It often starts with occasional help around the house, or driving your parent to a doctor's appointment, but it can steadily increase as the parent's age and limitations increase.

We're not prepared for this new role. We usually don't plan for it, and nobody teaches us about the questions we'll face or the resources that are available to help us. The truth is that there's quite a bit of help available. Here are brief descriptions of some of the most frequently used services.

• Senior Centers - Municipal or private centers. Most offer activities, classes, and recreation. Costs are typically very modest.

• Transportation Services - Among the hardest services to find especially if you need point-to-point transportation. The local municipal or regional bus service may operate special vans for those with handicaps. Some senior services offer transportation. American Red Cross will provide transportation to medical appointments.

• Friendly Visitors/Companions - Some programs, such as "Senior Companions" are federally funded and at no cost.

• Telephone Reassurance - Phone calls to check in on homebound elderly. Usually free or low cost.

• Home Maintenance and Repair - Apart from the usual sources you'd find in the Yellow Pages, there aren't many other choices. Some churches have fix-up or snow shoveling or lawn mowing programs.

• Home Delivered Meals - Local community agencies or religious groups offer home delivered meals. Usually free or minimal charge.

• Homemaking and Personal Care - In-home care services, offered by non-profit or for-profit agencies can provide help with personal chores, meal preparation, light housekeeping, etc. Charges average $14 -21 /hr.

• Emergency Response Systems - Electronic alert systems enable an elderly person to signal for help in case of injury or illness. When alert buttons are pushed, a call center dispatches emergency personnel and usually notifies relatives.

• Adult Day Care - Supervised activities, meals and usually some health care, at a group facility. Adult day care is typically from 9 to 5, and transportation to and from home is often provided. Charges range from $35 to $55 per day.

• In Home Health Care - Services typically include those noted under homemaking and personal care, but may also include skilled nursing care. Can be arranged once or twice per week, up to 24-hour care.

• Respite/Relief Care - Designed to give family caregivers a break for an evening, a few days or longer period of time. Fees are comparable to in-home health care agencies.

• Money Management - Help paying bills, signing checks, balancing checkbooks. Monthly or bi-monthly. Free or minimal cost.

• Elder Care Managers - Social workers or nurses with specialties in gerontology, care managers can be an enormous help. They know the local resources and they can negotiate the medical and social service bureaucracies. They can evaluate, make recommendations and arrange for care. In addition to their objective opinions and advice, they can provide support and peace of mind. In long distance caregiving, they're indispensable. Care managers charge by the hour, with fees ranging from $45 to $85/hour.