Juggling Caregiver Duties in the Jungle

“Slogging away at life––battles of daily living––a mine field.” Life and our relationship with it are often described as a conflict. We compete for jobs; advance careers; win contracts; scratch out a living; struggle to stay healthy; fight traffic; combat inflation or socio-economic factors.

“It’s a JUNGLE out there,” songwriter Randy Newman describes LIFE in his theme song for the television show, “Monk.” (Monk is a brilliant, obsessive-compulsive police detective. The series ran from 2002 to 2009.) “It’s a jungle out there, disorder and confusion everywhere.” As human beings, we have to figure out HOW to live. “You’d better pay attention or this world we love so much might––just––kill–– you.” (Oh, the irony!) “No one seems to care… Well, I do,” Newman continues, making the point that we are in this together.1.

Arise Home Health Care DOES CARE, which is exactly why Jay and Melody Vachel founded the company in 2000.

“At that time, we were caring for our son, Isaac––dealing with cerebral palsy and blindness––and Melody was primary caregiver for her father,” says Jay. “It was important that care be delivered in the home, where our loved ones were comfortable. And, because we couldn’t find the support we needed and wanted, we created a support system ourselves. Now we make these services available to the community through our home health care company.”

When it comes to meeting the typical challenges of caring for an aging parent or chronically ill child, Melody and Jay have “been there and done that.” Through their guidance, our staff has been prepared to deliver the care families want for their loved ones.

Stacy,* Tim,* and their parents have benefited from the professional care Arise Home Health Care delivers. Eighty-three-year-old Helen* is temporarily at the Good Shepherd apartments; her husband Stan* is in the nursing home. Helen’s home health aide Becky stops in three times a week to help with housekeeping (vacuuming, shopping, laundry), personal cares (hygiene, dressing, hair care), and medication reminders. Helen cannot forget to take her cancer medications.

The cancer diagnosis was a one-two punch for Helen and her children, since they were already handling the stress and logistical challenges of caring for Stan. Becky, cheerful and positive, was a source of compassionate care for Helen when she returned from the hospital and was sick from follow-up radiation and chemotherapy treatments. (See “Caring for Seniors Undergoing Chemotherapy – Advice for Families and Caregivers.”2.)

“My caregiver Becky has been outstanding,” says Helen, who experienced anxiety during therapy. “She has been a great help to relieve stressful situations in my life.”

“My mother adores Becky,” says Stacy. “She trusts her, and they have a very positive relationship.”

A positive step for many families is to arrange for in-home care. Care may include non medical tasks such as a light housekeeping, meal preparation, and companionship. Or there may be specific health concerns. In Helen’s case, her son handles financial tasks because he lives elsewhere. Her daughter lives in the city, so she handles transportation, medical appointments, and visiting. The home health aide performs as a family member, supporting the loved one and giving the family caretakers much-needed mental and physical breaks from their duties. The aide works with Arise Home Health Care’s RN case manager to administer care according to plan. The Care Plan is updated with hospital or doctor’s instructions, which might include rehab exercises or relaxation techniques to improve quality of life. (See “Relaxation can help relieve stress of having cancer”3. and “Relaxation Therapy for Seniors.”4.)

Life in the jungle means “survival of the fittest” for some. For others, life in the jungle offers us opportunities to love and support each other––especially our vulnerable elderly and their overworked caregivers––encouraging one another to “never, never give up.”

As a local, homegrown, in-home care company, we want ALL families juggling caregiving duties to know “we’ve been there” and that Arise cares.

Do you have a question for our professional Arise Home Health Care staff? Contact Us.

* Not the individual’s real name

1. Listen to the song on YouTube at: http://www.youtube.com/watch?v=BhKlBH2_dVY

2. “Caring for Seniors Undergoing Chemotherapy – Advice for families and caregivers,” Care.com, http://www.care.com/senior-care-caring-for-seniors-undergoing-chemotherapy-p1143-q274605.html

3. “Using imagery to meditate can help with stress of cancer, Sheryl M. Ness, R.N., Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/cancer/expert-blog/guided-imagery-and-cancer/bgp-20180810

4. “Relaxation Therapy for Seniors,” Care.com, http://www.care.com/senior-care-relaxation-therapy-for-seniors-p1144-q317326.html

Who believes Garbo’s “I want to be alone” was a tragic flaw?

Q: Who believes Garbo’s “I want to be alone” was a tragic flaw?

A: Arise Home Health Care

Actress Greta Garbo’s penchant for alone-ness (Grand Hotel, 19321.) added mystery to her life, but we think it may have added misery as well.

Many people can function in solitude––an opportunity of quiet to reflect upon life or to meditate on the spiritual, to remove one’s self from the fast pace of society, or to enjoy an absorbing activity. A person may seek solitude for healthy reasons.

However, isolation is often imposed. Sometimes, it involves a loss of a friend through death. Sometimes, economic hardships have removed a person from a source of companionship–a workplace or neighborhood. Perhaps family has moved on, leaving a member behind. Loss of mobility, sight, hearing, or independence can impose isolation. Relocation to an assisted living or care facility further disrupts previous patterns of socialization. Ultimately, isolation is unhealthy.

According to a University of Chicago study, lonely persons have a 14% higher chance of dying prematurely than those who don’t. (See “Feeling lonely? It may increase your risk of early death.”2. and Loneliness: Human Nature and the Need for Social Connections.3.)

Ninety-year-old Florence* is prone to loneliness. Her husband had suffered from multiple medical problems and dementia, demanding much of her until his death in 2009. She’d also been a community volunteer. However, since her balance and hearing had worsened, Florence had retired. So, she had plenty of time to languish. She rarely ate in the dining room or joined residents in the senior apartments for cards because of her hearing. Also, her inability to climb steps prevented bus rides to seniors’ outings. Florence often felt lonesome, which she shared with her family.

Family members had tried to keep her occupied, but they had busy lives, and only two lived in town. A daughter took her to breakfast on Sundays; a son had lunch and played Scrabble® with her during the week. All six children called regularly; it wasn’t enough.

So, her family called us, and Florence now has a companion. Chris takes her shopping and driving around the old neighborhood. Since Florence gets so much mail, Chris also helps with sorting and shredding. Chris has helped rearrange the apartment and Florence’s photos. And they’ve visited about children and big events in their lives.

“Chris is a big help,” says Florence’s daughter, Ellen*. “We’re part of a ‘sandwich generation,’ caught between caring for elderly parents and our own kids. I feel guilty that I can’t see Mom more often, but I have a day job, and visiting after dinner and dishes is too late. This way, I can ask Mom over the phone about her day with Chris.”

Chris performs those small acts of kindness that have a big impact on an elderly person living alone. When she reminds Florence about the exercise class offered at her apartment complex and encourages her to attend, or demonstrates how to use the single-serve coffeemaker and suggests she invite a neighbor in for a cup, Chris gives Florence ways to combat isolation. (See: “A hidden killer of elderly people––loneliness”4.)

We at Arise Home Health Care hire our exceptional staff from this community. These employees know their way around town for shopping or outings. Many have been with us since we opened 10 years ago. Family caregivers regularly call our registered nurse Paula Muggli to discuss the needs of their loved ones and use her as a community resource, knowledgeable about the eldercare network.

Children in the “sandwich generation” can trust Arise Home Health Care, just as Florence’s children do. We are a dedicated, passionate community resource and proponent for in-home companion care. Why? Because Arise cares about keeping seniors from being isolated.

Do you have a question for our professional Arise Home Health Care staff? Contact Us

* Not the individual’s real name.

1. “Grand Hotel” movie clip, http://www.tcm.com/mediaroom/video/582338/Grand-Hotel-Movie-Clip-I-Want-To-Be-Alone-.html

2. “Feeling lonely? It may increase your risk of early death,” by Nancy Hellmich, USA TODAY magazine, 2/17/14,


3. Loneliness: Human Nature and the Need for Social Connection, John T. Cacioppo, http://www.amazon.com/Loneliness-Human-Nature-Social-Connection/dp/03933352833

4. “A hidden killer of elderly people: loneliness,” by Neville Zammit, 2/3/13,  http://www.timesofmalta.com/articles/view/20130203/health-fitness/A-hidden-killer-of-elderly-people-loneliness.456195

Who believes that elders who cannot do teach?

Q: Who believes that elders who cannot do teach?

A: Arise Home Health Care

Meat and potatoes. You’ve probably heard of a “meat-and-potatoes” person, typically a no-frills eater who enjoys healthy portions. There are two important considerations in that description, especially for an elder with Type 2 diabetes: 1) potatoes, and 2) hearty portions. Potatoes are a good source of vitamins and minerals. (See “Why You Should Be a Meat and Potatoes Guy.”1.) However, they DO have a high glycemic index; high GI foods cause blood sugar swings and insulin spikes. So, it’s good to balance the potato (one medium-sized spud) with a 2-3 oz. serving of meat, which has no glycemic index. (See “Serving Sizes and Diabetes,”2.) If the elderly person is open to learning about diabetes and how to regulate food intake, a sweet potato can be substituted for an Idaho or red, and chicken or seafood can take the place of a steak or beef roast. There are definite pluses associated with learning new ideas and behaviors because diabetes in the elderly can often lead to deterioration in brain function. (See “Type 2 Diabetes Deteriorates Brain Function”).

When it comes to caring for elderly loved ones in the home, Arise Home Health Care believes continuing education is essential––for caregiver and the cared for.

Eleanor* is 83 years old, and she’s lived alone for years. She was not happy about having to find home care. But she’d developed type 2 diabetes, so she needed to take better care of herself. Eleanor found our phone number on her church bulletin and called for a home health aide and companion.

Well, Eleanor calls her initial experience with us a “rocky start.” She knew WHAT she wanted done and exactly HOW she wanted it done––cooking, cleaning, laundry, etc.––but had difficulty training our staff person. And of course, as you’ve probably experienced, the elderly can become impatient and frustrated when a caregiver doesn’t quite understand what’s required. We’re proud of how Mary responded to Eleanor’s criticism––with empathy, compassion, and an endless reserve of patience––and how, today, Eleanor cannot say enough about how dependable Mary is and how quickly she responds to Eleanor’s requests for any additional chore.

Did we mention that Mary also helps Eleanor regulate her Type 2 Diabetes? By assisting with meals and prepping dishes according to Eleanor’s dietary specifications, (See “Diabetes Superfoods.”4.) Mary helps stabilize Eleanor’s blood sugar readings, which she routinely enters into a log for tracking by our homecare registered nurse. Mary reminds Eleanor to take her insulin before meals, too. And because she’s knowledgeable about diabetes, Mary is also on the lookout for behaviors indicating glucose levels are too high (headache, fatigue, disorientation, thirst, frequent urination) or too low (chills, shakiness, clammy hands, racing pulse, sweating, blurred vision, irritability, confusion, anxiety).

Mary is a Home Health Aide; she came to us as a certified nursing assistant (CNA). So, she’s qualified to care for Eleanor’s personal care needs. She participated in orientation, online and with Paula Muggli, RNC, a public health nurse and certified Gerontological Nurse through the American Nurses Credentialing Center. Mary trained an additional six hours prior to being assigned a client. (CNA’s are also required to take eight continuing education units each year or they will loose their license.)

We carefully hire and train staff. Each employee reviews the client’s Care Plan and Instructions with Paula Mugglie (if a CNA) or with Sue Christianson, Director of Business Development (if a Homemaker or Companion). And as we’ve mentioned, our clients train their caregivers. (Employees must be open to criticism and flexible to adapt to the particular––and sometimes peculiar––needs of elderly clients.)

Each client is unique––whether a “meat-and-potatoes” person or a diabetic with dietary needs. They allow us to come into their homes, share their lives, and learn about compassion, empathy, and listening to our hearts as we minister to their needs.

We enjoy serving them because “Arise cares.”

Do you have a question for our professional Arise Home Health Care staff? Contact Us

* Not the individual’s real name


1. “Why You Should Be a Meat and Potatoes Guy,” Details Magazine, www.details.com, http://www.details.com/blogs/daily-details/2013/01/why-you-should-be-a-meat-and-potatoes-guy.html

2. “Can Diet and Exercise Prevent Loss of Brain Cells in Type 2 Diabetes,” American Diabetes Association,

www.diabetes.org, http://www.diabetes.org/research-and-practice/patient-access-to-research/can-diet-and-exercise-prevent-loss-of-brain-cells-in-type-2-diabetes.html

3. “Serving Size and Diabetes,” WebMD, www.webmd.com, http://www.webmd.com/diabetes/understanding-serving-sizes

4. “Diabetes Superfoods,” American Diabetes Association, www.diabetes.org, http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/diabetes-superfoods.html

Who believes “aging” is not a dirty word?

Q: Who believes “aging” is not a dirty word?

A: Arise Home Health Care

Our culture is fixated. How many weight-loss programs and health products are touted on the TV? What about commercials for hair coloring and wrinkle removal? And what about gossip magazines, featuring face-lifted and airbrushed celebrities? (Watching Oprah’s body shape-shift over the years has been reaffirming!) There’s plenty of focus on youth but not much talk about how to handle the inevitable––aging.

Al* is a youthful 99 years of age. His longevity can be attributed to good genes and clean living, we suppose, but also to his spry frame-of-mind. He’s a regular at the St. Cloud Area YMCA and Sertoma Club. He prefers to keep active socially, mentally, and physically.

Not everyone is as healthy in his or her elder years as Al. The “kid” in many of us is challenged by age or disease. That’s how it is with Al’s wife Bea,* a soft-spoken––yet sassy––93-year-old with dementia. And because we care about Al and Bea, Arise Home Health Care is making sure the two continue living comfortably at home without worrying about Bea.

“Arise enables you to stay home and maintain a residence and continue your independence like you’re used to doing,” says Al. “Medically, she (Bea) belongs in a nursing home, and we didn’t like that.”

Bea’s dementia is the result of high blood pressure and small stokes. It’s a vascular dementia that affects memory and intellectual functions, and interferes with her ability to perform regular activities. (The National Institute of Neurological Disorders and Stroke1.. is a good resource for additional information.) Bea cannot remember to take her medications, even though she’s a former nurse and consistently tells her caregiver, “I can understand those things, too.”

Bea would like to be in the driver’s seat, however, she simply cannot. And if you’ve had to work with an elder who has dementia, you know there’s no reasoning with the person. On any given day, Bea will refuse to get out of bed or to take her meds. “I don’t have to do it because I’m 93,” she’ll declare. (Familiar?) Often, our staff resorts to chocolate chip cookie bribes. When cookies fail, caregivers rely on patience, patience, and more patience.

The Arise Home Health Care homemaker/aide, Whitney, certainly provides more services to Bea than to Al. She accompanies Bea on walks and assists with range-of-motion exercises. She helps Bea with bathing, grooming, dressing, and trips to the toilet. She takes and tallies blood pressures, too, and reminds Bea to take the medications set up by our home health nurse. Whitney cooks meals for the couple (mindful of Bea’s need for a low sodium diet), cleans, and also does the laundry, freeing Al from these tasks so he can go out and play.

Al gets tired just watching everything Becky does. (He’s thinking, “They’re worth every dollar.”) In fact, he HAS remarked, “It’s probably less than half” of what they’d be spending on a nursing home.

Life expectancy in the U.S. is 78.7 years (2011 data), according to the CDC.2. If you’re male and a resident of Stearns County, expect to live to age 79.4. And the average age for a female is 84.6!

Certainly, Al and Bea are well above the average and are probably responsible for skewing the data higher. However, many of us will spend one-third of our lives as “elderly,” even if we never see 90. We’ll want to remain in our homes for as long as possible, yet we won’t want to be a burden. We’ll be angry and frustrated when we cannot complete a task yet, we’ll remain 19-years-young in our memories.

No doubt as we age, we’ll use those wrinkle creams and hair coloring and maybe, make a strategic nip and tuck. There’s also a chance we may feel old and alone at times. Then, someone will have to remind us, as Al and Bea were reminded …

You’re not alone because “Arise cares.”

Do you have a question for our professional Arise Home Health Care staff? Contact Us

* Not the individual’s real name


1. National Institute for Neurological Disease and Stroke website: http://www.ninds.nih.gov/disorders/dementias/dementia.htm

2. Centers for Disease Control and Prevention website: http://www.cdc.gov/nchs/fastats/lifexpec.htm

3. “For a long life, choose Stearns County,” by Colleen Stoxen, Minneapolis Star Tribune, http://www.startribune.com/lifestyle/blogs/148163145.html

Who Helps Keep Mom & Dad at Home in Their Own Beds?

Q: Who Helps Keep Mom & Dad at Home in Their Own Beds?

A: Arise Home Health Care

Heels dug into the ground. Jaw set. Many elderly persons are resistant to moving from their home to an assisted living or long-term care facility. We don’t blame them one bit. (No matter how “user friendly,” a facility is not a family home.)

When an elderly individual has needs that can’t be met by a spouse or other relative, a move from the residence is often proposed. The benefits of the move are clearly, rationally indicated––safety, improved care, peace-of-mind for concerned family––all good things. (Read “Moving Elderly Parents: Convincing Mom and Dad”1..) However, left unspoken are the intangibles––the security of a private bathroom, the contours of a favorite chair, and the enjoyment of watching small critter activity from a perch on the porch swing. Years of living have fashioned a familiar cocoon of comfort and memories for the elderly person. Yet now, when he or she is dealing with the challenges of aging or infirmity, the family (albeit reluctantly) adds another burden to their loved one––loss of a home. It doesn’t have to be this way.

Truly, there IS no place like home. This is why Arise Home Health Care brings caregivers into the home to specifically address challenges facing an aging parent and make his or her transition into the sunset years easier on everybody.

Corrine* and Daryl* need the day-to-day to be easier, but they are NOT ready to move. Eighty year-old Corrine is dealing with Parkinson’s Disease. (See “What is Parkinson’s Disease,” Parkinson’s Disease Foundation2..) Her husband Daryl––a gentle, caring man who has been her sole caregiver––cannot continue. And even though they are private people and uncomfortable with allowing strangers into their home, they met with Paula, our Registered Nurse Case Manager. Paula sensed their discomfort and put them at ease while conducting the assessment.

“She sat on the floor in front of us like she was part of the family,” says Corrine, astonished. Daryl was also impressed. Paula’s first suggestion was a pill carousel for Corrine’s complex medication regimen, which helped them immensely. (Something as simple as a medication dispenser can make such a difference for a caregiver!)

So, Daryl is happy to have Arise staff as part of the in-home care team. Being a caregiver to a loved one with Parkinson’s Disease is no easy task. (See “Implementing the Team Approach to Treating Parkinson’s.”3.)

The couple likes and trusts Becky, the certified nursing assistant who helps Corrine with bathing and rehabilitation exercises in addition to housekeeping duties like cleaning and doing laundry. As a companion, Becky also reads to Corrine––a generally sweet, peaceful, and positive person who sometimes needs help with her moods. Parkinson’s can produce sadness, apathy, and anxiety.

Part of the anxiety is fear of losing control. (It is unsettling to adjust to rotating shifts of health care aides in a care facility.) A home caregiver service lets Corrine control the delivery of her care. Corrine is also particular about how tasks are completed and how she, her husband, and her home are treated.

“In my home, I have more control of my care,” says Corrine. “I feel very thankful to have home health care. It has helped make it possible for me to remain in my own home.”

Home is not only where the heart and hearth are, but for us at Arise Home Health Care, it is our platform for care delivery. We provide senior services in the home because we know how important the intangibles are to wellbeing … the homemade meals, the firmness of the bed, and the familiar sounds of the neighborhood on a summer’s afternoon.

No doubt, as we age, we’ll each want to remain in our home, just like Corrine and Daryl. And someone will remind us, as they were reminded …

We can age in place independently because Arise cares enough to make in-home senior services available in the greater St. Cloud, Minn., area.

Do you have a question for our professional Arise Home Health Care staff? Contact Us.

* Not the individual’s real name


1. “Moving Elderly Parents: Convincing Mom and Dad,” http://www.aplaceformom.com/senior-care-resources/articles/moving-elderly-parents

2. “What is Parkinson’s Disease?” http://www.pdf.org/en/about_pd

3. “Implementing a Team Approach to Dealing with Parkinson’s,” http://www.pdf.org/en/summer07_team_approach