Articles
As we become adults, our roles and responsibilities change as we enter the workforce, take on ownership of property, get married, and assume different job positions or career paths. For those of us who become parents, our role as caretakers of our children changes almost everything about the way we live.
When we take on these roles, we do so knowingly. We adjust to the necessary changes to fulfill our responsibilities. But when it comes to our parents’ growing older, it’s a different story.
When we’re young, we normally don’t anticipate having to take care of our parents. We think of them as independent adults who have raised children, paid mortgages, and dealt with difficult situations. We assume that they will continue to be able to take care of themselves. It often comes as a shock to realize that we need to begin to make decisions about our parents. This can happen during a holiday visit when we notice that their house is not as neat as it used to be, that they wear the same clothes every day during our visit, or that they are not quite sure what those 10 bottles of medication are for or when they must take them. These red flags show us that something is amiss and signal that we’ve entered into a new phase of life.
Taking Care Of Parents Involves Coping With Many Issues At Once
If parents live in a different state, we find ourselves in the awkward position of not really knowing what is happening to them every day. Even if they live close by, family and work obligations leave us with little time for continuous oversight. Several siblings may be involved—some more so than others—which can create tension. The transition from being the adult child to being the adult who needs to help parents make decisions leads us into uncharted territory.
It’s not easy when you have to ask parents about their income and expenses if they have always considered that information private. It’s even more difficult to help them become aware that they need some assistance when they don’t think they do. How do you bring up the subject that perhaps they should not drive or that they probably need to have someone come into the home to help them take a bath and clean their house? What do you do when your parents live 500 miles away and no family members are nearby? How do you start the conversation that the staff at the rehabilitation facility does not feel your parents are capable of taking care of themselves in their own home anymore?
On top of these are financial considerations. Where is the money going to come from to take care of your parents? What does Medicare pay for? What happens if they have to go on Medicaid? Can the state come after their money after they are dead? Should the paperwork for powers of attorney be taken care of while parents are perfectly healthy? All of these concerns are valid and they bring up hard-core issues that you need address. Where and how do you start?
Start By Being Proactive
Begin to learn about aging services before your parents or other relatives need them. Find out what is available where they live, get a good idea of what Medicare pays for, and have some discussions with your parents or relatives about your concerns. Find out about the different professionals in the aging field such as geriatric care managers and learn how they can help you.
You might find that your parents already have a plan or are willing to talk about what their wishes are. Rather than be driven by a crisis that requires instant decision-making, become educated on aging services and understand your parents’ hopes and financial constraints now so that you can make well-informed decisions and potentially avert a crisis later.
Part of the problem is that there is no single point of entry when it comes to learning about aging services. As parents, if we needed some form of daycare for our children, we knew we needed a child development center, a family daycare provider, or a nanny. When our children entered school, the sequence of grade school, middle school, high school, and then college was rather clear and obvious.
It’s different when it comes to our parents. Most of us have long been familiar with nursing homes and we see assisted-living facilities on many street corners. But the “other services” remain obscure and often have different names in different states or regions of the country. To compound the problem, our parents may have very different levels of needs. One parent may need some extra help at home, while the other—as a result of a crisis—may not even be able to remain at home.
Understand The Ecology Of Aging Services
Aging services can be divided into two large, general categories: those that are home- and community-based; and those that are institutional such as independent retirement communities, assisted living facilities and nursing homes.
Usually the first type of assistance that can be brought into the home is a home care agency, which helps with homemaking chores, meal preparation, and running errands. They can also assist with any degree of personal care—bathing, grooming, dressing, and transferring. They also provide general oversight.
Communities offer other services: meal programs (more commonly known as “meals on wheels”), senior centers where people can find stimulation and involvement, and adult daycare centers where elders can go if they need some supervision during the day. Hospice programs come into the home when end-of-life assistance is needed.
Many different living situations are available for elderly parents. Independent-living facilities usually offer supportive services such as dining, housekeeping, and transportation which can help sustain people for quite awhile. Assisted-living facilities are designed for those who need daily assistance or oversight. Most assisted-living facilities have additional levels of care that also involve increased costs. Nursing homes are most often associated with long-term, 24-hour, custodial care.
Professionals Are Ready To Help
Geriatric care managers are professionals who can provide valuable oversight. They are particularly helpful when those we are caretaking live at a distance. They come from a variety of backgrounds—some are nurses, others are master’s-level social workers—and they assess seniors’ situations, paying close attention to their physical and mental abilities and limitations, support systems, and financial situations. They identify areas of concern and recommend services that address those concerns. They are familiar with the resources in their communities and believe firmly that people should know their options so they can make informed decisions. Geriatric care managers can also educate you about community programs for older adults with limited incomes.
Elder law attorneys are extremely knowledgeable about Medicaid regulations and eligibility. They can educate you about estate recovery and how it affects those who go on Medicaid. They are also able to direct you to the various powers of attorney that should be in place so that you can act on behalf of a parent who is unable to make decisions for him or herself.
Take the time to educate yourself now and to discuss your parents’ wishes with them. Acting now will allow you to make better informed decisions when they become necessary.
