The Complete Guide

Click the links below for tips and information.

Planning Ahead

Taking Care of Yourself

Tips for Daily Living

Nursing Home Advice Given on the Oprah Winfrey Show

Internet Resources

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It's never too soon to start planning for what might come. That way, you'll be ready if your parent suddenly becomes ill or disabled. Three critical steps:

Talk with your parent.

It's not easy to do, but get your parent to discuss (with you or perhaps some other person) several issues:

• His fears, needs, priorities and wishes.
• His finances (long-term care can easily cost $40,000 to $80,000 a year or more).
• His medical care (what should you know if you have to make decisions for him one day).
• Housing options (where might he want to live if he couldn't remain in his home).

Make sure your parent has:

• An up-to-date will
• A durable power of attorney (this gives you or someone else the power to handle your parent's finances and make housing decisions for him if for some reason he cannot do this for himself).
• Advance directives (a living will specifies your parent's wishes concerning medical care, and a power of attorney for health care names someone to make medical decisions in his stead).

Do your homework.

We all think that our parents won't need companions, much less nursing home care, but many people need one or the other, or both. Do some research now so you're ready if such help is needed.

• Make a few calls to find out about senior services in your parent's community.
• Visit senior housing facilities so you know what's out there, and if necessary, put your parent on waiting lists.
• If you live far away, have the name of a neighbor or volunteer who can check on your parent if there's trouble, the names of doctors and lawyers, and a phone book from the community.

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It may seem like heresy to do things for yourself when your parent needs help, but it's a crucial part of the job. The fact is, you'll be of little use to your parent if you are exhausted, resentful, depressed or sick — and all too many caregivers are exactly that.

Define the job.

As much as you may want to, you cannot do it all. So decide what you are willing to do. Then make a list and stick with it. Don't keep trying to do more.

Accept help.

This is a big job and most of us cannot do it without loads of helpers. Sign up for community services (meal delivery, homemaker programs, adult daycare, in-home health care, etc.). Recruit other relatives to help and see if neighbors or your parent's friends might take on some small tasks.

Take breaks.

If your parent's care consumes a significant chunk of your life, get away from the task occasionally. Find someone who can step in for you or see if there aren't respite services in your parent's community. Go out for dinner with a mate, have a bath, or take a vacation. Do something else, think about something else. Your parent will survive and you will be a better caregiver.

Spend time with friends.

Studies show that caregivers who have social supports (friends, family, support groups) experience less depression and illness. Coffee with a pal may feel like a luxury, but it's a necessity.

Laugh.

Laughter makes the world more sane (or at least it makes the insanity more fun). And scientists have shown that it actually improves one's immune system and circulation, not to mention one's outlook on life and ability to cope with the impossible.

No comparisons, please.

Don't listen to other's opinions of what you're doing and never compare yourself to other caregivers. Every situation is different. You may have a more stressful relationship with your parent, fewer supports, a more demanding job, or just different priorities and makeup. Trust in yourself to find the balance that is right for you.

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You worry, worry, worry. Is Dad lonely? Is Mom eating right? Should Mom or Dad be living alone? It's stressful when a parent lives alone, or even when two slightly frail parents live together. Here's some food for thought:

Do a safety check.

Make sure smoke detectors work and that your parent can use fire escapes. Clearly label all chemicals, cleaning fluids, insecticides, medications, etc. Post emergency phone numbers. Get a medical alert system so your parent can push a button for help from anywhere in the house.

Fall-proof the house.

Tack down loose carpets. Get rid of throw rugs. Remove thresholds. Clear pathways. Install handrails and grab bars. Install non-slip strips in the shower. Be sure lighting is bright and evenly distributed. Use nightlights.

Make life easy.

Use lever-style faucets and cabinet handles, raise toilet seats, install soap dispensers, and so on. Opt for elastic-waist pants, slip-on shoes and wrap-around dresses, or replace buttons with Velcro closures.

Check the food supply.

Stock your parent's cupboards with dried and canned foods and other supplies so she only has to buy fresh foods and dairy products. A local grocer might deliver. A microwave or toast-and-broil oven is easier for single servings. Make sure utensils, plates, etc. are easy to reach. If you bring food, make sure your parent can reheat it. Check into meal delivery services and/or companions who might join your parent for a meal.

Keep the roads safe.

Driving is a tough subject, but don't be too soft because lives may be in danger. When your parent's driving skills become questionable:

• Correct problems (check vision and medications, elevate pedals, raise the seat, install large mirrors)
• Look into senior driving courses from AARP, AAA and the National Safety Council
• Learn about alternatives (cabs, buses, senior transportation services)
• Limit driving to safer times and familiar places (daytime, local roads, good weather, not rush hour)
• When it's time to quit, don't delay. If you can't do it, get your parent's doctor or a good friend to speak with him. If absolutely necessary, disable the car. Your relationship might be hurt, but at least no lives will have been lost.

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What to look for when touring a nursing home:

• Proximity to family and friends
• Safe, well-maintained building and grounds
• Residents who are busy, well-groomed and content
• Pleasant, caring staff
• On-call medical care
• Flexibility in meeting residents' needs
• Nutritious, appetizing food
• Ample rooms that can be furnished by resident
• Good inspection report
• Pleasant, caring staff and ample staff-to-patient ratio

To get the best possible care within a nursing home:

• Visit often (you and others), at various times and without warning
• Be involved in your parent's “plan of care” and in any family council
• Stay abreast of any changes in care, medication, daily activities, staffing
• Build a supportive partnership with staff
• Let staff know who your parent used to be (post photos of her from her younger days) and what upsets/calms/pleases/frightens her
• When you can't be there, get other friends, family and volunteers to visit, or hire a geriatric care manager, if possible

What to do if you suspect neglect or abuse:

• Act immediately
• Document everything
• Discuss the problem with staff caring for your parent
• Go to supervisor, then administrators and parent's doctor
• Contact the family/resident council, or other families
• Call the long-term-care ombudsman's office for the area
• Call the local citizen's advocacy group
• Report the problem to the state licensing/certification agency
• Contact the National Citizens' Coalition for Nursing Home Reform (202-332-2275)

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