Thursday, 4 December 2014

Talking Turkey About Eldercare Over the Holidays

By Jennifer Tucker, Vice-President, Homewatch CareGivers International, a home care brand whose locations provide care and support to elders so they can age safely in their own homes.



Going home for the holidays can be a joyous time of celebrating and reminiscing with loved ones.  It's also a time to check in with relatives, and make sure everyone is doing well, especially elder relatives who are living on their own.  The holidays are sometimes the only time the entire family is together, free from the usual daily distractions of work and responsibilities out of the home.  This creates an ideal time to sit down and have some tough conversations.  Talking openly and honestly with your loved ones this holiday season is the first step in figuring out the best options for their long-term care.

Take this opportunity to be caring and observant for any potential problems that your elder loved one may have a difficult time expressing to you.  Is the food in the kitchen fresh or are there items past past their expiration date in the fridge?  Is the mail being opened and properly sorted?  Do they seem confused about your name or get you mixed up with other family members?

As an adult child, this is a pivotal point in your relationship with your parents.  The first questions we often ask are: what can I do?  How do I make sure they receive care? How are they going to pay for the support they need?  It is, however, important to remain calm and understanding of your parents' wishes and needs.  Providing loving support and a promise to walk this next road together can help both of you make the best possible decisions.



Set aside a private time away from the holiday festivities to ask your relatives how they are doing.  Remember to listen.  Rather than offer to 'help', talk with them about their needs.  From there, you can work together to find solutions to meet these needs.  Maybe there are medical issues, which will need to be addressed by a doctor.  Help provide them with the resources necessary to find one they trust and offer to drive them to an appointment or arrange a ride for them.  Or perhaps they need a little assistance around the house with basic chores.  Offer to help them research home care companies, or interview care providers.  Taking a collaborative approach to this situation, rather than an intrusive one, can help to leave your loved ones feeling empowered, instead of demeaned by the experience.

Once the concerns are sufficiently established, the next step is figuring out how to pay for things such as long-term care, if that is needed.

When talking to loved ones about their current and future long-term care needs, ask if they might have a long-term care insurance policy.  Surveys show that the majority of older adults prefer to live in their homes as they age instead of relocating to an assisted living facility and long-term care insurance has the potential to support this desire.

Most modern long-term care policies are created based on the preferences of the person, so if your relative has a policy and wants to age at home, there is a good chance their policy reflects that, and covers home care.  Home care providers can offer support in activities - such as bathing, toileting, dressing, meal preparation, cleaning and transportation - that can be the key to keeping your loved one in their home.

One of the greatest gifts you can give this holiday season, is one of love and caring for your family's wellbeing as their needs change.

Thursday, 27 November 2014

Five Tips for New Caregivers

By Jacob Edward

As Americans, we tend to forget that care giving has existed for almost as long as humans have been around. Recently, with the recession in 2008, more people are living in multigenerational homes. In many other countries, multigenerational living is the norm, but for us we’re still working out the kinks. Maybe you became a caregiver gradually, or maybe you were forced into the position by a sudden medical emergency with an older parent or in-law, whatever the case, here are some quick tips to ease you into care giving duties.

Create a Schedule:


Some people find it easier to cope with their new care giving job by writing down a schedule directing them in their daily duties. A schedule could include which pills to take, which activities to do, or dietary planning. Research has shown that mind stimulating activities can help people stay healthy longer. The schedule could be hour by hour or portioned off into morning, day, and night. Set goals you want to complete each day and you’ll see you’ll become much less frustrated with your loved one. Older people still need to be treated with the same respect they have received throughout their adult lives. Frustration often leads to them feeling as if they are being reduced to the state of a child because of their mental or physical decline. If you are working and care giving, make sure to talk to your employer about flexible hours and possible leave in case an emergency strikes. Creating a schedule is especially helpful in reminding you to constantly monitor and note your loved one’s health changes. Early detection, rather than negligence, can often prevent much larger problems down the road. Also, a schedule can minimize daily changes which are oftentimes upsetting to elderly people suffering health conditions.

Don’t be afraid to ask questions:

If you are unsure about something, say the level of care your charge may require, don’t hesitate to contact their doctor. Also, you can ask the patients themselves whether or not they feel you are doing an adequate job. Most times, people are caring for aging relatives so even though you are in each other’s lives in a different way now; don’t forget the familiarity you’ve always shared with them. If you have very specific concerns, however, don’t hesitate to call a social worker or a care giving professional.

Fall-proof the home:

You may be moving into their house or they may be moving into yours, but whatever the case, it’s important to fall proof the home to avoid falls. Make sure there are no worn or loose carpets, no exposed cords, and no clutter. Maintaining a clean environment is not only important for peace of mind, but can also benefit the patient greatly if they are still able to walk on their own. Also, install handle bars in the entrance to the shower, non-slip mats on any floors that tend to get wet or slippery, and adequate lighting throughout the house. Dim areas, especially for someone who can’t see very well, can prove to be dangerous. If you regularly leave the house for any extended periods of time, you may want to purchase a medical alert so your loved one can alert the authorities if they do happen to have an accident. Falls, especially when not dealt with quickly, can mean the quick demise of a person.

Know when it is time to make the transition into assisted living:

We like to think we can do it all, but sometimes caring for a loved one just becomes too much.
If your loved one has dementia, especially in a more advanced case, and they begin to wander, it’s time to get help. You’d never leave a child unattended around a swimming pool, and similarly, people who begin to wander need constant supervision. Even a quick trip to the bathroom or a shower taken by the caregiver can prove to be dangerous for an elderly person who wanders. The chance of injury increases greatly. Once it becomes unsafe for the person being taking care of to remain in their home, it’s time for assisted living

Find a Support Group:



If your duties do become overwhelming, there are support groups online with other people going through the same things as you. Support groups can be tremendously beneficial not only in relieving your stress, but in answering questions you may have about your new role. Care giving can be extremely rewarding for both parties involved and many people find that taking care of a loved one boosts their own value and self esteem. 


Jacob Edward is the manager of Senior Planning and Prime Medical in Phoenix Arizona. Jacob founded both companies in 2007 and has helped many seniors navigate the different types of care available in Arizona. This includes assistance to seniors and the disabled, finding and arranging care services, and applying for state and federal benefits. In his spare time, Jacob enjoys dining out and supporting his alma mater Arizona State's Sun Devil sports teams. Jacob lives in Tempe Arizona.


Tuesday, 25 November 2014

Preparing for The Holidays - A Caregivers' Conversation

This week, I had the pleasure of chatting with other caregivers about how we prepare for Thanksgiving and Christmas.

I had this online chat on the wonderful site Caregiving.com which led me continue my reflections on holiday preparations yesterday:



I sent this video chat to another caregiver friend to begin a personal conversation about how we prepare for the holidays.  My friend is the mother of two adult children with severe disabilities.  Sadly, one of her boys passed away a few years ago and she misses him still.  Her surviving son requires 24/7 nursing care, so holidays are very different for her family than they are for most.

Here's what she said:
In the old days, every single room in our home was decorated to the maximum. It looked like the Christmas Store exploded in our house. I made numerous fresh floral arrangements (as I was into that for a few years as therapy). I baked. I made candles, pouring wax into assorted forms and decorating them when finished to give as gifts. I hosted parties for our close friends for gift exchange, and made huge meals for the occasion. All of this, I did as a single parent. In our graduate student days, when we were poor, I baked pecan pies, and drove in the freezing snow on icy roads to deliver them in person to our friends. My pies were famous, so I was usually greeted at the door with fork-wielding friends!

My Uncle and Aunt had the largest home, so my Aunt insisted that she hold both Thanksgiving and Christmas. That meant that I got to haul my boys and their chairs, their meds, diapers, changes of clothes, books, toys, and whatever else, along with my pot luck contribution of veggies, and at Christmas ~ all of our Christmas gifts to the family. Then I drove an hour to their house ~ Load, unload, load, unload, arrive home after midnight, put the kids to bed and collapse.

When I insisted that I wanted to host Christmas, my Aunt said, "We're just trying to make it easier for you." I explained that it was far easier for me to cook dinner in my home than it was to haul everything down to their home and back again.

So what happened on Christmas Eve night the first time I hosted? One son had pneumonia, and at 3 a.m., he, my other son, and I were driving to ER in the fog. Got home at 6 a.m. Put the turkey in. Got the boys settled, tended to them, and when the family arrived on Christmas afternoon, I was ready. I pulled it off.

Not anymore. Now, I decorate a bit, with maybe a touch here or there in the living/dining room/kitchen. I don't have the strength or energy to decorate ~ unbox, put out, take down, rebox, put away. It's a lot of work. The Christmas decorations are on the top shelf in the garage, a precarious reach on the ladder for my husband. A broken hip isn't worth the festive ambiance!

Just the little decorating we do for the boys is tiring enough for us. As long as we honor them and bring beauty and sparkling, meaningful surroundings to them, we have celebrated Christmas exactly as we should.

We are just so grateful to spend Christmas at home, as we've spent a few in the hospital; Christmas 2004/New Year 2005. In 2010, our young man was released on Christmas Eve from ICU, but he was not ready to be home, and was sick that weekend, while we waited for a nurse. He was back in ICU by January 24 2011 for 40 days (we watched the Super Bowl in ICU). 

Choose any holiday, and we've been in the hospital with one of our boys. Easter, Valentine's Day, Fourth of July, all of them ... When that happens, I bring the holiday to them. I wear Christmas sweaters, or I bring in a stuffed bunny from the gift shop, or balloons, or some appropriate decoration for that holiday.

As you said in the podcast, we're different. Even after 45 years, my remaining family members don't quite grasp how different we are. That's because I spent so many years trying to be Super Woman, attempting to make everything as normal as I possibly could.

And, as situations changed, we changed with them. We adapted. Because every day here is like the other for us, I have to work a little harder to make sure we acknowledge any holiday. I want to continue to be as normal as we possibly can, regardless of our situation.

In addition to our challenges as caregivers, my husband and I are grieving parents. The holidays are exceptionally difficult for us, because we miss our son. To help us through the holidays, we incorporate our angel son into everything we do. His room holds our tree and family ornaments and presents. 

I guess I've always felt our difference, but it is never more profound than during the Thanksgiving-Christmas holidays. It is such an effort to try to be normal, while also cherishing our difference. It's been an unusual life. To say the very least.


My friend's holiday home experience made me think, "Every year, our celebrations shrink a little.  Soon, we celebrate in one room with just our small family.  But that's OK.  There is love in that room and we know that everyone is comfortable with what we cannot and cannot do. And we are grateful."
Nick's designed his own 'manly' Christmas tree for his room.  Note the World Wrestling Entertainment decorations and crushed beer can for a 'star'.  All the gifts under the tree are from him to us and his helpers. 

My book, The Four Walls of My Freedom: Lessons I've Learned From a Lifetime of Caregiving (House of Anansi Press) is available now from all major booksellers in the USA and Canada.

Thursday, 20 November 2014

Good Friends vs Toxic Friends

Telling the difference between good friends and toxic friends is especially important for caregivers.  Caregivers simply don't have the dual luxuries of boundless time and energy to invest in friendships that are not reciprocal.  So, here's a quick guide to recognising good friends and toxic friends.

TOXIC FRIENDS

For caregivers, there are two common types of toxic friends; the troll and the narcissist.  The troll is someone who calls and visits often.  He or she will ask many questions about your loved one and may even visit in hospital to chat over coffee or lunch.  They will appear warm and concerned, while inquiring into the minutiae of your loved one's symptoms and treatments.  This type of toxic friend does not offer help of any kind.  They simply want to know.  The human drama of a caregiver's life provides vicarious interest and fodder for their dinner table chat, but that is all.  This type of friend cannot make the intellectual leap between listening to your experience and offering to sit with your loved one or doing your grocery shopping.

The second type of toxic friend is the narcissist.


Narcissists rarely, if ever, ask how you or your loved is doing.  They are bored by others' experiences, so constantly direct the conversation back to themselves.  No matter how difficult a caregiver's situation may be, it will always be worse for a narcissist - and despite their healthy family status, they will want you to listen and sympathise.

GOOD FRIENDS



Caregivers soon find out that longstanding friendships don't necessarily translate into good friendships when the going gets tough.  Some lifelong friends do show their loyalty and generosity, while others suddenly become too busy to call or drop by.  The messy and often sad events in caregivers' lives may be too difficult for some people to witness and absorb.  The fact is, not everyone is cut out for helping others through the toughest times. The trick is to determine quickly who will be a good friend for the long haul and who may be limited in their ability to walk with you through your caregiving journey.  Wise and experienced caregivers will advise forgiveness in the case of friends who disappear upon hearing your loved one's diagnosis.  Holding on to bitter feelings will only make it more difficult to spot new friends who genuinely want to help.


The extraordinary friend is one who intuits your needs, listens without judgement, visits often and always brings food.  The new friend is an acquaintance who, upon hearing that you are giving care, offers help that is truly helpful.  The kindness of new friends is always a surprise - often the most helpful friends are those you would least expect.  Whether a good friend is old or new, it is clear that your friends are those who truly want to help.  Friends will want to give what they can.  Some may not cook, but their keen wit can suddenly flip fear into hilarity - that is a gift to a caregiver.

KEEPING FRIENDS

Caregivers have the obligation of reciprocating friendship, too.  Most often, this means saying thank you.  The sincere expression of gratitude is not a sign of weakness or evidence that the caregiver is miserably incapable of handling a loved one's needs independently.  The gracious acceptance of help and friendship in the full knowledge that love flows both ways, is the key here.  Good friends say,  "You look tired. Here, let me help you."  That's just what good friends do.

My book, 'The Four Walls of My Freedom: Lessons I've Learned From a Life of Caregiving' (House of Anansi Press) is now available from all major booksellers in the USA and Canada




Wednesday, 19 November 2014

LIFE GETS EASIER WITH CONNECTION TO A CIRCLE OF CARE

This week, I was honoured to contribute an article to The Home Care Technology Report, a publication of Rowan Consulting Associates.  Tim Rowan is a consultant and information broker on everything to do with home care and technology.  I'm pleased to tell you that I've had a huge and positive response to this article from caregivers and health providers alike.  Thanks, Tim!
CLINICIANS IMPROVE OUTCOMES BY CONNECTING TO A CIRCLE OF CARE
Today, my family uses technology to coordinate our son’s complex care in the community, but it wasn’t always so. Nicholas is 26 years old and resides in a small care home in our neighborhood. He is non-speaking and medically complex, requiring one-to-one nursing care 24/7. For the first 22 years of his life, Nick lived at home with us and I struggled to communicate important messages between home and the multitude of home care workers and medical professionals who were part of his care team.

I do not have that struggle anymore. A software program called Tyze Personal Networks now effectively connects everyone who cares for and about Nicholas. Tyze is owned and offered by Saint Elizabeth Health Care, a Canadian not-for-profit organization that has been supporting people at home for more than a century. Tyze is a private and secure online network that was developed to combine the efforts of family members, friends and professional supports in a circle of care. It is free to individuals but becomes more valuable when supported by a healthcare organization.
Each personal Tyze network is password-encoded and not publicly searchable. It has enough data storage to allow for a virtual filing cabinet of medical records and even highly sensitive documents such as wills and end of life directives.  Healthcare provider organizations in Canada, the US, and beyond use Tyze to reach out to their clients, inviting them to start their own care networks. Most importantly, Tyze gives organizations the ability to share information with all network owners – for example, education materials, newsletters, videos, updates, and events.

LIFE BEFORE TYZE
Before we were introduced to Tyze, Nicholas had a bedside, hospital-style chart where caregivers recorded both health and personal information. There was also a separate drug chart where staff signed for medications given. If Nicholas’ morphine dose changed, I couldn’t be sure that staff would see the notation in the bedside charts, so we installed a white board above Nick’s bed. There, we wrote important messages in large red lettering, hoping that new directives begun by one caregiver would be followed by the next one, especially if I was not home to point them out at shift change. Too often, a part-time health aide would give the old dose of anti-seizure medicine or morphine, assuming that nothing had changed since the previous week. They simply didn’t see the notes we had left.

LIFE AFTER TYZE
Today, we still use the bedside charting, but we do not rely on it to communicate messages of change in care protocols or important appointments coming up in the diary. Tyze Personal Networks shifts the responsibility for care from an individual model to a network model. A traditional, individual model of care looks like this:

An individual model of care assumes autonomy on the part of an able-bodied patient – someone who is verbal and capable of following through on measures for treatment compliance at home. This was not the case for Nicholas.  No single individual could keep Nick alive and healthy – he needed a team. Tyze gave us the communication tool we needed to effectively function as a network of care, which looks more like this:

The home page of Nicholas’ Tyze site includes all his front-line workers, members of our immediate family, executive staff members at the care home where Nick resides, and his family physician. Staffing agency case coordinators are part of the Tyze network too, and when there are last minute HR issues to be solved, everyone can offer to help and stay in the loop.

Tyze has many features that enhance both social opportunities and continuity of care. For example, specialist medical appointments as well as recreational outings are entered into the calendar feature and network members receive timely reminders on their smartphones. Network members report feeling group solidarity because everyone has shared and equal access to information about Nick. Tyze has made it easy to share resources, to ask for help and problem-solve within the group.

OVERCOMING BARRIERS & ACHIEVING SUCCESS
"How did you persuade medical professionals to be part of a Tyze network?" is a question that many curious friends ask. The answer is not straightforward. In the case of Nick’s GP, he understood immediately that an online tool would help him to manage complex care involving multiple players but he was concerned that he would be bombarded with messages. He was relieved when we assured him that only the head nurse would send him private messages via the Tyze site.  Plus, recent changes in allowable physician billing codes mean that our doctor can now be paid for the time he engages with Nick’s Tyze network.

The trickier barrier to getting Tyze up and running was compliance on the part of frontline care staff, especially after Nick moved out of our home and into a care facility. Every agency or institution has its own in-house communications linkages such as an intranet. At first, it was necessary to remind staff that their intranet excluded Nick’s family members but, eventually, everyone realized that the corporate knowledge of complex care was better managed as an integrated team with equal access to information shared by family and paid staff. Everyone began to appreciate the benefits of a single communication tool.

Like any tool, Tyze is only helpful if users populate it with pertinent information. When frontline staff members forgot to input appointments, I reviewed all my communications strategies and looked for ways to improve compliance. I realized that posting ‘need to know’ information on Tyze, such as staff shift rotas and holiday schedules would draw people to Tyze. Eventually, Tyze became the go-to site for all Nick-specific information. Now, if Nicholas has an emergency hospital admission, his network members know they have access on their phones to his medications list as well as his care plan.

Nicholas does not use Tyze himself, but it is only because he would rather use his laptop and iPad as sources of sports news and social media. Still, Nick reaps the benefits of being cared for by a well-coordinated team of people who love him and share his care. And for that, we are all grateful to Tyze.
Donna Thomson began her career as an actor, director and teacher.  In 1988, when her son Nicholas was born with severe disabilities, Donna embarked on her second career as a disability activist, author, consultant and writer. She is the Special Advisor for Caregiving at Tyze Personal Networks and is the International Advisor to the PLAN Institute for Caring Citizenship.  She is the co-founder of Lifetime Networks Ottawa, a PLAN affiliate and is a member of the Cambridge University Capability Approach Network.  Donna is also an instructor at the Advocacy School (Ottawa, Canada), teaching families how to employ best practice political advocacy tools when advocating for care. Donna holds degrees in Fine Art (Theatre), Education and Theatre in Education.  Donna’s interest in new modes of social engagement for marginalised families led her to sit on numerous boards such as the London International Festival of Theatre, Women for Women International Leadership Circle and Dovercourt Community Association. Donna can be reached at donnathomson.com. For more about Tyze Personal Networks, visit tyze.com.
BUY MY BOOK AT ALL MAJOR BOOKSELLERS IN THE USA AND CANADA!  


Friday, 14 November 2014

A Caregiving Story: The Fonseca Family

                   Q: Tell us about yourself and your family.

We are the Fonseca family - Dad is Joe, Mom is Christine, and our son is Ethan.  We are high school teachers and Ethan is 12 years old, in grade 7.  Our family used to include 3 beloved pets - 2 ragdoll cats, Emmy and Iris, and one big white dog - Thom, a Great Pyrenees.  But all of our pets have passed on. 


Q:  Who do you care for? 

Like all parents, we look after our son.  However, Ethan is 100% dependent on others for everything, so in addition to being his Mom and Dad, we are also his main caregivers.  Ethan's medical conditions include quadriplegic dystonic cerebral palsy, global developmental delay, breathing issues, and reflux disorder. He is g-tube fed and communicates via facial expressions as well as laughing, or crying.

Q:  What do you love about caregiving? 
We don't really think about this question.  To us, it's just "uber-parenting" (parenting turned up a few notches).  But we feel rewarded and honoured knowing that we are here to help him live his life in the best possible way.


Q:  What do you find most difficult about caregiving?
It is never ending and there are no breaks.  Even though we have help with nursing at school and at night (we've had the night nursing since Ethan was 9, which has been a Godsend), and other short term care workers , we are always "ON".   Even when we are not with him, we are always in a hyper-vigilant mode.

Q:  Do you have any life lessons or truths about family/community you would like to share?
We have proven that we can do this.  Joe calls it "battle-tested parenting".  However, we have had support from others, and we are very thankful for that.  Many helpers (care workers, nurses) who have come to support Ethan began working with our family during Ethan's most difficult days.  Many continue to support us.  We felt and continue to feel very blessed.

Q:  Tell us a story.  What was a lovely and intimate moment that you shared with Ethan recently. 

After planning a summer trip to Portugal for the 3 of us this past year, which included many things (such as arranging private duty nursing, a hospital bed, etc.), Ethan got double pneumonia.  It was July, 2014.  He was very ill and ended up being on oxygen at home for 9 days.  We didn't think that we would be able to go on our trip, but on the 24th of Julywe literally put Ethan on the plane - with oxygen.  It was a horrible plane ride, but we got there, and he healed beautifully in the ocean air. The most amazing moment was when a local cafe in Torreira, Portugal (Cafe da Praia) let us try out their beach wheelchair!  With the help of 2 lifeguards, Ethan was able to get down to the ocean's edge and put his feet in the water (something that he has not done since he was very small).  That's when we all took a moment, and reflected on how awesome it was that we had made the trip.   And we felt especially thankful for the help of strangers - the lifeguards - who didn't even know us. 




Q:  How do you think caregivers can be better supported by their communities and their governments?
As for communities; it's so great to see Inclusion becoming more common in society today.  We feel very thankful that our son was born in this day and age, not in the mid 1900s!
Regarding governments; it took a long time for us to get the okay for overnight nursing, an essential service in our family.  It was only after Ethan was found unconscious at 2 different times within 5 months when he was 9 years old, that we were finally granted night nursing.  Although we are very glad for it, we just wish we had had it a lot sooner.

Q:  Take this opportunity to share anything else you would like to say about your caregiving experience!
We are so thankful when, at the end of each day, all is " stable" with Ethan and with both of us.

My book, 'The Four Walls of My Freedom: Lessons I've Learned From a Life of Caregiving' (House of Anansi Press) is available now in the US and Canada from all major booksellers.


Wednesday, 12 November 2014

Helping Family Caregivers Face the Future

November is National Caregiving Month, so I could think of no better reason than to tell you about two new trends in caregiving.  And they're both good news for families.

The first is called The Greenhouse Project.  It's an international movement in humanising eldercare, but it was a small project in Wyoming that caught my eye.  Green House Living for Sheridan (Wyoming) is about as far from a traditional nursing home as you could imagine, and the residents of Sheridan like it that way.



From the Green House Living for Sheridan website:   We envision homes in every community where elders and others enjoy excellent quality of life and quality of care; where they, their families, and the staff engage in meaningful relationships built on equality, empowerment, and mutual respect; where people want to live and work; and where all are protected, sustained, and nurtured without regard to the ability to pay.


So what makes Green House Living for Sheridan (and other Greenhouse Projects) different?  A list of core guiding principles will give you an idea of how radical this project is:

Elders rule

This is the person’s home.

The individual is not the sum total of his/her age and ailments.

No decision is taken without first asking "Would a person have this in their own home? Would they do this?"

(Typical day: based on elders – eg. When people wake up, they can wake up whenever they want. They can have breakfast at 10am and choose whatever they want. They sit at a long table like  a family.)

Eldercare Solutions That Respect Family Relationships

Everyone dreads aging and becoming dependent.  Why?  We envision being isolated from our family, being forced into nursing homes where cries for help go unanswered.  Loving family caregivers worry about what will happen when dependency needs become to great to manage at home.  The founders of the Greenhouse Project designed living for elders with these concerns in mind - have a look at this video (sorry, it's Vimeo and I couldn't figure out how to embed it, so you'll have to click the link): http://vimeo.com/102882205

Activities must be meaningful, not just made to pass time.


The name Shahbazim is given to house managers (Greenhouse trained Certified Nursing Assistants) and they decide how the house will run.  Registered Nurses partner with house managers as experts, so medical model power relationships are flipped in the day to day running of the Greenhouse.  12 elders live in each home.

Middle management is diluted and the Shahbazim are trained to be full care professionals, so they manage the home as well as individual care of elders.  In the Greenhouse model, there is no dietary department or housekeeping staff.  The Shabazim multi-task as family members would at home - they are the midwives of eldercare.  Because families and community medical experts respect this model and this role, the Shahbazim have a respected and meaningful career path.

But how is it paid for?
Financing for Green House homes comes in a variety of forms.  In addition to commercial loans, Green House homes have being developed using bonds and government backed loans, as well as non-traditional loans. Through our partnerships with RWJF, AARP Foundation and The Weinberg Foundation, we are able to provide special financing for organizations serving low income elders.  To learn more about financing opportunities, visit The Green House website

The second model of care I want to tell you about today is from the UK.  U-SHED is a cooperative, a bit like AARP - each member pays the small amount of 4 Great Britain pounds to join and that money forms a fund to help seniors top up old age pensions and pay for basics that they need.  It's a model based on seniors helping seniors.  

From the website:
USHED was formed by senior citizens for senior citizens to enable us to help ourselves and make life easier without relying on the government who seem unwilling to recognise us.
By registering you become a member and we would hope to build an organisation where we can rise up and be able to offer senior citizens savings on everyday essentials and commodities. The funds will sit in a central "pot" and will be used to buy from source and subsidise services for members.
Registration forms will be available at GP offices, Post Offices, in newspapers and online.
Interested? Then please take the time to complete the registration.
Shown below is a break-down of the services of U-SHED:-
  1. For a small monthly membership fee we will enable members to save between 10 and 50% on everyday essentials such as food, insurances, community tax, gas, electric, water e.t.c.
  2. Mobile dentists, opticians and audiologists could make these routine examinations much more accessible to elderly, immobile and infirm.
  3. Funds could be used to buy larger items from source and offer them to members with substantial discounts rather than going to the high street companies who do not offer special rates for pensioners.
  4. A lot of the older generation do not like using computers or shopping online. It is rare these days to find somewhere which offers the facility to call and be able to buy in confidence.
  5. It is hoped that we will grow and eventually have enough funding to enable us to sponsor hospital wards and care homes.
The cost of the above benefits is £4 per month.

The more members we have the more savings we will be able to offer.


Stan Stearman is the founder/creator of U-SHED and he told me that UK municipal governments have begun to take a real interest in the project and are supporting it.  The fund is already helping seniors become more connected to their communities while staying in their homes longer.  

As family caregivers, we want our loved ones to have a good life.  We want to support them, but we cannot do it alone, especially when their needs increase over time.  Knowing that some communities are creatively rising to the challenge of helping families keep their senior loved ones safe, secure and happy is 'chicken soup for our caregiver souls'.

My book, The Caregivers' Living Room: Lessons I've Learned From a Life of Caregiving is available in Canada and the USA from all major booksellers.