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Produced by The Caregiver Education and Support Services Seniors Counseling and Training Case Management Services of San Diego County Mental Health Services1250 Moreno Blvd. San Diego, CA 92110 (619) 692-8702, Robert Torres-Stanovik, LCSW, Editor First Printing - January 1990; Second Printing- July 1990

This Caregiver's Handbook was developed and produced in booklet form by The Caregiver Education and Support Services, Seniors Counseling and Training Case Management Services of the San Diego County Mental Health Services; Robert Torres-Stanovik, LCSW, Editor.

Because of ongoing changes and problems in collecting data, San Diego County or Dr. Stall cannot assume responsibility for the accuracy of the information printed herein, nor does this handbook provide listings of all resources.

Copyright 1990

The following is added at the request of the San Diego County Mental Health Services:

*The content of this document is public information and may be copied by governmental and non-profit entities for use in their caregiver training and related healthcare programs and for free distribution to the general public for those purposes. Reproduction of this Handbook for commercial sale and/or other for-profit purposes is prohibited.*

Acknowledgments by Robert Torres-Standovik, LCSW

I wish to especially thank the Beatitudes Center, D.O.A.R. for both their concept and much of the copy in the original *Caregiver's Guide, Help for Helpers of the Aging.* Without their initial guide, this might not have turned out as well as it has. Acknowledgment is also given to AARP's pamphlets on Caregiving, and to several books, which have been noted in Appendix B, especially *The Loss of Self,* by Cohen and Eisdorfer, for their invaluable ideas.

Thank you to my family, Maida, Shawn and Sylvia for their loving patience for allowing me the time/energy to complete this handbook; thank you to my support staff of students Karen Zaustinsky and Laurie McFarland for their assistance with the initial stages of this handbook, and the typists Heidi Peters, Fatima Ruiz, and Ewald Brieske for their many revisions and re-revisions in order to arrive at this handbook; thank you to the San Diego County Senior Teams, the Southern Regional Resource Center, Frank Dwinnell, MD, Stanley Rest, Ph.D., Donna Pasanen, the Telephone Friends, several caregivers and care receivers for their assistance in editing, advising and encouraging me with this handbook. 

Special thanks to Mimi Campbell-Goodman for the bear graphics (Note from Mike: I deeply regret not being able to include the graphics. They are excellent.) A very special thanks to Ray Schwartz, my supervisor, editor, and above all encourager who was always close at hand with his red pen and some kind words.


Older citizens are more likely to be disabled or dependent due to medical problems. These problems change a person's relationships with family and friends. A husband, daughter, or friend may find that they are now also a *caregiver,* the person primarily responsible for seeing that a patient's physical, psychological, and social needs are met. Another person now depends on them for basic physical needs.

Regardless of whether the disability is due to progression of a chronic illness such as heart or lung disease, stroke, dementia, arthritis, or the combined effects of multiple medical and social factors, the caregiver role is a profound change for both people. These adjustments are often stressful, as well-established patterns must be abandoned, and new adaptations developed. This provides opportunities for personal growth, but also, invariable causes emotional turmoil and distress. Being a caregiver is rewarding, but also can exhaust a person physically and emotionally, leading to illness and inability to further provide care.

This book is directed primarily at the caregiver. This is not a *how to* book focused on problems of the ill patient. Rather, it offers practical approaches to common caregiver problems. Staying healthy, avoiding depression, remaining active, making friends, enjoying pleasurable activities are an essential part of any human life, including those of caregivers. Serving as the primary caregiver for an ill loved one should not make life meaningless.

Caregivers for frail and ill older people should read this book. Family members who are not primary caregivers should also read this book to become more aware of the problems facing caregivers. Caregivers, other family members, and care receivers will find the resources, tables, and questions useful in improving the quality of life for all concerned.