Caring for your aging parents is something you hope you can handle when the time comes, but it's the last thing you want to think about. Whether the time is now or somewhere down the road, there are steps that you can take to make your life (and theirs) a little easier. Some people live their entire lives with little or no assistance from family and friends, but today Americans are living longer than ever before. It's always better to be prepared.
Mom? Dad? We need to talk
The first step you need to take is talking to your parents. Find out what their needs and wishes are. In some cases, however, they may be unwilling or unable to talk about their future. This can happen for a number of reasons, including:
If such is the case with your parents, you may need to do as much planning as you can without them. If their safety or health is in danger, however, you may need to step in as caregiver. The bottom line is that you need to have a plan. If you're nervous about talking to your parents, make a list of topics that you need to discuss. That way, you'll be less likely to forget anything. Here are some things that you may need to talk about:
Preparing a personal data record
Once you've opened the lines of communication, your next step is to prepare a personal data record. This document lists information that you might need in case your parents become incapacitated or die. Here's some information that should be included:
Be sure to write down the location of documents and any relevant account numbers. It's a good idea to make copies of all of the documents you've gathered and keep them in a safe place. This is especially important if you live far away, because you'll want the information readily available in the event of an emergency.
Where will your parents live?
If your parents are like many older folks, where they live will depend on how healthy they are. As your parents grow older, their health may deteriorate so much that they can no longer live on their own. At this point, you may need to find them in-home health care or health care within a retirement community or nursing home. Or, you may insist that they come to live with you. If money is an issue, moving in with you may be the best (or only) option, but you'll want to give this decision serious thought. This decision will impact your entire family, so talk about it as a family first. A lot of help is out there, including friends and extended family. Don't be afraid to ask.
Evaluating your parents' abilities
If you're concerned about your parents' mental or physical capabilities, ask their doctor(s) to recommend a facility for a geriatric assessment. These assessments can be done at hospitals or clinics. The evaluation determines your parents' capabilities for day-to-day activities (e.g., cooking, housework, personal hygiene, taking medications, making phone calls). The facility can then refer you and your parents to organizations that provide support.
If you can't be there to care for your parents, or if you just need some guidance to oversee your parents' care, a geriatric care manager (GCM) can also help. Typically, GCMs are nurses or social workers with experience in geriatric care. They can assess your parents' ability to live on their own, coordinate round-the-clock care if necessary, or recommend home health care and other agencies that can help your parents remain independent.
The first step you need to take is talking to your parents. Find out what their needs and wishes are.
Don't try to care for your parents alone. Many local and national caregiver support groups and community services are available to help you cope with caring for your aging parents.
Ways to safeguard the home
Install an emergency alert system that can be activated from anywhere in the home. Install grab bars and handrails, place nonslip strips in tubs and showers.
Secure or remove rugs, keep paths clear, and make sure lighting is adequate to prevent falls.
Get support and advice
Don't try to care for your parents alone. Many local and national caregiver support groups and community services are available to help you cope with caring for your aging parents. If you don't know where to find help, contact your state's department of eldercare services.
Or, call (800) 677-1116 to reach the Eldercare Locator, an information and referral service sponsored by the federal government that can direct you to resources available nationally or in your area. Some of the services available in your community may include:
Once you've gathered all of the necessary information, you may find some gaps. Perhaps your mother doesn't have a health-care directive, or her will is outdated. You may wish to consult an attorney or other financial professional whose advice both you and your parents can trust.
Tips for Caregivers
Housing Options for Aging Parents
| In-Home Care | Assisted-Living Facility | Nursing Home | |
|---|---|---|---|
| When to consider | Parent can live independently but needs some assistance | Parent can live independently but needs some assistance | Parent can't live independently and requires regular nursing care |
| Types of care provided | • Medical care (nursing or health aide)
• Household help • Companion or caretaker services • Meal delivery • Transportation |
• Rental rooms, apartments, or houses
• Housekeeping services • Meals • Social activities • Transportation • May provide limited health-care services |
• 24-hour access to medical care
• Custodial care: some help eating, bathing, dressing, or taking medications • Skilled nursing care |
| Potential advantages | • Can remain in familiar surroundings
• May be less expensive than assisted-living or nursing home care if limited services are needed |
• Staff available 24 hours a day
• Social interaction with other residents • May have home-like atmosphere |
• Social interaction with other residents
• Access to round-the-clock medical care • May have special care units for individuals with Alzheimer's disease or related conditions |
| Potential disadvantages | • Strangers in home
• Can be difficult to coordinate care |
• Limited privacy
• Long waiting lists • High fees for extra services |
• Limited privacy
• Long waiting lists • Very expensive |
| What you need to do | • Assess hazards and functionality of home, renovate if necessary
• Check credentials of agency or individual providing service |
• Research facility thoroughly
• Consult an attorney before signing a contract |
• Research facility thoroughly
• Consult an attorney before sig |
Medicare, Medigap, and Medicaid
| Medicare | Medigap | Medicaid | |
|---|---|---|---|
| What is it? | Federal health insurance program for those age 65 or older or younger people who have certain health conditions. Parts A and B comprise the original Medicare program. Medicare Advantage (also referred to as Part C) plans are also available in most areas. They provide managed care and fee-for-service options through private insurers that contract with Medicare. | Medicare supplement insurance issued by private companies. | Joint federal-state need-based health insurance program. Eligibility requirements and covered services vary from state to state. |
| What does it cover? | All or some portion of: Part A: Hospital and skilled nursing facilities, home health agency care, hospice care, inpatient psychiatric care, and blood transfusions. Part B: Doctors, outpatient mental health services, therapy, part-time skilled home health care, certain preventative services, and other medical services. Part C: All the benefits offered by the original Medicare plan. Some offer added benefits such as dental care, eye exams, and hearing aids. Most offer prescription drug (Part D) coverage. Part D: Prescription drug coverage (optional). | All or some portion of: Medical care not covered by Medicare, deductibles, co-payments, and coinsurance; plans may also cover other services such as eye and dental exams. | All or some portion of: A broad range of medical services including inpatient and outpatient hospital care, prescription drugs, nursing home care, and skilled care. |
| Who is eligible? | Generally, persons age 65 or older, and those with certain disabilities or diseases are eligible for Medicare Parts A and B. Anyone eligible for Parts A and B is eligible for Part C and Part D. | Individuals who are enrolled in Medicare Parts A and B. Those enrolled in Medicare Part C don't need (and can't enroll in) Medigap. | Individuals who have limited income and resources and who meet other eligibility requirements. |
| What is the premium cost in 2021? | Part A: Most beneficiaries don't pay for this coverage because of prior Social Security covered employment.
Part B: Most beneficiaries will pay the standard premium of $148.50 People with higher incomes may pay a higher premium, while some people will pay less than the standard premium. Part C: Varies by insurer, state, and plan. Part D: Varies by insurer, state, and plan. |
Premiums vary by company, region, and plan. There are generally 8 available plans, each offering different levels of coverage. Not all plans are available in every state. | No premium. |
| What does it take to enroll? | If you've been receiving Social Security or Railroad Retirement Board benefits for at least four months before you turn 65, you will be automatically enrolled in Part A and Part B. Otherwise, you will need to enroll in Medicare through the Social Security Administration by applying online, by mail, or in person. | Purchase a policy from an insurance company. You can find information on Medigap policies offered in your area by visiting the Medicare website or calling (800) 633-4227. | Application procedures vary from state to state. For information, contact the agency responsible for administering Medicaid in your state. |
Common Incapacity Documents
| Durable Power of Attorney for Health Care (DPAHC)/Health-Care Proxy | |
|---|---|
| Advantages | Disadvantages |
| • Is flexible--allows your representative to act on your behalf and make medical decisions based on current circumstances
• Generally, your representative can make any decision you would be allowed to make • Generally can be used any time you become incompetent |
• Not practical in an emergency--your representative must be present to act on your behalf
• Not permitted in some states |
| Living Will | |
|---|---|
| Advantages | Disadvantages |
| • Allows you to convey decisions regarding your medical care without relying on any one person to carry out your wishes | • Generally can be used only if you are terminally ill or injured, or in a persistent vegetative state
• Generally used only to make decisions regarding life-sustaining treatments • Emergency medical personnel generally cannot withhold emergency care based on a living will • Not permitted in some states |
| Do Not Resuscitate (DNR) Order | |
|---|---|
| Advantages | Disadvantages |
| • Allows you to decline CPR if your heart or breathing fails
• Effective in an emergency--your doctor should note an in-hospital DNR order on your chart. Out-of-hospital DNR orders take various forms, depending on the laws of your state. ID bracelets, MedicAlert® necklaces, and wallet cards are some methods of noting DNR status. |
• Some states allow DNR orders only for hospitalized patients--others do not restrict eligibility
• Only used to decline CPR in case of cardiac or respiratory arrest • Not permitted in some states |
| Durable Power of Attorney (DPOA) | |
|---|---|
| Advantages | Disadvantages |
| • You control who acts and what they can do with your property
• Low cost to implement • Decreases the chance of court intervention |
• Some states do not permit a "springing" DPOA (i.e., a DPOA that is effective only after you have become incapacitated) |
What do You Need To Open A Checking Account
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Why You Should Open A Health Savings Account
Do you wish you had better control over how you spend your health-care dollars? If so, you may be interested in an alternative to traditional health insurance called a health savings account (HSA).
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