Caregiving

What can a caregiver do to take care of themselves?

DEAR DOCTOR K: I'm the primary caregiver for my ill, elderly father. I'm exhausted and upset all the time. What can I do to lighten my load without costing us much? Neither of us is well off.

DEAR READER: You're not alone. Approximately one in five American adults helps an elderly or disabled family member with the daily tasks of life. This caregiving runs the gamut from grocery shopping, cooking and cleaning house, to helping with baths and personal hygiene or providing hands-on medical care. That's often in addition to caring for other family members and holding down a paid job.

I care for my mother with Alzheimer’s. How can I ease the guilt and frustration I feel as I watch her decline?

DEAR DOCTOR K: I do my best to care for my mother, who has Alzheimer's disease. But I often feel guilty and frustrated. Can you help me change my outlook -- for my sake and my mother's?

DEAR READER: Fortunately, I never had to face the challenge that you face, as both my parents died while in full possession of their faculties. But many of my patients and friends are experiencing what you are going through. And like you, they often feel guilty and judge themselves harshly.

What is sundowning?

DEAR DOCTOR K: My husband and I are in our early 80s. Sometimes in the evening he is agitated, confused, and just quite a handful to deal with. The doctor says he has "sundowning." What is it, and is there anything I can do?

DEAR READER: Some older people have trouble concentrating, grow agitated or even confused, and become especially fatigued at the end of the day. This phenomenon is known as "sundowning" because its effects tend to coincide with sunset -- usually occurring in the late afternoon into the evening, then settling down late at night.

What can we do to ease my mother’s transition to assisted living?

DEAR DOCTOR K: We've finally convinced my mother to move to an assisted living facility. After spending the past five decades in her current house, she is very nervous about the move. What can we, and she, do to make the transition easier?

DEAR READER: Assisted living facilities are designed for people who can't live on their own because they need help with the tasks of everyday living. The facilities generally provide meals, help with taking medication, housekeeping, laundry and activities. They are not meant for people who need round-the-clock nursing care.

What is palliative care?

DEAR DOCTOR K: My mother was recently diagnosed with cancer. I told her to look into palliative care, but she insists that's for patients who have given up.

DEAR READER: It sounds like your mother may be confusing palliative care with hospice care. It's a common mistake. Hospice and palliative care are often talked about as if they are the same thing, but they're not.

Would palliative care help my ailing mother live out her remaining days comfortably?

DEAR DOCTOR K: My mother has advanced cancer and has only a few months to live. How can we help her live out her remaining days with as little pain and as much peace as possible?

DEAR READER: Sadly, as in your mother's case, there are times when cancer takes hold and doesn't let go. In that situation, palliative care can help maintain quality of life and lead to a "good death." Palliative care focuses on both emotional and physical needs. It makes relief of pain and suffering a top priority. It also provides active support to loved ones and caregivers, including information about how to take care of someone at home.

What are some caregiving services available for my ailing father while I’m at work?

DEAR DOCTOR K: I'm a working mother. I also care for my ill and aging father. Are there professionals or services that can help me care for him?

DEAR READER: There can be plenty of rewards in caring for an ailing parent. My parents both died suddenly while apparently healthy, so I never faced this situation. But I've had many patients and friends who have told me that they got closer to their parents in the process of caring for them. However, that care takes a toll, especially when you're also juggling other responsibilities.

How do I help bathe my aging and ailing parent?

DEAR DOCTOR K: I would appreciate suggestions for how to help an aging and ailing parent to bathe.

DEAR READER: Until you step in to help, you may not even be aware of all the obstacles that can make bathing difficult for someone who is older or ailing. Arthritis, mental confusion or curtailed physical abilities can all contribute. Your first step is to determine what is causing the problem.

Are there services that can help my older mother remain in her own home?

DEAR DOCTOR K: My mother lives alone. She refuses to consider assisted living and insists on remaining in her home. Are there services that can help my mother remain independent in her own home?

DEAR READER: If I were older and alone, I'd be like your mother: I'd want to remain living in my home. We all want to hold on to our independence for as long as possible. Two services can help make this a reality for some people. They are home health care and private duty care.

How can I make my home safer for my elderly mother?

DEAR DOCTOR K: My elderly mother is moving in with me, and I'm worried she will fall while I'm at work or asleep. How can I make my home safer for her?

DEAR READER: With some fairly simple steps, you can reduce your mother's risk of falls. Among people 65 and older, falling ranks as the top cause of injuries. In older people, injuries from falls can be disabling, even fatal.