Tuesday, July 31, 2007

Coping With The Emotional Challenges Of Caregiving A Parent

By: Dana Sanders

Do you know someone acting as a caregiver to an aging or disabled parent, maybe a friend, loved-one, or a co-worker? Are you serving as the role of caregiver yourself? Do the emotional challenges seem impossible to deal with some days, and you just don’t know how you can handle anymore?

As a caregiver for my mother, I would like to share my personal experiences and insight on how to successfully cope with the emotional challenges of serving as a caregiver to an aging or disabled parent. In my e-book Becoming Your Parent’s Caregiver, I detail my caregiver experiences and helpful resources to help you cope with all the emotional challenges you may face while serving as caregiver.

I believe the best way for caregivers to cope with the many emotions they will experience in providing care to aging parents is to prepare themselves for the wide range of emotions that pave the long and unforgettable road of caregiving.

Initially caregivers may relish in a great sense of self-worth and accomplishment, believing they have found a worthwhile purpose in their life. While some adult children are thwarted into the role of caregiver unexpectedly, many others eagerly agree to the role with a nurturing perspective that only they can provide the best care for their parent.

However, months or even years down the emotion-paved road of caregiving, the gung ho attitude is usually lost, or quickly dissipating. Caregivers begin to encounter more overwhelming emotions such as fear, frustration, guilt, and even caregiver burnout. When I provided care for my mother, I experienced all of these emotions at one time or another.

The one same fear most caregivers share is that of the unknown. Many caregivers worry that they won’t be able to afford adequate housing, appropriate medical care, or long-term insurance, if and when, the time ever comes to make those decisions. Caregiving to a parent on a limited income can make matters even more stressful. However, caregivers can combat the fear of the unknown by making preparations and planning before making any life-altering decisions.

Aside from fear, caregivers also feel extreme emotions of being overwhelmed at least once during their role as caregiver. Often caregivers feel guilty and torn between spending time with their own families and friends, while acting as a caregiver. Caregivers with a career also feel overwhelmed trying to juggle a career while trying to successfully allocate time to be a caregiver. The legal responsibilities associated with caregiving are also overwhelming. Issues such as naming a Power of Attorney, Living Wills, and Healthcare Proxies, can not only be physically and emotionally draining for a caregiver, but extremely frustrating if preparations haven’t been made in advance.

Usually in the midst of being overwhelmed, the caregiver forgets about the most important person of all - the caregiver. Oftentimes caregivers hold to the belief that they can do it all, never asking siblings or other family members to share in the caregiving responsibilities.

If you or someone you know find yourself in this situation, it’s important to realize asking for help and seeking support groups is not a sign of weakness. There is also a wealth of valuable resources available to help cope with all the emotional challenges of acting as a caregiver to an aging or disabled parent.

Article Source: http://www.articlesnatch.com

About the Author:

Dana Sanders is the author of Becoming Your Parent's Caregiver, an ebook written out of her own experience and that provides advice for the children of an aging or disabled parent. Please visit www.caregivingaparent.com for information to help you care for your parent.

This group of caregivers on Yahoo I met today.

So I was poking around at some of the links I posted over there on the right side this morning and I ran across a Yahoo group for caregivers and sent up a flare not knowing what to expect and I got flooded with responses from people all over the country in very similar situations as mine.

I am literally shocked by the kind and understanding responses I received and am grateful and humbled by the experience. If you feel alone as I did this morning I'm here to tell you that you never have to feel that way again. Just go here and send up a flare like I did and you'll be amazed and fortified before the day is done.

alt="Click here to join chck_thmpsn">
Click to join chck_thmpsn

Monday, July 30, 2007

Breaking the silence


I'm writing this blog more for myself than anyone else. I need to break the shroud of silence that has all but engulfed my very being and taken me to insanity's gate. I have been the sole caregiver to both my elderly and infirm parents now for going on five years. I am a single 49 year old man in relatively good health and "should" be watching my children go off to college or getting married or celebrating a silver wedding anniversary and preparing for retirement and enjoying the fruits of my labor as I approach my 50th year. At least that's the way I had envisioned it would be as a young boy dreaming of what my life as an adult would be like. I don't think anyone can describe the absolute anguish that a caregiver endures day in and day out but another caregiver. The constant internal conflift and feelings of guilt are at times debilitating beyond consolation yet the sun comes up and another day is upon you and you have to do what needs to be done. There is no calling in sick, there is no taking a day off, there is no life of your own when your a caregiver. The only solace comes in the darkest hours of the night when the bells stop ringing and the medications have finally done their job for a few hours resbit and I can drift off for a few hours and dream of summer vacations on green lawns alongside the crystal blue waters of a mountain lake with children laughing and singing in the midday sun.

The first year I slept at his feet on the floor in the family room. He was unable to lie in bed so the recliner was his bed and the floor was mine, rolled up in a down comforter like a sleeping bag. His apnea was quite pronounced these early days after his stroke and I can remember lying in my bedroll and counting one mississippi, two mississippi,three mississippi sometimes up to 150 or 160 before he made this loud gasp that made me jump and he began breathing again. Many times while counting in between gasps I would think, "What if this is it? What if no gasp comes and he's gone?" and before I could finish the thought the sound I will hear forever in my head came and made me jump and snap out of it. Back to counting, one mississippi, two mississippi and I'd cry sometimes but eventually I'd just pull the comforter over my head just about the time the sun was coming up and get some sleep.

Strategies for Working with Discharge Planners

What do you do when your loved one goes to the hospital? If you are caring for someone with dementia, you probably worry about the hospital’s understanding of the illness and the ways your loved one needs to be cared for. If there is an acute episode, for example a stroke, broken hip or pneumonia, you worry about your loved one getting better, and what the needs will be when he or she leaves the hospital.

Often, caregivers spend many hours at the hospital, overseeing care and offering support. By the time your loved one is discharged from the hospital, you might be more tired than ever—and you might be scared that you won’t know how to provide care now.

So, what happens when the hospital stay is over? We’ve all heard about the late Friday afternoon discharge from the hospital. You have been there every day, talking to the nurses about your loved one’s condition and needs. Suddenly, you are told he or she is going home this afternoon. There has been no discussion about what the home care needs are and what you need to know in order to care for your loved one.

Perhaps you’ve met with a discharge planner, who has told you a little bit or arranged for your loved one to go to a rehabilitation facility for physical therapy and to get his or her strength back. Or you have been told to go look at nursing homes and let the discharge planner know what you’ve decided. You may have been told your loved one needs 24-hour care, but no one has told you how to find that care or what it will cost. You may not even know how to get your loved one home from the hospital—who will pay for an ambulance if it’s needed, how will he or she get up the stairs in the house, where will he or she sleep if the bedrooms or bathrooms are upstairs?

Several governmental agencies and research projects have examined the discharge planning process, the fragmentation of services and what caregivers need to know to succeed in navigating the care system. All agree that changes are needed to make discharge planning more successful.

It has been well documented that patients are being discharged from the hospital “quicker and sicker” than in the past. This also means that patients have more complex care needs and may be dealing with multiple illnesses and disabilities. Nurse discharge planners may tell you about medical situations, and social work discharge planners will tell you about community organizations, but in too many cases, no one is overseeing the information and the referrals you are given or how to access and coordinate the help you need.

If your loved one is discharged to a rehabilitation facility, the discharge planner at the hospital will assume that someone at the facility will answer your questions. Unfortunately, the discharge planners at the facility may not be trained to respond with the information you need. There is no care coordination across the discharge process, e.g., from hospital to facility to home care. You are left stressed, confused and feeling helpless.

What can you do under these circumstances? First, it is important to be an advocate not only for the patient but also for yourself. Be aware that there is an appeal process available if you feel your loved one is being discharged too soon. (See the Resources section at the end of this article.) Write down your questions and make sure you get answers before taking your loved one home.

The first set of questions is about the illness:
What is it and what should you expect in terms of recovery?
What should you watch out for?
Will you get home care and will a nurse or therapist come to your home to see that the patient is doing ok?
How do you get help—for advice about care, danger signs, a phone number for someone to talk to, follow-up medical appointments?
Have you been given information either verbally or in writing that you understand and can refer to?
The second set of questions is about treatment and care:
What medicine should be taken and when?
What side effects you should be looking for; how do you help your loved one transfer from bed or chair to standing?
What do you do if he or she falls (particularly when you are holding him/her)?
What medical equipment does your loved one need, e.g., a hospital bed or commode or walker, and how do you use them?
Will someone come to your home and do an assessment to see if you need home modifications to care for your loved one in his or her new condition?
Third, where do you find help in the community:
What agencies are available to help you, with, say, transportation or meals?
What is adult day care and how do you find out about it?
What public benefits are you eligible for, such as In-Home Supportive Services?
Where do you start to look for such care (make sure you are given specific referrals and not just a resource guide which can be overwhelming)?
Whom can you call to help with these referrals or if you have trouble connecting with an agency?
And finally, you need to have the discharge planner address your needs as a caregiver. This means that they should assess your ability to do the required tasks:
Have they trained you in transfer skills?
Do you know how to turn someone in bed so he or she doesn’t get a bedsore?
Do you know how to help someone swallow a pill or give an injection?
Does your loved one require help at night and if so, how will you get enough sleep?
What things are scary or uncomfortable for you to do, e.g., changing a diaper?
What medical conditions and limitations do you have that make providing this care difficult?

We know that if your health is compromised in caring for someone, he or she will return to the hospital or need nursing home placement sooner. It is important for you to say, “I cannot do that,” rather than to hurt yourself or your loved one trying to do something.

We often get calls from caregivers saying they don’t know where to start to get help or are confused by what the discharge planner has told them. Feel free to call your Caregiver Resource Center if you need guidance when your loved one is in the hospital and when the discharge plan is being made. And most important: don’t be afraid to be assertive in getting your concerns addressed before your loved one comes home.

For More Information
Center for Medicare Advocacy’s Tip Sheet for Beneficiaries: Hospital Discharge Planning


Medicare Rights Center
Medicare Home Health Eligibility, available at: http://www.medicarerights.org/maincontenthomehealtheligibility.html

A Family Caregiver’s Guide to Hospital Discharge Planning, published by the National Alliance for Caregiving and the United Hospital Fund of New York.

Hot Weather Tips

HOT Weather Tips

We all suffer in hot weather. However, for elderly and disabled people and those with chronic health conditions such as vascular disease or diabetes, the weather does not have to hit 100 degrees to cause heat stress or even deadly heat stroke.

As we age, we gradually lose the ability to perspire and regulate our body temperature. This is why older people tend to overdress—they don't feel heat the same way anymore. Heart rates do not speed up-or return to normal-as fast during exercise. Older skin also thins and offers less protection from the sun. Poor circulation, heart, lung and kidney diseases, and high blood pressure increase the risk for heat-related illness. Being overweight or underweight also increases risk.

Medications taken for a variety of diseases and symptoms can also interfere with one's ability to manage hotter weather. These medications include antipsychotic drugs commonly given to Alzheimer's patients to control agitation, anticholinergic drugs, tranquilizers, sedatives (including over-the-counter sleeping pills), amphetamines, diuretics and drugs to control blood pressure, antihistamines, and some antidepressants.

A person with cognitive impairment, whether from disease or injury, may not be able to communicate distress. In some cases, they may not even "feel" the heat or discomfort because of changes in the brain's abilities to process sensory information or regulate their body's responses to heat.

Caregivers can prevent a heat-related emergency (hyperthermia) by keeping a loved one cool, watching for signs of heat stress and following these tips for dealing with hot weather.

Wear cool clothing: See that the person is dressed in light-weight, light-colored, loose-fitting clothing, preferably of natural fabrics like cotton. Use hats and umbrellas outside. If the air conditioning appears to bother the person, offer layers, such as a long-sleeved shirt or sweater over the shoulders, or a light cloth over the ankles.

Use air conditioning: Keep the air conditioning on below 80 degrees F. If you don't have air conditioning, invest in a room air conditioner or use room fans to circulate inside air. If possible, drive the person a short distance to an air-conditioned place where they can sit, such as a library, mall, restaurant or theater. But avoid overcrowded places and rush hours.

Cover windows: During the day, pull the curtains on all windows that are in direct sunlight. Open windows at night and use fans or cross-ventilation to circulate cooler air. (An open, uncovered window during the day will simply make the inside temperature the same as outside.)

Avoid direct sun: Stay indoors during the hottest hours, 11 a.m. to 4 p.m. Drive as close to the door of destinations as possible, but don't leave the person in the car where temperatures can soar quickly. If the person wants to be outside, make sure it's during cooler hours and that he or she is in the shade, on a covered porch, or under an umbrella. Also check the news for information about temperatures, humidity levels and air pollution alerts.

Eliminate or limit physical activity: If the person's physician approves light exercise such as walking and movement exercises, limit them to short periods during cool hours. Eliminate entirely on very hot days.

Drink plenty of fluids: Give the person plenty of water and fruit or vegetable juice even if they say they're not thirsty. No alcohol, coffee or tea. Seek medical help if you suspect dehydration.

Light meals: Avoid hot, heavy meals and don't use the oven.

Monitor medications: Find out if the person's medications increase his or her risk for heat stress. Be sure to ask a physician about all the medications being taken, including off-the-shelf items.

Take cool showers: Help the person take a cooling shower or bath. Lay a cool, moistened towel over the forehead or back of the neck and replace often.

Check in often: If the person lives alone, check in daily or ask a neighbor to look in several times a day. If the person lacks transportation, make sure someone takes him or her to and from appointments, grocery stores, etc.

Inform others: If the person is in a nursing home or other facility, make sure the facility has a plan for dealing with rising temperatures and is following the tips mentioned above. Visit as often as possible.

Be alert: Remember that a cognitively-impaired person may not be able to tell you when he or she is feeling hot or ill. Also, older people tend to feel colder than younger people so they may not sense the danger of hotter weather.

If you are caring for an elderly or disabled person, learn the signs of heat-related problems. Seek medical assistance for any of the following signs and - if you suspect heat stroke - call 911 or medical personnel immediately.

Headache, nausea and fatigue are signs of at least some heat stress.

Heat fatigue: cool, moist skin, a weakened pulse, feeling faint.

Heat syncope: sudden dizziness, pale, sweaty looking skin that is moist and cool to the touch, weakened pulse and rapid heart rate but normal body temperature (that is, 98.6 degrees, taken with a thermometer).

Heat cramps: muscle spasms in the abdomen, arms or legs after exercise. (Note that these may be caused by lack of salt but do not give salt or salt tablets without consulting a physician.)

Heat exhaustion: this is warning that the body is getting too hot. Watch for thirst, giddiness, weakness, lack of coordination, nausea, and profuse sweating. Cold, clammy skin. Body temperature may be normal (98.6 degrees). Pulse is normal or raised slightly. Pupils may contract. Urination decreases and the person may vomit.

Heat stroke: this is life-threatening. Immediate medical attention is required. Death can occur quickly when heat stroke occurs. Body temperature rises above 100 degrees F (some sources say 104 degrees F), and the person may become confused, combative, behave bizarrely, feel faint, stagger. Pulse is rapid. Skin is dry, flushed and may feel hot. Lack of sweating. Breathing may be fast and shallow. Pupils may widen or dilate. Delirium, seizures or convulsions, and coma are possible.

To alleviate symptoms for any heat-related problem and while waiting for medical help:

Have the person lie down in a cool place.

Elevate the feet.

Apply cool, wet cloths or water to the skin, especially the head, groin and armpits which cool quickly.

Fan by hand or with an electric fan.

If possible, give small sips of cool water (no salt without a doctor's approval)

Do not use rubbing alcohol.

And remember - if you suspect heat stroke, call 911 or summon medical personnel immediately.

Following a heat stress episode, a person will likely feel tired and weak for several days. Continued monitoring is important.

"Hyperthermia: A Hot Weather Hazard for Older People"
National Institute on Aging
(800) 222-2225 (ask for hot weather department)



Fact Sheet : Advocacy Tips for Family Caregivers

A Call to Action

Families—not institutions—provide the majority of care to chronically ill and disabled loved ones. These families know the enormity of the burden in caring for someone with Alzheimer’s or Parkinson’s diseases, stroke, traumatic brain injury, or other long-term conditions. They also know the challenges in locating appropriate advice, services and respite.

Personal experience with community agencies, round-the-clock care, and financial hardships mean families know what the important issues are. This puts family caregivers in a unique position to act as advocates. Caregivers can educate elected officials charged with development of public policy and funding priorities.

This fact sheet offers tips for effective strategies for families to get involved in local, state or federal advocacy efforts.

How Families Can Help Effect Change at the Public Policy Level
Write or e-mail a letter to your elected representative.
Representatives rely on communication from their constituents to keep them informed and to know where constituents stand on critical or controversial issues.
A personal letter or e-mail are effective methods to get your message across.
Write legibly, type or e-mail your message and try to keep your communication to one brief page.
Make your message to the point. Example: “I’m writing in support of HR 1, the Long-Term Care Act.” (Refer to the bill name or number, if
you can.)
Give a reason for your position (support or opposition). A personal experience is powerful in establishing your case.
Let them know what you expect. Example: “I hope I can count on your support for this bill. Please write back and let me know your position on this important issue.”
Include your name and address on both the letter and the envelope or within your e-mail message.
Target and time your letter. Representatives will give the most weight to letters from their own constituents. However, if a bill is to be heard in a particular committee or subcommittee, you may need to communicate with the committee leadership (e.g., Chairperson of the Senate Health and Human Services Committee). In this case, explain that while you are not from the legislator’s own district, you hope that the needs of all citizens will be considered in reaching a decision on the bill. Naturally, timing the letter before a vote is taken is critical.
Follow up by thanking your representative when his/her actions support your position.
Where to Write:
U.S. Congress
The Honorable_____________
U.S. Senate
Washington, DC 20515

Dear Senator (name):

The Honorable______________
House of Representatives
Washington, DC 20510

Dear Representative (name):

California State Legislature
The Honorable_______________
State Capitol
Sacramento, CA 95814

Dear Senator (name):

The Honorable_________________
State Capitol
Sacramento, CA 95814

Dear Assemblymember (name):

Make a Phone Call
When time is of the essence, a phone call can be a practical way to express your concern to an elected representative. The most effective calls are to the Capitol offices, particularly when a vote is imminent.

Introduce yourself and give your affiliation if you are working on behalf of a particular group, organization or campaign. Be sure to mention if you are a constituent.
Don’t expect to speak to your representative directly. Most likely, you will speak to a receptionist or legislative staff. These individuals are responsible for keeping the legislator informed.
Explain why you are calling. Example: “I’m calling to register my opposition to the proposed budget cuts for adult day care centers. Please be sure that the Assemblyman is informed of my concern.”
You may need to communicate your position to a committee which is hearing a bill or budget item. If you are not sure of the committee name or hearing schedule, you can ask staff at your own representative’s office.
Where to Phone: Capitol Switchboard Washington DC, (202) 244-3121. The operator will refer you to any U.S. Senator or U.S. Representative (Congressman/woman). In California, the Assembly Chief Clerk can help you reach any Assembly member (916) 445-3614. The Senate Secretary will provide phone numbers for any California State Senator (916) 445-4251.
Faxing is also an effective way of sending your letter to a legislator. All state legislators and members of Congress have Fax machines. Fax numbers can be obtained from the same sources as legislative and Congressional telephone numbers (see “Where to Phone” above).

Visit Your Elected Representative
Meeting face-to-face with a legislator or designated staff is an excellent way to establish a relationship and convey your point of view.

State legislators often go home to their district offices on Thursday or Friday. Meetings at the State Capitol are best set for Tuesday or Wednesday.
Congressional Representatives in Washington, DC are more likely to come home on the weekend or on extended holidays or periods of Congressional recess. Contact the Capitol office to determine the best time to make an appointment.
Plan ahead. Legislators’ schedules fill up weeks in advance. Plan your first visit before there’s a “crisis” to establish a friendly rapport.
Do not set your hopes on meeting with your representative in person. Legislators are busy and schedules often change at the last minute. An effective meeting can be held with a legislative staff aide (often the very people who craft legislation or brief their bosses on important issues).
When you call the office, ask to speak to the scheduler. Introduce yourself, explain the nature of the visit, give the names and number of other people who will come along on the visit, how long you will need (15 to 30 minutes), and when you would like to come. You may be asked to send a request in writing.
After an appointment has been scheduled, it is wise to confirm the information by mail, e-mail or phone (correspondence should be addressed to the legislator him/herself, even if the meeting is scheduled with staff).
If scheduling more than one meeting at the Capitol in one day, leave 30 minutes between appointments to get from one room to another. (In Sacramento, some legislative offices are located outside the Capitol.)
Do your homework by learning something about the person you will visit. Rehearse what you will say, keeping in mind the legislator’s background and interests. You may wish to begin by sharing your own personal caregiver story. Show your knowledge by mentioning any action taken or bills authored/supported by the legislator in a similar area, if appropriate.
Be clear about the purpose of the meeting. Example: “I am here today to familiarize you with the needs of family caregivers,” or "I would like to know if I can count on your support for improving the quality of care in nursing homes.”
Add your voice to others who share similar concerns by joining a larger group or organization going to visit the Capitol. This way you can coordinate with existing efforts and increase your clout.
Understand that current fiscal constraints make it difficult to advocate for increased funding for programs and services. Do not apologize for this fact. Instead, be clear about the importance of a program or service to you and your family. Example: “I know funding is tight and not everything can be considered a priority, but I am here to tell you what is a critical issue for me and others like me.”
Bring a few brief written materials, if available, to leave in the office which relate to the purpose of your visit.
Bring a camera. Even if a legislator cannot meet with you in person, he/she may be pulled out of a meeting momentarily for a photo opportunity.
Remember to thank the legislator or staff for your meeting. It is also a good idea to send a thank you letter addressed to the legislator.

Other Activities
Stay informed. There are a number of organizations which monitor legislative activities at either the state or the federal levels. Newsletters and other publications can keep you up-to-date (see the Resources listed at the end of this Fact Sheet for agency names and addresses).
Contribute your ideas and energy: join a committee, task force or campaign. Such groups may work on a single issue or a variety of issues. Tasks might include organizing a public event or drafting policy recommendations. Even if you don’t attend committee meetings you can still lend your support to a letter writing campaign or telephone tree.
Write a letter to the editor or opinion editorial “op-ed” piece stating your views in your local news-paper. This is an excellent sounding board to help educate the public about a cause.
Testify at a hearing. Legislative and Congressional committees often hold hearings to gather support and expert opinions while drafting legislation. Family caregivers can provide compelling stories of their daily struggles in caring for a loved one. Be sure to contact the committee the day of the hearing; last minute schedule changes occur frequently.
All federal bills can be searched and downloaded from the Library of Congress TOMAS website. You can also request copies of bills from your representative. California bills are available at the Legislative Council of California's Legislative Information website.

Selected Advocacy Resources
National Organizations
Alzheimer’s Association
225 N. Michigan Avenue, Floor 17
Chicago, IL 60601-7633
(800) 272-3900
(local chapters throughout the U.S.)

601 E. Street, NW
Washington, DC 20049
(888) 687-2277

Families USA
1201 New York Avenue, NW
Washington, DC 20005
(202) 628-3030

Family Caregiver Alliance
National Center on Caregiving
180 Montgomery Street, Suite 1100
San Francisco, CA 94104
(415) 434-3388 or (800) 445-8106

National Citizen’s Coalition for Nursing Home Reform
1828 L. Street, NW, Suite 801
Washington, DC 20036
(202) 332-2275

National Senior Citizens’ Law Center
1101 – 14th Street, NW, Suite 400
Washington, DC 20005
(202) 289-6976
(Also in Oakland and Los Angeles)

National Committee to Preserve Social Security and Medicare
10 G Street, NE, Suite 600
Washington, DC 20004
(800) 966-1935

Older Women's League (OWL)
3300 N. Fairfax Drive, Suite 218
Arlington, VA 22201
(703) 812-7990

California Organizations
California Advocates for Nursing Home Reform (CANHR)
650 Harrison Street, 2nd Floor
San Francisco, CA 94107
(415) 974-5171
(800) 474-1116 for consumers

Center for Health Care Rights
520 S. Lafayette Park Place, Suite 214
Los Angeles, CA 90057
(800) 824-0780 (in LA only) or (213) 383-4519

Disability Rights Education and Defense Fund (DREDF)
2212 Sixth Street
Berkeley, CA 94710
(800) 348-4232 or (510) 644-2555

Health Access California
1127 11th Street, Suite 234
Sacramento, CA 95814
(916) 497-0923
(Also in Oakland and Los Angeles)

Family Caregiver Alliance
180 Montgomery Street, Suite 1100
San Francisco, CA 94104
(415) 434-3388
(800) 445-8106
Web Site: www.caregiver.org
E-mail: info@caregiver.org

Family Caregiver Alliance (FCA) seeks to improve the quality of life for caregivers through education, services, research and advocacy.

FCA’s National Center on Caregiving offers information on current social, public policy and caregiving issues and provides assistance in the development of public and private programs for caregivers.

FCA's e-newsletter. Caregiving PolicyDigest, offers up-to-date information on national policy issues.

For residents of the greater San Francisco Bay Area, FCA provides direct family support services for caregivers of those with Alzheimer’s disease, stroke, ALS, head injury, Parkinson’s and other debilitating health conditions that strike adults.