Hi, Helaine: I’ve been living with my elderly parent for two years. It wasn’t intentional. It’s a voluntary choice that became an entrapment. My sister wanted my dad to move into assisted living. It was an expensive disaster, close to $10,000 a month. After that, I took a year off paid work to get his life settled -- taking care of hospitalizations, rehab, and an aging house that needed repairs (something I supervised). We’ve since hired a weekday helper, and I am working part-time. But my sibling -- married with kids -- isn’t very involved. We will both inherit the estate and home. She’s promised to “make me whole” based on money I’ve expended for caregiving, but it’s beginning to feel burdensome and unfair.

I don’t want to get into a fight over assets, yet it doesn’t feel quite right that I’ve taken time from my career, and continue to live a sort of half-life, and I’m not making a full-time salary. That’s money not going toward retirement at an age when once again getting the kind of well-paid job I once had isn’t easy. Essentially, I am the replacement for the pricey old-folks home. How do I have this conversation? -- A Very Tired Caretaker

Dear Very Tired Caretaker: This is how life happens. You make one decision, and then another, and then another. They all seem like the right one at the time, but no one involved realizes the full-on consequences. Two years later, you are serving as an unpaid caretaker, dependent on your sister’s ethics and honor to be compensated when it’s all over.

You absolutely need to have this conversation, and sooner rather than later. The typical female caretaker for an older relative will lose more than $300,000 in lifetime earnings. One solution seems rather obvious: Your father -- or whomever is in charge of his financial affairs -- should pay you for your services in real time. You could do this via a caregiver agreement, something an eldercare lawyer could help you structure.

So how to proceed? I suggest you get all your financials in order -- how much money you are losing monthly helping out, and the long-term consequences of it, such as retirement savings and Social Security payments, and what you believe you need to be compensated for on a monthly basis as well as what your services are saving over, say, an assisted living or nursing home placement. Then send your sister a note saying you need to have a sit-down to address the financial aspects of the situation at her convenience but in the near future. There’s no way to make this easy, but it needs to be done.

And, finally, a word of caution, and one I hate to issue: If your sister is resistant to addressing the issue now, you might take that as a warning for how well you’ll be made “whole” by her after your dad passes. I will also remind you that what you are doing is wonderful, but if you cannot do it any longer and decide to once again look at assisted living for your dad, you are still a good person.

(To ask Helaine a question, email her at askhelaine@gmail.com.)

(EDITORS: For editorial questions, please contact Sue Roush at sroush@amuniversal.com)

Hi, Helaine: I just read your article on medical expense etiquette. What do you suggest if you tell your doctor, following an exam covered by Medicare, that you can get new glasses for much less elsewhere, and he flies into a rage saying, "You know, we don't get much from Medicare, and you want cheap, crummy glasses from somewhere else. We lose money on people like you. We don't need customers like you. In fact, we don't want customers like you. Don't ever come back. I'm putting a note in your file that we will not serve you." This really happened. I was flabbergasted. -- Astounded

Dear Astounded: Your letter is similar to my column last week in which I counseled a letter-writer who was made to feel awkward by her eye doctor when she didn't purchase contact lenses at the practice because she could get them for less money online. I suggested the writer be up-front about why she was no longer doing so and see if the doctor would match the online price. As your letter shows, my advice isn't going to help everyone.

You need to find a new eye doctor. This behavior is simply not acceptable. Yelling at a patient -- for any reason -- is a no-go zone. It's rude and bullying.

I am not denying the truth of what your doctor said: It's quite possible you will get a better-fitting pair of glasses in person rather than online. It's also quite possible the reimbursement rate -- whether it is via Medicare or Medicare Advantage (since Medicare doesn't cover routine eye exams, only ones related to the possibility of cataracts or glaucoma; I suspect your doctor is complaining about the latter) -- is not adequate. But if the practice wants you to compensate for that by purchasing corrective lenses like contacts and glasses from them, they need to explain the value added -- what they can give to you in return -- in a courteous and persuasive way, instead of attempting to intimidate patients into using their retail arm. They should also understand that many seniors live on a limited fixed income and might not have the financial ability to pay extra money for uncovered services.

When you do leave the practice, I suggest writing a short email explaining why you are moving on. You don't want this to happen to anyone else.

(To ask Helaine a question, email her at askhelaine@gmail.com.)

(EDITORS: For editorial questions, please contact Sue Roush at sroush@amuniversal.com)

Hi, Helaine: My ophthalmologist sells contact lenses. Glasses, too. I used to buy my prescription lenses from his office, but about two years ago, I noticed they were significantly less money at an online store. So I am now ordering them that way. That’s good, right? But it’s awkward. The receptionist always asks if I need to reorder “again” when I come in for my annual checkup. So does the doctor. They both obviously recall when I did buy the contact lenses at the medical practice. I say no and look away. Is there a method to handle this so I feel less embarrassed? Or do I need to find another doctor who takes my insurance and start anew? -- Seeing Red

Dear Seeing Red: Repeat after me: You are not in the wrong. You have nothing to feel embarrassed about. And, by the way, neither does the doctor or the receptionist, as long as they are not aggressive about pushing the service on you. Many eye doctors supplement their earnings by selling contact lenses and eyeglasses and the like in their offices. They aren’t the only doctors who do this, by the way. Have you ever visited a dermatologist’s office and not seen a pile of skin potions for sale? You are absolutely not obliged to buy any of this stuff.

But ... it sounds like you would like to continue giving your business to the doctor’s practice, or you would if the price for the contact lenses were the same. So here’s my advice: When you go in for your next annual checkup, and they ask you to purchase the lenses, say you would love to do that but you found them for a lower price online. They might well ask you what that price is and offer to match it. Think about it from their perspective for a moment: They don’t know why you suddenly ceased buying from them. They would probably like to know the answer to that. And by telling them the truth -- lenses are cheaper elsewhere -- you are giving them the choice of how to handle the matter.

(To ask Helaine a question, email her at askhelaine@gmail.com.)

(EDITORS: For editorial questions, please contact Sue Roush at sroush@amuniversal.com)