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Monica Dodds understands the pressures that millions of middle-aged Americans endure as they become caregivers to aging parents. Her professional work with the elderly has exposed her to the complex medical, financial, and legal problems that entangle older people. Her personal experience helping ailing family members has given her deep insight into the difficulties caregivers face in dealing with these problems. A Catholic Guide to Caring for Your Aging Parent is a comprehensive guide for caregivers. Dodds ...
Monica Dodds understands the pressures that millions of middle-aged Americans endure as they become caregivers to aging parents. Her professional work with the elderly has exposed her to the complex medical, financial, and legal problems that entangle older people. Her personal experience helping ailing family members has given her deep insight into the difficulties caregivers face in dealing with these problems. A Catholic Guide to Caring for Your Aging Parent is a comprehensive guide for caregivers. Dodds insists that faith is a fundamental part of caregiving, and her approach is deeply rooted in Catholic spirituality. She shows adult children how they can love and serve their aging parents better by deepening their own spiritual lives. "Caregiving", she says, "is a time of many grace-filled moments." Dodds explains how to properly assess the needs of a failing older person, and she writes in detail about the physical, mental, emotional, interpersonal, and spiritual dimensions of care. Three extensive appendices provide checklists for assessing needs, a compilation of resources, and an anthology of prayers.
Introduction: Caregiving Is Personal
Over the years, a lot of caregivers have told me their stories. Some caregivers—still in the thick of it—share what they’re experiencing right now. Others—their duties completed—reflect on what that relationship, that role, has come to mean to them since the death of their loved one.
Some caregivers take care of an aging parent or another senior family member. Others care for a spouse or a son or daughter. In any case, caregiving is always personal. It’s one person providing for another, and that other accepting care. Both the giving and the receiving have their challenging moments.
I’ve discovered that while every caregiver has his or her own story, in many ways every caregiver’s story is the same. It’s always a unique blend of successes, regrets, frustrations, fears, and fatigue; a combination of laughter and tears, love and grace.
My stories are no exception. In 1970, as a senior in high school, after months of helping my grandpa remain at home as his cancer slowly advanced, I rode in the back of an ambulance with him as he was being transferred from his apartment to the hospital for the last time. Then, a few years later, I stood at my grandma’s bedside on the last day of her life and assured her, “It’s OK to let go now.”
I’ve been a caregiver a number of times over the years, but, I must confess, it wasn’t until recently—when caring for a senior family member in failing health—that I began to truly understand just how complex the task of caregiving can be. It was only then that I began to realize the most powerful support I have is an awareness of the presence of God as I go about my daily caregiving tasks.
That’s what I bring to this book. It’s what I want to hand to you. It’s what separates A Catholic Guide to Caring for Your Aging Parent from the many other fine books on caregiving on the market today. For me and—as I’ve found from the stories I’ve had the privilege to hear—for many others, the spirituality of caregiving is not incidental. It’s fundamental. This is true even when those grace-filled moments—moments of awareness of God’s infinite love for this person whom I so dearly love and of God’s gratitude for the work I am performing—are fleeting.
The truth is that you have been chosen. God has asked you to help his beloved son or daughter. This is true even if your response, like mine, hasn’t always been enthusiastic—if, unlike Mary at the Annunciation immediately saying, “Your will be done,” you’ve done your share of muttering and grumbling.
I’m reminded of the Gospel parable of the two sons asked by their father to go work in the vineyard (Matthew 21:28–31). The first answered, “No way!” but then went out and got the job done. The second said, “Sure thing” but didn’t budge. “Which of the two,” Jesus asked, “did the will of his father?” The answer is obvious. The answer is encouraging for those of us in the vineyard who still mutter and grumble from time to time.
In This Book
Because of the complexity of caregiving, this book has three layers.
First, there’s some basic, real-life, practical information: ideas you can use day in, day out, to provide care and to better understand what you and your loved one are going through.
Second, there’s information about the support offered by the Catholic Church. This includes the church’s teaching on life and death, Pope John Paul II’s encyclical The Gospel of Life, and the sacraments available to your parent and to you.
And third, there’s discussion of the role of spirituality in the caregiving experience. Spirituality is blended into this book, intertwined in the chapters, just as it is in your daily life. That spirituality may be under the surface, or dramatically above it, staring you in the face, ready to catch you when you feel like you’re falling or hold you tightly when you feel like you’re going to break apart. At the end of each section, you’ll find a prayer to help you slow down and reflect on your caregiving experience. You’ll also find some basic principles and guidelines reflecting the underlying values of caregiving.
I’ve included three appendixes in the book:
Resources for Caregivers
There is a wealth of information available to you as a caregiver, and it would be impossible to go into great depth about that information in a guide of this kind. The resources appendix will give you a running start as you look for the assistance your parent or family member may need and the support you may need. It is critical for a caregiver to get current and accurate information. Do your research, and always remember to check your sources.
Assessment Guides, Checklists, and Reminders
Everyone gathers information in a way that’s most efficient for him or her. I’ve found checklists helpful, so I’ve included some that might make your tasks easier. The lists in this appendix will help you assess your parent’s needs, look at safety issues in the home, and evaluate a nursing home, among other tasks.
Traditional Prayers of the Catholic Church
This section features traditional Catholic prayers. You may discover that, at this point in your life, they speak to you—and for you—in a new way. Then, too, you can use them if your loved one would like to pray in a formal way or would like to say with you some of the prayers he or she learned as a child. My favorite prayer is the rosary. You’ll find it here.
About the Author
My experience with the elderly and with caregiving has been professional as well as personal. With a degree in social welfare, I’ve worked with the active, well elder as a program coordinator at a senior center; with the independent needing some assistance as a case manager for in-home care; and with the neediest, the homebound, as the manager of Meals on Wheels for Seattle/King County. I’ve also served as an officer on the Council on Aging for Snohomish County, Washington, where my role included examining policy issues related to the field of aging.
My husband, Bill, and I write columns on family life for Catholic News Service and Columbia magazine, published by the Knights of Columbus. We edit a devotional magazine, My Daily Visitor, published by Our Sunday Visitor. Together we wrote The Joy of Marriage: Inspiration and Encouragement for Couples (Meadowbrook Press) and Caring for Your Aging Parent: A Guide for Catholic Families (Our Sunday Visitor), now out of print. I also had the wonderful experience of writing (with the help of St. Thérèse!) Praying in the Presence of Our Lord with St. Thérèse of Lisieux (Our Sunday Visitor).
In 2004, I began the Web site YourAgingParent.com. I invite you to visit me there. It offers spirituality, information, and resources for Catholic caregivers. In 2006, I launched CatholicCaregivers.com, an online community and a resource for parishes and dioceses. That same year I started the Friends of St. John the Caregiver (FSJC.org), an association that is the parent organization of both. Its fundamental purpose is promoting care for the caregiver.
Why St. John? Who better to be the patron saint of caregivers than the one Christ chose from the cross to care for his own mother? “When Jesus saw his mother and the disciple whom he loved standing beside her, he said to his mother, ‘Woman, here is your son.’ Then he said to the disciple, ‘Here is your mother.’ And from that hour the disciple took her into his own home” (John 19:26–27).
You, too, have been chosen. Under whatever circumstances, for whatever reasons, God has asked you to become a caregiver.
I hope you find this book helpful as you face the many challenges of caregiving and as you travel along on your spiritual journey. My prayers are with you and your loved one.
St. John, patron of caregivers, pray for us.
Part One You Are a Caregiver
The Realities of Growing Old
“Not My Parent”
Everybody gets older. Everybody dies. But this isn’t “everybody.” This is different. This is your parent.
You’re not the only one feeling this way. Members of the baby-boomer generation are facing the undeniable fact that as they enter and pass through middle age, their parents are marking their seventieth, eightieth, or even ninetieth birthdays. Likewise the adult children of these boomers are assuming caregiver duties more and more frequently. And suddenly—it always seems sudden—the people who cared and nurtured and taught and provided are the ones who need help. Suddenly Mom isn’t as independent as she used to be. Suddenly Dad is neglecting tasks he’s been handling faithfully for more than half a century.
The realization that a parent needs help is a realization that gnaws at the heart and begins with self-doubt. Soon after, guilt, panic, frustration, and grief fight for dominance. If you’re an adult child living near your aging parent, you probably blame yourself for not noticing the gradual deterioration. Maybe Mom had a small stroke and fell on the kitchen floor and lay there all night until a neighbor happened by. Why didn’t you drop in more often? Why did it take something big to make you see what was going on?
If you and your aging parent live in different parts of the country, you may not notice the small and not-so-small changes adding up. Perhaps a visit home to Dad—a visit you’ve put off for how long?—brings a shocking revelation: the spunky, independent person you remember is no longer there. Why didn’t you come sooner? Why didn’t you notice the changes when the two of you spoke by phone? Why wasn’t it obvious that his letters were more muddled and arrived less frequently? Why did you take that job so far away?
You start to feel panicky. You need to solve these problems now! But you can’t. In fact, you shouldn’t even try.
First, you can’t solve all the problems now. Your parent didn’t reach this condition overnight, and it will take time to make changes. There are no quick fixes.
Second, you—singular—shouldn’t solve the problems. If you swoop in and begin giving orders, you may be not so pleasantly surprised to see that the proud, self-reliant (some might say stubborn and cantankerous) person you thought had gone is not gone entirely. Not by a long shot. The more your parent is involved in finding solutions to the problems, the more cooperative he or she will be.
Gradually you realize that you are a caregiver. Frustration mounts. Why does it take a dozen phone calls to find the right agency to deliver the service your parent needs? Why do you always feel as if you’re either not doing enough or doing too much? Why don’t you have the energy or time or money to properly take care of your spouse, your kids, and your parent?
In the dead of night, grief wins. There’s the icy realization that your parent is going to die. As you try to cope and solve and assist, you can’t help feeling this is the beginning of the end. You can’t help the grief you feel because you know someday your mother or father will be gone.
You lie there and pray, “Please, God, not yet. Not my parent.”
Dear God, time is just passing too fast. The thought of my life after my parent dies scares me. What will it be like? I know I need to trust in you. Help me accept your timeline. Amen.
Throughout our lives, our bodies change. As long as a human body is living, it’s growing older. So how can you tell if your parent is developing a new and potentially serious health problem, or if what you see is simply part of what could be called the natural aging process?
The temptation is to assume that a new problem your parent develops is one every older person experiences and that nothing can be done about it. Not necessarily.
Take being confused, for example. Doesn’t everyone, if he or she lives long enough, develop some form of mild dementia? Yes, the chances of developing a form of dementia (Alzheimer’s disease being only one of the possible diagnoses) increase with age, but there are other reasons a parent might be confused. Maybe Dad’s metabolism has changed, and a medicine he’s taken for years is now causing side effects. Or the problem is a new medicine combined with what he’s already taking. Maybe, without your knowledge, Mom is drinking more than she used to. Maybe she has had a small stroke.
It’s a good idea to do some research and then ask your parent’s primary physician about the “normal” aging process—what, in general, is to be expected—and keep the doctor up to date on what’s happening with your mother or father. If you see something new, ask the doctor about it. It’s a good idea to consult with the physician even if you think what you see is to be expected with any chronic condition your parent may have. (And it’s important for you to know the usual progression of that condition as well.)
For example, Mom has arthritis, and she’s having more pain and more difficulty using her hands. Yes, her condition may grow worse over time, but perhaps a more effective medicine or treatment will help as the inflammation reaches this new stage. Would physical therapy help her feel better, and is it available? Would occupational therapy or an adaptive device make it easier for her to perform daily tasks like holding a fork or using a zipper? Ask about these things.
Don’t compare your parent’s condition or symptoms with another older person’s. Maybe your best friend noticed that her father was growing hard of hearing, and he now wears a hearing aid. You notice your father’s hearing isn’t what it used to be, but you hesitate to bring up the subject with Dad or his doctor because you’re fairly certain getting your parent to accept a hearing aid would be a tremendous battle. At the same time, Dad has noticed the trouble he’s having, and he’s worried but too frightened to say anything about it.
While you both tiptoe around the subject, the source of your father’s problem may be nothing more than wax buildup in his ears. His doctor’s nurse could quickly and easily take care of it and give both of you tips on how to avoid the problem in the future.
In other words, don’t assume that you understand what you are seeing, and don’t assume that there’s little to be done about it. Remember that while you and your parent may become very good at spotting and diagnosing a change or a problem, that’s not the same as having an objective health-care professional evaluate what’s happening. Let that person be the one to decide if it’s an inevitable part of the aging process.
My Lord, so many people are afraid to grow old. Give me wisdom to understand the aging process. Keep me alert to the changes in my parent’s life. Make me an alert caregiver. Amen.
Welcome to Caregiving
The Sandwich Generation
Caregivers can feel like the “sandwich generation”: there’s pressure from your children on one side and your aging parent (or even grandparent) on the other, and sometimes it gets messy in the middle. Add in a spouse and a job, and it’s no wonder you often feel that you don’t have nearly enough time and energy for all you have to do.
Pressure comes from expectations. Maybe your parent took care of Grandma or Grandpa. Your spouse took care of your mother-in-law or father-in-law. Your friends or coworkers seem to be able to handle their situations. But you are having trouble. Then comes guilt. When you realize that you can’t do all the things you’re supposed to do, you think you’re letting everyone down. If you just worked a little harder, slept a little less, sacrificed a little more, then somehow . . .
If you find yourself in that situation, these suggestions might help:
Remember that there is no single “right” way to do this. Trying to mimic what another person has done probably isn’t going to work for you. Each case is unique because the personalities and problems in each case are unique.
You need to take care of yourself. If you don’t, you will burn out quickly and be of little use to anyone, including yourself. The situation in which you find yourself is not a sprint; it’s a marathon. Yes, someday it will end, but that may be a long, long time from now. In the meantime, if you do not pace yourself—or sometimes even pamper yourself—you won’t be able to keep going. That’s not because you’re weak; it’s because you’re human.
The big picture can look and feel overwhelming. Sometimes it helps to break it down into the many tiny pieces that make up the whole: what you have to do for your parent, your children, your spouse, your job, yourself. The lists may be long, but somehow no single item is overpowering.
Prioritize your tasks. Making those lists helps. Obviously, getting Mom to her doctor’s appointment is more important than vacuuming her apartment.
Give away some of the low-priority duties. Someone can be hired to do the apartment cleaning. Someone else—the bakery at the local grocery store, for instance—can supply the brownies you’re supposed to send to the next Cub Scout den meeting.
Get support for yourself. Groups for caregivers and organizations that focus on your parent’s particular illness or condition can help you deal with what you are facing. Doctors, social workers, and your region’s Area Agency on Aging can give you local contacts.
Write it down. Take notes on all the information from doctors, therapists, pharmacists, teachers, coaches, your boss, your spouse, your kids . . . There’s no way you can remember all the things you need to remember without help. It may seem like the day is completely packed, but if you jot down your own to-do list, you may discover there’s half an hour free here, twenty minutes there. A little oasis like that gives you something to look forward to—a short break to at least partially recharge your batteries before you have to go, go, go again.
Jesus Christ, sometimes my life feels like a tug-of-war, and I’m the rope. Keep me strong so I won’t break. I need you right here next to me. Amen.
Stages of Caregiving
Start by doing what’s necessary, then what’s possible, and suddenly you are doing the impossible.
—St. Francis of Assisi
There is no single, tidy, all-encompassing definition for caregiver. Rather, it’s a job that includes multiple responsibilities that vary not only from family to family, and not only from one family member to another, but also from caregiver to caregiver. The caregiver you are today may not be the caregiver you were six months ago, because the care your parent needs has changed. In the same way, the caregiver you are now may not be the caregiver you will be in six months. If your parent’s health improves, you may be less involved. If it worsens, you may be more involved.
Nevertheless, the caregiving role is typically a continuum that you move through as your parent’s needs change. Generally, the role of a caregiver follows a particular identifiable pattern. In other words, it’s possible to identify where you are right now on that “continuum of caregiving.” Recognizing where you are on that spectrum can help you better understand why you feel as you do. You may be more tired because your duties as a caregiver have crept up incrementally and now demand more of your time, energy, and patience.
One aspect of caregiving is that it has many stages. A list of these stages can not only help you identify what parts of a caregiver’s vast “job description” are in the forefront for you right now, but also better prepare you for what may soon lie ahead. These are the stages that can be identified, although they don’t necessarily follow this sequence:
Pre-caregiving: The caregiver is a helper, beginning to lend a hand with a limited number of tasks but not identifying him- or herself as a “caregiver.”
Self-identifying: Those caregiving tasks have increased to the point that the caregiver realizes and says, “I am a caregiver.” The caregiver now defines the role for him- or herself or continues to “just do it.”
Studying and researching: Adopting the role of a student, the caregiver wants to know about and understand a parent’s condition or illness, including the symptoms and prognosis, and begins to look for resources for stress management and for informal support, such as family and friends.
Acting like a caregiver: The caregiver is actually doing the work—increasing the number and frequency of tasks, learning new skills and improving on others—and, as his or her parent’s health deteriorates, begins to feel more stress.
Recognizing challenges: The caregiver sees the impact of the situation: the emotional strain for both the parent and the caregiver, the parent’s resistance to accepting help, and the caregiver’s own exhaustion, anxiety, and anger.
Getting help: The caregiver acknowledges the need for help. The spirituality of the role of caregiving becomes more apparent, and the caregiver incorporates prayer and the awareness of God into daily activities. The caregiver locates and accepts formal support from social services and expands informal help to include the extended family, more friends, and the parish community.
Managing the role of caregiver: With the added help, the caregiver begins to be more proactive in his or her approach to the role. The caregiver may decide on a game plan, learn about and use new coping strategies, and begin to feel more in control and more confident.
Preparing for the end of caregiving: The caregiver understands that the role of caregiving will end with the death of Mom or Dad. In many ways the caregiver begins to grieve the loss of both the once-healthy parent and the parent who now needs care. This is when the caregiver most clearly sees the true value of caregiving and the love and respect he or she has for the parent.
Moving on after death: The caregiver experiences shock, even if death was expected, and grieves the loss of his or her loved one. There may be an empty period in the day, a feeling of “Now what do I do?” This is a good time to rest and reminisce. Acceptance and appreciation of the experience will gradually come.
In a perfect world a caregiver would move step by step through the list. In the real world, in your world, that might not happen. The next time you’re feeling overwhelmed, review this list to see if one of the steps gives you some ideas for helping you to feel more in control.
See the information fact sheet about caregiver stress on page 267.
Most Holy Spirit, guide me on my journey as a caregiver. Each step of the way I need you. I don’t know how long this trip will last. Please give me comfort and rest when I’m done. Amen.
The Basics of Catholic Caregiving
Some underlying themes of caregiving are repeated throughout this book. They can be used as basic principles and guidelines while you care for your parent. When you, the caregiver, are facing a particular issue or concern, it can be helpful to keep these in mind. Consider how your idea, plan, or solution corresponds—or doesn’t correspond—with these themes:
Love and respect: No matter how old you and your parent are, you will always be child and parent. The lifetime bond between you is like no other. As an adult, you probably realize that this relationship is seldom ideal and never perfect, and yet it is tremendously important. As the adult child of an aging parent, you’re now being given the opportunity—the challenge—to honor your mother or father in a new, different, and more demanding way.
Self-determination: It’s still your parent’s life, not yours. You’re there to assist, not take over. As long as your parent is mentally competent, he or she should be included in decisions, and his or her choices should be respected.
Normalization: A basic goal for you is to help your parent continue to lead the same lifestyle he or she has been leading and wants to keep leading (provided, of course, that lifestyle is not undermining his or her health or safety). The fewer the changes in his or her daily routine, the better.
Individualization: Just because your friend did this or that for her parent doesn’t mean it’s best for your parent. And what was good for Mom may not be what’s good for Dad. Each life is unique, and therefore one’s care must be tailor-made.
Communication: Planning early and talking often, even about difficult subjects, will help you and your parent avoid having to work things out in the middle of a crisis.
Support: A number of support systems are available for both you and your aging parent. In addition to the informal support of family, friends, neighbors, and members of the parish, you can access the more formal support of professional counseling. A support group, for example, can be extremely helpful. You don’t have to reinvent the wheel. Others have been here before. You can learn from them.
Use of resources: Many resources and services are available. Research can be challenging, but it’s worth the effort. (Remember that there are resources and services for both your parent and you, the caregiver.) The aging network is growing rapidly. Keep looking for whatever you need. Don’t assume that the help you need isn’t out there.
Solutions: Try not to panic. Most often there is no quick fix to your parent’s increasing needs, no simple answer. Keep in mind that even the best solution is only temporary. As your parent’s situation changes—and it will—even the best answer will have to be reviewed and reworked.
Minimum to maximum: Change is difficult for all of us, and sometimes little steps at a time make it easier to accept. If you meet with resistance from your parent, start with the most basic and critical help needed. Stick with that and keep it limited. Then, gradually increase services to cover more needs. This approach helps your parent stay within his or her comfort zone, and it also helps you evaluate how things are going and what more may be needed. The challenge is to begin with the minimum amount of help or change that’s necessary and then, as needed, gradually increase it.
Ongoing process: The aging process is ongoing, and each step along the way brings new challenges for both you and your parent. As your parent’s health deteriorates, you and your parent’s traditional roles as child and adult—the one who needs help and the one who has always provided that help—may continue to fluctuate or reverse. These changes are new for both of you and can seem overwhelming. Remember, neither you nor your parent has to be an expert at this. You can learn together.
Prayer: As is true when facing so many of life’s challenges, the best coping strategy includes turning to prayer. Pray for your parent, that he or she can accept what is happening and find comfort. Pray for yourself, that you will have the strength to do the many tasks before you. Pray that both you and your parent will have wisdom when decisions need to be made. Pray that you both will feel the love of God, our heavenly Father. Pray for your fellow caregivers. Pray—right here, right now.
Father in heaven, I want to be a good caregiver, the best, because I know you want this for my parent. Gently remind me that I have a responsibility to you to care for my parent. I accept the assignment you have given me. Amen.
Contents Introduction: Caregiving Is Personal xv
Part One: You Are a Caregiver
1 The Realities of Growing Old 3
“Not My Parent” 3
Understanding Aging 5
2 Welcome to Caregiving 9
The Sandwich Generation 9
Stages of Caregiving 11
The Basics of Catholic Caregiving 14
3 The Spirituality of Caregiving 17
God Knows 17
The Role of Spirituality in a Caregiver’s Life 20
A Prayer for a Greater Awareness of the Presence of God 22
How to Nourish Your Spiritual Life 23
Praying as a Caregiver 25
Responsibilities of the Church and Your Parish 28
How Your Parish Can Support Caregivers 30
4 What to Expect . . . and What to Do about It 33
Handling Unexpected Emotions 33
Respite Care 40
The Need to Talk 43
5 Caregiving Is a Family Affair 45
You and Your Siblings 45
Preparing Your Children to Visit Your Parent 47
When You’re Married to the Caregiver 50
Caring for an In-Law or a Stepparent 51
Part Two: Caring for Your Parent
6 Conduct an Assessment 57
Physical Condition 59
Mental Ability 60
Emotional and Social Health 61
Spiritual Life 63
From an Evaluator’s View 64
Choosing the Best Solution 65
7 Understanding Your Parent 67
Your Parent’s Generation 67
Independence, Control, and Self-Determination 71
viii • Contents Losses 73
Confusion about Role Reversal 79
“I Don’t Want to Be a Burden” 80
Always a Parent: Worries about Adult Children 82
Challenges of Communication 83
8 Doctors and Hospitals 87
The Doctor 87
Getting a Second Medical Opinion 90
When the Professionals and Your Parent Disagree 92
At the Hospital 93
9 Physical Well-Being and Decline 97
Vision Loss 97
Hearing Loss 100
Dental Problems 102
Poor Nutrition 104
Problems with Mobility 106
Wheelchairs, Walkers, and Canes 108
10 Mental Health 111
Mental Illness 111
Dementia and Alzheimer’s Disease 115
Depression and Suicide 119
Tobacco Use 125
11 Emotional and Social Health 129
The Need to Have Fun 129
The Danger of Isolation 131
Celebrating Birthdays and Anniversaries 133
Writing Memoirs 137
Leisure-Time Activities 140
12 Spiritual Matters 143
Spiritual Health 143
Helping a Parent Find Forgiveness and Peace 147
Welcome Back to the Church 149
The Gospel of Life 150
The Sacraments 151
Penance and Reconciliation 152
The Eucharist 154
The Anointing of the Sick 156
13 Your Parent’s Safety 159
Home Safety 159
Personal Safety 162
In Case of an Emergency or a Disaster 164
14 I s It Time for Your Parent to Move? 169
Housing Options 169
Choosing a Nursing Home 171
Should Mom or Dad Move In? 174
When Mom or Dad Moves In 176
Saying Good-Bye to the Family Home 178
Finding Help for Your Parent 180
Hiring a Case Manager 181
When Mom or Dad Doesn’t Want Help 183
15 Finances and Other Paperwork 185
Financial Management 185
Health Care and End-of-Life Decisions 188
Personal Affairs 190
16 Some Special Problems 193
Helping Your Parent Give Up the Car Keys 193
Long-Distance Caregiving: Talking on the Phone 196
Long-Distance Caregiving: Visiting Home 198
Keeping Secrets, Telling Lies 200
Dealing with Your Parent’s Racial and Ethnic Prejudices 203
Euthanasia and the “Right to Die” 204
Taking Care of a Crabby or Formerly Abusive Parent 206
Refereeing Fights between Mom and Dad 209
17 Dying and Death 213
Preparing for Death 213
Talking to Your Children about Death 216
Words That Sting, Words That Comfort 218
Sorting Out, Moving On, Remembering 221
18 The Church and Dying 225
Funerals, Memorial Services, and Cremation 225
The Vigil 229
The Mass of Christian Burial 230
The Committal Rite 231
The Communion of Saints 232
Part Three: Appendixes
Appendix I: Resources for Caregivers 237
Critical Issues 242
Death and Dying 243
Mental Health 251
National Organizations 253
Resource Information 257
Suggested Reading 261
Appendix II : Assessment Guides,
Checklists, and Reminders 265
Tips for the Caregiver 266
Caregiving Stress: Warning Signs 267
An Assessment Checklist 269
Home Safety Checklist 275
Depression Checklist 280
Driving Skills Checklist 282
Legal and Financial Paperwork Checklist 284
Elder Abuse Checklist 288
Evaluating Housing Options 290
Evaluation of Assisted-Living Facility 292
Evaluation of Nursing Home 298
Appendix III : Traditional Prayers of the Catholic Church 303
Sign of the Cross 303
Apostles’ Creed 303
Lord’s Prayer 304
Hail Mary 304
Glory Be to the Father 305
Hail Holy Queen 308
Peace Prayer of St. Francis 308
Contents • xiii Prayer to the Holy Spirit 309
Act of Contrition 309
Prayer to My Guardian Angel 311
Grace before Meals 311
Grace after Meals 311
The Universal Prayer, Attributed to Pope Clement XI 311
Eternal Rest 314