Every state offers either disabled parking cards, or plates, or both. While the requirements vary by state, they are very similar. While not in every case, it often requires a doctor’s letter.

To give you an idea of what they typically require, we’re posting Wisconsin’s basic requirements below:

• Cannot walk 200 feet or more without stopping to rest;
• Cannot walk without the use of, or assistance from, another person or brace, cane, crutch, prosthetic device, wheelchair or other assistance device;
• Is restricted by lung disease to the extent that forced expiratory volume for 1 second when measured by spirometry is less than one liter or the arterial oxygen tension is less than 60 mm/hg on room air at rest;
• Uses portable oxygen;
• Has a cardiac condition to the extent that functional limitations are classified in severity as class III or IV, according to standards accepted by the American Heart Association;
• Is severely limited in the ability to walk due to an arthritic, neurological or orthopedic condition;

We’ve included links to each state so you can check the specific requirements. The links either take you to an application form, which typically include the requirements, or to their department of transportation page which discusses the application requirements. Links to Acrobat documents are noted with ‘PDF’:

• Alabama (PDF)
• Alaska
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• Florida
• Georgia (PDF)
• Hawaii
• Idaho (PDF)
• Iowa
• Illinois
• Indiana (PDF)
• Kansas (PDF)
• Kentucky (PDF)
• Louisiana
• Maine (PDF)
• Maryland
• Massachusetts
• Michigan (PDF)
• Minnesota
• Mississippi (PDF)
• Missouri
• Montana (PDF)
• Nebraska
• Nevada
• New Hampshire (PDF)
• New Jersey
• New Mexico (PDF)
• New York
• North Carolina
• North Dakota (PDF)
• Ohio
• Oklahoma (PDF)
• Oregon (PDF)
• Pennsylvania
• Rhode Island
• South Carolina (PDF)
• South Dakota
• Tennessee (PDF)
• Texas (PDF)
• Utah
• Vermont
• Virginia
• Washington State
• West Virginia
• Wisconsin
• Wyoming
• District of Columbia

Courtesy a4gpa via Flickr

We’re always looking for the best resources on the Web that can help the busy, perhaps harried, caregiver do what they need to do with confidence and compassion, while maintaining a balance in life. Sometimes it’s not easy. One thing working in our favor is that we do have the Internet and its abundance of resources. We also have the networks of caring people with which to share information and ideas. But sorting through the huge volume of information can be challenging and time consuming.

While surely not a definitive list, we thought we’d provide our picks of some of the best caregiver resources among the embarrassment of riches. Our picks were chosen to get someone a little more thoroughly grounded in role of caregiver. If we’ve missed a great resource, let us know in the comment section below.

Family Caregiver Alliance

While there’s much to be had on the Family Caregiver Alliance site, we honed in on the “Caregiving Issues and Strategies” section of the site. This page provides links to printable pages on a good number of topics, including:

• Caregiver’s Guide to Understanding Dementia Behaviors – Includes Ten Tips for Communicating with a Person with Dementia
• Caregivers’ Guide to Medications and Aging – “Any symptom in an elderly patient should be considered a drug side effect until proved otherwise.”
• Caring for Adults with Cognitive and Memory Impairments – A very thorough over of the topic, from tips on getting started to more resources.
• Caregiving and Ambiguous Loss – Addressing the stress caused by unpredictable memory loss that, “comes and goes—one moment here, the next moment gone”.
• Dementia, Caregiving and Controlling Frustration – A great guide to dealing with the personal challenges that we have to deal with.

There’s plenty more from Family Caregiver Alliance

Alzheimer’s Association CareFinder

This area of the Alzheimer’s Association website focuses on help for a person with Alzheimer’s, or their caregiver. This part of the site is well organized and serves as a good, high-level guide to addressing needs of someone with Alzheimer’s. The major sections of this site include:

• Planning Ahead
• Care Options
• Coordinating Care
• Support and Resources

The site also include an interactive tool called, “Your Personal CareFinder” that asks a number of questions about the patient so it can then recommended care options and questions to ask when screening a caregiver or facility.

Particularly helpful are the “Topic Sheets & Forms“. Included are a number of pages and PDF files categorized as, Forms, Daily Living, Financial, Legal and Insurance Issues and Home and Residential Care. Some, of particular note, are Individual Needs Assessment, Wandering: Preparing for and Preventing, Caregiver Stress and a couple of real thorough documents on taxes and Alzheimer’s.

AARP, Navigating the World of Caregiving

As you might expect, AARP has a good area on their site that helps caregivers find the kinds of information that they’ll need while helping a senior. The major, and best, parts of this site include:

• Planning Ahead
• Providing Care at Home
• Preparing Your Home
• Housing Options
• Legal and Insurance
• End of Life

There’s a lot of good detail here. While none of them are really deep, they’re helpful in that they give a good overview of each topic area.

The site has a couple of “interactive features” that are rather unimpressive. One is a quiz to see how stressed you are. You rate yourself on a number of factors and then it scores you on how stressed you are. I like that it has a button below your score that says, “Try Again”. Will me stress go down if I keep doing the quiz? There’s also a video section on the site with a lot of short videos on a variety of topics related to caregiving. Dr. Bill Thomas stars in many of them. The AARP also has a Caregiving area that has more timely articles.

Some Quick Hits

We also have a couple of quick hits for caregivers:
10 Tips for Family Caregivers (PDF) – Good tips from the National Family Caregivers Association
Stages of Caregiving – Also from National Family Caregivers Association on their Family Caregiving 101

Did we miss your favorites, or an obvious one?

I also recently learned that you can purchase a book from their site on The Altzheimer’s Project for $19.99 and a 3 dvd set for $24.98.  If you choose to purchase both the book and dvds at the same time, you can get them for $39.99.  Click here for a direct link to the HBO store.

That’s why Getting Things Done (GTD) has become so popular among the Internet crowd. Those of us who are regularly online, on the Blackberry, or iPhone, manage to pack the day with interruptions, misdirections and a level of productivity that leads to a stressful life. Helping seniors can be particularly rewarding, but only if we can reduce the stress.

The main tenant of GTD is that a stress-free day is attained through recognizing that the process will manage all the balls in the air for you. While the process takes a little time to get used to, it’s not particularly complicated, nor could it be to be effective.

The overall workflow follows five main steps:

1. Collect
2. Process
3. Organize
4. Review
5. Do

Initially collecting can be a very long process. It’s gathering everything you want to do, or need to do, into buckets–your email inbox, your physical inbox, etc. The idea is to get everything that’s in your head into an inbox and ready for processing. All of these buckets are processed, or emptied, at least once a week.

When processing a bucket, a prescribed workflow is followed:

• Start at the top.
• Deal with one item at a time.
• Never put anything back into ‘in’.
• If an item requires action:
  • Do it (if it takes less than two minutes), OR
  • Delegate it, OR
  • Defer it.

• If an item does not require action:
  • File it for reference, OR
  • Throw it away, OR
  • Incubate it for possible action later.

In the organize phase, there are four set of list that you’ll maintain:

• Next actions – For every item decide what the next action that needs to, and can, be taken. It might be make a call, send an email, or schedule a meeting. While there are many items that are required to accomplish an item, there is only one ‘next step’.
• Projects – Projects are things that go on for a period of time and need revisiting on a periodic basis to make sure that there is still a next action associated with it.
• Waiting for – When there is someone, or something, that you must wait for, it goes here. These items are periodically reviewed to see if there is something that can be done to move the item forward.
• Someday/Maybe – These are items that you legitimately want to do, but you’re not ready to start…like learn Russian.

Review
Really two things fall into this area. The first is to review the next actions at least once a day. During the review, you should be determining the most important action that needs to be done immedately. The book covers a number of strategies to make the review step more effective.

At least once a week, you should review all of your outstanding actions, projects, and waiting fors.

Do
Basically the “Do” phase takes some emphasis off of the organizing and puts it on…Getting Things Done.

While certainly not for everyone, Getting Things Done will help many of you enjoy the time you spend with your parents.

Related Links

Tech Junkies Crazy About ‘Getting Things Done’ (NPR)

43 Folders (productivity site and big fans of GTD)

Courtesy code poet via Flickr

We ran across The Caregiver’s Marketplace a while back and wondered if it was worth the effort. After looking into it, I think that depending upon your financial situation, it could very well be a help to the everyday household budget.

The Caregiver’s Marketplace is a rebate program for a good number of products that you may find yourself buying on a regular basis if you’re a senior, or a caregiver. Many of them are routinely purchased items like Benzodent, Citrucel, Comfort Bath, Depend, Ensure, Glucerna, Kaopectate, Oscal and Poise.

The way The Caregiver’s Marketplace works is that when you buy five, or more, products that are part of the program, you can send the receipts with the rebate form and get anywhere from 25 cents to $2.00 back per item you purchased. Most of the rebates look to be 75 cents and $1.00. The important thing to note here is that if you purchase fifty Ensure six packs in a year, that’s $50 back. There appears to be no limit to how many rebates you, as an individual, can get.

The obvious strategy here is to put the rebate form, that you can download from their site, and the weekly receipts (with the eligible items circled) in an envelope. Periodically send in for your rebates. You may decide to do it every time you have five plus items, or once a month/quarter, or whatever is most convenient for you.

Most of the products are for seniors, but there are a number of products for babies as well. So if you’re a caregiver for two generations, you may be able to save even more.

For more info on respite care, see our recent post on respite care for more information.

Many sources of funds for respite care require a level of financial need. If the senior can afford to pay for the care, some of the avenues that might pay for respite care will be closed to you. You should still investigate your options.

Find the right organization

There are a number of reasons why you may find yourself in a situation where respite care, and that’s the first tip for finding help. For instance, commonly seniors who are in need of continuous, or near continuous, care are suffering from chronic, debilitating, progressive diseases like Parkinson’s, or Alzheimer’s. Organizations like Alzheimer’s Association and National Parkinson Foundation have programs that may help pay for respite care. Other organizations like these may offer help with respite care.

If the senior is nearing the end of life and is in the care of Hospice, Medicare will cover inpatient respite care. You can stay in a Medicare-approved facility up to 5 days each time you get respite care. Medicare requires that the patient pays for 5% of the care associated with respite care. For more information on Medicare covered respite care, see their publication (PDF) called Medicare Hospice Benefits.

Go local

One of the best ways to find help with respite care and possible sources of funds are to talk to people locally. Both the Parkinson’s and Alzheimer’s sites have ways of finding local chapters and support groups. Ask them what they would recommend for respite care in your area.

The Eldercare Locator, a public service of the Administration on Aging, U.S. Department of Health and Human Services, can help you find care locally. They have a good page on respite care.

Check out Chapel Hill Training-Outreach Project. They have a respite locator to help you find a respite care provider in your area. They may be able to give you help in finding a way to pay. They also have links to state respite coalitions that may help.

Consider contacting a SHIP counselor who may be able to help guide you to help on respite care.

Catholic Social Services and other church-based programs often help with respite care.

Other considerations

Not all respite care is alike. In some cases, the need is for a day, or even a part of a day; time enough to get away and have time to relax for a few hours. In other cases, it’s truly time for a week’s vacation. Each type of respite care has different solutions. Investigate your options for both, because you’ll likely need both.

Let us know if you have any tips on paying for respite care.

Related Links

Alzheimer’s Association: Respite Care Guide (PDF)

The Senior Organizer: Personal, Medical, Legal, Financial
The title is pretty self explanatory. This is a book, largely of forms that helps organize critical information that will be important during medical emergencies, diminished mental capacity and ultimately the death of a loved one. The Senior Organizer has a place to put all the information that you’re going to need for a number of situations.

Up front, the organizer has an index to the most important information in the book for emergency situations. It simply points the reader to the most important pages, like: specific information on the senior, emergency contacts, medications and other information stored in the book that can be important to have in an emergency. Overall, the book has two major sections after that that contain “personal & medical” and “legal & financial”.

The personal and medical section includes everything from doctors, doctor visits and prescriptions, to insurance and contact information.

The legal and financial is as you would expect, including information on banks, taxes, real estate holdings, insurance, health directives and end-of-life documents like wills.

This may seem like something you could do on your own, and it is, but the value that the editors of The Senior Organizer bring is their thoroughness and that they’ve packaged it into a very usable book. A thoughtful bonus is that buying the book entitles you to free downloads of new pages if you have to revise or add anything, or if you want to create a notebook instead of keeping it in a paperback.

One caution that I would make is that the book has places for information (Social Security number, date of birth, and credit card numbers) that would be ideal for identity theft, or outright theft. It should be agreed that this kind of information be kept in a more secure location.

Family Caregiver Organizer: A Personal and Medical Journal for Care-receivers and Their Caregiver(s)
The Family Caregiver Organizer is singularly focused on health care and, I would argue, on individuals who receive a lot of health care.  The organizer is spiral bound and a little friendlier for every day use than The Senior Organizer. The bulk of the organizer is monthly logs that include: My Calendar, Questions for the Doctor, Lab Tests, Medications and daily logs among other things. There are six months of logs and you can order more pages.

Up front is, “All About the Care-receiver”, including sections called My Health Now and My Health History.

The organizer includes a Family Caregiver Answer Book, a reminder booklet for caregivers called, Caring for the Caregiver and a File of Life, covered recently here on SHF.

My take? I’ve ordered both for my parents.

The site provides the following warning signs:

• Feelings of anger
• Difficulty concentrating
• Unproductive worrying
• Feelings of sadness
• Frequent mood swings

The online article also provides several physical warning signs to look for:

• Stooped posture
• Sweaty palms
• Tension headaches
• Neck pain
• Chronic back pain
• Chronic fatigue
• Weight gain or loss
• Problems with sleeping

Access the article online for a list of suggestions for reducing such stress.

A December 30, 2008 post by Laura McGowan provides a list of resources for caregivers and 10 tips for family caregivers from The National Family of Caregivers Association.

Every state offers either disabled parking cards, or plates, or both. While the requirements vary by state, they are very similar. While not in every case, it often requires a doctor’s letter.

To give you an idea of what they typically require, we’re posting Wisconsin’s basic requirements below:

• Cannot walk 200 feet or more without stopping to rest;
• Cannot walk without the use of, or assistance from, another person or brace, cane, crutch, prosthetic device, wheelchair or other assistance device;
• Is restricted by lung disease to the extent that forced expiratory volume for 1 second when measured by spirometry is less than one liter or the arterial oxygen tension is less than 60 mm/hg on room air at rest;
• Uses portable oxygen;
• Has a cardiac condition to the extent that functional limitations are classified in severity as class III or IV, according to standards accepted by the American Heart Association;
• Is severely limited in the ability to walk due to an arthritic, neurological or orthopedic condition;

We’ve included links to each state so you can check the specific requirements. The links either take you to an application form, which typically include the requirements, or to their department of transportation page which discusses the application requirements. Links to Acrobat documents are noted with ‘PDF’:

• Alabama (PDF)
• Alaska
• Arizona
• Arkansas
• California
• Colorado
• Connecticut
• Delaware
• Florida
• Georgia (PDF)
• Hawaii
• Idaho (PDF)
• Iowa
• Illinois
• Indiana (PDF)
• Kansas (PDF)
• Kentucky (PDF)
• Louisiana
• Maine (PDF)
• Maryland
• Massachusetts
• Michigan (PDF)
• Minnesota
• Mississippi (PDF)
• Missouri
• Montana (PDF)
• Nebraska
• Nevada
• New Hampshire (PDF)
• New Jersey
• New Mexico (PDF)
• New York
• North Carolina
• North Dakota (PDF)
• Ohio
• Oklahoma (PDF)
• Oregon (PDF)
• Pennsylvania
• Rhode Island
• South Carolina (PDF)
• South Dakota
• Tennessee (PDF)
• Texas (PDF)
• Utah
• Vermont
• Virginia
• Washington State
• West Virginia
• Wisconsin
• Wyoming
• District of Columbia

Flickr by Burning Image

According to the American Public Transportation Association (APTA), (December 7, 2005), more than eighty two percent of Americans “age 65 or older worry that they will be stranded and unable to get around when they can no longer drive.” 

In addition, the APTA reports that “nearly all of the respondents (98 percent) said that maintaining their independence is “extremely important.” 

Care.com recommends, “Prior to a move or in anticipation of the need for alternative means of transportation, assessing the availability and cost of town-owned senior transportation services is a great idea. Seniors should know what to expect in terms of how they will be able to get around town independently, especially if their needs or health suddenly change. Call your local senior center or Eldercare Locator (1-800-677-1116) to learn more about transportation services or vouchers for seniors in your area.”

We have found a couple of additional resources for you to check for transportation solutions in your local community:

• The American Public Transportation Association’s website provides a list of local and state transportation links 

• ITN America is a transportation organization that specializes in “Dignified Transportation for Seniors.”  There are currently ITN affiliates in eleven markets throughout the United States.