Re-imaging our Care Work

There are only four kinds of people in the world

“There are only four kinds of people in the world. Those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need a caregiver.”

~Roslyn Carter

Although we care for others or are cared for by others at different levels throughout the arc of life; at both poles of life, we are more vulnerable and dependent upon care.

Dr. Bill Thomas, an international authority on geriatrics, talks of embracing elderhood as a transformational developmental stage of life. Just as early childhood is unique, with specific challenges, joys, and perspectives, so is adulthood, and so is elderhood. Entering elderhood extends a possibility to shift into a new way of being human.

At both poles of life care is amplified. At both poles of life, humans are whole and complete – both children and elders offer us unique insights, unparalleled wisdom, and an invitation to live a creative life; to notice what matters, and to live in the now.

Let’s reimagine our care practices. By looking at care at both poles of life and by placing care in the context of the self-actualizing journey of human development—we realize the purpose of our work in caring for another is to nurture growth.

Care is a partnership that moves the other towards becoming more. Care offers independence, not helplessness. Care offers strength, not weakness. Care offers a connection, not isolation.

Let us rescue care from the confines of the undervalued, unappreciated realms where it has hidden We can be blazing defenders of care. We can shine a light for the advancement of a great society. Let’s be a part of the care revolution!

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About the author 

Jean Garboden, Marketing and Innovation Leader for Compass Senior Living is  in her 70’s and is experiencing newfound joy in aging. She is working passionately to lift up care and to care for the caregivers. She is redefining elderhood. We are in the midst of re-imagining what it means to grow old. She has no plans to “hand over the torch” but is now claiming her role as a wise experienced leader who can now let her torch shine brighter and bolder than ever, while she lights the torch of others and exerts ongoing unique influence at the crescendo of her life. https://www.compass-living.com/ 

Not invisible any more – a courageous journey to change the world!

“We sometimes speak as if caring did not require knowledge –  as if caring for someone is simply a matter of good intentions or warm regard. But to care, I must understand the other’s needs and must be able to respond properly to them – and clearly good intentions do not guarantee this. To care for someone, I must know many things.”

– Milton Mayeroff

Yes – to care for someone, I must know many things!

I have the privilege of teaching our care teams in our Independent, Assisted Living, and Memory Care communities in the United States about how to embark on a courageous journey to change the world by embracing and evoking their power as educated caregivers.

Let’s make the invisibility of care visible as we gain specialized knowledge about human development.

Invisibility of Care 

The deep assumption about caring is that it is something anyone can do, but we do not take care of human beings the same way we take care of a house or a lawn!  We must know many things.

The way we touch others increases or diminishes their self-worth.

• The sensations of the body are the pathways to intellect and emotions. Caring routines involve engagement around bodily functions (elimination, cleaning, eating, sleeping) and therefore they hold the most intimate importance.
• In the past, caring tasks may have been viewed as custodial. In the emerging future, care is viewed as an honorable practice that requires specialized knowledge about human development.
• When we see the other as competent and capable, we practice caring as a conversation — a reciprocal exchange.  We find ourselves doing things “with” others instead of doing them “to” others.  We engage in relationship-planning rather than care-planning.
• We view care as a practice that nurtures another’s development, actualization, and self-sufficiency. This is the opposite of caring in a way that creates helplessness, frustration, dependency, or entanglement.
• Caring is associated with strength and power — not passivity or weakness. The other feels his or her wholeness in our caring response.

Caring and being cared for can give meaning to our lives

I believe that caring plays a much bigger role in our lives than you might think. The experience of caring can ‘shape us’, and help create order and stability in our own lives.

• Knowing – “I must understand the other’s needs and be able to respond properly’” and “I must know what my own powers and limitations are”.
• Alternating rhythms – Moving back and forth between a narrower and a wider framework- at times focusing on the detail, at others on the wider picture; sometimes doing, sometimes doing nothing; always watching and seeking feedback on those actions/inactions.
• Patience – “I must enable the other to grow in their own time and in their own way –  giving the other room to live.”
• Honesty – This means being open to oneself and to others – seeing others as they really are and seeing myself as I really am.
• Trust –  Trusting the other is to let go; it includes an element of risk and a leap into the unknown, both of which take courage.
• Humility – There is always something more to learn. Through caring, I come to a truer appreciation of my limitations as well as my powers.
• Hope – Through caring, the carer instills hope into the relationship.
• Courage – a carer needs courage because, as with any relationship, this is largely a journey into the unknown.

Caring is what makes us human.  By educating ourselves and claiming the power we have to grow and impact others – we each have an opportunity to evolve into powerful change agents to be part of a movement creating a caring world.  Let’s take this courageous journey as super-caregivers!

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Jean Garboden, Director of Education & Innovation at Compass Senior Living

About the Author: Jean Garboden is an Elder Advocate and Eden Alternative Educator with over 30 years’ experience in not-for-profit and for-profit healthcare organizations. She is honored to lead the mission and values culture development for Compass Senior Living in Eugene, Oregon. Jean lives in Las Vegas, Nevada where she enjoys the weather and volunteers with the Nevadans for the Common Good, advocating for caregivers and elders in southern Nevada

Tax Deduction Tips for Assisted Living Costs 2016

Did you know that if you are an elder adult or a caregiver for one, there are ways to get a tax deduction for assisted living costs?  In order for assisted living expenses to be tax deductible, the resident must be considered “chronically ill.” This means a doctor or nurse has certified that the resident either:

• cannot perform at least two activities of daily living, such as eating, continence care, transferring, bath, or dressing; or
• requires supervision due to a cognitive impairment (such as Alzheimer’s disease or another form of dementia).

Elders who are not chronically ill may still deduct the portion of their expenses that are attributable to medical care, including entrance or move in fees.

What is the criteria to claim the tax deduction for assisted living costs?

• The medical expenses have to be more than 10 percent of the resident’s adjusted gross income. (For taxpayers 65 and older, this threshold will be 7.5 percent through 2016.)
• In addition, only expenses paid during the year can be deducted, regardless of when the services were provided.
• Expenses are not deductible if they are reimbursable by insurance.

Which Expenses can be deducted?

• Room and board for assisted living if the resident is certified chronically ill by a healthcare professional and following a prescribed plan of care. Typically this means that they are unable to perform two activities of daily living (ADLs) or require supervision due to Alzheimer’s disease or other conditions.
• Entrance or move-in fees for Assisted living.
• Cost of prescription drugs.
• Personal care items, such as disposable briefs and foods for a special diet or nutritional supplements.
• Cost of travel to and from medical appointments.
• Premiums paid for insurance policies that cover medical care are deductible, unless the premiums are paid with pretax dollars. Generally, the payroll tax paid for Medicare Part A is not deductible, but Medicare Part B premiums are deductible.
• Payments made for nursing services. An actual nurse does not need to perform the services as long as the services are those generally performed by a nurse.
• Fees from doctors, laboratories, home health care and hospitals.
• The cost of long-term care in a nursing home or rehabilitation center, including housing, food, and other personal costs, if the person is chronically ill.
• Home modifications costs such as wheelchair ramps, grab bars and handrails.
• The cost of dental treatment.

For a full list of allowable medical expenses, see IRS Publication 502. Read about the rules that govern deductions and for more tax tips for elder adults and their caregivers.

My parent lives in my home with me.  Can I qualify for a dependency deduction?

If you care for an elder parent in your home, your parent may qualify as your dependent, resulting in additional tax benefits for you. Once you determine that both of you meet IRS criteria, you can claim your parent as a dependent on your tax return.

To qualify for a dependency deduction, you must pay for more than 50% of your qualifying relative’s support costs. The relative only qualifies as a dependent if he or she meets the gross income and the joint return test. If your relative doesn’t qualify as a dependent because of these tests, you cannot claim a dependency deduction, but you can still claim his or her medical expenses. For more information, read page 20 – 21 (Support test to be a qualifying relative) of the IRS Publication 501 on tax exemptions.

See the 5-minute video below for more details about the dependency deduction.

By nature, tax rules are complex. It’s important to consult a tax attorney or accountant versed in eldercare tax issues about your specific situation before finalizing your taxes. The AARP also offers free assistance and tax tips for elder adults through its Tax-Aide program.

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About the Author: Jean Garboden is the Director of Education and Innovation at Compass Senior Living, located in Eugene Oregon. Jean is an Elder Advocate and Eden Alternative Educator with over 30 years’ experience in not-for-profit and for-profit health care organizations. She is honored to lead the mission and values culture development for Compass Senior Living. Jean lives in Las Vegas, Nevada where she enjoys the weather and volunteers with the Nevadans for the Common Good, advocating for caregivers and elders in southern Nevada

Human connection ~ at the core of everything that matters in the world

I  believe that trusting relationships are the most basic of human needs and the strongest foundation for caring for one another. Despite that belief, it’s easy to get caught up in a one-woman hamster wheel of working, consuming media, and just being busy with the many tasks on my to-do list.

I teach our care teams about the power of human connection through eye contact, touch, and conversation. I teach them that each person has a unique worth from birth through the end of life, as fully capable human beings.  I teach our leaders about the power of creating a culture of caring in a person-centered workplace in their responsibility to care for their care teams and families while becoming well-known to one another.    Yet, I acknowledge that I sometimes take human connection for granted; I forget its value and forget to nurture it.

This 15 minute Ted talk by Elizabeth Lesser “Say your truth, and seek them in others”  touched me, and I found new ways to strengthen authentic relationships in my life.    Lesser challenges us to “Be like a new kind of first responder… the one to take the first courageous step toward the other.”

Elizabeth Lesser starts her talk with the lessons she learned from being a midwife. “Everyone in this room is a former baby with a distinctive birthright,” she says, and we are all possessed of a “unique spark.”

In this busy holiday season, I invite you to take 15 minutes to reflect on the relationships in your life.  Authentic, genuinely caring relationships are at the core of everything that matters in the world.  What greater gift can we give to another than the gift of ourselves?

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About the Author: Jean Garboden is the Director of Education and Innovation at Compass Senior Living, located in Eugene Oregon. Jean is an Elder Advocate and Eden Alternative Educator with over 30 years’ experience in not-for-profit and for-profit health care organizations. She is honored to lead the mission and values culture development for Compass Senior Living. Jean lives in Las Vegas, Nevada where she enjoys the weather and volunteers with the Nevadans for the Common Good, advocating for caregivers and elders in southern Nevada

Speak Up! – We all need an advocate in our lives!

“We can, all of us stand up for care.  We can change how we think, how we talk, how we plan and work and vote.  We can come together as women and men. We can finish the business that our mothers and grandmothers began and begin a new revolution of our own.” Anne-Marie Slaughter, author, Unfinished Business

As a young mom, I advocated for my children’s care.  As a wife, I advocated for my husband’s care.  As a daughter, at the end of my mother’s life, I advocated for her care.  We all need advocates and people in our lives to advocate for us. We need each other!

I have been thinking about the sacred and honorable act of caring for a long time.  My daughter Carol and I have talked about this for years.  My work is in elder care and elder empowerment, and hers is early childhood.

We both feel passionately that caring for others is the most honorable, rewarding and challenging work imaginable.  We recognize the vulnerability of humans at each pole of life – early childhood and elderhood. We value the care required to enter and exit this life. We celebrate the wholeness, dignity and competence of the vulnerable. We talk about burn-out and together we have been seeking to understand self-care and how to glean the joy and nourishment that we believe caring can yield to ourselves, to our profession and to our society.

We dream about how different the world will be as we facilitate a shift in society’s thinking regarding the way our culture views caring for human beings at the beginning of life and the end of life.

Here are the commonalities we discuss:

• In both fields, the important caring types who do the direct work are often under appreciated.
• Relationships are the key to doing this human work well. We look for people who can make connections and form real relationships.
• In both elder care and child care, the caregivers must also be responsive and supportive of the whole family – realizing the individual is part of a family system.
• The very nature of caring rituals: washing others, holding others, feeding others and dressing others – is intimate work and requires being present with goodness, dignity, respect, intelligence and kindness.
• At the beginning of life and the end of life – humans are dependent upon others to care for them. Caring for others comes with a great responsibility and a commitment towards service to others.

Creating a culture of caring is important in our families, in our work, in our cities, our towns, in our country, and in the world.   It starts with us advocating for one another.  Speak up!

 The video above is courtesy of Speak Up! This  information is used for public service announcements, websites, community newsletters, health fairs, closed circuit patient education television, and staff education. The popular animated videos have been downloaded by organizations in more than 70 countries.

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About the Author:    Jean Garboden is the Director of Education and Innovation at Compass Senior Living, located in Eugene Oregon. Jean is an Elder Advocate and Eden Alternative Educator with over 30 years’ experience in not-for-profit and for profit health care organizations. She is honored to lead the mission and values culture development for Compass Senior Living.  Jean lives in Las Vegas, Nevada where she enjoys the weather and volunteers with the Nevadans for the Common Good, advocating for caregivers and elders in southern Nevada.  She spends her leisure time with her husband Art, her dog Max, her cat Molly, and a 50-year-old desert tortoise named Myrtle. Jean is pictured here with her daughter Carol.