Sunday, February 17, 2013

Happy Anniversary, FMLA!

On February 5, 1993, President Bill Clinton signed into law the Family and Medical Leave Act (FMLA). (Yeah, I’m a few days late with the anniversary wishes – I blame the puppy). J

FMLA provides unpaid protected leave to eligible employees employed by a business with 50 or more employees.  Specifically, the Department of Labor defines the FMLA as follows:

The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave. Eligible employees are entitled to:

·         Twelve work weeks of leave in a 12-month period for:

o   the birth of a child and to care for the newborn child within one year of birth;

o   the placement with the employee of a child for adoption or foster care and to care for the newly placed child within one year of placement;

o   to care for the employee’s spouse, child, or parent who has a serious health condition;

o   a serious health condition that makes the employee unable to perform the essential functions of his or her job;

o   any qualifying exigency arising out of the fact that the employee’s spouse, son, daughter, or parent is a covered military member on “covered active duty;” or

o   Twenty-six workweeks of leave during a single 12-month period to care for a covered service member with a serious injury or illness if the eligible employee is the service member’s spouse, son, daughter, parent, or next of kin (military caregiver leave).

 
According to the Department of Labor, the “findings and purpose” of this revolutionary leave act was to “balance the demands of the workplace with the needs of families.”  

Twenty years ago, the President and Congress recognized that the majority of caregiving roles fell to women and these caregiving responsibilities affected women in the workplace more than they did men, therefore one purpose of the FMLA was to “promote the goal of equal employment opportunity for women and men.”

While the majority of caregiving responsibilities do fall to women, that has even changed over the years as more men become primary caregivers.

In a 1997 study, the National Alliance for Caregiving and AARP showed the face of caregiving looking like this:

o   There were more than 22 million caregiving households;

o   73% of caregivers were women;

o   23% care for more than one person;

o   85% of caregivers care for a relative; (Robert’s Sister note: the specific relatives were not broken down in this study);

o   64% of caregivers were employed;

By 2009, a study by the National Alliance for Caregiving and AARP shows the changing world of caregiving:

o   65 million caregivers provide care to someone who is ill, disabled or aged;

o   66% of caregivers are women;

o   33% of caregivers take care of more than one person;

o   86% of caregivers care for a relative; 33% of caregivers care for a parent. The rest care for a child, in-law, sibling, grandparent, grandchild, spouse or other relative or friend;

o   73% of caregivers were employed at some time when they were caregiving;

o   Among the working caregivers, two-thirds have needed to revise their work schedule in order to take care of caregiving responsibilities;

The number of caregivers exploded over those years, with an increase in the number of working caregivers and those caregivers caring for more than one person.
 
It is obvious many of those being cared for do not meet the definition of family under FMLA: there are caregivers providing care to grandchildren, grandparents, aunts, uncles, siblings and adult children (who are not dependents) in addition to those who care for a spouse, parent or dependent child.
 
In order to keep up with the growing caregiving population – and keep those growing numbers of caregivers in the workforce – FMLA needs to change.
 
Keep in mind, FMLA is an UNPAID protected leave. 
 
Would a paid leave help family caregivers stay in the workforce longer?  Of course.  However, as an employer, I understand this could be a strain on employers so I am not asking for that (okay, not yet). 
 
What I’d like to see changed in the near future is an expanded definition of family.  Why not include siblings, in-laws, grandparents, domestic partners, adult children (non-dependents) and grandchildren? 
 
What I would like to see changed is a lower employer threshold.  Why not allow eligibility to those employed by businesses that have fewer than 50 employees?
 
FMLA needs to expand the definition of family and FMLA needs to lower the threshold of the minimum number of employees in a business to qualify for coverage. Many states have taken steps on their own to address these limitations within FMLA. 
 
California is one state which has made strides in changing the definition of family under the California Family Rights Act (CFRA) by including domestic partners but has stopped short of including any other type of family care.  Legislation has been introduced the last few years to expand the definition of family under CFRA but, unfortunately, has not yet succeeded.
 
I would like to see change in the definition of family on both the national and state level of these family leave acts.
 
I am grateful for what President Clinton did twenty years ago for the working family caregiver but it is time to recognize caregiving responsibilities have changed and include more than what was envisioned in 1993. 
 
I hope you had a nice anniversary, FMLA.
 
Now let’s make some changes.

Thursday, February 7, 2013

Puppies, Turkey Sandwiches and Adjustment

I’ve been MIA.

Thankfully, it isn’t because Robert is in the hospital or because caregiving duties have become overwhelming.  (Unfortunately, my mother-in-law is in the hospital but that has been a recent development).

The reason for my absence? 

This little guy:


Meet Taz - not usually this still!
We had no intention of adopting a puppy. 

In fact, we had recently claimed a cat that was living on our porch which was enough for me.  We fed him, named him Rambo, got him his shots, neutered him and brought him in to a warm house with other cats.
 
He hates it. 
 
Rambo lived on the streets for 18 months and now he’s trapped in a house.  I recently walked in on him trying to climb out a second story window – he was between the glass and the screen and two steps away from flying out the window.  I rescued him but realize how unhappy he is now.

 Rambo isn’t the reason I’ve been MIA, though.  Heck, cats are usually super easy.

Meet Rambo - Not loving the indoors
It’s the puppy.  Taz came to us by way of my daughter.  She works for RedRover which is an animal rescue organization that helps out animals that are displaced during a natural disaster and provides financial assistance for those who need help with urgent veterinary care.  It’s a wonderful organization but it is not a shelter.  Just over a week ago a man came to their office with a puppy he had found roaming a WalMart parking lot.  He couldn’t keep him, the shelters were closed that day and the good-hearted people of RedRover couldn’t turn the animal away. 
 
I mean, who could resist this face?

Taz came to live with us and it has been quite the adjustment.  He is a bundle of energy and has lived up to his name.  Our middle-aged lab, Oz, wasn’t quite sure what to make of him; after all, he was used to smaller dogs but they were all old and not nearly as energetic as this little guy.
 
It’s taken a week of adjustments (and realization the little guy wasn’t going anywhere) but Oz is starting to come around (for the most part).  It’s not perfect (yet) but I’m not such a nervous wreck when they’re together (well, maybe just a little bit).
 

I’m adjusting but it is taking time.  The whole family schedule is completely thrown off and I don’t have near enough computer or relaxation time.  I’ve been so used to old dogs and cats just lazing around while I write or watch television. 
 
It’s only been a week so there are more adjustments to be made.  I’m hoping to be able to write another blog post in six months or so. J
 
Robert has only had one day with Taz and it mostly involved Taz trying to steal Robert’s turkey sandwich. 
 
Robert was not a fan.   
 
Again, more adjustments are needed. Along with time.
 
My problem is I am impatient with adjustments but I know they do happen and things work out – in time.  Fitting in taking care of Robert took some adjustment but now we have it down to a routine which only gets thrown off by hospitalizations (we’ve even adjusted pretty well to how seizures throw off the schedule).
 
A friend of mine wrote a blog post on Caregiving.com and shared information about adjustments  written by Lara M. Stepleman, Ph.D., a licensed psychologist and Professor of Psychiatry and Health Behavior at Georgia Health Sciences University.  Dr. Stepleman was writing about adjusting to a chronic illness but her wisdom applies to any adjustment.  One observation by Dr. Stepleman really hit home with me, “Adjustment doesn’t just happen once, it happens over and over. Few, if any of us, are ever finished adjusting.”
 
Oz isn’t the only one who needs to adjust to the puppy and his boundless energy.  Robert needs to adjust, I need to adjust, my husband and daughter all need to adjust. 
 
Not to mention our cats and poor Rambo!
 
I have faith we’ll adjust and end up with another very happy member of the family (who, hopefully, will eventually realize how wonderful it is to curl up on a blanket and relax).  I have faith Robert will come to love Taz and look forward to having another animal to pet when he visits. 
 
I’m not quite convinced Rambo will adjust to the benefits of being an indoor cat but we’ll give that some time too or we will find another way to keep him happy. 
 
In the meantime, I’ll make sure the windows stay closed.   

Monday, January 28, 2013

The Tough Talk: End of Life

Christopher MacLellan (aka, The Bow Tie Guy) cares for his partner, Richard, who has esophageal cancer and was given three to four months to live – 16 months ago.

Chris is an inspiration in so many ways: he is a loving caregiver to his partner and is an avid advocate who created his blog The Purple Jacket to focus on “LGBT Seniors and the struggle of aging in a straight society.” Chris is also a “healthy caregiver” having lost 100 pounds and being one of the creators of the Caregiving.com “V-Ride” – a virtual bike ride meant to inspire caregivers to move even if they cannot leave the house to exercise. 


Robert a few years ago -
He thought it would be funny to play dead!
Chris and his partner, who he refers to as “The Little One,” recently discussed end of life issues on Your Caregiving Journey with Denise Brown.  A blog post of his followed as did a Twitter discussion (search for #carechat to see the discussion). 

In his blog post, Chris relayed five questions created by Denise and described in her recap of the radio show to help family caregivers get the usually difficult end of life discussion started.  After discussing my husband’s wishes with him, I turned my attention to Robert. 

After all, Robert has lived long past his expected expiration date.  (That may seem like a cavalier attitude but believe me, after numerous surgeries, life-threatening infections, too-many-to-count concussions, a coma and serious accidents due to seizures causing falls – I know how lucky we are to still have Robert around and consider each day he’s alive a “bonus” day).  Even after all of these close calls, I realized I hadn’t had the end of life conversation with him.  I do have Power of Attorney for Robert and he agreed at the time to a DNR (Do Not Resuscitate) but I hadn’t really talked with him about his wishes when he died.

I guess I thought the conversation would be difficult not only because it’s a touchy topic but because Robert has intellectual challenges.  He thinks, well, simply and I wasn’t sure how the conversation would go.  I was inspired by Chris, Denise and the chat on Twitter so my husband and I talked with Robert.

I used the questions Denise created as a guide to the conversation and started by telling Robert I knew he was very religious.  I then asked him what he thought would happen to him after he died.

Robert’s answer was matter-of-fact:  “I know I will go to heaven.” 

There must be comfort in such conviction.

I continued:  Do you want to be buried in same place as mom and dad? 

Robert said, “Yes.”  Then followed that up with a joke:

“No, I want to be buried next to George Washington.  Haha.  Only joking. Only joking.”

He continued (I suppose in case I didn’t know he was joking), “I want to be buried next to my mother.”

Is there anything else special you’d like to have happen after you die? 

Robert:  I want to be buried next to my mother and step-dad, George. 

I asked if it was okay if he was buried next to our dad (but close to Mom and George) since I thought there was more room by him and Robert said that would be fine.  (My dad wanted to be buried next to my mom since she died first but since they had such a volatile relationship in life, we didn’t want to create any problems for mom in the after-life.  He’s in the same cemetery but just out of throwing distance.  Believe me, it’s for his own good.)

My next question to Robert was, “What’s a good day like for you?”

Robert looked at me like I just asked him something crazy and said, “Just about every day is excellent.”

Duh!  What was I thinking?

I then asked Robert if there was anything he wanted to do before he died and his only answer was that he would like to read the bible more.

Have you lived a full life?

Robert:  Yes.

I tried again: Do you want to do anything else before you die?  (I don’t why I kept asking this - was I expecting him to say he wanted to parachute once or go to Disneyland one more time?)

Robert:  I want to do my word search puzzles. 

I continued (obviously, this question was more important to me than him):  How do you want to spend your time before you die?    

Robert:  I want to call Judy to get my leather jacket back.  Also, I have some shoes there.  (Robert lived with his companion, Judy, for many years before we realized he needed more care to stay healthy and safe.  He continues to talk about a leather jacket Other Brother gave him for Christmas one year and is certain it is still at Judy’s house.  I think I might actually have to check with her to see if it is indeed at her house.)

Moving on from the leather jacket and any big end of life plans he might have, I asked, “What do you want from me and Richard before you die?”

Robert:  I don’t need anything.  Just your love.

Richard and I shared a “aw, how sweet” moment with this answer.

So far, Robert had no problem answering the questions and didn’t seem uncomfortable at all.  I was curious about one more thing:

Do you think if you were sick and going to die, would you want to die at home or in the hospital?

Robert:  Probably at home.

Richard asked him, “Do want machines to keep you alive?”  Robert didn’t quite understand this so I explained that it would be like if he was in a coma and not able to be awake again.

Robert:  I’d like to pass away then. 

Do you have any questions for us?

Robert:  Is it about 8:30 in Modesto? 

Oh boy.  I know where this is going.  No you can’t call Judy right now about your leather jacket.  I’ll call her for you another time and see if she has it. 

Robert then reminded us he was about ready for his Rocky Road Ice Cream. 

End of life discussions difficult?  Ha!  Nope, not according to Robert. 

The difficult conversation is going to come if I can’t find that beloved leather jacket.

Friday, January 25, 2013

Chronic Pain: My Turn to Listen

My proclivity toward kitchen fires started when I was quite young.  I was no more than ten years old and baking cookies (I’m going to bet they were chocolate chip but don’t recall for sure).   The house filled with the delicious smell only chocolate chips cookies can emit (and, I’m going to also bet, my younger brothers were clamoring nearby for their share once they finished baking).
Photo Credit: Lowes

When the timer told me the cookies were done, I used both a kitchen towel and an oven mitt (I assume my fear of getting burned from the hot rack led me to double up on the protection) and the kitchen towel somehow touched the oven coils at the bottom of the oven and caught fire. 

There was a lot of screaming (mostly me, although I’m betting mom did her share once she ran into the kitchen) but I somehow managed to get the towel in the sink and douse it with water before the house burned down. 

Thankfully, the cookies were unharmed.

Nothing soothes frazzled nerves better than some delicious chocolate chip cookies. 

Fast-forward through teen years, my twenties, thirties, forties . . . you get the idea.  I have had several kitchen mishaps (okay, small fires or smoke-alarm incidents) through the years. 

These incidents were so expected within my family that I my own mother bought me a fire-extinguisher for a birthday present one year. (My mom could be quite practical).

Happy birthday to me. 

I have not actually had to use the fire-extinguisher because these all-too-often incidents don’t get too out of hand but there was one time the fire department was called.  That one really wasn’t my fault though (I was using an apparently just-cleaned oven at an apartment I recently moved into and the apartment filled with a horrible smell.) 

So kitchen “mishaps” happen but the biggest casualties are usually an appliance (or two).  A toaster caught on fire and was ruined because of an exploding Pop-Tart (it happens – look it up!).  As a poor college student, I wrote to Kellogg’s and insisted they buy me a new toaster.  (I didn’t get a new toaster but I got coupons for free Pop-Tarts which helped my almost non-existent grocery budget.) 

The most recent kitchen “incident” was probably the worst so far and we lost a microwave because of it.  I was making dinner and using the microwave as a timer.  Or so I thought.  I accidentally started the microwave “cooking” instead of timing for twenty minutes. 

Not a horrible mistake unless there’s a plastic container of frosted sugar cookies stored in the microwave. 

Yikes. 

The house filled with smoke and the smell of burnt plastic was horrendous.  Plastic melted into the bottom of the microwave and, even though we were able to clean out the inside, the smell never went away. 

This time the cookies (nor the microwave) could be saved and I had no company to write to asking for replacements – this was all on me. 

My husband and I shopped for a microwave on our next date night (I’m obviously as practical as my mom was) and came home with a gorgeous stainless steel microwave. 

This was the best result of a kitchen fire ever!

While deciding on the microwave, my husband made the comment that we should pay for the install (of course, I had fried the above-the-stove microwave and not a cheap countertop microwave).   Richard was envisioning the lifting and drilling and more lifting.  I was envisioning saving a few dollars.  When the salesperson came over to assist, he assured Richard the install was easy. 

My husband has serious chronic back pain issues.  He is also inclined to do more than he should so when he says we should pay someone to install an appliance, I really should listen to him.  He does not say these things lightly. 

However, I wasn’t really thinking and we both were easily swayed by the salesperson’s insistence that the install would be easy.

Helping my husband lift the very heavy old microwave out of the cabinet and install a new, only slightly less heavy microwave, was enough to make me bang my hand against my head asking, “What was I thinking?!”

Richard was able to install the shiny new microwave but paid for it with increased back pain for the remainder of the day – and the next.

I have learned a few things from this experience:
  1. Don't use the microwave as a timer (the risk is too great);
  2. Listen to my husband (at least when it comes to his back pain);
  3. Always, always save the cookies . . .