A: If you have any doubts about your status, Carolyn McIntyre, LCSW-R, CEAP, suggests you take her "Are You a Caregiver" Quiz. Think back over the last year and ask yourself the following questions:

Have I . . .

• Taken my loved one to a healthcare professional or spoken with any healthcare professionals about my loved one's health?
• Helped my loved one dress, bathe, prepare or eat a meal?
• Administered to my loved one's medical needs?
• Assisted my loved one with shopping, paying bills or doing chores around the house?
• Arranged for outside services for my loved one, such as nurse's aides, transportation, housekeeping, medical care or other personal services?
• Handled issues relating to Medicare, Medicaid, Social Security, health insurance or other aspects of my loved one's finances?
• Been involved in decisions regarding my loved ones housing options or housing needs?
• If you answered yes to any of these questions, you are a caregiver.

A: It is important to know what to look for in order to help your children in this challenging time, says Anne Whyte, MA, NCC, who offers these suggestions:

Be aware of signs that your child is feeling distress, such as changes in normal eating, sleeping or playing habits; changes in grades; crying spells or angry outbursts; increased nightmares and fears; and clinginess. Seek advice and help from professionals if these signs persist.

Set aside distraction-free time with your children so that they can voice their feelings and concerns in all areas of their lives. Play a board game, take a walk or simply flop on the floor next to them, then ask open-ended questions and be sure to let them talk more than you do.

Be alert to the signals you convey - and the words that you say - to your child about an ill or elderly family member. If children sense stress or resentment on your part, they may mirror your behavior toward the person or feel helplessly conflicted about two people they love.

Be sure to provide children a forum to express their concerns, a place where they can ask questions and say the things they might not want you or other family members to hear. Counselors and support groups are available everywhere to help even the smallest among us.

And, although it is not always easy, try for some occasional respite from constant caregiving for yourself to keep life in perspective for you and all of your family. Caregivers need time to refuel emotionally, physically and spiritually; you cannot share what you do not have.

A: According to the Centers for Disease Control, activities for daily living (ADLs) are simply “activities related to personal care and include bathing or showering, dressing, getting in or out of bed or a chair, using the toilet and eating.”

Assessing limitations in these activities will go a long way in determining if the loved one in your care is still capable of living independently. In the Medicare Current Beneficiary Survey, “if a person had any difficulty performing an activity by him- or herself and without special equipment, or did not perform the activity at all because of health problems, the person was categorized as having a limitation in that activity. The limitation may have been temporary or chronic.”

An assessment of any limitations should be done by your loved one’s primary care doctor. Once that occurs, it should determine if they’d need day-to-day assistance.

Should moving the person in with you—or hiring someone to move in with them—not be a realistic option, the alternatives are to help the person in your care move to an assisted-living community or, in more serious cases, a nursing home.

A: Suzanne Mintz, co-founder and president of the National Family Caregivers Association (NFCA), likens the caregiver who is about to suffer burnout to a teakettle. "When all the heat and steam build up inside and you hear the kettle whistling," she says, "it is like a scream for help."

To say the least, caregiving is physically and emotionally demanding work. It can take a toll so great that many caregivers feel they simply cannot go on any longer.

"If you don't take care of yourself, you will end up giving a piece of yourself away, and then more and more pieces of yourself," says Colette H. LaFosse, MSG, director of rehabilitation and recovery programs with the Colorado-based National Stroke Association. "You will eventually lose who you are. When your caregiving duties end, you will have to completely re-create who you once were."

LaFosse advises that caregivers take time out for themselves, whether it’s 15 minutes for a cup of coffee, or to chat on the phone with a friend at least once a day—or as often as you can fit such breaks in. "Caregivers need to take time out—even if it is only a few tiny moments—to step back and relax…it is important to take care of yourself both physically and emotionally," she says.

Two tips to keep in mind:

Collect on offers of help. When friends or others say you should let them know if there's anything they can do, write their contact information in a notebook to assist you in remembering who has volunteered to help. Also, make a list of specific things—a casserole for the freezer, two hours of coverage for you to get respite time, a shopping run—so that you can suggest the help you really need.

Find the de-stresser that works for you. Explore different ways to enjoy yourself and lessen the stress. Meditation works for some caregivers, others swear by the benefits of practicing yoga, while many seek comfort by keeping a day-by-day journal. What's important is making the most of ways you know will help you relax.

A: Millions of Americans - twice as many women as men - experience bladder-control problems. And unfortunately, most are too embarrassed to discuss them with their doctor. Yet, the right treatment can improve or cure incontinence in about 80 percent of sufferers, says Christopher J. Klingele, MD, assistant professor of obstetrics-gynecology and member of the Urogynecology Continence Clinic at Mayo Clinic in Rochester, Minnesota.

Successful treatment of incontinence starts with a full evaluation by your family doctor or a specialist, which includes a medical history and tests to check bladder function. Therapy depends on the cause and severity of the problem.

A medicine your mother is on may be causing or worsening symptoms, and switching drugs or lowering the dose may be all it takes to control the problem. Culprits include certain high blood pressure drugs, antidepressants, sedatives and sleeping pills.

What's more, treating common health problems may cure incontinence. For instance, constipation can increase abdominal pressure and make stress leaks more likely. And a bladder infection can trigger pelvic-muscle contractions that increase “gotta-go” urges as well as cause burning urination. If constipation is to blame, medication or a fiber supplement may bring relief. If it's a bladder infection, a course of antibiotics can wipe out the bug.

So, delicately but firmly, insist your mother talk to her doctor. Urinary incontinence, which can occur at any age, is not a part of normal aging, notes Dr. Klingele.

A: You should have an old-fashioned family powwow to:

Assess the family network and individual skill sets
There will be multiple tasks to be managed, and assigning individuals with the best skills to the relevant task will lead to a clear management plan. Identify the tasks with which each person is most competent, perhaps matching communication styles, interests and comfort level.

Agree to roles and reassess them regularly
Clarity of roles and responsibilities will go a long way toward minimizing the inevitable conflicts likely to arise as you deal with complex and emotional issues.

A: The good news: “Any detergent, when used in accordance with the directions for heavy soils, will eliminate these odors,” says Russ Maziarka, Product Manager for Ecolab, Inc., a leading provider of cleaning, food safety and health-protection products, in St. Paul, MN. Doing so will require a few extra procedures.

"The first step would be to maintain a clean environment," Maziarka advises. "If the clothes are held in a hamper for an extended period of time prior to washing, the hamper must be cleaned with soap, hot water and a disinfectant each time the clothes are washed. To insure that you eliminate even the highest level of odors, you may want to rinse or pre-soak the clothes in hot water prior to putting them into the washing machine. When washing the clothes, follow the detergent use instructions for heavy soils, and wash the clothes in a normal manner."
Maziarka adds that too many items in the washer prevents a good rinse. Also, other solutions or wash formulas may be used, but in this case, he says, "No special chemical is needed."

A: When out of sight is anything but out of mind, Dianne Zimmerman, an experienced long-distance caregiver, offers these suggestions to get you off on the right foot:

Create a plan before a crisis occurs
Anticipate a decline in health and the need to step into the role of long-distance caregiver. An open discussion with family members to develop a plan in advance will prove valuable later on. There will be many things to do for everyone, so determine who’ll best be able to perform them. Schedule daily, weekly or monthly updates—via teleconference, email or face-to-face meetings—depending on what works best or what is needed most.

Get organized
Create folders or a tabbed binder to organize all information about a loved one's personal, health, legal and financial affairs. As care needs evolve, so, too, will your informational needs. Also, obtain a phone directory of your loved one's local area.

Identify a support team where your loved one lives
It's essential to build a local team of advisers, including medical and non-medical personnel. Healthcare professionals include physicians, nurses, pharmacists, physical therapists and others; non-medical experts and counselors might include an elder-law attorney, geriatric case manager, social worker, clergy, friends and relatives.

Plan face-to-face meetings with professionals
Build solid relationships with those caring for your loved one. The next time you plan a visit, also schedule a face-to-face meeting with key people on the medical and support team, either individually or as a group. Don't leave this to chance! You'll want them to be available and ready to talk to you, so plan this when making your travel arrangements.

Involve the person receiving care in the decision process
Involving the care recipient is a clear demonstration of respect and love. It also brings dignity, peace and self-affirmation to this delicate situation, lifting the sense of isolation and fear during uncertain times. This can cause some controversy, however, since some family members may instead want to "protect" the person from reality.

A:  Make sure the must-have documents listed here are in order. That way you’ll know your loved one's wishes and have the ability to make - or help make decisions - based on discussions, resources and knowledge.

Durable Power of Attorney - Provides a designated person control of legal and financial matters should the care recipient be unable or unwilling to handle such affairs.

Healthcare Proxy - Allows the designated person access to all medical information relating to the patient's condition and, when necessary, to make medical decisions for the patient based on knowledge of the patient's wishes.

Will - Expresses the care recipient's desires for the distribution of his estate-who gets what, how heirs get what's bequeathed (directly or through a trust, for instance), and who is in charge of making sure all is handled as instructed.

Living Will - States the care recipient's wishes under certain healthcare scenarios, especially end-of-life, eliminating confusion and questions as to the desire for certain treatments

In addition to legal documents that must be in order, your life will be made easier if you also have - and keep up to date - the following:

List of Doctors - Provides immediate access to the healthcare team, and should include each doctor's name, address, phone number, email address, appointment schedule and the reason that doctor is being seen.

List of Medications - Charts what medications are being taken - including prescriptions, over-the-counter meds, herbal treatments, vitamin supplements, etc. - as well as when each is taken, the assigned dosage and the reason the person is taking it.

A: Carolyn McIntyre, LCSW-R, CEAP, suggests that once you are in a caregiver role, an excellent place to learn about resources is through your employer.

First, ask your human-resources representative if your company has an employee assistance program (EAP) or a work/life benefit.

The EAP usually offers free phone consults and a few face-to-face appointments with a licensed social worker or psychologist. This counselor will be available to listen to your concerns and feelings and to provide help in finding resources.

The work/life benefit offers only free phone consults with counselors who do database searches to find eldercare resources in your area. They will also do searches for licensed childcare services and assistance for children with special needs.

If you are wondering who should know about your situation, McIntyre’s advice is to consider the work culture as well as your relationship with your boss or co-workers. If you have a supportive boss and a flexible work environment, and you are viewed as a strong contributor to the team, then it may be safe to give them limited amounts of information. When they respond in a supportive way, their compassion and support can be invaluable and serve as another resource.

Working Caregiver Reminder: Coordinate your vacation time with your care-support team, says McIntyre. Confident that your loved one's care is covered, you'll be able to relax and get a needed break from work—and caregiving.