Dr. Farber (left) with Dolly Goff (middle) and Dorothy Harrison (right).
Like so many elderly with chronic illnesses, Mrs. Goff is being cared for full time by her daughter, Dorothy, 63, who has her own health problems. A few years ago, Mrs. Goff had a hip replacement and moved in with her son and daughter-in-law in South Carolina for 16 months. She then moved to New York City to live with her daughter, who gave up her job and activities to become her full-time caregiver.
Her Doctor's Comments
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A conversation with daughter Dorothy Harrison about what it's like to care for her mom, her fears about what is ahead, and her own health problems.Watch »
Dr. Jeffrey Farber, a geriatrician at Mt. Sinai Hospital in New York City, and a member of its Visiting Doctors Program, talks about the heavy burdens facing Mrs. Goff's daughter, Dorothy.
[Dolly Goff] is a woman who came to me about a year ago with her daughter [Dorothy Harrison] for the first visit. She was progressing with dementia. That was her main illness. She has other medical problems, including some pretty significant heart disease, diabetes and very advanced kidney disease, which has been a factor affecting lots of her care.
“It] will be very difficult for Dorothy, as great a helper as you can ask for, to continue to care for her mom at home through the very end.”
Jeffrey Farber, MD
[But the main issue] was really burnout for the family down there [South Carolina], the inability to really be there 24/7 and to alter their lives to the extent to which they can manage her and help. This led to her coming up north to live with her daughter, who herself is a retired nurse, and so is kind of medically savvy and knows things. It's very helpful, very helpful to have a patient like that, who's got a caregiver who's so helpful. ...
[But it's] really a full-time job, caring for her mom. She doesn't work as a nurse right now. She in a sense works as a private nurse for her mom, and she does all of the caregiving. She's starting to show signs of burnout, stress. It's hard for her. So we're working on getting her some services at home. ...
[Harrison] also has medical problems. She needs to get to the gym; she needs to exercise. She needs to have surgery soon. Those kind of issues could have huge impacts on her mom, on my patient. When she goes in for surgery, who's going to care for her mom? There's high risk for getting confused and disoriented and very upset when the situation changes, when her daughter's not around. ...
- Costs of Care
- Medicaid/Medicare cover $8,640/yr for medical needs as well as the costs of a part-time home aide for about 12 hours a week (estimated at $15/hr based on the average rate in New York City).
I understand Ms. Harrison is with her mom 24/7, even shares a bed with her. That must be an enormous commitment and burden.
This patient and her daughter are not the norm. Unfortunately, it's probably fair to say it's not everyone who can dedicate her life really to caring for someone else. That level of care that she needs, that constant, 24-hour, around-the-clock care, is taxing. Most caregivers do get depressed. They do get burnt out. They need help. But again, we don't have a great system for giving them that support. What she needs is time to herself. She needs a weekend off, away, [where she can be] comfortable knowing that someone who's skilled and caring is in her place to take care of her mom. And that's hard to come by.
It's often a struggle. ... Some caregivers aren't comfortable and don't trust the people coming in and won't leave. So even though they have someone come for four hours during the day to help out, they're not going to leave the apartment to do what they need to do, to take care of themselves, to fill their own prescriptions, to go to their own doctor's visit, to go visit their own friends and socialize because they're so nervous and untrusting of who's coming in.