About 180 people attended the conference, mostly caregivers of a spouse, relative or parent. Outside the spacious auditorium, the hall was lined with tables of sponsors from home health care agencies, nursing homes, non-profits providing services to seniors, insurance companies, financial planners and the like. Another company was giving equipment demonstrations in the library section.

The program started with the President of St. Francis Hospital, Robert Savage, who welcomed everyone and showed a short video about SFH's trauma center. He introduced Dana Pavelock who was the primary organizer of the conference and he introduced the sponsors and individuals who made it possible.

Mr. Savage introduced Bonnie Meadow who described her role at the Jewish Community Center as helping people to find the resources for care. She learned how difficult this is when as a single mother of 3 sons she was put in the position of taking care of her mother after her father had passed away. The task of putting all the pieces together for her mother's care was overwhelming. Transportation, personal care, finances, legal issues all had to be dealt with and organized. In addition there were activities to organize so that her mother "had a life," and wasn't sitting at home every day. Somehow Bonnie managed to make her mother's care work, and out of her efforts came the idea for this conference - a place to access all the available pieces of the puzzle in one afternoon's time.

Bonnie went on to introduce the plenary speaker of the conference, Shari Hubner, an attorney who practices exclusively elder law, who gave the address entitled "Demystifying Elder Law - Planning in Advance."

Shari Hubner, Esq. Demystifying Elder Law - Planning in Advance
Shari started her talk by emphasizing that the most important tool that we have in elder care is knowledge. Her decision to specialize in elder care law was influenced by the fact that she also had to take care of her aging parents and realized that there were an incredible amount of details to attend to. In order to have the energy to care for our aging spouse or parents it helps to have all the technical pieces in place.

What is elder law? It addresses the needs wants, goals and fears of people over the age of 65. Among other things it involves the Power of Attorney, Health Care Proxy, Living Will, Last Will and Testament and Health Care Trust. Most lawyers have a working knowledge of these documents, and normal legal issues also apply to older people but an elder law attorney brings a more detailed understanding of how all these documents fit together in planning for the client's gradual loss of ability. They also know details of Medicare and Medicaid coverage and how these relate to nursing homes and long term care.

Shari went on to discuss the Health Care Proxy and Power of Attorney documents and how small changes and details in these known by elder law attorneys can make big differences in the client's future as well as having a solid knowledge of Medicare rules and regulations and a thorough knowledge of patient's rights in nursing homes. The elder law attorney works with the financial planner and the medical team and this gives her a better chance to piece the clients care together in a holistic way. The elder law attorney understands the entire context of the patients situation and this is important, but in watching Shari it was obvious that she brings an element of service and compassion to her work. She understands the stresses on families and the patience that is required in caregiving. She prefers to keep the entire family working together but in the end will side with the client. She enjoys working with elderly clients who have, for example, dementia, who don't have normal
processes of thinking. Shari emp
Victoria Barrett Gregory and Meg Boyce Caring for the Caregiver
The next presentation was by 2 social workers/administrators who have extensive experience in working with the elderly as well as in caregiving itself. Victoria is director of St. Francis' Workplace and Meg is head of the Alzheimer's Association Hudson Valley chapter.

In Victoria's family as she was growing up, caregiving was the norm. Both of her grandparents lived in her home and taking care of them was a part of her life. Over 120 million people are now caring for an elderly or disabled person and that number will rise to 138 million within the next few years. So it is important for the caregiver to know that he or she is not alone (even though it is normal to feel that way). It is also important for the caregiver to be able to take care of him/herself.

It is difficult for the caregiver to deal with the balancing of things and there are many signs that show that they are experiencing stress. Denial, anger, social withdrawal, anxiety, depression, exhaustion, sleeplessness, irritability, lack of concentration and health problems are some of these. Denial comes when it is difficult to see the person they are taking care of in a different light. This might take a crisis situation to "break through," especially because the elderly want to keep the knowledge of their disability away from us. Health problems on the part of caregivers are becoming more prevalent because we are all living longer.

Victoria went on to list the physical, behavioral, and intellectual/emotional signs of stress overload including anger, frustration and yelling as well as inability to relax, loss of appetite and mood swings. Some stress management techniques were provided. It is important to get a proper diagnosis as soon as possible, find out what resources are available and get help. The caregiver has to care for him or her self. This is important. Diet, rest, exercise and humor of some ways of managing stress.

Meg gave some practical ways to deal with anger and frustration as well as help in handling everyday hassles. Stress turns into frustration and awareness of one's own stress, if he or she is "approaching the top," is very important. Walking away from anger and frustration is a very effective technique... simply leave the situation and do something else for a while. The situation will have changed when you return to it. Also ver important are to know your stressors, learn to expect the unexpected, and get help when you need it. The twelve steps for caregivers were presented and the caregiver's bill of rights. The session closed with a presentation of the prayer of faith and a short guided relaxation.

See http://www.aarpmagazine.org/family/caregiving/caring_for_the_caregiver.html for further discussion on these topics.

Panel Discussion
The next part of the conference was a panel discussion with Linda Rashba, case manager for St. Francis home care; Kristen Swanson, program educator for Dutchess County Hospice; Carol Wood, Administrator at the Fountains of Millbroook an adult residential facility; Sue Koppenhaven, administrator at Eden Park Skilled Nursing Facility; and Ellen Miccio, Heap administrator and Housing information Dutchess County Office of the Aging. Eachj of these presenters talked about either the nature of their service, facility or administrative agency. They also discussed differences in Medicare reimbursement and rules for Medicare in their facilities or programs.

After a lunch break, Shari Hubner and Denny Quinn presented on Legal and financial planning. All in all, this conference was a comprehensive presentation of much if not all of the information that a caregiver might need in facing a long term caregiving situation. The participants came away with a good knowledge of how the system works and where to go for more information about the various aspects of it. Also, the various exhibits and handouts complemented the information that was presented so that attendees had something in their hands when leaving that they could refer to and specific instructions they could act on. All in all this was a very valuable conference and we hope that it continues to grow in the upcoming years as more and more of us face (in Ira Byock's words) the greatest the challenge of our age, the challenge of compassionate caregiving.