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Reprinted from GATEWAY Magazine by  permission by Debra Englander
Debra's article is for ideas & guidance only,  Asbury UMC has no control over content or accuracy of article.

Email, pagers and online resources can make caring for aging relatives a whole lot easier

In the next few years, there's a good chance you'll take on the role of caregiver for ailing parents or aging relatives.  Nearly one-fourth of American households already care for someone over age 50 as record numbers of baby boomers, along with their parents, get older.  In 1900, for example, only 4% of the population lived past 65.  Today, there are some 34 million people aged 65 and older, and that number is expected to surpass 50 million in only 20 years.  That may be pretty good news but it also throws up a host of concerns (to learn more about talking to older parents, see How to talk to parents about Aging).

When a relative suddenly falls seriously ill, you may not know what to do.  "Caregiving is such an emotional experience because we're dealing with potentially life-and-death issues for people whom we love," says Suzanne Mintz, president and cofounder of the National Family Caregivers Association (NFCA) in Kensington, Md.  (see below for online resources).  There are several ways to deal with immediate caregiving issues.  A good first step is to hire an eldercare attorney who can help with traditional legal matters and also refer you to other experts.  At his Hendersonville, Tenn., firm, for example, elder-law attorney, Timothy L. Takacs takes a "holistic" approach to client needs.  "We can draft a will or power of attorney," explains Takacs.  "When someone has questions about the type of care provided at a nursing home, we can help look at the available facilities and evaluate the care."

Just a few years back, caregivers had to spend hours on the phone to find information about nursing homes or assistance programs.  If you lived in another state, you were lost.  Today, the Internet provides access to directory listings of care facilities, medical and financial info and contacts, support groups and more.  But, of course, technology is only a tool.

"Caregiving requires so much personal intervention that you can't automate the process," says Karen Stevenson Brown, publisher of Elderweb.  No gadget or software can replace loving care.  But "with the Internet," says Brown, "you can figure out your options and get information quickly."

By logging onto the Net, for example, you can learn about ongoing medical research, government programs and medical aid.  On several occasions, says the NFCA's Suzanne Mintz, whose husband has MS, she logged onto bulletin boards to ask about specific drugs and symptoms related to her husband's illness.  You can also find a wide range of support groups online.  Having a community of people who understand what you're going through can be very beneficial.  "Information may be empowering," says Mintz, "but when you're going through a crisis of caregiving, you need someone to help you sort through the information."

Remember, too, that there's no "seal of approval" for Internet sources.  Try to get information from government, association or university sites before cruising commercial ones, which tend to be selling something.  Double-check your referrals.  Always ask questions.

Technology also offers immediate and fail-safe communications for family and caregivers, whether local or long-distance.  For example, email eases the difficulties of conflicting time zones and some of the legal requirements.  Linda Humphrey, a Seattle architectural writer, lives near her 88-yearold mother, Wilma, who's now in a nursing home.  Linda's sister, Mary, lives in Santa Fe.  The sisters frequently talk on the phone but, says Linda, "We are trustees of our father's estate, so I'll email her because we need to have a written record."

If your relatives are alert enough, you might also consider logging them on.  Attorney Takacs, for instance, gave his old computer to his parents after he upgraded his office equipment.  He taught his mother how to send and receive email, use the Internet as well as perform a few rudimentary word processing tasks.  Within a year, Takacs had to buy her a new PC because she was frustrated by the old computer's slow speed.  "Make sure you get your relatives a powerful machine and set it up for them," advises Takacs.  "My mother had no computer skills but now she loves it.  She's found childhood friends via the Internet and she finds it more convenient than writing."  In fact, Takacs is now thinking of getting a Webcam and cable interface service so they can have face-to-face meetings online.

Email and online resources are lifting a great deal of the burden of caregiving, leaving more time and energy for actual care. High tech can help in other ways.

• Emergency services 

  • Personal Emergency Response Systems (PERS) have been around for a couple of decades and there are now more than 30 companies providing such services. 

  • But these systems have recently been refined. 

  • PERS are designed to allow someone to remain self-sufficient at home even though he or she require some oversight or aid. 

  • The services are also useful when a caregiver can't be around 24 hours a day

• Pagers

  • Caller center pagers that dispatch help

• Beepers

  • Beepers to remind patients to take required medication

• Call Buttons

  • That  ring emergency services

Each system roughly works by pressing a button on, say, a wristband or pendant that connects to a phone line.  A call is then placed to an emergency response center.  Depending on instructions at the center, police, medical personnel or family are contacted and dispatch to the caller's home.

Today, some of the systems are interactive, so once you press the button, you can talk to an operator.  The operator could then ask what kind assistance you need.  Among the newer features, American Medical Alert has special activators, including a touch pad and a breath switch, to accommodate handicapped people who can't press a button.  Fees vary, though generally there is a onetime installation fee and a monthly monitoring rate.  One variation on PERS is the SOSPhone, a battery-operated cellular phone with buttons for 911, auto emergency and the 24-hour monitoring center. A patient or caregiver could use this anywhere in the country.

• Medication services 

  • Similar to PERS are services that alert you when it's time to take medication.  

  • PageMinder, for example, pages you with a customized message, like, "Take your red pills" 

  • MedReminder works similarly but includes a pager 

• Software support 

  • Most helpful to caregivers and their patients is the ability to talk with other people to compare experiences and learn how to cope with specific problems. 

  • Just released this spring are two interactive programs in the Virtual Conversations series, from Interactive Drama, a software developer in Bethesda, Md. 

    • The programs use voice recognition, so you can ask questions of patients and caregivers

    • The were developed in conjunction with the National Institute of Child Health an Human Development of the National Institutes of Health 

    • One deals with amputees and the other, brain injuries.

What's ahead?  As more information becomes available, the Internet will make it easier to navigate different stages of caregiving.  Elderweb's Karen Stevens Brown predicts access to databases that cover housekeeping to companions, as well as medical and nursing information.

Just keep in mind that the Net can't replace face-to-face interaction.  "The Internet will let you do background research and may enable you to make the right connections," advises Brown. "But there's no substitute for a visit to a nursing home or interviewing a prospective caregiver."

DEBRA WISHIK ENGLANDER
is a New York personal finances and business writer and editor

Sites That Care

• Administration on Aging's ElderPage

  • Most states hove federal Area Agencies on Aging or similar agencies dedicated to the elderly.  

  • Essential starting points, they provide referrals to healthcare professionals, meals-on-wheels services and more. 

• Carehub

  • A new site offering medical, legal and financial advice for both pros and consumers. 

  • Most useful is the interactive planner that lets you calculate caregiving costs. 

• ElderWeb

  • A comprehensive site, ElderWeb features referrals to healthcare and senior-care facilities, as well as thousands of links to other sites about medical, legal, financial and other issues. 

• Extendedcare.com 

  • Rely on this site for a list of nursing homes in your community. 

• National Academy of Elder Low Attorneys

  • This professional lawyers' group specializes in eldercare issues. 

  • The site offers links to useful sites and a checklist when hiring attorneys. 

• National Association of Professional Geriatric Care Managers

  • You'll find listings of professional caregivers and managers, plus a wealth of site links.

• National Family Caregivers Association

  • This nonprofit group offers information, referrals and support. 

• SeniorNet

  • A nonprofit outfit, this site provides computer education for adults age 50 and older. 

  • The group runs more than 150 national learning centers where members can learn to use computers for free or nominal expenses ($35 annual membership fee). 

• Social Security Online 

  • This government site provides resource info about Social Security, Medicaid and Medicare programs.

And some helpful books:

• Baby Boomer's Guide to Caring for Aging Parents by Bart Astor (Macmillan/IDG) 

• The Comfort of Home: An Illustrated Step-by-Step Guide for Caregivers by Maria M. Meyer with Paula Derr, RN (Caretrust) 

• The Cost of Caring: Money Skills for Caregivers by Anne M. Johnson & Ruth Rejnis (John Wiley & Sons) 

• How to Care for Aging Parents by Virginia Morris (Workman Publishing)

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If you're concerned about whether or not your loved ones will be well cared for as they age, the best advice, say eldercare experts, is to talk to them while they're still active and healthy.  These conversations may be difficult or awkward.  But discussions while your parents are still able to make their own decisions can save you lots of heartache-and hassles, later on.  If your parents refuse to talk to you, suggest their attorney, accountant or a trusted friend.

You'll have to deal with the same financial, legal, medical and insurance issues whether you're providing care for a relative who lives across town or one thousands of miles away.  

The primary concerns: 

• Financial Security - Have your parents set aside money to cover hospital bills, nursing home fees or other services?  Do you have a complete record of your parents' finances and access to their bank and brokerage accounts?  If not, do you know their attorney?  Have your parents drawn up durable powers-of-attorney documents, a will, living will, medical-care proxy and other legal documents?  

• Medical needs - Can your parents remain at home with visiting health aides to provide assistance?  If not, what type of care facility do they need - assisted living or nursing home?  

• Responsibility - Who will be the primary caregiver?  Even when family members live nearby, it's rare for siblings to share responsibilities equally.  There's usually some division of financial and actual caregiving duties.  If you're shouldering most of the caregiving, stay in touch with family members, so you can ask for help when you need it.  Sometimes, a regular weekly email message can be used to quickly bring everyone up-to-date.

Revised: May 11, 2009

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