Chapter 25
Helping Aging Parents Plan
In This Chapter
- Stepping in when it’s necessary
- Helping Mom and Dad with money matters
- Keeping everyone involved and up to date
- Planning for appropriate housing
- Knowing that care-giving is hard work
If you’re lucky, your parent or parents are financially stable, in a comfortable living situation, and have planned well for their futures.
It’s nice to be able to sit back, confident that Mom is financially comfortable, and settled nicely in the new, manageable home she moved into after Dad died. Or that Mom and Dad are planning to take some of the trips they’ve always wanted to, now that Dad’s finally retired.
Maybe your parent or parents require help with daily tasks such as dressing and bathing, and reside in an assisted living center. Or they may still live at home, managing quite nicely in their 70s and 80s.
If your parents are independent and capable, count your blessings. Don’t, however, skip over this chapter because you think it doesn’t pertain to you.
As members of the sandwich generation, we all need to think about the possibility that we’ll one day be called upon to assist our aging parents. As you read in Chapter 1, “So, How’s Mid Life Treating You?” there are 25 million family caregivers in the United States, most of whom are women who work and have children. Caring for an aging parent can be rewarding, but it can put tremendous stress not only on the primary care giver, but on her family, as well.
In this chapter, we’ll explore how you know when it’s time to step in to help aging parents, and some of the tasks you might find yourself responsible for.
Knowing If Your Parents Need Help
Sometimes, the fact that your parents need your help is painfully obvious. Your dad has a stroke; Mom falls and breaks her hip. You go to visit and find that the house is a mess and there’s no food in the refrigerator.
Money Morsel
If you don’t live near your parents, try to establish a contact in their building or neighborhood who will keep an eye on them.Check in with the contact now and then (or more often if you’re worried about your folks) just to make sure everything is okay and your parents aren’t having any major problems.
Often, however, the need for help isn’t as apparent. It’s important to understand that many older people—perhaps including your parents—are fiercely independent. Most of our parents are of a generation that values self-sufficiency. They may deny that they need help, even when the need is clear to everyone else.
If you don’t live close to your parents, you might be unaware that they could use some help. If you live in New York and they’ve retired to Arizona, for instance, chances are that you don’t see them too often. Their situation may change significantly between your visits, and you might not ever know that they need help with household chores, managing finances, or whatever, until the situation has become very serious.
Sometimes, one parent will express concern about the other, alerting family members that there’s a problem. Maybe Mom confides that she’s terribly worried about Dad because he’s increasingly confused and disoriented. Or Dad fears that Mom’s diabetes is getting worse, but she refuses to see the doctor about it.
If that happens, be sure to take the concerns seriously, and start thinking about how you might help. Your dad is likely to have remained quiet about his concerns for a long time for fear of being “disloyal” to your mom. By the time he finally talks to you about the problem, chances are it’s quite serious. If you have brothers and sisters, remember to tell them about your concerns and get their input on how you might help your parents.
The best situation is if you’re able to sit down and talk frankly with your folks about their living situation. If you notice they’re having trouble keeping up with writing checks and paying their bills, for instance, it would benefit everyone to discuss the problem and figure out how to solve it.
Unfortunately, real life often isn’t like that. Your dad might feel ashamed to tell you that he can’t figure out the bills anymore, much less deal with his income taxes. It may be next to impossible for your mother to discuss with you the problems she’s having with incontinence, much less ask you to buy her Depends.
It’s extremely difficult and painful, both for you and your parents, when the parent-child relationship begins to shift and change. Of course, your parents haven’t been taking care of you in your adulthood, but they maintain their parental status. If you need to step in and start taking care of them, the parent-child relationship becomes distorted. Watching that relationship change is hard.
If you have sisters and brothers, be sure to inform them of any problems your parents are having. Nobody likes to feel left out of a family situation, and, they may be valuable resources for help.
As difficult as it may be to alter your relationship with your parent or parents, there are situations in which you’ll have no choice. If any of the following circumstances apply to your folks, you’re going to need to step in and make some changes:
- Their living situation is not safe. Dad has fallen four times—that you know of. Mom has burned the bottom of every pan she has because she can’t remember to turn off the stove. Dad walked to the corner store for some groceries and couldn’t find his way back home.
- One parent is causing too much strain on the other. Mom has started sitting up for most of the night to make sure that Dad doesn’t wander out of the house. Or Mom’s breathing condition makes it necessary for Dad to wait on her hand and foot, and he’s clearly at the end of his rope.
- The situation is causing too much stress for you or other family members. You’ve been stopping by your mother’s house four times a day since her last fall, helping her with small chores and cooking her dinner every night. On weekends, you clean her house and keep her company. You’re absolutely exhausted with trying to keep up with all those responsibilities in addition to work and your own home and family. Your husband and kids are complaining that they never see you, and you’ve completely lost touch with all your friends.
- Circumstances are clearly out of control. You visit for the first time in four months and are shocked to see that the house is filthy and smells terrible. Or you try to call your folks and find out their phone service has been shut down because they didn’t pay the bill, and their electricity is due to be discontinued, as well. Or you learn they haven’t been to the grocery store for three weeks because it’s too difficult for them to get there and get the groceries back home.
If any of these scenarios sound too familiar, it’s probably time to get your parents some help. As difficult as it might be, you need to address the problem, and help them to find a solution. It might be as simple as setting aside one night a month to help them write out checks and organize papers. Or it may be as difficult as having to start looking for a nursing home for Mom or Dad.
If you need to step in to help your parents, be sure you do so in a manner that will protect their dignity. No one likes to be told they’re not capable of keeping up with their responsibilities. Think carefully about what you’ll say and how you’ll act.
Assessing Their Financial Situation
Finances are one of the areas in which elderly people most often need assistance. If you need to help your parents with their finances, you’ll first need to understand where they stand. The only way that you’ll really be able to know what they have, what they need, and what their options are, financially, is to assess their situation.
Is there enough money, for instance, if one of them should require home health care or have to go to a nursing home? Do they have the resources necessary to pay for their regular medications? If they pay rent or have a mortgage, how do those payments affect the balance of their available money? Will they have to sell their home in order to meet their expenses?
You might be pleasantly surprised and find out that your parents have made good investments over the years and accumulated some serious assets. Or you might be dismayed to learn that they have very little, and the future is looking rather bleak. Either way, however, it’s better to know than not to know.
If your parents don’t have a good handle on their finances, you may have to pull everything together for them. You’d need to figure out their net worth, just as you learned in Chapter 5, “Getting It All Together,” to do for yourself.
Don’t Go There
Don’t forget to check on Mom’s credit card bills. If she’s wracking up debt on her cards, your first job is to help her get them paid off and convince her to go cash only.
Once you’ve got an idea of their net worth, calculate their current monthly income, including pensions, Social Security payments, income from a property, and income from securities or retirement accounts.
Then, add up their current monthly expenses. These would include mortgage or rent, utilities, maintenance costs on the home, grocery bills, medical costs, entertainment, transportation, insurance premiums, clothing, travel, and so forth. This will allow you to figure out if your parents are meeting their expenses with their current income, or if they’re having to dip into their savings in order to pay their bills and other expenses. Knowing this can help you to get a better picture of their overall financial situation.
Talking Things Through
Once you’ve got a general picture of Mom and Dad’s financial situation, you should sit down and have a frank conversation concerning their future. This assures that you all have the same understanding of the situation, and opens the door for figuring out how to improve their financial condition or solve any problems that may be occurring.
Remember, though, that this conversation may be very difficult for your parents; attitudes about money have changed greatly in the past 20 or 30 years. Talking about money used to be practically taboo, unless you were speaking with a banker, insurance agent, or car salesman. Money was a private matter, and not discussed in general conversation.
Your parents probably didn’t include you in any financial discussions or decisions as you were growing up, and it may be difficult for them to do so now. Revealing the details of their finances to you may signify to them a beginning of a loss of independence. This could make them resistant to sharing financial information. You’ll need to be sensitive to these, and any other feelings and attitudes that your parents might have that are associated with money.
If their situation isn’t great, you may need to help them figure out how they might trim their expenses or find some additional sources of income. You might even help them to set up a budget, so that they’ll know exactly where their money is going, and how much they can afford to spend.
Some parents simply will not discuss their finances with their children. If that’s the case with your folks, don’t insist or try to force them to share information with you. You’ll only make them uncomfortable and resentful, and perhaps suspicious toward you. Do, however, suggest that they confer with a financial planner or lawyer, and offer to help them find a qualified person.
If any area of their expenses seems out of balance, be sure to take a close look at what’s going on. If the utility bills seem to be overly costly, for instance, check out Mom’s appliances. Old, nonenergy-efficient refrigerators, freezers, and other appliances can cause huge drains on electricity and increase utility bills substantially. If this is the case, consider exchanging the appliance for a different one, possibly a used one.
Medical bills are another potential drain on your parents’ finances. If Mom needs eight different prescription drugs for various ailments, the cost of those medicines could be wreaking havoc with her budget. If this is the case, consider talking to her doctor about the possibility of less expensive medicines, or see if there’s a generic brand. Generic drugs can cost 50 percent less than brand name ones, and they all must be approved as equivalent by the Food and Drug Administration. The cost of prescription drugs rose by 17.4 percent in 2000, despite an overall inflation rate of less than 2 percent.
If you’re worried about your parents’ capability to handle their own financial affairs, you might want to suggest that they consider appointing an agent in a durable power of attorney. Explain to them that signing a power of attorney doesn’t mean they relinquish all control of their finances. They’re still in charge, but the person they appoint as their agent will help them and take care of the day-to-day chores such as paying the bills, sorting out the insurance statements, and making bank deposits.
If they’ve been having a difficult time keeping up with financial matters, they may welcome the offer for help. If they’re willing to appoint an agent, be sure to let them decide on their own whom that person should be. Do, however, point out that it should be someone who lives fairly close by, and who has time and is willing to perform the necessary duties.
And, be sure to keep siblings informed, and include them in any decisions you make concerning Mom and Dad’s finances. Nothing is likely to breed resentment as quickly as the notion that you’re meddling in your parents’ financial matters and keeping it a secret from your siblings.
Deciding Together Where They’ll Live
Housing is another important, and potentially difficult area in which your parents might require your assistance. Ideally, Mom and Dad will be able to live safely and comfortably in their own house for their entire lives. Some people are fortunate enough to have that happen.
Go Figure
It’s estimated that about 1.5 million people over the age of 85 live on their own, and that number will double in the next 20 years. And researchers say that by 2020, there will be 15.2 million people who are 65 or older living by themselves.
Chances are, however, that one or both parent may someday need to move.
This could occur for many reasons. Perhaps the family home your folks have lived in for the past 40 years is simply too large and requires too much upkeep. Or one parent might die and the other moves in order to be closer to a son or daughter. Maybe Dad is tired of cleaning and cooking for himself and decides to move to an apartment building designed for elderly folks that includes meals and a cleaning service. Or Mom may need to go into assisted living because she can no longer take care of her own needs.
If your parent or parents are thinking about moving, you can assist them by letting them know what options are available. Older people have many more housing options these days than they used to, and some of them are really interesting. Let’s take a quick look at some of what’s available.
ECHO Housing
ECHO homes (it stands for Elder Cottage Housing Opportunity) are fairly new, but they’re gaining in popularity. They’re modular homes that you move onto your property for as long as necessary, and remove them when they’re no longer needed. Usually about the size of a large garage, a typical ECHO home includes a living room, kitchen, eating area, bathroom, and one or two bedrooms. Because they’re designed especially for older people, they are wheelchair accessible, energy efficient, and all on one level. They typically cost about $25,000. Be sure to check with the municipality in which you live to make sure this type of housing is permitted. You can find out more about ECHO housing on the Senior Resource’s Web site at www.seniorresouce.com/hecho.htm.
Be aware that there are many services available to help aging people be able to stay in their own homes. Most communities have programs that provide home helpers, meal-delivery, drop-in visitors, transportation services, and senior centers. Contact your local Area Agency on Aging to see what’s available in your community.
Adult or Retirement Communities
These vary greatly in scope, and offer different services and amenities. Typically, retirement communities are clusters of homes on small lots. Outside maintenance usually is provided, and there normally are common areas for residents to share. Some communities include a lake or pond for fishing, a golf course, tennis courts, shuffleboard courts, horseshoe pits, and so forth. There often are planned activities, such as bingo or card games, day or overnight trips, entertainment, and educational programs. Your parent would either buy or rent the house, and would pay a monthly or quarterly fee for services such as grass cutting, snow removal, and outside painting. If your parents are considering moving to a retirement community, be sure they shop around before committing themselves. There are huge differences from community to community, and, while many are very nice, others are less desirable. The cost of retirement communities varies greatly depending on location, the type of homes, services provided, and whether your parent would buy or rent. Some retirement communities offer lots for sale, and allow you to build a house of your choice.
Continuing Care Communities
Continuing care communities are those that offer independent living, assisted living, and skilled care, all on the same campus. They’re usually large, often upscale complexes, sometimes sprawling over miles of land. The basic concept of a continuing care retirement community is as follows. Mom and Dad pay an entrance fee that gets them a house or an apartment.
Mom and Dad live on their own until something happens that means one of them can’t live independently anymore. Let’s say that Mom has a stroke. When she returns from the hospital, she and Dad find that she can’t take care of herself, and it’s too much for Dad to handle. At that point, Mom gets moved to the assisted living section of the community, while Dad remains in the apartment. Dad can go visit Mom every day, and has peace of mind knowing that she’s getting the care she needs. If Mom gets well enough to take care of herself again, she moves back in with Dad. If she continues to need assistance, she stays where she is. And, if she encounters another health problem that makes her unable to do anything for herself, she’ll be moved to the skilled care section of the facility, which is really a nursing home.
Continuing care communities are expensive places to live. Entrance fees can range from $30,000 to $300,000 or more, depending on the type of dwellings offered. And, monthly fees can vary from $500 to $3,500, depending on services.
Senior Apartments
Senior apartments can be built and run privately, although many are constructed and maintained by the Department of Housing and Urban Development (HUD). HUD housing is intended for low-income seniors, and is subsidized by the government. The eligibility for this type of housing varies from state to state, so you’ll need to inquire with your local housing authority if you want to see if your parent qualifies. Because this type of housing is built exclusively for seniors and uses federal money, it must be fully handicap-accessible. Most senior apartments have dining rooms where residents may eat, although many include individual kitchens. Some community agencies offer services on-site at senior apartments, and many senior apartments have their own bus or van to transport residents to the doctor, grocery store, or so forth.
Assisted Living
Assisted living is a level of care that’s somewhere between independent living and nursing home care. It varies greatly because every person in an assisted living facility may have different levels of need. Geriatric specialists say that people in assisted living generally need help with activities of daily living, such as dressing, bathing, eating, and using the bathroom. Assisted living also provides, or provides help with, tasks such as using a telephone, taking medicine, cooking, managing finances, using transportation, and so forth. Most provide three meals a day, with residents eating together in a dining room. Many offer transportation to doctor appointments, shopping, and other locations; activities and recreation; and housekeeping and laundry services. Assisted living facilities are not nursing homes. While some facilities accept high-need residents, most do not take people who suffer from dementia or who are incontinent.
Anticipating an increased need for assisted living, the Marriott hotel chain has entered the assisted living arena with its Brighton Gardens communities. These are upscale assisted living facilities that cater to the needs of elderly persons.
Nursing Homes
No one likes to think about sending a parent to a nursing home, but there sometimes is just no choice. If Mom has Alzheimer’s disease or anther type of dementia, is incontinent, can’t move, or is just too sick for you to care for and no longer qualifies for assisted living, she may need the skilled care of a nursing home staff. Most nursing homes provide 24- hour nursing care, on-call physicians, personal care, meals and nutritional monitoring, laundry, activities, therapy, rehabilitation services, and counseling. Patients with different needs normally are placed in different sections of the building. Alzheimer’s patients, for instance, may live in a separate wing. People who are in the nursing home temporarily for rehabilitation services after a stroke or illness may be housed in a certain area. All nursing homes have to be licensed, and they’re inspected by state and federal agencies. There are a lot of issues—financial, practical, and emotional—involved with placing a loved one in a nursing home. Some resources to help you are listed in Appendix B, “Resources.”
Senior citizens are coming up with some innovative housing solutions on their own. Some are taking on a roommate, or arranging for house sharing situations. Allow your parents to be creative when assessing their living arrangements.
Sorting It All Out
Helping your parents with financial issues, housing arrangements, health care, and other topics relating to aging can be extremely difficult. You’ll need to be patient, caring, and understanding.
It’s important to understand that everyone has a different capacity for care-giving. Some people are naturals, while others have to work harder to be helpful and available.
If you’re about to start helping your parent or parents to deal with finances, housing, or other issues, be sure to talk to your own family about how they may be impacted. If you’ll be spending a lot of time helping an aging parent, you’ll likely need to make some adjustments in your own life.
Be as helpful as you can to aging parents, but allow them to continue making their own decisions and to remain independent for as long as possible. Be respectful, and remember that, regardless of how much assistance they require, they’re still your parents.
The Least You Need to Know
- If it’s very clear that your parents need help, it’s your responsibility to step in and provide assistance, even if they’re resistant.
- Before you can help a parent or parents with their financial matters, you’ll need to get a clear understanding of their situation.
- Once you understand your parents’ financial position, sit down and discuss the situation, and look at how you might address any problems or issues.
- Help your parents to make decisions concerning living arrangements by letting them know all the options available.
- Remember that care giving requires patience, understanding, and great empathy.