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If you're caring for loved ones at home, much of your regular schedule may be disrupted. You may be desperate for ways to keep your loved ones busy and yourself from tearing your hair out! Here are some ideas to help out:   Reading - Choose a book to read together and read aloud to them. Or connect with other family members and friends on the phone or video chat and do a book club - either sharing info about the books each are reading or you could all read the same book and discuss. Re-read an old favorite or try a new book. You can order books online for delivery or download ebooks or audiobooks from your publilc library (if you don't already have a membership you can join the library online in most places). Send a card or letter to family members and friends - it's the perfect chance to revive that old tradition that people don't do much anymore! Write to first responders and military and thank them for what they are doing in this crisis. Write to nursing facility staff, home care staff and others who care for older adults. Write to friends you know are also stuck at home.  Document your loved ones' life story - it's the perfect time to start that memoir or make a video of your loved one telling stories about their life. You can check out StoryCorps for guidance on how to do that (and they also have an app you can use).  Try jigsaw puzzles, board games and card games. My Mom loved to play Uno and we just adapted it so Dad could play too (he had Alzheimers). Sometimes the older, simpler games are easier for your loved ones to play (remember Chutes and Ladders?!), and others will relish a competative game of Monoply or Checkers.  Take an online adventure. Virtually tour museums or explore outer space with NASA’s free online video and image library. From bees to birds to bison to bears you can observe nature and animals with Explore.org’s livecams. Re-live your own adventures by flipping through photo albums and videos. And dream about (and plan) your next adventure — near or far — when the coronavirus social distancing advisories are a thing of the past. Movies and TV shows are always good - but if your loved one is getting too anxious about coronavirus you might want to limit time watching the news. Think about TV series you can "binge watch" - it's fun to watch an entire series in a row! Old movies are fun and bring back memories, and musicals are fun to sing along and the plots aren't too complicated! Get organized - have them help you organize a drawer or closet. Scan paperwork and shred to get rid of paper. Organize photos and make photo albums.  Go for a drive or get outside and take a walk - that is still allowed in most communities.  Enjoy time together - for some this is sort of a unique opportunity to spend time with loved ones and have good conversations, reminisce and just "be".  What are you doing to pass the time?     
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My parents are in their early eighties, both with health issues. They don't seem to think that there should be plans in place when they can no longer do for themselves. We live 2000 miles apart, I'm an only child.  They won't consider moving closer to me and I fear that if something happens to either of them, we will be faced with making poorly thought-out arrangements. They won't engage in a serious conversation and I feel they are in denial. How do others approach their parents? Are there articles on this topic?   @LauraLG28 wrote: My parents are in their early eighties, both with health issues. They don't seem to think that there should be plans in place when they can no longer do for themselves. We live 2000 miles apart, I'm an only child.  They won't consider moving closer to me and I fear that if something happens to either of them, we will be faced with making poorly thought-out arrangements. They won't engage in a serious conversation and I feel they are in denial. How do others approach their parents? Are there articles on this topic? This is one of the KEY issues for adult children of aging parents.  My guess is one of the AARP amazing experts will respond with article suggestions. I know that "Prepare to Care" as a guide is TERRIFIC and on this site. Step by step and very thorough.    What I'm guessing is that you are trying to bring up this difficult topic by phone rather than in person since you are 2,000 miles away. I think in person would be much better, but since not too many people are traveling, perhaps zoom or facebook messenger or google hangouts or if they have apple then facetime... Looking and watching their faces and their ability to see your expression will help. And there are ways to frame the discussion. WIth Covid19 there's always the 'would you want to be on a ventilator' issue. But its not a good idea to dive in with that. Oy.   It might be helpful to inform yourself about how other elders in the family are planning ahead: is there an uncle or aunt who has done advance directives? Talk to cousins and find out? If one of your parents' sibling has done any of this, it mght help to bring that up. Do they have a pastor they trust? Call up the pastor and say, would you back me up if i start talking to my folks about what they would want done if they became incapacitated? Enlarge your caregiving circle ... so you aren't doing this all solo.   Also, doctors talk about 'goals of care' and POLSTs rather than 'living wills'. It might help to talk to their doctor. It's now telehealth time because of COVID and you could probably get a chance to talk to their primary care provider about what she or he recommends in terms of care. For example, for people with Parkinsons Disease, its a good idea to assume that once the person cannot swallow safely, its time for home hospice rather than time for a feeding tube... there are specific thoughts for each illness as to what is ideal end of life care.   i hope that's helpful...  Jane   @LauraLG28 Hi Laura! @JaneCares gave you some great suggestions! Just to add a tad bit to that...   Here is my short blog post with 4 Tips for Difficult Family Conversations - you'll find also on that page my video on the topic with more tips! (both are quick and I loaded them with practical stuff!)   It sounds like you're in that position that so many adult children face - I know it's hard!    One approach that works for some is to couch it as they will be doing something for. YOU by talking about current and future situation and plans. Many parents don't want to "burden" their kids with this stuff or with care, but what they don't understand is that it actually causes MORE stress for the kids when plans aren't in place for all the contingencies that might come up. If you can get them to understad that it is actually MORE of a burden to feel so up in the air about all of this maybe they would make the effort to start the conversations and share their plans with you.    Many people just fear change or are happy where they are and really don't want change. That is understandable. But there are many options along the way that don't necessarily lead to them re-locating - at least not right now. Now is the time to be researching the options. Home-based care. A senior community in their area. Technology to keep you more connected and help you monitor how they are doing....lots of options.    Sometimes legal issues are a good place to start - just making sure advance directives are in place - and as Jane mentioned you can open with "X family member" just got theirs done, or I just got mine done - and stress that any adult should have advance directives in place at any age - sometimes it helps to not make it about age. Here's a good article from my friend and colleague Amanda Singleton about powers of attorney.    I hope this is helpful - take a look at the blog and video and let me know how else I can help!   Take care, Amy Goyer, AARP Family & Caregiving Expert Author, Juggling Life, Work and Caregiving       You may want to start with very small steps and keep it an on-going, non-confrontation thing.  Perhaps start with a general conversation about what THEY want done when, down the road, they can't get around too well anymore.   As mentioned, Advance Directives are very important - our Family Doctor is very pro-active about these - hopefully theirs is too.  Perhaps you can ask if they have discussed this with their doctor.   Finances will also play a large role in where they get cared for in the future, ideally you have a general idea of their resources, though that may also be another tricky conversation to start.   P.S. My response is based on personal experience and opinion, and is not any kind of professional advice, as some of the others responses may be.   Thank you, for your input. It's challenging. They are so often on the defensive when I try so hard to frame my questions in concern for their future... I get, 'Oh don't worry honey'. And yet thy don't, as far as I can see have anything in place.   I'll work on opening the conversation, maybe by giving them information about planning and see where it goes. At least it's a start.   Laura   Thanks, Amy,   You make a lot of great points. I find myself in a difficult position. No siblings. Dad has only one much younger sister. Their doctors do not appear to be getting involved in such issues. My parents are sure they have everything under control even though they have nothing in place and rarely listen to any suggestions I give them on health care. It is amazingly frustrating.    Can you suggest any articles that are directed at them for preparing for their future that I can pass on to them? This may be a way to start the conversation.   Thanks Laura   Hi Jane, Thank you. I'm in the difficult position that there are very few people in my family and none at this stage in their lives. They have no religious affiliations. My parent's doctors don't seem too involved in their future planning. It appears to be left to me to initiate the conversation, even from this distance. They seem to think everything is in control while nothing seems to be in place.    I may try to frame the conversation around my concern about my mother-in-law, who also didn't plan ahead and is now in Europe by herself after choosing to move there with my now-deceased father-in-law while in their seventies. At least she is looking into senior facilities.   Thank you for your input, I'm going to look into some of your suggestions. Laura   Parents aren't the only ones you should talk to about this.  Many younger people with children have no instructions in place about their children or estates.  Everyone needs to have some kind of a will as well as medical instructions.  I was appalled to find out that my daughter and her husband had no will when they were getting ready to cruise to Europe, leaving minor children at home with their Aunt in charge.  They have one now!   @LauraLG28 Here are some articles that might be helpful!    Estate Planning During Coronavirus    Create Your Will for Free   The Ultimate Guide to Estate Planning   5 Estate Planning Documents Every Family Should Have   Hope these help - let me know how it's going and if you need any more suggestions!    Take care, Amy Goyer, AARP Family & Caregiving Expert Author, Juggling Life, Work and Caregiving    
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  Did you know that there is a whole AARP local resources and solutions page! Take a look, change the location to your area and get the help you are looking for! There is an even a COVID-19 specific portion.   Anything on the page stick out to you? How was it able to help? How can we make it better?      
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  Here is a fluid list of which phases different states find themselves in with the intent to re-open. How has re-opening affected you and your loved one in your area, or has it?  
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AARP Expert Amy Goyer Coordinating the never-ending doctor appts, trying to get lab results, setting up therapy appts, getting new medicines and treatments - it's all exhausting! I did all this for more than a decade for my parents and some for my sister when she was hospitalized so I know how hard it can be. Here are a few quick tips to help make things go as smoothly as possible:   Get the legal authority to coordinate care -  Make sure your loved ones have advance directives in place. A power of attorney  (POA) for health care gives you or someone else on the caregiving team the legal right to talk with practitioners, manage your family member's health care and make decisions if the person is unable to do so. Be prepared for appointments -  If you make their job easier and faster, medical professionals will be much more responsive to you. For example, download new patient forms and complete them ahead of time; bring your notes and questions with you; bring medical history and other medical documents; allow plenty of time so you aren't late and your loved ones aren't rushed. Ask about telemedicine -   Virtual medical appointments can be an effective and convenient tool for both practitioners and patients, especially for those with significant mobility issues or health conditions that make them more vulnerable to infections. Take notes - Document everything! You never know what might be important someday. I take notes at every appointment and procedure and also record when tests take place, as well as the results. Often, I can find what the doctor said at the last visit more quickly in my notes than she can on her computer. Clarify roles - If you're lucky, you are not the only person working with the health care team. While I held the primary health care POA for my parents, my sisters sometimes helped coordinate care. It was important that we kept one another updated and that practitioners knew it was OK to talk to any of us about our parents. Don't assume one doctor knows what another is doing - You are the information hub. Keep track of tests, diagnoses, treatments, and plans, and share that information with each of your loved one's physicians. Many health care offices have online portals on which you can set up a profile for yourself or a family member, exchange messages, get doctors’ notes, and see the lab and other test results. Establish mutual respect - Establish positive relationships with doctors, nurses, assistants, technicians, therapists, social workers, support staff, and others, and be respectful of their skills and time. And when any of them does a good job, be sure to express your gratitude. At the same time, gain their respect. Model the kind of interaction you'd like to have from them, including being pleasant and patient. Ask clear and concise questions to avoid stretching out appointments, but be firm about getting them answered. Focus on what gets results in each office - I've saved time and improved communication with providers by building relationships with receptionists, office managers, billing staff, and physician's assistants. It may take some trial and error, but you'll figure out who in each office is most likely to get a question answered and get back to you. You'll find more details on these tips and a few additional ones in my column on AARP.org "Tips for Family Caregivers Managing Medical Matters"!   Take care, Amy Goyer, AARP Family & Caregiving Expert Author, Juggling Life, Work and Caregiving   Find more Caregiving Tips by visiting our Caregiving Tips forum today.  
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AARP Expert Amy Goyer Here are some tips if you are looking for transportation for an older adult or someone with disabilities:   Start by contacting the Eldercare Locator to get contact information for your local area agency on aging. You can also call the Eldercare Locator at 1-800-677-1116. Ask the area agency on aging about the availability of transportation services available in your area. The area agency on aging contracts with local organizations to provide transportation services. They may include home health agencies that provide personal care as well as transportation, organizations that offer a variety of services for older adults or those with disabilities or they may be organizations that only provide transportation.   You can also search in the online Community Resource Finder. Click on "Care at Home" and then "Transportation" and enter your zip code. You'll then get a list of organizations that provide transportation services (some may be home health agencies that also provide transportation).   You can also use rideshare services like Uber or Lyft, and in some areas, they partner with organizations to provide special services for seniors. But if you do that be sure they are following safety protocols for COVID-19. If you want to go that route, you might try using a service like GoGo Grandparent   - a service in which you can call to get a rideshare instead of using a smartphone. They also offer communication with caregivers.    Contact the VA if you or your loved one is a Veteran, and ask if they provide any transportation services for Veterans or if they know of local organizations that do. You can contact your local VA office, medical center, or your social worker, and if you aren't already connected with the VA you can start with the VA Caregiver Support Program website or call 1-855-260-3274.    Ask about the cost. Some offer free or sliding fee scale (based on your ability to pay), or flat rate transportation for older adults or those with disabilities. If using a rideshare service you can ask about typical rates for some of the places you go to frequently.   Ask about who drives and what type of vehicles are used. Are drivers paid staff or volunteers and what training do they receive? Vehicles might include taxis, buses, vans, wheelchair vans, SUVs, sedans, black cars, private vehicles.   Ask about exactly what services are offered. Will they: Help you go to and from the house and into the car? Manage a transport wheelchair or walker and put them into the car for you? Offer a wheelchair van with a lift so you can stay in the wheelchair? Drop you off at an appointment or store and come back when you call to say you are ready? Wait in the parking lot until you are ready to go? Offer "escort" service - where they will help you into the appointment or store, help you there and wait with you? Offer additional services, like carrying and unpacking and putting away groceries, doing housekeeping, etc.? Also, ask if there will be other passengers in the vehicle.   Ask about safety and security, including a background check and other screening for drivers and vehicle upkeep. In this time of COVID-19, it is very important to ask about safety precautions to protect you from infection, including cleaning the cars and opening the windows between passengers, wearing masks, other people in the vehicle, etc.    A few additional resources: This article has a good explanation of the various options   "Where Can I Find Affordable Transportation Services" This article is geared toward caregivers but even if the transportation is for you it has good info for you!   "Transportation: What Caregivers Need to Know" The Mobility Management Center   might also be helpful - there are often local mobility managers who can help you set up transportation.   I hope this is all helpful!   Take care, Amy Goyer, AARP Family & Caregiving Expert Author, Juggling Life, Work and Caregiving  
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  Need help finding local resources during the Pandemic...check out this resource that AARP is offering. You can get the contact information you need by state!      
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AARP Expert Amy Goyer Many states and communities are loosening up on restrictions, but what is really safe? Here are some tips to help you navigate the "new normal":   Find out what is open in your area.  Keep in mind that parts of a state may be more "open" than others. Individual counties and cities can impose (or loosen) restrictions regarding what is open, how many people can be in a place of business and whether or not face masks are required etc.. So it's best to check on your city or county website or check with a local news station to find out what's going on near you. AARP provides this list of states and their current state of restrictions (it's updated frequently because things change so much).  To find out what services for older adults are resuming, contact the service provider or facility directly, or contact your local area agency on aging (to find your local area agency on aging go to the Eldercare Locator at www.eldercare.acl.gov or call 1-800-677-1116).  Be sure to take safety precautions for yourselves and your loved ones. Make good decisions for you and your loved ones. While states and local governments issue restrictions, it's still up to us to take care of ourselves. Remember that the virus is still out there and some area numbers are still going up. Just because things start to open up doesn't mean the danger is gone. Also be aware there are a lot of myths about coronavirus floating around so educate yourselves about the truth.  You may adjust your precautions according to where you are - this article has many specific examples for what to do in various places, like restaurants, hair salons, retail shopping, beaches, golf course, etc.  Find safe ways to visit loved ones who are at risk. If your loved ones live at home, in a facility or a senior community, visitors are starting to be allowed in some places, generally on a limited basis. Weigh the risks and plan visits carefully, erring on the side of caution. Many people are making window visits, talking on the phone but still being able to see each other. Using video chat, or take a walk outside observing distancing precautions. Here are more tips about visiting older family members at home. It's wise to continue to be very careful, especially if you or your loved ones are more vulnerable or at-risk. You can still stay home, use grocery delivery services, wear face masks, use telemedicine for doctor appointments and therapies, continue being careful about touching your face and washing your hands if you do go out, etc. Remember that people of all ages can be asymptomatic carriers of the virus too.  Continue to take care of your health, get plenty of sleep, eat healthy foods, exercise, manage stress, and find ways to socialize in safe ways. For more information about dealing with the pandemic, visit www.AARP.org/coronavirus.    
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AARP Expert Amy Goyer Regardless of your specific caregiving situation, there will be numerous conversations you'll need to have with loved ones - those you care for, siblings, etc. And some of them are difficult, like talking about the future, legal issues, estate planning, future care plans, treatment plans, financial matters, housing, stopping driving, and more. Here are some of my tips to help make these conversations easier:   1. Talk early and often. Early because it's just easier to talk about things when they are seen as being in 'the future' (not now or not looming overhead). Also because one never knows when there will be a sudden health change, an accident, a sudden financial change...it's better to be prepared. And often because things change. Years ago, you may have talked about your parents' wishes for where they want to live as they age, but as the years roll by they may change their minds, or their financial situation changes, or their health needs changed, and you need to be aware of their wishes NOW. Another example is they may have powers of attorney set up but whomever they had designated has had a change - someone passes on, moves is no longer to assume that role. Things need to be updated.      2. Observe before you act.   Before you even begin a conversation, spend time with loved ones observing and gathering accurate, specific information about your concerns. If you want to talk about driving, ride along first to make sure your concerns are valid. It helps if you can spend a few days with them and actually stay at their home. Is the mail piling up? Are they having trouble navigating stairs? Are they able to prepare healthy meals? Try to be objective, talking with other family members, and key people who see them regularly. Then do your homework:   Research the options   for support and care for them. Never bring up a change unless you have realistic alternatives to offer. For example, if your loved ones stop driving, how will they get to the store, appointments, etc.? (Note that it helps if you can talk about a problem   before   it’s a major issue. It’s always easier to discuss how you might handle a situation when it's still hypothetical.)   3. Approach with love, concern, and support.   Make sure your mind and expectations are in the right place to set the tone. Starting out with a confrontational, negative attitude will sabotage the discussion. Don’t make it a power play. Remember that your role is   always   to support your loved ones and help them be as independent as possible, for as long as possible —   not   to take over their lives.   4. Communicate effectively. Use conversation starters.   If you’re uncertain about how to bring up the subject, try an indirect approach such as discussing   an article   or   a book   you read, a friend’s situation, or   a television show . You'll find many great articles and videos at AARP.org/caregiving. Ask them for input.   It’s not a one-way conversation, so ask how they think they are doing and what adjustments they’ve thought about. Specific questions can be helpful, such as, “Are you ever worried about taking care of the house and yard?” “Is there anything you’d like to have more help with?” “Do you have any worries or concerns?” “If/when it’s time for you to hang up the keys, have you thought about other changes you’ll need to make?” Use “I” statements.   Starting sentences with “You need to…” or “You just have to…” puts people on the defensive. Instead, try “I am concerned about…” or “I want to support you with….” Listen, reflect, and validate.   Listen with an open mind, then rephrase and reflect back what you’ve heard from loved ones. Have compassion for their situation and understand that change is hard for anyone and that the “unknown” is the biggest fear for all of us — at any age. They may feel scared, angry, confused, or hopeless. Try to understand their fears and concerns. Confirm that you understand their views and feelings, and take them into consideration when you talk about options. 5. Include key people in the conversation.  Sometimes the right people at the table can make all the difference. It may be a certain family member they listen to or a respected adviser such as the lawyer, doctor, faith community leader or friend. You might even consider an objective third party, like a  care manager , counselor or mediator, to help facilitate the conversation   Hope these tips are helpful!!! Let us know how YOUR conversations are going!   Take care, Amy Goyer, AARP Family & Caregiving Expert Author, Juggling Life, Work and Caregiving  
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How do I help myself and others process grief? - LydiaN586309   Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away. You may experience all kinds of difficult and unexpected emotions, from shock or anger to disbelief, guilt, and profound sadness.
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Find out how to navigate airports trouble-free as a traveling caregiver.
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Question My mother is caring for my stepfather with dementia. It has been explained to us that it is alcohol-induced dementia, due to his heavy drinking. He no longer drinks, BUT he drives!!  As everyone on this site has said, he has good days and bad days. My siblings and I all live 7+ hours away from my mother, and she is caring for him by herself. She continues to let him drive, so as not to rock the boat. She has to tell him where to go, when to turn, and where they are. They have lived in this community for 30 years! My siblings and I have told our mother that we are not comfortable with him driving her around. She says, "he still knows driving rules and shows good judgement when driving!" She does not want to take this away from him, as he can be a very angry man! I have told her that since he has been diagnosed with dementia, if they get in an accident, their insurance may not pay for the damage.  But our concern more than that is her safety!!! I need to hear from people who have dealt with this issue and how we might deal with this. Answer  It sounds like you are in a tricky situation - and your Mom is too! I understand your concern about your mother's safety. A few thoughts about what you could do: Have you or your siblings taken a ride with him? It's always a good idea for you to ride along so you can get a sense of his judgement and skills. Your mom says it's good, but is she saying that partially because she doesn't want to rock the boat?  You can suggest she talk with his doctor and have the doctor talk to him about not driving - sometimes it's better received from a non-family member who your step-dad respects (lawyer, doctor, etc.). One family told me they had the doctor write a prescription and put it on the refrigerator that said "no driving until further notice" (which made it sound temporary so their mother was ok with that - she kept asking when she could start driving again, but eventually stopped asking.)  What is the back-up plan if he can't drive anymore? Is your mom ok to drive? Is there public transportation? Can they use uber or lyft? Is there senior transportation (contact your local area agency on aging to ask about that - go to   www.eldercare.acl.gov). It's always best to have back up options and alternative transportation when you have the talk about hanging up the keys.  You might want to put a GPS device in the car in case he takes the car on his own and gets lost. There are tracker devices you can get now that are quite small and could be put in the trunk etc. where he won't notice them. Or, he could wear a medical alert device that has GPS tracking and can be worn anywhere in the community. If he uses a cell phone your mom can get an app (with his knowledge) that tracks where his phone is.  Does he have any other health conditions you can pin it on? My dad had dementia, but he also had Glaucoma, so his doctor focused on the visual impairment and the fact that it made it unsafe for him to drive - he wasn't buying the fact he had dementia but the visual issues were obvious to him. AARP has a great free online seminar - a resource about driving that's called "We Need to Talk: Family Conversations About Driving"  You can go through that online and there are a lot of other great resources there too. The bottom line is he will eventually have to stop driving in terms of safety - so it's good you and your siblings are looking at this! Glad he's not drinking anymore but you're right, the driving is a big safety factor. He will have good days and bad days, but you never know when his skills will change so a good day can turn into a bad day really quickly!  
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Question Any suggestions on resources or lists for how to make a home easier to move around/cook/bathe in and also safer as one gets older? Answer AARP has a terrific Homefit Guide -- Click on that and you'll find the landing page where there are numerous other links, resources, and worksheets you can download. You can download a copy of the Homefit Guide (or order a print copy to be mailed to you. You might want to do both, as the print copy has some great illustrations of options to make a home better and safer). The guide has super-simple things that you can do in each room of the house, including steps and stairways, bathrooms, laundry room, living room, bedroom, garage, outside, etc.    Just make your motto "safety first" and you'll do great!  But comfort and quality of life are also very important. For example, make sure you can comfortably put clothes in the washer and dryer. Front-loading appliances that raise up might be helpful.   I also included an entire chapter about caring for loved ones at home in my book, Juggling Life, Work and Caregiving, and that chapter also includes info on who can help you assess the home in person. There is also a checklist for home modifications and "smart" (or universal) design.   Fall prevention is the first step -- and it's important to remember that means home modifications from simple things like clearing clutter and removing throw rugs, to increasing lighting, adding handrails, moving the laundry to the main floor, looking out for stray electric cords or other tripping hazards, changing the type of chair you sit in (one with arms and not too low is easier to get up out of. At some point a lift chair may be helpful too.), and also using technology like monitors and alerts and motion sensors.    A medical alert system (to detect falls or call for help), and one that includes GPS if going outdoors, is usually the first step for home safety. Here is my column about how to choose one: How Caregivers Choose a Medical Alert System.    A few other suggestions: First, we have a Care Guide just for this -- Help Caring for a Loved One at Home. This free guide that you can download can help you step-by-step with this transition.    We also have a document and video on how to prepare your home for safe mobility. And here's another great article on how to make your home safe.    Some other resources include: https://homemods.org/ https://assets.aarp.org/external_sites/caregiving/checklists/checklist_homeSafety.html https://www.seniorsafetyreviews.com/tips/guide-home-senior-safe/ https://www.cdc.gov/homeandrecreationalsafety/pubs/english/booklet_eng_desktop-a.pdf    
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As the Baby Boomers advance in years, due to divorce rates, less children, and several other factors, there will be lots of seniors who don't have relatives at the ready to assist with medical and other needs. For those who may not have extra hands on deck, it is an important part of your planning to assemble a care and advocacy team before you need it.      In 2012, the American Geriatrics Society published a study describing tens of thousands of patients nationwide who had no family members or designated surrogates available to help with medical decision-making. The study found that  16% of patients in intensive care units, 3% of nursing home residents, and a large (unspecified) number of individuals in a variety of settings who were facing end-of-life decisions were all facing the absence of a relative or designated surrogate.
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Question What is the difference between a living will and a will?   Answer A "living will" is a document that formalizes your wishes for medical decision making at the end of your life. If this is what you are looking for, there are many excellent resources available online, and AARP offers a state-by-state guide that will bring you to a form that may be used in your state. Here is the link for that page:  https://www.aarp.org/caregiving/financial-legal/free-printable-advance-directives/   A "will" is a document that formalizes your wishes for how your property will be distributed after you die and names a person (or people) to be the executor/personal representative who can manage your property until it is distributed.   Question Is it possible to get a will form from AARP that we can just fill out ourselves and have notarized, or do I need a lawyer for a will?   Answer There are form wills out there, but they generally don't cover the full picture (including the practical side of how everything works after you've passed). In general, form wills are not often suggested because there is a lot that goes into that type of planning. Even if we think our assets aren't much or if we don't own much property, there is always some work that needs to be done to close up a person's affairs after they pass away. If we can dictate that through thoughtful planning in a way that can avoid probate, reduce possible conflict among surviving family members, and streamline the whole process, then it makes that work so much easier.   Consider talking to a professional and perhaps seeking out what services are available in your state (there are many programs that do pro bono or low bono wills and estate planning). It can be a small up-front investment, but the benefit to you and your loved ones can be significant.   Wills are not as simple as knowing who you want to inherit what assets. All the bases may not be covered by simply filling out a form. For example, an attorney can work with you on the best ways to leave assets to charities to maximize your gift to them, whether there are deeds that can pass your home directly to someone without need for probate, how to avoid your assets going to creditors instead of your loved ones, ways you can title your accounts now so that they go right to your loved ones when you pass, and countless other ways. It is possible that probate can be avoided completely and you can squash any possible conflicts among your heirs by way of a well-crafted estate plan.   Question What is the difference between a living will and a POLST? I have a POLST from one state and recently moved to another. Do I need to make changes or update it because of the move?   Answer A POLST is a Physician's Order for Life-Sustaining Treatment. It is a document for people with advanced illnesses that specifies the type of care they would like in an emergency situation. Because it is a "Physician's Order," a physician or medical professional is the one who signs this document along with the patient making it. These are not the same as advance directives, which are legal documents. Think of POLSTs like medical orders.    Every state has its own rules and practices. Many states have documents that are conceptually similar to the POLST, but may go by a different name (MOST, MOLST, POST, SMOST, SAPO, etc.). It may be worth your while to do a refresh of all your documents in your new state (both your advance directives and your medical orders). Consult with your medical providers on this point. In the meantime, here are some resources that may be helpful:    Here is an AARP article that provides more information about POLSTs.   Here is the POLST.org webpage, which includes state-by-state information.   Question Can the government (state or federal) or a place where the dying might be being cared for outside the home—hospice facility, hospital, assisted living, nursing home, specialized care facility—somehow intervene to force tube feeding on a dying person despite having an advance directive? If I specify in my Health Care Directive that I do not want tube feeding to keep me alive, and my appointed health care directive representative also knows of my wishes, can a health care provider or a state force it upon me because of "humanitarian" gestures of not wanting me to starve to death?   Who has the final say in carrying out my wishes at times like these—the state or the individual?   Answer There are serious clinical, ethical, and legal implications in this kind of example. The guidelines of an advance directive are what should determine a patient's end-of-life care, and this is why they are such an important part of our conversations about living and dying according to our own wishes.   All fifty states and the District of Columbia have laws that legalize the use of advance directives like living wills, health care proxies/surrogates, and durable powers of attorney. In 1991, the federal government passed the Patient Self-Determination Act that validated all of the states' laws. These documents allow a patient to receive care that is consistent with their desires.   Tube feeding is very specifically addressed in many advance directives. Here is a link to the Oregon Advance Directive. If you look, you'll see that this advance directive doesn't just address tube feeding but it also talks about it under a variety of scenarios (what if the patient is close to death, has an advanced illness, is permanently unconscious, etc.) and gives options like "I do want tube feeding," "I do not want tube feeding," and "I want as the physician recommends."    It may not be pleasant to think about, but half of all patients lose decision-making capacity at the end of life. Of this half, over two-thirds face choices on specific end-of-life treatment options. A living will is what speaks for the patient when they cannot communicate about those end-of-life treatment options themselves. Despite this, while 92% of people have heard of living wills, only 36% have actually completed them.   In short, living wills and advance directives are the tools that allow us to truly be the "captain of our own ship" right up until the time of death, up to and including decisions such as tube feeding. 
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Question We are selling my mom's house and I am not sure what to change her address to—the assisted living facility where she resides, or my address so I am sure to receive anything important. Thoughts? Answers It depends on a bunch of factors. A couple questions to ask include: Do you live near the assisted living facility and will be visiting her regularly to bring her "social mail"? Who takes care of her "business mail"—Does she handle her own checkbook, or do you take care of all of that?   You may decide to have important mail sent to your house to make sure it isn't lost and you can handle it promptly. But have social mail sent to her—greeting cards, newspapers, magazines, etc., if you don't visit her often.   If you have financial power of attorney (POA) or an agreement with your mom to help her pay the bills, I'd have the mail sent to you and then you can hand deliver personal mail when you visit (at least weekly).     If you have POA, like the others have said, make your address her legal address so all bills, tax documents, bank statements, brokerage statements, Medicare EOB, and anything from Social Security, etc., come to your address. This will be the address that you will use for her for tax document and anything legal.   You could give her Assisted Living address to friends and family who might want to write to her. Many assisted living places do not have a secured mailbox for the residents, so keep that in mind. Sometimes a resident may pick up the mail of others by mistake or because they have a mental impairment.     You probably need to change her address officially to your address on Medicare and Social Security. Sometimes this is a problem when picking a Medicare plan since they are by area. But if you are not very far from her, this is no big deal.   If there is a need, now or later on, she needs to add your name to the Medicare and Social Security file so that you can talk to them about any matter. If she becomes mentally incapacitated, you will have to become a Representative Payee on Social Security. This only means that you are authorized to spend this money for her benefit and will have to account for such with them. 
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  Question What do I need to know about hiring an insured caregiver?   Answer If it is time to hire an in-home caregiver, make sure the person you hire is adequately insured.  Whether the caregiver is employed by a service or is an independent contractor, it is important to verify the following:   Workers Compensation. The caregiver should furnish proof of their insurance that covers medical bills and lost income should the worker be injured on the job.  General Liability. This covers claims of bodily injury or property damage should the caregiver's services injure someone or damage a customer's property. Professional Liability. Some caregivers possess advanced medical certifications and training. In these instances, a general liability policy might not be sufficient to cover their errors, if one should occur. They might need professional liability insurance. Auto. If the caregiver drives a client to and from errands, appointments, etc., verify that his auto insurance will cover damage to vehicles and bodily injury to passengers or others and that the limit of insurance available for such claims is sufficient. You may be asked to enter into a contract with the caregiver or their employer. That contract could contain clauses that expose you to financial liability that falls outside your homeowner's liability. Talk with your insurance agent or broker about the extent to which your homeower's policy covers in-home caregivers.  
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Question My sister and I are struggling with juggling the caregiving schedule.  We both live an hour away from our mom and are looking for a way to share a calendar and a To Do List. It seems like there should be an easy-to-use tool for this. I'm not looking to recruit volunteers, etc. We just need to be able to look at the caregiver schedule and check in on our To Do List.   Any suggestions?  I haven't found anything online that looks user friendly.   Answer I wrote a column about this! "Apps to Help Caregivers Stay Organized" here on the AARP Family Caregiving website. Lotsa Helping Hands focuses more on coordinating a lot of volunteers, and CaringBridge has an emphasis on providing updates to a wide number of people who are following the care journey—but also has shared calendar and task options. Carezone is a bit more focused on managing various aspects of caregiving and includes a shared calendar and task list, as well as medication lists, automatic reminders, and many other features but you can choose to use just the features you want to use.   I'm partial to apps and sites that I can use both on my computer and on my phone and tablet. There are many "to do list" apps—I use Wunderlist for a task list, and you can create lists that you do then invite other people to, so they can also add tasks and also check off tasks. You can assign tasks to people as well. I use it for my personal, work and caregiving. For a calendar I primarily just use my iCal on my Apple products and send my sister mtg invitations and vice versa. Then we both have the appointments in our personal devices that we also use for the rest of our life. I have color coded so that I can easily see which appts are for me, those I'm caring for, work etc. Google calendar is very similar.   I provide more tips in my column, "6 Tips for Choosing Family Caregiving Technology"!  
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Question Where do I go to sign up to care for my parents and get paid?     Answer The first place to start depends on what state you live in. Here in Florida, the Senior Resource Alliance is the place to start. Find your state's equivalent to that. Your loved one will have to qualify for what is called a Medicaid Waiver. So, once you find your state's equivalent to a Senior Resource Alliance, you call them and tell them you are looking for a "home and community-based Medicaid waiver for a long-term care program" for your loved one. They will walk you through the process from this point.
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Question How do I protect my mother's financial assets from irresponsible or abusive relatives?   Answer  Contacting the bank sounds like a good idea. Your mother may need to be present, as it is her account. You may want to be added to her accounts or she can appoint you as her "Power of Attorney".     Many states have laws in place to protect their senior residents. Elder financial abuse and exploitation are not taken lightly, and often come with higher criminal penalties. If there is imminent danger to your mother, 911 is always the first course of action. Theft of any kind should be reported to law enforcement. You may find helpful information through your state's Adult Protective Services, and any local or state social services agencies. Your state should also have an elder abuse hotline that you can find through the National Center on Elder Abuse (https://ncea.acl.gov)   The bank should be made aware of this situation ASAP, whether it is through the authorities or through you. Just please know that the bank will probably not speak with you about much detail unless your name is on the account or your mother designated you as her agent.
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