Prepare to care: having a plan of action and being aware of the resources available is fundamental when caring for aging parents

American Fitness, Sept-Oct, 2004 by Victor M. Parachin

* Marie is an accountant in the Boston area. Each week she struggles to squeeze in a few hours of telephone calls to handle her widowed mother's finances and Medicare forms.

* Toni is a Midwest public relations writer. She has been increasingly taking more time off work, so she can drive her father, who recently suffered a major heart attack, to the hospital for ongoing physical therapy.

* Ron, an electrician based in Oregon, is using up his vacation days to attend to both parents. He divides his days between the hospital to be with his mother, who broke her hip, and his parents' house to care for his father, suffering from the early stages of Alzheimer's disease. Ron knows he will soon have to make arrangements for his father to be placed in a nursing home.

As parents grow older, declining health can make them more dependent on their children. An increasing number of adults find themselves not only parenting their children, but providing care for their parents as well. Statistics indicate that caregiving for an elderly parent will become a reality for more adults in the future. Currently, more than 6 million seniors require assistance with such basics as getting out of bed, dressing, cooking, cleaning and handling finances. On any given day, an estimated 5 million Americans spend some time caring for a parent. This figure is expected to double within the next two decades.

A recent Travelers Insurance Company survey of its employees, over the age of 30, revealed that 20 percent spend 10 hours per week in elder caregiving. That involved assistance in household chores, personal care, providing transportation, managing finances and selecting medical services. Eighty percent said their duties interfered with their social, emotional and family needs, some or most of the time. In addition, 18 percent said they had not taken a vacation from those duties in two years.

Although this care is motivated by love, tending to an aging parent can exact a tremendous physical, emotional and financial toll, not only on the caregivers but also on their spouses and children. Following are some ways to make this process easier.

Begin with a family conference. Many such family councils are called for the first time when faced by an imminent decision, typically, should mother or father be placed in a nursing home? In order to make care giving a healing, rather than hurtful, experience for your family, have a conference with the principal people involved long before such a drastic decision must be made. This should include the aging parent(s), siblings and other extended family.

Understanding everyone's expectations early in the caregiving process can eliminate problems in the future. During the conference, try to establish who wants to be actively involved in caregiving and their level of commitment. If there are financial implications, discuss how they will be shared and met. A key point during this family conference is to find out what the aging parent(s) envisions. Does he or she plan to live alone, get a roommate or move to a retirement community? Do not assume a relative expects a place in your home. According to a recent American Association of Retired Persons (AARP) survey, 84 percent of respondents, age 55 and older, wanted to stay in their own homes.

Don't make promises you may not be abJe to keep. When Bonnie's 72 year-old mother began to express concerns about her future care, Bonnie quickly responded: "Mom, don't worry about ending up in a nursing home because I'll always be able to take care of you." However, as her mother's health dramatically declined, it became clear she needed 24 hour care. "Because I work full-time, I could not provide mother with the care she needed," Bonnie explains. "Reluctantly, and with great guilt, I found a good institution which provided my mother with constant professional care. In spite of the fact that the nursing home was an excellent facility, my mother resisted being placed there and I felt as though I had abandoned her. She died two years ago and I'm still feeling guilty that I didn't keep my word to her." The lesson from that sad experience: think twice before making commitments you may be unable to fulfill.

Find out what social services are available. Although some families can afford to pay for the services of a social worker or nurse who specializes in geriatrics, there are many low cost services available for those who cannot. Here is a brief listing of where to look in your telephone book.

In the white pages:

Council on Aging

Catholic Charities Family and Community Service (You need not be Catholic)

Jewish and Community Services (You need not be Jewish)

Protestant Federation of Welfare Agencies

Salvation Army

American Red Cross

Mental Health Association

Legal Aid

In the yellow pages:

Health and Welfare Agencies

Home Health Care

Homes-Residential Care

Nursing Homes

Nursing Services

Retirement and Life Care Communities

Senior Citizens' Service Organizations

Social Workers

In city, county, state and federal listings: