 years old and a recent widow. She’s an avid bridge and Scrabble player, and has lots of friends and an active social and family life. Her calendar is full. Her goal, despite daily pain and reduced mobility caused by chronic arthritis, is to live vibrantly in her home for as long as she can. Bev is Ruth’s oldest daughter. She lives 15 minutes away. Ruth and Bev have been handling things themselves but, aside from gardening, which Bev’s husband helps out with on the

Photos: CanStock

Home maintenance

SPRING 2021 | Australian Carers Guide 27

weekends, there are a number of other more serious issues that need to be addressed. Clipboard in hand, mother and daughter decided to create a to-do list with priorities and action steps. They invited a handy-man friend to join them, and paid a community occupational therapist to help them create a detailed home safety check.

The To-Do List Here’s what the team came up with: n Safety first. Check the batteries in the smoke and carbon monoxide detectors. Add another fire extinguisher in the kitchen and re-demonstrate how to use it. Review security system protocols. n Better lighting. Install hallway nightlights and a motion light in the bathroom, and switch to eco-friendly, long-lasting lightbulbs in fixtures. n Watchful help. Add a webcam in the bedroom and kitchen, and a peephole in the front door. n Upgrade devices. “Mum needs a new phone.” Make sure she chooses one that’s user-friendly, and has two-way speech and alerts. n Clean vents. Clean the stove fan, laundry vent, and air-conditioning and heating ducts, and call a chimney sweep for the fireplace and chimney. n Change to double-sided locks. Add double-sided locks to the bathroom, basement and exterior doors for easier access in emergencies. n Drips and leaks. Fix the plumbing to eliminate leaky pipes and reduce the potential for dampness and mould. Change the laundry room sink and taps, and fix the leaking showerhead and cracked tile. Re-grout. n Stairways. Secure the railings on all staircases, and replace and secure carpeting on the stairs. 28 Australian Carers Guide | SPRING 2021

n In case of an emergency. Re-stock the first-aid kit and create a list of emergency contacts with their correct telephone numbers. Keep the list somewhere visible. n Out with the old. Throw out the kitchen chair with the broken arm, de-clutter the stairs, hallways and other areas to prevent tripping and fire hazards. n In with the new. Add a new coat of paint to freshen up the kitchen and the family room, as Ruth and her friends spend a fair bit of time there. n Check small appliances. Replace the old kettle and toaster, as they no longer seem safe. Of note: Many of these tasks are simple fixes that could be done in a day or two if Ruth and Bev set their minds to it and get a little help.

Inside and out Along with the interior to-dos, there was also work to be done outside. At first the list sounded overwhelming, but with a closer look the handyman said things weren’t in as bad shape as they seemed. Ruth’s husband had done a good job of keeping things up before he passed away. The pair hired the handyman, who was actually the neighbour’s husband, to keep an eye on things from now on. They asked him to immediately fix a few torn window screens, level the side pathway to get rid of uneven paving stones that might cause a fall and fix a dozen or so roof shingles that had come off during the winter. He also promised to help Bev clean out the garage to make room for garden tools and hoses. Replacing the back eaves and cleaning the rest made it onto the list as well. All in all, Ruth and Bev were suddenly set and hadn’t spent too much time or money in the process. Plus they’d done their best to prevent a spill and a hospital trip.

Sarah and Linda Both retired, these ladies became fast friends while volunteering at their local food bank. In fact, they became almost inseparable—until Linda had a stroke.

Suddenly different Not only was life turned upside down all of a sudden but, in addition, Linda—who was barely 70 and lived alone— needed care. She couldn’t drive, dress herself, make her meals or maintain her two-bedroom house. Sarah moved in to help out and instantly became a carer—a role she hadn’t really bargained on. Their new reality left both women feeling isolated, bored and very restricted. Not only were they worried about what to do each day and how they’d manage to do it, but they were also concerned about the future.

Creative solutions

Skype as inexpensive ways to stay in touch with friends and family. Once Linda was well enough, they continued volunteering at the food bank and joined community boardgames groups, and invited friends to bring pets around in the afternoons. Sarah decided to take an online course and Linda listened to TED talks. Together, they elected to write a blog called “Just the two of us” to share their daily thoughts and adventures. Changing it up By acknowledging their frustrations and working together to come up with some productive, interesting solutions that would “change things up,” Linda and Sarah managed to get a new lease on life— albeit a changed one. It’s up to you. Take a look at your life today and explore your own risks. Being able to stay independent is about staying positive, making the right choices, being proactive and reducing your risk factors as much as possible. ACG

Let’s explore some of the ways they managed to get active again and stay on track. They both joined their own support groups: Linda’s for stroke survivors and Sarah’s for carers. They created their own in-house gym, with DVDs, weights and yoga mats. Twice a week, a physiotherapist came to exercise with Linda and Sarah hired a trainer. The duo began using WhatsApp and

possible risks of living alone

1. Medication mess-ups 2. Financial forgetfulness 3. Emergency preparedness 4. Safety and cleanliness

5. Personal care and grooming

7. Lack of transportation

6. Poor nutrition or alcohol use

9. Depression or isolation

8. Insufficient exercise 10. Possible abuse or fraud

Photos: CanStock

Mary Bart is the chair of Caregiving Matters, an Internet-based charity that offers education and support to family carers.

SPRING 2021 | Australian Carers Guide 29

The important role of respite for care givers Caring is an incredibly important job, but it’s crucial carers look after themselves too by taking regular breaks to prevent physical and emotional exhaustion.

“If you’re better placed emotionally, then you’re in a much better position to care for that person in a meaningful way and that will beneﬁt the person as well,” says Robyn.

Why respite care matters Bupa’s Manager of Dementia Services, Robyn Attoe says caring for someone living with illness or dementia is a 24 hour a day role and studies reveal that primary caregivers are at higher risk for stress related health conditions like depression.

Respite in an aged care home is one way to help familiarise the carer, and the person, who may be living with dementia, with a care home and can make the transition into permanent aged care easier when the time comes.

“Respite is not a luxury but should instead be seen as essential part of caregiving,” says Robyn. Robyn recommends regular scheduled respites, rather than waiting until the carer is on the verge of burnout. Types of respite care There many types of respite care; formal Bookareyour free and informal. It all depends on your personal situation, the type of care required, care providers in your area and the length of stay. The beneﬁts of respite care When there is adequate access to respite care, it can often enable the person to stay in their own home longer.

Bupa has been helping people live longer, healthier happier lives for over 70 years and we bring together expertise to oﬀer wide-ranging health services. Bupa Aged Care looks after over 6,000 people in over 60 care homes nationally for respite short-stay care and as permanent residents. If you are thinking about respite short-stay or longer term residential aged care for a loved one, call us on 1800 785 592 and we’ll guide you through the steps.

food for thought There’s an old joke that goes something like this... Q: Why do more Men die before Women? A: Because they want to

Hahaha.

Whilst that may have made you chuckle, the truth is that women do outlive men by 8% on average. As an old friend of mine, Professor Sumner-Miller, used to say, “Why is it so?” There are many opinions floating around out there as to why that is, from biological to genetic. But I say it’s more likely to be spiritual. They just give up the will to live.

A final thought We all need a reason to get up in the morning and a purpose to contribute something to someone in some way. So, remain conscious of giving ageing men something valuable to do and worthwhile to contribute to and when doing so, watch their faces light up.

Why men more so than women? When you think about it, a man spends most of his life working with a purpose to provide for his family. When a man stops working, they can find themselves without a purpose and are often lost. When men lose a reason and purpose, they can also lose their will to live.

Women On the other hand, women spend most of their life nurturing people. Whether it be their partner, children, family, extended family or building relationships in their communities. No matter what age, a woman never loses the ability to care for and foster relationships, health permitting.

Even if it is just to hold the yarn.

Special subscription offer BUY 3, GET ONE FREE

THE PERF E PRES CT ENT

Photos: CanStock

4 issues for $19.95 +gst 30% off the newsstand price Call 1300 717 515 or subscriptions@acguide.com.au

SPRING 2021 | Australian Carers Guide 31

M ental health

How to

deal with anxiety? F

may be caused by stressful or traumatic events; eelings of anxiety can be normal and healthy, or they can indicate an anxiety alcohol,medicationsorcaffeine;afamilyhistory problem. It’s normal, for example, to of anxiety disorders; or other medical feel afraid when a large dog snaps at you and/or psychiatric problems. Anxiety or to worry when a family member is in older adults is common—it often goes unrecognised and can take several hours late and has not called. Australians had an anxiety different forms. The following are Thesefeelingscanhelpyoutoprotect and/or mood disorder in some of the more common forms, yourself and others you care about. the past 12 months. Source: Beyond Blue. listed in order of how often they are Once the situation is resolved or seen in older people: changes, the fear or worry should go away. However, you may have an anxiety TYPES OF ANXIETIES problem if your feelings of worry or fear occur most of the time, keep you awake at night or Generalised anxiety disorder: Where prevent you from doing things in the day. This people worry often over a long period

3.2 million

32 Australian Carers Guide | SPRING 2021

of time. Phobias: Where people fear a specific thing, such as going outside, heights or spiders. Post-traumatic stress disorder: Where intrusive memories, dreams or flashbacks cause people to relive the intense fear experienced during a traumatic experience, such as a war, violent assault, or accident. Panic disorder: Where people have episodes of extreme fear, often with physical symptoms such as shortness of breath and chest pains. Obsessive–compulsive disorder: Where troubling uninvited thoughts, urges and images surface in the mind repeatedly and lead people to perform time-consuming rituals aimed at calming their distress.

WHAT ARE THE SIGNS? The worry and fear that come with anxiety can cause people to avoid situations, things or people, even when they know that what they are feeling doesn’t make sense. It can also cause them to feel physically ill. Signs include: n

irrational and excessive worry or fear

checking and rechecking for safety

avoiding routine activities

avoiding social situations

racing heart

s hallow breathing, trembling, nausea and sweating

WHAT CAN A PERSON DO? People with anxiety are often aware that their fear is excessive but are unable to control it. It can make it hard, if not impossible, to enjoy life. The first step is to rule out a physical problem by visiting a family doctor. If anxiety is diagnosed, then it can often be managed with a combination of counselling, medication and relaxation techniques.

Carer’s Worry (-less) Guide

Become an expert on the condition. Learn about the condition that you or your loved one has, its symptoms and how to recognise when symptoms begin.

Develop and stick to a plan for managing symptoms of anxiety.

Use skills learned in therapy to manage symptoms and take medications as prescribed.

Develop a social support network.

Family, friends and a support group can help you to recognise when stressful situations are triggering anxiety symptoms, and can boost you (and them) when feelings of discouragement set in.

Learn to cope with stress.

Stress, fatigue and feeling out of control can trigger symptoms. One way of managing stress is to do things that are relaxing, pleasurable, or interesting to you. This can help to take your mind off the things that are causing stress and make them seem less important. Other ways to manage stress includes breathing techniques, meditation and exercise.

Live a healthy, well-balanced life.

Eating well, getting enough sleep and keeping active can all help you to manage stress and feel well. Focus on developing a work-life balance with time for family, friends, work or volunteering and leisure activities. “This too shall pass” Anxiety or panic attacks don’t last forever. When those unpleasant feeling come, try not to run or let your mind race off into catastrophic thinking. Instead go with the feeling knowing that just like a wave, it will come, and it will go. The adrenaline surge released in a panic attack doesn’t keep increasing arbitrarily. Once our bodies realise there is no “real threat” the cortisol starts to reduce and a sense of calmness returns…Always remember, ‘This too shall pass’. ACG

Adapted from “Improving our response to older adults with substance use, mental health and gambling problems” by the Centre for Addiction and Mental Health.

SPRING 2021 | Australian Carers Guide 33

echnology

WHAT IS

virtual AND WHY ARE AGED CARE

34 Australian Carers Guide | SPRING 2021

reality PROVIDERS EMBRACING IT?

SPRING 2021 | Australian Carers Guide 35

If you’ve been looking around at new ways to support your residents, chances are you’ve heard the words “virtual reality” being offered as a new idea. Maybe you’ve even seen pictures of people wearing headsets and waving their arms about.

But what is virtual reality, or VR, and why is it making such an impact in the aged care space? IMMERSIVE BEYOND BELIEF Virtual reality is a simulated environment that looks and feels incredibly realistic. A key tool for using VR is the headset, which allows you to explore this digital space by looking up, down, and all around you. Unlike a computer or tablet which has a fixed field view, virtual reality adapts to your head movements to immerse you in a rich 360-degree, 3D environment. This means that putting on a virtual reality headset feels like stepping into a completely different world. But the big question is, what can you do in this immersive virtual space?

36 Australian Carers Guide | SPRING 2021

THE IMPOSSIBLE BECOMES POSSIBLE The answer is: Anything you can imagine! For the adrenaline seekers, how about skydiving, swimming with dolphins, or racing in an F1 car? For those looking for a calmer escape, maybe chilling out on the beach, exploring a tropical rainforest, or visiting a museum? The technology is limitless, and it can even allow us to experience things that are impossible - a trip to Mars perhaps? Or walking around the interior of the Titanic? VR can make that happen too. That all sounds fun, but we’re talking about older adults here. Why would care providers be so keen to take their care recipients out of the four walls of a facility (virtually)?

VIRTUAL EXPERIENCES WITH CLINICAL BENEFITS

and physical functioning of those with mild cognitive impairment or dementia”.

The answer lies in research, and whilst these experiences are certainly fun for all ages they’re anything but frivolous.

And what could be more important for someone living with dementia, than to reconnect them to their true self, their culture, and their loved ones. Now we’re really pushing the dial with “joy”!

Virtual reality experiences have been shown to improve the quality of life in older adults. Participants in an American study were “less socially isolated… less likely to show signs of depression” and “feeling better about their overall wellbeing”. Another study from Taiwan revealed that VR “can provide older adults with the confidence to get involved in social activities”.

So, it’s clear that VR can have a range of positive impacts on care recipients. But the most exciting benefits of all are linked to who we are as individuals. A PERSONAL JOURNEY Imagine being able to visit a childhood home, a church you were married in, or a place you went on holidays with your family. For those of us born overseas, what about taking a journey back to experience familiar sights and sounds, and reconnect with your culture? Maybe a faith-based pilgrimage or personal spiritual practice? VR is at its best when it’s partnered with a deep understanding of the individual and what’s important to them. That’s how innovative care providers are getting the most out of VR. By building upon their strong connections with the individual, carers can deliver meaningful personalised experiences that leverage the power of VR to connect to identity.

FOR ALL WALKS OF LIFE No matter what stage of life an individual is at, virtual reality may provide engagement, excitement, and an opportunity for connection. Particularly for those of us supporting a loved one with dementia, as VR has been shown to “positively affect the cognitive

Sometimes what’s important, isn’t a clinical benefit.

GOING BEYOND THE CLINICAL What is immediately apparent when you try on a VR headset is that it’s like magic. Whilst there may be benefits in wellbeing and cognitive function, it’s an experience to bring wonder, enjoyment, and positive emotions, But the big and this can be question is, what supercharged can you do in when sharing this immersive the same virtual space? experience in a group VR setting. Any tool that can help bring significant and measurable joy, happiness, and excitement to the life of care recipients is one that’s worth exploring. Ultimately, that might be the driving factor in the growing use of VR in the aged care space, a growth that’s led by innovative companies.

CHANGING LIVES THROUGH VIRTUAL REALITY Melbourne based virtual reality startup, SilVR Adventures, has been taking care recipients on shared virtual reality experiences since 2019. Providing a turnkey VR solution to care providers across Australia and New Zealand, they enable care team members to take people with a variety of needs on immersive, group VR experiences. “Our content focuses on storytelling, emotional journeys and reminiscence therapy,” said Colin Pudsey, CEO of SilVR Adventures. “We want to build engaging and inspiring experiences for older adults, SPRING 2021 | Australian Carers Guide 37

no matter what stage of life they’re at.” With the largest library of world tours, spiritual journeys, and bucket list events, they’re experimenting with new ways to engage care recipients. “But the real magic,” he says, “happens when the headset comes off.”

CREATING MEANINGFUL CONNECTIONS Colin explains that most powerful moments in working with VR are the social connections it stimulates. “We’ve found that the winning formula is taking people on adventures together. They’ll have an amazing time travelling the world or experiencing something brand new, then the headsets come off and they’re chatting about where they went, where they want to go to next and sharing memories and stories from the past. It’s incredible to watch!” And it’s clear that aged care providers agree too, with some around Australia establishing weekly ‘Travel Clubs’ to build camaraderie and friendship, through shared experience, across multiple sites.

come at a better time, with restrictions and lockdowns significantly increasing feelings of isolation, loneliness, and depression among our elders.

THE FUTURE OF THE TECHNOLOGY Virtual reality has made great strides in the past few years, but it still has an exciting journey ahead. With companies like Facebook and Google making big investments in the space, it’s clear that the technology will continue to grow and develop. There’s room to grow in the personal care space too, with VR companies pivoting away from residential facilities and, beginning to offer services to be used in home care too. Colin explains “so far there’s nothing on offer for people in the home, that’s why SilVR Adventures is thrilled to be launching our home care solution in 2021. We’ll be able to support older adults ageing in place with enhanced connections and deliver meaningful virtual adventures, in their own home - and that’s something to get excited about.”

A RICH AND INCREDIBLE VIRTUAL WORLD

“We’re super excited to be able to connect up to 40 participants around the world in a As we head towards 2022, there is still a lot shared virtual reality experience, then have of uncertainty, but whatever happens, it’s them meet in a digital space afterwards, like clear that we need to find new ways to stay our virtual café, and chat about it,” says Colin. connected and engaged, and that couldn’t The ability to link people couldn’t have be truer for those of us receiving care. Leading aged care providers around Australia are increasingly turning to the immersive power of VR as a potential tool for reducing isolation, improving wellbeing, and strengthening connections. Very soon, personal carers in the home will be taking this technology for a spin too. ACG By Colin Pudsey

SilVR Adventures provides meaningful virtual reality experiences and activities to improve mental wellbeing. For more details, please contact: 1300 192 552 sales@silvradventures.com.au www.silvradventures.com.au

38 Australian Carers Guide | SPRING 2021

D ementia care

Dementia v Alzheimer’s M

disease

Photos: CanStock

any people have heard of dementia but might not understand what it is or what the difference is between Alzheimer’s disease and dementia. Dementia is a progressive, fatal disease of the brain. It is an umbrella term to describe a large group of illnesses which cause progressive decline in a person’s day-to-day functioning. It is a broad term used to describe a loss of memory, intellect, rationality, social skills, and physical functioning. There are many different types of dementia – in fact, there are more than 100 different types - with the most common form being Alzheimer’s disease. Other forms include vascular dementia, frontotemporal dementia and dementia with Lewy Bodies.

BY MAREE MCCABE AM, CEO DEMENTIA AUSTRALIA

SPRING 2021 | Australian Carers Guide 39

Is there a difference and what are the symptoms to look for?

Early symptoms also depend on the type of dementia, which vary a great deal from person to person. COMMON EARLY SYMPTOMS INCLUDE: • Memory problems, particularly remembering recent events • Increasing confusion • Reduced concentration • Personality or behaviour changes • Apathy and withdrawal or depression • Loss of ability to do everyday tasks

Sometimes people fail to recognise that these symptoms indicate that something is wrong. They may mistakenly assume that such behaviour is a normal part of ageing, or symptoms may develop so gradually they go unnoticed for a long time. Sometimes people may be reluctant to act even when they know that something is wrong. For the person experiencing the symptoms, the very nature of these changes within the brain may mean that the person is unable to recognise that there are changes. In 2021, there are an estimated half a million Australians living with dementia and an estimated 1.6 million people involved in their care. Without a medical breakthrough, the number of people living with dementia is expected to increase to more than one million by 2058.

Because the diseases that cause dementia develop gradually, the early signs may be very subtle and not immediately obvious. 40 Australian Carers Guide | SPRING 2021

Remember that many conditions have symptoms similar to dementia, so do not assume that someone has dementia just because some of the above symptoms are present. Strokes, depression, alcoholism, infections, hormone disorders, nutritional deficiencies, and brain tumours can all cause dementia-like symptoms. Many of these conditions can be treated. The best place to start is with the person’s doctor. After considering the symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis and will, ideally, refer the person to a medical specialist such as a neurologist, geriatrician, or psychiatrist.

Some people may be resistant to the idea of visiting a doctor. Sometimes people do not realise that there is anything wrong with them because the brain changes that occur with dementia interfere with the ability to recognise or appreciate the changes occurring. Others, who do have insight into their condition, may be afraid of having their fears confirmed. One of the best ways to overcome this problem is to find another reason to visit the doctor. Perhaps suggest a blood pressure check or a review of a long-term condition or medication. Another way is to suggest that it is time for both of you to have a physical check-up. A calm attitude at this time can help overcome the person’s worries and fears. IF THE PERSON STILL WILL NOT VISIT THE DOCTOR: • Talk to the person’s doctor for advice • Contact your local Aged Care Assessment Team (ACAT) via My Aged Care on 1800 200 422 for information • Call the National Dementia Helpline on 1800 100 500

If you feel your doctor is not taking your concerns seriously, consider seeking a second opinion.

Each year for Dementia Action Week we work with the community to raise awareness about dementia and our services. This year it will take place on 20-26 September with the theme, A Little Support Makes a Big Difference.

During the week, we will be providing simple and practical tips to help people who are supporting a person living with dementia. Many Australians will start experiencing the impact of dementia amongst their own family and friends in the coming years. If we are to prepare for this increase, it is vital we clear up some of the prevailing misconceptions about dementia. A little support really does make a big difference for people living with dementia and their family carers. Make sure to keep an eye on our website and social media accounts during the week. ACGAt Dementia Australia At Dementia Australia we offer carer support services including counselling, client and family education programs, carer support groups and group social support. Our National Dementia Helpline open Monday to Friday from 8am to 8pm. Visit dementia.org.au for Help Sheets, education programs and more.

“I would like to acknowledge the extraordinary work carers do, especially those who look after people living with dementia. Please get in touch if you need information or support. – Maree McCabe AM, CEO Dementia Australia Maree McCabe AM, Chief Executive Officer Dementia Australia. A recognised leader, Maree brings extensive experience and expertise to the health, mental health and aged care sectors. Her career accomplishments include leading the former federation of Alzheimer’s Australia to unify and become Dementia Australia. Maree’s vision led to the development of internationally recognised, cutting edge, dementia education tools using computer games, virtual reality, artificial intelligence and innovative apps.

Maree is a member of the Commonwealth Health and Aged Care sector committees, sector Boards and, a member of the Alzheimer’s Disease International Asia Pacific Regional Committee and Chair of the Nominations Committee. On 14 June 2021 Maree was appointed a Member of the Order of Australia in the Queen’s Birthday Honours for significant service to people living with Alzheimer’s and Dementia, and to the aged care sector, and included in the COVID-19 Honour Roll for contribution in support of Australia’s response to the COVID-19 pandemic.

SPRING 2021 | Australian Carers Guide 41

Photos: CanStock

W ell-being

42 Australian Carers Guide | SPRING 2021

Self-Care

is not Selfish

et’s face it. Although caring for someone can be rewarding, it can also be an exhausting journey, even for the saints among us. Even though, we keep at it almost to the point of burn out, any thought of putting ourselves first when others are in need can come across as selfishness. Just the idea of anyone thinking that, can infuse us with feelings of guilt and anxiety. However, nothing could be further from the truth.

It is critical for those you care for.

Taking care of ourselves is the opposite of selfishness because it strengthens us and enables us to better support our loved ones. In fact, taking the time to make sure our needs are met, only makes us better at ensuring that our loved one’s needs are met as well. It also shows responsibility that because we are maintaining our wellbeing, we are preparing and posturing ourselves to always be ready and able to support those we love.

In my case, that wasn’t always so, and I came to that realisation the hard way. I had to almost hit rock bottom before the lights came on. So, I write this article in the hope that my story and experience, can help other carers find it easier to prioritise selfcare and not feel guitly But before I do, I’d like to share a little about myself and my background. I’m Mandy Walker. I’m a Carer Coach, a Social Worker and the eldest sibling in the family. I am also providing care to my elderly mother, who lives about ten minutes from me. I have two brothers who married women from other countries and are living overseas. My father

passed away over ten years ago. I live alone with Finch, my three-year-old Cavoodle. My mum, Agnes, is now aged 82 (but please don’t tell her I told you that) and lives on her own two suburbs away. You would think that taking care of her day-today needs would be easier because she is not that far away. It has been more problematic. In my case, proximity fuelled higher expectations and some days, I wished we didn’t live so close to each other. Mum is very traditional in that she expects to be cared for by family. After all, that’s how it is in many cultures and how she cared for her mother in her generation. Even with the demands and pressures SPRING 2021 | Australian Carers Guide 43

‘Put the oxygen mask on yourself before attending to the needs of others.’ on people in our modern world, whenever I raised the subject of getting Mum some professional people in to help a few hours a week, she would not even entertain the thought. Case closed! For two years before Covid, being Mum’s primary carer was taking its toll on me physically, mentally, and emotionally. I struggled with feelings of anger and resentment. Mum would call all the time and expect me to be with her every second I wasn’t working. Half the time she created a need out of thin air so that she could guilt me into dropping in. I don’t know why but she always made me feel like I wasn’t doing enough for her. Those two years were the most depressing, anxious, and unhappy time of my life. My needs were shoved to the back burner whilst trying to figure out how to best care for Mum with my life. Feeling anxious, exhausted, and irritable are clues that you, like me, might be getting dangerously close to ‘carer burnout.’ While I was in this state, I could not provide the level of care my 44 Australian Carers Guide | SPRING 2021

mother needed, nor did I want to. Mum felt neglected and unloved, which really affected her wellbeing and her sense of joy. I was short, impatient and sometimes felt resentful. No one wins in that situation. When you have nothing left to give, everyone loses. Sound familiar? So, in a moment of reflection during my lowest point, I realised a truth that existed all along. It was a small and simple shift in my thinking that had occurred. If the demise of my happiness and wellbeing, resulted in the demise of my mother’s happiness and wellbeing, then my wellbeing was not independent of my mother’s rather it was connected directly to it. Eager to end my misery and get some balance back into my life, I made time to sit with my mother and share my new thoughts with her. I wanted to talk about the last six difficult months, how it was not in our best interest to continue the way we were and my thoughts on what needed to be done.

I began by apologising for my irritability and impatience, and for causing her to feel unhappy and neglected. Mum accepted my sincere remorse and then went silent. Wondering what Mum was thinking, I asked her what she thought we could do to avoid this situation again, to avoid me becoming irritable and bordering on burnout and unable to give her quality care again. There wasn’t the immediate epiphany I was hoping for, in hindsight, it probably wasn’t the smartest thing to do. My question was met with a great deal of push back. Because Mum is quite a bit older, she always perceives her needs as greater as she has the traditional mindset.

“

My well-being is not independent of my mother’s, but rather it is connected to it.

”

Because of all her years of sacrificing for us kids growing up, it was only right for me to sacrifice myself for her.

Mum eventually accepted that my self-care had to be included in her care plan, and so we did just that.

I understand that mindset and am very appreciative of everything Mum did for us kids. Having said that, life was very different in her generation. Women didn’t work anywhere near as much as they do now, and families lived in supportive communities. Nevertheless, perhaps Mum wouldn’t have suffered so much if she had looked at it another way. So, to help Mum understand our situation, I used this analogy.

I proposed to give my wellbeing a scheduled place and time in Mum’s care plan. Instead of my old unhelpful thinking that I was being selfish to make time for my own needs, I now looked at it

If you’ve ever flown in an airplane, you’d know that before each take off, the flight attendant instructs us, that in case of an emergency to ‘Put the oxygen mask on yourself before attending to the needs of others.’

So, when I changed the way I looked at things, the things I looked at changed.

Photos: CanStock

We all know that we cannot be of any use to those that are reliant on us unless we first ensure that we are well. Somehow, as carers, we seem to forget that. Using this simple analogy was very useful in helping mum realise that it is true. My wellbeing was just as important, as I was the one she ultimately relied on as her primary carer.

as essential. This began a journey to investigate what external care I could find and afford that Mum would accept, while still being able to assist Mum three afternoons a week. I discovered a community

of local volunteers and council led initiatives that I didn’t even know existed. After some trial and error, I arranged for people to pick Mum up and take her to a community center. She loves it there and this has given Mum something to look forward too. I also engaged a fantastic home care service that would visit Mum two hours a day and attend to her needs. As I stepped out, I found out just how much external care was available. So, when I changed the way I looked at things, the things I looked at changed. So, now I look at selfcare through a different lens. Making time to care for myself is vital in ensuring my wellbeing to better care for my mother. After a bit of trial and error, I gradually gained a level of satisfaction in knowing that I was moving my life forwards while still making sure that Mum was safe and comfortable in her home. Sure, there were still days where some of my choices were lousy, and perhaps my blood pressure rose a tad. However, now when I call in on Mum and tend to her needs, I do it from a position of fullness. Whilst not perfect, it has restored balance to my life. And as for Mum (who would occasionally guilt me into more visits), she now sees first-hand that a wellbalanced Mandy is in both her and my best interests. ACG SPRING 2021 | Australian Carers Guide 45

Introducing Carers SA If you provide assistance to a family member or friend who is frail due to age, has a disability, a drug or alcohol related problem, dementia, experiencing mental illness or a long term medical condition,

Carers SA is here to support you

1in 8 Australians are carers • Almost 2.65 million Australians are carers • Over 235,000 carers are under the age of 25 • Nationally, unpaid carers provide 1.9 billion hours of care every year, saving the Australian government up to $77.9 billion annually

In South Australia there are 245,000 unpaid carers This includes up to 30,000 young carers aged between 7-25

Who are Carers SA? Carers SA has over 30 years of experience providing support, services and information to unpaid carers. In April 2020 Carers SA became the lead agency for supporting carers in South Australia and is the Carer Gateway provider in South Australia. The Carer Gateway is a large part of what we do at Carers SA, and in addition to this service we also advocate for carers and provide other local services available to carers in SA. Carers SA is a statewide organisation and employs staff who are based across metropolitan Adelaide and rural and remote South Australia. Carers SA has partnered with Dementia Australia, Skylight Mental Health, Life Without Barriers and NPY Women’s Council, to provide essential Carer support and services. 126 Australian Carers Guide | SPRING 2021

46 Australian Carers Guide | SPRING 2021

Whatisisthe the What CarerGateway? Gateway? Carer A long consultation process with carers A long consultation process with carers and the sector resulted in the new and the sector resulted in the new Australian Government Carer Gateway, Australian Government Carer Gateway, launched April 2020. launched April 2020. Carers SA is the Carer Gateway provider Carers SA is the Carer Gateway provider in South Australia, and provides these in South Australia, and provides these Carer Gateway Services: Carer Gateway Services:

Connect with other carers Connect with other carers Meet with people in similar caring situations Meet with people in similar caring situations and share your stories, knowledge and and share your stories, knowledge and experience. experience. • In-person – meet local carers, share advice – meet local carers, share advice • In-person and learn from each other in a safe space. and learn from each other in a safe space. • Workshops – Workshops are available – Workshops are available • Workshops on different topics aimed at connecting, on different topics aimed at connecting, supporting and empowering carers. supporting and empowering carers.

Financial support Financial support

Coaching Coaching Coaching can be up to 6 x 1 hr sessions and Coaching can be upbe toaround 6 x 1 hranything sessionsthe andcarer discussions can discussions be on around anything the carer wants tocan focus including: wants to focus on including: • Health and wellbeing • Health and wellbeing • Understanding inclusion and advocacy • Understanding inclusion and advocacy • Exploring the emotions of caring • Exploring the emotions of caring • Exploring how the caring role can change • Exploring how the caring role can change over time over time • Navigating the day to day challenges of the • Navigating the day to day challenges of the caring role caring role • Exploring how to build and maintain mutually • Exploring how to build and maintain mutually supportive relationships supportive relationships • Work, study and volunteering • Work, study and volunteering • Exploring the financial implications of the • Exploring the financial implications of the caring role. caring role.

Counselling Counselling If you’re feeling stressed, anxious, sad or If you’re feeling stressed, anxious, sad or frustrated, a professional counsellor can talk frustrated, a professional counsellor can talk with you about your worries and offer help. with you about your worries and offer help. • In-person – speak one-on-one with a – speak one-on-one with a • In-person professional counsellor in your local area. professional counsellor in your local area. • Online counselling – speak with a counselling – speak with a • Online counsellor online in the comfort of your counsellor online in the comfort of your own home. own home.

Get financial support to assist you in your Get financial support to assist you in your caring role. caring role.

Financial support packages: Financial support packages:

• one-off practical support in the form of • one-off practical support in the form of equipment or an item to assist you in your equipment or an item to assist you in your caring role. caring role. • a range of ongoing practical supports, such • a range of ongoing practical supports, such as planned respite or transport, provided as planned respite or transport, provided over a twelve-month period. over a twelve-month period.

To find out how To find out how Carers SA can help you Carers SA can help you call 1800 422 737 call 1800 422 737

Emergency Respite Emergency Respite Get assistance in looking after the person you Get assistance in looking after the person you care for if an unplanned event stops you from care for if an unplanned event stops you from being able to provide care. For example if you being able to provide care. For example if you are ill or injured. are ill or injured.

An Australian Government Initiative An Australian Government Initiative SPRING 2021 | Australian Carers Guide 127 SPRING 2021 | Australian Carers Guide 127

SPRING 2021 | Australian Carers Guide 47

A place C arers

TO BE HEARD A place

unders

AND “I TO BE HEARD understood

t’s not like a complaints room where 72-year-ol you can sit down and whine and looks afte moan – it’s just so that we can have in Eastwo a chat about how things are going. I think talking ab she atten when yout’s talk about things, it 72-year-old helps Colleen to is an unpaid carer not like a complaints room where who you can sit down and whine and looks after her elderly and unwell husband relieve you of that stress and anxiety. moan – it’s just so that we can have in Eastwood, a suburb of Adelaide,Colleen’s and she is a chat about how things are going. I think talking about the Carer Peer Support group You know you are being heard and not she attends. chronic p when you talk about things, it helps to relieve you of that stress and anxiety. Colleen’s husband Brian is 81 and lives with hip judged,” explains You know you are beingColleen heard and not Magor. chronic pain from arthritis. “He’s had two replac

“I

judged,” explains Colleen Magor.

128 Australian Carers Guide | SPRING 2021 48 Australian Carers Guide | SPRING 2021

hip replacements. He’s quite full of arthritis

doesn to hers

“

Collee an art the co house One of the biggest issues for Colleen was theshe fo fact Brian wouldn’t shower regularly. It was her Carer Peer Support group that allowed for Car her to make peace with this. a Care “I have learnt that is OK for him not to have a shower from the group. I just had to learn to group step back and say it is

Sometimes when you go to these groups you see other people and what they’re going through, and it puts your life into perspective. You don’t sit around thinking woe is me, it’s more of a case of saying my life isn’t too bad and I can cope.

through his back, knees, ankles. He’s in a lot of pain but won’t take any medication because he says it makes him feel sick,” she says.

D AND

Colleen does everything for Brian. She helps him get dressed, makes the meals and does all the cleaning and all the daily living acticvities. She has been his full-time carer for more than 10 years. Colleen says it does get wearing at times and she doesn’t get much time to herself.

stood Colleen briefly joined an art group around the corner from her house, and that’s where she found a pamphlet for Carer Gateway and a Carer Peer Support group in her area.

”

OK if he doesn’t have a shower, the world won’t end,” she says.

The F Gatew for un and o

Colleen had a stroke in March this year, and while she is slowly getting better, she is still using a walking stick to get around. The stroke has made her realise she needs more help, for both of them. “I got very stressed as I didn’t know what would happen if something happened to me. Who would look after Brian? And what do you do when you have two of you that aren’t too well?” she asks.

ld Colleen is an unpaid carer who er her elderly and unwell husband ood, The a suburb of Adelaide, Federal Government’s Carer and she is providesPeer supportSupport services boutGateway the Carer group for unpaid carers including in person nds. and online peer support.

“I went helpfu go to t Since then, she has managed to get Meals what t on Wheels delivered three times a week. “I went along and found that it was quite husband Brian is 81 and lives with life int helpful,” says Colleen. “Sometimes when you Brian now goes to a Men’s Shed every go to these groups you see other people and Monday which gives her a few hours to pain from arthritis. “He’s had two thinkin herself. “I’m trying at the moment to get what they’re going through, and it puts your myself involved in some yoga classes life into perspective. You don’t sit around cements. He’s quite full of arthritis because every day is pretty much Brian day, saying thinking woe is me, it’s more of a case of saying my life isn’t too bad and I can cope.”

and a break would be good.”

SPRING 2021 | Australian Carers Guide 129

SPRING 2021 | Australian Carers Guide 49

F inance

Discover

SAVE

HOW TO ON AGED CARE

hen it comes to residential aged care (what used to be called “nursing homes”) many people believe that if they don’t have any money, they won’t get in. Which is simply not true. You see, in residential aged care there are two groups: market price residents and low means residents. And the overwhelming majority of aged care homes need to keep a mix of each in order to receive funding from the government. 50 Australian Carers Guide | SPRING 2021

BY RACHEL LANE FROM AGED CARE GURUS

Market price residents, as the name suggests, pay the market price for their aged care accommodation. The aged care facility will advertise the price and you can pay any amount up to the advertised price, but not more than it. How you pay the price is up to you – you can choose to pay by daily payment, lump sum or a combination. Low means residents pay a contribution towards their accommodation based on their assets and income. The government “tops up”

the amount the resident pays, up to a maximum of $59/day. Just like market price payers, low means residents can choose to pay for their accommodation by a lump sum, a daily payment or a combination. But it’s important to know that as a low means resident even though the amount you pay is based on your assets and income that doesn’t mean that it will be affordable. In fact, you can find that the amount you need to pay is more than the market price.

SO WHAT WILL YOU PAY? Well everyone in aged care can pay the basic daily fee, set at 85% of the Age Pension, currently $53 per day so that’s the starting point. Beyond that the means test will calculate a contribution to your accommodation costs based on 17.5% of your assets between $51,000 and $173,075 and 50% of your income above $28,101/year for singles or $27,581/year for members of a couple. The income threshold is based on the amount of income you can have to get the full age pension, so for most low means residents it is the asset test that affects them. Now when it comes to the means assessment there are a few things to know. If you are a couple your assets and income are assessed jointly on a 50/50 basis, regardless of legal ownership. Your former home will be included in your aged care assets up to a capped value of $173,075 unless a protected person lives there. A protected person includes your spouse or dependent child, a carer who has been living in the home for the last 2 years + and is eligible to receive an Australian Income Support Payment or a close relative who has been living in the home for the last 5 years + and is eligible to receive an Australian Income Support Payment. If your assets exceed $173,075 or the combination of your assets and income give a calculated amount above $59 per day you won’t qualify as a low means resident and will need to pay the market price.

Let’s look at the example of Shirley who receives the Full Age Pension, she has $95,000 of investments and $5,000 in personal assets. Shirley’s daughter lives in her home with her and qualifies as a protected person. Shirley’s accommodation contribution under the income test is zero. Under the asset test her accommodation contribution is $23.56/day which is $8,575/year. Shirley can choose to pay her accommodation as a daily payment of $23.56 or she can pay by a lump sum. Her lump sum is calculated using a government set interest rate, currently 4.04%, which gives her a lump sum of $212,252. continued...

Rachel Lane is the Principal of Aged Care Gurus where she oversees a national network of specialist advisers. She writes regular columns on retirement living and aged care for the Sydney Morning Herald, Melbourne’s The Age and the Brisbane Times and she regularly speaks on TV and Radio. Rachel has co-authored a number of books, including the Best Seller Aged Care, Who Cares? and her new book Downsizing Made Simple. SPRING 2021 | Australian Carers Guide 51

For many low means residents aged care fees cause a lot of financial stress. The accommodation contribution on top of the basic fee means Shirley’s cost of aged care is $76/day which is almost $28,000/ year and far more than her pension and other income. Paying a lump sum of $212,000 is likewise impossible. She could choose to pay by a combination, for example she may choose to pay $50,000 by lump sum which would mean her daily payment would be $17.96 per day. This would reduce her cost of care to around $71/day which is $25,800/year and still more than she can afford. If Shirley pays a lump sum she could choose to deduct her daily accommodation contribution from that amount, which would ease the pressure on her cash flow but reduce her lump sum to zero in around 13 years. All figures correct as of 1st September 2021.

52 Australian Carers Guide | SPRING 2021

But if Shirley sought advice she may be able to reduce her assessable assets under the means test, in turn making her aged care more affordable. Let’s say she sought advice and reduced her assessable assets by $40,000 – which could be through a combination of gifting, pre-paying funeral expenses and/or purchasing an income stream with an asset test exempt amount – Shirley’s accommodation contribution under the asset test would drop from $23.56/day to just $4.33/day and her equivalent lump sum would also reduce from $212,252 to $39,000. Many low means residents think that they can’t afford to get financial advice. Personally I think they can’t afford not to get it. ACG

L aw

Prevention

is cheaper

than cure SPRING 2021 | Australian Carers Guide 53

Do you know what often happens to your elderly’s financial affairs?

BY MICHAEL CLOHESY

t a recent professional development meeting I attended, a well-known Melbourne Wills & Estates lawyer offered this comment to the attending solicitors, “When I first meet my clients I say to them, I’m going to let you in on a little secret … you’re going to die!” There was a roar of laughter from the group. However, the bluntness and truthfulness of his comment really grabbed my attention. Death is not something we like to think about. It is kept secret. Most of us have not really turned our minds to the consequence of our demise. It’s just too awful to consider, so we avoid thinking about it. And we subsequently don’t do anything about it. The blunt comment made me realise that my own death is not something I really want to think about either. Would I like to be buried or cremated? Oh my goodness; neither sound at all pleasant. I’ll just stop thinking about that little problem for the time being. When I meet with my own Estate Planning clients, I’m usually not so blunt regarding their demise. Maybe I should be. I generally ask them something like, “When the inevitable occurs what will be your legacy? Will you leave behind a mess for your family to stumble through or will you provide them with a clear set of directions?” As a Wills and Estate lawyer, I’ve seen close hand what happens when people die without a Will. All too often I witness families brutally turning upon each other. The legacy of their parents created vicious disputes that required huge amounts of money to resolve. 54 Australian Carers Guide | SPRING 2021

There will be no more family get togethers or Christmas lunch. The family is ripped apart forever. It also never ceases to amaze me how often I am called in to palliative care wards to draft Wills for people with a long-standing illness. They can barely hold the pen. The sicker these people get, the harder it is for them to think about their financial affairs. And the Will sicker these poor people you leave get, the harder it is behind a mess for their family for your family to members stumble through or to raise the will you provide them issue without with a clear set of sounding greedy or directions? opportunistic. As a carer it is really important that you take a little time to talk to your elderly loved ones about what their end-of-life intentions are. If they don’t have a Will, then it’s time to talk about it.

What happens when a person dies without a will? INTESTACY – THE WILL YOU GET WHEN YOU DON’T HAVE A WILL If you die without a Will, state laws determine who will get your financial estate. Dying without a Will is referred to by lawyers as ‘intestacy’. Most Australian states have similar intestacy rules based on a hierarchy of family relationships. Die without a Will and the first beneficiary in line will generally be your spouse. However, sometimes the children can get a share as well. If you have children from different partners, then distribution starts getting complicated. And if you have an unregistered domestic partner (or more than one partner as I have witnessed), then things start getting lively.

Real life Scenario Let’s say that Grandma would like to leave all of her jewellery to her favourite grand-daughter Mandy and promises it to her on a visit. Unfortunately, if Grandma dies without a Will, then the jewellery will pass to Grandpa. And if Grandpa has already passed away, then the jewellery will go to Grandma’s estranged son (even if they haven’t spoken for thirty years).

YOU NEED TO PICK THE BEST EXECUTOR The Willmaker also needs to think about who will be in charge of sorting out the estate when the inevitable happens. This person is called an ‘Executor’. In short, they ‘execute’ your Will. That is, they ensure that the Will is sent to the Supreme Court to be validated/ proven (this is known as ’Probate’).

Photos: CanStock

The executor is entrusted to collect all of the funds and shares, pay all of the bills and then pass on what’s left to the beneficiaries. I often suggest that the person who is inheriting the most money in a Will is the best choice as executor as they tend to take an active interest in what is going on. SPRING 2021 | Australian Carers Guide 55

WATCH OUT FOR CREDITORS AND PREDATORS … (AND TAX) Is it a good idea that your child inherits a large sum on their 18th birthday? Will they invest it wisely or will they blow the lot? Is it a good idea that a child with substance abuse or gambling issues inherit a large lump sum? Is your child in a shaky marriage or are they about to go into bankruptcy?

Real life Scenario Let’s say Grandpa has loaned $200,000 to his son to buy a house. He decides to leave his remaining $200,000 to his daughter but doesn’t get around to signing a Will. When Grandpa passes away his son and daughter will get half of his estate each (that’s $100,000 each). His daughter will be most upset as her brother gets significantly more than her.

SUPERANNUATION IS WHERE MOST OF YOUR MONEY IS From my experience most people don’t actually hold a lot of cash in the bank. Generally, the bulk of their wealth sits in a superannuation account (known as ‘Super’). And here is the problem when it comes to death … A Will does not tell us where all of that Super goes when you die. The solution is a further document (known as a ‘Super Death Benefit Nomination’) that tells us where the Super goes when you die. These Nomination forms are often filled out incorrectly which can invalidate them. The Nomination forms can also lapse after three years. Also, the Super can be heavily taxed if it goes to the wrong person. 56 Australian Carers Guide | SPRING 2021

These are all important questions to consider. If you are concerned about what will happen when your kids inherit your estate, then it might be worth considering a ‘Trust’ in your Will. A trust allows you to choose someone responsible to look after your kid’s inheritance. The trust can ‘drip-feed’ funds to your children when they need it.

“

THINGS CHANGE From experience most of my clients do two Wills in their life. The first Will is drafted when a couple have young children and there is a need to consider who will look after the kids if they both pass away.

The only two certainties in life are death and taxes. – BENJAMIN FRANKLIN

The second Will is drafted when the kids are grown up and are appointed as executors.

”

In summary the inevitable is going to happen. A professionally drafted Will ensures that your hard-earned savings goes to the right people. Leaving a Will is plainly and simply good manners. ACG Michael Clohesy is the National Head of Legal Services at Gathered Here. Michael can be emailed at michael@gatheredhere.com.au

Do you know your aged care choices? Seeking additional care for an aging loved one can feel overwhelming. Their loss of independence can be extremely distressing, and expectations weigh heavily on family.

PLANNING FOR YOUR NEEDS Being time poor or supporting a family member who is showing resistance to care, means carers often struggle alone. Dana Sawyer from My Care Path explains, “Many carers don’t know their options. Planning together, we consider lifestyle, cultural, family and budgetary considerations, empowering carers to make choices centred around their unique circumstances”.

provide highly personalised aged care coordination with empathy and sensitivity, to help families support the best interests of their elderly loved ones. Mary from Victoria was supported by My Care Path to secure a care package for her elderly mother. “Navigating the system was completely foreign to my sister and me”, she said. “Jayne from My Care Path guided us every step of the way with kindness and compassion. Now Mum has the support she needs to stay living in her much-loved home”. Whether seeking in-home or residential aged care, the team at My Care Path are ready to support you to understand your choices.

STAYING HOME FOR LONGER Many older Australians prefer to stay in their homes for as long as possible and, increasingly, they can. My Care Path’s expert consultants

Discover your options: mycarepath.com.au 1300 755 702

AUSTRALIA’S PREMIER AGED CARE COORDINATION SERVICE Your path to quality aged care My Care Path is a national aged care coordination service. Whether you are considering government or privately funded options, looking for home or residential care providers, our end-to-end service will support every step. We will navigate this complex sector providing you with expert advice, to find the right support for your loved one.

Our services include: ✔ Aged care advocacy ✔ Selecting an aged care service to match your needs ✔ Home Care Package Comparison report ✔ Shortlisting aged care vacancies ✔ Explaining fees and charges ✔ Assistance with Centrelink and admission paperwork ✔ Support accessing and understanding ‘My Aged Care’ Every case is unique. No matter your budget or care needs, you don’t need to struggle through the system on your own.

Call us on 1300 755 702 mycarepath.com.au SPRING 2021 | Australian Carers Guide 57

M ental health

Soul Food

Managing your emotions before they manage you. It’s not what you’re eating, it’s what’s eating you.

58 Australian Carers Guide | SPRING 2021

If you’re a carer who struggles with feelings of frustration, anger, bitterness or guilt, then just know that you’re not alone. In fact, research shows that these negative emotions are more prevalent in today’s family carers than most other people groups.

Why Carers? Caring for your elderly loved one usually starts between the ages of 40 to 50. At this age, most lives are well established. Some have families of their own, some have thriving careers, a social life, and a regular health regime. It is also generally around that time that they notice their parents developing some health concerns. There ahead, is the road that’s about to be well-travelled; looking in on their loved one once or twice a week, picking up some groceries on a regular basis, setting up doctor’s appointments, attending those appointments and before they know it, they’ve arrived! They are now their loved one’s pillar upon which they lean. Now, even the saints among us, who love providing care, often underestimate the incredible disruption caring can cause to a normal way of life. Maintaining healthy and well-balanced relationships with partners, children, employers, friends and so forth can be very demanding. This is where they enter the clash of two worlds, both of which are vying for their time and attention. So, don’t be surprised if a little sense of resentment creeps in. That’s NORMAL!!

Let’s look at lovely Heidi. Married to Mark and mother of four. She works full time as a primary school teacher and has the usual handful of friends, hobbies, and social activities. Her father is no longer with them and her mother lives close Research by. Mum lives on shows that negative emotions are her own and more prevalent in today’s is relatively family carers than independent. most other people One day, Mum groups. takes a fall. She rings Heidi to come and help her, which of course, Heidi does. It turns out that her mother is diagnosed with the onset of Multiple Sclerosis, the loss of balance and possible tripping is a side-effect. Consequently, Heidi begins dropping in on her mother more frequently. The frequency escalates when Heidi sees that her Mum’s movements diminish. What began with enjoyable pop-in visits every few days, an hour here and there, soon progresses into a substantial caring role with major responsibility for Heidi. Now, Heidi loves her Mum, but Mark also loves Heidi as do her kids. She values her job but is having to take a great deal of time off. Often, Heidi isn’t home for dinner because her Mum is becoming more demanding of her daughter’s time. She begins to miss her family, her children, her routine, and her time-out. Her work has been supportive, but their grace is starting to wear thin. Before she knows it, she has developed negative emotions about which she feels terribly guilty. Now, does that make Heidi a bad person? Absolutely not!!! But what it does indicate is that she is “overloaded”!! Ring a bell? SPRING 2021 | Australian Carers Guide 59

Caring for the Carer We sometimes ask why some people are tasked with additional challenges in life. There is no easy answer. But what we do see is that there are thousands of carers in Australia providing care and support to that important person in their lives – partner, friend, parent, child, grandchild or extended family member. This is an invaluable role and contribution to the health and welfare of Australians that can not manage alone. You are their heroes! The role of a carer is different for each person, but there are also similarities - the need for selfcare, self-praise and self-time. To be the whole and best person you can be for the person you are supporting also means taking time to heal and regenerate yourself. Reach out to good friends, take time to have those few minutes to smell the daisies. You are a hero!

60 Australian Carers Guide | SPRING 2021

Call us on 1300AGECARE visit seniorhelpers.com.au

The Danger of suppressed Emotions Having negative emotions isn’t the problem, it’s what we choose to do with them that matters. Some people are quick to forgive, some turn the other cheek whilst others, well, it’s just ‘water off a duck’s back’. Great! But what if you’re not wired like that. What if the emotions you carry are too difficult to confront because, like Heidi, you love your Mum? Sadly, many carers choose to suppress them because they feel terrible for having these feelings toward their loved ones. But here is where the danger lies. Burying them in The Ostrich Syndrome especially over a period-of-time, will create a toxicity in your soul and will have serious consequences to your health and wellbeing. Whatever we suppress inwardly will eventually be expressed outwardly and often with, albeit unintentional, adverse effects.

Mind, Will and Emotions How often do you stop to think about your next meal? Do you consider that what we’re eating is good for our bodies? Will it be good for our families? We look at packaging to find out the ingredients as well as the chemicals because intrinsically we want to be healthy. Our body also cooperates with this goal by retaining what’s good and eliminating what’s not.

just stick around until eventually, one day, unexpectedly, they rise up and come to life. You know it’s true. Whatever we suppress will eventually be expressed.

Still With Me? Then, I want to share with you a 4-step process that helped me to develop a healthier relationship with my feelings and emotions which empowered me to make positive changes. I became less re-active and regained control of the way I responded. One thing I learned through this process was that change is possible if you keep an open mind, are willing to be introspective and alter your internal narrative.

THE FOUR STEPS 1 Stepping out, become the observer: Separate yourself from your emotion. 2 Name the toxic emotion: - Name the emotion(s) you are struggling with. 3 Choose your higher value: - Look at your values and find the one that dissolves your negative emotion. 4 Walking your why: - Values guide above emotions that react. Let your values guide you, walk your higher set of virtues.

Photos: CanStock

Yet, when do we apply the same level of consideration to the health of our soul, our ‘mind, will and emotions’? I’d be confident to go out on a limb and say, ‘not too often’, especially if you’re a busy person who is also a giving person. We tend to allow these negative emotions to sneak in, and worse, remain buried in our souls and become toxic, often having negative consequences on our wellbeing. So why do we do this? Maybe it’s simply because we don’t know what to do, or more commonly we fear the consequences of what will happen to those we love if we suddenly let out our supressed emotions that have been festering for months even years. Consequently, these toxic emotions SPRING 2021 | Australian Carers Guide 61

Preparation: Before we begin to work through these steps, you’ll need some paper, a pen and a mirror. Using the paper and pen, write down as many of your own personal core ‘Values’ as you can. If you’ve never been asked this before or are finding this difficult, we have included a cheat sheet at the end of this article to help you. A core belief is a favourable reception or belief in something.

The Process: Try this

I was the observer: The observing self is not a thought or a feeling. It is a state of awareness. You know that you are thinking and feeling because there is part of you that is aware of your thoughts and feelings. You don’t know you are breathing until the observer in you becomes aware of your beathing.

Step 1: - Stepping out Become aware of the observer in you. What do I mean by ‘The Observer’?

Photos: CanStock

The best way to explain it, is for you to experience it. Now it’s time to get your mirror, look at yourself… Write down what you see. In my case, I was a person who was tired, lonely, frustrated, and overweight. Now look at what you wrote and ask yourself, “who was the one you asked to write down what you saw? Was it the person in the mirror or the one observing the person in the mirror?”

62 Australian Carers Guide | SPRING 2021

Step 2: Name the toxic emotion Face your thoughts or feelings with curiosity and acceptance. Even though you may be tempted to ignore the uncomfortable ones, face them anyway, this clears the way for positive change. Label them, whether positive or negative. Acknowledging them makes them real. REMEMBER, no guilt! You can use the list of emotions at the end of this article to help you identify and name the negative toxic emotions you are holding onto.

Step 3: Choose your higher value Detach from your emotions. This detachment will enable you to feel far more autonomous over your actions and decisions. See them for what they are, simply emotions, not who you are. In doing so, label them as accurately as possible, this will help you to better understand their causes and what to do about them. Look at your list of values and try to identify the value that opposes the toxic emotion.

SCENARIO 1:

Rachel’s spouse keeps demanding her time and trying to pull you away from caring visits to her mother. Unable to be in two places at once, Rachel feels angry at the unrealistic demands placed on her by both parties. When Rachel drills deeper, as per this process, she realises that in fact she was feeling frustrated and not angry. Frustrated at the fact that both her mother and her spouse are insensitive to the physical realities or should I say, unrealities of the situation. As the process teaches, she now looks at the core values to find the one most opposed to the frustration she was feeling due to unrealistic expectations and discovers, it was at odds with her value of cooperation. Everyone was not cooperating with each other, and that was why she feels torn in two.

SCENARIO 2:

If you value fairness, you may choose to have a difficult conversation, rather than avoiding it because doing so reflects fairness to your elderly loved one and yourself. Action plan: Rachel, being led by her values, decides to invite her spouse to join her in her caring visits three times a week and her Mum agrees to be not so demanding which allows Rachel one on one time with her spouse. Values are easier to follow than feelings…Values never change but feelings do. Feelings follow values and eventually catch up.

Step 4: Walking Your Why Try to always use your core values to drive you forward. When deciding on what action to take, ask yourself whether this decision reflects your core values and in harmony with who you are.

Conclusion: The next time you have a negative emotion or bad feeling because of something that happened or a situation that was imposed on you, stop…Don’t react. Let the feelings come. Be mindful of your inner experiences but do not be caught up in or led by them. Step out and become the observer. In doing so, it will free up your internal resources to commit to actions that align with your values. Activate the observer in you and observe you having these feeling…name them as accurately as possible. Then before reacting or responding, ask yourself: What is my objective? What am I truly trying to do? What response here is most aligned with my values? Your thoughts are constantly changing sometimes they are pleasant, painful or joyful. The same is true for your feelings: at times you feel anxious, sad, angry, and frustrated. The roles in your life are also changing. Sometimes you are a parent, sister, teacher, husband, wife, brother, employer and yes, even a carer. It is incredibly powerful when we start to recognise that a thought is just a thought, and not a direction, and our emotion is just an emotion, not a direction. Ask yourself, who is in charge, the thinker or the thought? Authenticity may require some discomfort, but it also opens the doors to joy, creativity, self-respect and empathy. ACG

Discomfort is the entry price to being fully alive. SPRING 2021 | Australian Carers Guide 63

List of Core Values Accuracy

All for one & one for all

Adventurousness

Orderliness

Honesty

Integrity

Beauty

Concern for others

Commitment

Perfection in details

Loyalty

Knowledge

Cleanliness

Equality

Creativity

Punctuality

Pleasing of others

Love

Content over form

Collaboration

Decisiveness

Quality of work

Respect for others

Openness

Continuous improvement

Cooperation

Determination

Regularity

Self-giving

Perseverance

Discipline

Coordination

Equanimity

Safety

Service to others

Personal growth

Efficiency

Community

Faith

Speed

Teamwork

Resourcefulness

Endurance

Fairness

Goodwill

Systemisation

Tolerance

Self-reliance

Excellence

Freedom

Goodness

Truth

Trust

Self-respect

A List of Emotions Angry

Sad

Anxious

Hurt

Embarrassed

Happy

Grumpy

Disappointed

Afraid

Jealous

Isolated

Thankful

Frustrated

Mournful

Stressed

Betrayed

Self-conscious

Trusting

Annoyed

Regretful

Vulnerable

Isolated

Lonley

Comfortable

Defensive

Depressed

Confused

Shocked

Inferior

Content

Spiteful

Paralyzed

Bewildered

Deprived

Guilty

Excited

Impatient

Pessimistic

Skeptical

Victimized

Ashamed

Relaxed

Disgusted

Tearful

Worried

Aggrieved

Repugnant

Relieved

Offended

Dismayed

Cautious

Tormented

Pathetic

Elated

Irritated

Disillusioned

Nervous

Abandoned

Confused

Confident

* THE ABOVE LISTS ARE NOT EXHAUSTIVE. 64 Australian Carers Guide | SPRING 2021

Self-Managed

Home Care PACKAGES

What are the benefits?

t’s no secret that most older Australians want to continue living at home, as independently as they can, as they grow older. It’s been the finding of every survey, investigation and report on aged care services for decades and it’s been a major driver of government policy on aged care. The Home Care Package (HCP) program, which provides four different levels of

support at home with different levels of funding attached, is the fastest growing component of the aged care system. In the 10 years between 30 June 2010 and 30 June 2020, the number of people receiving Government subsidised home care packages, tripled (from 47,684 people to 142,436 people, an increase of 199%)1 and the Government expects more than 275,000 home care packages will be available by 2023.

SPRING 2021 | Australian Carers Guide 65

It’s hardly surprising. We are living longer than ever before, despite often managing a few health challenges. Let’s face it: many of us are likely to need some form of support at home to help us continue to live well, independently, into our 70s, 80s and 90s. But that shouldn’t mean having to compromise choice and control over our adult lives. Right? That’s where the concept of self-management of Home Care Packages comes in.

CHANGING EXPECTATIONS As the Home Care Package program has grown, it has also changed to meet evolving community expectations. Prior to the full introduction of the human rights-based policy of ‘consumer directed care’ in 2017, having a HCP tied you firmly to your aged care provider with sometimes quite limited choices. It meant working with their available support options rather than individually tailored approaches, accepting the service provider staff they sent you and fitting into their schedules and rosters. While people were often grateful of any assistance, the lack of flexibility and control over what were often quite intimate interactions with strangers, has been a persistent complaint. Indeed, a research study2 commissioned by former Minister for Aged Care, Ken Wyatt, into the experience of people using HCPs, found the most common complaint about home care providers was the high turnover of unqualified, inexperienced and untrained support workers coming into the person’s home. Changes from February 2017 saw HCP funding allocated to the individual, rather than to the aged care provider; and HCPs becoming fully portable. It meant that, armed with their funding allocation, people could really ‘shop around’ and, for the first time, they had the option to exercise ‘self-management’ of their package if they desired.

BEING IN CONTROL Self-management has a lot to recommend it. For a start, you can choose and engage your own service providers and health professionals directly to suit your particular needs. You might want someone who lives nearby and knows your neighbourhood; someone who speaks your language; someone who shares your interests; who can meet your scheduling requirements or any other Let’s face preferences you might it: many of have. us are likely to

need some form of A big support at home to help positive for us continue to live well, those who independently, into choose to selfour 70s, 80s manage their HCP is and 90s. the potential substantial savings on administration fees. The high cost of fees charged by package providers – on average 35 per cent, but in some cases over 50 per cent for administration and case management3 - has been another consistent theme for complaints about HCPs and one of the focuses of the Royal Commission into Aged Care Quality and Safety.

People who choose self-management can make substantial savings on these fees which can be redirected into more hours of actual care and support. The cost of care is generally another positive when choosing self-management. Rather than pay a marked-up hourly rate to the provider - with only a fraction going to the actual person providing the care - you can negotiate rates of pay directly, knowing the full amount will go to the worker themselves and their associated costs.

1 AIHW: Factsheet 2019-2020 – GEN Aged Care Data; People Using Aged Care 2 Russell, S: ‘Older People Living Well with In-Home Support’ 2019. Age Matters 3 Russell, S: ‘Older People Living Well with In-Home Support’ 2019. Age Matters 66 Australian Carers Guide | SPRING 2021

The Home Care Package (HCP) program, which provides four different levels of support at home with different levels of funding attached, is the fastest growing component of the aged care system.

HORSES FOR COURSES

CHOOSING SELF-MANAGEMENT If you’re ready to explore self-managing your HCP, there are two steps involved. The first step is choosing a provider that offers genuine self-management; and not all package providers do. Some only offer a diluted form of it. However, there are a growing number of approved HCP providers that specialise in self-management. Their administration fees vary between 12 and 17 per cent, which is substantially lower than most traditional package providers. You can find GOVERNMENT some reputable providers in EXPECTS this issue of the Australian MORE THAN Carers Guide.

While there is no doubt about the potential positives of self-management, it’s not an option that suits everyone; and some people will be very happy to have their package provider manage all or a large part of their HCP, with just some input and direction from them.

With self-management, you need to consider the time and work involved for you or your family member to be in full control - finding, interviewing, engaging and managing people in your support home care packages team, including discussing will be available by and agreeing

275,000

Once you have set up your self-managed package, the second on pay rates and other 2023 step is finding the people arrangements. who can provide the There are some very good online services you need; and building marketplaces where you can easily find your care and support team. qualified and safety-checked service providers in your area but you’ll need to feel That’s where online marketplaces comfortable with online platforms and can help enormously. have reliable access to the internet.

It also helps to have some understanding of the healthcare system, to be comfortable with understanding financial statements and managing budgets. For many older Australians and their representatives, none of these things are barriers – it’s what they might have done all their lives - but they are important factors to bear in mind when considering the self-management option.

At the end of the day, the rights of older people ‘to make decisions about their care and the quality of their lives’ - part of the UN Principles for Older Persons adopted by a UN General Assembly resolution in December 1991 - is what is most important. It can mean taking full control over all our decisions, which we can if we choose selfmanagement; enabling others to make decisions on our behalf; or something in between – but it is always our choice. ACG SPRING 2021 | Australian Carers Guide 67

Freedom

OF CHOICE What most know because nobody tells them What mostcarers carer’sdon’t don't because nobody he tells them

aking decisions around aged care is emotional, stressful and confusing. Being my first time trying to navigate the aged care system, I had no idea where to start. I tried Centrelink, but soon realised I needed another degree to understand

the system. I have a young family, work full-time, and my dad has an aggressive form of dementia. While he is still largely independent, my mum is now his full-time carer. This process overwhelmed me as is the pressure to make the right decision for the person who has spent most of his life helping me make life’s big decisions.

68 Australian Carers Guide | SPRING 2021

BY JAYNA HOSKIN

Fortunately for my mum and me, Fortunately for my mum and me, we were introduced to placement we were introduced to placement consultants – a game-changer.

LISTENING AND UNDERSTANDING

LISTENING AND UNDERSTANDING Jayne then short-listed facilities and Jayne then shortlistedus facilities accompanied on siteand tours. As a part of accompanied us on-site tours. As a part of the initial briefing, she spent a lot of time consultants – a game-changer. the initial briefing, she spent a lot of time understanding who Dad is, so the facilities understanding who Dad is, so the facilities knew it was important for him to feel at OUR FAMILY STORY knew it was important for him to feel at OUR FAMILY STORY home, have access to a garden, internet home, have access to a garden, internet For my family, guidance from our placement space walk, andto a place to have For my family, guidance from our placement access,access, space to walkto and a place consultant called Jayne, helped us navigate glass of and red watch wine and watch sports . consultant called Jayne helped us navigate have aared wine sports We the aged care system. Her experience andprograms. At each facility, we At each facility, we assessed the aged care system. Her experience and experts expertise as an Aged Coordinator assessed whether there whether there were other expertise as aged and careCare coordinator many areas o We seek significantly eased our stress, were other residents residents who were significantly eased our stress, whichwhich has has been lives –insurely how experts so compounded who were like him like him – many been compoundedby byCovid-19 Covid-19 and and media media many areas of our see out the end of our – manypeople, people, attention surrounding the aged care system. attention surrounding the aged care system. lives – surely how we is as important a including including me see out the end of our lives At our first meeting with the placement the other s me before At our first meeting with Jayne, we talked as important as all before this, assumeisthat along the consultant, wedad: talked inhe detail about this, assume in detail about my who is, his likes my dad: the other steps that aged care is full he is, likes and interests andwho dislikes, hishis interests anddislikes, hobbies,his and tthat aged care is full of old, people. M alongfrail the way. of old, frail people. My and hobbies, of courseWe hiswere form of dad is very independent and young at hear of course his formand of dementia. dad is very we independent and needed toand make sure the place tha dementia. We were genuinely surprised genuinely surprised by how much she knew by young at heart, and we needed andhow understood of the disease, specifically Jayne knew and understood the disease, becomes his home not only has the things to make sure but the also placehas thatneighbours becomes he can form needs his rare form of his dementia. From specifically rare form of there, dementia. From his home not only has the things he and become friends with. Our she there, guidedshe us through thethrough financialthe side, guided us financialneeds connections but also has neighbours he can form consultant took all of these into account. including CentrelinkCentrelink and payment side, including andoptions payment connections and become friends with. Our all of this into account. andoptions, put us inand touch with planner put us a infinancial touch with a financial consultant took all of this into account. whoplanner specialises aged care. Jayne also whoinspecialises in aged care. She DAD’S SO HAPPY processed forms for us, taking much of SO HAPPY NOW NOW also processed forms for us, taking much DAD’S of the the logistical load load off sooff weso could focus focus on logistical we could onWith Jayne’s With Jayne’s help, weafound facility that w help, we found facilityathat choosing a facility and caring for Dad. believe my dad his care choosing a facility and caring for Dad. we believe will will suitsuit my dad and and his care requirements. is a for garden for him to requirements. There isThere a garden him to HELPING TO GET OUR FINANCES HELPING TO GET OUR FINANCES maintain, andfor space fordinners family with dinners with maintain and space family IN ORDER IN ORDER kids and grandkids, and it’s his kidshis and grandkids, and it’s close to close my to my mum’smum’s home. home. Continued family contact Continued family and contact and The financial planner went through the finer The financial planner went through the finer connections are veryare important to us, and connections very important to us, and t details with us, including an audit of assets details with us, including an audit of assetsthis facility ticks all the boxes for what DadDad will facility ticks all the boxes for what and a consideration of our circumstances. and a consideration of our circumstances.will need. need. This meant that we could work out quickly This meant that we could work out quickly what the financial situation would be for our The next thebe transition what the financial situation would be for our The step nextwill stepbewill the transition family with the help of an expert. They took family, with the help of an expert. They took from from our family home home of 35 years everything into account, including things our family of 35 years to everything into account, including things we we hadn’t considered, such as whether my to hishis newnew home. I am not not suresure I amI am hadn’t considered, such as whether my mum home. I am mum should continue working, and how readyready for thefor next weand are we notare no working, and how the the should financialcontinue side of aged care might impact thestep, nextand step, financial sideofof aged caresuch might impact other sure when it will be, but we do know it other members the family, as my sure when it will be, but we do know it members of the family, such as my sister, sister, who my mum also cares for. It moved is inevitable, and we are now prepared. whojust my the mum also cares for.took It moved beyond inevitable, and we are now prepared. beyond finances – Jayne a just approach, the finances – Jayne holistic holistic showing ustook whatathis Looking for an aged care facility for my dad approach, what this and decision has been Looking for an aged care facility for my d decision wouldshowing mean forus the lifestyle an emotional and overwhelming mean forofthe lifestyleinvolved. and care has been emotional andcare overwhelm experience. Havingan Jayne as our aged carewould arrangements everyone experience. Having Jayne as our Aged Care arrangements of everyone involved. SPRING 2021 | Australian Carers Guide 69

Coordinator to guide my family through the Coordinator to guide my family through the process has been a blessing. She went beyond process has been a blessing. She went beyond just the logistics and finances and has just the logistics and finances and has reassured us that if at any point we need to reassured us that if at any point we need to change the plan we can. This is not a ‘set and change the plan we can. This is not a ‘set and forget plan’ – this is about giving my dad the forget plan’ – this is about giving my dad the best life possible. We found that our Aged best life possible. We found that our Aged Care Coordinator was flexible, honest and Care Coordinator was flexible, honest and accommodating, and Jayne advocated for my accommodating, and Jayne advocated for my dad and my family every step of the way, dad and my family every step of the way, making sure that we found a solution that was making sure that we found a solution that was in everyone’s best interest. in everyone’s best interest. Knowing what I know now, I would never go Knowing what I know now, I would never go through this process without an Aged Care through this process without an Aged Care Coordinator. We seek experts in so many Coordinator. We seek experts in so many areas of our lives – surely how we see out the areas of our lives – surely how we see out the end of our lives is as important as all the other end of our lives is as important as all the other steps along the way ACG steps along the way ACG

Reputable Reputable AgedCare Care Aged Consultants Consultants canbe befound found can inour ourguide guide in andon on and ourwebsite. website. our

70 Australian Carers Guide | SPRING 2021

SPRING 2021 | Australian Carers Guide 55 SPRING 2021 | Australian Carers Guide 55

E lder care

Advocating

for your loved one: What you need to know

Photos: CanStock

lder adults who become unable to handle their own affairs can become frustrated, angry or confused and others must, often tactfully, become involved. When my father lost his memory and his ability to talk as a result of Alzheimer’s disease, I was left to serve as his advocate—essentially becoming his eyes, ears and voice. Protecting someone’s quality of life and managing their personal and business affairs is a significant task for a family member or

BY RICK LAUBER

friend to take on. Although to make it official, you will need legal forms filed but it is not as complex or daunting as you might think. First you must decide what sort of advocacy does you loved one require. The most common two types are Enduring Guardianship and Power of Attorney

WHAT’S THE DIFFERENCE? You may be wondering what distinguishes the two. The key difference is that a Power of Attorney makes decisions over financial and legal affairs. Whereas an Enduring Guardian SPRING 2021 | Australian Carers Guide 71

has the power to decide on matters regarding lifestyle, health, and welfare. However, they are similar in that they are both legal documents that provide the carer with the power to act on your behalf. This comes into effect when you no longer have the capacity to do so. Generally, both documents are included as part of your will or estate plan.

SHOULD I HAVE BOTH? Short answer – yes. While it may seem unnecessary or unlikely you will need an Enduring Guardian or a Power of Attorney, things can happen. It is important to appoint both an Enduring Guardian and a Power of Attorney. This is because they both play important roles in ensuring your affairs remain in order and your wishes are heard. When you are choosing someone to appoint, it is important you trust them. Further, you should ensure they have your best interests at heart and that they understand your wishes. For assistance on actioning these matters, you can customise the General Power of Attorney legal document found at ‘legal-information’ on the myagedcare.gov.au website for free. The rules are different in each state and territory, so contact the relevant authority where you live, or your legal adviser, for details on the guardianship and administration laws in your state or territory. If in South Australia, the Guardian is referred to as the Administrator

CONCLUDING THOUGHTS While an Enduring Guardian and a Power of Attorney may seem similar, there is a fundamental difference in their powers. It is always best to be proactive and appoint people in these roles early, before it becomes an urgent matter.

For more information and advise, we recommend consulting an Estate Planning Lawyer for assistance.

Ask questions:

Talk to everyone Take a dvoc involved with atin your g a loved nd le t you facili one’s care. r lov ty st ed o a ne’s ff or Remember, p care rofes r s sion when know al that a r e advocating you serio us ab for someone out doin g so. else, there are no foolish questions. Ask until you fully understand. As a former co-carer, I carried around a notebook and pen, and made sure I took it to every appointment. I wrote down responses and returned to them later to ensure my complete understanding before reviewing my to-do list. Thankfully, many phones now have a voice recorder, so I suggest taking a few minutes immediately following each appointment (so that you don’t miss anything) to record your thoughts and comments shared.

serio

usly

Peer into the parental closet: I’m not

asking you to look for skeletons! Rather, this is fully practical advice that can help make sure your loved one is being well looked after. Check that their room (if not their closet) is swept/vacuumed and mopped daily so that germs don’t pose a health risk. If they are in a care facility then also check the facility’s public washrooms, stairwells and food-service areas. Dirt can accumulate under furniture as well. We attached small wheels to the bottom of a bookcase in Dad’s room so that cleaners could easily roll the bookcase aside to clean.

As a carer, you need to speak up for your loved one. But if you are having doubts about your own ideas or need help with the legality of policies, care costs or human rights issues, then there are a number of local and free government organisations you can turn to. 72 Australian Carers Guide | SPRING 2021

Plan sporadic visits: Years ago, when

Dad was alive, I would stop in to see him every Sunday afternoon—like clockwork. But I certainly didn’t stop there! There were intermittent visits as well. By dropping in sporadically, I felt better able to see any inconsistencies with my father’s care (or even that of other residents).

Schedule visits around resident mealtimes. These can be hectic times at a care facility. Is your loved one eating a full meal and getting any help necessary? Monitor health and grooming:

While you may not have the medical knowledge to diagnose a problem, it can be easy to identify a person in pain. Does your loved one limp when walking? Are they grimacing when bending over? Keep your eyes open for any unexplained sores, cuts or bruises on their body. Watch to make sure personal support workers are managing to keep your parent groomed and clean. Are clothes coming back from the laundry or are they getting lost? Monitor the bathing schedule—how often are baths or showers provided? I also routinely check my father’s chin stubble to confirm that he’s been shaved.

Photos: CanStock

Insist on regular updates: Keep open

lines of communication with your loved one’s care facility or care providers. If your relative has been moved to another room, isn’t eating or needs a change to their medical prescription, you will want to know. Providing the care facility or care provider with your up-to-date contact details is important—but it is even more important to be proactive and call in regularly.

Meet with management: I was able

to schedule meetings with the facility’s management to talk about Dad’s ongoing health, ask questions and, if necessary, air grievances. If you do need to raise an issue, be sure to create a paper trail. I would always send a quick email to the facility’s manager following our meeting that read something like: “Thank you for meeting with us today. As discussed, I understand that you have noted [whatever concern] and have recommended [whatever answer].” If follow-up is necessary, state a date when you will be back in touch for further discussion. Remember to copy other family members on your emails and perhaps print out copies to save. ACG

Look beyond your immediate resources: As a carer, you need to speak up for your loved one. But if you are having doubts about your own ideas or need help with the legality of policies, care costs or human rights issues, then there are a number of local and free government organisations you can turn to. Take advocating seriously and let your loved one’s facility staff or professional carers know that you are serious about doing so. Rick Lauber is a published author and freelance writer of The Successful Carers Guide (Self-Counsel Press).

SPRING 2021 | Australian Carers Guide 73

A dvice

provide better care BY CAROLINE TAPP-MCDOUGALL

Photos: CanStock

ways to

74 Australian Carers Guide | SPRING 2021

Being involved in family caring isn’t the easiest task for anyone, given its personal nature and inherent challenges. After all, the circumstances carers face are often difficult and stressful. Let’s look then at things to think about and ways to stay as happy and healthy as possible while still providing the best care:

Watch for daily changes

This might well be a fragile period in your parent’s life. Changes can occur on a day-to-day basis, and behaviours may be inconsistent or hard to read. Don’t sweat the small stuff but know that your parents may hide or cover problems to avoid worrying you. Be diligent and keep your eye out for things that signal all is not well and be ready to get involved if necessary.

Walk the line

Knowing when to step in and when to leave well-enough alone is a sensitive issue that often ruffles feathers. There’s a delicate balance between encouraging and supporting independence and taking unnecessary risks. Often, adult sons and daughters straddle the line between what’s okay and what’s going to cause arguments or stress. Wise advice: Think before you blurt and be strategic and considerate when approaching difficult topics.

Balance your time

Be open to doing things differently and find a system that divides tasks into what you (and only you) can do and what you simply can’t handle. Then, delegate accordingly. Done well, this will reduce your stress and help you to relax and focus on other things that are important to you. Downtime and simple pleasures are not a luxury when you’re a busy carer.

Photos: CanStock

Find a funny and share it

Studies have shown that there is a connection between having a sense of humour and the overall ability to cope with

what life dishes out. Laughter is said to boost the immune system, cheer you up, improve your Build in a emotional state 15 to 20-minute nap and even into your daily help you to schedule to help put things into you stay alert perspective. Having a good laugh has been compared to internal jogging when it comes to cardiac conditioning, and it has also been shown to improve gastrointestinal health and respiratory function. So, go ahead! Laugh about it.

Practice good sleep habits

Sticking to a sleep schedule will help you to stay fresh and be ready to tackle the day. By keeping your sleep/wake cycle synchronized and working on improving your sleep habits, you’ll be in better shape to handle the challenges that being a carer brings. Try to go to bed and get up at the same time each day. If you feel you need to, build a 15 to 20-minute nap into your daily schedule shortly after lunch to help you stay more alert. Avoid having nightcaps because alcohol suppresses REM sleep and causes frequent awakenings. And the experts suggest that you put aside your phone and other electronic devices a while before bedtime, to get your mind ready for sleep.

Stay connected

Keeping up with friends and family can be hard to do, but it’s important. Loneliness SPRING 2021 | Australian Carers Guide 75

A CLUE

that intervention

might be needed

Activity levels: Suddenly Mum is a “glass half empty” gal, focusing on the negatives. You notice that she is no longer pursuing hobbies or social interests that once provided her with pleasure.Thiscouldbeasignofdepressionor ofanotherissue,andsomeclosequestioning or a visit to the family doctor might be required.

Personal grooming: Few things raise the spirit like newly coiffed hair, a trimmed beard or a freshly laundered shirt. However, when people are depressed, personal hygiene and grooming are often the first daily activities to fall by the wayside.

Bill paying: If your parent is recently widowed and is having difficulty with the bills, they might just need a helping hand. But if your parent was a good cook or housekeeper or very conscientious about paying the bills and you see a marked change in these habits, there is reason for concern.

Health watch:

Photos: CanStock

Many symptoms of a decline in health are caused by medical conditions that can be treated. Medical intervention may be required if your loved one shows a marked loss of appetite, change in sleeping patterns, loss of hearing or incontinence, or becomes accident prone.

76 Australian Carers Guide | SPRING 2021

Medication management: Is your parent using medication inappropriately? Perhaps there are too many drugs and can’t recall which medication does what. While a good medication regimen has positive effects, taking medications improperly can have unfortunate and sometimes deadly results.

Confusion: Your parent may have become confused, suspicious or fearful. If this was not your elder’s personality in the past, or the fears seem exaggerated, then this is a sign that there is a problem.

can become toxic unless you have quality relationships where you can count on other people, according to Dr. Robert Waldinger, who directed a study on the subject. Isolation and loneliness are said to have the equivalent effect on health of smoking 15 cigarettes a day. It’s certainly worth thinking about for both yourself and your loved one.

Alleviate suffering

Do your best to keep your parent comfortable and pain free. Watch for bedsores, which can come with inactivity or sitting or lying in the same position for too long. Check bony spots such as the elbows, heels and buttocks. And don’t forget to keep your family doctor in the loop, even if only by phone or email. After all, help is usually only a call or an appointment away.

Plan visitors

Company is good for everyone, but spontaneous visits from friends are not always well timed. Plan social visits on days that are not filled with medical appointments or other activities. Be mindful of the noise and confusion that youngsters can cause and beware of guests who overstay their welcome. The moral of the story…It’s better to pace both yourself and your mum or dad.

COMIC CORNER TOP 4 GAMES

Accept the challenges

Acknowledge that there will be times when you’ll feel down and think about what it is that’s bothering you. It’s okay to talk about your loss and realise that what is happening is not your fault. Look for support and help when you need it. Don’t be afraid to chat with friends and family about how you feel.

Know who to call for help

Make sure you have all of the necessary contact information for health team members, medical records, insurance papers, prescription information and legal papers, including health cards, advanced directives and living wills. When things are not going well, the last thing you will want to do is rummage around looking for papers and the information you need. Simply put… With the (over) 2.65 million people involved in caring activities in Australia, it’s easy to see why a lot of help, patience and wise advice is needed. Taking these on board can allow you to provide the finest care, avoid burnout and make caring for a loved one a more rewarding experience. ACG

only seniors play Seniors with one eye love playing

I SPY WITH MY ONLY EYE But they get 2 turns so its even

Lively Seniors love playing

SNAP

Only with an orthopaedist present

Seniors hard of hearing love playing

KNOCK KNOCK

But never know who’s there

Romantic Seniors love playing

DOCTORS n NURSES

But their masks kill the mood

Photos: CanStock

But also remember that a visitor can take charge for a while, so you can go to the shops, run an errand or just have a few hours off.

SPRING 2021 | Australian Carers Guide 77

Dealing with ANGRY & Elderly Parents 78 Australian Carers Guide | SPRING 2021

We are all aware of elder abuse and sadly it is becoming more prevalent in our society. However, there are a minority of elders that can be a tad abusive to their carers which is usually one of their children or even their spouse.

Understanding

Communication

Like everyone, the elderly has their good and bad days, but there can be no doubt that the last 18 months have been particularly challenging for the elderly and their families, during this global pandemic. Mood swings stemming from frustration, lack of communication, poor health, stress, pain and lack of privacy or dignity can easily lead to your elderly loved one taking their frustrations out on those closest to them.

Communication is key and sometimes you have to continually reinforce the message because your elderly loved one is forgetful or struggles to process the information you share. If your parents seem increasingly frustrated, anxious or otherwise emotionally disturbed, it’s your responsibility to find out why and assist them to fix that. Try broaching the subject Whilst when they are in a there is no pleasant mood simple solution in and warming dealing with this type of them to the behaviour, we can offer conversation some suggestions with alluding that may help. questions. This may take a couple of visits before you succeed or make any headway.

As we age our individual character traits can magnify. Someone that was short tempered may suffer full on bouts of rage in their old age. Unfortunately, family members are often the target of these outbursts. Whilst there is no simple solution in dealing with this type of behaviour, we can offer some suggestions that may help.

Handling Anger Outbursts Whilst it may seem obvious, it needs to be said, don’t take these negative behaviours and anger outbursts personally. Pain and stress can cause us to act in inappropriate ways, and in hindsight regret. It’s important to determine if anger and aggressive outbursts are indeed caused by their current situation or just something that they express to you. Knowing which it is will help you determine the strategy to take. To identify this, ask as many people as reasonable to call or visit your elderly. Then report back to you on how they found their behaviour. Knowing this will help you determine what response is appropriate.

Cursing and Abusive Language Verbal abusive and harsh language can be detrimental to all involved, especially when things are said in the heat of the moment. If your loved one suffers from Dementia, profanities can be out of character and part of the effects of the disease. To mitigate excessive swearing and anger, try appealing to their character and your opinion of them. You could say things like. ‘I don’t remember you using such vulgar language. This is not the respectful person I remember admiring. and looking up to’ or ‘You were never so disrespectful in front of people and especially your family’. If you need the big bat, try, ‘It so sad to see you reduce yourself from a person I respected, to a disrespect vulgar person.You’re better than that’. It can help to use visual imagery by reminding them of their forthright and respectable reputation held by those closest to them. Easier said than done, but worth trying! SPRING 2021 | Australian Carers Guide 79

5 TIPS

THAT HELP TO REDUCE OUTBURSTS:

1 CARROTS & STICKS 2 DEPRIVING OF YOUR COMPANY

3 DON’T BITE ME, WRITE ME

4 NEVER ATTACK BACK, SEPARATE THE PERSON FROM THE BEHAVIOURS

A PERSON’S WHO IS NOT WHAT THEY DO

5 REINFORCE AND

REWARD BALANCE AND PEACE

Physical and Emotional Abuse Many elderlies are unaware that their behaviour is abusive and that makes a solution difficult. If you have tried communicating with a heart-to-heart conversation and that hasn’t worked, you need to look at having a short break from providing care. There are respite options at many homes. You could also look at consulting a professional family counsellor or outsourcing to professional in-home care for help and assistance. Photos: CanStock

Paranoia and Hallucinations If your loved one is suffering from paranoia or hallucinations, then you need to seek help from a medical professional to diagnose

80 Australian Carers Guide | SPRING 2021

any possible serious mental disorder. If this behaviour started suddenly, then check to see if it coincides with a change in their medication and if so, talk to their doctor as their medication may need to be altered. If it has started mildly and gradually gotten worse over time, then it may be a symptom of Dementia or Alzheimer’s disease. If this is the case, get them checked and diagnosed by their doctor asap. Dealing with angry and emotional parents requires a lot of patience and empathy. Whilst difficult and frustrating, communication and persistence can go a long way in achieving a much more stress free, healthier, and happier environment for all. ACG

C arers

5 BY DR. MARK FRANKEL

stages of a family carer

Giving care is like being in a dramatic movie where the inevitable end is already known but the story itself is unpredictable and full of twists and turns, highs and lows, peaks of joy and sorrow, high anxiety and quiet satisfaction. Although you already know the ending, looking after a parent is full of surprises that may just cause you to wonder “What comes next?” while you catch your breath!

Photos: CanStock

here is, however, a distinct pattern and storyline to it all, despite the day-today rewards and hurdles. What comes next, in fact, is that family caring typically unfolds into five distinct stages. Knowing those stages, including their challenges, costs, and opportunities, can give you a head start.

STAGE 1 Theme: Independence Soundtrack: My Way The storyline This may not seem like a “caring” stage at all, but Stage 1 is the period when elderly parents don’t want any help. It is often a time when adult children “see” their parents as older and less capable than do the parents themselves. Regardless of perceptions, seniors at this stage are usually quite capable of taking care of themselves,

though perhaps not in the ways preferred by their children. They may indeed be experiencing some of the chronic ailments associated with aging (e.g., heart conditions, diabetes, arthritis, hearing, or visual impairments), but they are able to compensate on their own for any loss of function. Some adult children take pleasure in seeing their parents at this stage. But many others worry about their parents’ health, judgment and what will happen if a parent falls seriously ill. Besides worrying, SPRING 2021 | Australian Carers Guide 81

there are indeed some proactive things that adult children can do at this stage. Resources for family carers Financial planners and legal advisors. You can model good legal and financial planning for your parents. Let your parents know about your own arrangements for the future; will, living will, powers of attorney, financial plan, insurance—and respectfully encourage them to start to plan if they have not already done so. There is a vast array of educational material in books, magazines, newspapers and online on the topic of aging. Educate yourself about the emotional, physical, social and spiritual dimensions of aging, so that you can be better aware of your parents’ experiences and challenges.

STAGE 2 Theme: Interdependence Soundtrack: We are Family

Photos: CanStock

A typical scene Mrs. Morris is an 86-year-old widow still living on her own, for the most part, in a three-bedroom multi-level townhouse. She has four grown children on whom she is very dependent. They have a rotating schedule for caring /checking in on her every day. She suffers from severe arthritis, a heart condition, is losing her sight and hearing and may be showing some early signs of dementia

82 Australian Carers Guide | SPRING 2021

(undiagnosed). She requires assistance for many aspects of daily living, including laundry, transportation to doctors’ appointments and grocery shopping. This situation is extremely stressful for everyone. Mrs. Morris’s children all agree that she needs to have someone with her 24/7 or be in a facility with continuous care and monitoring. However, Mrs. Morris is refusing; she does not want to even consider outside help and does not want to leave her home and all the memories of the past 60 years. The storyline At this stage, seniors may, due to disabilities, need substantial assistance. However, they are firmly resistant to hiring outside help, either citing the cost, denying the need, or both. What most seniors will

“

We are young only once, after that we need some other excuse.

” accept at this stage is family help. If you can prepare some meals or drive mum or dad to the bank, doctor, or supermarket, or assist in other practical ways, this support is usually accepted. Resources for family carers At Stage 2, seniors are more likely to accept technical devices that help them and their loved ones to stay in touch. For example, emergency call systems are increasingly popular.

They enable the user to wear a pendant or a wristband that they can activate if they fall or need help. Internetbased video systems have become more sophisticated and less expensive; they enable elderly parents and adult children living far away to stay in touch visually as well as by voice.

residential buildings with amenities to make life easier for the seniors living there.

More exotic electronic systems are also coming onto the market now, including “smart homes” with a variety of monitoring devices to keep track of the occupant’s activities and “carebots”—sophisticated mobile robots that can also serve as helpful communication and monitoring devices.

Theme: Supported Living

Finally, Stage 2 is a time when a retirement residence is appealing to some seniors, depending on their preferred lifestyle and their financial means. Retirement residences are multi-unit

These residences are not health-care facilities. Instead, they are stressfree, independent living and thus are often acceptable to independent-minded seniors.

STAGE 3 Soundtrack: Home! Sweet Home! A typical scene Mr. and Mrs. Black, both in their late 60s, live in their own two-storey home. Mr. Black, diagnosed with Parkinson’s approximately 10 years ago, is now dealing with many of its symptoms. He has problems walking and with other daily living activities. Mrs. Black has recently had a hip replacement. This means that Mrs. Black needs care herself, which has made it

impossible for her to assist her husband. While Mrs. Black has been convalescing at home, they have both needed the help of personal support workers to assist with meals, bathing and dressing, and Mr. Black will continue to need this extra care. He also has to have a physiotherapist brought into the home to help with mobility and exercise, as well as an occupational therapist to help with daily living activities. At this time, they are also relying on family and friends for transportation to medical appointments and grocery shopping. The storyline In Stage 3, seniors are trying to cope with multiple disabilities and often chronic pain. This is the stage at which seniors begin to accept outside carers who can help with personal care and/or healthcare. Family members are also often heavily involved in helping to find, hire and coordinate formal carers (personal support workers, nurses, therapists) and assisting their elderly loved one with activities of daily living themselves.

Photos: CanStock

Resources for family carers Family carers can benefit at this stage from a variety of services and programs, including community intake and referral services; homecare and home healthcare agencies; public healthcare facilities offering aged care assessments SPRING 2021 | Australian Carers Guide 83

Photos: CanStock

of your loved one; and educational programs, books and online services that can help you learn about and find resources and navigate the system.

STAGE 4

The storyline

Theme: Complex care/ crisis management

Although the vast majority of seniors at this stage have a very strong desire to remain in their own home (no matter what difficulties this presents), some will accept the alternative of assisting living residences (sometimes called “residential aged homes”). Assisted living facilities, both private and publicly funded, typically offer private or semi-private bedroom accommodations, a dining room, a full activity and recreational program as well as trained staff who provide direct assistance to residents needing help with any of the basic activities of daily living (eating, dressing, bathing, grooming and mobility).

Mr. Bauer, an 88-year-old man, lives with his 83-yearold wife. He has been dealing with severe Alzheimer’s disease for the past four years and his wife has been, for the most part, his only support. Their daughter helps with errands, groceries and doctors’ appointments, and their son-in-law looks after home maintenance. Mr. Bauer rarely speaks, has poor balance when walking, cannot dress or feed himself and no longer recognizes his family. A personal care worker has been hired to help dress and feed Mr. Bauer. Lack of sleep and exhaustion have led Mrs. Bauer to seek respite, and she has health concerns of her own.

Stage 4 is a difficult and often painful stage for all concerned. Your loved one’s physical and/or mental condition has declined to such a degree that he or she is dependent on others for most of the care. There are usually multiple health conditions challenging your parent, requiring a variety of treatments and therapies. If cognitive problems (thinking, memory, impulse control, judgment) are a

84 Australian Carers Guide | SPRING 2021

Soundtrack: Help! A typical scene

“

I remembered walking into the kitchen, but by the time I got there I didn’t remember why?

”

Despite the involvement of formal carers, the levels of care in the home available to the family at this stage may be inadequate or too expensive, leading to one crisis after another. At this stage, it is common that the only thing preventing admission to a residential aged care facility, an earlier promise to the elderly parent, or oneself, to never place the parent in such an institution.

social workers or nurses specifically trained to assess seniors’ needs, devise a comprehensive plan of care and help a family coordinate and manage the care and carers required.

STAGE 5 Theme: Dependence Theme song: Missing You The storyline At some point, many families come to see that the wellbeing of both their elderly

Resources for family carers Self-care for family carers is not a luxury at this stage—it is a necessity. This is the stage of family care when the carer, be it an adult child, spouse, sibling, or friend, finally “burns out” and gives up, resulting in a major crisis. Self-care for carers, including stressmanagement programs, meditation and yoga, is invaluable. So are therapy programs to help the carer deal with depression and sleep deprivation. Community referral services can help you locate these programs as well as respite care programs. A competent aged care specialist can also help; these specialists are

a loved one there. However, even here there are valuable resources to assist family members. Written materials can coach family members on how best to advocate for the treatment and welfare of a loved one in a residential aged care home. There is also usually a social worker in the facility with whom you can discuss concerns and feelings, especially feelings of grief and loss related to the current state of your loved one. Finally, many residential aged care homes organise family councils where you can address issues of common concern.

FINALE

loved one and other family members will be better served by residential aged care admission. In fact, at this stage the patient is often safer and more comfortable with 24-hour institutional health and personal care than with a patchwork of homecare services. Resources for family carers Anyone who has visited a residential aged care home, even the best ones, knows how difficult it can be to see

Not all aging individuals and their families pass through all of these five stages. Nor do they pass through all stages at the same pace. We know that most Australians die either at home or in a hospital and have never seen the inside of an Aged Care facility. But the five family stages of care provide a framework for understanding the main needs and issues for your family at any point in time, and help you anticipate what the next stage in your journey might be. ACG

Dr. Mark Frankel is founder and CEO of TakingCare Inc

Photos: CanStock

part of the problem, close, skilled supervision is also required—often around the clock.

SPRING 2021 | Australian Carers Guide 85

F amily life

5 tips for Carers

for working with family:

The good, the bad and the neutral

Photos: CanStock

BY RICK LAUBER

86 Australian Carers Guide | SPRING 2021

Creates animosity: Disagreements between siblings can become After all, heated. Siblings may happiness not always agree on and personal the best path for satisfaction are not goals, but Mum/Dad, what level by-products of a of care to provide, life well-lived. and when and how – ELEANOR ROOSEVELT far to step in. Family arguments can also start (and carry on) over finances and impending inheritances, and old grievances can resurface.

t’s true that carers often benefit from outside assistance, but is it the best idea to ask for help from your own family? Before approaching a sister, brother or other relative for help, consider the following pros and cons.

“

The good… Instills confidence: Handling the ongoing responsibilities of being a Carer can be difficult. But managing these tasks successfully and making good decisions can boost your ego and it can build trust between you and your family members. In addition, the “I can do this” mentality can influence your thoughts and actions outside of caring.

”

The neutral…

Builds bonds: Working together can bring siblings closer. My sisters and I worked quite well as a team. I also found that my father’s Alzheimer’s disease improved my relationship with him. Dad, always a very private man, didn’t readily share his thoughts and feelings with me. I thank Alzheimer’s disease for knocking down the protective walls he’d built. Dad actually showed his gentle character and a previously unrealized affection for hugs.

Reduces expense: I’ve listed this as a “neutral” tip as money matters may or may not be a problem. Some seniors will have a sizable nest egg to continue paying both regular bills and the extra expenses of additional care. Even if this is the case, however, all may not go as planned… After my parents moved to live closer to me and my sisters, they were still on the hook financially for their monthly house fees until we found a buyer. Thankfully, they could afford it. For others, though, family members may be forced to financially support an aging parent, causing imbalanced abilities to contribute funds.

The bad… Increases stress: Stress is a popular term when it comes to caring, and rightly so. You will be watching and grieving your loved one’s decline. Demands will come at you from all angles. You may be asked to do things that you had never imagined. Stress can negatively affect your own family, career, sleep patterns, patience levels and more. 1

Be hard on solving the problem, not the people.

Keep the conversation going in real time.

Ask yourself would I rather be happy or right.

Resist the urge to turn everything into a catastrophe.

Bite your tongue. Think before responding.

SPRING 2021 | Australian Carers Guide 87

Photos: CanStock

Working with your family to provide care has its positives and negatives. To keep things harmonious, carefully consider your choices and talk with your siblings before delegating your responsibilities as a parental carer.

Over 25,000 Australia to deliver confidence w ConfidenceClub is Australia’s largest specialist direct supplier of continence management aids “As daughter and full time carer of both my parents, the ‘no leaks’ pull-ups save me time and energy that I don’t always have. The product is better. The service is better. The options are better. And the delivery is better. I will be sticking with ConfidenceClub... period!” – Carol E.

Over 1500 more 5-star reviews

ConfidenceClub.com.au Call us on 1800 86 11 99 (Mon-Sat) SPRING 2021 | Australian Carers Guide 86

ns trust us when it counts

SPECIAL OFFER Try Up To $50 of Products for FREE just pay $9.95 for delivery

Click Here to see this offer at confidenceclub.com.au/free or call us on 1800 86 11 99 and mention “Carers Guide” 87 Australian Carers Guide | SPRING 2021

abbreviations

When it comes to Aged Care, acronyms are plentiful…ACSA, HCP, CHSP… But what do they all mean? Fear no more. We’ve compiled a list of the most commonly used ones – how they work and their service to the community.

ACAS: Aged Care Assistance Service (Victoria) Provides teams who help frail older people and their carers, to work out what kind of care will best meet their needs. After Ever had each a chat with someone where the talk is littered with acronyms – but you have absolutely no idea what they’re saying?

assessment, a patient’s level of support and service needs are recommended. ACAT: Aged Care Assessment Team Helps the elderly and their carers determine what kind of support will best meet their needs when they are struggling in their current living situation. ACF/ACH: Aged Care Facility or Aged Care Home Accommodation for older people who can no longer live at home independently, who require help/support for everyday tasks/health care. ACIA: Aged Care Industry Association (ACIA) Association of aged care providers, whose members 90 Australian Carers Guide | SPRING 2021

operate residential aged care, home care, home support and retirement living services.

care needs increase to a high care.

ACS: Aged Care Services

CA: Carers Australia

Support and services provided to older people in their own home or in an aged care home to assist with everyday living, health care, accommodation and equipment.

The national peak body representing Australia’s unpaid carers, advocating on their behalf to influence policies and services.

ACSA: Aged & Community Services Australia Is the leading national peak body supporting not-forprofit, church and charitable providers of retirement living, community, home and residential care. ADL: Activities of Daily Living Refers to the basic skills needed to properly care for oneself and meet one’s physical needs in six areas: eating, dressing, bathing, toileting, continence, and mobility. It’s used as an indicator to determine the level of care and supportive services needed in senior’s care plan. AIP: Ageing in Place Indicates that a resident can enter an aged care facility at low care and can remain there as their

ATSI: Aboriginal Torres Strait Islander

CBC: Centre Based Care For elderly people who require low to medium living support, group activities, excursions and social support are provided in a local centre. CC: Community Care Personalised care and support services to help the elderly continue living at home. CDC: Consumer Directed Care Are services chosen by the elderly person living independently at home, they decide the types of services and care and the providers of the services. CHSP: Commonwealth Home Support Program  The entry-level home support program assists older people to live independently in their homes and communities. It also provides respite services to give carers a break.

COTA: Council on the Ageing

HACC: Home and Community Care

RAD: Refundable Accommodation Deposit

Provides leadership in social policy and community information, and education for older persons.

Services are jointly funded by the Commonwealth and State Governments. Includes at home care or in day care.

Is a lump sum payment for accommodation in an aged care home. This is the price of a room, in lump sum form that you have agreed with your aged care home to pay and is fully refundable when you leave the aged care facility.

CRCCs: Commonwealth Respite & Carelink Centres Assists carers by providing access to information, respite care and other support appropriate to carers’ needs and circumstances, and the needs of those they care for. DAP: Daily Accommodation Payment Is the daily non-refundable payment for accommodation in an aged care home. It can be paid regularly up to a month in advance, similar to paying rent. DOH: Department of Health Develops and delivers policies and programs and advises the Australian Government on health, aged care and sport. DTC: Day Therapy Centre Offer a range of services (physiotherapy, podiatry, occupational therapy) for older people living independently either in their own home, or aged care homes. EACH: Extended Aged Care at Home Individually planned and coordinated packages of care, tailored to help frail older Australians remain living at home. Packages are flexible.

HC: Home Care Services/support given to older people with care needs to live independently in their own homes. HCP: Home Care Packages A program funded by the Australian Government to support older people with complex care needs to live independently in their own homes. They use a consumer-directed care approach to ensure the support suits a person’s needs and goals. HCS: Home Care Service(s) Support/care services provided to an elderly person in their own home. ILU: Independent Living Unit A small home designed for older people who are actively independent, usually in a village environment NESB: Non-EnglishSpeaking Background NDIS: National Disability Insurance Scheme NDIS provides information and connections to services for people with disability. The scheme also provides support for their families and carers.

RC: Respite Care Services designed to give carers a break from their caring role during planned or regular breaks, short holidays or emergencies. RV: Retirement Village Group of residential premises predominantly occupied by senior citizens who live in apartment style rooms /suite of rooms. SM HCP: Self-Managed Home Care Packages A program funded by the Australian Government to support older people with complex care needs to live independently in their own homes. The elderly package receiver can choose the provider(s) and services given, including the workers or contractors, when the services are provided and can control how the funding is spent. STRC: Short-term Restorative Care

NSA: National Seniors Association

A program which provides services to older people for up to 8 weeks (56 days) to help them delay or avoid long-term care.

Is a not-for-profit membership organisation and advocacy group of working and retired older Australians.

Home care for eligible veterans, war widows/ widowers through the department of Veterans’ Affairs.

VHC: Veteran’s Home Care

SPRING 2021 | Australian Carers Guide 91

R ecipes Caring

meals that heal BY KARA O'ROURKE

Hello to my fellow carers Spring is always so special. The weather is getting warmer, the sun is shining, flowers begin to bloom, and their beautiful aroma fill our nostrils. People are out and about more, and our ‘Spring’ carnivals get underway. To help you celebrate the inspiring season of Spring, we are featuring some delicious and colourful culinary delights, guaranteed to fertilise the soul and bring a little healing to the body. Enjoy!

92 Australian Carers Guide | SPRING 2021

Berry Coconut Smoothie

Start your day feeling uplifted and refreshed! Packed full of healing antioxidants, hydrating electrolytes and protein to build muscle, this smoothie will nourish and energize your mind and body and leave you feeling satisfied.

INGREDIENTS

METHOD

½ cup coconut milk

Add all ingredients to a high-speed blender.

½ cup coconut water 2 tablespoons full fat yoghurt (or coconut yoghurt) ½ banana ½ cup mixed berries 1 tablespoon chia seeds 1 tablespoon oats

Pulse for 10 seconds then blitz until smooth.

“

Spring is always so special. Weather is getting warmer, sun is shining a lot longer, flowers begin to bloom, and their beautiful aroma fills the air. People are out and about more, and our ‘Spring’ carnivals get underway.

”

Pumpkin, Sweet Potato and Carrot Soup

Celebrate immunity with this delightful soup, packed with vitamin C and vitamin A rich vegetables. Also rich in fibre, this warm bowl of goodness assists in improving digestive function while boosting the immune system.

1 brown onion sliced 2 cloves garlic 1 tablespoon oil 1L reduced salt vegetable stock 300g sweet potato cut into cubes 100g potato chopped into cubes 400g butternut pumpkin chopped into cubes 200g carrots chopped into cubes

1 zucchini chopped into large chunks

Bake for 30-40 minutes (until golden and roasted).

1 medium gala apple chopped

Transfer to a large pot. Add butter, apple and stock. Simmer for 10 minutes.

½ teaspoon vanilla extract 40g unsalted butter 1teaspoon cinnamon

Turn off the heat and add vanilla and cinnamon.

METHOD

Transfer to a blender, or food processor, pulse for 30 seconds then blend until smooth.

Preheat oven to 180°C.

Add salt and pepper to taste.

Salt and pepper to taste

Place onion, garlic, oil and vegetables into a lined baking dish.

Photos: CanStock

INGREDIENTS

SPRING 2021 | Australian Carers Guide 93

R ecipes Caring Apple and Pear Crumble

Enjoy this bowl of warmth and comfort for breakfast or a snack. While apples and pears contain fibre and pectin to nourish intestinal flora, protein and good fat from the oats and coconut will assist in stabilizing blood sugar and promote healthy cholesterol.

INGREDIENTS

225g unsalted butter, melted

3 medium size apples, cored and diced

1 teaspoon cinnamon

2 medium size pears, cored and diced 2 tablespoons orange juice ½ teaspoon cinnamon Crumble ½ cup plain flour ½ cup almond meal ½ cup desiccated coconut 1 cup rolled oats

Photos: CanStock

2 tablespoons raw sugar

94 Australian Carers Guide | SPRING 2021

1 teaspoon vanilla

METHOD Preheat oven to 180°C. Place the apple, pear, orange juice and cinnamon in a bowl and mix to combine. Spoon into a 1.5 litre ovenproof dish. For the crumble, place the flour, almond meal, coconut, raw sugar, cinnamon, oats, vanilla and butter in a bowl and mix until just combined.

Spoon the crumble mixture over the apple and pears and bake for 40–45 minutes, or until the crumble is golden.

Baked salmon and mixed potato salad

Enjoyed as a side dish or the main event. Salmon is full of omega 3 essential fatty acids, that reduce inflammation and protect cardiovascular health. Joined by antioxidant rich greens, fibre and carbohydrates, this dish truly is a nutritional all-rounder.

INGREDIENTS 2 fillets salmon 1 tablespoon oil for cooking 3 sweet potatoes chopped into cubes

2 tablespoons chives finely chopped 2 tablespoons parsley finely chopped 1 tablespoon lemon juice

3 potatoes chopped into cubes

1 tablespoon olive oil

125g whole egg mayonnaise (preferably organic)

3 hard boiled eggs cut into quarters

¼ cup cucumber finely chopped

Salt and pepper to taste

½ cup celery finely chopped 1 cup green beans chopped

Preheat oven to 180°C. Place salmon fillets on a tray lined with baking paper and rub with oil. Bake for 20 minutes.

In a large bowl place mayonnaise, cucumber, celery, sour cream, chives, parsley, lemon juice, olive oil, egg, salt and pepper. Mix until combined. Add potatoes and salmon (flake salmon with a fork into the salad) and give a gentle mix. Season with salt and pepper.

Photos: CanStock

2 tablespoons full fat sour cream

METHOD

Boil potatoes until just cooked, approx. 20 minutes. Drain and cool. Boil green beans for 3 minutes. Drain and set aside.

SPRING 2021 | Australian Carers Guide 95

Time Out

Improve your memory, concentration and reasoning. The benefits of puzzles are numerous. They maintain or develop problem-solving skills, and help you relax, even when they are so frustrating.

Wordwheel

Find as many words of three or more letters in the wheel as you can.

Each word must use the central letter and a selection from the outer wheel – no letter may be used more times than it appears in the wheel. Can you find the nine- letter word hidden in the wheel?

M T

P W

A R D A D

G O

A C

B A

P O R

P M U

P W W N

M B

N A

G A M O W T

O B

T W

V W A

A C

R R

B A A U K O D

O P

U U

Wordsearch

Can you find the words in the grid? They will be placed only once and may be either horizontal, vertical or diagonal and go either forwards or backwards. Words can cross. ABRACADABRA

RABBIT

ASSISTANT

SECRETS

B D N

R N

D O U

A C

CARDS

SHOW

A A

N Q

R R

CONJURE

SPELL

R B C

N N D

ESCAPOLOGIST

STAGE

R G S

U G

S O U

ILLUSION

TRICK

LEVITATION

VANISH

MAGICIAN

VOLUNTEER

N A

MISDIRECTION

WAND

PROPS

WIZARD

H A

O G R U

O M P

N W E

K C

W B

Q H

96 Australian Carers Guide | SPRING 2021

Codeword

Can you crack the entire code to complete the crossword grid? Each number from 1-26 represents a letter of the alphabet from A-Z. Every letter appears in the grid at least once, and is represented by just one number. We’ve given you 3 letters to help you start.

11 11

19 24

11 12

24 25 11

17 11

19 17

14 5

25 12

21 7

19 17

17 3

10 20

1 6

21 9

22 20

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

SPRING 2021 | Australian Carers Guide 97

Jumbo Crossword

Solutions on page 106

Complete the crossword clues to fill the grid. 1

LOVE PUZZLES? All puzzles are kindly supplied by Richardson Puzzles & Games - their puzzle book range is available to purchase from all good book retailers.

98 Australian Carers Guide | SPRING 2021

ACROSS

DOWN

Former female pupil (6)

11. Act of going before in time (11)

Domestic assistant (2,4)

12. Unintelligible (11)

Gambol (6)

13. Refund (9)

Capital of the Bahamas (6)

14. Consent to (5)

Was scared of (6)

15. Clean thoroughly (5)

Disease caused by a lack of thiamine (8)

18. Kitchen sideboards (8)

Bring about (6)

20. Ordered (9)

Continuing obstinately (10)

22. Conceivable (10)

10. Grotesque monster (7)

24. Style of painting (8,3)

15. Motorcycle attachment (7)

26. Does the same thing again (7)

16. Divergence out from a central point (9)

29. Not spiritual or sacred (7)

17. Fragility (11)

31. Extend by inference (11)

19. Hair-cleansing product (7)

32. Help (10)

20. Mayhem (5)

34. Received by genetic transmission (9)

21. Agreeable sound or tune (5)

36. Urgent (8)

23. Apportioning (9)

39. Road information boards (5)

25. Exchanges of several strokes in tennis (7)

42. Climb onto (5)

26. Attains (7)

45. Get rid of completely (9)

27. Expect to happen (5)

46. Shade of blue (11)

28. Spirited horse (5)

47. Instance of buying or selling (11)

30. Irritate greatly (10)

48. Versions of a book (8)

33. Three-hulled sailing boat (8)

Device that sends a rocket into space (8)

35. Fortification (7) 37. Make beloved (6)

did you know?

Your brain contains nearly 90 billion neurons. That's roughly half the number of star's in our galaxy!

38. Welcomes (6) 40. Land surrounded by water (6) 41. Cared for (6) 43. Agreement or concord (6) 44. African fly that transmits sleeping sickness (6) SPRING 2021 | Australian Carers Guide 99

Give your brain a daily workout!

Solutions on page 106

Looking for a mental challenge? This editions brainteasers will really get those cogs whirling!

Sudoku

2 7 8 9 4 9 1

Place the numbers 1-9 once in each row, column and 3x3 bold-lined box.

6 8 3 7 1 4 7 2

6 4 3 8 2 6 8 3 1 8 2 2 2 7 8 3 1 5 6

EASY

5 7 2

5 9

5 2 9 3 1 7 6 7 4 3 9 4 1 8 7 7 4 MEDIUM 100 Australian Carers Guide | SPRING 2021

4 7 3 6

3 2

9 5 6 4

9 8 3 1 6 9 7 HARD

3 1 4 8 7 9 2

Jumbo Arrow-word Complete the clues to fill the grid.

The arrows show the direction in which the answer to each clue should be placed. Having inherent ability

Item written on with chalk

Tennis score

Truck

Not containing anything

Mauna ___: Hawaiian volcano

Relating to wolves

___ Fitzgerald: famous jazz singer

Lipid

Extremely impressive

Quality of being weighty

Fixed costs

Very vocal (4-7) Curved shape

Former term for euro

Drivel; nonsense

Peak

Angry

Pace

Hit high into the air

Woody plant

Over there (literary) Soon; shortly

Vessel or duct State of armed conflict

On a grand scale

Normally

Capital of Canada

Up and about

Stadiums

Depend upon

Gives an account of

Vital plant juice Definite article

Lyric poem

Flying saucer (inits)

Single in number

Spoken for

___ Lanka: island country

Run at a moderate pace (of horses)

Backbone; fortitude

Word used to express disgust

Computer graphics (inits)

Imitated

Fly high

__/_ whole: in general (2,1)

Sheltered side

Small brownish spot on the skin

___ Pot: Khmer Rouge leader Command to a horse

Type of carp

Eg almond or pecan

Wound together

Swollen mark

Not wet

SPRING 2021 | Australian Carers Guide 101

expert advice HANDY ANDY Our neighbour lives alone and seems to have a handyman to fix and paint all the time. I worry that she’s lonely and he’s taking advantage. A: There are a number of ways that people target or take advantage of trusting seniors. In some cases, it’s trade people— and in others, it’s scams. Here’s some wise advice that we like to give: 1) A sk a trusted relative to review any quotes or representations of work to be done. 2) G et several quotes from reliable and established companies. In your case, we suggest asking one of her family members or the police to check things out if you’re worried about the odd job man. Better safe than sorry.

INFUSION THERAPY

Photos: CanStock

Are there options for infusion services outside the hospital? You can book a clinic appointment or request in-home services if they are available in your area. Clinics are a safe, convenient choice for oncology, neurology, immuneoncology, rheumatoid, arthritis, gastro, dermatology, intravenous or antibiotics. They have the same equipment and safety protocols as hospitals in a comfortable environment. In-home administration of infusions and injections can be arranged for a more personal experience.

102 Australian Carers Guide | SPRING 2021

I TOLD YOU SO I’ve heard that the Australian Federal Police (AFP) is warning seniors about scams. My mum won’t listen to me. Can you print some of the worst ones? To protect yourself and your loved ones from fraud, it helps to be aware of common scams. The AFP warns Australians about these common schemes: • Extortion scams and debt collection scams: Scammers pretend to represent government agencies, such as the ATO or Utility companies. They demand personal information, including financial details and passwords, or payment for “tax debt” by credit card payment. • Technical service scams: Fraudsters pretend to offer services such as Internet, finance, energy or telecommunications services; including insurance and extended warranties. According to the AFP, the most-reported service scams targeting Australian are the antivirus software scam (fake Microsoft or Windows technicians) and lower interest rate scams. • Charity scams: Scammers impersonate real charities in person, on the phone or online, often exploiting a real-world disaster or issue. They may use the logos and branding of real charities as part of the ruse. If you think you or someone you know has been targeted by fraudsters—or if you’ve lost money to a scam—report the incident to the police. You can also notify the Australian Anti-Fraud Centre, by calling (02) 5126 0000. Call, even if the amount you lost is small; reporting it may help prevent others from being scammed.

IF THE SHOE FITS My mum needs a new pair of shoes, but she has wide feet with curling toes. What shoes would be the most appropriate?

PRESSURE SORES What do I need to know about wound prevention?

Foot deformities are common among seniors. It is important that you buy the correct shoe size, while accommodating the foot’s skin integrity and width. Don’t purchase a larger size to fit your mum’s foot width, because this can increase the risk of falls and change the structure of the foot.

First, you need to know how a wound can develop. There are four common ways:

Take out the insole and compare it with the shape of the foot. If the foot overhangs the insole then the shoes are too narrow. Look at the shoe’s toe box—the area of the shoe where the forefoot lies—and check that there’s enough space to maintain the skin integrity of the curling toes.

2) Shearing. This occurs when the skin is pulled in one direction, but the supporting structures below (e.g., muscle, bone) either don’t move or move in the opposite direction.

Consider stretchy material to help accommodate other foot deformities and alleviate pressure points to boney prominences. Try medical-grade shoes from custom shoe shops and healthcare stores. PUFFY LEGS? My aunt has very swollen legs. What can we do for her?

Photos: CanStock

QnA

Swelling can be a result of many different factors. Ask your aunt’s pharmacist or doctor for her medical history and medications to be reviewed. Consider working with a health professional trained in lower-leg assessments to help determine the cause of the swelling by examining the skin and condition of the legs, and by completing a special test to determine if the swelling is from venous or arterial issues. If the swelling is from venous insufficiency, then compression stockings might help to manage the swelling. If it is from arterial issues, however, then further investigations may be required.

1) Pressure. When blood flow is impeded, oxygen and blood are stopped from getting to the area. Common areas in which pressure wounds develop are the back of head, spine, tailbone, sit bones, heels and ankles.

3) Moisture. Prolonged moisture on the skin can decrease the skin’s resiliency to damage. 4) Friction. This is seen when skin is moved one way over a surface, while that surface remains stationary or moves in the opposite direction. To prevent wounds and maintain your loved one’s skin condition, monitor their skin for red marks and ensure your loved one is frequently repositioned. This will assist with proper blood flow to high risk wound areas. Check that your loved one is properly positioned to prevent sliding, and make sure that skin folds, groins and buttock are kept clean and dry. Another important area to consider for wound prevention is eating a good diet and drinking well to keep the body healthy. If your loved one has a wound or is at risk for skin breakdown, ask for a referral to your local occupational therapist for an assessment.

Jillian Heiberg has been an Occupational Therapist for 10 years and has an interest in developing networks particularly for our outback rural areas.

SPRING 2021 | Australian Carers Guide 103

editor’s choice

CONVERSATION APPS:

The Your Life Talks app is an easy way to record yourself or a family member speaking or typing answers to our carefully selected Conversation Starter Questions. It is easy to use with 50 questions to answer in both the ‘Your Life Story’ and ‘Your Life Wishes’ Conversations. Simply ‘Talk’ or ‘Type’ your responses to each question! Our app will transcribe your spoken answers into text, or alternatively, you can choose to type the answers. Everything in our life, from the everyday to the extraordinary, is a story waiting to be told. Recalling yours or a family member’s fondest memories and life experiences can be lots of fun. Available for IOS or Android Yourlifetalks have also created two sets of 50 Conversation Starter cards called ‘Your Life Story’ and ‘Your Life Wishes’. Talking about your life’s journey and recalling your fondest memories and life experiences can be lots of fun, and the importance of having a conversation with your family about your end of life wishes will give peace of mind to all concerned. These cards provide a great way to kick start a conversation. They can kick start a conversation, 104 Australian Carers Guide | SPRING 2021

and recalling great family memories is always a great way for families to feel comfortable about talking and letting go on some buried memories.

DEMENTIA SUCKS: A Carer’s Journey Tracey Lawrence lost both of her parents to dementia. In Dementia Sucks, she discusses how the disease caused her life to change along with that of her parents. Going from being a graphic artist in northern New Jersey to a full-time, hands-on caregiver, she discusses the challenges she faced with the same sense of humour that got her through it all. Her heartbreaking yet hilarious tale will enlighten, amuse and shed some light on a new way of coping with loss after loss.

PARENTING: Your parents A Practical Guide for Family Carers Help for the Hard Road Ahead

Dr. Grant Ethridge and his wife, Tammy, have been there, having given care during their dads’ last days. They know the stress and uncertainty you face. Through their story and other carer stories, Grant and Tammy share research and practical tips to aid you in dealing with everyday struggles and situations. Focusing always your peace of mind. Remember, as you give care to your parents, your Heavenly Father is always caring for you. ©2019 Grant Ethridge and Tammy Ethridge (P)2019

websites

CARING FOR ELDERLY PARENTS IN AUSTRALIA A non-for-profit website whose mission is nothing more than to create a community of carers who currently care for an aging parent(s). What makes this Facebook group a standout, is that it is the genuine deal. No hidden motive except to ensure its integrity as an authentic community of carers to connect with other carers walking a similar path. Carers are welcomed to share their stories and struggles, ask question, learn from each other, laugh and cry together. Highly recommended for all carers in particularly the lonely and isolated. Search Facebook for “Caring for elderly parents in Australia”

EMBRACING UNCERTAINTY Life is uncertain: we can never be 100% sure what is going to happen. Some people are OK with this and find it easy to embrace new experiences. Other people struggle with uncertainty: it is almost as if they have a phobia of it, and they often do things like worry or plan in attempts to reduce uncertainty.

INTOLERANT OF UNCERTAINTY Motivation: seek certainty (safety). Behaviour: worry, plan, check, avoid, seek reassurance, routine & habit.

Situations that are: • Ambiguous • Novel • Unpredictable

EMBRACES UNCERTAINTY Motivation: seek new experiences. Behaviour: open, curious, spontaneous, willing to tolerate discomfort.

Embracing uncertainty can allow you to enjoy more of a life, and to respond more flexibly to challenges that come your way. One way of doing this is to gradually introduce uncertain events into your life. Try to embrace uncertainty by experimenting with some of the tasks below:

Walk a different route.

Order something new from the menu in a restaurant.

Try a new class.

See a film at the cinema without reading reviews.

Have a different lunch every day.

Read a different newspaper, or something by a new author.

Wear something ‘new’ for you

Do an activity that you have avoided so far.

Sit in a different place than you normally do.

Delegate tasks to others.

(e.g. style, brand).

Talk about things that are more ‘risky’ for you

(e.g. politics, yourself, opinions).

Sleep on a different side of the bed.

Go somewhere you have never been. Talk to someone you don’t know

(ask a question, pay them a complement).

Listen to music that you wouldn’t normally listen to. Try a different brand of toothpaste.

Tips for embracing uncertainty: • Adopt the mindset that it is good for you to take small risks and challenge yourself. • Make ‘trying new things’ a regular part of your life. • You’re trying to build a ‘tolerance of uncertainty muscle’ so you will need to practice regularly. • Maintain a curious and open approach by focusing on the outcome of your experiments, not on the emotional experience: What did you learn? What did you experience that was new and exciting? What did that experiment do for your confidence? SPRING 2021 | Australian Carers Guide 105

SOLUTIONS PUZZLE SOLUTIONS

106 Australian Carers Guide | SPRING 2021

EMERGENCY numbers

If you are needing direction on where to go get help, we’re here for you. Carers Australia call 1800 242 636 Emergency Respite Care 1800 422 737 Carers Gateway Commonwealth Respite and Carelink Centre call 1800 052 222 Lifeline’s 24/7 service on 13 11 14 or text 0477 13 11 14, 6 pm-12 am Suicide Call Back Service’s 1300 659 467 24/7 telephone counselling service Beyond Blue’s support service on 1300 22 46 36. SANE Australia’s service 1800 187 263 10am-10pm Monday to Friday MindSpot Clinic call 1800 61 44 34 for adults with anxiety or depression QLife’s support service on 1800 184 527 Urgent mental health care for anyone having a mental health crisis: • Australian Capital Territory – Mental Health Triage Service 1800 629 354 • New South Wales – Mental Health Line 1800 011 511 • Northern Territory – Crisis Assessment Telephone Triage Service 1800 682 288 • Queensland – 24-hour mental health care 1300 642 255 • South Australia – Mental Health Triage Service 13 14 65 • Tasmania – Mental Health Services Helpline 1800 332 388 • Victoria – Mental Health Services go to health.vic.gov.au for local provider • Western Australia – Mental Health Emergency Response Line 1800 676 822 National Dementia Helpline 1800 100 500 Dementia Support Australia 1800 699 799 Aged & Disability Advocacy 1800 818 338 Centrelink for Carers & Disability 13 27 17 Centrelink for ABTSI 1800 136 380 Centrelink for older Australians 13 23 00 Department of Veterans Affairs 1800 555 254 My Aged Care 1800 200 422

Medicare 13 20 11 Emergency medical care 000 (TRIPLE 000) Elder Abuse Prevention 1300 651 192 National Continence Helpline 1800 330 066 Healthdirect for a nurse triage service 1800 022 222 (all states except for Victoria) NURSE ON CALL phone 1300 60 60 24 for health help from registered nurses in Victoria Poisons Information Centre 131 126 for 24/7 assistance 1800 RESPECT 1800 737 732 for sexual assault/domestic and family violence counselling Gambler’s Help hotline 1800 858 858 24/7 MensLine Australia 1300 78 99 78 support to helping men deal with relationship problems Australian Men’s Shed Association 1300 550 009 National Alcohol and Other Drug 24/7 Hotline 1800 250 015 for free support. National Debt Helpline 1800 007 007 for free financial counselling GLBTI peer support on 1800 184 527 Mon–Thurs 6 pm–10 pm, Fri–Sun 6pm–9pm Relationships Australia 1300 364 277 relationship support services Translating and Interpreting Service (TIS National) 13 14 50 and 1800 131 450 SPRING 2021 | Australian Carers Guide 107

Resp it perm e and anen t plac e s avail able

Considering aged care for a loved one? At Bupa Aged Care, whether for respite short-stay or as a new home, our experienced registered nurses and carers provide the care each resident needs in the way they prefer. Care is first and foremost. We embrace and support residents to live their day their way, with teams dedicated to their well-being.

New residents welcome. To book a visit with us, call 1800 785 592

bupaagedcare.com.au/carer

People rarely expect to need aged care, but if your family does, we’ll guide you through the steps.