Caregiving

I’m drawing up a living will — Can you explain the medical terms I’m encountering?

DEAR DOCTOR K: I'm drawing up a living will, but I don't understand many of the medical terms I'm encountering. Can you help?

DEAR READER: Many people, certainly including me, have asked themselves how they would want to be cared for if they became very sick and unable to speak for themselves. The two most common ways of doing that are to designate one trusted person, such as your spouse, who knows your wishes to make decisions for you -- a health care proxy. Another is for you to write a living will.

Why does marriage have such a positive effect on patients with cancer?

DEAR DOCTOR K: I read about a study that said married cancer patients do better than those who aren't married. Why does marriage have such a positive effect?

DEAR READER: You're probably talking about a study that was published earlier this year in the Journal of Clinical Oncology. The study included about 735,000 people diagnosed with 10 different types of cancer. Married men were 23 percent less likely to die of cancer than those who were single, widowed or divorced.

How can a geriatric care manager help me take care of my elderly father?

DEAR DOCTOR K: Taking care of my elderly father, with his complicated medical care, has become more than I can handle. A friend suggested I hire a geriatric care manager. How can this person help?

DEAR READER: Caring for an elderly parent takes a lot of time, energy and patience, and it may also cause financial strain. But caregiving also can be wonderfully rewarding. Even if you do find it rewarding and don't want to stop playing a major role in caring for your parent, you might still feel overwhelmed.

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?

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 often feel guilty and frustrated when taking care of my mother with Alzheimer’s — Can you help me change my outlook?

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 my parents both 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 wife is in her late 70s. Lately she appears very tired and agitated in the evenings. I talked to a doctor friend who said she might be "sundowning." What is sundowning, and what can we do about it?

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.

How can I help care for my elderly mother long-distance?

DEAR DOCTOR K: How can I help care for my elderly mother? She lives alone, but not close enough for me to visit regularly.

DEAR READER: My father died young, but my mother lived into her late 70s. She lived 3,000 miles away, and alone. As she started to lose some of her energy and independence, it was pretty stressful for me. You just can't know what's going on with the person you love. Supervising care and handling problems that arise are difficult, too.

Should I have an advance directive?

DEAR DOCTOR K: I've been very ill and have been hospitalized several times in the past year. I don't have a fatal disease, just a chronic illness. Should I have an advance directive? Can you tell me about it?

DEAR READER: What if you suddenly get very sick, due to accident or illness, and cannot communicate what type of medical care you want to receive? Advance directives are legally binding documents that allow you to control how you are treated if and when you can't speak for yourself.

What are bedsores and how can they be prevented?

DEAR DOCTOR K: I care for my elderly mother, who is confined to her bed most of the time. I'm worried about her getting bedsores. How can I prevent them?

DEAR READER: You're right to be concerned, since bedsores cause pain and can lead to serious infections. Fortunately, there are several things you can do to prevent your mother from getting them.

What are the long-term care options for my elderly parent?

DEAR DOCTOR K: My elderly father lives with my family. But I have my own health issues and don't think I'll be able to care for him much longer. What are my options for long-term care?

DEAR READER: When I was in medical school, there were basically two options for long-term care: People moved in with their kids, or they were cared for in nursing homes. Nursing homes were an option only if the older folks had medical conditions that required constant nursing care.