Last time out, we talked about the growing number of folks experiencing Alzheimer's and also about the majority of folks taking care of them being family members, in other words, family caregivers.

And now let's take a little closer look at this caregiver situation. As mentioned above, the vast majority of the caregivers are family members taking care of someone at home. Since about 70 percent of these folks remain in their homes while being cared for, the idea of "If I get Alzheimer's, I'll have to go to a facility" isn't necessarily accurate. Now, as the condition progresses, there may be other physical issues that require a different living situation, but that is certainly a person-by-person determination.

In many instances, a lot of tough questions need to be asked, and each one generates others. For example: The decision is made that Dad is not going to a facility. How's that going to work? If he stays in his own home, who will be there to help him? If the family has their own obligations and responsibilities, who is most able - and willing - to drop everything and move in with Dad?

OK. Dad can move in with one of the kids. Will someone have to quit work to be there? Is Dad willing to go along with this? And how do the kid's family (spouses, children) feel about that?

And those are just the start-up questions. Add to that, who will be responsible for checking into such things as Durable Power of Attorney and any other paperwork that may be needed? Or how about that question that's usually only considered when you need to know right now? "How do I take care of Dad?" Lots of questions ... and the beginning of a journey into uncharted waters - complete with a rollercoaster ride of emotions that may range from sadness to frustration; from frustration to resentment; from resentment to guilt. And then it all begins again.

There are times and circumstances in which family members just simply cannot do it. Understandable, and though words often do little to help, let me say this: You may feel guilty about not being able to provide the necessary care, but sometimes things are what they are - and guilt is not the best reason to take on a situation that may cause your own family to deteriorate.

Enter Family Caregiver Support services. The folks involved in this have a lot of experience, expertise and information to help support caregivers. Contact information appears at the end of the column. And what happens if family isn't able to provide the care? In-Home Care agencies provide services in the home and vary as to cost. They do, however, have trained staff complete with background checks and experience. Call one of the numbers at the bottom of the column for a list of those serving our area.

Medicaid In-Home Care (COPES, MPC, MNIW, etc.) programs may be another option, and may pay for the cost of the caregiver, if two main criteria are met: 1. Low-income, and 2. Physical care needs. The financial eligibility is roughly $1,869 per month income and a maximum of $2,000 in "liquid" assets. The physical care involves needing assistance in personal care needs such as bathing, toileting, medication management, ambulation and so on. As mentioned in the last column, Alzheimer's begins with memory losses, but progresses to physical deterioration, so a family member may very well meet these criteria. Again, call one of the numbers at the end of the column for more info.

Of course, even if you have a paid caregiver in place, the family will still have some responsibility for care and support - particularly in the area of getting finances, legal papers and medical arrangements organized. The good news in all this? You don't have to go it completely alone. Give us a call for more information, or use the contacts below.

? Family Caregiver Alliance at (www.caregiver.org)

? The Administration on Aging at (www.aoa.gov)

? The National Hospice and Palliative Care Organization at (www.nhpco.org)

? Medicare Rights at (www.medicarerights.org)

? Olympic Area Agency on Aging (us) at (www.03a.org)

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