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Dear healthwellness82@gmail.com, Taking care of a loved one with a debilitating disease can dominate and even derail your life, but it doesn’t have to. Case in point -- best-selling author Gail Sheehy, author of Passages: Predictable Crises of Adult Life, took care of her husband for 17 years as he struggled with four separate cancer diagnoses. She offers eight strategies to help anyone overcome the emotional and physical challenges of caregiving -- and includes support networks so you don’t have to go it alone. If you’re already starting to sweat the costs of keeping your home cool this summer, you’ll want to hear from home-improvement expert Don Vandervort, author of The Home Problem Solver. He shares an energy-saving secret that is so effective it can help keep your home cool in the summer and, believe it or not, warm in the winter -- while saving you money. All the best,  Jessica Kent Editor BottomLineSecrets.com Passages of Caregiving Gail Sheehy About 65 million Americans currently serve as primary caregivers to chronically ill or disabled relatives. Few of these caregivers ever expected to become caregivers, and fewer still are prepared for the enormity of the task. Until 2008, Gail Sheehy, author of the acclaimed book Passages: Predictable Crises of Adult Life, was one of those caregivers. Her husband, Clay Felker, founding editor of New York magazine, required her assistance as he battled four separate cancer diagnoses during the final 17 years of his life. Bottom Line/Personal interviewed Sheehy, who explained that the caregiving process is like a labyrinth. As endless as it can seem, there is a path through, but there also are passages, or "turns," along the way that make it difficult to see what lies ahead. Here, the eight turns that caregivers can expect and strategies for coping with each... Turn 1: Shock and Mobilization The call to caregiving can come out of the blue. A previously healthy relative experiences a major medical problem, and suddenly you’re asked to provide not just care, but assistance sorting through treatment options. This is important and often complex, yet you are pressured to make quick decisions. Expect to feel fear and confusion. Strategy: Seek out multiple opinions and treatment options before proceeding. Example: When my husband’s throat cancer reappeared after a period of remission, Clay’s doctor said his voice box would have to be removed. Fortunately, we knew not to jump at the first treatment option suggested. We tracked down a specialist in my husband’s type of tumor, and he offered a different treatment strategy that preserved Clay’s ability to speak and extended his life. Record your loved one’s consultations with doctors using a small portable voice recorder. These consultations can be emotional and confusing, which makes it easy to get the facts wrong if you’re working from memory. Tell the doctor that this recording will help you avoid bothering him/her with questions later. During these initial medical consultations, ask doctors... "Will you be the one to coordinate care?" "Will you help us decide among treatment options?" "Will you help address pain and other side effects of treatment?" These questions will point you toward a "medical quarterback," a doctor who is willing to take the lead in your loved one’s care. Turn 2: The New Normal You have reached this turn when you realize that you are a caregiver -- and that caregiving is likely to be a big part of your life for a long time. On the bright side, your sense of panic should begin to recede as you settle into this new reality. Strategy: Do not settle into this new life alone. Seek out friends, relatives, neighbors and colleagues who are willing to help provide care and support. Also, if the patient is elderly, hire a geriatric care manager (GCM), an expert in sorting though insurance and Medicare mazes and finding resources available to caregivers. These professionals typically charge $80 to $250 per hour and are not covered by Medicare or most insurance policies, but it’s worth paying for at least a one-hour consultation even if money is tight. The National Association of Professional Geriatric Care Managers can help you find a GCM in your region (520-881-8008, www.CareManager.org). Turn 3: Boomerang Months have passed, perhaps years. You have settled into the routines of caregiving -- and then there’s another crisis. Your loved one’s health has taken a turn for the worse, and you feel like you’re right back at Turn 1. Only you’re not -- you’re now much better equipped to handle these emergencies. You’ve become an expert on your loved one’s medical condition... you’re an old hand at dealing with insurance companies and Medicare... and you have a medical quarterback in place. Strategy: The relative calm of The New Normal might have convinced you that you can handle caregiving. The emotional roller coaster of the Boomerang serves as a reminder that caregivers require care, too. If you haven’t already done so, find a support network for yourself. The Well Spouse Association (800-838-0879, www.WellSpouse.org) directs spousal caregivers to local and online support groups. The Family Caregiver Alliance (800-445-8106, www.Caregiver.org) directs caregivers to a range of appropriate support groups, many associated with specific health problems. Turn 4: Playing God Many caregivers understandably come to see themselves as pivotal to their loved one’s survival. It is perfectly fine to take pride in your caregiving efforts -- but it is vital that you do not view your loved one’s good days and progress as proof of your value. If you do this, you are likely to blame yourself for your loved one’s bad days and setbacks -- and bad days and setbacks are virtually inevitable with chronic health conditions. Strategy: When there are changes in your loved one’s condition -- good or bad -- remind yourself that there is a God, and it is not you. Be sure to involve family members and the patient in decision-making to protect yourself from guilt if something goes wrong. Turn 5: "I can’t do this anymore!" There are no weekends or vacations for many caregivers. Their responsibilities seem unending -- but no one can be a caregiver every day for years. We reach the end of our rope. Strategy: Get out of the home and away from your loved one for at least one hour each day and at least one full day every month, even if this means stretching the budget to hire a professional caregiver. If your loved one is on Medicare, contact the hospice or palliative care department (see Turns 7 and 8) of a local hospital and request a "respite." Most caregivers do not realize that Medicare often will pay most or all of the costs of having this department look after their loved ones for as long as five days as frequently as every 90 days so that the caregiver can take a break. (Private medical insurance generally does not cover respite care.) Turn 6: Coming back You have reached this turn when you realize that your loved one is never going to fully recover. He will only become more dependent. You have reached the center of the labyrinth, and it is time to start planning your journey back out. This is the most painful turn in the caregiving process because it forces a caregiver to acknowledge that the only way to escape the labyrinth is to start to release his/her loved one. A caregiver who can’t take this step becomes indistinguishable from his loved one, so lost in another person’s medical struggles that he loses his "self" and becomes a caregiver, nothing else. Example: By the end of my husband’s life, I began to doubt my ability to write, something I had been doing virtually all my life. Strategy: Take up a challenging and fulfilling hobby that you can pursue while in the home, such as art, writing or music. Just waiting for your next caregiving task is not a life. Turns 7 and 8: The in-between stage/The long good-bye Hospitals are designed to cure medical problems, not treat patients with incurable conditions. Hospice care is intended only for patients in the final months of life. Caregivers often are at a loss for where to seek medical care when neither of these solutions fits. Strategy: Find a local hospital that offers "palliative care" (go to www.GetPalliativeCare.org, then search the "Provider Directory"). Like hospice care, palliative care focuses on pain relief -- but unlike hospice care, it is not just for those close to death, and it can be combined with treatments meant to address the underlying condition. Hospice care becomes an option once a doctor has determined that the patient most likely has six months or less to live. Caregivers often receive the most cherished benefit of hospice care. They and other family members almost universally express gratitude for being guided and supported through the mysteries of the dying process. The common refrain is, "We couldn’t have done it alone." Bottom Line/Personal interviewed Gail Sheehy, an award-winning journalist and author of the book Passages (Ballantine), which spent more than three years on The New York Times best-seller list and was named one of the 10 most influential books of our time in a Library of Congress survey. Her latest book is Passages: Predictable Crises of Adult Life (Morrow). Sheehy served as AARP’s Ambassador of Caregiving in 2009. www.GailSheehy.com   Are You or Your Loved Ones Taking Any of These Highly Prescribed Medicines? Beyond the Thermostat -- Ways to Save More on Cooling Costs Don Vandervort Heating and cooling systems typically are responsible for the greatest portion of home energy bills. Here are ways to stay comfortable and still save money... Create more zones. Homes with heating and cooling "zones," where one part of the house can be cooler or warmer than the other, are ideal for saving energy. If your home has a ducted forced-air heating-and-cooling system that wasn’t initially designed as a zoned system, dampers can be installed to create a similar effect. Consider hiring a professional to install in the key ducts a series of motorized dampers that direct heated or cooled air where it’s needed. Cost: About $1,000, depending on the type of damper and ease of accessing ductwork. Install room air-conditioning units. If you and your family spend several hours a day in one room, such as the living room, an air conditioner in a window or wall or a portable unit might help save money even if you have central air-conditioning. You can turn on one of these units instead of central air and save energy. A portable unit, which sits on the floor and can be easily moved, has a venting hose that is put in an open window, along with a temporary sealing device. Cost: $120 to $600. Install ceiling fans. Ceiling fan technology has improved considerably and can help you save as much as 30% off your air-conditioning bills by better circulating air. Look for the Energy Star designation for energy efficiency. Cost: Between $80 and $500 or more per fan, plus installation. Make ductwork more efficient. Researchers at University of Oregon found that central heating and cooling systems that use ductwork lose as much as 50% of their energy through leaky ductwork. Have ductwork inspected for leaks once every three years by a heating contractor. All connections should be properly sealed, preferably with metal-reinforced tape or mastic, a rubbery fiber-reinforced goo that is applied with a brush. Some homes have flexible ductwork with built-in fiberglass insulation. Rigid metal ductwork needs to be wrapped with fiberglass duct insulation. All are available on-line and at most home-improvement stores. Another way to make your ducts efficient is to apply an aerosol sealant called Aeroseal, developed by Lawrence Berkeley National Laboratory and licensed by Carrier Aeroseal, LLC. This aerosol, which must be applied by a Carrier-approved contractor, seals leaks, reducing energy loss by as much as 90%. To find a contractor, go to www.aeroseal.com and click on "Locate Dealer." Cost of application: $300 to $1,800, depending on the size of your home. Install heat-recovery ventilators (HRVs). These units get rid of air contaminants, such as cooking odors, cigarette smoke, dust and mold. HRVs also grab much of the heat or cold from that outgoing air and recycle it back into the house with the incoming fresh air, cutting energy costs. They are especially useful in tightly sealed homes. Cost: Room-sized models run from $350 to $450... whole-house units can cost $1,500 or more, plus installation. Bottom Line/Personal interviewed Don Vandervort, founder of HomeTips.com. A leading home-improvement expert based in Glendale, California, he has written more than 30 books on home improvement, including Home Magazine’s How Your House Works (Ballantine) and The Home Problem Solver (Perseus). He appeared as segment host on HGTV’s The Fix. www.hometips.com. Shocking #2 Cause of Cancer An official at the American Cancer Society said that it's easy to avoid half of all cancers. However, an adviser to the American Institute for Cancer Research was even more optimistic when he said that nine out of 10 cancers are related to factors we control. Of course, their #1 piece of advice is "stop smoking." We all know that. But I bet you don't know the #2 cause of cancer. It's something totally under your control -- it's much easier than quitting cigarettes -- and it's the last thing you'd ever expect. I'll tell you about it in a moment. Keep reading... Important: Help your friends get much more out of life -- forward this E-letter to them. Better: Send it to many friends and your whole family. This is a free weekly e-mail service of BottomLineSecrets.com and Boardroom Inc. Boardroom Inc. 281 Tresser Boulevard Stamford, CT 06901-3229 ATTN: Web Team You received this e-mail because you have requested it. You are on the mailing list as healthwellness82@gmail.com. Or... a friend forwarded it to you. Disclaimer: Bottom Line Secrets publishes the opinions of expert authorities in many fields. But the use of these opinions is no substitute for legal, accounting, investment, medical and other professional services to suit your specific personal needs. Always consult a competent professional for answers to your specific questions. Bottom Line Secrets is a registered trademark of Boardroom Inc. Subscribe | Unsubscribe | Update My E-mail Preferences Change My E-mail Address | Contact Us | Privacy Policy Copyright (c) 2011 by Boardroom Inc. |
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