Talking with your loved one about issues surrounding health care, finances and basic needs and wants associated with aging is a difficult subject. But it can be done! Here is some helpful information to get you started from Volunteers of America’s aging expert, Rosemarie Rae.
It’s never too early!
Start well in advance of when you think you need to begin planning and talking about what parents or loved ones may need as they age…and when everyone is still in good health! It’s much easier to discuss care planning before anyone actually needs assistance. In the same way people save for college years in advance, we also need to start talking about our needs and wants before it’s too late to make good decisions.
As the future caregiver to my own parents, I offer this from my personal perspective, but this useful information can easily be translated to the parents’ point of view for those who wish to talk to their children about what they would like to see happen as they age and become frail.
It’s hard for my mom and dad to acknowledge their diminishing cognitive abilities and failing health. It’s hard as a daughter to witness the decline and imagine my mom and dad not being part of my life. And so, we say nothing – and my father hopes I don’t notice his changing memory and my mom doesn’t want to burden me with her financial needs.
How to Begin the Conversation
A great way to approach this sensitive and important subject is by letting your loved ones know that you want to support them, and they can count on you; but in return, they have to help you prepare. Start with something that feels a bit more neutral. Agree to organize and prepare the following:
- An advance directive (a document that allows you to convey your decisions about end-of-life care ahead of time) and power of attorney.
- A listing of assets and copies of related mortgages, investment statements, bank and savings accounts.
- A listing of other assets such as cars and jewelry.
- A listing and copies of insurance policies including long-term care (and if they don’t have it and can afford it – they should buy it), disability and life insurance policies. Remember to include policies that may be offered through employment or previous employment.
- Document burial and funeral arrangement wishes
It may be helpful to engage an elder law attorney if you can afford it. Many communities offer low-cost or free long-term care planning services, so make sure to check community Web sites for resources.
Change Begins at Home
Understand caregiving and long-term care living options that may include home modification, home care, technology, assisted living, senior day centers, nursing homes and hospice. It’s important that families understand that there isn’t a single solution. Home care may not be feasible forever. Agree on when it might be right for assisted living or nursing home care.
Most of us envision aging in our own homes or the homes of our children. Realistically think through what home modifications will be required to facilitate that decision. For example, washer and dryers are frequently in the basement – not a practical solution for frail older adults. A care manager with expertise in elder care can be very helpful while investigating options. IONA Senior Services in Washington, D.C. is a wonderful resource. Many families blanch at the cost, but it is well worth the investment.
Understand all possible benefits that may help pay for long term-care including Medicare, the Department of Veterans Affairs and Long Term Care and other private insurance. Because many seniors will not have sufficient resources to pay for all of their long-term care needs, read and understand the ins and outs of Medicaid benefits and the associated eligibility requirements. The Administration on Aging offers a Long-Term Care Savings Calculator (www.longtermcare.gov/LTC) that can give you a rough idea of how much you might need and whether you would be able or want to use your private resources to cover long-term care services.
From the Heart
So now you’ve made a compassionate commitment from the heart. But please know it’s extremely important to also emotionally prepare for caregiving. Agree to some ground rules as a family – mom/dad, the adult children, spouses and grandchildren. Caregivers are rarely prepared for the emotional “wear and tear” on their marriages and sibling relationships. This is particularly true when a daughter-in-law is the primary caregiver. While caregiving can be rewarding, it can also stir up years of resentments and unresolved family issues. Engaging a neutral third party to negotiate can be very helpful. Many communities offer senior conflict resolution.
Health and Happiness
If your parent doesn’t have a relationship with a gerontologist or internist, make sure they build one. Beyond carrying for medical needs, the doctor is often someone a family can turn to when facing care planning decisions. Many times parents don’t listen to their children and vice versa, but many times the medical professional can put everyone at ease with sound advice for all to follow. Proactively seek guidance from a gerontologist when you suspect that your loved one may be experiencing dementia or early signs of Alzheimer’s. It is so important to calmly share your concerns with your loved one and that you think a doctor’s visit is warranted due to certain symptoms you have observed. Happily, Alzheimer’s medication started early often means the slowing progression of symptoms associated with this common disease associated with aging.
Remember to breathe! This is a marathon not a sprint. Caregiving typically occurs over years not months. Ensure that you have included maintenance of your own life into your caregiving plan. Going on vacation, attending family reunions, spending time with our own children or just having time to ourselves is what keeps us sane and feeling connected.