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Family Caregiving: Sink or Swim

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May is the time when homeowners who are fortunate enough to have a pool decide to open it for the season. A week ago, I was preparing to open for the season and realized pool maintenance is analogous to caring for a family member with dementia.

There are really three phases of pool maintenance that a homeowner must tackle throughout the year: opening, maintain/balance, and closing.


Opening the pool for the year can be an eye-opening experience. You’re never quite sure what you will find when you pull the cover off. This time of year, I lurk on pool care websites and often there are new homeowners who pull the cover off of the pool and discover they have a swamp on their hands. It’s not unusual for them to find wildlife in the pool such as tadpoles, algae infestations that make the water look like a black lagoon, and leaves that make you wonder if the pool was opened in the past ten years.

Even a pool without these issues can have serious equipment problems. Vinyl liners eventually leak, as I found out last year. Filters and pumps can fail and piping can develop leaks. The long and short is that there are a lot of variables to consider when opening for the year.

This is not unlike the situation I see with my clients when family members discover they are suffering from dementia. There are always a lot of questions. There’s always vast unknown. A lot of family members describe their life during this time period as a whirlwind. They typically describe how fast everything seems to be happening. A lot of times it may be a crisis event that triggers our meeting.

The family realizes, at this time, there are a lot of moving parts just as there are a lot of systems that need to be evaluated when opening a swimming pool for the season. What are mom or dad’s abilities? Can they complete some, none, or all of the activities of daily living? Do they need caregivers to come into the home? Is the home safe? What if they need to move to a personal care home or nursing home in the future? Will they have the money to pay for that? Will the nursing home or government take their home and assets away?

All of these are good questions. They each require careful thought and consideration. At this stage, it is particularly helpful for families to sit down and talk with an elder law attorney and care manager to flesh out the details of the situation, clear up any misconceptions, and develop a plan of action to ensure the client’s needs are going to be met.


As you can probably guess, the work doesn’t stop after the pool is opened for the year. Pool chemistry is extremely important in keeping the water sanitized, free from algae infestation, and clear and inviting.

The most popular pool sanitation chemical is chlorine. The issue with chlorine is that it burns off very quickly when exposed to sunlight. To counteract this, a chemical called stabilizer (cyanuric acid or CYA) is added to the water as well to prevent this burn-off. The balance between these two chemicals is actually the most important to understand in pool chemistry because stabilizer reduces the sanitation effectiveness of chlorine and therefore the higher the amount of stabilizer in the water, the more chlorine is required to properly sanitize the water. This balance needs to be checked every few days at least and constantly re-evaluated to ensure the conditions are right.

Once the preliminary decisions have been made and a plan has been put in place to help a family member suffering from dementia, it must be constantly re-evaluated. If there is one thing I know, it’s that things change in life. Sometimes the chemical balance gets out of whack and adjustments need to be made. Sometimes families need to bring caregivers into the home to help their loved one, or increase the number of hours or type of care they provide. Humans suffer illness such as urinary tract infections, broken bones, etc. Our mobility is likely to decrease as we age further, perhaps requiring home modifications. During this period, it’s important to keep a watchful eye.

Despite all this, it is important that pool owners take time to enjoy the pool by swimming or relaxing in the sun. Family caregivers are often overworked, stressed, and concerned about keeping the balance right in their life. Still, as much as they can, they should take time to enjoy spending time with their family member as much as they can and also take time for themselves to relax.


This is the part that nobody wants to think about. Hopefully it has been a long summer and the pool has been put to good use. Eventually, in Pennsylvania, fall will arrive and cold weather will set in. It will be time to dust off the winter cover once again and close up the pool for the season. Closing, like opening for the year, has a lot of moving parts. The equipment must be shut down, the water level lowered below the plumbing, and the pipes drained of water so they don’t freeze over winter.

So too, there are a lot of items to consider at the end of life. Eventually, for all of us, our time on Earth will end. We hope that when the time comes we will have lived full and enjoyable lives spending time doing things that we loved with people we loved. Hopefully we’ve taken some time to prepare for this time.