As many as 20 million Americans – mostly women in their 40's and 50's – have a lot on their mind as they find themselves responsible for care for an aging parent or in-law. It is very often a highly emotional time as the loved one grapples with recovery from surgery, a serious chronic condition, or even a diagnosis of a terminal condition. What makes it even tougher is that few families are prepared for this. Nobody has talked about it in advance.

There are agencies that help with care at home and, if you can navigate the rules, insurance and Medicare can help defray the cost. But it is often a tension-filled experience for many reasons: You are being asked to help "parent your parent" and they may not take kindly to this; you are unfamiliar with the lingo, the rules, or torn in too many directions with other responsibilities; you may have siblings –even ones who live at a distance – who are not in agreement with your approach (nor appreciative) and think they know better.

How do you prepare for the inevitable situation of needing help caring for a loved one at home – or maybe sooner or later at an outside facility? There are geriatric care managers who can help. But it will cost you. That may be money well spent. And discharge planners at hospitals may have some guidance, so will ratings on medicare.gov. Your loved one's doctor's office may have advice, as well. But the best advice is to sit down as a family and discuss these almost certain eventualities long before the crisis hits. It's like living in tornado or hurricane country. You know it will happen so you have to be prepared. It's the same with someone needing homecare and/or adult daycare, assisted living or other kinds of long-term care. Few families can do it on their own anymore.

On one of my most recent Patient Power programs I interviewed two former nurses and healthcare administrators who consult with organizations that provide such care. They share secrets of how you, the consumer, can get the best. Be sure to listen because it's very likely you will need this information before long. The price of not know what to do is: stress, family conflict, and possibly poorer health outcomes for someone you love.

Andrew