Caring for elderly parents 'long distance Published Aug. 14, 2008 By Chaplain (Maj.) Keith Muschinske 341st Missile Wing Chaplain MALMSTROM AIR FORCE BASE, Mont. -- She's 86. My mother, that is. I saw her last month while in Wisconsin on leave. I suppose she's approaching the definition of "frail." She's driving so slowly these days ... I wonder what's next. How to ensure good health care, find the right living situation and handle legal questions is often complicated for those of us stationed many miles from elderly parents or other family members. Here are some helpful ideas to consider. - Talk gently and honestly about their wishes, their abilities and their options. Share your own feelings, help them keep whatever control is possible, educate yourself on legal, financial and medical matters, and respect your own needs -- be honest about your time and energy limits. - Danger signs may indicate an elderly person needs extra help or a change in living arrangement. A few to watch out for are sudden weight loss, failure to take medication or over-dosing, deterioration of personal habits, increased car accidents, general forgetfulness, bizarre behavior of any kind or disorientation of a consistent nature. If you recognize danger signs in your parent's behavior, discuss the changes and do some research. There are a number of housing options available -- choosing the best one depends on the elderly person's preference, age, health and financial situation. Home care services, adult day care and respite care can help an elderly person live in his or her own home or apartment. Other options include assisted living communities, rental retirement communities, life care or continuing care communities, personal care homes and subsidized housing for the elderly. If the elderly person is not capable of independent living, a nursing home may be the appropriate option. Nursing homes offer two levels of care -- skilled nursing and intermediate care -- depending on the patient's needs. Most nursing homes offer both levels of care at a single site. Many people think Medicare will cover long-term care needs. It will not. Medicaid is the major payer of nursing home care. The Medicaid requirement to "spend down" all income and assets created a great hardship for the spouse of a person needing nursing home care. Changes in the Medicaid rules now allow the spouse to keep a monthly income and some assets, including the primary residence. The purchase of additional insurance can help provide access to a greater choice of facilities without dipping into additional financial resources. Medigap is privately purchased supplemental health insurance that can help cover some of the gaps in Medicare coverage, however, it does not cover long-term care. Long-Term Care Insurance is available from a variety of private insurance companies. It's not always easy to grow old. It's not always easy to live far from loved ones who are struggling as they grow old. Consider what you can do -- even long distance -- because one day the one who has grown old will be ... you! Useful Eldercare Resources To get information on eldercare services in a particular community, contact the Area Agency on Aging through the Eldercare Locator Service (1-800-677-1116 or http://www.eldercare.gov). Alzheimer's Association, Inc. 919 North Michigan Avenue, Suite 1000 Chicago IL 60611 Tel: 1-800-272-3900 http://www.alz.org American Association of Homes for the Aging 901 E Street NW Washington, DC 20004 Tel: 202-783-2242 Fax: 202-783-2255 http://www.aahsa.org American Association of Retired Persons 601 E Street NW Washington, DC 20049 Tel: 202-434-2277 http://www.aarp.org Provides the following free pamphlets: Miles Away and Still Caring (D-12748); A Handbook About Care in the Home (D-955); A Path For Caregivers (D-12957) National Council on the Aging, Inc. 409 3rd Street SW Washington, DC 20061-5087 Tel: 202-479-1200 http://www.ncoa.org Publishes Perspective on Aging, a bimonthly magazine, and Family Home Caring Guides. National Institute on Aging 9000 Rockville Pike Bethesda, MD 20892 Tel: 301-496-1752 Web site: http://www.aoa.dhhs.gov Long-Term Care Link A comprehensive web site with links to eldercare services and insurance information. Updated web site addresses for all State Agencies on Aging: http://www.longtermcarelink.net/state_programs3.html For general resource information: http://www.longtermcarelink.net/index.html State Agencies on Aging A listing of web sites is available at http://www.aoa.gov/eldfam/How_To_Find/Agencies/Agencies.asp