Caring for your parents and yourself

For most of us, taking care of our parents in some way in their later years is just an inevitable reality. It also seems pretty fair, seeing as most parents bring their kids into this world and take care of them when they are small and helpless. Turning around 40 years later and helping them during their worst moments just seems like returning the favor. Knowing that this is a probable thing is different than really knowing what the reality of this will look like.

We go into this stage of our parents lives unprepared for what might be a physically, emotionally, financially and professionally draining experience. Many of us will be so involved in our own lives that we will miss the early signs that help is needed. Then once care begins, the situation can become daunting fast.

Below is a brief guide to help you with through this process.

How to care for our aging parents:

1. Keep in regular contact with them, to best gauge how they really are.

o (appearances are not always true)

2. Keep their wishes and best interests at heart.

3. Get their intentions in writing. (wills and trusts should be updated regularly)

4. Coordinate and collaborate with your siblings and other relatives, where appropriate

o Misunderstandings and hurt feelings can be avoided if everyone is on the same page.

5. Bring in professionals as needed. Do not wait until you are burned out or sick.

6. Help them create their plans long before they need to use them.

Questions to ask and considerations to determine if mom and dad are really ok:

Make sure they are really ok: Don’t take their word for it.Our elders are very proud and see needing help as a sign of weakness and they fear losing their independence. Don’t take their word for it- look around and pay attention to your loved ones and their environment.

In the beginning look for the following signs:

The answers to these questions can be red flags that our loved ones are declining.

• Is there food in the refrigerator and in the cabinets? (does it appear fresh and nutritious?)

• Does their home look and smell clean?

• How do mom and dad look? Are they clean? (Are their clothes clean?)

• Have they gained or lost a lot of weight?

• Are the bills being paid on time and in the right amount?

• Can mom and dad still drive safely? Should they still be driving? Prepare to take their keys.

• How can they get around safely? If mom and dad don’t drive, who is available to take them to medical appointments, grocery shopping, on errands or to church/temple?

• Medication-Mom & Dad take a lot of medication. Do they understand the instructions? Do you?

As we age we see a larger variety of doctors. Does the Primary Care Physician or anyone else know all of the meds being prescribed? Is your mom on conflicting drugs or being over prescribed? The best way to find this out is to do a “drug reconciliation” where you bring all of their prescriptions in to their doctor or pharmacist. Clarifying what instructions mean is also of value.

From bad to worse: When our loved ones need much more care

Activities of Daily Living- There are six basic activities that well people routinely do without assistance.

• Bathing

• Dressing

• Feeding one self

• Functional Mobility

• Toileting/Continence

• Grooming/ Personal Hygiene

There may come a time when your loved one cannot complete at least 2 or more of the activities of daily living. The different reasons for care dictate to some extent the type of care you get- but at this point long term care is needed. At this point Mom and Dad will need a lot more care, 12-24 hours a day, 7 days a week.

Who is going to take care of Mom or Dad 7 days a week?

People who don’t plan this in advance assume they will just take care of their parents when the time comes or that Medicaid will help out.

Medicaid only helps the very poor and doesn’t pay for most in home care.

Your parents don’t want to be a burden, especially to their adult children.

Caring 10-24 hours a day for a parent causes stress on family relationships, can inhibit job performance or career opportunities, affect marriages and sibling relations. It can also be uncomfortable for the elder to be cared for by their child.

When mom or dad stops being able to do the basics having regular help can make all the difference in the world. So it is best to plan accordingly.

What are my options?

1. In Home Help- Full time or part time. They can be the primary care giver or offer relief to a familial caregiver.

2. An elder community facility (for rent or ownership): these communities all differ in what level of care they offer and which community they cater too. They are designed with the elderly and can usually accommodate the limitations of the aging body.

3. Traditional Nursing Home- Usually a shared, slightly impersonal room, around the clock nursing and supervision. This is sometimes necessary for a loved one with severe medical needs. Some people go to nursing homes for a short period of time to recover from a surgery or a fall. But others end up living in nursing homes for years.

The first two options mentioned are very good options and often the ones people would choose for themselves. These options are not covered by Medicaid. The traditional nursing home is covered to some extent, after the elder’s resources are all used up.

SO how do I plan for this?!?

Most people will need at least one type of the above assistance in their lifetime. These services can be very costly and eat up retirement income or force the sale of assets. To properly plan for this many people buy long term care insurance or hybrid product to pay for much of their care, covering home and assisted living care plus adult and nursing home care. Some buy life insurance to replace the wealth spent on their final days, for the surviving spouse to live on or to leave a legacy for children or grandchildren. Having a wealth replacement strategy via LTC or life insurance can provide peace of mind for the family. Often a trust may be used to own the life insurance.

Who can help me figure this out?

Elder Care Attorneys- Specialize in issues for the elderly in their life time.

Estate Planning Attorneys- Specialize in ones affairs at the time of and after death.

Licensed Insurance Professional- An experienced Insurance professional can help you sort out your parent’s financial situation and help you choose the best insurance strategy for all.

A brief but important list of things children should know to best help their parents.

1. How do you want to live?

2. Where do you want to live…your home, assisted living or a nursing home?

3. What do you want to happen if you develop dementia, Alzheimers, or on life support?

4. Do you want your children to sell your home or preserve it?

5. Who should handle your affairs and make important decisions?

Get these in writing- Living wills are not enforceable in all states. Having one in place can same time, effort and heart ache in the years to come. A signed & dated statement of your intentions is valuable.

6. Health Care Proxies. This is the legal document that gives a designated loved one or other person the power to make health care related decisions on your behalf.

7. Durable Powers of Attorney- This gives a trusted loved one or other person the power to make financial decisions on your behalf, when you are too ill physically or mentally to take care of your financial obligations.

8. Wills and trusts and review regularly to keep them current.

9. What are your funerary wishes?

10. Where do you keep your important paperwork, including passwords info?

• Wills & Trusts

• Deeds/titles to your home, car and burial plot

• Life insurance policies

• Bank Statements and Online Banking information

• Safety deposit box and key

• Retirement account details and beneficiaries

• Certificates: Marriage, birth, death

• Where are your physical assets

• Leave a list of your advisors lawyers, accountants and insurance agents.

11. Review your retirement accounts and make sure the beneficiaries match your wills/ trusts as the beneficiary designations on the accounts are what will be enforced.

12. Review your life insurance policies to verify appropriate beneficiaries

13. Material possessions- Make sure your wishes are known in advance and come up with a strategy that is most fair, and let your children know what you are thinking and why.

The time for planning, simply stated, is not on the way home from the funeral. Let your wishes be known and your loved ones know that you’ve done your homework to make life easier and more comfortable for them