Caring for Your Aging Parents
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:
- Incapacity
- Fear of becoming dependent
- Resentment toward you for interfering
- Reluctance to burden you with their problems
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:
- Long-term care insurance: Do they have it? If not, should they buy it?
- Living arrangements: Can they still live alone, or is it time to explore other options?
- Medical care decisions: What are their wishes, and who will carry them out?
- Financial planning: How can you protect their assets?
- Estate planning: Do they have all of the necessary documents (e.g., wills, trusts)?
- Expectations: What do you expect from your parents, and what do they expect from you?
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:
- Financial information: Bank accounts, investment accounts, real estate holdings
- Legal information: Wills, durable power of attorneys, health-care directives
- Funeral and burial plans: Prepayment information, final wishes
- Medical information: Health-care providers, medication, medical history
- Insurance information: Policy numbers, company names
- Advisor information: Names and phone numbers of any professional service providers
- Location of other important records: Keys to safe-deposit boxes, real estate deeds
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.
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:
- Caregiver support groups and training
- Adult day care
- Respite care
- Guidelines on how to choose a nursing home
- Free or low-cost legal advice
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
- Post important telephone numbers in case of emergency (e.g., physician, emergency services).
- Safeguard your parent’s home.
- Complete first-aid and CPR courses.
- Talk to your parent about the future; understand his or her wishes.
- Make sure your parent has a will, durable power of attorney, health-care proxy, and living will.
- Join a support group or cultivate friendships where you can talk openly about your caregiving responsibilities and challenges.
- Seek assistance from friends and relatives, community services (home health care, meal delivery, adult day care, etc.), and other sources.
- Talk to your employer. Some employers will help by offering flexible schedules or other assistance.
- Be aware that the Family and Medical Leave Act requires employers of 50 or more employees to grant eligible employees unpaid leave to care for a member of their immediate family who has a serious health condition.
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 signing a contract |
Medicare, Medigap, and Medicaid
| Medicare | Medigap | Medicaid | |
| What is it? | Federal health | Medicare supplement | Joint federal-state |
| insurance program for | insurance issued by | need-based health | |
| Social Security | private companies. | insurance program. | |
| recipients. Parts A and | Typically, individuals | Eligibility requirements | |
| B comprise the original | who have Medicare | and covered services | |
| Medicare program. | Advantage would not | vary from state to | |
| Medicare Advantage | need a Medigap plan. | state. | |
| (also referred to as | |||
| Part C) plans are also | |||
| available in some | |||
| areas. They provide | |||
| managed care and | |||
| fee-for-service options | |||
| through private | |||
| insurers. | |||
| What does it cover? | All or some portion of: | All or some portion of: | All or some portion of: |
| Part A: Hospital and | Medical care not | A broad range of | |
| skilled nursing | covered by Medicare, | medical services | |
| facilities, home health | deductibles, | including inpatient and | |
| agency care, hospice | co-payments, and | outpatient hospital | |
| care, inpatient | coinsurance; plans | care, prescription | |
| psychiatric care, and | may also cover other | drugs, nursing home | |
| blood transfusions. | services such as eye | care, and skilled care. | |
| Part B: Doctors, | and dental exams. | ||
| 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 prescription | |||
| drugs, eye exams, and | |||
| hearing aids. | |||
| Part D: Prescription | |||
| drug coverage | |||
| (optional). | |||
| Who is eligible? | Generally, persons | Individuals who are | Individuals who have |
| age 65 or older, and | enrolled in Medicare | limited income and | |
| those with certain | Parts A and B. | resources and who | |
| disabilities or diseases | meet other eligibility | ||
| are eligible for | requirements. | ||
| Medicare Parts A and | |||
| B. | |||
| Anyone eligible for | |||
| Parts A and B is | |||
| eligible for Part C and | |||
| Part D. |
| What is the premium cost in 2016? | Part A: Most beneficiaries don’t pay for this coverage because of prior Social Security covered employment.
Part B: Most beneficiaries will continue to pay $104.90, the same premium as in 2015. Others will pay the standard premium of $121.80 or a higher premium, depending on income. 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 10 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 are receiving Social Security or Railroad Retirement benefits (or are applying for benefits) at or prior to age 65, you will be automatically enrolled in Part A and Part B.
Contact the Social Security Administration to enroll if: • You will not receive Social Security or Railroad Retirement benefits at age 65 • You want to enroll in Medicare Part C • You want to apply for benefits prior to age 65 due to a covered medical condition |
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) |
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.
Medicaid eligibility rules are complicated and differ from state to state. It’s important to get the advice of an experienced Medicaid planning professional before applying for benefits.
Copyright 2006- Broadridge Investor Communication Solutions, Inc. All rights reserved.
Broadridge Investor Communication Solutions, Inc. does not provide investment, tax, or legal advice. The information presented here is not specific to any individual’s personal circumstances.
To the extent that this material concerns tax matters, it is not intended or written to be used, and cannot be used, by a taxpayer for the purpose of avoiding penalties that may be imposed by law. Each taxpayer should seek independent advice from a tax professional based on his or her individual circumstances.
These materials are provided for general information and educational purposes based upon publicly available information from sources believed to be reliable—we cannot assure the accuracy or completeness of these materials. The information in these materials may change at any time and without notice.
*Non-deposit investment products and services are offered through CUSO Financial Services, L.P. (“CFS”), a registered broker-dealer (Member FINRA / SIPC) and SEC Registered Investment Advisor. Products offered through CFS: are not NCUA/NCUSIF or otherwise federally insured, are not guarantees or obligations of the credit union, and may involve investment risk including possible loss of principal. Investment Representatives are registered through CFS. Coastal Federal Credit Union has contracted with CFS to make non-deposit investment products and services available to credit union members.
CFS representatives do not provide tax or legal guidance. For such guidance please consult with a qualified professional. Information shown is for general illustration purposes and does not predict or depict the performance of any investment or strategy. Past performance does not guarantee future results.
