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Posted July 21, 2006

Ask An Expert

Caregiver Care: What to Do When at Your Wit's End

Q. My Mom was diagnosed with Alzheimer's disease in May of '98. I have been looking after her ever since, and in the last two years living with her. Since November 2005, I have had to have a sitter when I am at work. I have tried to get her into a nursing home twice since then, and was told that she does not meet Medicaid criteria. She has no money and draws on Social Security and SSI.

Physically, indeed, she is as healthy as anyone I know at that age. I would say she is in the middle stage of Alzheimer's disease. I have no help from siblings. They have not seen her for years, and consider her dead already. As far as I know, there is no law to force them to help me, and they have no conscience.

I want to do the right thing by my Mom. Still it is not my intention to spend the rest of my life taking care of her. I have no life -- zip. I am 45, and spend my time either at work or with her dogging my every step. I don't see any end in sight. Is there one?

Her father lived to be 93, and never set foot in a hospital until about two weeks before he died. The area I live in has no resources, adult day care or anything like that. On good days I tolerate her, and on bad days I resent her even being alive. It did not start out that way, but back then I thought it would end at some point. Can you offer me any hope?

Dale F., Rainsville, AL

A. I can certainly appreciate what a stressful situation you are in. I hope you are at least giving yourself credit for the good job you are doing. I have three practical suggestions, which you may have already tried:

First call your county's area agency on aging to learn about any existing resources.

Next, I would make every attempt to see an elder law attorney, even if you have to travel to meet with one. The website for the National Academy of Elder Law Attorneys is This site can locate one near you. An elder law attorney is the best person to review Medicaid eligibility, as they are familiar with the latest regulations. From what you have told me, your mother should certainly qualify for Medicaid.

Lastly, I strongly suggest that you try to take some breaks from the caregiving -- you definitely need respite! Perhaps the sitter who works with your mother could give you several hours in the evening or on weekends? Best wishes!

This answer is provided by Paula P. Tchirkow, MSW, LSW, ACSW, president of Pittsburgh-based Allegheny Geriatric Consultants and a certified and licensed geriatric care manager. She specializes in geriatric care management for elderly parents and relatives, and middle-aged adults who have chronic illnesses. In addition to working with families, she also works with attorneys, financial advisors, physicians, bank trust officers and human resource directors. She can be reached at

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