Table of Contents

Part 1 Problem Solving Amid Confusion 1

1 What's Really Wrong with My Parent? 3

Signs That Something Is Amiss 4

Aging's Big Four 6

Heart Attacks 7

Brain Attacks 9

Cancer 12

Alzheimer's and Other Dementias 13

Getting a Heads-Up: Geriatric Assessments 19

Researching Medical Conditions 21

2 Defining Problems: Considering All Viewpoints 23

Appreciating Your Parents' Perspective 24

Deciphering What's Really Going On 26

Identifying Your Motivations and Emotional Triggers 29

Defining the Problem 32

3 Developing a Caregiver Game Plan 35

Identifying Caregiving Needs and Tasks 36

What's the Goal? 41

Set Your Criteria for Your Solutions 42

Sizing Up Your Life and Resources 44

Creating Solutions 45

Plan B 47

4 Getting Your Caregiving Plan Organized 49

Doing the Advance Work 50

Setting Up a Portfolio 52

Long-Distance Caregivers-More Advance Work 53

Delegating Tasks and Family Meetings 56

Holding a Family Meeting 57

Meeting Preliminaries 58

Sample Agenda 59

Rules of Engagement 60

Social Networking and Online Information Sharing 61

5 Managing Your Stress 63

Understanding the Toll of Stress 64

How Stressed Are You? 68

Caregiver Emotions: Breaking It Down 70

Guilt 70

Worry 72

Sadness and Depression 73

Resentment 74

Anger 75

Everyday Stress Relievers 77

Respite Care by the Day and Vacations 78

Support Groups: Real and Virtual 80

Caregiver Covenant 81

Part 2 The Elder Care Landscape: Know More, Act Confidently 83

6 Caregiving Services to the Rescue 85

Geriatric Care Managers 85

Community Services 88

Adult Day Centers 90

Home Health Care 93

Nonmedical Senior Care 96

Public Caregiving Programs 98

Eldercare Locator: Locating Services Nationwide 99

Area Agencies on Aging 99

Home and Community-Based Services Waiver Programs 101

The Veterans Administration 101

Medicare 102

Benefits Checkup 103

7 Finding the Best Living Option for Your Parent 105

Living at Home 106

Universal Design 106

High-Tech Services and Devices 107

Electronic Medication Dispensers 108

Sensors for Stove Safety 108

Activities of Daily Living Remote Monitors 109

Telehealth Devices 109

High-Touch Human Services 110

Independent Living Communities 110

Assisted Living 113

Skilled Nursing Facilities 114

Research Nursing Homes 116

Consider the Costs 118

Alternative Living Arrangements 119

Group Homes 119

ECHO Housing 120

Natural Occurring Retirement Communities (NORC) 120

Moving Made Easy 121

8 Common Legal Matters and How to Work Through Them 123

Having That Conversation with Your Parents 124

Elder Law Attorneys 125

General Power of Attorney 128

Durable Health-Care Power of Attorney 129

Wills, Letters of Instruction, and Trusts 131

Wills 131

Personal Property Memorandum and Letter of Instruction 133

Trusts 135

Testamentary Trusts 135

Revocable Living Trusts 135

Irrevocable Living Trusts 135

Guardianship as the Last Resort 136

Understanding "Do Not Resuscitate" Orders 137

Part 3 Managing Medical Life 139

9 Getting Organized Medically 141

Navigating Body Parts Medicine 141

Finding a Captain: The Primary Care Doctor 144

Preparing for Doctor Appointments 145

How to Relate to Your Parents Doctors 145

What to Ask the Doctor 147

Managing Medications 149

Getting Health-Care Providers on the Same Page 152

A Few Pointers on HIPAA Privacy Rules 154

10 The Insurance Maze 157

The ABC's and D of Medicare 157

Hospital Insurance: Part A 158

Medical Insurance: Part B 158

Medicare Advantage Plans: Part C 159

Prescription Drug Coverage: Part D 161

Medigap Policies: Alphabet Soup 162

Medicaid: State Assistance 163

Long-Term Care Insurance 164

State Health Insurance Programs 167

Fighting Back: Filing Appeals 168

11 When Your Parent Is Hospitalized 173

The First Hurdle: Finding the Best Hospital 173

Once Admitted, Are You Really a Patient? 175

Meet the Hospitalist 177

Getting Out Alive 179

How to Stop an Early Discharge 181

Everybody's Favorite: Emergency Rooms 183

What Are They Saying? Understanding Medicalese 184

12 End-of-Life Care 189

Stages of Coming to Terms with the End of Life 190

Living Wills or Advance Directive 192

What Dying People Want 194

The Painless Promise of Palliative Care 197

When to Call in Hospice 198

Part 4 Family Dynamics in the Swirl of Caregiving 203

13 Working Through the Generational Gap 205

Describing the Generations 206

Baby Boomer Missteps 209

See a Problem, Fix a Problem … Quickly 209

Question the Doctors, Search for Experts 211

No Reaction Means They're Okay with It 211

Let's Hire Some Help 212

Greatest Generation Missteps 213

Disregard Risks 213

Ignore the Facts 214

Suppress Information 215

Use the "Parent Card" 216

Finding Common Ground 217

14 Siblings and Caregiving: Making It Work 219

Childhood Revisited 219

Mom and Dad's Role in Shaping Your Relationship 222

Gender Bias 223

Playing Favorites, Competition, and Labels 224

Refocusing Your Sibling Lens , 225

Recognize What You're All Going Through 226

Parents' Perceptions 227

Refocusing How You See Your Siblings 228

Reacquainted and Working Together 230

15 Making the Family Dynamic Work 235

Elder Care's Impact on Family Structure 236

Dimensions of Blended Families 237

When Blended Becomes a Battleground 240

Caregiving Styles Within Families 241

Facilitating 242

Balancing 242

Advocating 243

Directing 243

Working Families: Setting Realistic Expectations 244

New Times: Mom, Will You Hire Me? 247

Part 5 Communicating in Sync 249

16 Reaching Accord: Styles of Communicating for Caregivers 251

The Four Styles of Communicating 251

Passive Communicators 252

Aggressive Communicators 253

Passive-Aggressive Communicators 254

Assertive Communicators 255

What's Your Style? 256

Using a Style That Works 258

17 Four Classic Elder Care Conflicts 263

Unsafe Drivers Who Won't Give Up the Keys 264

When Dementia Makes Living Alone Unsafe 266

Considering Your Spouse's Feelings When Your Parent Moving In Is Up for Discussion 267

Soliciting Help from Siblings When You're the Caregiver 271

If Your Sibling Doesn't Get Along with Your Parent 272

Ways Your Sibling Can Help Without Interacting with Your Parent 273

18 Talking Through Money Issues 275

Why You Should Talk About Money: The Costs of Elder Care 276

It's Not Just About the Money 277

What's Your Money Style? 280

The Saver 280

The Spender 281

The Avoider 281

The Worrier 282

Talking Through Money and Elder Care Issues 282

A Few More Financial Considerations 284

19 Talking Through Dementia 289

Family Emotions 290

Sadness and Depression 290

Anxiety, Anger, and Guilt 291

Embarrassment and Isolation 291

Dementia's Seeds of Discord 292

Communicating with Someone Who Has Alzheimer's 294

Establishing a New Normal 296

The Care Receiver's Values 298

Appendixes

A Resource Directory 301

B Caregiver Forms 317

C Medical Forms 321

Index 325