Author Archive for Suzanne

Advice on Preventing Falls

Advice on Preventing Falls

The Center for Disease Control recently reported that the number of American seniors who die from fall-related injuries has nearly doubled since 2000 and , that while roughly 30 seniors in every 100,000 died following a fall in 2000, that figure jumped to nearly 57 per 100,000 by 2013. The following is some expert advice from members of the Erie County Falls Coalition.

Suzanne Desfosses-Gilliam, President, Touching Hearts at Home, says:
“Falling is the number one reason that older individuals enter the emergency room but it is also the most preventable. The Falls Prevention Coalition exists to review and appraise all of the available falls prevention information, services and exercise programs. Seniors here in Erie County are fortunate because all over the age of 60 are eligible to participate in the CLUB 99 body strengthening exercise sessions being held at senior centers throughout Erie County. Developing stronger legs will significantly reduce your chances of falling.”

See what other experts have to say about preventing senior falls.

The Benefits of In-Home Care for Seniors

The Benefits of In-Home Care for Seniors

We’re living longer and healthier lives than ever before in humanhistory. However, if a time comes when help is needed, questions about livingarrangements that include assistance or care often arise. Because so manyseniors wish to remain in the home and community that holds a lifetime ofmemories, a wide variety of home care services have evolved in recent years tomake this feasible.

Home care typically refers to non-medical servicesthat assist individuals with activities of daily living. Home care is anincreasingly popular choice for care because it enables individuals to remainin their own environments, and can also be a lifesaver for caregivers.

For example, simple tasks such as housekeeping, shopping, mealpreparation, opening a jar, or driving to appointments can become increasinglydifficult for many older adults. Personal tasks such as bathing, dressing,grooming, toileting and even transferring from the bed to a chair can becameunmanageable alone. Many types of individuals, including those who are trainedand supervised by agencies, provide such services. In general, home careproviders are available 24 hours a day, seven days a week. They may work bythemselves or as a team on a shift, part-time, hourly, live-in, or on anas-needed basis.

While some home care agencies provide health-oriented services, it isimportant to understand the difference between non-medical home care and homehealth care. Home health care is more specialized medical care, such as thatprovided by nurses or physical and respiratory therapists. Care providers aretrained medical, health care and psychiatric professionals, or certifiednurses’ aides. Home health services are usually ordered by a physician and maybe covered by insurance.

What typesof services are available for seniors living at home?
Homemaker Services – Can include help with cooking, light cleaning, laundry, grocery shopping, and other household chores.
Personal Care – Assistance with a variety of daily living activities such as bathing, dressing, toilet use, grooming and eating.
Companionship – From daily telephone calls from a “buddy,” to a daily “friendly” visitor, to round-the-clock paid companions.
Home Health Care – Skilled care that can include nursing; speech, occupational, physical, or respiratory therapy; home health aides, and social work or psychiatric care.
Adult Day Care – Daily, facility-based programs in a community center setting for seniors who need monitoring or companionship during the day.
Activity Groups – Games, trips, shopping outings, and other stimulating group activities.
Respite Care – A trained volunteer or para-professional stays with your loved one and takes over your caregiving role, whether for several hours or several days. These brief reprieves from a caregiving situation are healthy for the caregiver and also for the care recipient…a change of daily routine for both.
Live-in Help – Home care best suited to long-distance caregiving or other situations in which the primary caregiver can’t be there in person and the senior needs round-the-clock support. Room, board and, in many cases, a salary, is provided in exchange for meal preparation, light housekeeping, and other non-medical services.
Hospice Care – Medical, social, and emotional services for the terminally ill and their families.
Support Groups – Support for issues about aging, peer companionship, illness-based support, groups for caregivers, grief support and many others to help seniors experiencing life changes or specific challenges.

Whenshould I consider using home care services?

For many caregivers, there don’t seem to be enough hours in the day. It’sdifficult to care for all of the needs of a family member and still have enoughtime and energy left for your own family, a job and yourself. Exhaustion andstress can become overwhelming.

Seniors who become home care recipients most often would rather stay intheir own homes than move into residential care. And economically, except forround-the-clock nursing care, home care can be less expensive than most boardand care homes, skilled nursing homes and assisted living facilities. However,this is not always the case, and prices should be compared.

If you or your loved one has the living space and financial resources,you might consider hiring a live-in care provider. This type of home care isvery well suited for long distance caregiving situations in which the primarycaregiver can’t be there in person and the elder needs full-time assistance ormonitoring.

How do Iknow what types of home care I need?

In addition to consulting with your senior family member and any relevantmedical or therapeutic professionals, consider a “needs assessment,”which can be conducted by a care manager or home care specialist—or you can doit yourself. A needs assessment helps to evaluate every aspect of care,including physical and cognitive functioning, and issues relating to the homeenvironment. An assessment also asks about your needs as a caregiver and theservices you use now to help provide care. It will help a person understand howextensive an informal support network that might already have in place.

How can Ilocate home care providers?

You can research and hire home care providers privately or go through ahome care agency. To locate agencies or private providers, check with any orall of the following resources:

· Yellow Page listings for Senior Services, HomeCare, Home Health Care and similar subject areas

· Area Agency on Aging (Call 1-800-677-1116 forthe AAA in your area)

· Local community and senior organizations

· Religious affiliations including churches andsynagogues

· Doctor or hospital referrals from your carerecipient’s medical affiliations

· Agencies that select and supervise their ownpersonnel, and are liable for any staff or care problems that arise.

· Friends and acquaintances. Referrals from peopleyou know who have used an agency or individual for their relative are one ofthe best sources of trusted help.

As families and individuals throughout the country prepare for the impact of aging, it is essential to understand the effects of the aging process. Take time to investigate the care options in your area. A proactive approach will help you and your family best determine a course of action that can help you remain healthy and happy.

The Sandwich Generation

“The Sandwich Generation – The Cluttered Nest”

Posted on 05/25/2011

adapted from an article by Sheri & Bob Stritof

What is the Sandwich Generation? It is a demanding time when a couple or an individual is still dealing with parenting issues, thinking about their own retirement, and yet facing the issues of coping with aging parents. Deciding which has the highest priority can tear a marriage apart and/or impact family dynamics.

An estimated 22 percent of the American population can be classified as the Sandwich Generation meaning they are parenting their own children and taking care of their parents at the same time. Some estimates show that nearly two-thirds of the baby boom generation will be taking care of an elderly parent in the next ten years.

Many of these couples or individuals face major stress in their finances, emotions, and relationships. What happens to a couple’s dreams for a secure retirement, travel, and slowing down?

However, co-residency apparently does not cause major problems for the majority of couples who are have intergenerational households. With good communication, having three or four generations under one roof can enhance a family’s sense of well-being, provide a sense of belonging for younger children, assist teenagers in moving on to adulthood, and eases the burden of chores due to the extra helping hands.

■Take care of yourselves and do what you need to do to stay healthy. This includes having some fun and living life to the fullest! Don’t put your lives on hold.
■If you are married, don’t neglect your spouse. Make time for one another.
■Be practical. You can only do what you can do. Don’t overload yourselves either emotionally, physically or financially.
■If you have boomerang children returning home, make sure all your expectations have been shared. Call them to be responsible adults even though they are living in your home.
■If you decide to have an aging parent live with you, again, share all your expectations. Remember that your parent can and probably wants to have responsibilites in your household. Let them be involved, productive members of the family.
■Protect your privacy and time alone as a couple and as individuals.
■Realize that any unfulfilled dreams may cause problems in your relationships. Talk about these with one another.
■If your parent has dementia obtain additional information and explore community resources.
■Don’t be afraid to ask for help from community and governmental resources.
■Start talking now about the possibility of someday being part of the Sandwich Generation. How do you think you would handle it?

Tips for avoiding trips and falls

Helping an Aging Loved One Avoid Slips, Trips, and Falls

Posted on 02/03/2012

As we age and grow older there becomes a time when there’s no longer such thing as a simple slip or fall. As many elders and their caregivers discover, the slips, trips, and falls that they may have shrugged off when they were younger now can result in serious injury! In fact, you have most likely heard about a fall resulting in a broken arm, shattered pelvis or worse. Because it takes longer to ‘bounce back’ and recover from even minor injuries, the aging process can change our bodies and contribute to more significant injuries.

As we age our bodies become less resilient, our bones break more easily, and we bruise more easily. To accommodate these changes it is important to think preventatively. As Ben Franklin coined, “An ounce of prevention is worth a pound of cure.”

Here are six (6) tips provided by the Mayo Clinic that can help to prevent elder slips and falls[1]:

1) Make an appointment with your doctor

There are several health conditions elders’ experience that can contribute directly to slips and falls. Gout, bursitis, arthritis, and similar conditions can make it difficult to maintain one’s balance, especially if you’re on uneven ground. Your doctor may provide additional elder care advice such as checking the side effects of prescription medications. They may make you dizzy or unsteady on your feet.

Begin your fall-prevention plan by making an appointment with your doctor and be prepared to answer questions such as:
■What medications are you taking? Make a list of your prescription and over-the-counter medications and supplements, or bring them with you to the appointment. Your doctor can review your medications for side effects and interactions that may increase your risk of falling. To help with fall prevention, your doctor may consider weaning you off certain medications — such as sedatives and some types of antidepressants.
■Have you fallen before? Write down the details, including when, where and how you fell. Be prepared to discuss instances when you almost fell but were caught by someone or managed to grab hold of something just in time. Details such as these may help your doctor identify specific fall-prevention strategies.
■Could your health conditions cause a fall? Certain eye and ear disorders may increase your risk of falls. Be prepared to discuss your health conditions and how comfortable you are when you walk — for example, do you feel any dizziness, joint pain, numbness or shortness of breath when you walk? Your doctor may evaluate your muscle strength, balance and walking style (gait) as well.

2) Keep Moving

Physical activity can go a long way toward fall prevention. With your doctor’s OK, consider activities such as walking, water workouts or tai chi — a gentle exercise that involves slow and graceful dance-like movements. Such activities reduce the risk of falls by improving strength, balance, coordination and flexibility.

If you avoid physical activity because you’re afraid it will make a fall more likely, tell your doctor. He or she may recommend carefully monitored exercise programs or refer you to a physical therapist. The physical therapist can create a custom exercise program aimed at improving your balance, flexibility, muscle strength and gait.

3) Wear Sensible Shoes

Footwear choices can have a tremendous impact on slips and falls. Consider changing your footwear as part of your fall-prevention plan. High heels, floppy slippers and shoes with slick soles can make you slip, stumble and fall. So can walking in your stocking feet. Check the shoes and slippers you wear to make sure soles have good tread because smooth bottomed shoes make it easy to fall. Replace worn out shoes and slippers regularly. This is also a great way to help cut down on the fungal infections that plague many elder’s feet!

■Have your feet measured each time you buy shoes, since foot size can change.
■Buy properly fitting, sturdy shoes with nonskid soles.
■Avoid shoes with extra-thick soles.
■Choose lace-up shoes instead of slip-ons, and keep the laces tied. If you have trouble tying laces, select footwear with fabric fasteners.
■If you’re a woman who can’t find wide enough shoes, try men’s shoes.

4) Remove Home Hazards

Take a look around your home. Your living room, kitchen, bedroom, bathroom, hallways and stairways may be filled with hazards. Clutter and debris that gets underfoot can contribute directly to falling down. Most elders have the best intentions. They mean to keep their living areas clean and tidy. However, that isn’t always possible. Having someone help perform the tasks of daily living ensures that you are in a tidy environment without the clutter that causes falls.

■Remove boxes, newspapers, electrical cords and phone cords from walkways.
■Move coffee tables, magazine racks and plant stands from high-traffic areas.
■Secure loose rugs with double-faced tape, tacks or a slip-resistant backing — or remove loose rugs from your home.
■Repair loose, wooden floorboards and carpeting right away.
■Store clothing, dishes, food and other necessities within easy reach.
■Immediately clean spilled liquids, grease or food.
■Use nonskid floor wax.
■Use nonslip mats in your bathtub or shower.

5) Light Up Your Living Space

One reason elders fall is that they simply don’t see the obstacles that trip them up. Our vision changes as we get older. Cataracts, diabetic retinopathy, and macular degeneration make it hard to see, especially in a low light environment. Keep your home brightly lit to avoid tripping on objects that are hard to see.

■Place night lights in your bedroom, bathroom and hallways.
■Place a lamp within reach of your bed for middle-of-the-night needs.
■Make clear paths to light switches that aren’t near room entrances. Consider trading traditional switches for glow-in-the-dark or illuminated switches.
■Turn on the lights before going up or down stairs.
■Store flashlights in easy-to-find places in case of power outages.

6) Use Assistive Devices

There are many ways you can make your home safer. Installing handrails and grab bars in slip-prone areas, such as the bathroom, can make a tremendous difference. Something as simple as having a bar to hold onto while getting in and out of the shower can make independent living much safer for your elder. Stair lifts, chairlifts, and vertical platform lifts are all specialized lifts that can be installed in your home so you can travel from one floor to another without having to physically climb the stairs. This greatly reduces the risk of falling.

Your doctor might recommend using a cane or walker to keep you steady. Other assistive devices can help, too. Here are types of devices that can help:
■Hand rails for both sides of stairways
■Nonslip treads for bare-wood steps
■A raised toilet seat or one with armrests
■Grab bars for the shower or tub
■A sturdy plastic seat for the shower or tub — plus a hand-held shower nozzle for bathing while sitting down

For fall prevention information please contact your local Touching Hearts at Home office by visiting our website:



What are the real tax consequences of employing non-agency caregivers?


10 tax goofs many of us keep making

Year after year, the IRS sees Americans committing the same sorts of mistakes
on their returns. Many of these errors are easy to avoid; some are more

By Jeff Schnepper,
MSN Money

PrevNext8 of 11
Woman holding cleaning supplies © Colin Anderson/Blend images/Getty Images
Failing to report domestic workers

Even if you don’t want to be a Supreme Court justice or the U.S.
attorney general, you still have to pay the payroll taxes on your nanny, housecleaner or in-home

Sorry, it’s the law. If you paid $1,700 or more in 2011 to any
one household employee, you were required to withhold, and match, both Social
Security (6.2%) and Medicare (1.45%) taxes. (Note that for 2011, an employee
gets a new 2% credit and pays only 4.2% for Social Security.) You must file Schedule H to compute and report the liability.

You’ll owe federal unemployment taxes if you paid wages of $1,000 or more
in any calendar quarter to household employees. You may also owe state
employment and disability taxes.

If you paid your children under age 18 who qualify, you may
escape liability for Social Security and Medicare taxes. For federal
unemployment taxes, qualifying children under 21 leave you free from liability.
See Publication 926 for detail


Copyright © 2012 Microsoft. All rights reserved.



Older Americans 2010: Key indicators of Well-Being


Older Americans 2010: Key Indicators of Well-Being is one in a series of periodic reports to the
Nation on the condition of older adults in the United States. The indicators
assembled in this chartbook show the results of decades of progress. Older
Americans are living longer and enjoying greater prosperity than any previous
generation. Despite these advances, inequalities between the sexes and among
income groups and racial and ethnic groups continue to exist.As the baby
boomers continue to age and America’s older population grows larger and more
diverse, community leaders, policymakers, and researchers will have an even
greater need to monitor the health and economic well-being of older Americans.
In this report, 37 indicators depict the well-being of older Americans in the
areas of demographic characteristics, economic circumstances, overall health
status, health risks and behaviors, and cost and use of health care services.
Selected highlights from each section of the report follow.


demographics of aging continue to change dramatically. The older population is
growing rapidly, and the aging of the baby boomers, born between 1946 and 1964
(and who begin turning age 65 in 2011), will accelerate this growth. This
larger population of older Americans will be more racially diverse and better
educated than previous generations. Another significant trend is the increase
in the proportion of men age 85 and over who are veterans.

  • In 2008, there were an
    estimated 39 million people age 65 and over in the United States,
    accounting for just over 13 percent of the total population. The older
    population in 2030 is expected to be twice as large as in 2000, growing
    from 35 million to 72 million and representing nearly 20 percent of the
    total U.S. population. (See “Indicator 1: Number of Older Americans.”)
  • In 1965, 24 percent of the
    older population had graduated from high school, and only 5 percent had at
    least a bachelor’s degree. By 2008, 77 percent were high school graduates
    or more, and 21 percent had a bachelor’s degree or more. (See “Indicator
    4: Educational Attainment.”)
  • The number of men age 85 and
    over who are veterans is projected to increase from 400,000 in 2000 to
    almost 1.2 million by 2010. The proportion of men age 85 and over who are
    veterans is projected to increase from 33 percent in 2000 to 66 percent in
    2010. (See “Indicator 6: Older Veterans.”)


older people are enjoying greater prosperity than any previous generation.
There has been an increase in the proportion of older people in the high-income
group and a decrease in the proportion of older people living in poverty, as
well as a decrease in the proportion of older people in the low-income group
just above the poverty line. Among older Americans, the share of aggregate
income coming from earnings has increased since the mid-1980s, partly because
more older people, especially women, continue to work past age 55. Finally, on
average, net worth has increased almost 80 percent for older Americans over the
past 20 years. Yet major inequalities continue to exist with older blacks and
people without high school diplomas reporting smaller economic gains and fewer
financial resources overall.

  • Between 1974 and 2007, there
    was a decrease in the proportion of older people with income below poverty
    from 15 percent to 10 percent and with low income from 35 percent to 26
    percent; and an increase in the proportion of people with high income from
    18 percent to 31 percent. (See “Indicator 8: Income.”)
  • In 2007, the median net worth
    of households headed by white people age 65 and over ($280,000) was six
    times that of older black households ($46,000). This difference is less
    than in 2003 when the median net worth of households headed by older white
    people was eight times higher than that of households headed by older
    black people. (See “Indicator 10: Net Worth.”) The large increase in net
    worth in past years may not continue into the future due to recent
    declines in housing values.
  • Labor force participation rates
    have risen among all women age 55 and over during the past four decades.
    As new cohorts of baby boom women approach older ages they are
    participating in the labor force at higher rates than previous
    generations. Labor force participation rates among men age 55 and over
    have gradually begun to increase after a steady decline from the early
    1960s to the mid-1990s. (See “Indicator 11: Participation in the Labor



Health Status

are living longer than ever before, yet their life expectancies lag behind
those of other developed nations. Older age is often accompanied by increased
risk of certain diseases and disorders. Large proportions of older Americans
report a variety of chronic health conditions such as hypertension and arthritis.
Despite these and other conditions, the rate of functional limitations among
older people has declined in recent years.

expectancy at age 65 in the United States is lower than that of many other
industrialized nations. In 2005, women age 65 in Japan could expect to live on
average 3.7 years longer than women in the United States. Among men, the
difference was 1.3 years. (See “Indicator 14: Life Expectancy.”)

prevalence of certain chronic conditions differs by sex. Women report higher
levels of arthritis (55 percent versus 42 percent) than men. Men report higher
levels of heart disease (38 percent versus 27 percent) and cancer (24 percent
versus 21 percent). (See “Indicator 16: Chronic Health Conditions.”)

1992 and 2007, the age-adjusted proportion of people age 65 and over with a
functional limitation declined from 49 percent to 42 percent. (See “Indicator
20: Functional Limitations.”)

Health Risks and Behaviors

and lifestyle factors can affect the health and well-being of older Americans.
These factors include preventive behaviors such as cancer screenings and
vaccinations along with diet, physical activity, obesity, and cigarette
smoking. Health and well-being are also affected by the quality of the air
where people live and by the time they spend socializing and communicating with
others. Many of these health risks and behaviors have shown long-term
improvements, even though recent estimates indicate no significant changes.

  • There was no significant change
    in the percentage of people age 65 and over reporting physical activity
    between 1997 and 2008. (See “Indicator 24: Physical Activity.”)
  • As with other age groups, the
    percentage of people age 65 and over who are obese has increased since
    1988–1994. In 2007–2008, 32 percent of people age 65 and over were obese,
    compared with 22 percent in 1988–1994. However, over the past several
    years, the trend has leveled off, with no statistically significant change
    in obesity for older men or women between 1999–2000 and 2007–2008. (See
    “Indicator 25: Obesity.”)
  • The percentage of people age 65
    and over living in counties that experienced poor air quality for any air
    pollutant decreased from 52 percent in 2000 to 36 percent in 2008. (See
    “Indicator 27: Air Quality.”)
  • The proportion of leisure time
    that older Americans spent socializing and communicating—such as visiting
    friends or attending or hosting social events—declined with age. For
    Americans age 55–64, 13 percent of leisure time was spent socializing and
    communicating compared with 8 percent for those age 75 and over. (See
    “Indicator 28: Use of Time.”)

Health Care

health care costs have risen dramatically for older Americans. In addition,
between 1992 and 2006, the percentage of health care costs going to
prescription drugs almost doubled from 8 percent to 16 percent, with
prescription drugs accounting for a large percentage of out-of-pocket health
care spending. To help ease the burden of prescription drug costs, Medicare
Part D prescription drug costs, began in January 2006

  • After adjustment for inflation,
    health care costs increased significantly among older Americans from
    $9,224 in 1992 to $15,081 in 2006. (See “Indicator 30: Health Care
  • From 1977 to 2006, the
    percentage of household income that people age 65 and over allocated to
    out-of-pocket spending for health care services increased among those in
    the poor/near poor income category from 12 percent to 28 percent. (See
    “Indicator 33: Out-of-Pocket Health Care Expenditures.”)
  • The number of Medicare
    beneficiaries enrolled in Part D prescription drug plans increased from
    18.2 million (51 percent of beneficiaries) in June 2006 to 22.2 million
    (57 percent of beneficiaries) in December 2009. In December 2009, 61
    percent of plan enrollees were in stand-alone plans and 39 percent were in
    Medicare Advantage plans. In addition, approximately 6.2 million
    beneficiaries were covered by the Retiree Drug Subsidy (See “Indicator 31:
    Prescription Drugs.”)


Elderly population Statistics

Number of Older Americans

growth of the population age 65 and over affects many aspects of our society,
challenging policymakers, families, businesses, and health care providers,
among others, to meet the needs of aging individuals.

  • In 2008, 39 million people age
    65 and over lived in the United States, accounting for 13 percent of the
    total population. The older population grew from 3 million in 1900 to 39
    million in 2008. The oldest-old population (those age 85 and over) grew
    from just over 100,000 in 1900 to 5.7 million in 2008.
  • The baby boomers (those born
    between 1946 and 1964) will start turning 65 in 2011, and the number of
    older people will increase dramatically during the 2010–2030 period. The
    older population in 2030 is projected to be twice as large as their
    counterparts in 2000, growing from 35 million to 72 million and
    representing nearly 20 percent of the total U.S. population.
  • The growth rate of the older
    population is projected to slow after 2030, when the last Baby Boomers
    enter the ranks of the older population. From 2030 onward, the proportion
    age 65 and over will be relatively stable, at around 20 percent, even
    though the absolute number of people age 65 and over is projected to
    continue to grow. The oldest-old population is projected to grow rapidly
    after 2030, when the Baby Boomers move into this age group.
  • The U.S. Census Bureau projects
    that the population age 85 and over could grow from 5.7 million in 2008 to
    19 million by 2050. Some researchers predict that death rates at older
    ages will decline more rapidly than is reflected in the U.S. Census
    Bureau’s projections, which could lead to faster growth of this


  • The proportion of the
    population age 65 and over varies by state. This proportion is partly
    affected by the state fertility and mortality levels and partly by the
    number of older and younger people who migrate to and from the state. In
    2008, Florida had the highest proportion of people age 65 and over, 17
    percent. Maine, Pennsylvania, and West Virginia also had high proportions,
    over 15 percent.
  • The proportion of the
    population age 65 and over varies even more by county. In 2008, 36 percent
    of McIntosh County, North Dakota, was age 65 and over, the highest
    proportion in the country. In several Florida counties, the proportion was
    over 30 percent. At the other end of the spectrum was Chattahoochee
    County, Georgia, with only 3 percent of its population age 65 and over.
  • Older women outnumbered older
    men in the United States, and the proportion that is female increased with
    age. In 2008, women accounted for 58 percent of the population age 65 and
    over and for 67 percent of the population 85 and over.
  • The United  States is fairly
    young  for a developed country, with 13 percent of its population aged 65
    and over in 2008. Japan had the highest percent of 65 and over (22
    percent) among countries with at least 100,000 population. The older
    population made up more than 15 percent of the population in most European
    countries, 20 percent in Germany and Italy.



Welcome to Touching Hearts at Home of greater Buffalo, NY

Touching Hearts at Home serves the greater Buffalo, NY region from the Williamsville, Lancaster area.

Early signs of Alzheimer’s

Here is some information for those who are worried that they or a family member may have early signs of Alzheimer’s.

Early signs of Alzheimer’s

The cost of elder care

As the costs of caring for the elderly continue to rise, we all need to start preparing. This is a quick video that shares the costs for care, what we can do about them, and what or who will cover the costs.

Caring for your parents: The cost of elder care…