Find Free Social Services to Help You Take Care of Your Loved One

In our more honest moments, we can admit: it is incredibly difficult—both financially and emotionally—to provide long-term care for an elderly family member.

Even those who have saved for the challenges of a family member’s old age find themselves facing rising medical costs, hidden fees, and dwindling savings.

And, worst of all, many people who find themselves responsible for an older family member experience “caregiver burnout,” and their motivation and patience wane as time goes on. And while such feelings are totally normal—expected, even—that feeling of burnout can lead to resentment and guilt.

Those who care for family members often believe that they are utilizing every opportunity to provide consistent and thoughtful care. Luckily, there are often extensive—and free!—untapped resources available.

Let’s take a look at some of the social services available in your area, and how to access them.

Step One: Log On and Find Your State’s Homepage

Here’s the good news: there a numerous social programs available to seniors, and to the people who provide care for seniors. Here’s the bad news: most of these programs are hidden in the dark corners of your state’s very old, very difficult to navigate homepage!

Texas is a perfect example. The state provides a wide range of programs for senior citizens and caregivers, but the Texas state homepage is… mystifying, to say the least.

But the search can be worth it. Texas’s Department of Aging and Disability Services has a list of services by county, and offers free or low-cost programs related to respite care, support groups, education on navigating the health care system, counseling for individual family members, and disability benefits. There may be waiting lists to utilize such programs, but many services are in fact under-utilized, and you may face no wait time whatsoever.

The assistance provided by each state is different, and some states provide more care than others. But the quest can be fruitful, as citizens of New York can attest.

To find your state’s website, go to a search engine such as Google, Yahoo, or Bing, and enter your state’s name followed by the word “homepage” (don’t include the quotes). The site you’re looking for should be in the first two or three results. Click on it and remember—the frustration of the search may be worth it!

Step Two: Find a Support Group—But Not Only for Emotional Help

Numerous studies have shown that caregivers who look to their communities for support are less likely to get sick themselves, and are more likely to experience “emotional resilience.” There is no question that the emotional backing that a support group offers can alleviate some of the more difficult aspects of caregiving.

So if you haven’t found a support group, you should. Weekly or bi-weekly attendance helps members explore (and hopefully dissolve) some of the more difficult emotions related to caregiving.

But while that alone is reason to attend meetings, it paints an incomplete picture of the value of support groups. We often forget that support groups are full of people who have an incredible amount of knowledge—and who have already navigated the difficulties of determining care for loved ones.

Wherever you live, the people who populate your local caregiver support group will have an understanding of the health care system, local services programs, and which local agencies can provide assistance.

So—get out there and make some new friends! Share your knowledge, and find out what others in the same situation are doing.

Step Three: Explore Services That Might Not Perfectly Fit Your Situation

It may sound odd, but services that are only somewhat related to your needs may furnish exactly the help you’re looking for.

Here’s an example: in many states, there are community mental health clinics that offer free therapy sessions to families who have a family member with a mental health disorder. For the most part, these counseling sessions are used to discuss schizophrenia, depression and anxiety, or bipolar disorder. However, in some cases, the counseling sessions can be used by families who have a family member suffering from Alzheimer’s disease or dementia. Even though the service is listed as a mental health resource, it can be utilized by families who are struggling with various aspects of elder care.

So how you do find such programs? Visit your county’s website and look for a tab that says “Programs and Services” (or something like it). Counties often offer services that are not available at the state level, and you need to investigate each.

A quick tip: a “spoonful of sugar” goes a long with the therapists who work at mental health clinics. Because the counselors and clinicians at these agencies are used to dealing with unhappy or difficult clients, an earnest and polite request from someone who is motivated to seek help can put you at the top of the list for services. For the most part, counselors want to work with motivated clients, and if you can show that you are a good candidate for help, they will be happy to work with you.

Another quick tip: Explore services in the counties surrounding the one you live in. While most counties are strict about division of services, the programs in some counties may be under-utilized, and they may accept out-of-county applicants. We know of one person who was seeking legal advice with an elderly father’s finances, and was able to attain the help of an out-of-county program.

Step Four: Hang in There!

Persistence in key. It can be difficult to arrange free services—but it can difficult to arrange paid services, as well! In every state and every county, there are programs that can help you help your loved ones. Keep at it, and see what you can find!

About the Author

Matthew Morris is a hospital social worker in Brooklyn, NY, and has helped many clients attain social services on a state and local level. He also runs The CNA Career Agency to help individuals start a nursing career in the healthcare industry.

Caring for an Elder: The Healing Process after a Stroke

My mom had a stroke two years ago. The healing process is still ongoing, and I remember even just a year ago she would suddenly burst into tears if she was having a particularly rough go of it that day. She would be so disappointed with herself for not being able to do things as she did before – from flying her own plane over the countryside to adventurously riding her horses by herself. There is still healing to be done, but she has made huge strides. As a first time caregiver, it can get a bit overwhelming to deal with, but understanding the healing process really helps.

Healing from a stroke is a slow process.

I remember my sister brought over her children to visit us not long after the stroke, and my mother got so overwhelmed with the kids and having her mind flooded with happy memories from her past, “healthy” self.

If you are caring for an elder recovering from a stroke, I am sure you have experienced some of what I have discussed. The main goals of a caretaker should be to maintain a positive attitude in the stroke victim with emotional support and an environment of mental and physical healing in addition to ensuring that a second stroke does not occur.

Emotional support

This part can be quite trying, but also very rewarding. I’ve never been closer to my mother, and I am so glad I’ve been able to care for her at my home even though it has been stressful. Remember to care for yourself too! It’s important to deal with the stress inherent in caregiving – ask for help from other family members and get plenty of alone time!

Mental healing

Stimulating and teaching the areas of the brain to function in ways they never have before isn’t as hard as it seems. There is a free app we love called Mind Games that helps with many things including memory and critical thinking. There are many brain fitness programs to help mentally sharpen any mind, whether the elder wants to lower his or her risk of dementia or heal after a stroke.

In addition to the app my mother uses, we play board games and card games. This is not just for fun, but also to exercise her mind. The more she uses it, the more quickly and efficiently she can think. The goal is to get to the same level as where she was mentally before the stroke, and I fully believe in her ability to get there.

Physical healing

Physically strengthening the body with exercise including aerobic and muscle training is very important in the healing process. My mother’s left side of her body was still very weak a year and a half ago, but now it is stronger and nearly completely healthy.

We go on 30 minutes worth of brisk walks daily in addition to the occasional yoga or Tai Chi classes we take. At first my mother was too weak for 30 minutes of walking, so we split into small chunks throughout the day. We also heard about how it is that exercising the right side of her body (that wasn’t weakened by the stroke) can actually help strengthen the weaker left side as well and have started giving that a try.

This seemed counterintuitive to us too, but a new study in Experimental Brain Research has found that strengthening one side of the body actually cross-educates to the other side too. The muscles on the side that isn’t getting exercised receives new connections to the brain, and participants found equivalent strength gains in both legs after 25 minute sessions three times a week.


Healing can mean taking medication to prevent blood clots from forming. My mother has a heart condition called Atrial Fibrillation, which causes the blood to pool in the heart as the heart beats irregularly. Anticoagulants work really well for her, but they can be dangerous depending on which drug you get. Always be aware of the dangers of drug side effects. It’s better to know what the risks are than to pay with your health for any ignorance later. A good example is the Pradaxa lawsuits due to irreversible internal bleeding.

With emotional support and mental and physical healing, there is life after a stroke. With patience, positivity, and taking a day at a time, you and your loved one will get through the healing process.

About the Author

Madeline Ferdinand is a writer for Her main goal is to keep the old youthful and the youthful wise. She likes piña coladas and getting caught in the rain (in moderation of course).

Now What? Tips for First-Time Caregivers

Tips for First Time Caregivers

When my mother-in-law moved in with my husband and me after her stroke, I watched my stress levels skyrocket. I wanted to provide the best care possible, but I didn’t know where to begin. After doing a lot of research and talking to friends who had been in similar situations, I discovered that there are some really wonderful resources out there for first-time caregivers like me.

By taking advantage of the following tips, those of us who are new to caregiving can relax and focus on caring for our loved ones knowing that we are well-prepared.

The Basics

Accepting your new role as a caregiver can be tough, and there is no reason to pretend that it’s not. One of the best things you can do, for you and your loved one, is remember to take care of yourself, too. A healthy diet, regular exercise, and setting aside time to enjoy your favorite hobbies and the company of your friends can all help you manage stress. And when your stress levels are kept in check, you will be more clearheaded, calm, and energetic, all of which translate to a better, more sustainable ability to provide great care. It is sometimes difficult to not feel guilty about taking time for yourself. Try to remember that by taking care of your needs, you are indirectly taking care of your loved one’s needs, too.


Caregiving can lead to all sorts of emotions, questions, and concerns. Having a robust community that can offer support, camaraderie, and advice is crucial, especially for new caregivers who are most likely to need a little reassurance.

You may find that your closest friends do not understand what you are going through. This can be frustrating and lead you to feel alienated or alone. Fortunately, there are a variety of online support groups for caregivers that provide a place to share your worries and aggravations. At the end of a long day, I find comfort in connecting with others on discussion forums who can relate to my experiences. Sharing stories remains one of my favorite ways to make new friends and learn new information.


It’s normal to feel overwhelmed by everything you need to keep track of when you are caring for a loved one. Medications, medical visits, and daily regimens can quickly add up to a pile of lists that are all too easy to lose. With the help of apps for smartphones, tablets, and other devices, you can ditch the pen and paper. Microsoft Health Vault allows caretakers to keep medical records all in one place, which makes it easy to track down contact information for a loved one’s physicians, or to forward relevant medical history to new doctors. Other programs help keep track of medications, dosing schedules, and allow you to check whether or not medications—including over-the-counter drugs—interact with each other.


When it comes to caregiving, knowledge is power. And power provides peace of mind. While you’re sure to learn about your loved one’s medical conditions, medications, and other treatments, there are additional issues that you’re almost guaranteed to run across. You may find yourself being asked to make decisions about your loved one’s finances and end-of-life wishes, among other things. Investing time early on in learning as much as you can will prevent a situation in which you’re faced with the panic of navigating circumstances you know nothing about. At the least, try to familiarize yourself with first aid and CPR, other assisted living options and their associated costs in the event your loved one eventually requires a different level of care, and the current state of your loved ones financial and legal affairs.

Be Realistic

As you settle into your role as caregiver, try to keep your expectations realistic. You can provide excellent, compassionate care, but you cannot plan to meet each and every one of your loved one’s needs one-hundred percent of the time. Remember that there will be good days and bad days, and more importantly, that that’s okay. Ellen Besso’s book, The Caregiver in Midlife, gives advice from a balanced perspective that is supportive without any sugarcoating.

About the Author

Shanon Raynard believes prevention and preparedness are one of the most important elements of health and wellness. She partners with to raise awareness about life support certification resources that follow the latest guidelines from the American Heart Association.

Caregiving for a Proud Elder Patient Who Needs Your Help

Caregiving for a Proud Elder

As people age, the simplest daily tasks we’re used to doing can become increasingly difficult to complete, but what can be even more difficult is entering a stage when the realization that the days of an independent lifestyle may be coming to an end, especially after living a full and independent life where he or she learned to be self-reliant.  This realization can lead to denial of the situation, and even more so when others begin to take notice.  Moving from a life like that can be incredibly difficult and it’s completely understandable.  People often don’t want to admit they need assistance, even when it’s clear they do.

If you find yourself in a similar situation and notice a parent or loved one is in need of assistance, but has shunned attempts at help, it can be an incredibly challenging hurdle to overcome the denial of the circumstance.  It may be possible if you’ve noticed a shift in behavior and attitude, especially if it appears to be dramatic, that the person be developing a neurological condition.  It doesn’t necessarily mean its dementia or even Alzheimer’s, but any change over a period, brief or extended, should be addressed by a healthcare professional.  A geriatric screening may be beneficial.

Of course, even getting a geriatric screening can be another challenge to overcome with someone who is stubborn, prideful, and unabashedly independent.  However, if you are in a caregiving position, there are several things to consider that will make caring for a strong-willed individual.


It may be a cliché to call patience a virtue, but in this case, having patience with a stubborn individual or someone who has dementia is critical.  A lack of patience will only lead to grief and misery for both parties and it will create a highly stressful situation.  There will be a considerable amount of stress.  In caregiving, it’s unavoidable.  Managing the stress and having patience is a major first step, but managing stress is a learning process.  It’s about knowing when to take a step back and to breathe.

Plus, if you’re caring for a loved one, it can be emotionally and physically taxing.  You might ask yourself what you’re getting out of it. Emotions can certainly run high and probably will.  If it does become too taxing and stressful, don’t be afraid to find someone else to provide care.  A great way to reduce stress on both you and the person you are caring for is to stay active.  Keeping mentally and physically active is critical.  When they aren’t active, it can be detrimental to their health and mood and if they are already in a state of declining health it can worsen their condition.


You don’t want to be the only one doing the communicating.  Listen to what the person has to say and remember that not all communication is verbal.  Look for nonverbal cues in body language and behavior.  If the person wants to be alone, it’s ok to let them be alone for a while.  Instead of demanding that they need your or a caregiver’s help, ask them and engage them in conversation.  If the person is a parent, it can be especially difficult because there can often be a sense of betrayal, which goes both ways.  In any case, you want to be direct and straightforward when you communicated and respond.  You want to avoid letting the person’s hostility to manifest itself in you, because if it does, it can be difficult to recover from and can easily break your patience.

It’s also important not to expect an immediate positive change—or a change at all—in the individual during you care of them.  While you’re a support structure in someone’s life, a pillar, they may lack the cognitive ability to realize that.

About the Author

Christian Wilson currently works in the home care industry. He writes about issues facing the elderly and spends a lot of his work day answering questions regarding home care. When he’s not at work he enjoys traveling with his family and meeting new people.

Families: First Line of Defense in Elder Abuse

Many adult sons and daughters make every effort to visit their aging parents in nursing homes and other retirement communities in order to stay in touch and reduce the feeling of isolation their loved ones may have. There is a larger benefit to doing so and it extends beyond just one family. Nursing home abuse is not uncommon and it takes little effort for families to help elder law attorneys and senior advocates.

Many aides at nursing homes are trained very little and asked to work long hours at little pay. This is in part because facility operators do not get any more money from the Centers for Medicare and Medicaid Services if they provide exemplary care. Therefore, many operate at the bare minimum. Working with aging residents who have varied and significant needs can also be taxing. Many aides snap.

While the situation creates the conditions, those actions are unacceptable. Families on visits should watch for any signs of bruising or injuries suffered by their loved ones. It may be difficult to assess any problems in the case of mental disability such as Alzheimer’s Disease, but that is not a reason to completely discount any complaints. Any repeated comments should be addressed with the facility’s staff at a start, and an elder law attorney if incidents seem to continue.

It also does not hurt to check in with nearby residents, especially if you know that they rarely receive visitors. Seniors in nursing homes are a very vulnerable population and the Centers for Medicare and Medicaid Services and state agencies only make annual inspections at best. It does not take more than a minute or two to ask about a parent’s roommate or the man or woman across the hall.

Finally, in addition to checking with the facility, making a complaint to the state Department of Aging or Health and Human Services should be made so that an investigation can be made (for more information on agencies related to nursing home care look here). In some cases, calling the local police department may also make sense. In any case, making examples of elder abuse public help not just your loved ones, but those of many others.

Finally, keep in mind that abuse is not always easily visible. If an older parent is acting differently, they may be depressed from a lack of independence. However, they could also not be fed properly or having their medications restricted without good cause by nursing home aides or nurses. These are more difficult to identify, but adult sons and daughters should be wary of these as well.

Ensuring that one made the right decision can be difficult, especially if there is not a clear sign of abuse. Check with a local senior advocate or even the family doctor to see what signs should be visible, or consider getting in touch with an elder law attorney. Abuse can be devastating to older residents, and family visitors can be on the front lines of making sure it stops sooner rather than later.

This was written by attorney Jonathan Rosenfeld. Jonathan is the founder of Rosenfeld Injury Lawyers in Chicago, IL and has a law practice concentrating in cases involve nursing home negligence.

Will Your Loved One’s Senior Care Community Perform CPR?

When our parents move to an independent, assisted living and dementia care community, we often assume we’re paying for their entire care.  I mean, we’ve done our homework, right?  We’ve checked that they have nurses on staff.  We’ve check that the med room is safe, and we made sure that the community has a good safety record and adequate staff.

But what actually happens when there is an emergency?  What happens in the event the staff needs to intervene to potentially save your loved one’s life?  The answers aren’t always clear. And there is no real way to see it in action.

Below is a sad and eye opening story from Bakersfield, California.  In this story, an elderly resident was denied CPR from the nurse on duty because it was not the policy of the community to engage in such activities.  Despite the pleas of the 911 operator, the nurse would not perform CPR and would not find anyone who would.

So this begs the question: do you know what the policies of your loved one’s community is? Would they step in during an emergency? If you don’t know the answer, you should find out and make sure you are comfortable with it.

People Rise to the Challenge

I want to share a story that serves as an important lesson that many of us already know, but we’d likely forget under the stress of caring for a loved one. The story starts with a single sentence that forever changed my mom’s life: “People rise to the challenge.”

This isn’t my quote. To be fair, I heard these words for the first time after visiting many, many skilled nursing facilities. The source of the quote was a woman by the name of Andrea Arambula, and she was the admissions director at Belmont Village (formerly Crown Cove). It is to Andrea that I owe an enormous debt of gratitude. Andrea, if you are reading this, thank you!!!

Rewind back to December 2005. My mom had been in skilled nursing for more than five months. As dicussed in the previous blog post, skilled nursing is a mix between a hospital and an apartment. Patients usually share a room, and nearly all require treatments from a registered nurse. While my mom was there, one of her roommates passed away and several others were taken to the hospital. They did not return. While some are in skilled nursing for a short stay, many have declined to the point where it is required.

After driving 120 miles round trip, 4-5 times a week, usually after a full day at work, I decided to move my mom closer to me. I asked the head nurse for a care recommendation. She recommended skilled nursing.

She went so far as to tell me that my mom would likely be permanently bedridden, and that I should explore hospice. At the time, I was 34 years old and knew no better than to take her advice at face value. I started looking for skilled nursing facilities closer to my home in Orange County.

By chance, I called one assisted living facility and a woman answered the phone. It was Andrea.
She convinced me that my mom had no medical necessity for skilled nursing. Sure, she had problems walking, but that was a physical therapy issue. She told me something repeatedly, and I’ll always remember the words. People rise to the challenge. You just have to let them.

So I reviewed my mom’s medical records with her doctor, the assisted living community, the physical therapist and Andrea. It was a go! My mom was going to need a lot of help, but I was convinced that she would rise to the challenge.

I’ll always remember the ride there. Since my mom needed to be lifted (yes, lifted) into a wheelchair, driving my car was not an option. So I rented a shuttle, and my mom and I rode a little over an hour in the back of a wheelchair- accessible Super Shuttle (yes, the ones you take to the airport).

She was scared. I was scared. But in my heart I knew she could do it. When she first entered assisted living, she couldn’t walk. In fact, she couldn’t roll herself out of bed. She needed two people to literally pick her up and put her in a chair.

Within a year, she could walk the hallways with a walker, walk to dinner, come over to my house for BBQs, get in and out of a car, and resume some normalcy in her life. In fact, she even got featured in her physical therapist’s brochure. I guess she’s a testimonial for hard work and good physical therapy.

Each time my mother passed a new milestone, I thought of the skilled nursing recommendation and urging to explore hospice. And each time I smiled about the progress my mom made.

Why the long story? The details of the story are important. It’s human nature to fight, struggle and be determined. And regardless of your age, most people respond to the challenges they face. In the case of my mom, it was walking. In the case of your loved one, it may be something else.

So while I learned from Andrea that people rise to the occasion. I learned from mom that you have to let them.

So trust in your loved one. Trust in yourself. And I know you’ll find that you can both rise to the occasion. Perhaps – and most likely — there will be tears along the way, but there will be many wonderful moments of warmth and laughter, too.

Photo Credit: Vick the Viking

Tips for Managing Caregiver Stress

Chances are that, to some degree, you been a family caregiver for your loved one for some time now. To one degree or another, you’ve been tending to their needs: taking frequent phone calls, grocery shopping with (or without) them, and performing chores around their home.

Whether you are the child, sibling, or the spouse of your loved one, you’ll be feeling the emotional and physical strain of the role you’re playing. There’s an uncomfortable shift in the dynamics between you.

If you’re the child, you’ve become a parent of sorts. If you’re the spouse, you’re forced into a new and often unwelcome level of intimacy. And, if you’re a sibling, it’s imperative that your decisions not be clouded by childhood memories or resentments.

Being aware of these shifts in roles and responsibilities is the first step in self- care for the caregiver (that’s you, remember). The second step could be to seek support and assistance. One great resources is National Caregiver Support Groups. These groups can put you in touch with their local chapters. In addition, you can get information regarding support groups in your area from local nursing homes or eldercare agencies.

The Effects of Caregiver Stress

Dealing with the health problems of someone you love naturally produces stress in your life. It can wear you down, both emotionally, and physically.

I mentioned in my opening story that at one point in my mother’s illness, I was driving hundreds of miles each week to visit her in the hospital or skilled nursing facility. My mother’s condition was the result of a sudden event – which is different from the lingering decline described as part of the assessment process. With such a dramatic event comes shock, guilt and acute sorrow.

The time spent on the road gave me hours to think about how things could have been different; the traveling to and from her bedside took time away from my work, and my relationships. The stress of my mother’s illness was dominating my life and had manifested itself in many ways.

Stress manifests itself in three ways: physically, cognitively and emotionally. Below is a list of stress symptoms. Looking back at that period in my life, I realize stress has manifested itself in many of those symptoms.

Physical Symptoms

  • Headaches
  • Sore back / stiff neck
  • Teethgrinding
  • Sexual dysfunction
  • Heart palpitations
  • Restlessness
  • Shortness of breath
  • Heartburn
  • Diarrhea/constipation
  • Jumpiness
  • Chronicinsomnia

Cognitive Issues

  • Difficulty in making decisions
  • Decreased problem-solving ability
  • Obsessive thinking
  • Short-term memory loss
  • Decreased concentration
  • Drop in organization skills
  • Limited attention span

Emotional Signs

  • Loss of interest in hobbies or recreational activities
  • Frequent crying or tearfulness
  • Persistent sadness or depression
  • Irritability
  • Chronic anxiety

Are you currently suffering from one or more of these symptoms of caregiver stress? I’m not surprised! Even in the early stages in dealing with the chronic health issues of a loved one – whether parent, sibling or spouse – you’ll find that you’ve become (more or less) tolerant of many of these manifestations of stress.

What I’ve learned is simple: taking care of yourself is essential to the well-being of your loved one. Here’s a short list of some of the things you can do to support yourself during the coming weeks:

Seek support from others. Turn to your loved one’s neighbors and friends; or other family members. They may be able to spend a few hours caregiving while you run errands, or even just take a short nap. Don’t feel you have to do it all alone!

Find a way to release your emotions. If you’ve got a pastor, spiritual advisor, close friend, or a therapist – someone you can trust 100% – be sure to reach out to them. They will be able to listen to you lovingly, and keep what you tell them to themselves.

Take time for yourself. If you like to walk on the beach, go shopping, take your dog to the park, or simply go see a movie – do it! Do not procrastinate on this: taking time for simple pleasures every day is critical to your well-being.

Simplify your life. Ask yourself this question: What can I let go of right now? Maybe you shouldn’t tackle new projects at work; maybe you should let go of hunting for that new house – whatever you can put ‘on the back burner,’ now is the time to do just that.

Avoid excessive alcohol or drugs. Ah, the temptations of self-medication. Don’t give into them. It’s not the wise path; ultimately, the care you are trying to provide suffers, and you’re less able to take care of the other things in life. Your job, marriage or parenting duties will suffer. That’s why I highly recommend the next tip:

Continue or begin an exercise program. It’s been clearly proven: aerobic exercise causes the brain to produce endorphins, which are your body’s natural way to enhance your mood and relieve your stress. Find a way to build regular exercise into your week: walk, run, practice T’ai chi; go bowling or play a round of golf with friends. Note: Always check with your doctor before beginning a new exercise program!

Do yoga. Yoga can be a fantastic stress reliever which providing a great deal of exercise and better flexibility. I cannot recommend Yoga enough, as it alone helps me reduce my stress level and irritability. A note for the men reading this book: Yoga can be hard work, very challenging and a great way to relax and build muscle. Don’t think Yoga is effeminate or too easy!

In the wonderful book, When Someone You Love Needs Nursing Home Care, the authors, Robert Bornstein and Mary Languirand help their readers to build a long-term plan, based on six principles:

  • Plan ahead. It may be a difficult subject to broach with your loved one, but planning ahead provides them with the opportunity to fully participate in the decision-making process.
  • Get advice. Don’t discount the value of speaking with those people who have been down this same road. Join a support group (online or offline), and speak with doctors, nurses and health care professionals. When it’s financial or legal advice you need, turn to attorneys and accountants.
  • Get others involved. Share the workload with family members, co- workers, and friends. Remember they care about you, and would love to help when they can – so don’t hesitate to ask!
  • Keep colleagues informed. Those people in your workplace need to be taken into your confidence; they’ll want to know why you’re frequently absent from your desk, or unable to take on additional work.
  • Take care of yourself. We’ve already touched upon ‘self-care’ as being critical not only to your well-being but to the well-being of your loved one as well.
  • Put things in perspective – and keep them there! Short-term thinking (“Things are falling apart and will never get better”) is a trap. As I’ve learned so clearly, people grow through adversity, and you’ll never be able to know just how this growth will manifest itself. Remember that change is inevitable…“this too shall pass.”

Photo Credit: lululemon athletica.

Life, Death on Her Terms

This is a guest post from Susan B. Schaffer, the oldest of three daughters of Beatrice Belopolsky, of Burlington. Susan can be reached at

My mother was my best friend. As she approached 90 years old in excellent health, I occasionally wondered how this woman, who continued to live life with such fierce independence, would eventually leave this earth.

The matriarch of a family of three daughters, she had continued living a full life after being widowed 30 years before. She served actively on community boards, lent a hand with her six grandchildren whenever she could, and traveled the world in her unique style. She was a source of wisdom, in a quiet, commonsense way, and yet remarkably she remained completely open to learning from others. She was ageless, fitting into any group, not as a fifth-wheel elderly parent, but as a contemporary who was interested in others, happy to meet new people and have new experiences.

And so in January 2009, when Mom suddenly began reporting vague aches and pains and her typically sharp reasoning became somewhat fuzzy, I was concerned by the uncharacteristic behavior and sudden signs that she was slipping, both physically and mentally. We began the search, through a series of medical appointments, to determine the cause of these sudden changes.

In April, she was diagnosed with squamous cell cancer of the mouth. Eventually, after meeting with Mom, hearing about her active life, and looking at her blood tests, which were remarkably normal, Mom and her oncology team agreed that concurrent radiation treatment with antibody therapy was a reasonable option. Mom was realistic. She knew the treatment might not work, but she “had to give it a try.”

After two difficult months of radiation and chemo, the treatments ended on her 88th birthday. We all looked forward to Mom’s regaining her strength and her humor, but she didn’t rebound as quickly as we had hoped.

After Labor Day, we learned that the treatment had not worked; the cancer had spread and her life expectancy was now measured in months. It was the only time throughout the ordeal that I saw Mom cry. She told me that she was not afraid to die, but she was afraid of the pain and suffering to come. She wanted to be in control of her life and was thinking about whether she could just stop eating, but feared that would be just as painful.

I felt torn, wanting to hang onto every remaining minute of her time with us, but understanding her dilemma. I suggested that she discuss her options with my husband, Elliott, a family doctor and geriatrician.

Mom and Elliott had a long talk, and Elliott shared information with her about people who forgo food and water – that not only do they not experience increased pain or hunger, but in fact generally those people enjoy a peaceful death with little or no suffering. Mom decided that this was the course she wanted to take, but she was not ready to stop taking nourishment just yet.

Once Mom’s closest friends and family heard about her prognosis, they all arranged to visit her. She quietly and individually met with her brother and each of her six grandchildren and their significant others. She smiled as her great-grandsons rolled around on her bed. The morning after saying her goodbyes to her loved ones, Mom quietly informed her daughters that she was ready to stop eating and drinking.

Her choice itself was not a surprise, but the timing was a shock. We quickly arranged for one of us or an aide to be with her at all times, expecting her strength to fail precipitously. Each morning, I would approach her apartment with trepidation, wondering how much closer to death Mom had traveled overnight.

Amazingly, I found that each day Mom’s spirits grew lighter and more peaceful. There was an immediate and dramatic change the day after Mom made her choice. It was as if she realized that she no longer had to struggle – that she had taken control – and she found comfort in that.

The stream of friends and family continued, and Mom would doze lightly between visits. The rabbi came to visit and came back to chat with her each day thereafter. At first we thought we should protect her from so many visitors – that it would tire her too much – but then we asked ourselves, “Protect her for what?” She was always cheerful during these visits – nostalgic about her life and relationships – and open to discuss her decision, which almost everyone found somewhat shocking.

At the end of the first week, Mom was so comfortable that she wondered, “When is something going to happen?” We assured her that it generally takes no more than two weeks for a body to slip away without food and water. Mom continued to deny feeling any hunger. She did express appreciation for the few sips of water that she took with her pain medication; we soothed her dry mouth with a spray that helped replace saliva, and that seemed to satisfy her.

At no time in the days that passed did Mom appear to be suffering. She lived those last days with a tremendous grace that touched everyone who was privileged to spend time with her. We talked about death; she was clearly not afraid of dying. She frequently smiled and acknowledged what a good life she had lived. Mom expressed curiosity about what she would experience after death and whether she would see her parents or her husband, but then quickly dismissed her curiosity with a cheerful acceptance of her fate.

On Day 11, Mom became less responsive. On Day 12 she peacefully slipped away.

Mom taught us much at her life’s end and particularly in those last 12 days. Witnessing her grace, her humor, her wisdom, and her compassion for all whom she touched in the extraordinary circumstance of her passing was an experience that I will never forget. Seeing her take control of her death, much as she had of her life, was empowering to everyone who was with her and who heard of the circumstances of her death. I am so proud to be her daughter.