Caring for elderly parents catches many unprepared
[A ] Last July, Julie Baldocchi，s mother had a massive stroke and was paralyzed. Baldocchi suddenly had to become a family caregiver, something that she wasn"t prepared for. “I was flying by the seat of my pants,” says Baldocchi, an employment specialist in San Francisco. Both of her parents are 83, and she knew her father couldn’t handle her mother’s care. The hospital recommended putting her mother in a nursing home. Baldocchi wasn’t willing to do that. But moving her back into her parents’ home created other problems. Baldocchi, 48, is married and lives about a mile away from her parents. She has a full-time job and has back problems that make it difficult for her to lift her mother. “I couldn’t do it all,” she says. “But I didn’t even know how to find help.”
[B] With help from the Family Caregiver Alliance, she eventually hired a live-in caregiver. “But even if you plan intellectually and legally, you’re never ready for the emotional impact,” Baldocchi says. In the first two months after her mother’s stroke, she lost about 30 pounds as stress mounted. More than 42 million Americans provide family caregiving for an adult who needs help with daily activities, according to a 2009 survey by the AARP. An additional 61.6 million provided at least some care during the year. And many are unprepared.
[C] While many parents lack an advance care directive, it’s the most basic and important step they can take. The directive includes several parts, including: a durable power of attorney, which gives someone legal authority to make financial decisions on another’s behalf; a health care proxy, which is similar to the power of attorney, except it allows someone to make decisions regarding medical treatment; and a living will that outlines instructions for end-of-life care. (For example, parents can say if they want to be kept alive by artificial measures.) “It’s invaluable for the kids, because it’s hard to make those decisions for a parent,” says Jennifer Cona, an elder- law attorney at Genser Dubow Genser & Cona in Melville, N.Y. An advance care directive is the first line of defense if a situation arises, says Kathleen Kelly, executive director of the Family Caregiver Alliance, which supports and educates caregivers. Without an advance directive, the family will have to petition the court to be appointed the parent’s legal guardian, says AgingCare.com.
[D] It’s important for families to talk about long-term care so the adult children know their parents，preferences, wishes and goals, says Lynn Feinberg, a caregiving expert at AARP. But it’s not an easy conversation. Elderly parents are sometimes suspicious of their children’s financial motives, says Susan John, a financial planner at Financial Focus in Wolfeboro, N.H. One client asked John to hold a family meeting because they needed an intermediary to talk about financial issues, she says. And when there are many siblings, the family decisions can become a three-ring circus with much acrimony, says Ann-Margaret Carrozza, an elder-law attorney in Glen Cove, N.Y. Families who need information and help sorting out disagreements can call on elder-law attorneys, financial planners, geriatric care managers and caregiver support groups. In February, AARP said it will offer its members a new caregiving support service through financial services firm Genworth.
[E] Many families are unprepared for quick decisions, especially when they find out that Medicare doesn’t pay for long-term care, Feinberg says. The median cost of a year in a private room at a nursing home in 2011 was $77,745, according to Genworth. And only those who have spent most of their assets can qualify for Medicaid to pay for the nursing home.
[ F] Assisted living is another option. Residents can have their own apartment to maintain some independence. But the facilities generally provide personal care services, such as meals, housekeeping and assistance with activities. Still, it’s not cheap: The national median cost in 2011 was $39,135, according to Genworth. Assisted living isn’t covered by Medicaid.
[G ] If they have a choice, at least 90% of elderly parents prefer to stay at home as long as they can, according to
AARP research. But if the parents can no longer safely live at home, it can be hard for children to move them into an adult care facility. There may be another option. Sometimes the home can be modified so a parent can stay there. For example, Baldocchi put in a chair lift for her mother. She also arranged for a home caregiver.
[H] Family caregivers take over many responsibilities. One might manage a parent’s finances, while another sibling will take the parent to doctors" appointments and shopping. Those who move in with a parent take on a significant and sustained burden of care. Jan Walker moved into her mother’s home in Leesburg, Fla. After her mother, who is 83, had fallen, she wasn’t able to get around as well. Walker, 55, has three brothers. But she is the only daughter, is divorced and has no children. “I always knew that this was the role that I would have, and I guess my mind was prepared for it,” says Walker, who now is a full-time caregiver and works from home as a tutorial instructor for a digital scrapbooking website. “When you get into the trenches, it’s literally baptism by fire,” she says. “New things come up. It’s not just about advance planning for finances or medical care. It’s everything,” she says.
[I ] Caregivers need to also watch their own health. “There is such a thing as caregiver burnout, ” Cona says. Among female caregivers 50 and older, 20% reported symptoms of depression, according to a 2010 study on working caregivers by MetLife. “It’s a hard job,” Walker says. “But most worthwhile things are hard. She was always there for me when I needed a helping hand. It’s only natural that I be here for her now.”
1. When elderly parents cannot live at home safely, their children can change their home instead of sending them to an adult care facility.
2. To talk about long-term care is not easy because sometimes aged parents are suspicious of their children’s financial motives.
3. Besides advance planning for finances or medical care, family caregivers take over many other responsibilities.
4. The difference between a durable power of attorney and a health care proxy is that the latter allows someone to make decisions regarding medical treatment.
5. Baldocchi did not want to send her mother to a nursing home, but she had difficulty taking care of her.
6. Over 42 million caregivers helped an adult with everyday activities in the USA in 2009.
7. If a family needs information or help to sort out disagreements, there are many people they can call on.
8. Caregivers should pay attention to their own health, or they may burn out or become depressed.
9. One will have to petition the court to be the parent’s legal guardian, if there is no advance directive.
10. The national median cost of assisted living in 2011 was $39,135 and it is not covered by Medicaid.
【答案解析】
1. [G]。題干意為，當(dāng)上了年紀(jì)的父母住在家里不安全時，他們的孩子可以改變他們的家，而不是將他們送 到成人看護(hù)中心去。注意抓住題干中的關(guān)鍵詞live at home safely和adult care facility。文章段落中，[G]段提 到了上了年紀(jì)的父母住在家里不安全和成人看護(hù)中心的內(nèi)容，該段第二至四句提到，如果上了年紀(jì)的父 母住在家里不再安全，對于孩子來說將他們送到成人看護(hù)中心也很難，不過有另外一種選擇——可以改 變他們的家以適合他們在那里度過晚年。由此可知，題干是對原文的同義轉(zhuǎn)述，故答案為[G]。
2. [D]。題干意為，談?wù)撻L期護(hù)理問題并不容易，因為有時老年人會懷疑自己孩子有金錢方面的動機(jī)。注意 抓住題干中的關(guān)鍵詞talk about long-term care、suspicious of和financial motives。文章段落中，[D]段提到了 談?wù)撻L期護(hù)理和老年人會懷疑自己孩子的內(nèi)容，該段前三句指出，家庭成員談?wù)撻L期護(hù)理問題是很重要 的，這樣才能了解父母的喜好和意愿等，但是這并不容易，有時候父母會懷疑子女有金錢方面的動機(jī)。由 此可知，題干是對原文的同義轉(zhuǎn)述，故答案為[D]。
3. [H]。題干意為，除了提前進(jìn)行資金和醫(yī)療方面的規(guī)劃，家庭護(hù)理人員還有其他許多責(zé)任。注意抓住題干 中的關(guān)鍵詞planning for finances or medical care和many other responsibilities。文章段落中，[H ]段首先就提到 了家庭護(hù)理人員要承擔(dān)許多責(zé)任，該段最后指出，家庭護(hù)理不僅僅要提前做好資金和醫(yī)療規(guī)劃，一切問題 都要考慮到。由此可知，題干是對原文的同義轉(zhuǎn)述，故答案為[H]。
4. [C]。題干意為，永久授權(quán)書和醫(yī)療保健代理委托書的區(qū)別在于，后者允許某人做出有關(guān)醫(yī)療方面的決定。 注意抓住題干中的關(guān)鍵詞a durable power of attorney和a health care proxy。文章段落中，只有[C]段提到了 這兩個專有名詞，該段第二句指出，護(hù)理指示應(yīng)該包含a durable power of attorney、a health care proxy和a living will。在介紹health care proxy時提到，它與durable power of attorney相似，只是它允許某人做出有關(guān)醫(yī)療方面的決定。由此可知，題干是對原文的同義轉(zhuǎn)述，故答案為[C]。
5. [A]。題干意為，Baldocchi不想將母親送到療養(yǎng)院，但是她又很難照顧她。注意抓住題干中的關(guān)鍵詞 Baldocchi和nursing home。文章段落中，有幾段都提到了 Baldocchi,但是提到她不想將母親送往療養(yǎng)院但 自己照顧母親又有困難的只有[A]段。題干內(nèi)容是對原文第一段的總結(jié)，故答案為[A]。
6. [B]。題干意為，2009年，美國有超過4200萬護(hù)理人員幫忙照料成年人的日常生活。題干中的關(guān)鍵詞為Over 42 million caregivers和help an adult with everyday activities。文章段落中，[B]段倒數(shù)第三句提到 了 More than 42 million Americans provide family caregiving for an adult who needs help with daily activities,其中 More than 42 million和daily activities分別與題干中的Over 42 million和everyday activities為同義互換。故答案為[B]。
7. [D]。題干意為，如果一個家庭需要解決糾紛的信息或幫助，他們可以向很多人求助。注意抓住題干中的關(guān) 鍵詞sort out disagreements和call on。文章段落中，[D]段倒數(shù)第二句提到，如果一些家庭需要解決糾紛的信息或 者幫助，他們可以向老年法律師、金融規(guī)劃師、老年人護(hù)理經(jīng)理和護(hù)理人員組織求助。由此可知，題干是對 原文的同義轉(zhuǎn)述，故答案為[D]。
8. [I]。題干意為，家庭護(hù)理人員應(yīng)該注意自己的身體健康，否則他們可能會累垮或者變得心情抑郁。注意抓 住題干中的關(guān)鍵詞their own health、burn out和depressed。文章段落中，提到要護(hù)理人員注意自己身體的是[I] 段，該段前三句指出，家庭護(hù)理人員也要注意自己的身體，有的時候護(hù)理者可能會累垮。對年齡在50歲及以 上的女性護(hù)理人員的調(diào)查顯示，有20%的人稱自己有抑郁癥狀。由此可知，題干是對原文這三句話的同義轉(zhuǎn) 述，故答案為[I ]。題干中的 pay attention to their own health和原文中的 watch their own health對應(yīng)。
9. [C]。題干意為，如果沒有提前準(zhǔn)備一份護(hù)理說明，那么想成為父母的合法監(jiān)護(hù)人需要向法庭申請。注意 抓住題干中的關(guān)鍵詞petition the court、parent’s legal guardian和no advance directive。本題比較簡單，這幾個關(guān) 鍵詞均在文章[C ]段中直接出現(xiàn)，該段最后一句提到，Without an advance directive, the family will have to petition the court to be appointed the parent’s legal guardian。由此可知，題干是對原文的同義轉(zhuǎn)述，故答案 為[ C]。
10. [F]。題干意為，2011年，全國生活協(xié)助的平均花費為39，135美元，而且這項花費也不在醫(yī)療補(bǔ)助計劃的范 圍之內(nèi)。注意抓住題干中的關(guān)鍵詞2011、$39，135和Medicaid。本題也比較容易，掃讀全文，可以發(fā)現(xiàn)在[F] 段出現(xiàn)了2011和$39，135這兩個關(guān)鍵詞，并且后面也提到生活協(xié)助并不包含在醫(yī)療補(bǔ)助計劃之內(nèi)。由此可 知，題干是對原文的同義轉(zhuǎn)述，故答案為[F]。
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