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Special Report:  Study Shows Half of Caregivers Spend 10% of their Income to Care for an Older Loved One

 The Evercare/National Alliance for Caregiving Study finds that half of those caring for a loved one 50 years or older are spending on average more than 10 percent of their annual income on caregiving expenses and often sacrifice their own long-term financial and personal well-being to do so. Family caregivers who have annual median income of $43,026 spend an average $5,531 a year on caregiving, an amount that is $400 more than the average American household spends each year on health care and entertainment combined, according to the Bureau of Labor Statistics. Further, the Study found that at lower income levels the annual average costs remained about $5,500 – making their financial burden even heavier.  

The Study also uncovered that one in three respondents (34 percent) had used some of their savings to cover the cost of caregiving and one-quarter (23 percent) said they had cut back on their own health care spending. But, according to the respondents, the most significant sacrifice was their own time spent caring for an older loved one. Importantly, most of the caregivers from the Study still saw their caregiving role as a labor of love and one they do willingly.  

The Evercare/NAC study provides the first in-depth look at the financial and other “personal costs” of caregiving, and indicates that as many as 17 million people, or 51 percent of the 34 million caring for a loved one 50 years or older, are spending on average more than 10 percent of their annual income on caregiving expenses, more than twice as much as previously reported.  

Other caregiving studies have looked at the costs to employers or the economic impact on society. A 2004 study by NAC/AARP showed that 21 percent of U.S. households contain at least one caregiver. According to the U.S. Census Bureau, that number is expected to surge as today’s Baby Boomers age and the number of Americans over the age of 65—35 million now—doubles over the next 10-15 years.  

The Study also looked at the difference in costs for varying caregiving situations. Long-distance caregivers had the highest average annual expenses ($8,728), followed by co-resident caregivers ($5,885) and those who cared for someone living less than an hour away ($4,570).

 

What Caregivers Sacrifice – It’s Not Just Money, But Also Time

 More than half of the Study respondents (53 percent) did not work while 37 percent of the respondents said they had quit their job or reduced their work hours. The respondents also reported they were spending on average 35.4 hours a week caring for their loved one with 19 percent providing care for more than three years and 32 percent caregiving for more than five years.  

While the survey focused on the personal financial costs of caregiving, it also revealed a ripple effect: respondents felt their out-of-pocket costs carried an emotional and physical price. Study respondents reported on the personal and emotional impact which includes heightened stress or anxiety (65 percent), difficulty sleeping (49 percent), increased financial worries (43 percent), depression or hopelessness (37 percent), and new or worsening health problems (26 percent). 

 

The Importance of Supporting Caregivers

 The care provided by family caregivers is an integral part of America ’s health care system. Yet, alarmingly, statistics from a 2005 brief provided by the Commonwealth Fund show that caregivers are twice as likely as the general population to develop multiple chronic illnesses. People with chronic illnesses also are among the heaviest users of medical care in the nation; people with five or more chronic conditions make up just 20 percent of Americans age 65 and older, but account for 68 percent of all Medicare spending according to a 2004 report by the Partnership for Solutions.

 

What Project Compassion is Doing to Help  

To respond to significant caregiving needs that professional health care services are unable to meet, Project Compassion began creating a community-wide network of volunteer caregiving support teams in 2002.  Caregiving Support Teams provide free carefully-coordinated consistent support for individuals and families who need assistance with caregiving.   

Support Teams take a comprehensive approach to community caregiving support.  Volunteers pool their talents, creativity, time, and leadership abilities to offer much more support than one volunteer can provide alone. Teams average 6-12 volunteer members and often have 2 volunteer co-leaders and a Project Compassion coach.  Their activities often include a carefully coordinated combination of:

·         Practical Support:  such as help with transportation, respite, meals, errands, household tasks, yard work, etc.

·         Emotional and Social Support: such as visits, calls, check ins, shared time together, etc.

·         Quality of Life Support:  such as social outings, gardening, help with hobbies, computer access, art projects, cookbook projects, pet care, etc.

·         Advocacy and Resource Support:  such as tapping community resources, help with problem solving, accompanying friends on doctor visits, organizing records and bills, etc.  

On average, Support Teams deliver 40 hours of caregiving support per month, equal to 480 hours of support a year.  For an individual or family to pay for this support would cost an average of $9,340.00 a year.   

Because the economic burden of family caregiving is so significant, this service is provided at no cost to individuals and families.  Project Compassion funds this support by donations from individuals and organizations and by local grants.  

Project Compassion recruits, orients, educates, coaches and supports teams as well as providing the educational resources, leadership tools, and communication tools teams need to document, facilitate and evaluate the team process. Through Project Compassion, recipients, team members, leaders, coaches, and partner organizations receive the support they need to create and sustain this support over months or years.   

In 2007, Project Compassion created and supported over 50 caregiving Support Teams for people living with illnesses like cancer, congestive heart failure, ALS, kidney failure, Alzheimer’s and Batten disease living in Orange , Chatham and Durham counties.  Over 400 volunteers joined forces to provide caregiving support for 225 individuals.    

 

What You Can Do to Help  

You can help families stretched by the financial, emotional, spiritual and social challenges of caregiving by supporting Project Compassion’s Support Team Initiative:  

·         Tell others about Project Compassion and the Support Team approach by forwarding this e-letter to your friends.  Anyone can subscribe to our free monthly e-letter by emailing jane@project-compassion.org  

·         Volunteer to be a support team member, doing what you enjoy doing to support others as part of a team approach.  Learn more by emailing james@project-compassion.org  

·         Make a donation to help support Project Compassion’s cost for creating caregiving support teams.  You donation helps keep this vital service available at no cost for people who are stressed by the challenges of caregiving.  Click here to go to our secure donation page.  

The full findings of the Evercare/NAC Study of Caregivers: What They Spend, What They Sacrifice can be found at www.EvercareHealthPlans.com

 

To see Project Compassion’s 2007 report “Building Bridges of Support,” click here.

 

Books, Books, Books!  

On Sunday, April 27th, Project Compassion held its second book event of the year! Project Compassion founder, Mary Sullivan, read and signed her book, Dancing Naked Under the Moon Uncovering the Wisdom Within, to the grateful attendees at The United Church in Chapel Hill . Thanks to everyone who came out and thank you to Mary for bringing her unique and powerful voice to our community.  

This event marks the third author to partner with Project Compassion! Trudy Couch’s books, Passing On Thoughtfully and Getting It Together, are available through Project Compassion as well as Mary Sullivan’s book and Tiffany Christensen’s Sick Girl Speaks!  

To purchase Dancing Naked Under the Moon Uncovering the Wisdom Within or Sick Girl Speaks, email tiffany@project-compassion.org.  To purchase Passing On Thoughtfully and Getting It Together, click here.  A portion of the proceeds of all books will benefit Project Compassion and help support the work we do.  

 

Tiffany Christensen Certified as a “Respecting Choices” Instructor

 Tiffany Christensen recently attended the National “Respecting Choices” Advance Care Planning training in La Crosse , Wisconsin .  She joins James Brooks as a certified Advance Care Planning Facilitator and Instructor.  

We will announce Tiffany’s upcoming projects in our e-letters, including plans for Disease-Specific Peer Facilitation as well as Advance Care Planning Facilitator Training for professionals.

 

North Carolina Donor Registry Now Online!

The new Donate Life North Carolina donor registry is now live!! Please go to www.donatelifenc.org to see the new site and to register. This is a huge milestone for North Carolinians !  To learn more about the registry or organ/tissue donation, visit www.carolinadonorservices.org 

 

Project Compassion Begins Our Finding Your Voice Initiative
with Tiffany Christensen

Project Compassion will launch Finding Your Voice, a series of consumer and professional workshops that thoughtfully integrate advance care planning and organ, eye and tissue donation education with a focus on increasing effective decision-making, communication, advocacy and professional education.

Tiffany Christensen will join Project Compassion half time to launch this initiative.  Tiffany is a recognized public speaker, community educator, author and life-long patient.  She was born with cystic fibrosis, has lived with debilitating pulmonary illnesses, and has survived two double lung transplants. Christensen has recently written and published a book entitled Sick Girl Speaks! (see below) and maintains a popular blog of the same name.  She has been a featured speaker for Carolina Donor Services and is a member of the Board of Directors the Second Wind Lung Transplant Association and has recently joined the UNC Hospital Bereavement Committee.   

Tiffany Christensen has volunteered with Project Compassion for nearly four years.  Now we are excited that she is working with us to develop and offer this exciting upcoming series of workshops and events.  Stay tuned for more to come.  Welcome, Tiffany! 

 

 

Advance Directive and Organ Donation Laws in N.C. 
Changed on Oct 1, 2007
 

Two North Carolina legislative bills became law on October 1, 2007, making changes to NC Advance Directives and NC Organ Donation options.  

House Bill 634 revised Advance Directives statutes and introduced the MOST form:

  • When a person’s living will and health care power of attorney are in conflict with each other, North Carolinians can choose which document will trump the other. 
  • To overturn a health care power of attorney, someone acting as guardian must go to court to petition the change. 
  • The MOST form (Medical Orders for Scope of Treatment), is a set of medical orders prepared on a state form by a health care professional based on input and consent from a patient or patient representative. It takes a more comprehensive approach than the Do Not Resuscitate form to spelling out a wide range of patient choices and options.   For an article from the Raleigh News and Observer on the changes, click here.  

House Bill 1372 (The Heart Prevails) established the heart symbol on the NC Driver’s License as sufficient consent for organ donation unless revoked by the donor. 

·        For many years, North Carolina drivers have signed up as organ donors by requesting the heart symbol on their license at the DMV.  However, until now, the symbol represented only the intent to donate and did not have any legally binding authority. The new law means doctors can immediately begin the process of organ recovery if someone who dies has the heart symbol on his or her license.  However, if the patient has advance directive documents leaving organ donation decision to family members, that decision can overrule the heart symbol.  Also, the heart symbol applies to solid organ and cornea donation.  Tissue donation still requires family consent. For more from the Raleigh News and Observer, click here.

In the coming months, Project Compassion looks forward to offering more resources and programs to help all of us better understand the implications of the new laws.  

 

Community Gathers to Explore Complementary and Alternative Therapies in Chronic Pain Management

At any given time, over 50 million Americans suffer with chronic pain.  Conventional medicine can help but often does not provide full relief.  Complimentary and alternative therapies can play an important role in relieving pain.  However many people do not understand the types of therapies available, how they work, how they interact with conventional medicine and what evidence exists about the effectiveness of complimentary and alternative therapies.        

On Saturday, September 29, 2007, community members gathered at the Seymour Center in Chapel Hill, NC to explore complementary and alternative therapies in pain management.  Project Compassion thanks the following community leaders for guiding us through this event: 

Dr. Stephen Prakken, keynote speaker, an expert in pain management, psychiatry and complimentary and alternative therapies.   

Naturopathy, Homeopathy, Supplements and Herbs
           
Susan Delaney, ND

 Hands Off Therapies such as Biofeedback, Guided Imagery, Meditation
           
Martha Simpson, PhD, CCAS 

           
Ellen Scheiner, MD, FACP 

Hands On Therapies such as Applied Kinesiology, Massage, Acupuncture
           
Ryan Fox, DC
           
Owen Dodge, LMBT  (contact though Chapel Hill Chiropractic Centre) 
           
Z.J. Chen, Lic. Ac.
 

Understanding the Patient Perspective and Patient Advocacy 
           
Tiffany Christensen

This program was sponsored by: 

            Project Compassion                   www.project-compassion.org               

             The NC Pain Initiative               www.ncpain.info

             The Seymour Center                 http://www.co.orange.nc.us/aging/index.asp

             Duke HomeCare and Hospice    http://dhch.dukehealth.org

 

 

Sold Out House Concert by Marilyn Hartman
 and Paul Fackler

Benefits Project Compassion,
 Inaugurates House Concert Benefit Series

 

On September 23, 2007 Marilyn Hartman and Paul Fackler hosted and performed at a house concert in Durham to benefit Project Compassion. This was the first in a planned series of monthly house concerts intended to bring together local musicians and an audience that loves home-grown music for the purpose of building community. Proceeds from each concert will benefit a different local nonprofit organization. Marilyn and Paul see this as a way to do for their community what they love doing – playing music and opening their house to friends.  

This first concert featured traditional and original fiddle and piano music from Ireland, Cape Breton, Quebec, and North Carolina and was followed by a potluck supper. Over 40 people attended, contributing $750 to Project Compassion. For information about future concerts, please send an email to paul_fackler@ncsu.edu or call 919-403-0627.

 

 

Ann Atwater’s Support Team

“They’ve Helped Keep Me Alive!”

 

Ann Atwater, renowned Durham civil rights leader and activist,  has advocated for others all her life.  Her groundbreaking friendship with former enemy C.P. Ellis, “Exalted Cyclops” of the Durham Ku Klux Klan, resulted in the integration of Durham schools in 1971. Their remarkable story is told in The Best of Enemies and documentary An Unlikely Friendship.  She has remained a powerful community organizer and voice for justice in Durham for decades.         

Following a health crisis this year, Ms. Atwater needed support herself.  “Coming out of the hospital, I felt lost.  I was by myself, alone.  If it hadn’t been for Project Compassion, I would have been STUCK!  I had no way of eating or getting anything done.” 

So much has changed since then.  First we created a community-based Support Team with 6 members to meet her most acute needs: transportation to doctors’ appointments, meals, and visits.  Then we partnered with Project Bridddge, a group of 25 Duke Divinity School students, to transport Ms. Atwater to church, provide meals, visit with her and help with household chores indoors and out.  They even helped find furniture to replace her broken pieces.  

Ms. Atwater says:  “I’ve gained a family who loves me and helps me thrive every day!  There’s a whole bunch of them and they are all my children, white or black.  We share experiences and learn from each other.  They’ve helped keep me alive.  I don’t know how Project Compassion did what they did!  You all are healing me.  It’s better than medicine.  Now I feel like I don’t have to do anything except LIVE!”  

 

Community Engagement

Expanded Significantly in 2006

In 2006 Project Compassion created two major community symposia and dozens of workshops and education events. 

In April our Spring Symposium:  “From Nancy Cruzan to Terri Schiavo: What Have We Learned?” featured critically acclaimed author and Cruzan family lawyer William Colby.  Over 330 people gathered at 3 events in 2 days focused on advance care planning.   

 

 In September, Project Compassion partnered with the NC Pain Initiative and the Duke Institute on Care at the End of Life to create “Taking Charge of Pain:  What Everyone Need to Know about Effective Pain Management.”  We gathered over 150 people at the Friday Center to hear Dr. Richard Payne, Rose Hoben, Tiffany Christensen, Julia Lunsford, and Marsha Rehm discuss pain management, patient advocacy and self-care.    

Project Compassion also offered a record number of community workshops in 2006, including:
The Art of the Condolence Note with Author Carol Henderson
Writing the Sacred Psalm:  A Workshop with Ray McGinnis
An Evening of Grief, Healing and the Arts
Rituals of Remembrance for the Seasons of Grief 
Family Milestones and Midlife Clutter 

 

 Project Compassion Creates
Teen Support Teams

 

In 2006, Project Compassion created Teen Support Teams to help children, teens and adults living with cancer.  One team provided musical evenings and game nights twice a week this summer for Caring House guests going through cancer treatment.  Jordan High School volunteers (pictured with some Caring House guests) include team leaders Grace Taylor and Jenny Walters, Emily Reep, Terrell Hicks, Erin Turner and Hannah Lingafelt.  Ryland Bishop is not pictured.   

 Many teen volunteers had experienced cancer in their families; one was diagnosed with cancer this summer.  Talking about the experience, a 15-year-old volunteer summed it up:    “I had no idea how much they would appreciate what we did.  They were smiling, laughing, talking about life.  It changed my thoughts about what it means to have cancer.  It made me think about what really matters.  I’m thankful for everything I have in life.”

 

 

Elizabeth's Friends Honored
for One Year of Service

Elizabeth is a 21 year old young woman living with Batten Disease, a rare illness affects 2 of every 100,000 children. This illness causes mental impairment, seizures, and a progressive loss of sight, motor skills, and the ability to communicate.  There’s no prevention and no cure.  Elizabeth’s family cares for her at home and the caregiving challenges are tremendous.  Her story was featured in May in Duke Divinity School magazine’s Building Bridges article.

 “Elizabeth’s Friends” Project Compassion’s Support Team in partnership with her faith community, just celebrated one year of support!   The team has 12 core members; others join in as needed.  They have coordinated to provide a meal nearly every other day for a full year: over 150 meals so far!  Members have also provided “respite, love and lots of prayers.”  Thanks in part to the support, Elizabeth is stable enough for the family to spend Thanksgiving at the beach!  On the one year anniversary of the team, Elizabeth’s parents wrote, “When things get too hard for you, God sends help like Elizabeth’s Friends…. This is the type of program people all over the country should sponsor and support.”    

  “Building Bridges”

This feature article in the Duke Divinity School Magazine tells the story of Elizabeth, one young woman with a Project Compassion Support Team and features our intern Sonia Norris.   To read the full article, click here   

 

Helping people plan ahead for end-of-life wishes has been a core Project Compassion initiative since we began almost 5 years ago.  However, two major news events  in 2005 have given us remarkable opportunities to engage people both locally and nationally around end of life planning matters. 

The Sunday New York Times 
Features Our Workbook
on Planning Ahead 

On January 2, 2005, the Business Section of the Sunday New York Times published a feature article entitled:  “After Writing a Will, You Still Have I’s to Dot”.  This article was inspired by Project Compassion’s collaboration with Dr. Trudy Couch, author of the workbook Passing on Thoughtfully. 

Passing on Thoughtfully is a remarkable 32 page workbook that helps people gather, organize, and communicate important information about legal affairs, financial affairs, health affairs and wishes, final plans, and significant life events. 

 Dr. Couch created this workbook after surviving a nearly fatal blood clot in her lung almost 5 years ago.  Now age 94, Dr. Couch wanted to make sure her daughters had all the  information they would need to care for her in the future.   

According to Dr. Couch, “Events in anyone’s life can take a sudden turn and catch you unprepared.  It’s vital to create one complete record of the information that is important to you and those close to you.  It is the most thoughtful gift you can give.”   

Since January, Project Compassion has distributed 3000 copies of the book in 48 states, Canada, and Great Britain. 

According to James Brooks, Project Compassion’s Executive Director:  “The response has been tremendous.  People from everywhere in the country have ordered the book for themselves, family members, and  friends and neighbors.  Lawyers, financial planners, retirement communities and faith communities have ordered the book in bulk for their clients, residents, or members. 

With Passing on Thoughtfully, we now take a whole-life approach to planning ahead.  The workbook has become a powerful tool to help people understand, communicate, and document not only health care matters, but also legal, financial, personal, and spiritual matters as well.  It’s a really effective way to get the important conversations and decision-making going.” 

The workbook is now available with a choice of title.  In addition to the original title Passing on Thoughtfully, the same book can be purchased as Getting It Together… Planning Ahead

  

End-of-Life Decision-Making
Dominates the Headlines
 

The second event that has shaped our community engagement around planning ahead this year was the  difficult and painful conflict that surrounded Terri Schiavo. 

Although viewpoints were sharply divided, what became crystal clear is how important it is for each of us to talk with the important people in our lives about the kind of end of life care we want for ourselves. 

Because we had the resources and community network in place when the headlines hit, we were ready to respond.  In March, April, and May:

·        150 people attended one of two public forums “It’s Time We Talk: Conversations about End-of-Life Wishes”  offered in partnership with the Duke Institute on Care at the End of Life.

·        540 people attended Project Compassion programs on advance care planning offered in 8 faith communities, 2 retirement communities and 2 service organizations. 

·        110 people received resources and support by phone or email. 

·        1800 people received a special edition of our e-letter.

·        550 additional copies of Passing On Thoughtfully were mailed to people all over the US. 

Although the media attention has subsided, the impact of the Terri Schiavo situation will continue for some time.  We continue to provide education to help clarify some of the confusion in the media coverage.  We also continue to offer resources, public programs, and one-on-one follow up.  Contact us if you are arranging a program or seeking more resources on these matters.      

Additional Resources
for Planning Ahead
 

www.caringinfo.org
includes advance directives for all 50
states and helpful planning info

 

 Creating Community for Caregivers

by James L. Brooks, M.Div., Executive Director, Project Compassion 

published in the National Hospice and Palliative Care Organization’s magazineInsights, March, 2005 

Family caregiving is quickly becoming America’s other profession.  An estimated 44.4 million Americans ages 18 and older provide some level of unpaid care for another adult.[1]  For many caregivers, the biggest challenge is finding enough time and energy for a job, a family, the person they are caring for, and for themselves.  As caregiving responsibilities increase, the risk of emotional stress, physical strain, and financial hardship increases as well. 

During my years as a hospice professional, I encountered many family caregivers who had been “on duty” for months or years.  By the time the patient was admitted for hospice care, many of the caregivers I met were physically, emotionally, and spiritually exhausted.  And yet, caregivers with strong informal networks of family and community support often seemed better prepared to travel the end of life journey. 

I wondered:  What if we could find a way to help patients, families, and community members create informal networks of care early on, when they first need caregiving support?  Could we work with local groups and organizations to create volunteer caregiving support teams for people as they travel the journey of diagnoses, treatment options, chronic care and hospice care?  Might patients and families cope better all along the way?  Might we catch a new vision of what it means to work in partnership and to lead our community in caring for caregivers?

 

Project Compassion and the Support Team Initiative

Project Compassion, the end of life care coalition for the Durham-Chapel Hill area of North Carolina, has been working to live out this vision of community care for caregivers for nearly five years.  Launched in 2000 as a free-standing non-profit organization, Project Compassion partners with area hospices, hospitals, faith communities, retirement communities, businesses, government agencies, neighborhood groups, and service organizations to create community and provide support for people dealing with serious illness, end of life, and grief.  Project Compassion has grown into a grass-roots network of 75 organizations, 315 leadership volunteers and 550 direct service volunteers. 

Early on, our community leaders and volunteers identified caregiving as a critical community need to address. Taking a cue from hospice on the power of a team approach and building on resources offered by the Support Team Network, we launched our Caregiving Support Team Initiative in 2002. 

Our Support Team Initiative is a dynamic network of volunteer caregiving support teams created in partnership with local and regional groups and organizations.  Support teams provide practical, emotional, and spiritual support for any individual/family that needs assistance with caregiving.  Using a team approach, volunteers pool their talents, creativity, leadership, and time to offer much more support than one volunteer can provide alone.  Support teams average 6-12 members but vary based on the need.  We provide teams with the resources, coaching, and support they need to create and sustain the team approach over the long haul.   

 Since 2002, Project Compassion has helped launch more than 75 volunteer support teams with 625 volunteers.  These teams have provided over 15,000 hours of volunteer caregiving for more than 250 people in our community.  Funding comes from individual and community donations and by grants.  We maximize existing community resources and leverage new, untapped resources. 

In 2003, Last Acts recognized this initiative as one of three model programs.  In 2004, the National Council on Aging selected this initiative as one of eight Wisdom Works demonstration programs.  Current evaluation includes a two year study in progress on the effectiveness of the team approach for volunteer caregiving funded by the Duke Institute for Care at the End of Life and the University of North Carolina Research Council.   

 

Some Keys to our Success 

By working with partner organizations and volunteer leaders, we engage our community in new and meaningful ways at the point of need.  Our partner organizations, volunteer leaders, and volunteer members become ambassadors for creating caregiving support.  As a result, we are now the hub of a dynamic community caregiving network. 

By integrating resources from our Community Education Initiative and our Advance Care Planning Initiative, we offer important assistance to individuals and families looking ahead to end of life. As a result, we help these families understand and anticipate end of life care issues and choices. 

By looking at caregiving beyond the last few weeks or months of end of life care, we open ourselves to a greater vision of community care and support.  As a result, we see a widespread community movement for caregiving support emerging.

 

A Snapshot of the Support Team Initiative in Action 

A 49 year old man in our community was diagnosed with pancreatic cancer.  He lived with his wife and her 6 year old daughter who has Down's Syndrome.  At the time of his diagnosis, he was physically building a home for his family. 

This family had tremendous caregiving needs:  respite care, child care, meals, errands, and help finishing the house.  They also needed emotional and spiritual support.  Project Compassion worked with two faith communities to create a volunteer support team and facilitate a hospice referral.  Coordinating support, hospice volunteers provided respite care. Support team volunteers provided support for the daughter with Down’s Syndrome, transportation, and three meals a week on different nights throughout the man's illness.  The support team helped the family move into a temporary home, finish building the house, and move into their new home. A week after the family moved into their dream home, the man died.  The support team continued to provide meals, friendship and support for his wife and child for months after his death. 

The modern hospice movement in America was started by volunteers who worked in teams to offer a new vision for end of life care.  I believe that the spirit that created the modern hospice movement offers us new horizons in caregiving today.  We now have the opportunity to offer a vision for creating community and providing support for caregiving.  As more and more of us become caregivers, I believe it’s time again to energize and help lead the way.



[1] Caregiving in the US, sponsored by AARP and the National Alliance for Caregiving, 1994.

 

 

Creating Community through Caregiving
by James L. Brooks

published in the national AARP Connections magazine
August, 2004

As Executive Director of Project Compassion in the Durham-Chapel Hill area of NC, I see the power of volunteer caregiving in action every day.   I remember a year ago when a 63 year old woman with breast cancer first called us for support.  She had been a “healthy, active, independent woman” all of her life.  However, surgery, chemotherapy, and radiation had changed her life.  She remembers:  “I needed help, and I wasn’t accustomed to asking for it!”  Her children provided some support but they had full-time families and jobs.  She wanted to remain independent and at home.  Then a friend of hers told her about Support Teams.   

A Support Team is a group of 6-12 volunteers who provide practical, emotional, and spiritual support for people who need help with caregiving.  Support Team volunteers do what they enjoy doing for others when they are able to do it.  Team members pool their interests, talents, creativity, and time to coordinate and support their volunteer caregiving efforts. 

 Partnering with a local faith community, we created a volunteer Support Team for her.  Team members drive her to and from chemotherapy, help with errands and meals, visit with her and phone her regularly.  When the team learned she loves the water, they created a picnic boat trip on a nearby lake.  This Support Team has become her caregiving community.  Now she hopes to join a Support Team herself one day! 

Last year Project Compassion created 42 Support Teams with 425 volunteers in partnership with 40 local organizations.  As a local Faith in Action program, we worked with AARP NC to create a friendly-visiting Support Team for residents of a local assisted living facility who are at greatest risk of isolation. 

When individual volunteers join forces to become a Support Team, they spark dynamic energy, creativity, and practical solutions to caregiving challenges.  I challenge you to bring a team approach to caregiving to your community.  By creating caregiving community, you might give someone the support they need to remain independent and at home. 

 

Volunteer Team Revives Holistic Aspect of Nursing
 By Sandra Jarr RN, MSN 

published in Nursing Spectrum Magazine
August, 2004
           

Nurses know that patients often need simple encouragement and human contact as much as they need their medical treatments. At University of North Carolina Hospitals, where I serve as Director of Surgery Service, we’re teaming up with a community non-profit organization to supplement nurses’ efforts in this area. A care-giving support team, consisting of community volunteers, visits patients and assists them and their families however they can; with anything from a friendly word to running an errand or even cooking a meal. 

This program is structured differently from traditional hospital volunteering and has several advantages. It gives volunteers a supportive team environment, encouraging people to participate who would not feel comfortable solo. It shows patients that people in their community care how they are doing. The program supports and encourages our busy nursing staff and reminds them of the importance of connection and compassion. The pilot care-giving support team has worked out so well in our North Carolina Jaycee Burn Center that we are now exploring the possibilities of expanding the program to other areas of the hospital. 

The Little Things Are Big

The best way to explain the program is to tell you about Edwin George, who we all call Mr. George. This 53-year-old man has been in our Jaycee Burn Center for a year, after a welding explosion left him blinded and with burns covering 68 percent of his body. 

Mr. George had been mentioning to his nurses how much he missed eating chili. When care-giving support team member Virginia Taylor checked in with the charge nurse one day, the nurse asked her to bring Mr. George some chili. “I went down to Wendy’s.” Taylor recalls. “When I brought it back, I asked Mr. George, ‘Do you eat chili a lot?’ He said, ‘I haven’t had chili for a year.’” 

For Mr. George, the fast-food chili was a taste from his life before his injury and a great encouragement. When somebody asked him about that cup of chili days later, Mr. George said, “Oh yes,” stretching the word almost into a purr. “Boy was it good!” 

In fact, all of the half-dozen members of the care-giving support team have gotten to know Mr. George. Each has spent time showing him kindness. One rubs cream on his healing skin. Another day, one scratches his head, which distracts him from pain and itching elsewhere on his body. Another volunteer even participated in his physical therapy by helping him to move his arm through exercises under the direction of a therapist. “It was one of the most satisfying experiences I have ever had.” said Dorie Keiser, a retired New York University staffer who volunteers with the team. “He worked with me.”  

Passion for Compassion

I worked with the local non-profit Project Compassion to form this team – on which I am proud to serve. I got involved with the organization at its founding in 2000 when my hospital’s chief operating officer recruited me to serve as the hospital liaison. Now I serve on its board of directors and as its treasurer. 

Project Compassion offers leadership, training, consultation and support to community-based teams who care for patients and families facing serious illness or death. These “care-giving support teams” are its largest initiative, and in 2003, provided 145 people with 6,400 hours of volunteer service. 

Project Compassion also educates the community about dealing with grief, illness and death and encourages people to formulate advance health care directives. It does all of this good work on a budget of just more than $100,000 per year. 

“Patients should have a clear, creative way for their neighbors and people in their faith communities to be involved in their care,” James Brooks, Project Compassion’s Executive Director, says of the care-giving support teams. “People often say they want to help, but they don’t know how to. This provides a way to give that support without the individual or the family always asking. The team really works with the individual to see what the needs of the family are.”           

Teams of six to 12 volunteers can be formed through religious congregations, retirement communities, health care institutions, or through a network of friends. They can serve one particular family or be a standing team that works regularly with any family. The team leader stays in close contact with the patient, discerning needs and asking members of the team to meet them. 

Non-hospital teams might pick up medicine, drive a patient to a doctor appointment, visit the patient and family, or simply call to ask how they are doing.  “It multiplies the kind of care that happens.” Brooks says.

 

Support Reaches Everyone

To form our hospital team, I placed an ad in the hospital newsletter asking for volunteers. Staff members from other parts of the hospital and community volunteers received training from both the hospital and Project Compassion before going to work.

Virginia Taylor, who fetched Mr. George’s chili, also happens to be Project Compassion’s Care-giving Support Team Director. She is so excited by the concept of hospital-based support teams that she volunteers on our Jaycee Burn Center team. Other volunteers are hospital staffers in other departments or members of the local community. 

Team members spend a few hours each week working with patients in the Jaycee Burn Center who need them. And we all meet together for one hour a month to discuss our experiences and support each other. “I thought, a team, gee, that’s ideal.” says Keiser, who had already been volunteering in the Jaycee Burn Center. “Then we can share as a group what we’ve done and help each other. When I worked up here alone, and I was the only volunteer for a while, I was fairly isolated.” 

The meetings also give team members a forum for dealing with our emotions about the patients we encounter. And it is a place where everyone can share the deep sense of fulfillment the work provides. 

“I cried because I had wrinkles until I met a man who had no face,” volunteer Patt Dower told all of us at a recent team meeting. “He was so newly injured, and it was clear that he wanted my company. But he had a trach tube. So I just put my hand on his arm, and we looked at each other. It seemed like an eternity. I bet it was 10 minutes of just human contact and acknowledgement.” 

Patients, especially burn victims who have been disfigured, are often worried about whether strangers will accept them. It must be so reassuring when someone from the community chooses to visit and sees a person rather than the injury.  

I will survey the nursing staff at intervals to get feedback about the initiative. The first data are not yet in, but I am encouraged by comments from members of the staff.  “It is an extension of us, someone with a fresh perspective on what we do well,” says Fred Price, RN, Jaycee Burn Center Nurse Manager. “Our priorities are giving the meds, assessing the patient, doing the paperwork. The five minutes of sitting and talking and rubbing and touching – the holistic part of nursing – can get missed. This program is a true spiritual extension that can provide some of those things.” 

Karen Klish, RN, Assistant Nurse Manager, adds that watching the volunteers renews her enthusiasm for her work. “I’m listening to them and thinking, just to touch somebody that you’re not doing something to is so important,” she said. 

Mr. George agrees. His family lives more than 80 miles away. Relatives have to work during the week and can’t visit as often as he would like. Visits from the care-giving support team mean a great deal. He has come to recognize each voice. “I have somebody to talk to,” he says. “They read the sports page to me and tell me what’s going on. My head itches a lot. They’ll scratch it a lot and it feels good.”  

As a recent support team meeting wrapped up, all of us stepped into the hallway and saw something that amazed and pleased us: Mr. George, walking with a little bit of assistance. 

Sandra Jarr RN, MSN, is director of surgery service for University of North Carolina Hospitals in Chapel Hill, N.C. For more information on Project Compassion, contact James Brooks at 919-402-1844 or e-mail james@project-compassion.org

 

 

Race for Remembrance:
Race Provides Lessons in Loving and Living

by Valarie Schwartz, Staff Writer, The Chapel Hill News
Published June 11, 2003, Page C3, www.chapelhillnews.com  

  While Mary Sullivan prepared to run in the Rock 'n' Roll Marathon -- which she dubbed "Race for Remembrance" --she believed she would be carrying the names of people who had died in her heart.  She had no idea that the stories of the people she had learned of, whose names were on her shirt, would carry HER through the 26.2-mile race through San Diego, Calif, on June 1.

In January, Sullivan went with a friend to a Teams in Training meeting for the Leukemia-Lymphoma Society.  She had always wanted to run a marathon and decided to run in the Rock 'n' Roll Marathon after soliciting donations for Project Compassion, the nonprofit agency she founded shortly after a long-time friend died from breast cancer.

A key element of Project Compassion is providing community support when a loved one is terminally ill or has died.  Sullivan sent out letters stating that she would wear a shirt bearing the name of her late friend Rhonda Wise Holman, along with names of family, friends or community members submitted to her.  The journey began for her as the letters started coming back.   "Some of us are really yearning to tell our story," said Sullivan, 40. Along with the $6,000 that came in were stories of lives cut short or lived long and the people who continue to love those who are gone.    

"Someone sent $56 because their friend would have turned 56 in August," Sullivan said. Sullivan mentioned others -- the sister of a young woman who died from an eating disorder, the woman whose father-in-law told her before he died how grateful he was that she made his son's life so happy, the woman who thanked her for the invitation to memorialize her mother eight years after her death.  "Great poetry and stories have come in," she said. "Some people sent in pages about their loved one." Sullivan hopes to be able to include the messages on the Project Compassion Web page.  

Sullivan included the names -- more than 90 of them -- on the front of the shirt she wore during the race with the Project Compassion logo and mission on the back.  Once the race began, it seemed to Sullivan as if the collective spirits of those named took over.  "It was really inspiring to me to have these stories and names of people inside me," Sullivan said. "They carried me."  

Every element of the race became a metaphor, she said.  When Sullivan's legs began to feel like lead, she thought of how difficult it had become for some of those named on her shirt to get around.  "Whatever I was feeling at the moment was nothing compared to what these people had been through," she said, "and mine was by choice."

Sullivan didn't train alone or go to the race alone -- her running partner, Malcolm Marler from Birmingham, Ala., was a part of the whole process. Most of their training was apart from each other, but having joint goals to accomplish kept each out and running.

In San Diego, there were 20,000 runners. Because it was the Rock 'n' Roll Marathon, there were 42 bands playing music along the course of the race.  "There was such great support and community all along the course, with people cheering you on," Sullivan said. "It was like music therapy -- at mile 20, I wanted to dance. "

 But during the last eight miles of the race, Marler was slowed down considerably by an injury.  "I went through four miles of internal anguish," Sullivan said. She wanted to run ahead, but didn't want to leave Marler behind.  Sullivan realized it was the same experience as for the caregiver of someone who is terminally ill, wondering if they should go ahead and have their needs met or stay by the loved one's side.  Sullivan dealt with it by running ahead, then doubling back to check on Marler, then running ahead again -- much as a caregiver has to work twice to keep things going.
"At mile 24 I asked if it would be OK if I just let it rip?" Sullivan said. It was what Marler wanted for her as well.   

She sprinted the last two miles with a rush of adrenaline screaming through her.
”It was so exciting," she said.  Then, she worked her way back to Marler again.  "He got a burst of energy when he saw the finish line," she said, and they crossed the line together. "It was emotional," she said. "I never had one minute of pain."

Sullivan said that she ran one mini-marathon 20 years ago and has run off and on through her adult life, but in no way considers herself a jock.  "I felt that at any moment the springs were going to start popping off!" she said, laughing. "The 26.2 miles was easier than any of the long-training runs because of the support around me."  

She le