The Eldercare Handbook: Difficult Choices, Compassionate Solutions

Stella Mora Henry, RN, with Ann Convery. The Eldercare Handbook: Difficult Choices, Compassionate Solutions . New York, NY: HarperCollins, 2006. 272 pages. (Also available in a Spanish-language edition.)

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Few children are prepared to deal with aging parents. As author Stella Henry, RN, puts it, "We are all pioneers in this strange frontier of caregiver and decision maker for parents. Just as children do not come with instructions, neither do parents."

In The Eldercare Handbook, Henry supplies just such an instruction manual for those facing care decisions involving an elderly parent or loved one. She is particularly well-positioned to write the book, having spent 26 years as a nursing home administrator witnessing firsthand the difficult choices families confront, as well as having struggled with the care of her own parents as they both endured Alzheimer's disease.

Henry notes that there are three ways to enter long-term care: following a medical crisis, after a long, protracted decline, or through advance planning. In her experience, 95 percent of families looking into long-term care are in a state of crisis (for example, hospitals frequently give only 24-hours notice to find a care facility). She hopes her book will help change this crisis-driven mindset.

The book's first half identifies the warning signs that a parent may require long-term care and may no longer be safely cared for at home. But equally important, Henry also discusses how to cope with the emotions (such as denial and anger) and shifting family roles that a parent's increasing disability typically trigger.

The second half of the book offers advice on selecting a long-term care facility and tips on accommodating to the new living arrangement, including when and how to visit, how to deal with "Take me home!" demands, and what to expect of the certified nurse's assistant (CAN), the person who has the closest contact with the nursing home resident. Henry also offers a brief roadmap to the medical, legal and insurance maze that inevitably accompanies the need for long-term care.

Henry's wise counsel is interspersed with compelling real-life accounts of parents and children coping with the need for care.

As Henry points out, the idea of a quick, peaceful death is a common myth. With lifespans increasing, it is more likely that death will follow a period of protracted illness or disability. The Eldercare Handbook is an essential guide as that final stage of life unfolds or, even better, before it begins.