Our care giving started out slowly and the irritations in melding his care into our life were minor at first.

It began when he/she read his New York Times. My father-in-law had the habit of watching TV until 11:30 and then reading the paper until 1:00am. He would sit in the living room recliner while watching and reading. Unfortunately for us our bedroom is across the hall from the living room and the light would shine directly into our bedroom. As we never slept with the door closed this became a problem. We ultimately resolved the reading problem by getting my father-in-law a TV and recliner for his room.

There will always be issues in any relationship, of course and eldercare is no exception. What began to be bother me was that all our efforts were taken for granted by my father-in-law and by other relatives. It was assumed that we would just do everything. I expected that we could integrate eldercare into our lives without effort, and more tellingly,  without clearly establishing what I needed from other relatives. I felt they should have known what to do and take a greater part in the care giving

I did not  realize the cost of elder care in terms of time, effort, money, and frustration because those costs came upon us slowly. I didn’t negotiate with others for their support. That was my fault and the beginning of years of building anger.

For a free DVD on elder care go to HomeCareSurvival.com .

The negative emotional aspects of anger, frustration, isolation, and guilt are more difficult to deal with. These emotions creep up on you, complicate your life and your care giving efforts, last long after the care giving is over, add to your physical stress, and can shatter families and lead to law suits.

This series of blog posts will try to address these negative emotions and how to deal with them.

Of course, there are positive emotions in elder care. Compassion, responsibility, gratitude, and competence are part of caring for an elderly parent. Some seniors have planned for their care so as not to be a burden on their children. Some families come together to support the primary care giver. Some cultures value older people and family members vie for the honor to care for their seniors. Elder care in these circumstances is a different, rewarding experience.

The positive emotions make care giving a wonderful family building experience. That was the expectations Jill and I had when we started caring for her father.

I loved my father-in-law. I met him the same day I met Jill. In the 35 years up to that day in 2001 when we began caring for him I never had a harsh word with him. He gave us the down payment for our home, the home we were now welcoming him into.

Our home has four bedrooms and our four children were living at home with us. My father-in-law spent the winter of 2001-2002 in California with his son and moved in with us in March 2002. Our son, Eric, gave up his room so my father-in-law had easy access to both the kitchen and the bathroom. In the beginning, he was able to bathe himself, dress himself, make his own meals, and could safely go for walks.

What could cause anger and frustration?

I’ll cover that in the next post.

For a free DVD on elder care go to HomeCareSurvival.com.

After a stay of at least three days in a hospital Medicare will pay up to twenty days in a live-in rehabilitation facility for your loved one (LO). His/her supplemental insurance should pay for up to an additional eighty days. The following is why and how you should take advantage of this opportunity.

First, let me state the obvious. Your elderly parent needs to recover in a rehab facility. Although this should be obvious, it wasn’t to Jill and me. The first time my father-in-law came home from the hospital we thought he would do so much better in our home.

What we didn’t realize was that his sleeping patterns would be off which meant that our sleep patterns would be off. His bowel movements were irregular which meant more accidents, more laundry, more carpet cleaning. It took weeks for his appetite to come back which meant more frustrations at meal times. Plus, everything moved at even a s-l-o-w-e-r p-a-c-e. We placed an unnecessary and undue amount of stress on ourselves.

Put them in rehab. They’ll do better and you’ll can catch up on your sleep.

When your elderly LO is in rehab he/she is monitored by medical professionals. They receive physical, occupational and speech therapy on a more frequent basis. If they need assistance at night, there is a night shift to take care of them.

Here is how to pick a rehab facility.

1) Some nursing homes, like the one we used, have beds available for rehab patients. Both patients share the same dining , bathing, physical, occupational, and recreational facilities. Fortunately, there is a rating system for all nursing homes that receive Medicare funds. Go to Medicare.gov/NHcompare, plug in your zip code and see how your prospective facility rates compared to other facilities in your area.

2) Find out if the is credited by the Joint Commission, an agency that rates medical facilities. This accreditation should be on  the facilities web site and a certificate is usually displayed in the lobby of the building..

3) Call the Area Agency on Aging in your county and ask if any complaints have been received.

4) A hospital social worker referred us to the rehab facility we used. Ask your social worker to give you the name of former patients who might share their experiences with you. It’s interesting to note that while we were satisfied with the care our facility provided other patients we met were very unhappy with their care.

The more you know the better decision you can make. It is very upsetting to your elderly LO to move them to another facility. Pick the right one the first time.

In my next post, I’ll hare with you how to prepare for your inspection by knowing what to look for and what questions to ask.

For more information on elder care check out my articles in ezine.com or get a free DVD on elder care at HomeCareSurvival.com.

This was no problem for us because my father-in-law had a bacterial condition that was not treatable with anti-biotics.  It did not endanger him but it could cause problems for other people. As such he was always segregated when he was in the hospital.  Interestingly, he was not segregated when he was in the rehab facility.

The nice thing about a private room is that it is, well, private.  Your LO doesn’t have to put up with the sounds and smells that come with a room mate.  The stream of visitors, interns, doctors, residents, nurses are bad enough when they come for him/her, it is doubled when they come for the room mate.

My father-in-law was annoyed that his room mate in rehab had fallen asleep and left the TV on too loud.  He got up unescorted and with out his walker.  He fell and broke his hip which required another operation and another stay in the rehab facility.

You can also request that the number of visits from interns be limited so that your LO can get more rest.

The equality of care depends a great deal on the nurses. They see your LO more often and for a greater length of time than a doctor.  We got to know the nursing staff by name.  We brought them lunch from the deli.  We baked cookies for them.  We even called every night so we got to know the night shift.  We wanted them to know that we appreciated everything they were doing for my father-in-law.

Lastly, use the time that they are in the hospital or in rehab to get caught up on your sleep.  Or take a mini vacation.  It helps to reduce your stress and you deserve it.

For a free DVD on the secrets of elder care go to HomeCareSurvival.com

Also bring this list with you when you come to the hospital.  As a side note, a copy of this list should be in a plastic bag attached to the refrigerator.  In case you are not home and there is a reason to call the paramedics, they will need this information.

Your LO will be given pre-surgical instructions in writing.  Be sure they are followed.  NO EXCEPTIONS.

Your LO will be given discharge instructions in writing upon release from the hospital.  Follow them.  NO EXCEPTIONS.

Now you know how to pick the right outcome.

For a free DVD on the secrets of elder care go to http://www.HomeCareSurvival.com.

This is what we did when our elderly father-in-law had to have a partial hip replacements.  He broke one hip while in the hospital.  A year later he broke the other hip while in rehab.  The same surgeon did both procedures and we were very satisfied with the results.

If however it is a complicated surgical procedure you may want to choose a board certified specialist.  These doctors are peer reviewed and have to meet higher standards.  To find a board certified specialist go to the website of the American Board of Medical Specialists at www.ABMS.org

For a free DVD on six secrets of elder care go to HomeCareSurvival.com

The problem is that while in the hospital your LO could be exposed to more germs or a medical mishap that could make their condition worse.  In our case it wasn’t infection, it was falling.  He had fallen a few times during his many admissions until he finally broke his hip and it had to be replaced.

You want their stay in a hospital to make them better not worse.  You don’t need the additional stress.

To help you to help your LO, I’ll show you how to pick

the right hospital

the right doctor

the right time

the right accommodation

the right care

and the right financing.

You will then get the right outcome

Pick the right hospital

If your LO’s condition could lead to a surgical procedure (joint replacement, heart surgery, etc.) choose the hospital with the best success rate for that procedure.  Go to www.hospitalcompare.hhs.gov (a service of Medicare) to compare how well your local hospitals performs that procedure.  You will get comparisons on general conditions, types of illnesses, and medical procedures.  Everything you will need to make the best decision.

We chose a local community hospital which was a part of a major regional health network.  The hospital was convenient, well maintained, and with a high nurse to patient ratio.

All this was very important to us because we had to drive him back and forth to dialysis three times a week.

Now you know how to find the right hospital for your LO which will increase the odds that your LO will survive their stay.

How to pick the right doctor will be in the next post.

Go to www.HomeCareSurvival.com for FREE DVD on elder care.

What makes my Action and Implementation Program unique is that I look at elder care from the caregiver’s point of view. My experience and that of many other care givers is summarized below:

1. One person bears most, if not all, of the work.
2. Unless you’ve done this before you have no idea of the amount of work involved.
3. The annoying attitudes or habits of your Loved One (LO) do not go away merely because they get old.  Those habits only get worse.
4. Federal or state governments or your relatives will not voluntarily reimburse you for any money you spend on elder care.  Out of pocket expenses average $500.00 a month.
5. The intersection of inheritance and elder care will set powerful emotions into play.  You have to look out for your interests.  I’ll tell you how to prepare for visits with your lawyer.
6. The perception of what relatives think is due to them from an inheritance can over ride rational decisions or compromises.  I’ll show you how to negotiate with your relatives.
7. The efforts you make in elder care will be heavily discounted by your relatives.
8. Day to day life may go on uneventfully, and then a crisis (a fall, a stroke, or an accident) will occur that changes everything.
9. Elder care can go on for longer than you expected.
10. You have to take action to prevent becoming isolated and overly stressed.
11. Taking care of your needs is not a luxury, it is a necessity.
12. You love is not going to save them.

Go to HomeCareSurvival.com for a free DVD about elder care.

To find out what other programs are available go to http://www.benefitscheckup.com/ and fill out the questionnaire.  It takes about thirty minutes to complete but when you finish you will know all the local, state, and federal programs that can help you pay for you mom’s care.

Use the Institute of Financial Planners at www.ICFP.org or call 1-800-322-4237 to find a certified financial planner to help you sort through your parent’s financial affairs.

A reverse mortgage could free up money to pay for their care.  There are issues you need to consider when thinking about a reverse mortgage.  Go to the National Center for Home Equity Conversion at www.reverse.org for critical information.

I have other phone numbers and web sites for the legal, housing, and medical aspects of eldercare that I’ll get out to you shortly.

Or you can go to HomeCareSurvival.com and sign up for my Action and Implementation Program.

The guidelines for what is covered vary from state to state and the amount of money available to pay for Medicaid covered services are subject to political forces.  To find out what those guidelines are in your state and which program is the best for your elderly parent, contact your local Area Agency on Aging.

The Qualified Medical Beneficiary Program is for those people who are at or below the poverty level which is defined as $4,000 in financial assets for an individual or $6,000 for a couple.  The state will cover the premiums and deductibles.

Specified Low Income Medicare Beneficiary Program is for those people who are 10% above the poverty level.

If you plan on using Medicaid for your elderly LO you should contact an elder law attorney who specializes in filing Medicaid applications.  The attorney will also advise you on how to manage your LO’s financial assets.

You need advice of what expenses are eligible and which are not.  You do not want the state to come after you to reclaim money to reimburse it for the expenses they covered.  Go to naela.com for a listing of elder law attorneys.

Hospitalization, doctors’ visits, and medications are covered.  Not all doctors take Medicaid so you have to find one that does and be prepared to wait for an appointment.  If you can’t wait for an appointment then you will have to go to the emergency room for treatment.

Most states have a waiver program that pays for services at home instead of placing your LO in a nursing home.  If your LO qualifies for admission to a nursing home but would prefer to live at home you might be eligible for PACE (Programs of All-Inclusive Care for the Elderly).  Your LO will be provided with all that he/she needs to live safely in their home.

Visit Medicare.gov/Nursing/alternatives/PACE.asp for more details.

Call your Area Agency on Aging or the State Health Insurance Assistance Program (SHIP) for information on the PACE program or any other issues regarding Medicare or Medicaid.