Caring For The Elderly Caring For the Elderly Videos Where Should Grandma Live? Anyone who is charged with the task of caring for an aging parent, particularly the only surviving aging parent, faces a tough decision at some time in the time of their caregiver years. And that decision is whether to have mom or dad move in with you. When that idea first comes to mind, you can probably think of more negatives than positives. It really goes against your orientation since you moved out of your parent's home as a youth. Since then your entire goal was to live separately from your parents, not to combine them again. How long you consider this idea depends on your living situation as well. If you are unmarried, separated or divorced, you may have the space in your home. And in that situation, you could combine your homes and save considerable money. You would not have to feel bad using a little of your parent's retirement or Social Security money to pay the rent since you would be saving them so much. And who knows? It might be nice to have the company. If you have a spouse and children, however, the decision gets a little more complicated. If the fact that you are even considering letting grandma or grandpa move in with you leaks to the kids, they will probably be extremely enthusiastic about the idea. After all, they love their grandparents and having them live here seems so ideal. But children are not aware of the additional stress having Grandma move in might cause. Additional positives about the idea of letting Grandma live in your home is that you would be there at all times to help with her medications or to jump to her aid in the event of a sudden medical problem. And worry about your parent weighs heavily on you as primary caregiver because the last thing you want is for something to happen to him or her and you were not there to help. Having mom or dad in your home would eliminate those many car trips to their condo, apartment or assisted living center as well. You could include the food preparation in with what you do for your family and in every way, they could just blend in. But when considering the big question of "Where should Grandma live?" most experts in caring for the elderly advise heavily against letting them live with you if it can be in any way avoided. For one thing, parents will be parents. And Grandma or Grandpa would not be able to resist getting in the middle of child discipline situations or being nosey about marital spats or issues that come up with teenage children. Teenagers are elusive enough as it is without having to answer questions from inquisitive grandparents that are around all the time. Within the context of your family, you already have some fairly sophisticated conflict resolution systems. And those work because everybody can read each others signals. Throwing Grandma into that mix would be a disaster. But the biggest reason not to have your aging parent live with you despite some attractive benefits as we have discussed is that you, as your parent's caregiver, need to be able to get away from them for a while. Caregiver burnout is a big problem when everything rests on you for the health and well being of your parent. So it's good for you to be able to go home and just let it go for a while. If that sanctuary away from the stresses of being a caregiver can be preserved, it should be at all costs for the health of you, the caregiver, your family and even for the well being of your parent. After all, maybe Grandma needs to get away from you from time to time as well. When is it Time to Step in? There comes a time in the adult lives of children and their parents when it dawns on you that you might have to step in and begin having a more active in your parent's lives, not as a child but as a caregiver. For every family, that time seems to come as a shock. It's strange because we all see reports on television about the transition that we go through when the parent becomes the dependent one and the child becomes the boss in the relationship. And the hardest part of that transition may be the first time you have to step in and "stage an intervention" because there is an area of life that your parent needs to let go of and you know they won't want to. So what are the signs that its time to step in and suggest or directly take action to make that change in your parents lives? When it comes to driving, your dad or mom's doctor will be able to help by determining if your parent is physically able to drive any more. When the senior citizen's eyesight dims to where he or she cannot distinguish details in the distance or when depth perception is poor so he might not be able to judge where the intersection is or if he is stopped at the stoplight or in the middle of the intersection, the time is right for Grandpa to give up the keys and let someone else do the driving. The time to start the process of moving mom or dad out of their own home and into an assisted living facility may be more tricky to determine. As with driving, the senior citizen will mount every effort to appear to be competent to continue to live independently. That ability to live on our own, go where we want when we want to and take care of our own needs is so fundamental to who we are and to our self esteem that this transition from living on their own to living where everything is done for them is emotionally difficult to be sure. So you as family members and as the caregiver for your parent need to watch for the signs that your parent's ability to take care of the house and of themselves living independently has come. Some of the symptoms of the need for change are: * How is your mom or dad's health holding up? Are they eating well? Check the pantry and the refrigerator. Is it full of good things to eat, fresh foods and lots of supplies for cooking or is it sparse showing that going to the grocery store is a trial for your parent? * Are your parents taking care of themselves? When you come over, do they look like they are sleeping ok? Are they groomed and clean and are their clothes clean and ready to use or is everything wrinkled because its too hard to do the laundry and press shirts and blouses? * How does the house look? Is it in good repair? Is it picked up and the kitchen clean with everything put away? If mom was always meticulous about her kitchen and now it's always a mess, she is having trouble keeping up with the housework. * Does mom or dad stay home all the time? If they were normally outgoing and always up for a car trip, an outing to church or even just the grocery store or even an adventure, becoming a homebody signals that they don't want to go through the trouble of getting fixed up to go out. Of all these symptoms, probably the one that signals the time to step in and take action is immediate is if your elderly parent falls or goes to the floor and then cannot get up. If your mom or dad has to pass the night on the living room floor because they could not get up and had to sleep there until someone showed up to help them, that's an emergency situation that calls for immediate action. Talk to your elderly parent about the risks of living alone, particularly in a scary thing like being unable to get up. By the time such a frightening incident happens, your parent may be suspecting the time to go somewhere that they can live with greater security and safety is here. The Greatest Loss of Them All Perhaps the hardest task you will ever be faced with is to help one of your parents cope with the loss of her spouse. Naturally, this is going to be a traumatic time for the whole family because as much as mom lost her husband and the father of her children, you have lost your daddy and you have grief yourself. So how do you help your mom and grandma to your kids get through this very difficult transition? It will be a time when you will need the understanding and support of your spouse and kids as well. And just as the grief you are coping with in yourself and in your now widowed mother is difficult, you also have to be strong and brave for your children as well. This is the purpose of the funeral because through the good words of the minister, those not as close to the family feel closure that this good life has gone on to his reward. If your dad was ill and going through a lot of discomfort, there is often a sense of relief that he is no longer suffering. And if the family is strong in a religious faith, that assurance of the afterlife is a source of comfort as well. Only you will be able to gauge how much support or comfort your widowed mother needs in the days just after the passing. It's important to remember that grief surfaces in strange ways. Many times the real deep grief does not surface at the funeral or even in the days just after as family stays around to be close and go through group processing of the loss of a loved one. It's when family goes home and the routine of daily life sets in that you should plan to be very accessible to your parent. That is when the emotions of grief will surface in the quiet and privacy of the home. It might be advisable in this kind of situation that you live with the grieving parent for period of a week or two to help with the transition. Another thing about grief is that it is selfish. While we put a noble face on it and say we are grieving "for" the lost one, the truth is the grief is really for the one who remains because it is she who has to learn to go through life's routines without that spouse. By being present during mealtime and those little moments of the day, you can "talk through" the different times when your widowed parent remembers that the dearly departed was part of this part of life. There will be a lot of rebuilding during those first months of being alone. So you as caregiver can help that transition by not letting the times of loneliness be so long between visits. Obviously, your parent will eventually have to learn to get through the rituals of life alone. But be there for her so that transition is not so jarring. But even if your parents was stoic at the funeral and only shows a happy face to the grandkids, there will come a time when she has to cry. Be there for her. Don't try to come up with any "comforting words." Just being present, maybe doing the dishes or pouring each of you a glass of wine can be the biggest comfort you can provide. Finally talk about the dearly departed. Ministers know the value of talking about the fun, interesting and wonderful things about the dearly departed. It is a way of reminding ourselves that he didn't really go away. The memory of him will be here forever in your hearts. So take some evenings and sit down with that box of family photos and go through them with the widowed parent and laugh about the different events of your family history when you were just a little squirt and mom and dad were young and good looking kids themselves. The joy of these times will be tremendously healing for the grieving senior citizen and for you too. But by going through grief, healing, closure and moving on together, you bond with your parent and lay the groundwork for the important care giving challenges you and she will face together in the months and years to come. But you will face them and you will conquer them because you are going to do it together. Taking Care of Yourself is Part of the Job The job of becoming the primary caregiver for your aging parent is universally recognized as one of the most difficult transitions we will go through. To start with, it's hard to go through the reversal of parent and child. All your life, mom or dad were the strong ones. They were the ones you ran to for help and who were always there to tell you, "It's ok. Everything will be all right." But now as your parent ages and you have to witness their demise mentally and physically, you realize that everything may not be all right especially if your parent is going through a slow decline of a terminal illness. When the only outcome of what you are dealing with in your parent's life is death, that makes it tough to stay upbeat, creative and proactive about how to handle life's daily challenges. The task of caring for an elderly parent is overwhelming. You have concerns about their finances, their medications, the progress of their disease if they are battling something terminal, their mental state, their diet and their emotional state as well. It's easy to begin to "hover" your senior citizen in an emotional attempt to block any more harm coming to him or her. This is a parenting instinct and one that your dad and mom probably won't resist because they want to be cared for. You feel the anxiety of your parent and the fears they face as the months and years ahead hold uncertain dangers and a certain outcome. So there is an instinct in caregivers to give 100% of your time, your energy and your resources to caring for that elderly loved one. The problem is that you, the caregiver do have other obligations other than caring for your loved one. You may have a job, a family and your own health and upkeep to think about. So it's a good idea for you the caregiver, the family of caregivers and event he one being cared for to keep your eyes open for caregiver burnout to help the one who is trying so hard to take care of Grandma or Grandpa to also take care of themselves a little bit so they will last a lot longer. Underlying much of the intensity of effort many caregivers put out to help their aging or align parents is guilt. Guilt can be a powerful force that feeds on itself in an unhealthy way. The outcome is not only does the primary caregiver feel guilty that mom or dad are even having to go through age related illness, they feel guilty for any time they take for themselves or to care for their own needs or the needs of their family. Caregiver burnout can result in decline in health in the caregiver and eventually may lead to changes in attitude about the task of care giving and in some cases a nervous breakdown. Symptoms include poor sleep and eating habits in the caregiver, a possible increase in drinking to help "settle the nerves" and an inability to think about anything else than what mom or dad needs. If you see these symptoms in yourself or someone you know and care about who may be suffering from caregiver burnout, act fast to get them some help. They need to realize that taking care of themselves is part of the task of caring for their aging parents. It may even be a situation that calls for a talk with the caregiver along with the one being cared for. If that senior citizen can see that they need to encourage their caregiver to go be with family, get some rest, see a movie and forget the responsibilities of care giving for a while, that respite from the stress can do a world of good for that important person in their lives. We Are the Sandwich Generation The generation born between 1950 and 1970 has often been called The Baby Boomer Generation. There have been some variations on that title including The Me Generation, The Vietnam Generation and even for the sake of a certain comedian, The Al Frankin Generation. But the title that is most appropriate to where we are now, as we become caregivers for our children as well as our aging parents is "The Sandwich Generation". This is a painfully appropriate term because those of us in our late 40s to early 60s find ourselves with responsibilities to the two generations before and after us, both of which can be quite needy. The result is a fair amount of stress on us as moms and dads with all the demands that rising children, teenagers or maybe the children of our children can put on adults in this new century. At the same time, caring for aging parents can be even more stressful and hard on The Sandwich Generation from an emotional stress point of view. The stress we realize when our parents begin to age is a new thing for us. Making ourselves aware of the needs of newborn babies is not hard to get our arms around at all. When everybody in the generation is having babies, there is plenty of support and help for those who are learning the quirks of what babies need. In addition to the great support and "parents training" classes and books, the arrival of a new baby in the house is a source of joy. There is great hope at the arrival of a new child and taking care of our children carries with it that creative element of doing something for the future. We see in our children our legacy so seeing them succeed and helping them overcome difficulty is exciting as we do all we can to "launch" the next generation of our family. But caring for aging parents carries less support and far less optimism. While there is some joy in knowing that helping your parents live a happy and productive senior life keeps grandma and grandpa around for the children, the senior years are ones that will have only one outcome. And as much as we do what we can to make things easy and give our aging parents the comforts and joys of the golden years, all the sugar coating in the world wont cover up the fact that at some point the end will come and we, the Sandwich Generation will have to be there every step of the way to guide them through the end in the same way we guided our new children through babyhood. The similarities between old age and infancy have been well documented. But it's very hard on caregivers to go from being the ones these parents were always strong for who always took care of us to seeing that dynamic completely reverse. To see daddy who was always the smart one, the strong one and the one you could run to get weak and old and lose his mental sharpness is hard to watch. Now is the time when he has to turn to you. It takes mature adults to be the sandwich generation. But we can take joy in knowing that, in a way, we are giving back to those strong parents who never spared any expense or time for us when we were growing up. Now when its you they need, they deserve no less devotion and dedication to doing all we can for them that they gave to us when we were youngsters. Caring for the Caregiver The relationship between an elderly person and his or her caregiver is complex and intense sometimes. But that relationship does not exist in a vacuum. There are a lot of people affected by what is going on when that caregiver goes to that senior citizens apartment and give to him or her that one on one attention that is so necessary. For one thing, the caregiver's friends, family and coworkers are affected. Becoming the primary person responsible for the care and well being of a senior citizen is a peculiar job because it is tremendously demanding and completely unpaid. Caregivers are for the most part children or close relatives of the senior citizen being cared for and they have jobs, families and a full life outside of the time they put in taking care of their parent or parents. So when that responsibility falls to you, those around you also have to give a little to help you accomplish that goal. But for those who are related to a caregiver, there is a demand on you as well. If mom has to go over to Grandpa's apartment every night for two or three hours, that means mom isn't home helping you with your homework, making supper or just being available if her little girl needs someone to talk to. If dad is gone thirty or forty hours a week taking care of Grandpa, that is time he is not home providing guidance for his kids, fixing the garbage disposal or making those corny but fun jokes the kids groan about but love. Similarly, the friends and working world of a caregiver are also asked to give up a little or a lot of the mind, the emotions and the time of that caregiver so he or she can go and care for that elderly parent and divert that energy and time in that direction. For those of us who have a caregiver in our family or part of our social or work circle, in addition to the sacrifices, you can become concerned for your friend or loved one because of the demands of caring for a senior citizen. It's a job that is taxing to even the strongest adult and one that take a lot out of your friend or family member. Caregiver burn out is a common syndrome and it doesn't just affect the caregiver. If your parent, spouse, coworker or friend undergoes a break down from the stress of caring for her mom or dad, that will have an impact on everyone. So there is a compelling need for all of us associated with a caregiver to learn to care for that caregiver to help her and support her in what she is doing. Some specific things you can do are: * Let them know you believe in what they are doing. Caregivers often feel very alone and guilty that they are not attending to family and other relationships. By letting her know you are 100% behind what she is doing and that you are doing fine, that guilt is removed which makes her know she can make it. * Let her know she is missed. * Pick up the slack. Each evening if dad and the kids can pick up the house, then mom can get some sleep and know that you are taking care of business at home so she doesn't have to worry about it. * Let mom sleep in. Maybe even bring her breakfast in bed every so often. * Pitch in. Go over and help grandma out yourself so it's not all on mom. * An unexpected surprise. Every so often do something to surprise and totally delight mom and give her a fun break from her worries of care giving. A movie out or a limo ride around town can go a long way for a weary caregiver. If the spouse, the children and friends and associates of the coworker can keep and eye on her to look out for those signs of burn out, it may be our responsibility to jump in and give her some support before everything falls apart. By caring for the caregiver, she is better able to give attention to that senior citizen she is caring for. So in a way we are all becoming part of the effort to give the caregiver's mom or dad the best care possible. And that is what community is all about. Caregivers and the Work Place More and more businesses are facing a challenge and some decisions to be made. As the baby boom generation moves into retirement years and becomes elderly, the workers that make your business function so efficiently are going to have the additional demands placed on them of becoming the primary caregiver for an aging parent. It's easy to just shrug at this need in your employee population but just as the demands of parenting can have a huge impact on the workplace, the personal needs of your employees to take care of their aging parents will have an impact on the office and the productivity of your business. Business can no longer be cavalier and declare, "Well they can just quit and we can find new employees." The brutal truth is that skilled, trained and mature employees don't, as they day, grow on trees. With the work force shrinking, it's foolish to think that if you have a solid and hard working employee who knows his job and does good work for your business, that employee can't just be replaced with a kid right out of school. The cost to your business can be devastating if you have a policy of running off good, hard working and smart employees because they are becoming caregivers in their personal lives and replacing them with younger, unskilled employees who are less informed about the ways of business. The costs of training and the learning curve of the job alone will easily be more than any costs of accommodating existing employees. Moreover, you cannot just replace judgment, relationships, market savvy and wisdom which many of the employees in the age bracket bring to your business. So how do you accommodate the needs of this new group of caregivers who are beginning to become a regular part of your workforce? The first step is to understand what they are going through. These people are going to take care of their loved ones whether you are aware of it or not. So if you can partner with them to make them successful at home, they will work extra hard to make you successful in the marketplace. Start with some seminars and brown bag lunches where people can come and share the demands they are going through as caregivers for elderly parents or loved ones. Invite everyone to these lunches because there will be many in your business who know that is coming up for them and want to learn all they can about what is ahead. By making an open discussion of elderly care issues part of the discussion at work, you are communicating that you want to help and not hinder what your employees are facing. And that will endear you to them and get you the reputation of being one of those "good employers" in town. Not all employees who are caregivers will need accommodation all the time. If their parent's needs are not that demanding, it will be more of an emotional adjustment than a demand on the schedule. But encourage each employee who is entering into a time of being the primary caregiver for their parent to communicate that to you both through meetings with the Human Resource department and to their boss as well. There is a practical side to getting inside of what is going on with your employees. To your workers, they see you as family and feel more bonded to the workplace because you are concerned about their parents. But for you, the business will know in detail what is going on with that situation so you can anticipate if that worker will see sudden interruption come up at work and adjust schedules accordingly. Be sensitive and be communicative with your employees and you can truly become their partner in dealing with this tough part of their lives. And in doing so, they will feel that you support them and their loyalty to the company will skyrocket. That loyalty will translate into better productivity and longevity in your workforce. That stability translates into a more efficient organization which is a more profitable organization. So in the long run, partnering with your caregivers in the workplace just makes good business sense. A Stressful Job It's an understatement that being a caregiver for an elderly loved one is stressful. And in general, by the time you accept that you are in the role of "primary caregiver", the need to help your elderly parent is already advanced. So you usually have some "catch up work" to do so you can establish some controls over your aging parent's medical situation, finances and lifestyle. To make the stress of the task more acute, in many cases neither the caregiver or the one being cared for like the job or volunteered for it. The senior citizen receiving the help is often hostile, resistant to the necessary changes that the caregiver must implement and sometimes downright disagreeable. Because this is probably your mom or dad you are taking care of, there are those trained reactions you have to them that when they say what goes, that's what goes. But now you are the caregiver and they are in the role of the one who must obey. That reversal of roles is hard for both parent and child to get used to. The stresses come from the elderly senior citizen, from expectations of other siblings and even from your own high set of standards. You may have the attitude that "nothing but the best is good enough for my mommy or daddy". And while that sounds good in a toast, being a caregiver is all about compromise. They may deserve your attention 24/7 but realistically if you can drop by an hour a day and then spend the rest of your day taking care of your job, your kids, your spouse, your housework and, oh yes, yourself, that is probably a reasonable expectation. So right up front, it's good to recognize that as you settle into the job of primary caregiver for an aging parent, there is going to be an increase in stress in your life. Stress has been identified as one of the big causes of physical and mental health problems for adults. Some stress in life is expected and is good for us. But when stress begins to overwhelm you, you can go through a decline of your own health that is not good for you, the one you are caring for or anyone in your family either. For family of the caregiver, you have some care giving to do yourselves. That one person is on the forward line of a struggle that really the whole family should be involved with. If you live far from your parent and your brother or sister is doing the careering, be aware of the stress they are under and be supportive. You can do all you can to help out to take some of the stress off. Perhaps you can coordinate with the other distant siblings and relatives to call your parent regularly and take some of the relationship pressure off of the caregiver sibling. Above all, if you have suggestions for the caregiver, give them in love and without "nagging". That sibling is painfully aware that she is carrying the load for the whole family so communicate your support and gratefulness and that your suggestions are meant only for mom or dads good, not to criticize the hard work your sibling is doing. But the one person that can do the most to deal with the stress of being a caregiver is you, the caregiver. You have to see taking care of yourself as much a part of the job of taking care of your parent as any of the other duties you do. You are a huge resource to your mom or dad so tackle care of that resource for their sake. If you do, not only will you be a better caregiver, you will live happier and continue taking good care of your family and other responsibilities as well. And that's a healthy approach to care giving and the only approach that will work if the job goes on for a long time. A Place to Go When you first started working with your elderly mom or dad in helping them settle into their retired lifestyle, you exposed yourself to all kinds of services that can help take care of senior citizens. If you feel your parent could use to be with people during the day but you are not able to be free to provide that support because of your job, the idea of an adult day care is often suggested as a solution to the problem. Of course the phrase "adult day care" can be upsetting because it only goes to reinforce the image of your adult parent becoming an infant and having to be treated as such. So when you suggest that you work together to find a place they can spend time at during the day, don't refer to it as an "adult day care" if you can. Immediately the senior citizen will feel that you are just "putting him away" somewhere so he won't be a nuisance to you. And you don't want him to get that idea. But many seniors are open to going to a senior citizen's center or to a church program for the elderly that serve the same function. The best way to find the right adult day care situation for your parent is for you and your elderly parent to take a tour of what is available locally and make the decision together. To do that, you will want to come armed with some pertinent questions for you to get some peace of mind about letting your mom or dad spend time there each day. Some questions to include might be: * Do they provide transportation to the different assisted care facilities in town? Does that transportation continue to run all day? You don't want your parent going to the center and "getting stuck" there. If there is transportation, that wont happen. * Do they have qualified medical people on hand should any problem come up? * How many seniors are there on any given day? Too few implies that the center isn't providing good service. Too many and your parent could get lost in the shuffle. * Do you provide food and beverages if the stay is all day? Are your food services sensitive to diet issues if your parent is diabetic or has other diet restrictions given to him by his doctor? * What are the costs? Of course for your mom or dad, the activities that the day care center offers will be a big part of their willingness to go there. During football season, if the center just provides a place where elderly men can cheer for the game or have other sports programming available, that is a lot more fun for your dad than sitting alone in his apartment and watching those same sports. If the day care center has a variety of activities that appeal specifically to each gender and then others that everyone can enjoy such as card games or puzzles, it could be an upbeat and fun place for your parent to pass the day. By spending some time there, you can get a feel for the friendliness of the staff and the general atmosphere of the center to determine if this will be a warm and welcoming place where your parent will have some fun and meet new people or a place where he will feel alone and out of place. But if you can find a good day care center for your senior citizen, it can take a big load off of your mind. And if you know he is having fun each day and getting out with people, you know that will be healthy for him and be invigorating so he will eat better and sleep better that night. And that solves a lot of problems all at once. Giving Thanks for Being a Caregiver Much of the adjustment that goes into being a caregiver for your aging parent goes into dealing with the stress and the emotional drain that role can bring. In addition to the issues of how to care for her in the best possible way, there are the emotions of anger when programs don't work right or when the facility she is in has problems. There is resentment at other siblings or even at your aging parent because of the demands this job has on you personally. There are other adjustments that are a huge drain on you emotionally. Balancing work, home and private life with the demands on your time being a caregiver requires is a juggling act that will involve as many "dropped balls" as successes before you ever get it right. And about the time you do get a good balance, the demands of your elderly parent might change and you are again pulled back into that stressful situation. So you have to think about ways you can offset the demands on you and try to take some time for you and for your family. These are all difficult emotions which may be why it takes a real adult to be a caregiver for an elderly person. But there is one emotion you may wish to foster and dwell on as much as you can to offset the worry, the anxiety, the anger and the resentment. That is the emotion of thankfulness. Now it may seem impossible to even ponder how thankfulness could become part of your emotional reaction to this demanding situation you find yourself in. But if you can find ways to be thankful that you are the caregiver for your parent, that positive emotion can do wonders to drive out those negative emotions in your heart. And when you think about it, there are quite a few great things you can be thankful for BECAUSE you are the primary caregiver for your aging parent. Some of those are: * You are able to give back a bit of the sacrifices they made to raise you. The amount of time and money and emotional effort your parents used up on you as a child is something that can never be repaid. But you are giving a little bit back in caring for them when they are old to say, "Thank you for raising me and never giving up on me. And now I am not going to give up on you." * There would be anxiety if you were not here. If you were far away in another state, you would be a basket case if you didn't know your mom or dad's medical condition. So by being close, you can get the facts quickly and get them right which cuts down on all of those "what if" bad dreams about your mom and dad. * You always know what's going on. There are a lot of "false alarms" with an elderly person. The need someone that can say, "It's all right. It's under control" to them. That someone is you. * You are needed and you are important to your elderly mom or dad. If ever there was a time when you felt needed not just every so often but every day and every hour of the day it is when you are there to help your parents through this tough time of their lives. * Celebrate those little times of laughter and joy. Celebrate when you enjoy a movie together or laugh at those "insider" family jokes that always bring a smile. Those times will be precious to you when your parent go on to their reward some day. There is something deep inside us that feels a sense of completion when we are able to stay with someone we love through a very tough time. Your love for your parent and between you and her will deepen and grow stronger in a way that will stay with you for the rest of your life. And even after your parent goes on to their eternal reward, you will be able to look back on those months when you gave all you could to make those final months of her life happy and peaceful and you will be able to say, "I did the right thing." And that is one feeling that is irreplaceable and something you will be able to be thankful forever. Easing into Care Giving There is one axiom that if your parents don't pass away young in life, you are going to watch them age. Now for the most part, this is a natural and nice part of life because mom and dad can slowly become grandma and grandpa which are nice roles for them after working so hard to raise you. But a corollary to that axiom is that if mom and dad are going to age, at some point you are going to begin helping them with the daily affairs of life. And that occasional helping will escalate as their needs grow strong until you will become a full-fledged caregiver for an elderly person. For many, the time when you suddenly become a caregiver is just that -- sudden. It happens often after the death of a parent and the widowed parent suddenly becomes needy because of the loss they are experiencing. For married couples who have been together for decades, that loss is equivalent to the loss of a limb and far more devastating so that may be the time when you suddenly go from having few concerns for your aging parent to having many. It might be strange to look at it this way, but the more you can ease into care giving, the more time you have to get used to it, for your elderly parent or parents to get used and for your family, forefends and coworkers to get used to it. And if you can step in and make some minor changes to the environment of your aging parent, you may be able to delay the time when they become very dependent on you. If your parent or parents are still living in their own home, there are things you can do to make their living space more accessible and safe including: * Create a lifestyle that is all on one level. Stairs can become a hazard for an elderly person. So early in your plans to adapt their living space, move them into a ground floor bedroom and put all significant rooms, including the kitchen, the pantry, the laundry room and the living room are on the same level. * Take some of the work out of daily chores. Most local grocery stores will deliver food to the elderly so you can make those arrangements for your aging parent. You can also find services that work by the hour that come in and clean the house, do simple repairs and chores and take care of the business of home ownership for your parents. * You can make arrangements with home health care professionals to drop by for an hour or two a week just to make sure your parents medications are still safe to use, that all prescriptions have been filled and that your parent understands their medications and when and how to take them. * Reorganize the kitchen so things your parent will use every day are on an eye level shelf and are easy to get to and to put away after washing. Make sure the toaster oven, microwave and other important appliances are also easy to get to and that your parent is comfortable with these units if the models that may have come with the assisted living center are not familiar to them. * Go through the house and make it easy for your parent to use. You can put in those walking and grab bars along the halls and in the bathtub and other places where your mom or dad might need the additional support. You can check the lights so there are plenty of visibility for what your parents have to do. To really take the preparation of your parent's living space for their ease of use and safety, look at pulling emergency pull ropes in every room. These units are used extensively in assisted care units and they make it possible for your parent to pull that cord if she is in trouble and set off an alarm or call to you or to emergency care, should there be a sudden medical need. By working to make your parent's work area easy to use and safe, you can do a lot to put off the time when your mom or dad may have to move to a retirement village or nursing home. And you keep them independent which allows you to slowly ease into care giving which is much easier on everybody. Does Grandpa Like Himself? Few of us think about our own self esteem. But how we feel about ourselves, our work, our relationship to family and the community and our place in the world is the cornerstone not only of your ability to function and be productive in life but of your mental and physical health as well. That is a basic concept of human psychology for everyone and that need for self esteem doesn't go away when you become a senior citizen. When you think about it, this episode of being a caregiver for your aging parent is not your first crack at care giving. You were the caregiver and to some extent still are for your children as they were growing up. You took care of their every need including their emotional and psychological needs. And any good parent learns early on that a child's self esteem if vital to their success in school and in life. Now you are in that relationship with your mom and dad and while you are not "raising them", you have taken on the caregiver role which means in addition to worrying about their finances, their physical health, their diet and their living arrangements, their mental health and self esteem are things for you to consider as well. Because it's not us going through it, its hard for us to empathize with the huge changes going on in the life of your aging mom and dad and the massive impact those changes have on their self esteem. For a parent, your sense of self worth comes from your independence, your ability to take care of your kids, do your job and be useful to others in society. In the senior years all of that disappears in what seems like an instant. In the eyes of the senior, they go from being the hero to their kids to being a pitiful old man or woman being taken care of like they were the child. Their feeling of being useful vanishes and is replaced by a feeling of being unnecessary and a nuisance. The "things" that they invested themselves in that are symbols of their success which includes their house, their ability to drive and their work all go away in rapid succession one after the other. Small wonder senior citizens undergo a tremendous drop of self esteem. And when you go from thinking highly of yourself to not liking who you are at all, that is a formula for disaster. It's a dangerous mental condition to stay in because without self esteem, the natural response is to turn to unhealthy thoughts of alcohol or drug abuse or in the most extreme cases, suicide. As a caregiver, be aware of the self esteem of your aging parent and the huge impact moving out of their home and losing their spouse and ability to drive is having on them. The symptoms of poor self esteem is your parent doesn't take care of himself like he used to, repeats stories over and over because those stories remind him of a time when he liked himself and seem to launch on desperate adventures to try things he really should not take on just to get a feeling of being someone again. You can do a lot to build that self esteem back up in your aging parent. Help him get in touch with family and old friends. Encourage him to talk about the old times and pour praise on him about those days. And above all, let him have lots of time with the grandkids. Those little angels could love anyone into liking themselves. So let them use a little of that magic on Granddad so he can like himself again as well. Making a Difference Together There is something very self absorbed about the caregiver to senior citizen relationship. By that we mean that most if not all of the decisions you make and subjects of concern focus either on the senior citizen and his needs or on the caregiver and the senior citizen and how you will work together to address his needs. It is small wonder then when we think about what your elderly parent talked about all day, it's usually all about his or her physical or emotional needs. The way the caregiver relationship works naturally encourages the idea that the senior citizens world revolves around the needs and issues of the senior citizen himself. But we know from raising children that if a person is completely focused on themselves, that is very unhealthy. That is how one can become a hypochondriac and become overwhelmed by obsessive compulsive habits because they think everything must begin and end with their problems and there is no chance to see the world or get some perspective by being with other people. So a bold step you as a caregiver can do is to suggest that you and your elderly parent get out of the apartment and do something of value to others. By getting involved in volunteering or at least going out and making a difference together, you provide a way for your elderly parent to get some self esteem from making someone else's life better. It gives them chance to get out in the fresh air and break up the constant thoughts about themselves by thinking about someone else or something else for a while. At first you may get some resistance to the idea and you may have to be downright stubborn about giving it a try. The knee jerk reaction that your elderly parent may have when you bring up volunteering together might be, "what does that have to do with my needs?" By explaining the value to him or her, you ca help your elderly parent remember that life was better when it was about others and that a life of service is a healthy life. You don't have to get really ambitious to find something good to do with your energies. And if your senior mom or dad is disabled, there are still things you can do. Some simple things you can do at first that gets the ball rolling are: * Go to the park and pick up trash on a slow walk so you make the park a prettier place. * Go visit someone else in the retirement community that he or she knows is lonely and would enjoy being dropped in on. * Help stuff envelopes or make phone calls for your church or a charity organization. This is something you can do from a wheelchair if that is the situation with your elderly parent. * Read to disadvantaged kids at the local library. * Become a big brother or big sister and take a young person to a ball game or to the zoo every so often. Most cities have a volunteer coordination agency that can match up your physical abilities with volunteer opportunities. Once you get your elderly parent involved in doing something for others, don't be surprised if their enthusiasm takes off like a skyrocket. The great feeling of making a difference for others can literally turn his or her life around. And on the way home as your parent chatters about the people you met and the things you are doing, you know that this idea was a hit. And when they can't stop talking about the next thing you are going to go do together, you will know that your parent has gotten the bug for service projects. And his or her life will never be the same again. And that's a good thing. Listening to Your Parents even Now Have you ever had that aggravation that you go over to your aging parents apartment or house to help with the housework and get some serious "care giving" done and the senior himself seems to be bent on stopping your progress? You no doubt came over with a list as long as your arm of things to do at the apartment to help your parent live a clean and healthier life by getting the place into shape. You know that part of your job as caregiver is to take care of chores and do the things your aging parent cannot do any more or just doesn't do because of fatigue or general lack of attention to detail. So when your parent wants you to forget all that work and just sit and talk, what is aggravating to you may be very important to your parent, maybe even more important than the apartment getting cleaned up. It's good for you to think about your role as caregiver because you really are not just called to be a maid, chauffeur and cook. Anybody could do those things. The reason you are perfect for the care giving role is you are close to the heart of your aging parent and you are the one that will understand when she talks about things she is thinking or feeling that day. So don't downplay the value of just being a companion to your parent during your visits. The emotional and family support you provide to your parent is central to his self esteem and feeling of who he is in the world. He will be storing up dozens of little anecdotes and stories to share with you when you come over. So in order to let him get all of that sharing "out of his system", its important for you to be a good listener. A good listener doesn't just let the other person talk and say "uh huh" every so often. If you are just tolerating your parent as she shares little things with you, that will become apparent and be worse than if you didn't talk to her at all. The best way to fit your fellowship and relationship time around work time is to start out each visit with some time together just to talk. Perhaps you might make it a habit that every time to come over, you and your parent will sit down and just talk about a half hour over coffee, a snack or tea. That is when you can focus all of your attention on what mom or dad have to say. Listen with focus and attention so when something is funny, you laugh and you can ask questions and explore the concept or situation being discussed in some depth. Then at an appropriate time, you can say, "Gee Mom, I would like to tidy up those dishes. Can you sit at the table and we can keep talking while I do that?" That is a nice easy transition to starting your work and keeping the lines of communication open. And you can continue to let your mom or dad "follow you around" as you do chores chattering away the whole time. Don't censor the topics or insist that what you talk about are only the important things. You should know from talking to your kids that you have to be ready to talk about the trivial things in their lives to prime the pump of communication about the hard issues and ones that will take some mature understanding to deal with. So be patient and open with your aging mom and dad and once they know you have good listening ears, they will open up about important things going on in their lives. And that is when your listening skills will really pay off. Is Mom a Sucker? Sometimes a caregiver is a combination of maid, doctor, spiritual advisor and amateur detective. It's no secret that elderly people sometimes become more like teenagers and children then mature adults. So, while we wish they wouldn't do it, your senior citizen mom or dad may be hiding a few things from you. And one thing parents are fiercely independent about is their finances and how they use their money. But being independent doesn't translate into being wise in how your retired parents use their money. And its one of your jobs as caregiver to look after your parents well being which means watching where their money goes so their limited financial resources can last a long time. There are plenty of horror stories about senior citizens becoming victims of scams and clever sales people who sell them a hope and a dream in exchange for their very real money. We shouldn't be too surprised that slick talking sales people will call or email our parents. After all, they try to get by you so why should your parents be immune to it? But the thing you don't know is if or when your aging parents become a victim of a scam and get ripped off. One thing is for sure is that your senior citizen parents are not gong to tell you they got ripped off. So you have to become that amateur detective to find out if mom is a sucker for a slick salesman and if you need to step in and start getting these shysters out of your parent's lives. Some signs that your parent has become a sucker are: * Watch your parent's mail. If mom is getting an unusually large amount of junk mail and a lot of get rich quick schemes, phony contests or other scams, it's possible your parent has become a victim of a scam or two. * Spend a little more time at your parent's house or apartment and answer the phone for her. If there are more sales calls for scam offers or charities, then your parent may have already fallen pray to these kinds of calls and their name got passed around to other scam artists. * Are there a lot of junk items lying around mom's house that look like the crap that are used for "amazing gifts" or junk products? * Start paying attention to your parent's budget. For one thing, if mom doesn't want you poking around her checkbook, there may be some problems going on with her account. But if you see a lot of checks to scam artists, you know mom has become a sucker. Watch her credit card statements as well for similar activity. * Watch her email and look particularly at her "sent items" folder. There you can see if she responded to any scam email schemes. Its going to take some gentle convincing to get mom to let you see some of these documents and you can expect her to be defensive about her activities. Getting involved with scams, bogus contests and get rich quick schemes has an addictive quality to it and even though mom may have already been suckered out of hundreds of dollars, she still will fall for the next crook that comes along because of the addiction. So as you would with any addict, be loving and gentle in how you approach the problem but do not neglect the problem either. The key to selling your aging parent on letting you take over her checkbook is convenience. You might start by taking over her taxes. Then once she feels comfortable with you being that close to her books, you can offer to take over bill paying and balancing the checkbook. Then you can gently begin to question expenditures that are questionable. Don't try to get her money back from crooks that have already victimized your aging parent. But you can begin making it very difficult for people to get money out of her account. Right away, cancel all direct debits that are not easily identifiable. Also, start getting control over the flow of junk mail, phone calls and emails. By making access to your parents accounts and to her to try to victimize her again, you can be both the detective and now the guard dog to keep bad people from getting to your parent's much needed money. Guilt Helps Nobody If the job of being a caregiver only involved giving help to your aging parent such as doing the dishes and helping fill out the Medicare paperwork, your life would be considerably easier. And if that were the case, even if there was a lot to do, the problem of caregiver burn out would not be such an issue. But the real drain on you and even on the senior citizen you are taking care of comes in the emotional toll that the care giving relationship brings with it. Because the "assumed understanding" of the care giving relationship is based on the extended giving of a very large favor, guilt becomes a common element in every aspect of the time you spend with your aging parent. It's very easy for the senior citizen to feel guilty for asking you for the work you do to take care of him. It's a strange situation because in most cases, they never asked. You may have stepped in because you saw your parent's life beginning to unravel and you knew that someone had to help get his retired life organized. And yet, the senior citizen feels a lot of guilt because you are giving him huge amounts of time and that is time away form your family and maybe your work to do things for him unpaid and very often without thanks. It doesn't help that the time of transition from independence to assisted care is one of huge loss of self esteem for your aging parent. There are a lot of tremendous changes that happen in rapid order for y our parent and they happen in areas of life that have remained unchanged for decades. If inside of a year your mom or dad go through a loss of their home to go live in an assisted living facility, loss of mobility because they cannot drive and loss of independence because everything is being done for them, that causes a lot of negative emotions. Guilt makes its appearance because they feel irrationally that if they had not grown old, this would never have happened. But guilt also is an issue for you, the caregiver. There always seems to be something more you could be doing for your parents. It doesn't help that the senior citizen you work so hard to care for also inflicts guilt on you by whining, "I wish you never had to go home" or by complaining about their lives and getting angry. So what can be done about all of this guilt? Guilt doesn't make the relationship better and it doesn't improve the quality of life for the caregiver or from the senior being cared for. So whatever we can do to shut it down would be a positive step for both parties. Probably the most proactive thing you can do about guilt is confront it directly. Sit down with your aging mom or dad and get those guilt feelings out in the open. It's not their fault they got old. Your parent should not feel guilty about being cared for by you. After all they cared for you for decades when you were just a child and young adult. Bu taking the teeth out of guilt, you have a real chance of getting that out of your relationship. By learning not to put guilt on each other, you become a team in care giving, not combatants. And these are positive steps toward a healthy senior citizen and caregiver relationship. Going to a Better Place There are some momentous events in the life of a senior citizen. And few can compare in terms of the tremendous change of lifestyle to the moment when your aging parent moves out of their home and into an assisted living facility. It's a very emotional decision. If your mom and dad have been living in the same house for decades, there is a bond with that place that runs very deep. So convincing your elderly parent to move to an apartment or assisted care facility can be difficult. Once you have gotten mom or dad on board to make that big move, the next major step is to find a facility that would be just the right thing. There are a number of factors that go into this choice. So when you set out to find the next home for your parent, you should have a fairly detailed check list for what you are looking for. And when you enter that facility, don't be ashamed to be darned fussy about that checklist. This will be your parent's next home and a place you will be spending a lot of time at during your visits. So make sure that when mom or dad move from their home to this facility that they truly are going to a better place. The design of the facility. This criteria is where your checklist will get quite specific. An assisted care facility for an elderly population is different from a run of the mill apartment complex. And how the facility is designed both in terms of the physical plant and the way the facility is run will tell you if they are a good place for your parent to live. Some items to include on your checklist are: * Safety * Food service. * Emergency preparedness. * Ability to respond. * Look and feel. The society. One of the selling points of moving is that your parent will be around other seniors and have more human contact to combat loneliness. The facility can do a lot to speed that process by holding regular social events for its residents. So interview some of the residents and get a feel for if they are friendly and if there are people there your mom or dad would enjoy becoming friends with. You can even arrange for your parent to spend a day or a weekend at the facility to get a feel for what it will be like to live there. Proximity. Where the facility is physically located is a qualification for which assisted care locations will make the short list. Those close to where you, the caregiver, live should get a priority look. You are going to be running back and forth to this place dozens of times each week. So if mom or dad live close, that proximity will help your care giving efforts tremendously. Even before you began talking about this big step with your parent, you no doubt have been thinking about it and discussing it with family and those close to your parent. You may have even done some preliminary walk throughs to get a feel for what kind of facilities are available in your area. When you start the formal search for the next place for your parent to live, it's vital that you take your parent with you on those visits. After all, no criteria will be more important than whether your mom or dad will like the facility. And if they get out there looking at facilities and interviewing the staff and management of different places around town to be considered, your parent will begin to get enthusiastic and begin to see this move as their next great adventure in life. And once they cross that threshold in their minds, you will be well on you way to being successful in this move and making it a reality to help your parent go to a better place. Senior Citizens Bill of Rights Sometimes when you and your elderly parent are partnering for their care, it seems like an "us against the world" situation. But since the senior citizen you are caring for has little fight left in them, it seems it's up to you to make sure that your elderly mom or dad get all they have coming. Just because a person becomes a senior citizen, that doesn't mean their fundamental rights go away. They deserve and should expect to be treated with respect and for those serving them to live up to expectations. But just as it was before your parent became a senior citizen, a right must be claimed to be a right. So while there is no formal "Senior Citizens Bill of Rights", there are laws on the books about how nursing homes must treat senior citizens. And even if your mom or dad is in an assisted care facility and not a nursing home, there are some basic expectations that were in that contract and that are fundamentally assumed that the facility will live up to. And its up to you as the caregiver to make sure they are living up to what is expected of them. First of all, the facility your senior citizen lives at should be reliable to provide the basics of safety and cleanliness. Look at the evacuation plan for the facility in the event of a fire or another emergency that would mean getting your parent out of the building. Is it a plan that is clear and is it workable considering the entire facility is full of elderly people who may not move very quickly? And what about emergency power? In the event of an emergency where the power goes off early, is there emergency backup power to operate elevators and automatic doors so everyone can get out? If the facility offers food service as part of their package of services and if there is a charge for that service, there is a basic expectation that there will be meals made available three times a day, that it will be healthy food and that your parent will never be denied service. It is also not out of line to expect that the food could be delivered to the senior citizens rooms if your parent is ill or injured. And your parent should be able to get some variety in their diet. If they are not doing a good job of making foods that your parents likes to eat, they shouldn't be making that additional charge for food service. As we mentioned earlier, your parent didn't lose his or her rights as an individual when they move into an assisted care facility. If your parent is paying to use that apartment, they have a right to live as they please in there. Within certain constraints because they are in a community setting such as keeping noise down after bedtime and the like, your parent should be able to do what he or she wants to do in the privacy of their home without the interference from others in the community or from the staff of the complex. This includes receiving guests, allowing family or friends to sleep over, how the apartment is decorated and what kind of music your parent enjoys. A right that really cannot be detailed but can be felt dramatically is your parent's right to be treated with dignity, compassion and respect. This is an intangible but how the staff of the facility treat the resident's means a lot to your parent when they see these people every day. Its not out of line to expect the staff and management of the facility to know your parents names and greet them warmly when they come down to eat or go to a social event. If the staff of the facility have to work directly with your parent, it should be done respectfully and pleasantly. If your parent reports verbal or emotional abuse going on by the staff, that is cause for you to investigate it and hold that facility to accountability for that problem. Remember the old saying that the squeaking wheel gets the oil. So if the facility needs to be reminded of their responsibilities, you be that squeaky wheel. Squeak loud and squeak often so your parent can live in a place where they enjoy their days and feel that this is a place they can genuinely call home. Quality of Life for your Senior Citizen When you were growing up, your parents were your care givers. They made sure you were safe, well fed, clothed had medical care and that the money was there for the things you needed. But being your caregiver for your mom and dad was about more than just giving you the basics of survival and health. Now your turn has come to be the care giver for your parents. They need you now as they move into their older years and they are less able to attend to those basic needs of life. But you can assure they are safe and that they have the right food to eat for their diet. You can make sure their clothes are clean and that their medications are there for them every day. You also can look after their finances so there is plenty there to take care of the necessities of life and none is wasted or taken from them by scam artists. But just as growing up in your family, there is another element of being a care giver and that element can be boiled down to the phrase, "quality of life." That is a good phrase because if your childhood had times of joy and happiness because you were part of a loving family, that was because your mom and dad went beyond the physical basics and made your life fun, full of love and laughter and good times that you would remember forever. Perhaps you sit and remember those times with your elderly parents even today. But as you remember those terrific vacations or all the wonderful, Christmases and the many funny things that happened in your family when you were growing up, two people made sure your life was rich and full that way. And those two people are these same two people you are now charged to care for -- mom and dad. So how can you do all you can to enhance the quality of life for your parents in their retirement years? If we can find ways to give them happy times, time of laughter and love, that will be a fitting pay back for the loving household they provided to you all those years. Here are just a few things you can make happen to make their lives happier: * Dinner every week. If you have a routine time when you either come to your parents home and bring dinner or have them to your place to enjoy some family time, that will become a favorite night of the week for your elderly senior citizen. * Lots of family time. The real value of being in the same town as your parents is they can have lots of time with your family. So let them be part of many of the family things you do such as church, school activities and fun outings during the spring and summer as well. * Make the holidays festive. What would the holidays be without Grandma? And if Grandpa makes a good Santa Clause, you are all set. * Make their house a home. As a caregiver, sometimes the chore of cleaning and maintaining your parent's apartment falls to you. But don't just "settle" for a nice clean look. Dig out those great things that mom used to have on the walls and shelves at home when she had her own place. Try to give that room at the senior retirement center as much like home as possible so she will feel comfortable and happy among the things that mean this is her place and hers alone. If you can create the same joy, the same fun and the same sense of "home" for your elderly parent that they were able to create for you and your siblings growing up, then you will have taken one more step toward giving back a little of what was given to you. But there is a real value to giving your retired parents the same love and good times they gave to you. Laughter and love and happy times are therapeutic and can do a lot for the health and well being of your retired parent. So put that extra creativity you have into really giving to your parents the quality of life they gave to you and they will blossom where they are planted, just you and your siblings have in life. When the End is near Providing care for your adult parent during their retirement years can be a demanding job. And the job continues to become more demanding as your parent gets older and his or her health declines. You will have to make more and more difficult decisions as the end grows closer and many of them you will make without the consultation your elderly parent if his mental abilities have slipped away due to the affects of aging. If the senior citizen you are caring for is dealing with a terminal illness that lingers, those demands will become virtually overwhelming. When the end is near like this, your need for assistance will become acute. This is no time to try to be stoic. Dealing with a dying senior citizen is something that is usually outside of the abilities of caregiver children. If you see that time coming, now is the time to make arrangements for additional help. If funds are in his estate, you can arrange for in-home nursing care. These outstanding organizations can be with the senior citizen for as many hours as day as you need them to be and provide skilled medical care to minister to the demands of your parent's terminal disease. But once your doctor confirms that your parent is terminally ill, waste no time in getting hospice involved. This is a federally sponsored program that is part of Medicare and they are trained specifically in dealing with death and the dying with skilled care, equipment and medications that will cost your parent nothing and take a huge amount of stress off of you. Hospice has been a lifesaver for many a weary caregiver who is worn out from months or years of care giving and is incapable of dealing with the extra demands of the patient's final months of life. But there is an adjustment you as caregiver will have to make as the nursing care personnel and hospice begin to surround your parent more and more in preparation for his or her final days. You have been so intensely involved with every aspect of your parent's needs. And you have done a good job of getting them this far. But now you have to step away and let these skilled professional caregivers provide the comfort and medical care that only they can give. This may be difficult because your parent will still call for you to be nearby especially during these weeks. This is a time to bring in clergy, and to alert your siblings who may have to travel to be by mom's bedside in her final days. While there will be tears, if they can be with her a little bit before the final moment comes, that is a closure for the family that is tremendously valuable. And it helps your aging parent to have her children close to her as she approaches her final transition to another life. Hospice will help you go through the transition in your own mind and heart to accept that the passing is near. It will take some emotional courage to begin preparing for the funeral even though your parent is still with you. But this can also be a bittersweet time of sharing because if your parent accepts what is to come, she can have some say into what she wants to have happen at the funeral and about other final arrangements. Perhaps the strangest transition that you alone as the primary caregiver will go through will happen in the days just after the passing. There is always a shock when your loved one dies even if it was very much anticipated. But you will go through another drastic set of emotions that can only be described as "separation anxiety". When you get that news that your parent has passed, you will suddenly feel the lifting of a burden that may have been on you for months or years. You no longer have to worry about your parent any more. You don't have to go there, take care of her food or medicine and comfort her any more. The lifting of that pressure can be liberating and disorienting for you. You will feel strange throughout the funeral and the family times as well. But keep these feelings in your heart as well because they will be sensations that only you and others who have been primary caregivers will ever be able to understand.
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