So a dilemma comes into to play very quickly. Can we afford to pay for outside services and if not, can we risk the health of mom or dad as the primary caregiver in a stressful and difficult situation? Choosing to care for a loved one, while eliminating the cost of an outside care provider has other hidden costs.

With serious chronically ill spouses, the caregiving spouse soon finds that her or his social life soon falls away as the demands to provide the level of full time care begin to mount making that isolation another hidden cost of caregiving and it takes its toll.

The concept of “us,” the feeling of being a couple can also become diminished as one spouse takes on the role of care provider, and the other assumes the role of care recipient. Anger, resentment, hostility and depression are common emotional reactions that are felt by the caregiver towards the patient for having lost the “good” life they led prior to the illness.  While these are “normal” reactions that have to be resolved, they are often followed by feelings of guilt by the caregiver for having these feelings toward a person they love dearly.

Sadly, there are no easy answers, and for some of us, because of financial limitations, there may be few choices. There are, however, caregiving strategies and plans, as well as ways to find respite though use of other family members, limited outside services and willingness to accept occasional help from agency and social services organizations in your area. The first step to take may be the hardest … ask for help.

Ron Kauffman is a consultant and expert on issues of geriatrics and aging. He’s in private practice in Henderson and Polk Counties. He is the author of “Caring for a Loved One with Alzheimer’s Disease.” His podcasts can be heard weekly at www.seniorlifestyles.net. Contact him at 828-696-9799 or by email at: drron561@gmail.com.