Professional Documents
Culture Documents
How to Help and Honor Your Parents through their Later Years
Beth Bowlen, daughter of Denver Broncos owner Pat Bowlen, and Mark
Koebrich, former 9NEWS anchor who is currently assigned to the 9News Senior
Source campaign, have teamed up on a “playbook” to help us navigate the
aging process with our parents and loved ones.
Beth draws from her experience in helping to care for her father Pat Bowlen,
owner of the Denver Broncos and one of the most iconic NFL owners in the
history of the league.
Mark draws from his experience in helping to care for his father and
mother-in-law, in addition to what he has learned from his extensive reporting
about the aging process on Senior Source on 9NEWS and 9NEWS.com.
The playbook also draws on the expertise of more than 20 local experts
including doctors, caregivers, and providers like Seniors’ Resource Center the
Colorado Chapter of the Alzheimer’s Association, and many other professionals
who practice and work in the Alzheimer’s and dementia space.
“Without emotional preparation and a solid game plan,” says Mark, “the aging of
a parent or loved one can be very difficult for all involved.”
The “Aging with Dignity Playbook’ covers lessons that Beth and Mark have
learned and includes suggestions, advice and resources for planning and
managing what may come.
Introduction
Through the many stages of our lives, we have informational resources to help
and guide us along our way. Most of us also have family and friends to turn to,
especially when it comes to having and raising children. Parents and
grandparents are usually more than happy to offer advice about raising the next
generation.
But it’s a different story at the other end of life, particularly when we are
confronted with the aging of our parents (and loved ones). Friends and family
may be less able or less eager to help. The challenges are compounded when
our parents experience dementia and other mental and physical and emotional
health issues that are complex and difficult to understand. There are resources
out there, but they are not always easy to find. Plus, everyone ages differently
and every situation is unique.
Turnovers
Emotional preparation is key because roles are reversed. Many of us are not
emotionally prepared to take care of those who have taken care of us.
Long-buried emotional issues can surface.
Family and friends can help, but they may have their own caregiving
responsibilities or may not live close enough or have the resources to help.
Unlike child-rearing, challenges tend to increase over time when caring for aging
loved ones. It is not unusual for family caregivers to feel like they are on their
own. And too often, the aging parent or loved one feels like a burden, dismissed
and forgotten. Resentment and obstinance can result as the elderly individual
experiences a loss of control over their own decision-making.
At Stake: Dignity and Family Relationships
Without emotional preparation and a solid game plan, the aging of a parent or
loved one can be very difficult -- physically, socially and emotionally – for all
involved. The worst thing that happens? The loss of dignity by the aging parent.
Too often, that loved one becomes defined and remembered by the decline they
experience in their later years. Family relationships are often strained during the
aging process of a loved one.
The Goal Line: Honor & Dignity
Beth and Mark believe that our later years should be filled with honor,
remembrance and celebration. Our parents and loved ones should be
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remembered for who they are, the relationships they’ve built and all they have
accomplished.
For most, this will not happen by chance. It takes an intentional effort, planning
and perseverance to make this happen. It will take a team and a game plan.
Beth and Mark are offering this "Playbook" for family caregivers to help get us to
that goal line of honor and dignity. The playbook offers advice, solid solutions
and identifies resources for dealing with the problems that come in helping
loved ones through the aging process. It also provides a game plan to make the
end of life a celebration, so that we can reach the end with honor and dignity.
This Playbook is offered by Beth Bowlen and Mark Koebrich with support
from Seniors’ Resource Center, 9News Senior Source, the
Alzheimer's Association of Colorado and many wonderful experts
who work everyday to improve or enhance the aging experience of
older Americans in Colorado.
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AGING WITH DIGNITY: A Playbook from Beth Bowlen and Mark Koebrich
How to Help and “Honor” Your Parents through their Later Years
“Our society honors and celebrates birth, youth and the promise and hope that
they bring,” says Beth. “Which is wonderful, but I think we can do better at the
other end of life.”
Beth has invested considerable time on this subject in her role on the Board of
the Alzheimer’s Association of Colorado and in her support of Seniors’ Resource
Center. Her interest in seniors, the aging process and its impact on family
caregivers, was spurred by the diagnosis of Alzheimer’s for her father Pat,
long-time owner of the Denver Broncos.
In caring for an aging loved one, the challenges go beyond simply helping with
everyday tasks such as giving rides or helping with medications, house-cleaning
or meal preparation. What many families are not prepared for is the basket of
emotions that come with caregiving for a parent.
“It is common for family caregivers to feel overwhelmed,” says Mark Koebrich,
who has personal experience with aging parents and who has followed many
families on their journeys through the aging process. “Over time, it is easy for
family caregivers to feel guilt, anger and resentment about the situation they find
themselves in.”
Underlying it all is denial. Denial from the parent about the help they need and
about the level of decline they are experiencing. Denial from family members
about the degree of help that is needed. It is not uncommon that family
members disagree about the level of help that is needed, and who should
provide it.
As a result, family caregivers suffer and family relationships are strained. It is not
unusual for families to splinter and become fragmented during the aging
process of a loved one. While this can and should be a time to honor and
celebrate, it can get lost in the logistical and emotional work of caregiving.
“Too often, our aging loved ones lose their dignity through this process,” says
Mark. “The last chapters of life should filled with honor, remembrance and
celebration.”
Beth and Mark encourage families to have discussions ahead of time, before
problems occur and include elderly parents, aging spouses and those directly
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affected with the aging process before a crisis arises... Learn about the
resources that are available before you need them.
Honor and Celebrate
For many families, the physical and emotional demands placed on caregivers
can be overwhelming. The danger is that the demands of the process can pull
all attention and energy to the day-to-day issues and to reacting to any crisis
that might arise. And sadly, it is natural for families and caregivers to frequently
find themselves in “crisis mode.”
When this happens, depending the severity of the problem, the dignity of the
parent can be sacrificed. Which is why Beth and Mark recommend that you
begin early with how you might honor and celebrate your parents.
Experts also agree that you should think about how you might do that early on,
rather than in later years when physical, mental and emotional decline begin to
creep in and lessen your opportunities.
“We are all unique individuals and we all have stories,” says Mark. “And aging
family members are often able to pull up many small details about growing up,
relationships with siblings or spouses, and wonderful times spent with close
friends. Helping them to recall those moments, I have discovered,” Mark
continues, “can produce feelings of being connected and generate
conversations with loved ones who have largely withdrawn.”
The following ideas offer possible avenues for reaching out. They are excerpted
from Seven Ways to Honor an Elderly Parent, by In Touch Ministries:
1. Express appreciation through a gratitude list that specifically names the
actions, activities, and virtues your parents fostered that were positive in
your life. Present it as something that could be framed and kept.
2. Give the gift of presence. Thanks to technology, we have so many ways to
offer our time. When possible, in-person visits are best of course. But
calls, cards, or even simple “thinking of you today” text messages can
communicate care and pierce the isolation many elderly feel. Work as well
at connecting your children to their grandparents’ lives.
3. Seek to understand them. Show interest in their past, their stories, their
photos. This is, after all, your family history as well. If possible, record the
memorable family stories others will enjoy.
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4. Involve them in decisions regarding their future and their care, whenever
possible. Many elderly experience a sense of powerlessness over their
own lives. Make time to hear their concerns, and respond to them. Help
them to feel heard.
5. Help them financially, as you are able. You already know the obvious
reasons: They gave you life, first. That’s enough right there. Now add
food, a bed, music lessons, baseball games, science projects, and so on.
6. Sincerely ask them to forgive you for the lapses, inadequacies, and
rebellions of your past and your part in whatever difficulties have occurred
between you. A humble heart heals both confessor and hearer.
7. Forgive them. If the six suggestions above feel impossible to you, reverse the
list and start here. Release your parents from the debts they owe you.
Understand that they cannot pay back what they owe us—often they are
bankrupt themselves. So we pass on to them the gift of mercy.
The Alzheimer’s Association also offers an exercise for caregivers to help their
loved one rediscover their dignity and worth. Just go to:
https://www.alz.org/i-have-alz/live-well.asp
Prepare Yourself: Dementia Affects One-Third of Seniors
After this initial focus on how to honor and celebrate your aging parent, prepare
yourself and be aware of the potential challenges ahead.
Seemingly everywhere you look these days, you can find people who are living
well into their eighties, nineties, and hundreds. These are the "new elderly" with
a longer life expectancy than the generations that preceded them. They are a
group that has increased mobility, a broad range of interest, financial means and
very often, they lead full and vital lives until their later years when they need
help.
But because of increased life expectancies, people may need help for a longer
period of time than in the past. People may also live beyond their resources. On
top of all this, most people want to live in their own homes or with family for as
long as possible.
According to the Alzheimer’s Association, one in three seniors dies with some
form of dementia. And by the age of 85, one in every two people can expect to
experience some form of and degree of dementia.
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Mental infirmities such as dementia are in fact so prevalent, that they have
caused the Denver Police Department to change practices. The Colorado
chapter of the Alzheimer's Association says that when officers are sent on a
domestic call for seniors, they anticipate the chance of discovering one person
with dementia and one caregiver. And usually, that caregiver has found
themselves overwhelmed by the task.
Caregiving can be too much for one person or even a family alone. Caregivers
need support. Organizations like Seniors’ Resource Center (SRC) exist to
provide this support, whether it is through in home services or transportation or
adult day care and caregiver respite. “We see it all the time. People get burned
out, feel guilty, and are unsure of where to turn,” says SRC’s President and
CEO, Monica Roers. “Caregiving does not come with any training. It’s crucial to
know that there are resources out there, and to find experienced and caring
people who can help.”
Not being prepared again results in a loss of dignity for the aging family
member, and new trauma for the family caregiver.
At the heart of the challenges for families who are faced with helping or taking
care of an aging parent or family member, is the difficulty that comes in
identifying the current condition of the loved one and preparing for the changes
that may or may not come.
According to the World Health Organization:
● Dementia is a syndrome in which there is deterioration in memory,
thinking, behavior and the ability to perform everyday activities.
● Although dementia mainly affects older people, it is not a normal part of
aging.
● Alzheimer's disease is the most common form of dementia and may
contribute to 60–70% of cases.
● Dementia has a physical, psychological, social, and economical impact,
not only on people with dementia, but also on their careers, families and
society at large.
Although Alzheimer’s is the most common form of dementia, the issues to be
faced are similar from family to family, whether it is diagnosed dementia or
simply a general decline resulting from the aging process.
Many people dealing with dementia experience anxiety and depression, as can
their caregivers. It is important to recognize the need and reach out for help.
Senior Reach is one option. It’s a simple way to help older adults get assistance
before a crisis develops. The service includes counseling, care management,
screening and treatment and serves those 50 and older in Boulder, Broomfield,
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Jefferson, Clear Creek and Gilpin counties. Senior Reach can be reached at
1.866.217.5808 or www.SeniorReach.org.
Understanding and anticipating the needs of the aging loved one, identifying
and planning the help that is needed on a regular basis, and managing the
emotions that come with family caregiving is truly a balancing act.
“To do all of this with a minimum of angst and as few surprises as possible,”
says Mark, “treating your parent with honor and dignity requires a clear mission,
a good team and a good plan.”
1. "START THE CONVERSATION"
The day after Mr. Bowlen’s announcement in 2014, a family member called the
Helpline at Alzheimer’s Association to say her dad had shared his diagnosis with
the family because the owner of the Broncos had publicly shared his diagnosis.
He told his family that if Mr. Bowlen could talk about it, he could too.
Beth’s hope is that this Playbook will have a similar effect and stimulate overdue
conversations among families about their aging parents.
That Helpline by the way is free and is available 24/7 with translation services for
more than 200 languages and dialects. It’s a wonderful resource for people
looking for information about memory loss or to connect with resources in the
Association or in their community. The Helpline number is 1-800-272-3900.
“If there is one thing that people remember about this Playbook,” says Beth, I
hope it is this: Start the conversation before a crisis hits and start it with your
aging parent(s) while they can contribute in a meaningful way to the
conversation.”
For your family’s caregiving plan, the best way to ensure that your plan will be
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honoring and respectful is by including your parent(s) in the development of the
plan. If possible, start this process when your parent is of sound mind and able
to convey their wishes.
“At this time, when your parent(s) is of sound mind, it is also important to
discuss and put in place Medical and Durable Powers of Attorney,” says Susan
Stern, who serves on the Community Advisory Committee of Seniors’ Resource
Center and is a long-time volunteer and supporter.
“This cannot be done in a crisis, when the individual may be unable to make
such decisions,” says Susan, “which may result in obtaining Guardianship
and/or Conservatorship.” (See pages 23-26 of the Colorado Senior Law
Handbook, which has links at the end of this Playbook.)
Work with your aging loved one to make sure that you understand what they
value most as they age. What are their “must-haves” as their capacities are
diminished? What are their “non-negotiables”?
Mark believes that involving our aging loved ones in this planning is respectful
and makes it more likely that they will cooperate with the caregiving plan.
Experts agree that family caregivers need to adopt a viewpoint of sensitivity and
empathy, which engenders a respectful plan.
Keys to the Game: Get started. Clarify the Goal. Recognize the challenges.
Start the plan with your parents. Know their wishes.
Caring for an aging parent or loved one is typically too big of a job for one
person. It is necessary to identify potential resources to help in the caregiving
plan. The size of each person’s role may differ, but it still takes a team. If
possible, a family caregiver should never “go it alone.”
The team may also need outside support. A good place to start is our local Area
Agency on Aging (AAA), which serves eight counties around the Denver metro
area. The Denver Regional Council of Governments (DRCOG) manages this
agency and offers a range of services and referrals for older adults and their
caregivers. Their number is 303-480-6700, and they also offer a website
directory of resources at
http://denverregion.co.networkofcare.org/aging/index.aspx. Seniors’ Resource
Center is a provider agency for the AAA. For resources in other areas of
Colorado, there are 15 additional Area Agencies on Aging to meet the diverse
needs of older adults and their family caregivers.
“Often, family caregivers begin their roles by helping family members with small
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needs,” says Susan. “But as time goes on, they find themselves delivering more
and more care as the disease progresses.”
“Caregiving is insidious,” says Susan, “like a slow boil.” It has a cumulative
effect, especially with diseases like Alzheimer’s and Parkinson’s, which become
worse over time. Issues and needs start out requiring small caregiving tasks, but
needs increase over time. By then, the caregiver role is established and
caregivers feel it is their duty to care for the family member at home.
Although overwhelmed, Susan says that family caregivers are reluctant to ask
for help. According to Susan:
• Family caregivers feel protective of their role and feel no one else can
do it like they can, even though it has become overwhelming.
• Family caregivers lack knowledge about available resources and how to
obtain services, such as: Adult day care, home health agencies for
companion care and home help, and VA (Veterans Administration) and
Medicaid benefits, if eligible.
• Cost of care is a factor. Many families feel they cannot pay for help in
the home or daycare programs. This can be the reality of the situation
or perceived because they feel funds will be needed down the road for
care.
• Often times there are unresolved family issues and the caregiver feels
the need to care for an elderly family member out of guilt, hoping to
resolve issues – which usually results in adverse situations.
• Many families don’t want strangers in their homes.
Family caregivers must watch out for caregiver “burnout.” Role fatigue,
economic pressure and isolation are challenges for the caregiver. On top of that,
caregivers may grieve their loved one’s loss of function and their inability to take
care of themselves.
There are options for respite. Adult day care, even for a few hours a week, can
make a huge difference. There are also caregiver support groups and
organizations through which caregivers can find help or just connect with others
going through the same thing. “It’s amazing to see the difference before and
after a caregiver joins a support group, or hear about what a little respite has
meant,” attests Monica Roers of Seniors’ Resource Center. “Caregivers feel
renewed after a break and can more easily support loved ones with patience
and dignity.”
“Don’t go it alone,” agrees Mark. “It’s too much to handle without some kind of
support system that you’ve had a hand in designing and can reach out to.”
As cases of dementia progress, family caregivers may find themselves caring for
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a loved one who does not recognize them and thinks of them as a stranger, and
not a family member. This can be emotionally trying at best, and even
devastating.
It is also important to understand the extent of help that is typically provided by
family caregivers. According to NORC at the University of Chicago, caregivers
do more than provide rides and run errands. Nearly half perform some kind of
medical care, from changing bandages to inserting catheters and feeding tubes.
It is imperative that family caregivers become aware of resources that can help
immediately, in the near-term and down the road. The Alzheimer’s Association
of Colorado has specific (and free, as are all of their services) classes for
caregivers on topics ranging from effective communication techniques for loved
ones less able to communicate to financial and legal planning and most all other
topics covered in the Playbook. Their professionals also offer support groups
around the state. Information on all of these resources are available through the
Helpline.
It is a good idea to have a “point” person to oversee the process and to drive it
forward. This doesn’t have to mean this point person is in charge, it means that
person is making sure the process is moving forward -- From the development
to the implementation of the plan.
When figuring out how you're loved one will be cared for, consider each family
member's preferences, resources and abilities. Consider non-family members to
join your team, such as their close friends, neighbors of your loved one, and if
possible, their church congregation.
Also look into community resources that can help. Seniors’ Resource Center has
been providing in home support for seniors and caregivers for 40 years, and
their adult day program specializes in care for those dealing with dementia. Find
out more at www.srcaging.org/services To the degree possible, responsibilities
should be shared in order to avoid caregiver burnout.
Some team members might provide hands-on care, either in their own homes or
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in your loved one's home. Others might be more comfortable with respite care,
household chores or errands. You and your family might also choose someone
to handle financial or legal issues. People who do not live close may be able to
help with some of the financial needs instead.
To stay on top of your loved one's care, plan regular family meetings. Include
everyone who is a part of the caregiving team, including family friends and other
close contacts. You might also share email updates with the entire family, or
send updates through social media resources.
If that falls short, and your family meetings tend to turn into arguments, consider
asking a counselor, social worker, mediator or other professional to moderate.
Keys to the Game: Build your team with clear roles and responsibilities.
Know their strengths and weaknesses. Make sure everyone knows the
wishes of the loved one and understands the game plan. Build a deep and
supportive bench.
Before starting your game plan, it is important to recognize that within every
plan there must be flexibility to adapt to change. Know that you will not be able
to anticipate everything. Changes can come slowly through the normal aging
process or it can come in fits and starts when dementia, especially Alzheimer’s,
is involved. Or it can come instantly due to an accident, hospitalization or a new
medical diagnosis.
Your game plan should best suit the needs of your loved one and your unique
family situation. It should help guide you through various stages of care, and can
include a daily to-do-lists for medications, activities and social engagement. It
may also include a timeline for alternate living situations.
Even if your loved one does not currently need a care plan, beginning to put
these pieces of the puzzle into place early on can save valuable time and help
you avoid a great deal of stress later on. If you’re drafting the plan in advance,
your parents do not necessarily have to share detailed financial or medical
records with you just yet. But simply having them keep an updated file with this
information can be incredibly helpful in the event of an emergency. This goes for
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medications, health information, and legal documents as well. There should be
multiple copies of crucial information in case of emergency. Should something
happen, you will have the fundamental materials needed to make any decisions
quickly and confidently.
A very helpful guide can be found at www.agingcare.com, entitled Personal Care
Plans: The Secret to Confidant Caregiving. According to this article, a good plan
would include the following:
Assess the Situation -- The first step toward devising a care plan is to address
any problem(s) at hand. Some loved ones may be resistant to such an
“intrusion” into their personal affairs, but getting a complete snapshot of
their situation is vital for developing an appropriate plan of action. On the
other hand, this first step is also useful in identifying the areas in which a
loved one is still self-sufficient and able to retain their independence.
Identify Needs and Set Goals -- Make an ordered list of all shortcomings or
concerns with the highest priorities at the top. Your loved one’s
immediate health and well-being are of utmost importance, so if they are
losing weight or not complying with their medication regimen, these
problems must be dealt with first.
Even if you do not identify any flaws in their day-to-day schedule, setting goals
for their well-being is a useful way to convey your interest in and
willingness to help them thrive. Longer-term objectives like financial,
advance care, estate and funeral planning should also be addressed.
Identify Gaps and Investigate Other Resources -- Any gaps or holes that remain
in your care plan after you assign responsibilities to your team members
should be filled by additional professional services, federal, state, or local
programs. Your local Area Agency on Aging or a geriatric social worker
can assist you in finding appropriate resources for your situation. While
most families would prefer to keep their care team to family and close
friends, this is not always realistic. Professional in-home care, adult day
care, and respite services are often necessary to fill in any remaining
holes. It can take a great deal of research to find the right programs or
services to complete your care plan, but this effort is well worth it.
4. EXECUTING YOUR GAME PLAN
Having a care plan and a care team in place will help you stay focused on
honoring your parent, even as the situation evolves and changes. As in the NFL,
the game will not likely develop as drawn up by the coaches on the sidelines.
“Falls and new diagnoses are game-changers,” says Mark. “Changes come fast,
are often dramatic and come when you least expect it.”
As the game progresses there will be difficult situations to address, many of
them emotional in nature. It is here where it is most challenging to support the
honor and dignity of the loved one that you are attempting to help.
“This is where families fall into “crisis-mode,” says Mark. “And where your loved
one feels like a burden. They can be angry, resistant and uncooperative.
Emotionally, this is a very challenging time for the family.”
The Caregivers’ Survival Guide, which is available at AgingCare.com, identifies
the following issues:
Ask what they need help with. Show respect. Let them contribute. But
remember, safety should always be your ultimate aim. If you have to
assume total control of a task to make sure your loved one doesn’t get
hurt, you should do so without hesitation.
● Keeping Peace in the Family. When a loved one starts to show signs of
needing additional care, there are many issues for family members to
discuss, and a host of important decisions that need to be made. The
gravity and potential implications of these decisions can make for some
contentious conversations—even among the most congenial clans. Here
are a few techniques for keeping the peace when discussing an elderly
loved one’s care needs with the rest of the family:
o Accept that not everyone wants to be involved: You don’t have to
agree with it, but allowing resentment to build over unhelpful family
members will only serve as an energy drain for those who do wish
to provide assistance.
o Pick a location: Family meetings should be conducted in a space
where every member feels welcome and comfortable. If the family
doesn’t have the time or resources to physically gather together in
one space, remote conferencing tools, such as Skype and
FaceTime, can be used to ensure that everyone who wishes to
participate in the discussion is able to do so.
o Plan ahead: Pick a set of talking points to cover during the
conversation and make sure each point is addressed.
o Consider outside help: If you know that your family has a tendency
to be combative, you may want to think about asking an objective
third-party, such as a family friend, a social worker or a clergyman,
to sit in on the meeting and help facilitate the conversation.
o Give everyone a say: All family members should be allowed to
voice their opinions and emotions without fear of criticism or
ridicule.
Keys to the Game: Stay Focused on the Goal. Let the Playbook guide you,
but adjust to game changes. Effective communication with teammates.
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Although Beth and Mark encourage us to plan for aging, this idea is not a natural
one in our youth-oriented, achievement-driven, technology-obsessed American
society. In fact, we are bombarded daily with advertising for products and
services that promise to keep us from looking and growing old.
“I don’t know many people who are interested in planning for getting older,”
admits Mark, whether it’s the aging of a parent or themselves. “But the fact is, it
happens to each and every one of us,” he adds, “if we’re lucky.”
"In our denial of death and the aging of the body, we have rejected the wisdom
of the aged, and in doing so,” says Rechtschaffen, “have robbed old age of its
meaning and youth of its direction."
“There really is much to learn from other cultures about how to view and treat
life in our later years,” says Beth. “Many cultures around the world truly respect
and revere their elders for their wisdom and life experiences,” she says.
“Our parents, our loved ones, have much to share with us about the things that
really matter. Things such as love, compassion, loss, betrayal and faith.”
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Helpful Resources
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The link below is to the Colorado Senior Law Handbook. This helpful guide
provides immediate access to the answers most caregivers are seeking in
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setting-up care for their family members. There is guidance both for those who
are just beginning the process with Mom or Dad, or to those who are deep into
the caregiving conundrum and are finding they have questions.
2 - Medicare
4 - Medicaid
6 - Veterans’ Benefits
9 - Employment Discrimination
13 - Family Relationships
17 - Annuities
20 - Reverse Mortgages
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23 - Powers of Attorney
25 - Conservatorship of Adults
26 - Guardianship of Adults
Dispute Resolution
Independence at Home
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