One of life’s difficult transitions happens when someone we have relied upon for years now needs our ongoing help. Often, this person has been in decline for a while before the need for help is recognized. While each situation is different, this guide covers the common core questions and issues for members just starting out.
- Initial Questions: Discuss with your parent what assistance he/ she thinks is needed. Aging people often believe they need less help than is truly required, so confirm what you are being told. Issues like Alzheimer’s are common among the elderly and difficult to recognize early on.
- Family Conferences: If you have siblings or others who should be involved, team up and start working out roles and responsibilities.
- Medical Evaluations: Accompany your parent to his/her doctor, dentist, eye doctor, etc. Discuss symptoms, issues, medications, and steps needed. Ask about current and longer-term care recommendations.
- Legal Underpinnings: Accompany your parent to his/her attorney to review existing wills, powers of attorney, living wills, etc. Update these as needed and prepare the necessary documentation for you to assist with or take over the parent’s affairs when necessary.
- Health and LTC Insurance: Understand your parent’s health care coverage, including Medicare and any pension benefits. Find out if he/she has Long Term Care Insurance (LTCI) and how to access it.
- Financial Condition: Understand his/her financial situation – assets, liabilities, pensions, social security, expenses, etc. Create a file of accounts, insurance policies, tax returns, properties and securities with account numbers. Communicate with each institution to understand their requirements (generally a power of attorney) to allow them to accept direction from you on behalf of your parent.
What living arrangement will best serve your parent’s needs?
- Living at home – independent living with appropriate in-home assistance
- Assisted living – community living assistance for things like bathing, dressing, cleaning, and meals, but no medical supervision
- Nursing care – community living with both medical care and assisted living services.
- Continuing-care retirement community (CCRC) – community living offering a continuum of care from independent living through nursing care. Typical arrangements are:
- Life-care contract, with large entrance fee + flat monthly fee regardless of care level.
- Hybrid contract, with moderate entrance fee + escalating monthly fee for higher levels of care.
- Fee for service, with low entrance fee + market rate monthly fee by level of care.
Who will schedule exams, help with parent-doctor discussions, verify medications are being taken properly, and respond when a parent falls? Some housing options include this, while others require your involvement or a paid service.
Who will pay bills and manage taxes, investments, etc.? Establish a power of attorney for each account and have bills sent to you. Do not comingle accounts with yours. Establish a system for records and payments (Quicken or similar) or hire a bookkeeping service. Line up appropriate resources for tax returns and investment management.
The above material is provided for informational purposes only and not for the purpose of providing legal or financial advice.
Additional Resources for Elder Care
- Administration on Aging
- Aging Life Care Association
- Alzheimer’s Association
- American Association. of Daily Money Managers
- Family Caregiver Alliance
- Meals on Wheels Association of America
- National Hospice and Palliative Care Organization
- National Institute on Aging (NIA)
- U.S. Department of Health & Human Services
- State Departments of Aging
- Local affiliates of organizations listed above
- Support groups organized by churches, hospices, etc.