CareSquare musings for families and caregivers

Birth is about the baby, not the mom. So do it in the hospital.

www.Caresquare.com

There is alot of pressure for pregnant moms these days to commit to experiencing a natural childbirth, and even a home birth.  These processes have been romanticized lately as a less traumatic experience for the newborn and for the mom. And for the cases of childbirth where everything is normal....well, great. But in the event that anything goes wrong, the trauma from an attempt at a natural birth or home birth increases exponentially. Let's remember that one in three woman used to die in childbirth. So when hospitals treat birth as a "medical emergency", there is a reason they are doing this. Ricki Lake's movie The Business of Being Born promotes home birth and natural childbirth, and paints the hospital to be big, bad and out to get you.

Many women enter their birthing process with a birthing plan. Hospitals have reputations for ignoring them. Why? Because an expectant mom has NO IDEA what is going to happen once she goes into labor. Birthing plans are written in the event that everything goes great, no complications, baby is born on the exact due date or very close to it. How often does this happen? Not too often.

Home birth means the baby is born at home, commonly assisted by a mid-wife. A mid-wife is great for normal deliveries, but as soon as anything goes wrong everyone gets rushed to the hospital, hopefully with enough time to save everyone involved. Hospitals typically allow mid-wives in the delivery room, and many hospitals allow the patient to request a mid-wife instead of a doctor. Seems like a great alternative to home birth. Besides, who has a home cleaner than a hospital?

Natural childbirth means childbirth without drugs - no epidural, no induction medications, no drugs. That sounds great for the scenario where the baby is born close to due date, mom's labor doesn't last for multiple days, noone gets dehydrated, and the baby slides right out with no problems. In hospitals, babies who are more than a week late are typically induced, for fear that 1) the placenta may dry up and no longer be able to nourish the baby, and  2) meconium gets passed into the amniotic fluid and swallowed by baby, causing lung infections, and 3) the baby doesn't get so large that he no longer fits in the birth canal.

My personal experience with my first son is that he was 8 days late, we went in for the induction, I labored for 24 hours with very little dilation, and then had an emergency C-section after his heart failed twice from the induction drugs. Upon doing the C-section, we realized the problem was his head was simply too large to even start a descent down the birth canal. If the year had been 1800 the doctor would have broken my pelvis to deliver the baby - we may or may not have survived. Thank GOD for drugs, and hospital procedure. My second son was born via planned C-section - it was fantastic. If I could have scheduled a C-section the first time round I would have - it clearly is the method that most greatly reduces all risks to the baby associated with childbirth.

It is my opinion that choosing a home birth and/or a natural birth is completely selfish and not done in the best interest of the child. The other day I saw a woman driving her car with a bumper sticker that said "My child was birthed at home". As far as I can tell, that is ALL you get from a successful home birth - a bumper sticker. A chance to show off your own actions in the birthing process....but what does that have to do with the baby? Birthing is not about the mom - birthing is about the baby. Expectant moms need to make the choice that reduces the risk for problems for their child.

FDA approves one-a-day Parkinson's pill

Caresquare.com

There’s a new tool in the fight against Parkinson’s disease. The FDA has granted approval for Azilect® (Rasagiline), a drug developed by Technion-Israel Institute of Technology researchers. The drug will be available in the United States within 8 to 10 weeks, and will be marketed by Teva Pharmaceutical Industries, Ltd.

The brainchild of Technion Professors Moussa Youdim (pictured left) and John Finberg, Azilect is the first once-daily product for the treatment of Parkinson’s, a chronic, degenerative disease affecting a million people in the United States and 4 million around the world.

Azilect is one of the few treatment options in the U.S. for all stages of Parkinson’s, including use as a stand-alone early-stage therapy and in combination with levodopa (a standard treatment for Parkinson’s disease) in more advanced stages of the disease. The drug is a monoamine oxidase type-B (MAO-B) inhibitor that blocks the breakdown of dopamine, a chemical that sends information to the parts of the brain that control movement and coordination.

“The approval of Azilect by the FDA represents important news for people with Parkinson’s disease,” said Dr. Warren Olanow, professor and chairman of the Department of Neurology at Mount Sinai School of Medicine. “Patients can now look forward to an effective new treatment option that improves symptoms and offers the simplicity of once-daily dosing without titration (careful measurement of dosage).”

FDA approval is based on data from three large, multicenter, multinational, double-blind, randomized, placebo-controlled clinical studies of more than 1,600 patients.

Teva has begun a large clinical study to investigate the drug’s effect on slowing the progression of Parkinson’s disease.

The Technion-Israel Institute of Technology is Israel's leading science and technology university. Home to the country’s winners of the Nobel Prize in science, it commands a worldwide reputation for its pioneering work in nanotechnology, computer science, biotechnology, water-resource management, materials engineering, aerospace and medicine. The majority of the founders and managers of Israel's high-tech companies are alumni. Based in New York City, the American Technion Society is the leading American organization supporting higher education in Israel, with 17 offices around the country.

Grandma Rita lived in Cleveland - Adventures in remote caregiving

We've launched senior care services on Caresquare, and going through the process of understanding the market for these services has made me revisit the lengthy process we went through in providing remote caregiving to my Grandma Rita in Cleveland, OH. Her needs were minimal until she turned about 90, and then the last 6 years of her life until she passed away at age 96 saw her needs grow immensely.

Grandma Rita lived in the same house for most of her life - it was the house she raised my mom and uncle in - in a quiet suburb of Cleveland called Shaker Heights. She loved her home, her neighbors, and her community there. Try as we did to convince her to move to California to be closer to her family in the final years of her life, she simply could not fathom being away from her home. She was active in the local library, the local newspaper, and the local Democratic club.

It was a wonderful house to raise a family in - two stories, a great big back yard, side yard, and front yard. But as Grandma Rita got older, she became unable to care for the place. She eventually stopped being able to climb the stairs. And the house only had one bathroom - on the second floor. She started using kitchen pots, instead of climbing the stairs. As time wore on, she often forgot to lock her doors at night, and the garage freezer where she stored meat was commonly robbed. Her house was broken into multiple times and the thieves took money and jewelry. By the time she realized what had happened, it was always too late.

We tried and tried and tried to move her. We wanted her near us, but knew she wouldn't come. We hired caregivers to come by the house, but eventually that was not enough. After a scare in the emergency room because she had forgotten to drink water one hot July day and became dehydrated- thank goodness my husband and I happened to be visiting that weekend - we finally convinced her to move to an assisted living facility.

My mom flew out and went through the arduous process of packing up a lifetime of household stuff, and moved Grandma Rita to the Menorah Park assisted living facility nearby. Mom stayed for a while, made sure Grandma Rita was settled in, and then came back to California. We thought everything was fine, until one day we called the facility and got a nurse on the phone. Turns out Grandma Rita had moved out weeks ago. She had convinced one of her old neighbors to move her out of the facility and back into her home!!

She was miserable in the facility, and wanted to spend her final days in her home, no matter how uncomfortable. We gave in - what else could we do?

Fathers and Friendships during the Family years

As our children mature, they take up more and more time in our life every day. Every day, a little more. Time we used to spend socializing with our peer group is now increasingly spent with the kids, or with the peripheral activities that raising them requires. Stuff like carpooling, the extra grocery shopping, the extra 30 minutes the walk to the post office takes when the 3 year old is along....all these things are wonderful and enriching and they take time. Seems like the first activity sacrificed from our former lives is time spent with friends. We make a point of maintaining SOME social life - but it is definitely alot less than it used to be.

The people around us with young kids are the same way. And there always seems to be one person managing the social calendar of a family - mom. As a result, mom becomes the de-facto gatekeeper for friendships with the family. Over time, that means that the relationships forged by dad are less and less attended to, less significant, and eventually less present. Dad's friendships from before the marriage and before kids seem to get less attention than the friendships and relationships forged by mom. Over time, this can mean that mom dictates the friendships dad ends up having.

I saw this clearly with my own parents - dad's friends tended to be the husbands of the women my mom was friends with. Over time, this meant very few people he could call on as close personal friendships of his own. My husband is more social in general than my dad, but I see him increasingly struggling with this same situation. Even if he wants to make plans with his male friends, they still need to run the idea by their wife. If their wife doesn't know me, she is less inclined to work these plans into the family schedule. Dad doesn't push it, it never happens. Dad ends up with few enriching, personally-chosen friendships in his life.

Female bonding around parenting is the foundation of friendships, communities, blogs and more. But what about dad? And male bonding around fathering? Is there such a thing?

Nanny sharing breeds strong young bonds...and more date nights!

We have done nanny shares for both of our sons, and it is one of the best decisions we ever made for our kids. There is of course the financial benefits of sharing a nanny, but the social ones are the reason that sharing is so great.

Our four year old is now in pre-school, but still considers the boys he did the share with (from 6 months to 3 years old) his best friends. There is a level of comfort between the three of them that I just don't see with any of his other friends. They are like lion cubs when they get together - their fluid play, interaction and familiarity is incredible.

They learned to play WITH each other - not parallel play, but actually with each other - before they were a year old. They learned to share, to fight with words instead of fists, to interact and to love their friends from the get-go. I believe the reason my son is so successful socially at pre-school is because of the nanny share.

The boys are all completely comfortable at each other's houses,  and with the other parents. This is a huge plus for playdates, sleepovers and babysitting shares. read: More Date Nights!

A few more tips from a mom in my mom's group regarding how to set up a nanny share:

Contract: Always a good idea. Use it to spell out responsibilities and work schedule, and the nature of employment.

Vacations: we gave our nanny 2 weeks of paid vacation per calendar year.
Beyond that, whenever either of the families goes on vacation, you just have
to pay the wages as usual, just as with any other day care provider or your
preschool. It's not fair to the other family to make them take the full
brunt of the hourly wage because you are away.

Holidays: we give all the major holidays off with pay, including December
24 and 31st and the day before Thanksgiving.

Sick time: this is optional but we did have an accrued sick time of a few
hours per month after the first three months of employment.

Reviews: we did an employee review three months in, to give her feedback on
good things and areas of improvement.

Location of Share: we alternated weeks between our house and the other family's
house. It has worked out very well because now the kids are comfortable in another house - great for future sleepovers and date nights.

When One Family Wants to Quit:  It can happen. You don't have any control over it.  And you
don't want to be wedded yourself if for some reason you decide to change
your child care plans, move, or whatever. So the most appropriate thing is
to just give everybody at least two weeks (preferably 4) notice if you want
to pull out of the arrangement.

 Sickness: Unfortunately, when your child is sick you have to stay home with him/her just like when they are in preschool or kindergarten.  Not only does it protect the other child from
getting ill, but also your nanny. (Of course, minor colds are not an issue). Even if you have the nanny all to yourself, if your child is ill, it's not eally fair to expose the illness to the nanny, just as you wouldn't want the nanny coming to work if she was sick.

Preschooler undermines mom's power after unfortunate maple syrup incident

Does anyone know how to get maple syrup out of carpet? How about honey? And Sharpie pens? How about those on carpet?

I know everyone loves these LOOONG summer days so much, but honestly, when you have a son that rises with the sun that means everyday you have a 5:30am wake up call. And since we imposed the "no starting anyone else's day until 7am" rule, Zo has taken it upon himself to get a little snack going for his early mornings. He brings the food into his room because his early mornings typically involve waking his baby brother up and the baby starts crying if Zo leaves the room. So Zo brings his snacks - if a honey bear and a can of maple syrup can really be considered snacks - into the room and proceeds to "make them breakfast". Pancakes and syrup without the pancakes, basically.  And then gets the broom to clean up the syrup and honey he spills on the carpet - thereby really spreading the love around.

Mom enters room and loses it. Gets really mad. Zo diffuses anger by completely undermining mom's power. See play-by-play of conversation below.

Mom: "Zohar! Why is there food in your room? There is honey and maple syrup everywhere! I am mad! I am FURIOUS!"

Child: "I am furious too! I am furious! Take all of my toys away - RIGHT NOW! And no more movies for me! This is terrible!"

Mom is dumb-founded. Power has been completely undermined by an almost-four-year old. Now what?

We are LIVE with new site, including Senior Care!!

We did it! We are live!! After many long nights and early mornings of building, testing and tweaking, we have launched our new site design that includes senior care. What do you think? We would *love* to hear your thoughts, comments, feedback, etc. Comment here, or else write us at info@caresquare.com.

All of the functionality and information from the old site is here - plus much more. New features include:

• Senior Care services
• Full SMS/Text integration - mobile Caresquare! Caregivers  can receive appointment requests and respond to them via text message. Families can receive appointment confirmations on requests via text. Go to your profile page and click on the Edit Pencil next to your phone number to get set up. Or else go into Settings to get set up. Picture below to show you how it's done.
• News Feeds on your My Caresquare page to let you know what your community is doing on the site
• Caregiver social networking
• More robust Reference capabilities

Do you love it?!?!?!?!

Tips for Nannies: Building and Maintaining a Strong Relationship with your Parent Employer

 Building and maintaining a healthy caregiver parent relationship can be tricky sometimes. There are bound to be ups and downs regardless of how well you get a long most of the time… it is just the reality of on-going relationships. Here are some hints to keep in mind as you partner with the parents in caring for their children. 

· Show them you find delight in their child and that even in difficult times you love them. Have little stories, not just problems to share every day.

· Always greet the parent upon arrival and departure. This can be with words or gestures. Ignore moodiness or strange moods and continue to and stay cheerful, it will help a parent returning home after a long day at work. make the transition into family life better.  Don’t take on their mood or take responsibility for their mood.

· Know the limits of your expertise and pass the questions to a professional. Try to avoid helping a parent get more worked up about a potential problem than they need to be.

· Find out things about their family, work, interests and use this to tailor your conversations. Show them you know them and their child. When someone feels like you know them or their child they feel more apt to listen to you or solve issues as partners in caregiving to their child.

· Allow parents to be experts about their child even if you feel strongly about something. Always remember they are the parent, even if you spend more waking hours with a child.

· Remember that although you may very well become good friends, the parent is also your employer so act accordingly.

· Limit your judgments. Even if caught off guard or surprised by a concern or complaint treat it as important.  Clarify what you think you hear in their concern so you are sure you understand and can respond appropriately.

· Mirror their concern, delight about stories they tell (without adding to drama). Thank parents for letting you know concerns and telling them you appreciate it when they address issue directly with you allow us to help them understand or move forward. Always let them know how much you appreciate their compliments, gifts or niceties. You are apt to get more kudos and be better appreciated when you do.

· Use their parenting philosophy and family culture to guide your suggestions or guidance.  Being unnecessarily adversarial won’t help any philosophical differences that may come up. If you do have difference use theory and research as back up not personal opinions.

· Say “let me think about it” to give you more time to be thoughtful before responding to any issue.

· Imagine yourself as a parent, wanting the best for your child. Always know that every parent regardless of behavior, deep down wants to be the best parent they can be and than we all have obstacles ( be it work or personal stress) that prevent this at times in our lives.

Working from bed

Oh man am I sick. Sick sick sick. Fever, chills, sweats, my skin feels uncomfortable on my body. Working from bed. Not glamorous. Three days and running. When will it break?

Logging in is such a waste of time

I love the internet. I love everything about it's ease of use, and the rapidity with which I can gain access to canonical information about any topic I wish.

What I hate about the internet is logging in. I hate registration, I hate logging in. My computer should know which sites I want to be logged into without me having to log in.....I surfed to this web page so obviously I want to be here, stop making me log in all the time.

Perhaps the technology behind keyboard stroke recognition could help solve this problem.