Millions of Americans coping with disabilities, illnesses, and chronic health conditions rely on family members, friends, and neighbors to get by. Caregiving is so much part of our national ethos, in fact, that an estimated 34 million adults have served as unpaid caregivers to someone age 50 or older in the previous 12 months, according to a recent study.

Family caregivers must learn, among many other things, to manage someone else’s medications; to talk to doctors and nurses on their behalf; to help them bathe or get dressed; and to generally take care of their household tasks, finances, meals, and so on.

This guide will help prepare you for managing the day-to-day activities for a parent, spouse, sibling, or adult child with a chronic condition who cannot care for him or herself. We’ve covered all the basics in an easy-to-understand format.

Family Care vs. Professional Care

As someone facing the responsibility for another’s care, your first thought might be, “I’ll do it myself.” But the do-it-yourself approach is fraught with personal sacrifices and financial risks including lost wages if you drop out of the labor force entirely as well as diminished pension and Social Security benefits. The total tab can run into tens of thousands of dollars.

The cost of professional caregiving help can be staggering. Here are average yearly costs for care:

Care Provider Average Annual Cost for Service
Adult day care center $18,200
Homemaker services $20,008
Home health aide Alaska* $59,488
Home health aide in La. & W. Va.** $36,608

Sources: MetLife, Genworth 2015 Cost of Care Survey

* Nation’s highest, ** Nation’s lowest

Are You Ready to be a Caregiver?

No one will blame you for not being prepared to be a caregiver — most Americans aren’t. It’s a role that’s thrust on many people without warning and leaves them with that in-over-my-head feeling.

It pays to weigh your caregiving options and plan for likely situations. Ask yourself five questions if you’re considering becoming a caregiver:

1

Do You Have the Skills and Stamina?

It’s important to assess your own availability, stamina, personality, and skill sets. Can you be your loved one’s chief provider of care, which might include offering help with dressing or bathing, preparing meals, providing medication management along with transportation to physician appointments? Can you handle someone else’s finances, for example, including insurance and Medicare matters?

2

Can Take Care of Your Loved One by Yourself?

The impulse may be admirable, but if your loved one needs intensive or constant attention, you’ll almost certainly need help from other family members, from professional caregivers, or from both.

3

Are You Prepared Financially?

Studies show that caregivers’ most common expenses were on household goods, food and meals, transportation costs and medical care co-pays and prescription drugs. Are you in a position to foot these bills for a loved one? Will other family members help out financially? Will you have financial support from siblings, for example, to get part-time help from in-home caregivers or by taking the person you’re caring for to an adult daycare facility maybe periodically?

4

Could Being a Caregiver Endanger Your Own Livelihood?

If your job is your chief source of income, make sure that taking on caregiving responsibilities won’t put you at risk of jeopardizing it. Do you have a flexible work schedule? Does your employer have policies in place to help caregivers? Either way, talk with your superiors about why your schedule is likely to change. They’re likely to be more understanding if they know about your situation in advance.

5

Do You Have the Support You’ll Need to Take On Caregiving?

Life as a full-time caregiver can affect your physical, mental, and emotional well-being. Seek the social support and resources you will need, including relying on other family members for assistance and for providing you with regular breaks from caregiving.

Snapshot of Caregiving in the U.S.

  • 34 million:

    Adults who’ve served as unpaid caregivers to someone age 50 or older in the previous 12 months

  • 75:

    Average age of caregiving recipient

  • 49:

    Average age of caregiver

  • 60%:

    Caregivers who are female

  • 86%:

    Caregivers age 50 and older who care for a relative

  • $45,700:

    Average household income of caregivers

Source: Caregiving in the U.S., a study by the National Alliance for Caregiving and the AARP Public Policy Institute.

Setting up a Routine: Your To-Do Checklist

Lay Out Everyone’s Expectations

What are your loved one’s wishes in terms of how you will live and work together? It makes sense to get everyone on the same page from the start.

Set Priorities

Make a list of your loved one’s day-to-day needs and how you plan to meet them. In caregiving, organization is the key to success.

Delegate

Make another list of all the tasks with which you need help and then make a list of all the people who can help you — family members, other relatives, friends, neighbors, friends, and so on. Then ask for help and have your loved one do some of the asking, too.

Create Backup Plans

Ask others to be on call in case of unforeseen events. Write down your care plans and schedules, and give copies to all family members and others who are involved and might be able to step in as needed.

Inventory Your Loved One’s Records

Make sure you know where all your loved one’s important documents and passwords are kept. Essentials include bank accounts, retirement accounts, investments, safe deposit boxes, wills and trusts, and medical information.

Find and Use Support When You Need it

If you’ve taken on the role of primary caregiver, don’t try to do everything on your own. Make sure you set aside time for communicating and coordinating with others and don’t be reluctant to call in professional help when needed.

Hold Family Meetings

Schedule them regularly to discuss and revise care plans, medical needs, finances, transportation issues and how things are going generally. Use these meetings to keep little issues and irritations from becoming big ones.

5 Free Tools for Caregivers

Many apps and trackers can help make caregiving life easier, and the list is growing. Most are free, or reasonably priced, so be sure to find the right ones for you.

Here are five top caregiving apps:

CareZone

This free app lets you use your computer, smartphone, or tablet to safely organize files, contacts, and medications, and coordinate with family members and other caregivers using a shared calendar and journal. You can also use it to record notes and observations; to maintain a synchronized to-do list and a database of contacts; and a medication-management function. There’s also a place to upload important files and photos.

CaringBridge

This free app allows you to start a free, privacy-protected website that you can use to share updates, photos, videos, and the like and thereby transform your personal connections into caregiving support when you need it most.

Elder411

This app provides lots of information based on the writings of Marion Somers, an experienced geriatric care manager and eldercare expert.

RxmindMe and Medisafe

Medisafe and Walgreen’s RxmindMe are medication and reminder apps to track a user’s intake of medications, vitamins, and supplements. Both are no-cost apps, and available on Apple devices. Medisafe is also available on Android devices.

Lotsa Helping Hands

This free app (iPhone and iPad only) bills itself “a painless way to organize help,” and its central feature is a calendar where you can ask for help — with things like meals for the family, rides to medical appointments, or just visits. It sends reminders and helps to coordinate logistics automatically to avoid things from falling through the cracks.

5 Websites That Help You Coordinate Care

If you’re on a new journey of caring for a loved one, you’re going to need some help along the way. Here are five excellent starting points for finding local and medical help online:

BenefitsCheckUp

This site, a project of the National Council on Aging, lets you quickly determine whether your loved one might be eligible for financial help with prescription drugs, health care, utilities, and other basic needs through more than 2,000 federal, state, and private benefits programs. Benefit Finder, a similar service from the U.S. government, covers more than 1,200 federally funded benefit and assistance programs.

Eldercare Locator

This online lookup tool, a service of the U.S. Administration on Aging, is a great way to find help where you live (just enter your Zip code) in more than a dozen different areas — from adult day care programs to transportation.

Family Caregiver Alliance

This information-packed website includes the Family Care Navigator, a state-by-state directory of services and assistance.

NeedyMeds

This nonprofit website has lots of information on programs to help people who can’t afford medications and health care costs. NeedyMeds also offers a free drug discount card that’s honored by more than 63,000 pharmacies nationwide.

VA Caregiver Support

Taking care of a veteran? You can find your local Caregiver Support Coordinator through this U.S. Department of Veterans Affairs website, plus lots of other information about VA programs for caregivers including skilled home care and respite care.

Legal Tools to Manage Health & Finances

It’s a good idea to identify, locate, and organize all the documents you’ll need as a primary caregiver. A good place to start is this “Caregiver’s Document Organizer” from the National Caregivers Library.

Here are four key documents you should have (or at least be familiar with):

Durable Power of Attorney for Finances

Gives you the authority to make legal and financial decisions on your loved one’s behalf, even if he or she has impaired cognitive abilities or becomes incapacitated. (See the MoneyGeek page Protecting Your Parents’ Finances to learn more.)

Durable Power of Attorney for Health Care/Health Care Proxy

Allows you to make all decisions regarding your loved one’s health care — from health care providers and medical treatments to end-of-life matters — but only if he or she is no longer competent or able to make such decisions. (See the MoneyGeek page Protecting Your Parents’ Finances to learn more.)

HIPAA Authorization

Allows your loved one to grant you access to his or her health information and medical records, which are otherwise required to be kept private under the Health Information Portability and Accountability Act (HIPAA). Although HIPAA is a federal law, most state government web sites offer blank HIPPA authorization to disclose forms, which you can download and use.

Living Will or Advance Directive

Allows your loved one to spell out, in advance, the type of medical care he or she does and does not want to receive. (See the MoneyGeek page Protecting Your Parents’ Finances to learn more.)

If you need professional help preparing any of these documents, check with the American Bar Association Commission on Law and Aging or the  National Academy of Elder Law Attorneys.

Siblings & Family Dynamics When Caring for Parents

Providing care for an aging or ill parent, the Family Caregiver Alliance points out, “can bring out the best and the worst in sibling relationships.”

In an ideal world, caregiving is a time for siblings to come closer together and put their own differences aside. Separate families become one. Unfortunately, however, things don’t always work out this way. Conflicts can arise, for example, when there’s an unequal division of caregiving duties, or when one sibling is in denial over a parent’s condition. It’s not uncommon, either, for male siblings to expect their female counterparts to take the lead in caregiving, or for an out-of-town sibling to leave most of the burden on the shoulders of the brother or sister who lives closest to the parent.

How can families keep frictions at bay and stay united to provide the greatest level of care for a loved one? Here are five tips to make caregiving as painless as possible

  • Keep Everyone in the Family Informed

    Share information honestly and directly, and if you need help, ask and don’t wait for others to volunteer.

  • Be Realistic

    Allow siblings to help in ways they are able to. Divide tasks according to individual abilities and current life pressures.

  • Don’t Take Others For Granted

    Be sure to thank everyone who helps including family members. Expressions of appreciation, even small ones, make a difference.

  • Keep Battles From Becoming Wars

    If communication breaks down, arrange a family meeting that includes a trusted third party, such as a social worker, counselor, religious leader, or friend.

  • There’s Always a Way to Help

    Maybe you can’t be on the scene 24/7 to care for a parent. But you may well be able to give your sibling a once-a-month caregiving break, or arrange for meal deliveries or respite care. What may seem like small gestures can make a big difference in keeping everyone together.

Tax Breaks for Caregivers

Generally, you can claim some care-related expenses, such as unreimbursed medical expenses for a spouse, dependent, or other qualifying relative as a deduction or credit on your federal taxes. A qualifying relative can be a parent, step-parent, mother- or father-in-law, or any other person who lived with you all year as a member of your household.

Many states have their own state tax deductions and credits to provide financial relief to caregivers.

The federal and state caregiver and medical expense tax rules can be tricky, so be sure to consult a tax professional before filing your returns.

Respite Care: Giving Caregivers a Break

The demands of caring for a loved one with a chronic disease or disability — including Alzheimer’s disease and other forms of dementia, cancer, diabetes, and Parkinson’s disease, to name just a few — can be extremely challenging. Studies have found that caregivers to those with chronic illness experience mental or emotional strain that could put their own health at risk.

Here are some strategies to cope with the stresses of caring for someone with a chronic condition:

  • Make Time For Yourself

    Schedule some “quiet time” every day to clear your head. Stay connected with friends. Seek out respite care so you can step off the caregiving treadmill occasionally.

  • Take Care of Yourself, Too

    Eat balanced meals, exercise, get enough sleep, and see your doctor right away if you experience any health issues.

  • Ask For Help

    Understand that you can’t do everything. Plan for and use respite time to give yourself time to recharge and take care of your own needs.

  • Reach Out

    Even if the person you’re taking care of is housebound, don’t let yourself become isolated.

It’s important, too, to find groups that can offer physical, emotional, and psychological support to you as a caregiver. Caring.com, for example, hosts more than 50 online support groups for caregivers, many of them focused on chronic conditions.

Churches, senior centers, hospitals, and disease-specific charities run thousands of caregiver support groups. For example, the Alzheimer’s Association online lookup tool will help you find support groups and education groups near you. The U.S. Administration on Aging’s Eldercare Locator can help you find services for older adults and their families. Other disease-specific charities offer support groups, too.

Finding Respite Care

As the U.S. population ages and at-home care has grown, respite care has grown in use. Respite care has many forms, but it has one purpose — a facility (or in-home service) where the primary caregiver hands-off responsibility for the person cared-for to someone else.

Respite care can be planned, such as instances where the caregiver needs to attend to their own needs, or emergency care where the primary caregiver is unable to take care of the cared-for person. Respite care is available for older adults and special needs children. It’s available for day use, commonly called Adult Day Care, and overnight care. It takes many other forms, too. In fact, the Access to Respite Care and Help lists a dozen different models used in in-home respite care.

It’s a good idea to plan for respite services before you need them. Follow this checklist when considering either a respite facility or in-home respite provider:

Checklist for Choosing a Respite Care Provider
  • Visit the facility or speak with the candidate provider on the phone

  • If your state licenses facilities of providers, check with the state to learn if the provider has unresolved complaints or violations.

  • For in-home providers, ask for references

  • Review costs

  • Select a provider and sign a contract or memo outlining costs

  • Scheduling respite dates

Depending on the medical issue of the person you’re caring for, it may make sense to schedule dates well in advance to give him or her a sense of structure and familiarity to the respite care. For some conditions, such as Alzheimer’s disease, a change in scenery and caregivers can have a therapeutic effect.

Paying for Respite Care

If the person receiving care is eligible for Medicare, he or she must pay 5 percent of the Medicare-approved amount for inpatient respite care. Here is where you need to talk to the doctor of the person receiving care to learn if the care is approved. This, of course, will depend on many factors, including the intensity of care required.

In the person you’re caring for is a veteran, the VA offers respite care to veterans of all ages. This benefit applies to inpatient, outpatient, and home settings.

The Financial Toll of Caregiving

Caring for a loved one can take a heavy toll on your financial well-being.

  • 37 percent:

    Caregivers who say these responsibilities have forced them to quit, retire early, reduce hours, or take a leave of absence.

  • 1 out of 2:

    Caregivers who say they’ve incurred more than $5,000 a year in out-of-pocket costs caring for a loved one.

  • 1 out of 5:

    Caregivers who say they spend more than $20,000 a year on such costs.

  • 2 out of 3:

    Caregivers who worry about the impact of caregiving on their own savings.

Source: Surveys by Caring.com

Caregivers Must Ask for Help: Expert Q&A with Sherri Snelling

expert Sherri Snelling Author

Sherri Snelling is the author of A Cast of Caregivers: Celebrity Stories to Help You Prepare to Care and a nationally recognized expert on caregiving. She is the founder and CEO of Caregiving Club, a former chairman of the National Alliance for Caregiving, and a contributing columnist on caregiving for PBS Next Avenue, Forbes.com, Huffington Post, and CareLinx.

What’s the biggest mistake most beginning caregivers make?

First is lack of planning. When there is no plan, a caregiver’s emotions can become frayed, finances can be depleted, and the caregiver can become physically exhausted. Having at least some questions answered ahead of time and knowing what your loved one wants is essential to every caregiving situation.

Second is neglect of the caregiver’s own health and wellness needs. Many caregivers become more ill than the person for whom they are caring. That’s why taking care of yourself while caregiving is so critical.

Why do so many caregivers see it as a personal failure to have to ask others, including family members, for help? What approach should they take?

Some caregivers aren’t sure what others can do to help; others feel no one else can provide the quality of care a loved one needs. That’s why exploring other avenues — seeking support services through the caregiver’s employer (many offer caregiving or elder-care help), getting help from other family or friends, or securing professional caregiving help — is so important. There are also some great online communities where caregivers can find help. (Editor’s note: See Tools for Caregivers for links to these and related apps.)

Caregiving is a marathon, not a sprint, and thinking you can do it all alone is a mistake.

Is it possible to be a “long-distance caregiver” if you can’t move near your loved one?

Some 8 million Americans are long-distance caregivers, meaning that they live more than two hours away from their loved one. In addition to the extra financial burdens (including, of course, the costs of traveling back and forth), long-distance caregivers often have “blinders” on because their infrequent visits home are typically short and everyone puts on a happy face. Not seeing the day-to-day activities makes it more difficult for long-distance caregivers to really understand the red flags that a loved one needs more help.

For most long-distance caregivers, it becomes important to find professional help, either with companies that provide trusted in-home care or through a geriatric care manager who can assess the loved one’s situation and then guide a caregiver to the best home and community-based services.

It also becomes imperative to create a local circle-of-care team — your loved one’s friends, neighbors, doctors, and so forth. They’ll become the eyes and ears you need to ensure that your loved one is getting the right kind of care.

Why do caregiving challenges so often generate rivalries and friction among siblings, especially when one adult child is local and another isn’t? How best to keep the peace?

The fear of watching a family leader become frail and vulnerable affects everyone. Emotions run high, and family dynamics become accentuated. The roles we played as children — bossy older sister, unreliable younger brother, etc. — can become areas for frustration and anger.

If one sibling lives close by, the hands-on caregiving typically defaults to that person. Any siblings living farther away have to be careful of giving too much “well intended” advice, because they’re not there on a daily basis and may not know the details. Offering financial support is often the best role for them — especially if it’s to give the hands-on caregiver a much-needed respite.

If families can’t resolve conflicts on their own, I always advise them to bring in a neutral third party, such as a geriatric care manager, to counsel them through these episodes.

How important is respite care?

On average, caregivers are in their role for four to five years, and for those caring for someone with Alzheimer’s it could be a 15- to 20-year journey. That’s why respite care is essential. Exhaustion and stress can wreak havoc with your immune system, and respite care becomes the needed prescription. It’s good to think of it like a daily vitamin.

Special Needs For Chronic Conditions

It’s not unusual to feel overwhelmed in your role as a caregiver for someone with a chronic condition. Fortunately, every chronic condition has a care game plan caregivers can follow. Take these steps before you jump into a caregiver role. Learn:

  • What causes the condition

  • The condition’s effects, and warning signs a caregiver needs to watch for

  • Your role, if any, in treating the condition

  • The likely outcome for people with this condition

Here are the challenges that caregivers face for common chronic conditions.

A stroke can occur when there is a blockage or rupture in a blood vessel leading to the brain.

Background Information

Chronic high blood pressure, high cholesterol, diabetes and obesity are risk factors for developing conditions that can lead to a stroke. Blood clots, weakened or hardening of the arteries can cause a stroke.

Effects of Stroke

Impairments from a stroke vary and depend on several factors like the type of stroke, how quickly medical attention was given, how severe it is and number of strokes. Caregivers may have a lot of responsibility in the care of a stroke victim. They could lose functionality in movement and sensation, talking, eating, vision, cognitive ability, perception, bowel and bladder control, emotional control, and overall self-care.

Treatment for Stroke

Urgent treatment for stroke consists of either surgery, medication or both from a professional medical staff. After which, a caregiver can help coordinate home care services or assist in choosing a rehabilitation facility if necessary.

The VA has a research center in Florida that explores treatments in neuroplasticity to help restore cognitive, motor and emotional fuctioning.

Outcomes of Stroke

Outcomes vary depending on severity of the stroke and how quickly it is assessed and treated. Stroke patients can develop significant long-term cognitive and physical impairment, language dysfunction and depression. Others may have minimal dysfunction. Because each outcome is different, caregiver support must be tailored to each person.

Dementia is general memory loss and/or other mental disabilities that are severe enough to interfere with daily life. The most common type of dementia is Alzheimer’s disease.

Background Information

Dementia is caused by damage to the brain, inhibiting proper cell communication which can lead to cognitive impairment, memory loss and adversely affect behavior and emotions. It may be triggered by having a stroke, thyroid problems, depression, medication side effects, alcoholism, or vitamin deficiencies.

Effects of Stroke

Dementia can cause confusion and impair the patient’s ability to handle daily tasks. Caregivers may need to assist them in bathing, dressing, eating, administering medications, and keeping them safe in general.

Treatment for Stroke

Because the cause for Alzheimer’s disease and other dementias is unknown, treatments are limited. Some medications may improve the symptoms of Alzheimer’s disease, and physical exercise may help. Caregivers will be asked to keep the patient engaged and participating in social events, which may slow the effects.

Outcomes of Stroke

Dementia is usually progressive and cannot be reversed. The caregiver will be asked to watch for signs of progression, depression, and in some cases violent outbursts.

Cancer involves the uncontrolled growth of abnormal cells that invade and spread throughout the body.

Background Information

While the exact cause of cancer is unknown, certain factors have been found to trigger its growth. Genetics and carcinogens such as tobacco, asbestos, arsenic, and radiation and anything that decreases immune function have been found to be factors.

Effects of Cancer

The effects of cancer can be pain, fatigue, and swelling. Most effects are from the treatments administered to battle the cancer, however. Nausea, vomiting, loss of appetite and a diminished immune system are also effects of certain cancer treatments.

Treatment for Cancer

There are several different treatments for cancer, depending on type and stage of cancer. A caregiver may need to help with general care after surgery, chemotherapy, radiation or other treatments that leave the patient weak or temporarily disabled.

Outcomes of Cancer

The outcome and prognosis of cancer is directly related to what type of cancer and at what stage it is found. A cancer patient may have complete remission and go on to live a full life, whereas another found in late stages may have weeks to live. Caregiving needs can be short- or long-term depending on the treatment and the type of cancer.

Multiple sclerosis that is a degenerative disease affecting your brain, spine, and optic nerves.

Background Information

Studies have not yet shown a clear cause for MS. However genetics, smoking and certain viral infections may increase the risk of developing the disease.

Effects of MS

MS effects vary from person to person. Some patients will be mildly impaired while others may experience blurred, double or loss of vision, muscle weakness, loss of balance and coordination, and possibly the inability to walk.

Treatment for MS

While there is no cure for MS, treatment includes medications that may slow down the progression of the disease. Various rehab programs can help at any stage of MS, and the caregiver may be asked to participate in physical and occupational therapy.

Outcomes of MS

A majority of people MS are diagnosed with relapsing-remitting MS (RRMS). This type of MS is characterized by episodes of relapses or flare-ups followed by periods of remission. While MS is unpredictable, early treatment may slow or halt this progression. Caregivers will be expected to report changes in activity level to the patient’s doctor.

Arthritis refers to joint pain or disease that can involve inflammation in one or more joints.

Background Information

Most common in women as they age, arthritis risk factors include excess weight, family history, age, certain infections, trauma, smoking, and high uric acid levels.

Effects of Arthritis

Pain and fatigue are often associated with arthritis, in addition there may be swelling, stiffness and loss of range of motion. Everyday tasks can become intolerable and they may need assistance with dressing or self-care. In certain cases, physical deformities may occur, causing loss of positive self-image.

Treatment for Arthritis

Arthritis can be treated with medications, physical therapy, surgery, natural supplements, and pain therapy. Alternative methods such as acupuncture and meditation may provide relief.

Outcomes of Arthritis

Arthritis outcomes vary on type of and location of the disease, as well as which treatment proves effective for the patient. Some may find relief after certain treatments, or suffer from mild to debilitating pain and total disability.

A mental illness or disorder is a mental or behavioral pattern that causes either suffering or a disability to function on a daily basis.

Background Information

The exact causes of mental illnesses are not known. Speculation centers around a combination of genetic, biological, psychological, and environmental factors. Emotional or physical trauma, drugs, and genetics may play a factor in developing mental illness.

Effects of Mental Illness

Effects of mental illness can include anxiety and mood swings, long-term abnormal changes in thinking, and impaired functioning. Those with mental illness may avoid social environments and have hallucinations. Caregivers need to watch for emotional imbalances that could lead to suicide or risky behavior as well.

Treatment for Mental Illness

Treatment varies. Medications can be targeted to the illness such as anti-depressants, anti-anxiety, anti-psychotic, and so on. Also available treatments could include psychotherapy, brain-stimulation treatments and also hospital or residential treatment as either in or outpatient treatment.

Outcomes of Mental Illness

Mental illness can affect daily tasks and cause personal, social and occupational impairment. It potentially can contribute to many situations leading to disability, pain, or death. Caregiver treatment must be tailored to each patient’s needs.

Chronic respiratory diseases are recurrent diseases of the airways and other parts of the lung. These include asthma, chronic obstructive pulmonary disease (COPD), lung cancer, cystic fibrosis, sleep apnea and occupational lung diseases.

Background Information

Chronic respiratory diseases can develop as a result of age, genetics, allergies, certain viruses, environmental factors such as smoking, but can also occur from long-term exposure to irritants, such as such as pollution, chemical fumes, or dust.

Effects of Respiratory Diseases

Those with chronic respiratory diseases often have a hard time getting through the day at home or work, due to fatigue and shortness of breath. Caregivers should be sure to have on-hand any type of breathing treatments in case of emergency.

Treatment for Respiratory Diseases

Treatment for chronic respiratory diseases include taking medication, increasing physical activity and avoiding triggers such as allergens, smoking and air pollution. Caregivers may need training in use of breathing apparatuses.

Outcomes of Respiratory Diseases

Certain chronic respiratory diseases cannot be reversed or cured, but they may be slowed down by avoiding future flare ups and taking medication. Some maybe life-threatening and can progressively lead to death.

A fractured hip in an elderly person is one of the most serious injuries from a fall, and difficult to from which to recover.

Background Information

Weak bones such as from osteoporosis and a loss of balance due to aging can lead to disastrous consequences. Most hip fractures are from falling sideways.

Effects of Fracture

Hip fractures reduce independence, at least temporarily if not for a long time. Complications can include blood clots in the legs or lungs, bedsores, urinary tract infection, pneumonia, and muscle loss. Caregivers should watch for signs of depression, which is common in type of incidents.

Treatment for Fracture

There are surgical and non-surgical treatments for a hip fracture, depending on the severity of the break and the patient’s health — if they are well enough to handle the surgery. Some fractures are repaired with plates and screws, others with a total hip joint replacement.

Outcomes of Fracture

Hip fractures can be life altering. Many patients lose some or all of their independence, and in some cases the fall can potentially lead to shortening the patient’s life. Caregivers should be aware of the physical and occupational therapy goals to aid in restoring the patient to independence.

Autism, or Autism Spectrum Disorder, are general terms for a serious and complex developmental disorder that impairs the ability to communicate and interact.

Background Information

Although there is no clear answer as to what causes autism, scientists believe genetics and environmental factors are involved. Autism is more common in prematurely born children.

Effects of Autism

Autistic children may exhibit impairments in social interaction and communication, repetitive and or inappropriate behaviors and have restricted interests. Verbal outbursts, crying, atypical eating habits, and self-injury can be some of the effects of autism.

Treatment for Autism

Early intervention is critical for successful treatment, which includes both medicines and various forms of behavioral therapy. Structured therapeutic activities that focus on social skills, language and communication, daily living, play and motor skills are helpful.

Outcomes of Autism

Autism is typically regarded as a lifelong condition that will affect communication skills, relationships, adaptive skills, academic and vocational attainment. Some behaviors may improve but a full recovery is not common.

Cancer diagnosed in children and adolescents is commonly found to be leukemia, brain or other central nervous system tumors, lymphoma, rhabdomyosarcoma, neuroblastoma, Wilms tumor, bone cancer, and gonadal (testicular and ovarian) germ cell tumors.

Background Information

The cause of most childhood cancers is unknown, while others appear to be genetic mutations that lead to uncontrolled cell growth and cancer. Environmental factors are still being studied, as to what the child may have been exposed to in utero or just after being born.

Effects of Childhood Cancer

Short-term effects of childhood cancer are similar to those of an adults from treatments. They can include pain, fatigue, rashes, swelling, nausea, vomiting, loss of appetite and diminished immune system. For children and adolescents, there are long-term effects also to consider, which can include learning disabilities, abnormal bone growth, thyroid, heart, lung, liver, kidney, vision, or dental problems, hearing loss, delayed puberty and fertility problems.

Treatment for Childhood Cancer

Childhood cancer treatments are based on the type and stage of the cancer. Options include surgery, radiation therapy, chemotherapy, and/or other types of treatment depending on the diagnosis. The caregiver will be involved in pain therapy and monitoring nutrition intake.

Outcomes of Childhood Cancer

The outcome of childhood cancers depends on the type and stage of cancer once discovered, but overall a child has an 83.6% chance of surviving five years or more. More than half will experience long-term effects and or secondary cancers.

Cystic fibrosis is a genetic disorder that affects mainly the lungs but also affect the pancreas, kidneys, liver, and intestines.

Background Information

Cystic fibrosis is a complex and chronic disease that can develop when a person has inherited a defective gene from their parents. It can affect people differently. More than 75 percent of CF cases are diagnosed by age 2.

Effects of Cystic Fibrosis

Caregivers of children with CF must always be on alert for breathing problems. There is a heavy mucus associated with this disease that can clog the airway. Many patients have a persistent congested cough, wheezing, breathlessness, repeated lung infections, stuffy nose. In addition, they may have some digestive problems including foul-smelling greasy stools, intestinal blockage, or severe constipation.

Treatment for Cystic Fibrosis

Treatment for CF may include physical therapy to help loosen and clear lung secretions, exercises that can help loosen mucus, stimulate coughing and improve overall physical condition, medications, dietary changes and supplements as well as treatments for intestinal obstruction. A lung transplant might be necessary in severe cases.

Outcomes of Cystic Fibrosis

Currently there is no cure for CF, and with proper medical and psychosocial support, many children and adolescents can lead a productive life. More than half of CF patients are living into their 30s and new medications are helping keep them comfortable. Many children go to school, play sports and have normal social lives.

Cerebral palsy (CP) is a group of permanent movement disorders that appears early in childhood that affects muscle tone and motor skills.

Background Information

Cerebral Palsy is caused by a brain injury or malformation of the brain while the brain is still developing either in utero or immediately after birth. The extent of the disorder is determined by the nature of the injury, where in the brain the injury occurred and how severe it is.

Effects of Cerebral Palsy

There are several symptoms and effects of CP in children. They might experience pain, muscle tightness and spasticity, difficulty moving or involuntary movements, mental retardation, learning disabilities, Attention Deficit Hyperactivity Disorder, seizures, skeletal Problems, vision impairment, dental problems, hearing impairment, trouble swallowing, speech impairment, bladder and bowel problems, breathing problems, trouble eating and skin disorders. Depending on the severity of the impairment, CP children may need a lot of care.

Treatment for Cerebral Palsy

CP cannot be cured but there are many treatments to help the patient cope and as comfortable as possible, including physical therapy, medicines, surgery, equipment and devises to help with movement, and lastly pain management.

Outcomes of Cerebral Palsy

There is no cure for CP and the outcome is difficult to determine with so many variables. However, most children can live long, happy and healthy lives. CP is not a progressive condition and usually does not worsen. In addition, children are still developing both physically and mentally, the outcome depends on a variety of factors.

Long-Distance Caregiving

For the long-distance caregiver, what may start out as an occasional phone call to check in on a loved one can, over time, can turn into regular help with managing household bills, obtaining medical information, and arranging for grocery deliveries — to name just a few examples. Many long-distance caregivers focus on tasks that can be done remotely, such as arranging for in-home care, coordinating insurance benefits and claims, and making sure that other family members are kept apprised of what’s going on. If a sibling or another relative is the primary caregiver, the long-distance caregiver can travel occasionally to lend a hand and provide respite care.

Closing the geographic gap, in fact, isn’t as difficult as it might seem. Some long-distance caregivers have feelings of guilt from not being able to live closer to their loved one, but experts say those feelings can quickly disappear once an appropriate care plan is in place. (It’s also helpful to have an emergency plan in place in the event your loved one is hospitalized.)

It’s important to remember that long-distance caregiving is built around teamwork — maintaining close relationships within your loved one’s caregiving community. Occasional face-to-face meetings, regular communications through other channels (email, texts, daily phone calls, and video-conferencing), and other creative communications and management strategies can go a long toward keeping everyone informed and on the same page.

These two resources are a good place to start:

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So Far Away: Twenty Questions About Long-Distance Caregiving

A publication of the National Institute on Aging that you can download for free.

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Since You Care: Long Distance Caregiving

The MetLife Mature Market Institute offers a free guide to long-distance caregiving, prepared in cooperation with the National Alliance for Caregiving.

Juggling Work and Caregiving

More than one of every six American workers care for a loved one. What’s more, nearly one in four middle-aged and older workers report being family caregivers.

Estimates of the lost-productivity costs to employers of having so many employee-caregivers on their payrolls range from $13 billion a year (MetLife) to $34 billion a year (National Alliance for Caregiving). Yet only 11 percent of U.S. companies with more than 100 employees offer elder care or caregiving support from an employee assistance plan or work-life program, down from 24 percent more than a decade ago.

If you’re a full-time employee and caregiver, consider these tips:

Understand Your Employer’s Policies

Talk to your human resources department or read your employee handbook to ascertain your employer’s policies with respect to caregivers. Find out about any benefits it may offer, such as an employee assistance program. Some employers provide everything from eldercare referrals to low-cost back-up eldercare to paid time off for family illnesses; others offer on-site support groups and manager training that focuses on the needs of caregiving employees.

Know Your Rights

Under the Family and Medical Leave Act, eligible workers are entitled to 12 weeks per year of unpaid leave for family caregiving, without the loss of job security or health benefits. (California provides pay beyond that period.) You may also find it useful to consult the Equal Employment Opportunity Commission’s “Employer Best Practices for Workers with Caregiving Responsibilities.” The EEOC has found that discriminating against workers with caregiving responsibilities may constitute discrimination based on sex, disability, or other characteristics protected by federal employment discrimination laws.

Be Frank With Your Manager

Some organizations are full of “closet” caregivers who fear that their bosses will think they’re not fully committed to their jobs if they double as caregivers. It’s probably a good idea, though, to be upfront about your role as a caregiver and the demands that it may sometimes put on you. If your employer offers flexible work schedules or telecommuting — about a fourth of all companies do — consider talking with your manager about using one of these options on an as-needed basis.

Ask About Flex Time

Do formal policies exist? If not, would your manager be willing to consider an arrangement to help you accommodate your caregiving responsibilities, maybe by letting you work part-time in a job-sharing arrangement?

Paid as a Family Caregiver

Your loved one may be able to — even want to — pay you for your caregiving services from his or her personal resources, through long-term care insurance benefits, or via a government-sponsored assistance program. That may be especially important if you have to quit your job or cut back on your work to provide care. See the MoneyGeek guide Aging in Place to learn more about government assistance programs and tax issues for caregivers.

More Resources for Caregivers

Here’s a list of trustworthy websites and other sources of authoritative information about caregiving.

Websites

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AARP Caregiving Resource Center

Handy list of resources, including links to AARP caregiving-related apps, free books, a care provider locator, and a long-term care calculator.

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ClinicalTrials.Gov

A search tool provided by the U.S. National Institute of Health that allows patients and famalies to look up clinical trails by condition and by location.

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Caregiver Action Network

Advocacy organization for people who care for loved ones with chronic conditions, disabilities, disease, or the frailties of old age.

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Eldercare Locator Resources

Local and national information and resources for caregivers.

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National Alliance for Caregiving

A non-profit coalition of national organizations focusing on advancing family caregiving through research and advocacy.

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Rosalynn Carter Institute for Caregiving

Establishes local, state and national partnerships committed to building quality, long-term, home and community-based services.

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ARCH National Respite Network Fact Sheets

More than 60 detailed fact sheets on all aspects of respite care, including how to choose a provider, national standards, how to pay for respite care, and finding a provider for people needing specialized care.

No-Cost Publications & E-Books

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Caring for a Person With Alzheimer’s Disease

National Institute on Aging publication totaling 106 pages. Covers how Alzheimer’s Disease changes the afflicted, getting help with caregiving, medicines to treat the disease, how to join a clinical trial and end-of-life care.

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Caring for the Caregiver

National Cancer Institute publication focusing on how people can understand their feelings in their roles as caregivers, how to ask for help, caring for themselves, and joining a support group.

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Care for the Family Caregiver: A Place to Start

National Alliance for Caregiving publication totaling 56 pages. Wide-ranging document covering many aspects of caregiving at a glance. Good introduction to caregiving.

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Prepare To Care: A Planning Guide for Families

AARP publication totaling 36 pages. A step-by-step guide for families who want to take a team approach to caregiving. Contains many resources, checklists, and similar hands-on tools for caregiving.

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Time for Living and Caring: Making Respite Service Work for You

Joint California State University San Bernardino and University of Utah document describing respite care and its benefits. This 16-page document contains extensive resources on respite care and caregiving.

Books

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Passages in Caregiving: Turning Chaos Into Confidence

416-page book by Gail Sheehy (William Morrow, 2010)