New York -- It's the "sandwich generation's" deepest worry: A frail parent, living alone, at risk of illness and falls. While you're minding your children and your job, your mind constantly travels to your parent, who may need more help than you're able to give.
The worrying is fierce for adult children who live far from their parents' home. But even if you live around the corner, it's hard to help a parent while handling other responsibilities, too.
Some corporations are giving their employees a hand, by employing consultants like WorkFamily Directions in Boston and the Partnership Group in Lansdale, Pa. These firms offer hot lines for handling emergencies, answer questions about elder care and direct employees to community services that their parent needs.
But most of us don't have access to these hot lines. Here, then, are some do-it-yourself ways of helping parents who cannot easily help themselves:
* Make a safety check of the house. Are the lights bright enough? (Older people need extra illumination.) Can you get rid of throw rugs? Should the doorsills be removed? (They're a major cause of falls.) Does your parent need a stool in the tub, a higher toilet seat, a stair elevator?
* Propose a living will and durable medical power of attorney if your parents shudder at the thought of living for years in a vegetative state. The living will expresses their wishes; the power of attorney appoints someone -- spouse, child, doctor -- to make medical decisions on their behalf. For free living-will forms, write to the Society for the Right to Die, 250 W. 57th St., New York, N.Y. 10107. In exchange for the forms, the society will ask for a small donation.
* Identify your parent's current support system: doctor, lawyer, banker, church or temple, friends, neighbors. Express your thanks to one and all, and ask them to call you if something's amiss. Certain friends may be willing to do a bit more, like trim the hedge or take your mother to the grocery store.
* Arrange for health and personal care -- a struggle even for children nearby, let alone those who live some distance away. Fortunately, most communities offer a web of services, both public and private. But it takes time, personal visits -- and, usually, money -- to line up all the help you need.
Start by calling the office for the aging in the capital of your parent's state. Get the phone number of the local Area Agency on Aging, which is a mother lode of good advice.
The agency offers (1) free booklets on elder care; (2) a directory of local services, such as Meals on Wheels, adult day care, financial aid, senior-citizen discounts, transportation, visiting nurses, visiting libraries; (3) access to free care managers, who will visit your parent, assess any health or homemaking needs, and suggest services that can help. There may be a waiting list for assessments but give it a try.
For other senior-citizen organizations, check the yellow pages. One good free booklet: "Miles Away and Still Caring," from the American Association of Retired Persons, 601 E St. N.W., Washington, D.C. 20049.
* Consider a private care manager. This new and rapidly growing field is peopled with nurses, social workers, psychologists and self-styled gerontologists. For a fee in the $150 to $500 range, they'll visit your parent and make a report.
For additional fees (perhaps $50 to $125 an hour), they'll find home-health workers, recommend nursing homes, pay regular visits and handle emergencies. Your first stop for referrals: local nursing homes, doctors and hospital social-service offices. You might also call the National Association of Private Geriatric Care Managers in Tucson, Ariz. (602-881-8008). Or send $2 and a self-addressed stamped envelope to Children of Aging Parents (Woodbourne Office Campus, Suite 302A, 1609 Woodbourne Rd., Levittown, Pa. 19057) for the names of some practitioners in your state.
Private-care managers are unregulated. So check every claim on the manager's resume to see if it's true. Interview at least three clients, get a written plan of action, plus costs, and don't choose anyone who rubs you wrong.