There are several articles in this post:

Why the Holidays Are the Best Time to Talk to Loved Ones
By: Elinor Ginzler | Source: AARP.org | Date Posted: November 2008
From : http://www.aarp.org/family/caregiving/articles/ginzler_family_caregivers.html
 
Elinor Ginzler is a national expert on independent living and aging issues. She currently serves as AARP’s lead spokesperson on caregiving, housing, and mobility issues, including older drivers’ safety.

BY THE NUMBERS

Did you know …
• In 2007, there were about 34 million family caregivers providing care at any given point in time. About 52 million provided care at some time during the year.

• In 2007, the “typical” caregiver in the U.S. was a 46-year-old woman who worked outside the home and spent more than 20 hours per week providing unpaid care to her mother.

November is National Family Caregivers Month—a time to honor the commitment of people all across the country who give their time, energy, and resources to enhance the lives of family members who need help. So who are caregivers and what do they do?

The term “caregiver” designates “a family member and/or friend who provides unpaid care to loved ones who need assistance with daily tasks.” Most of us take it for granted that we can perform these tasks—until they are difficult or impossible for us to perform. I’m talking about things as seemingly simple as bathing, dressing, eating, or as necessary as balancing checkbooks, getting to the doctor, and shopping for groceries.

When friends and family need help, it can mean a little or a lot. And the help that’s required can be short-term or long-term. Every situation is different and unique; that’s what makes caregiving a complex issue. Unfortunately, family members are often caught unprepared for the task.

November is a perfect month to honor caregivers, because it is a time of year when families gather for the holidays. And caregiving is a family affair: More than 75 percent of the care provided within the United States is given by family and friends. So this November, when your family is together for Thanksgiving, take the opportunity to check on Mom, Dad, or other family members, to find out whether they could use help of any kind.

Many of us do assess our loved ones’ living situations reflexively. We look in the refrigerator to check the expiration dates on food products, inspect the home to determine whether repairs are needed, and, most important, sit down with loved ones to talk about how they are doing. Discussing these kinds of issues with family members means dipping our toes into the caregiving pool.

Family conversations about personal autonomy can be challenging. Mom or Dad may say everything’s fine, something akin to “Don’t worry about me.” But you may see your mother having trouble walking, or notice a pile of unopened bills going back several months. You may see dents or scrapes on cars that were unblemished before; or you might notice prescription bottles that have no refills remaining.

Here are some tips for how to start the family conversation:

• Take the focus off the person who may need caregiving. Use the famous “I” statements: “I’m worried about you, Mom”; “I want to be sure that everything is OK”; “I noticed the car had a broken side-view mirror.”

• Try finding a local news article to jump-start the conversation. It might have a title along the lines of, “Senior Center Open: Offering Classes and Meal Program.”

• Talk about a friend who’s having issues with her older parents. For example, say, “My friend Jean’s mom is getting frail. How do you think she should talk to her mom about getting help?”

No matter how you start the conversation, always remember that everyone would like to remain independent and in charge all our lives. Caregiving is NOT about taking away control; it’s about helping the people you love to lead the best possible lives.

Complications exist—family dynamics, where family members live, and how to share the care. Who will take the lead? What can everyone do to juggle the time commitments involved? How will we pay for all this?

When we look at caregiving across the country, we see that expenses do add up, and caregiving uses many of our resources. Make no mistake about it: Family caregivers are the backbone of the long-term-care system in the United States, because they provide unpaid care that in 2007 had an estimated value to the U.S. economy of $375 billion, according to a new AARP study. That’s more than total spending for Medicare in 2005 ($342 billion) and is roughly equivalent to the revenue totals of Exxon ($377 billion) and of Wal-Mart ($351 billion) in 2006.

Caregivers definitely have a tough time in the workplace. In particular, of those with the most intense levels of caregiving responsibility, most arrive late to work and leave early or take time off during the day. Many take leaves of absence, and some report giving up work entirely. Business suffers in this situation, too. According to the AARP caregiving study, the net productivity losses to U.S. businesses from employees’ family-caregiving obligations are estimated to be as high as $33.6 billion a year.

When asked, caregivers almost always respond by saying something like, “I’m just being a daughter” or “I’m doing what family does—take care of each other.” That “taking care” takes a toll. Caregivers often get caught in the trap of providing help while ignoring their own needs. They let social relationships go, they cut back on their community involvement, and they even spend less time with their own families.

As mentioned earlier, too, there are usually financial consequences of being a caregiver. Taking time from work results in lost wages and may trigger loss of benefits, such as paid health care. In addition, retirement savings may be lowered because of reduced income, and Social Security earnings may be diminished.

In the United States, we need to work on multiple solutions to help caregivers help the ones they love. We need to improve families’ abilities to better manage their everyday care responsibilities, reduce their own burdens and health risks, and promote higher quality of life both for the older adults receiving care and for the family members providing it.

Family-friendly workplace policies are one place to start. Respite care programs, which allow caregivers to take time off from their responsibilities while knowing that a trained volunteer or professional is taking care of their family member, can also reduce the stress of being a long-term caregiver.

This column is for caregivers. Knowing the volumes of information on long-term care that’s out there these days, I will concentrate on the family member or friend who is helping a loved one. I hope that readers of this column will benefit from the tips and ideas that I provide on helping families better manage the caregiving roles that they embrace.

Caregivers provide the support that loved ones need, but they cannot do so effectively if they neglect their own well-being. As the airline safety instructions state:

“In the event of an emergency, when the oxygen masks deploy due to loss of cabin pressure, put on your own mask first, and then assist others.”

Elinor Ginzler is a national expert on independent living and aging issues. She currently serves as AARP’s lead spokesperson on caregiving, housing, and mobility issues, including older drivers’ safety. She has appeared on or contributed to many industry and consumer news outlets. She is co-author with Hugh Delehanty of “Caring for Your Parent: The Complete Family Guide,” published by Sterling Publishing. Ms. Ginzler earned a B.A. at the University of Pennsylvania and completed her graduate studies at the University of Maryland.

 

Original Article:http://www.mayoclinic.com/health/aging-parents/HA00082

Aging parents: 5 warning signs of health problems
From the Mayo Clinic

If your parents are getting older, you may want to make sure they’re taking care of themselves and staying healthy. But it’s difficult to monitor the health of your aging parents from miles away. Use your next visit with your parents to ask about their health and find out if there’s anything you can do to help them maintain their independence.

Sometimes your parents won’t admit they need help around the house. Other times they may not realize they need help. Here are five things to look for on your next trip home to help you gauge if your aging parents could use some help.

1. Have your aging parents lost weight?

Many people think that being thin is healthy, but losing weight without trying is a sign that something’s wrong. Weight loss could indicate a significant health problem in your aging parents, such as:

* Cancer
* Dementia
* Depression
* Heart failure
* Malnutrition

Talk to your parent about scheduling a doctor’s visit if you think his or her weight loss may be a sign of illness. Keep in mind, though, that the reason behind your parent’s weight loss isn’t always disease related. Your parent could be having difficulty finding the energy to cook, grasping the tools necessary to cook, or reading labels or directions on food products. Age-related changes to your parent’s body could mean that nothing tastes as good as it used to. Talk to your parent about your concerns. Together you can find ways to make cooking easier or to make food more appealing.

2. Are your aging parents safe in their home?

Take a look around your parents’ home, keeping an eye out for any red flags that might mean they’re having trouble maintaining their home. Are the lights working? Is the heat on? Has the well-maintained yard become overgrown? Are there dirty dishes in the sink? Is their home cluttered with piles of newspapers and magazines?

Think in terms of safety. Do your parents have difficulty navigating the narrow stairway? Have your parents mentioned any recent falls or injuries? Note any changes in your parents’ hearing and vision. Difficulty reading directions on prescription medications or hearing a doctor’s advice could pose safety threats.

Any big changes in the way your parents do things around the house could provide clues to their health. Scorched pots could mean a parent with dementia is forgetting about dinner cooking on the stove. Neglected housework could mean depression is robbing your parent of the motivation to take care of the home. Light bulbs that haven’t been replaced could indicate that physical impairments make it impossible for your parents to keep up with the regular maintenance around the house.

Point out potential safety issues to your parents. Together you may be able to devise a plan to fix these problems.

3. Are your aging parents taking care of themselves?

Pay attention to your parents’ appearance. Notice if they’re keeping up with their usual personal hygiene routines. Are your parents’ clothes clean? Do your parents appear to be taking good care of themselves?

Failure to keep up with daily routines, such as bathing, tooth brushing and other basic grooming, could indicate health problems. Dementia, depression or physical impairments could be to blame, and are among the most common reasons why older people move to an assisted living center.

4. How are your aging parents’ spirits?

Note your parents’ moods. Everyone has good and bad days, but a drastically different mood or outlook could be a sign of depression or other health concern. Ask your parents how they’re feeling. Do they seem withdrawn or blue?

Talk to your parents about their activities. Are they still connecting with friends? Have they lost interest in hobbies and other daily activities? Are they involved in social organizations or clubs? If they’re religious, do they attend regular services?

Tell your parents if you think they seem down or depressed. Encourage your parents to see their doctor and talk about their feelings.

5. Are your aging parents having difficulty getting around?

If your parents have any health conditions that make it difficult to get around, they may have difficulty caring for themselves. For instance, your parents may experience muscle weakness, joint problems and other age-related changes that make it difficult to move around.

Pay attention to how your parents are walking. Are they reluctant or unable to walk usual distances? Is knee or hip arthritis making it difficult to get around the house? Does your parent need a cane or walker? Talk to your parents about ways to make getting around easier.

If your parents are unsteady on their feet, they may be at risk of falling. Falls can cause major injuries and even death in older adults. The good news is that you can help your parents prevent falls by making their home safer and helping them stay active.
What to do if you have concerns about your aging parents

Talk with your parents if you have any concerns about their health and safety. Knowing that you’re concerned about their health may be all the motivation your parents need to see their doctor. Some parents may need a little more encouragement, so let them know that you care about them and that you’re worried. Consider including other people who care about your parents in the conversation, such as other relatives, close friends or clergy.

Together you and your parents can come up with solutions to problems around the home. Perhaps your parents could use assistive devices to help them reach items off shelves or to help them stay steady on their feet.

In talking with your parents, you might decide that it’s time for them to get some help around the house. Home care service workers can help with small tasks, such as errands and cleaning. Or it may be time to consider a long term care facility, such as an assisted living center.

If your parents aren’t willing to listen to your concerns or if they dismiss your claims, you can take other measures. Call your parents’ doctor for guidance. Some signs of medical problems aren’t easily spotted in a doctor’s office, and your concerns may help the doctor understand what to look for in your parents on their next visit. Your parents’ doctor won’t discuss private information with you unless your parents have given the doctor permission to discuss their care with you. However, their doctor or health care provider may be glad to hear your insights. Your parents’ doctor may also want to make sure he or she is allowed to speak with you regarding your parents’ care. In the United States, patient privacy is governed by rules often referred to as HIPAA, or the Health Insurance Portability and Accountability Act.

HIPAA does not prevent a doctor, nurse or health plan employee from discussing your parent’s care with you if it’s in the best interest of your parent. For example, if discussing your parent’s care would help a doctor take care of your parent, that’s considered in your parent’s best interest. You may have to fill out a form stating that you can discuss your parents’ medical information with their doctor or doctor’s staff.

You can also seek help from local agencies. For instance, the county in which your parents live may have social workers who can evaluate your parents’ needs and put them in touch with pertinent services, such as home care workers and help with meals and transportation. Your local agency on aging — which you can find using the Eldercare Locator on the Department of Health and Human Services Web site — can connect you with services in your parents’ area.

 

Navigating Care For Aging Parents
Nov. 29, 2008 (WebMD)

From http://www.cbsnews.com/stories/2008/11/26/health/webmd/main4634170.shtml

Hannah Kalil is 83 years old, and lives by herself in upstate New York. She has aides who help with her caregiving throughout the day. But the responsibility of managing her finances, health care – both mental and physical – and long-term living situation falls to one person: her daughter – and my mother – Eleanor.

It’s almost a full-time job. Making sure my grandmother is happy and not feeling lonely means daily visits. Her never-ending stream of medical issues means weekly – if not more frequent – trips to the doctors. Paying her rent and her aides, while keeping an eye on the bottom line, means constant vigilance if she is going to have any financial security in the long term. Finally, my mother must deal with the endless stack of paperwork for Medicaid and health insurance.

To make matters worse, my mother shoulders these responsibilities on her own – despite the fact that her two brothers and sister all live nearby.

This situation is not uncommon: When an aging parent needs care, it’s often one child out of several siblings who steps up to the plate to offer help. And with more Americans living longer – to 75 years and beyond – this scenario will only become more familiar.

WebMD talked to experts for their insights into the aging of America. What it means for adult children, like my mother, who are put in a position to care for their aging parents. How the one child who shoulders the responsibility of parent-care can enlist the help of others, without starting a family war.

Aging in America

The dynamic of age in America has shifted dramatically over the last 60 to 80 years, experts agree, and its impact on the family is clear.

“There is definitely a changing age structure within families today,” says Neal Cutler, PhD. He is the executive director of the Center on Aging for the Motion Picture and Television Fund in Woodlawn Hills, Calif. “Its cause is simply greater longevity.”

With more Americans living well beyond their 70s, more adult children are now left in a position where they have to be caregivers for their aging parents.

“There’s a greater likelihood today that, as a 55-year-old, you will have surviving parents, than there was say in the 1920s when both parents passed away before you reached the age of 50,” says Cutler, who is also dean of the American Institute of Financial Gerontology. “This means that middle-agers, who are planning for their own older years, also have to think about their parents.”

To complicate matters, one adult child of an aging parent often bears the responsibility of the parent’s care alone. What factors play a part in determining who takes on the care of Mom or Dad?

“There is a gender bias in terms of who cares for an aging parent,” says Lisa Hollis-Sawyer, PhD, coordinator of the Gerontology Program at Northeastern Illinois University. “It’s fairly universal that we think of women as a caregiver, so their role in helping an elderly parent is not uncommon.”

Another factor in determining who will take on the role of caregiver to a parent is age.

“It’s also likely it’s going to be the oldest,” Cutler tells WebMD.

“While gender does play a big part, now – with women in the workforce – it’s not necessarily the case anymore, and age and order of birth can come into play.”

But there’s more to who is going to care for a parent than gender and age.

Instead, siblings should consider who is the best fit.

It’s selective matching, explains Hollis-Sawyer, meaning that personalities, geography – simply who lives the closest – and finances all play a role in determining who might be able to provide the best care.

Caregiving for an Aging Parent: Taking Charge

If you are nominated – willingly or not – to be the caregiver for an aging parent, dealing with the situation can be a challenge. It can be especially difficult if your brothers and sisters aren’t willing to recognize their sibling responsibility.

What’s the key to enlisting the help of your family to ensure the best care for your parent? Read on for tips from the experts that will help you wade through not only the family issues that caring for a parent presents, but the practical ones as well:

Open the lines of communication

As a family, with all of your siblings and surviving parents, talk about how you will care for Mom or Dad before the situation turns into a crisis, suggests Cutler.

“Anticipate that these are decisions and choices that are best made before a crisis happens,” says Cutler. “Sit down with everyone together, and talk about what you want to do, whether it’s a financial issue or geographical issue. The key is conversation rather than crisis management.”

Then, when it is time for a parent to reach out to their children for help later in life, it’s clear who is responsible for what, from a financial and support perspective, without creating a family conflict.

Pick an age

Have this conversation when your parent is still of a “functional” age, whether it’s your mother’s late 60s or early 70s – meaning she still has her mental and physical health on her side.

“A good guideline is to talk about long-term care with a parent when issues like a health care proxy or living will come into play,” says Hollis-Sawyer. “If these are topics a person needs to think about, then how their long-term care will be handled should also be on the table.”

Support comes in many shapes

If one person is elected to be the primary caregiver for a parent, the siblings should think about how they can provide indirect support, whether it’s by pitching in with paperwork, finance management, or in-person help.

“A family needs to think about how to help support the sibling in charge of a parent, either with help or compensation of some sort, to help defray the cost that they are incurring,” says Steven Stern, PhD, a professor of economics at the University of Virginia, who specializes in aging and disability.

Understand the finances

“Talk to a financial planner about finances if you are caring for an aging parent on your own,” says Cutler. “You may be able to take a parent as a dependent on your tax return, if you are paying for more than half of their well-being, such as rent, nursing home care, or food.”

The financial aspects of caring for an aging parent need to be taken into consideration for the sake of your parent, but also for your own sake.

“Increasingly, the baby boomers will stay in the workforce longer, primarily because they can’t retire on time because of the need to care financially or otherwise for a parent, maybe even a grandparent, and the cost of raising children,” Hollis-Sawyer tells WebMD.

When help isn’t forthcoming

If the productive discussion before a crisis strikes doesn’t happen, and one child is left in charge with no support from his or her siblings, the key is still communication.

“This situation happens a lot,” says Hollis-Sawyer. “When it does, the caregiver has to look at their options, and ask themselves questions like, ‘Would I benefit by attempting to communicate my needs to others?’”

Reaching out to your siblings or other family members for support is a better option than trying to take on the situation entirely on your own.

“If you do reach out, and you don’t get the help you need internally from your family, then it’s time to look elsewhere,” says Hollis-Sawyer. “Turn to your community for support, like county-wide respite-care programs, or caregiver support programs, or estate-planning consultations to understand the financial issues at hand.”

It’s not all about you

Pay attention to your parent and his or her needs, and remember that there are two people in this situation – not just one.

“It’s so important to realize that there is a lot of stress to being the care recipient,” says Hollis-Sawyer. “There are just as many mental hurdles that need to be overcome for the aging parent – like accepting care and depending upon someone else almost entirely later in life maybe when you’d like to be financially secure – as there are for the adult child in charge of their care.”

The Upside of Caregiving for an Aging Parent

While the responsibilities of caring for an aging parent might overshadow the benefits at times, it’s important to remember the rewards of the situation as well.

“There are definitely benefits of a positive caregiving relationship for an elderly parent and an adult child,” says Hollis-Sawyer. “The bonding experience can create an intimacy that may not have been encountered when the adult child was going through their own mid-adult phase. Maybe hopefully, they are becoming closer to the parent.”

Many people, she says, find that caring for an aging parent is a growth experience, which creates an opportunity for both people to learn more about themselves.

For the parent, having a child around to spend time with, and provide care, may make a difference in quality of life.

“When kids provide help for the parent, it has a significant effect on the parent,” says Stern. “They have a stronger emotional connection to their child than they would to a stranger who is an aide or a nurse in a living facility. While it may not necessarily make them healthier, I believe it does make them happier.”

By Heather Hatfield
Reviewed by Louise Chang
©2005-2008 WebMD, LLC. All rights reserved.

Becoming ‘parent of your parent’ an emotionally wrenching process
By Mindy Fetterman, USA TODAY

From http://www.usatoday.com/money/perfi/eldercare/2007-06-24-elder-care-cover_N.htm

First you get phone calls that seem kind of strange. Mom is quitting her bridge club because “they think I’m stealing from them.”

A week later, she mentions an old boyfriend from the war who’s coming to take her to dinner. You think, OK, it could be true.

Then the police call from her house. “Your mom thinks there’s someone hiding under her bed.”

Now you know. The forgetfulness, the fantasies, are dementia, Alzheimer’s, something like that. Your sister suspects the worst.

This isn’t just the story of one petite brunette with terrific legs who was called “Shorty” by her husband, granddaughters and daughters, including me.

This is the story of millions of Americans caring for elderly parents and maneuvering in the murky worlds of medicine, law, hospitals, nursing homes, guilt, fear and family ties.

It’s estimated that 34 million Americans serve as unpaid caregivers for other adults, usually elderly relatives, and that they spend an average 21 hours a week helping out, according to a study being released today by AARP. Millions more grown children are calling regularly, flying into town every few weeks or months or just stopping by to take Mom or Dad to the doctor.

Among boomers who are helping their parents, 89% say the responsibility is only a “minor sacrifice” or “no sacrifice at all,” according to the USA TODAY poll. But as their elderly parents get older, some boomers are beginning to worry they won’t be able to care for them in the future.

AARP estimates that the economic impact of this “free” care was about $350 billion in 2006. That’s more than the U.S. government spent on Medicare in 2005. It exceeded the size of the federal budget deficit in 2006.

AARP estimates that unpaid caregivers who contribute financially spend an average of $2,400 a year on care. Those who put in more than 40 hours a week spend much more: an average of $3,888 of their own money each year, AARP says. But when a parent actually moves into the children’s home, the total cost isn’t really added up. Families pay and pay and pay, emotionally and financially.

The typical unpaid caregiver is a 46-year-old woman who works outside the home while taking care of a relative, according to AARP. That burden forces her to cut the hours she works at her regular job by about 41%, causing her salary and benefits to fall sharply.

The National Alliance for Caregiving (NAC) estimates that $659,000 per person is lost in pensions, Social Security benefits and wages as adult children — mainly women — take time off from work to care for their parents.

The physical toll can be severe, too. Caregivers report having one or more chronic conditions, such as high blood pressure, at nearly twice the rate of all Americans. Of those who say their health has worsened because of caregiving, 91% report depression.

Caring for elderly parents also can threaten the emotional health of caregivers and their families. Being the “parent of your parent” can unlock your family’s hidden dysfunctions — “You were always Mom’s favorite!” — and reopen old sibling rivalries and conflicts: “You’re trying to kill our father!”

If you never really got along with your parents or your siblings, it can be even more stressful. Elder care can exhaust and sometimes demoralize the caregiver who’s on the front line. And it can frighten and confuse elderly parents.

“My dad was never a gentle soul when we were growing up; he was a military guy,” says Nia Wilson, a lawyer with the state of Pennsylvania. “His kids were additional troops he had to keep in check.”

Now she spends most weekends driving about five hours from Harrisburg, Pa., to Washington, D.C., where her 84-year-old mother is caring for her 90-year-old father, who has Alzheimer’s. Her two brothers live nearby but don’t help much, Wilson says.

“They think they help, but not as much as I would like,” she says with a sigh.

In most families, women — daughters or daughters-in-law, aunts or nieces — typically assume the burden of care, according to the NAC. Wilson says her parents want to stay in their home, even though they probably belong in an assisted-living facility, she thinks.

“We keep raising the idea with Mom,” Wilson says. “But she says, ‘Don’t worry about me. I’m OK.’ ”

Starting to take over

After a second midnight call from the police, the sergeant tells my sister: “You all need to do something about your mom.” But what?

A plane trip back home to Louisville, and we face her: “Shorty, you have to see the doctor. We’ve made an appointment. Let’s go.”

She smiles and nods.

The next thing we know, the skittish 75-year-old woman has sneaked out of the front door and scampered across the street to a neighbor’s house. We find her hiding — literally hiding from her daughters — behind a tree in Mr. Trinkle’s backyard.

She’s frightened by what she senses is happening to her. On some level, she realizes she’s losing her ability to think and reason. But right now, she’s afraid of what might happen to her. She’s afraid she’ll be taken from her home and placed in a nursing home.

So she runs. What now?

A friend suggests calling in a man. “Women of that era will do what a man tells them,” she says.

I call my ex-husband, a man Shorty has known since he was 8 years old. “Put on a suit and tie and bring the Mercedes over,” I tell him. “Shorty will go to the doctor with you.”

He does. He talks her out from behind the tree and into the front seat of the big car. “Can I go, too, Mom?” I ask, tentatively.

Shorty talks only to John: “Tell her she can come, but she has to sit in the back seat.”

Starting to take over for your parents can be one of the most distressing experiences of a lifetime. “It’s so much more difficult, because they are our parents; we are the children,” says Julie Lucero of Vacaville, Calif.

For the past two years, Lucero’s 79-year-old father, Edward, has been living in her home with her three children.

“Right now,” she says, “we’re fighting about his driving. Not out of malice, but because I know it’s better for everyone if he doesn’t drive anymore. Heaven forbid if he injures himself or someone else.”

Her father, who has had some fender benders and mistakenly parked in the wrong driveway, disagrees. “They can take away my driver’s license, but I’m still driving,” he declares.

After Shorty had been driving fairly cluelessly for two years or so, we hid her keys. Her dementia had progressed to the point that she didn’t remember that she couldn’t find the keys. She had been a widow for 25 years; driving was vital to her.

A battle over keys can be the first struggle between elderly parent and child. “It’s my responsibility now,” Lucero says. “I have to decide.”

Obtaining legal rights

One trip to a gerontologist with Shorty confirms what we suspected.

“Your mother is very charming,” the young doctor says. “She even flirted with me. But she really doesn’t know what’s going on.” She couldn’t tell time or count change. She didn’t know who the president was. She didn’t know what day it was.

The doctor prescribes an anti-psychotic drug to help with the voices in her head. He checks her into a psychiatric ward for four days, primarily to give my sister and me time to figure out what to do.

“She can’t live alone,” he says. “She needs 24-hour care.”

So we begin the trek across town to assisted-living facilities and nursing homes. Both of us are single working women, so taking Shorty into either home isn’t an option.

Some facilities we see are elegant replicas of colonial homes with oriental rugs and cherry wood furniture. Lovely, but we realize she likely needs more medical care than those retirement homes could provide. (We suspect they were decorated more to please the adult children than the residents.)

Other facilities are starker, more medicinal. In one, a man was screaming. Shaken, we go home.

We try in-home care. But Shorty keeps firing people. We try her former house maid of 30 years, a woman who was 78 herself. She stays about five days, until Shorty throws her clothes out an upstairs window, yelling, “Get your —- out of here!”

We try an apartment at an assisted-living condo. Shorty calls a taxi three days later and has herself taken home. She lives at home alone for another year, with my sister stopping by each day after work to check on her. Very stressful.

Finally, we have her committed. We get a lawyer, take her to court and have her declared incompetent.

We sit across from a jury and testify against our own mother. My sister is named her guardian. We check her into a nursing home with an Alzheimer’s wing. That means the doors are locked.

“You’re doing the right thing,” the lawyer says.

Maybe, but we feel terrible.

Ray Payton knows the feeling.

She had to go to court to have her grandmother declared incompetent. Now she must file forms with the court every six months to prove she’s not wasting or stealing her grandmother’s money.

“I’m the legal guardian of my grandmother, who has dementia,” says Payton, 35, whose parents are deceased. “I thought, ‘How could me, a grandchild, take her to court so I could pay her bills?’

“I felt like I was being a bad granddaughter.”

Straining a family

Every rivalry you had with your brothers and sisters, every argument you had with your parents, every effort you ever made to become independent can be put to the test once your parents become old and sick.

You find yourself arguing with your siblings, arguing with your spouse, arguing with your parents, arguing with yourself.

“The No. 1 thing you’ll fight about is money,” says David Horgan, a producer of TV commercials from Ludlow, Mass. His 69-year-old mother-in-law moved in with him and his wife, Julie, and three kids about three years ago.

“We fight about Grandma a lot. My wife will say: ‘What do you want me to do? It’s my mother!’ And it goes back and forth, and then it escalates. As a good daughter, she always feels guilty, and I always come out the bad guy.”

They’ve spent thousands of dollars on a new air-conditioning system for their home because of his mother-in-law’s lung problems. He loves and admires her but feels crowded in his own home.

“The toughest thing is that she is a beautiful woman, the kindest and nicest person,” he says. “She’d do anything for you. But as soon as you live on top of each other, it’s hard.”

Lucero has nine half-siblings. Her father, who divorced her mother when Lucero was young, lived with one son for two years. He has only Social Security and some veteran’s benefits, about $600 a month. No savings. He can’t afford a nursing home or an assisted-living facility.

She wishes his other children would help more. “It was my choice to take him on, but now that he lives with me, they say, ‘Oh, Julie’s got it covered.’ ”

In my mom’s case, one daughter lives near Shorty, the other — me — lives hundreds of miles away. So the nearest sister gets the burden of visiting every week, often twice. She’s saddled with the emergency runs to the hospital and trips to the doctor’s office.

The faraway sister spends thousands of dollars on plane tickets and rental cars and buys most of her mother’s clothes and necessities. She spends money to keep up her mother’s house, so we can sell it. She spends money because she’s not there to help, and she feels guilty about everything.

Shorty’s money starts draining away, faster and faster. Nursing home care is $60,000 a year. After a few years, her savings are nearly gone. So we sell the house and most of her stuff. We divide the valuable and sentimental things. I ship home my new antiques.

We realize we’ve done exactly what Shorty feared that day she ran across the street and hid behind the tree: We’ve sold her belongings, taken her rights and put her in a nursing home.

In our minds, we know we did the right thing. But we feel terrible.

Epilogue: Evelyn Fetterman died in February at age 84. She had been living in assisted living or a nursing home for 10 years. Her daughters are sad and tired. They miss their mom the way she used to be. They’re relieved that it’s all over. And for that, they feel terrible.
 

PBS Special Reveals Stories of Love, Hope, and Loss
“Caring for Your Parents”

“Caring For Your Parents” is a Kirk Documentary Group, Ltd. Production for WGBH Boston.

As the population ages, many adult children are grappling with an unprecedented social, economic, and personal revolution as they become the primary caregivers for their aging parents. With family members now responsible for 80 percent of elder care in the United States, nearly every generation is feeling the ripple effects of the aging process.

“Caring for Your Parents” is a moving, two-hour special that draws much-needed attention to this emotional and universal reality. Incorporating a 90-minute documentary and a 30-minute panel discussion. (Watch show online).

The first 90 minutes of “Caring for Your Parents” covers the struggle to keep parents at home, tension among adult siblings, and the complexity of shifting caregiver roles, through an intimate look at five American families. In the end, the documentary—produced, written, and directed by award-winning filmmaker Michael Kirk—contends that successful caregiving requires one primary ingredient: love.

“Aging is the chapter in life that is too often skimmed over. However, it is a critical topic that directly impacts all of us, or will in the very near future,” Kirk said. “It’s imperative that we turn to our loved ones today so we are prepared for what happens tomorrow.”

Over the course of the film, Kirk examines the caregiving process through the experiences of families from varying cultural and economic backgrounds. The documentary exposes struggles to keep parents at home, shows the impact of caregiving on marriages, and reveals the financial repercussions of elder care. Through the stories of these five families, we are also given a glimpse into the often unnoticed emotional and physical effects of caregiving. Other stories explore the decision to stop driving, loss of independence, and tension among caregivers and medical professionals.

Immediately after the 90-minute documentary, medical correspondent Dr. Art Ulene leads “A Conversation About Caring.” This 30-minute panel discussion offers concrete advice and guidance on how to start the conversation—often the most difficult step in caregiving. The panel of experts includes AARP Publications editor-in-chief and co-author of “Caring for Your Parents: The Complete AARP Guide,” Hugh Delehanty; Newsweek columnist Jane Bryant Quinn; best-selling author of “Passages,” Gail Sheehy; renowned physician Dr. Cora Christian; and leading elder-care expert, Dr. Bill Thomas.