The phone rings at 2 a.m. Your mother's voice shakes as she tells you your father has been rushed to the emergency room. You have so many questions, most of which your mother cannot answer. If you live nearby, you head to the hospital. If you don't, you have to decide whether the situation is serious enough to make a trip.
See also: Ways to deal with caregiver stress.
Either way, you're in the midst of a caregiving crisis. It's stressful. It's overwhelming. But it can be managed. Here's how.
If you haven't had a crisis yet, being organized can help you better manage that call (and panic less) once it does happen. Compile a list of your parents' medications, their doctors' names and phone numbers, their medical history and copies of any advanced directives such as living wills, recommends Susan Fleischer, president of the National Association of Professional Geriatric Care Managers. Write all this down and keep it in a handy place. Memory often fails you in moments of crisis.
During the last years of her mother's life, phone calls at odd times were a common occurrence for caregiver Laura Shumaker, 55, of Lafayette, Calif. "It sounds silly and obvious, but when you are mentally prepared for the phone ringing at odd and unsettling times, you're able to go into problem-solving mode more efficiently," says Shumaker.
Develop a network
Whether you're near or far, having a go-to group of people who can support you in times of crisis is a must-have, says Fleischer. Get names and numbers of your parents' neighbors who can check your parents' home if you haven't been able to make contact. Attend at least one doctor's appointment with your parents so you can meet their primary care doctor and find out the physician's emergency contact information. Find friends or family who would be able to house sit, pet sit or babysit at a moment's notice.
Select a family spokesperson
"Some people think better when they're in a crisis," says Fleischer. "And some people become so scattered." Figure out who in your family performs best under pressure and designate him or her as the one to interact with doctors, nurses, social workers and other hospital personnel.
If no one is up to this task, or you're a long-distance caregiver, Fleischer suggests hiring a geriatric care manager (GCM). A GCM, which costs between $50 and $200 an hour, can coordinate information between doctors and help you figure out the next step after the hospital stay, whether it's establishing supports necessary to return home or choosing the best assisted living or nursing home for your parent's needs. For long-distance caregivers, a GCM can also help you determine whether you need to hop on the next plane or you can wait a couple of days. Some employers provide GCM services as part of their benefit packages, so call your provider and ask what elder care services are offered.
Establish one information source
Once a crisis happens, your cellphone will likely be overloaded with voice mails, text messages and emails from concerned family and friends. Telling the same story again and again can be mentally exhausting, says Fleischer. Websites such as CaringBridge.com or CarePages.com allow you to write updates in blog form and send them to a mailing list of your choosing. Fleischer suggests you set up a site before a crisis occurs, so that it's ready to go if and when you need it.
Yes, Dad adamantly wants to go back home after leaving the hospital. But as a caregiver, it's your job to do a reality check, says Fleischer. Is the home a safe place for him to be? Is he mentally competent to live alone? Can he afford in-home care? If living independently is no longer an option, what locations are available and what can he afford?
Fleischer recommends checking out assisted living and nursing home facilities in your area before a crisis happens so you have some idea of which places you like and which you don't, as well as what your parents can afford. If you didn't do this, the hospital social worker or a GCM can direct you to an appropriate facility.
Next: Express your love. >>
Support your parent
Our aging parents dread nothing more than becoming a burden on their children, says Janet Belsky, a psychology professor at Middle Tennessee State University and author of textbooks on life span development. So your ailing parent is dealing with feelings of guilt over getting sick, helplessness over his or her physical state and fear over what the illness means for the future.
In the midst of all these emotions, a parent needs to know you care. "Say, 'I love you and you're everything to me,' " says Belsky. "It would be an enormous support to them."
Go easy on yourself
It's common for caregivers to feel guilt about their parent's condition, worried that they could have done something to prevent it. Don't do that to yourself, says Belsky, because odds are there's nothing you could have done to prevent the crisis.
Forgive yourself for the seemingly shameful emotions you might be having — relief that mom has to go to a nursing home or hope that her suffering will end soon. "It's awful to watch someone fail," says Belsky. "Don't feel bad about these negative emotions, because everyone has them."
Instead, find someone whom you can confide in — maybe a spouse, a friend, a therapist — and talk about what you're going through. Having someone to lean on through these difficult times will give you the strength to make the tough decisions and endure the caregiving roller coaster.
Cynthia Ramnarace writes about health and families. She lives in New York.
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