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50+: Live Better, Longer

Caring for the Caregiver

Life as a Caregiver
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Making Difficult Decisions continued...

Like Vivian, some bring their loved one into their homes, managing their care the best they can. Others try "long-distance care" -- letting mom stay in her own home, hiring care managers who act as surrogate children, making sure she gets her medications, gets to the doctor, etc.

For others, assisted living centers where people live fairly independently -- or nursing homes that provide complete care -- might be the most viable options.

Some issues help make the best choice clearer. What type of assistance does mom need? Does she need help with daily living activities, like bathing, dressing, getting from the bed to the wheelchair? Or does she need total nursing care? Is the family caregiver available all day or just in the evenings? Can the family transport her to community services, like day care programs? Can they take her to medical appointments?

For some families, the logistics of transporting an elderly parent -- especially during a busy work week -- can be a significant problem, says Kelly.

Every family needs some guidance in figuring it all out, she says. "That's where a case manager can help. It really helps to talk through these things with somebody who understands the range of options," Kelly tells WebMD.

Letting mom stay in her own home -- and managing her care long-distance -- may seem like a good option until you talk with a case manager. "If you're at a distance, you may have to travel more frequently to check in. That extra cost, along with the cost of care, can be significant over time."

Then again, the emotional component of relocation may defy all rational arguments, says Kelly. "Relocating may seem like the best option, but not what the older person wants to choose at that time. You can't discount the emotional aspect. Sometimes it takes a crisis to precipitate a decision."

Figuring Out Finances and Legal Issues

Legal and financial issues must be dealt with early, says Kelly. How do you pay for it all? Who will make decisions about the patient's care when incapacity strikes? Sorting through the legalities is a complicated issue, one that involves -- among other things -- setting up trusts to preserve assets, she tells WebMD. It also means assigning "durable power of attorney" status, which gives legal power to the adult caregiver.

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