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Caregiver's Handbook: A guide to caring for the ill, elderly, disabled... and yourself

If someone you care about — a spouse, parent, relative, or close friend — needs help negotiating the daily tasks of life, this report can assist you in offering them the care they need while looking after yourself, too. While caregiving is one of the most worthwhile jobs you may ever undertake, it can cause undeniable strain. Many people feel unbearably squeezed between the demands of caregiving, the needs of their families, and the pressures of work. It’s common, too, for caregivers to feel isolated and neglect their own needs, especially when they’re caught up in medical crises.

If you’re a caregiver, surely you could use a helping hand, too. This report can help. It offers detailed information on putting together a caregiving plan, talking to your loved one about the situation, drawing on resources in the community, and addressing legal, medical, and financial planning issues. There’s also a questionnaire to help you assess the needs of the person you’re caring for and advice on handling daily tasks, like meals and hygiene. You’ll also find tips and suggestions on maintaining your own well-being.

Prepared by the editors of Harvard Health Publications in consultation with Anne Fabiny, M.D., Chief of Geriatrics at the Cambridge Health Alliance and Assistant Professor of Medicine at Harvard Medical School, and Suzanne Modigliani, L.I.C.S.W., C.M.C., Geriatric Care Manager, Brookline, MA. 48 pages. (2007)

  • Developing a plan
    • My caregiving goals
    • Scouting the path ahead
    • Talking with your loved one
    • Working with a geriatric care manager
    • Completing a needs questionnaire
  • Legal planning
    • Wills and trusts
    • Durable power of attorney
    • Guardianship
    • Advance care directives
    • Do-not-resuscitate orders
  • Financial planning
    • Organizing finances
    • Searching out benefits and services
    • Managing insurance policies
  • Navigating the Medicaid and Medicare Maze
    • Medicaid
    • Medicare
    • Medicare prescription drug coverage
  • Medical planning
    • Choosing doctors
    • Why choose a geriatrician?
    • Care in an emergency
  • Home to hospital to rehab: Navigating health transitions
  • Meeting needs
    • Making use of helpful services and professionals
    • Involving family members
    • Long-distance caregiving
  • Handling daily tasks and common problems
    • Mobility
    • Meals
    • Personal hygiene
    • Urinary incontinence
    • Bowel incontinence
  • Care for the caregiver
    • Gaining support
    • Seeking balance
    • Setting limits
    • Caring for your health
    • Relieving stress
  • When your loved one can’t stay at home
    • Options for care
    • Making a move
  • Glossary
  • Resources
    • Books
    • Organizations

Scouting the path ahead

Change is one of the few certainties of caregiving. Geriatrician Anne Fabiny emphasizes the need for caregivers to evaluate their situation early and often. Settle on a plan, but realize that circumstances are bound to change. Reassess your plan every few months if the situation is fairly stable, or from week to week if the outcome is unclear. As time goes on, you may need more assistance than you initially thought, such as additional help from family members or outside services. If possible, always keep a step or two ahead by asking experts for their best assessment of how the situation might change in another few weeks, months, or years.

Negotiating goals that everyone involved can embrace can help make necessary changes achievable. Elderly parents, for example, may long to continue living independently at home rather than move in with you or to a nursing home. With this in mind, what are the best ways to improve their daily life and enhance their abilities? How can you best support their independence? What care or services will they need to meet these goals?

Changes may be more palatable if they make it possible for a person to stay in a well-loved home or return to it after hospitalization. One option might be hiring someone for three to four hours a day to help an older parent or relative get going in the morning and remind him or her to take medications. Alternatively, you might only need to check in frequently and set certain services in place, such as yard work and snow shoveling, bill paying, grocery shopping, or delivery of hot meals. Or you might need to consider how to make the bathroom or other parts of the home more accessible to enhance the person’s mobility.

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