The Challenges and Rewards of Caregiving

Being a caregiver for an elderly or disabled loved one can be one of the most challenging, frustrating, and rewarding experiences of your life. And you won’t be alone. Today, there are about 53 million family caregivers in the U.S., and about a third of caregivers spend 20 hours or more caregiving. Depending on the degree of caregiving needed, such as caring for someone with dementia or severe health and mobility issues, that time can be much greater. 

“By mid-century, there will be only three family caregivers available for each person requiring care," said Dr. Susan Reinhard, senior vice president and director of AARP Public Policy Institute, after the release of a study several years ago. " That means, to avoid putting them at higher risk as they age, we need to provide support for existing caregivers who are underserved by the current long-term services and support system.”

Indeed, while many of us have found, and will find, ourselves in caregiving situations, we as a society need to find better ways to help each other in these situations. And we do that by first acknowledging what it means to be a family caregiver.

While helping out an elderly parent with chores and errands is something many people can manage easily, and maybe have done for years, what happens when the level of care needed suddenly escalates? Perhaps a serious medical problem emerges? Or the parent has a fall? Or signs of dementia begin to show themselves? Suddenly, many caregivers find themselves in an overwhelming situation and are forced to rearrange their entire lives around caregiving.

A recent article by Catherine Pearson in the New York Times was brutally honest about the situation, addressing the frustration and anger that can come with finding yourself in a caregiving role. And the difficulty of dealing with and expressing those feelings. 

“The stress is just monumental and constant,” said Ann Brenoff, 73, whose husband was diagnosed with acute kidney failure and needed round-the-clock care. She described feeling less like a wife and more like a medical case manager, losing touch with friends, and gaining 20 pounds.  “I was pissed off,” she said. A director of a caregiving clinic Pearson spoke to said that among the 4,000 or more caregivers she has worked with, she has "yet to meet one who has not expressed some form of anger."

Of course, as the director points out, beneath the anger is a "deep well of sadness" and a feeling of powerlessness. 

“Many caregivers can’t plan for the next day or week, let alone the next month or year,” said the clinic director. “And that’s maddening.” 

While the typical caregiver has for years been a 49-year-old woman and, most likely, the daughter of those being cared for, that has been changing. More men are becoming caregivers, typically the sons of those being cared for, and a quarter of those 53 million mentioned earlier are millennials who are an equal number male and female. For example, Pearson spoke to a woman who began caring for her mother full-time in her late 30s after her mother suffered complications from spine surgery. And a 39-year-old man found himself caring for both his parents after they suffered strokes within months of each other. And then there are the older caregivers, 75 years or older, who are usually the only supports their loved ones have. 

People are often unprepared for caregiving situations, both because someone's health takes a sudden or because roles get altered or reversed. For example, caregiving often requires a reversal of the parent/child relationship, and that can bring up all kinds of emotional and psychological issues among family members. And pit siblings against each other. Experts agree that self-compassion and peer support is crucial

And as the situation evolves, increasing stress levels and the feeling of being “trapped” can sneak up on you. That’s why researchers have found that affordable respite and in-home care were the most desired support among caregivers, along with other supports and resources to manage stress. Indeed, it’s not uncommon for caregivers to find themselves isolated, overwhelmed and even frightened by a caregiving journey they weren’t quite prepared for. This is why finding a way to express your complicated feelings is so important.

“A lot of caregivers are afraid to express their anger because they feel guilty,” a millennial caregiver who created a Facebook support group told Pearson. “...I think people worry if they express it to somebody who doesn’t totally get it, that it will overshadow the totality of their experience.”  

So, where does the reward come in with all this? Well, it doesn't come for everyone, but when it does it comes in the form of the help and love you have to accept from your friends and family, and your community — and the help and love that those being cared for have to accept from the children, friends, caregivers, and doctors they work with.

We deepen relationships with people, even our deepest ones, by struggling with challenges together, by revealing our vulnerabilities, by being straightforward and honest about our needs, and by riding together the often turbulent waves of feeling and emotion that make us truly human. All those come to the forefront in a caregiving situation. There’s no hiding from each other. We realize deeply that taking care of each other means taking care of ourselves, too.

If you're lucky, you'll end up feeling deeply grateful for the time you got to spend together in that caregiving situation — not because it was always fun or joyful, but because you got to experience the full depth and breadth of our humanity and the connection you had with your loved one. 

David McNair handles communications, media relations, and social media efforts for JABA

This article originally appeared in C-Ville Weekly.

Defying Ageism: Are you willing?

When it comes to ageism, we often have no one to blame but ourselves. A good-natured protest against being offered a senior discount, getting an AARP invite in the mail, or a self-deprecating aside about one's age are familiar and curious signals of our discomfort. They might seem innocent enough, but they help reinforce the idea that aging is something meant to be avoided, delayed, or even defied. Which can lead to some pretty delusional thinking. Indeed, when we say someone appears to be "aging backward" it's meant as a compliment, even though we know it's impossible and would likely be a nightmare if it wasn't.

Asked why she titled her new book "Honest Aging: An Insider’s Guide to the Second Half of Life," physician and author Rosanne Leipzig recently told the Washington Post it was because "so much of what’s out there is dishonest, claiming to teach people how to age backward."

"I think it’s time we say, ‘This is it; this is who we are,’ and admit how lucky we are to have all these years of extra time,” said Leipzig.

It's a refreshing idea. Instead of internalizing all the negative messaging about aging, instead of taking a gallows humor approach, why not take a practical look at the situation? For starters, as Leipzig alludes to, greater life expectancy is allowing more people to live longer. Something we should be celebrating. As a result, aging happens over a longer period and isn't the same experience for everyone.

“Predictable changes occur, but not necessarily at the same time or in the same sequence,” said Leipzig. “There’s no more heterogeneous a group than older people.”

What's more, Leipzig argues, a better understanding of the changes that occur as we age, and what we can do to adapt to those changes, can "help people understand that there are lots of things that you can do to adapt to your new normal as you age and have an enjoyable, engaged, meaningful life.”

For instance, understanding that your symptoms of an illness can change, that your body reacts to medications differently, or that energy levels, sleep patterns, eyesight and hearing strength, and muscle flexibility can all change as you age doesn't have to lead to frustration and despair. It simply means paying closer attention to your health, seeking your doctor's advice, eating consciously, staying active, and reducing stress. It means changing your attitude and adapting to your situation.

Of course, that's easier said than done. We know that ageism and negative attitudes about aging are all around us. And that facing one's mortality and the changes our bodies go through can be difficult. But we also know that carrying negative self-perceptions about aging is having a profound impact on our health and health systems. Researchers at Yale found that negative views about aging are associated with all the most expensive health conditions in America - heart disease, lung disease, diabetes, musculoskeletal disorders, and injuries. The estimated cost of ageism, Yale researchers found, was $63 billion per year!

“Never say never,” Leipzig said. “There is almost always something that can be done to improve your situation as you grow older if you’re willing to do it.”

This article originally appeared in C-Ville Weekly. David McNair handles communications, media relations, and social media efforts for JABA.

Social Connection: our lives depend on it

Ironically, as the world has grown more interconnected, people have grown more disconnected from each other. Even before the pandemic, which required people to self-isolate, many health professionals believed loneliness was becoming an epidemic. Emerging research showed that social isolation could be deadly, leading to heart disease, mental health issues, dementia, and shorter lifespans. Back in 2018, Britain appointed a “loneliness minister” to tackle the problem. Later Japan and Sweden followed suit. In America, Dr. Vivek Murthy, the former surgeon general, was calling loneliness a “profound public health issue.” Five years later, Dr. Murthy, who was reappointed as surgeon general, sounded the alarm earlier this year in an 81-page report on the “devastating impact” of loneliness. 

“Given the significant health consequences of loneliness and isolation, we must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity, and substance use disorders," wrote Dr. Murthy.

Back in 1964, the surgeon general issued a historic warning about the dangers of smoking, and many observers think Dr. Murthy’s spring report could be just as significant. 

“I suspect that this report on loneliness will also be remembered as one of historic significance,” wrote New York Times columnist Nicholas Kristof, who has written frequently about the epidemic of loneliness, pointing out that the 1964 warning helped “lay the groundwork for a long decline in tobacco use that by one estimate saved eight million lives.”

As Kristof mentions, Murthy wrote in the report that “loneliness is far more than just a bad feeling,” and offered this stark warning if steps aren’t taken to address the problem - “we will further retreat to our corners — angry, sick and alone.” And while seniors are particularly vulnerable to the physical effects of loneliness and isolation, we are all in this together, as research has shown that young adults are twice as likely to report feeling lonely than seniors.

However, as both Kristof and Murthy point out, while loneliness and isolation are widespread and dangerous to our well-being, and the causes complex, the cure is pretty simple: social connection

That was on display locally during the United Way’s annual Day of Caring last week, in which hundreds of volunteers across the region came together to work on dozens of projects and events. JABA, our local aging services agency, which operates centers across the region for older adults, also held its annual “Fall Ball.” Seniors from JABA centers in Charlottesville and Greene, Nelson, Louisa, Fluvanna, and Albemarle counties all came together (thanks to JAUNT buses) for music, dancing, games, and a Cajun-style meal at JABA's Greene County center location in Stanardsville. While you could notice different levels of engagement among the seniors, collectively there was such energy in the room. A rising sea of connection lifted all boats. And most importantly - everyone looked like they were having such fun. 

Community senior centers are vital social hubs for area seniors, especially in rural areas, and they strengthen the “social infrastructure” that Dr. Murthy cites as a strategy for combating the loneliness epidemic - the idea that “communities must design environments that promote connection, establish and scale community connection programs, and invest in institutions that bring people together.” Indeed, as Murthy wrote, combating loneliness involves a wholesale re-investment in our communities - upgrading parks, libraries, and community centers, improving public transportation, fostering better work-life balance, and deepening our cultural understanding of the importance of social connection, especially in relation to the digital environments that are now part of our lives. 

If you or an older adult you know appears to be spending too much time alone, consider joining a JABA center, becoming a member of the Center at Belvedere, joining a support group in your area, or simply visiting a park for a walk. Questions? You can call JABA’s Senior Helpline at 434.817.5244 to find out about area programs and resources. You are not alone. Reach out and stay connected - our lives and the health of our communities could depend on it. 

This article originally appeared in the September 27, 2023 issue of C-Ville.

Celebrating Hispanic Heritage Month

Every September 15 through October 15, we celebrate National Hispanic Heritage Month. September 15th marks the anniversary of independence for several Latin American countries, including Costa Rica, El Salvador, Guatemala, Honduras and Nicaragua. This month-long holiday serves to honor and celebrate the Latin heritage, culture and contributions made by members of the community.

The National Hispanic Council on Aging (NHCOA) has been in existence almost as long as JABA. Its four main goals are to promote health, economic security, housing and leadership development and empowerment. These are areas that are consistent with JABA’s efforts to help seniors age in the community.

According to the latest census, the Hispanic population in our region has grown to 5 percent, with higher numbers in some counties. We are intentionally broadening our outreach to the Latinx community in our region, especially by having a bilingual Outreach Assistant, who can identify the best avenues and provide a culturally-sensitive interaction. We have translated our key brochures and tool kits into Spanish to assist with this outreach. We are pleased to work with Dr. Max Luna, Latinx outreach from UVa Health System, as he has established a strong trust within the community and is helping to extend that to JABA.

This is an example of our value of Culture of Collaboration, as we are achieving more through working together, and our value of Inclusion, as we care about helping all seniors to age in the community. We celebrate the Latinx community and all of us who provide service and support to Latinx seniors. I am proud to be of Hispanic heritage and know that it has enriched my experiences and added to my perspective of caring for all.

Thank you,

Marta Keane, JABA CEO

Marta Keane: "...we really want people to move beyond those boundaries they've had."

JABA CEO Marta Keane joined NBC29's Kasey Hott to discuss Older Americans Month. This year, the governments of Charlottesville, Albemarle, Greene, Louisa, Nelson, and Fluvanna counties presented JABA with proclamations declaring May Older Americans month.

What does this year's Older American Month theme "Aging Unbound" mean?

"What it means is to challenge our stereotypes and ideas about aging," Keane told NBC29's Hott yesterday, "....and realize that as we age we can demonstrate wisdom and experience that we've accumulated over a lifetime. So we really want people to move beyond those boundaries they've had." Watch!

Older population declining in Charlottesville, climbing in border counties, report says

NBC29 spoke with JABA CEO Marta Keane about how the older population is increasing in surrounding rural counties, and more specifically, how it is decreasing in Charlottesville.

"The seniors are decreasing [in Charlottesville] and it's a concern," said Keane.

"Many independent cities had neighborhoods with a relatively large older population 20 or 30 years ago, in Charlottesville the area neighborhoods around downtown were 25-30 percent over 65 in 1990 but today they are probably under 15 percent," says Hamilton Lombard, a demographer for the Weldon Cooper Center, tells JABA. Charlottesville’s 65+ population has only risen slightly since the 2010 census, while Albemarle County’s 65+ population has gone from 12.5 % in 2000 to 19.4 % in 2020. Surrounding counties have also seen sharp increases in their 65+ populations in the last two decades.

A study JABA helped conduct showed there were three main factors that may be forcing seniors to leave Charlottesville.

"The three top areas were affordable housing, transportation, and social engagement," said Keane, emphasizing the cost of housing.

"That is one of the serious concerns for seniors who are on a set income unless they go back to work, and even then they have to watch what they earn. They have to really make everything fit within whatever their social security, and perhaps their retirement has provided for them."

Eight years ago, JABA and other organizations formed the Charlottesville Area Alliance, a collaborative effort to address those issues - which are also important to people of all ages - and to identify needed services and call attention to those that already exist.

"It doesn't need to be about our organization so much as elevating the needs of seniors," Keane said, and "to be that advocate and that voice."