What to Do If Your Parents Fall Ill : Gerontology: Care-giving can be a backbreaking task. Here are some suggestions on how to ease the burden.

Most elderly Americans are hale and hearty. But when illness or infirmity does strike seniors, their children come running. Better Homes and Gardens magazine provides the following tips on how to prepare for that day.

Care-giving is a backbreaking task. The sheer work and worry involved in caring for an aging parent can quickly exhaust the most stalwart care giver. Paper work required by public services agencies and insurance companies can be a nightmare. That’s why experts urge care givers to seek public or private aid to ease the burden. Home-based help includes:

* Home nursing. Visiting nurses handle many medical needs--changing bandages, even some intravenous therapy. In addition, some home health agencies help with toileting, bathing, dressing, medications and other constant chores.

* Home health aide and homemakers services. Maybe all the parent needs is an aide to be a companion, do light housework and help with shopping while their children are at work. Home health agencies sometimes provide these services. Check with the city or county social services department for public and private referrals.

* Respite care. Care givers often deny their own need for a break. That’s a major mistake. Call a local Area Agency on Aging office to find someone who will come to sit with the parent for a few hours, or even stay over one or more nights to allow for a vacation. Costs vary widely, but some volunteer organizations will offer a few hours of respite care for free.

* Barrier removal. An architect with experience in removing barriers can advise on widening doorways for wheelchair access, installing a chairlift, adding grab-bars in the bathroom, or lowering counters. Bath chairs, adjustable beds and the like can be rented at home health equipment centers. Medicare sometimes helps pay rental costs for prescribed, so-called “durable” equipment.

Either free-standing or located in nursing homes, churches, community centers or hospitals, elderly day-care programs are appropriate for seniors (including Alzheimer’s patients) who require some assistance with their basic physical needs and support during emotional downturns. Be warned, however, that some adult day-care centers refuse to accept clients who are incontinent.

In adult day care, patients socialize, exercise, play games, sing, enjoy a hot meal and even get a permanent or a haircut. Often, participants also receive personal care, nursing, and therapy. Fees, usually adjusted to the patient’s ability to pay, average $28 a day, with a number of subsidies available within many communities. Transportation to and from the center may cost extra. Check the local aging, social services, or health departments for information on nearby programs.

Two insurance companies, Travelers and Aetna, sell policies covering day care (and many other) expenses. Generally these policies are made available by employers and may cover both the workers and their parents.

Don’t rule out help from work. The responsibility of caring for parents can cause absenteeism and stress. A few companies support respite programs or allow extended leaves of absence.

Only about 7% of people between 75 and 84 require nursing home care. Sometimes, however, out-of-home care is the only solution. Some types of care to consider are:

* Skill care. For folks requiring around-the-clock nursing care.

* Intermediate. For people too frail to live alone who are prone to health emergencies.

* Custodial. For elderly who need companionship and help with eating, dressing and hygiene.

Intermediate and custodial care often are not covered by insurance, so consider in-home care or group living before turning to a nursing home.

If a nursing home is the answer, investigate thoroughly before making a commitment. Some things to look for and ask:

* Is the home equipped to care for the patient’s specific condition?

* Notice if the staff is helping the residents eat. How close is the supervision?

* Is the home clean and pleasant?

* Is the home certified for Medicare and Medicaid? Ask to see a copy of the state licensing inspector’s latest report.