Twenty-five ways to help the Homebound and their caregivers

By Donna Karabin and Nadia Koblosh

We are blessed in our Orthodox communities by the friendships we develop and nurture when we greet each other at Divine Liturgy and spend time together at parish events. Those who are absent from parish life because of ill health or disabilities are sometimes forgotten. They may be referred to as “homebound” which means they are unable to independently leave home. Even with the help of a caregiver, the effort is a taxing one.

Families are the mainstay care providers for the frail, chronically ill, disabled of any age and the impaired elderly. Paid outside caregivers are the exception, not the rule. More than one-fourth (26.6%) of the adult population has provided care to a family member or friend during the past year. The caregiver directly provides or arranges for help when a dependency situation arises. He or she provides medications, meals, assistance with such personal care tasks as bathing, dressing and hygiene. The caregiver may have responsibility for arranging medical appointments and providing transportation. One vital caregiving aspect is companionship, necessary for the care recipient of any age. On average, twenty hours of care per week is provided. Twenty-one hours or more is considered to be intense caregiving.

Some sources report that the pool of family caregivers is dwindling, but the Federal Government Administration on Aging states that the degree of caregiver involvement has remained constant over the past decade despite increased geographical separation, a greater number of women in the work force and changes in family life in our culture.

Older persons make up half of all caregivers. In the absence of a spouse, a daughter or daughter-in-law has traditionally been most likely to assume the caregiving role. But new information reveals that caregiving is no longer predominantly a women’s issue. Men now make up forty-four per cent of the caregiver population.*

The Challenges for Caregivers Are Many

The challenges for caregivers are many. Of those caring for an aging parent, eighteen percent live more than one hour away. Forty-one percent care for a child under the age of eighteen. More than sixty percent balance a career with caregiving responsibilities.

Intense, heavy-duty caregivers, especially spousal caregivers, do not get consistent help from other family members. One study has shown that as many as three-fourths are “going it alone.” Sadly, sixty-one percent of intense caregivers have experienced depression. One-third of all caregivers describe their own health as fair to poor, often indicating they are not sure they will outlive their loved ones. In those cases there are two persons at risk. Special vigilance is needed for those in remote or rural areas, one example being Alaska. A saying heard from Alaskan native elders when in crisis is, “Who will cross the river with me?” It is a question that is also applicable to family caregivers no matter where they may live. **

The undeniable resounding message is that families need help! It is our calling as Orthodox Christians to reach out to minister to their needs wherever and whenever we can. We can do so always being mindful of their (and our) safety, their personal privacy and the need for them to maintain as much independence as possible. Spiritual and practical support from the faith community can be a vital component towards the well-being of both the homebound and the caregiver.

How an Individual or a Parish Can Help

The following list has twenty-five suggestions that can guide a man or woman of any age, a family or a parish to undertake an outreach program:

1. Pray daily for the homebound person and the caregiver.
2. Offer to assist in bringing the homebound and caregiver to Church.
3. Offer transportation to medical appointments.
4. Commit to making a weekly phone call.
5. If the homebound person lives alone, visit regularly with coffee, snacks and news of the parish.
6. Commit to regularly scheduled visits so they can be anticipated.
7. Read to the homebound if unable to read or provide assistance to obtain “talking books.”
8. Serve as translator with service professionals if a language barrier exists.
9. Help write letters or cards with the homebound to send to friends or family.
10. Assist with insurance or other paperwork.
11. Prepare meals weekly, or have several people take turns 1-3 times a week.
12. Offer to stay with the homebound once or twice a week, or if possible for a weekend, to relieve the caregiver.
13. Remember to ask about the caregiver’s physical and emotional health.
14. Offer to help with heavy housekeeping chores or arrange a “maid brigade” of parish friends.
15. Offer tools and time to help with household or car repairs.
16. Mow the lawn or shovel snow when needed.
17. Offer to pick up needed supplies or groceries when out doing your own errands.
18. Be sure there is a working telephone especially if the homebound is living alone.
19. Let them know you would be available 24 hours a day in the event of an emergency.
20. Offer to help them get an “emergency response system.”
21. Ask the priest or parish secretary for copies of notices received in the church mail related to community resources that could be passed on to the homebound or caregiver, e.g. energy assistance, tax relief, community services, seminars, etc.
22. Link the homebound and caregiver to the National Family Caregivers Association (NFCA), a service organization not disease or age specific, for resource materials, advisory support and advocacy: www.nfcacares.org or 1-800-896-3650.
23. Link them to the local Area Agency on Aging through the U.S. Administration on Aging Eldercare Locator at 1-800-677-1116 or www.aoa.gov. Click on Elders and Families, then NFCSP for information on the National Family Caregiver Support Program which provides services, counseling, caregiver training and respite care.
24. Research other Resource Handbook articles at www.oca.org or in the printed format in your parish library, e.g. “Twenty-something Ways for Youth to Minister to the Elderly,” “St. Euphrosynus the Cook Project” (Providing meals for shut ins.), “Ministry to Shut-ins and Hospitalized Patients,” “Home Health Care Services,” “Ministry of Listening,” “No Small Change” (Our attitude toward the disabled.), and the Christian Living Series booklet “Eldercare, The Church’s Ministry with the Elderly.”

* Statistical information was adapted from U.S. Health and Human Services Administration on Aging’s National Family Caregiver Support Program, the National Family Caregivers Association, and CareFirst Blue Cross Blue Shield Vitality magazine, Issue 1—2003.

**Take Care! Self-Care for the Family Caregiver,” Volume 12, Number 2, Summer 2003, “Caregiving in Remote Areas,” p 3.