Caring for Aging Parents

As the population grows older and life expectancy increases, more and more people find themselves responsible for the care of one or both elderly parents. Should you find yourself in the role of caretaker, it’s important to know that you have options. The more you understand how elder care changes the landscape of housing, healthcare, insurance, and financial decisions, the easier it can be to make informed decisions.

Having your parents age as gracefully as possible is important. So, too, is having the confidence that you’ve made the right decision for them during a potentially stressful time.

Preparing For Emergencies

Although every situation is different, it is likely that, in a crisis, doctors may turn to you for pertinent personal and medical information about your parents. Collecting this information beforehand could save precious time in an emergency.

You will want to have the following on hand:

• Names, phone numbers and addresses of doctors, dentist and pharmacy
• Lists of prescription medications and over-the-counter drugs – including any and all herbal supplements and vitamins
• Past surgical/medical procedures
• Major medical conditions, such as diabetes and heart disease
• Allergies
• Dates and results of recent medical tests, including exams, x-rays, CT scans and MRIs
• Insurance Information
• Birth dates
• Living wills or durable power of attorney for healthcare, if applicable
• Religious beliefs
• Lifestyle information, including alcohol and tobacco use

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Articles	Helping to Care for Aging Parents

Financial Affairs

There may come a time when your parents have difficulty keeping track of their finances. Although it can be a difficult conversation, it is helpful for you to discuss your parents’ financial affairs and get as much detailed information as you can regarding:

• Income sources, such as retirement, disability benefits, social security
• Financial assets, such as cash, bank accounts investments, life insurance
• Real estate
• Other assets, including automobiles, boats, inheritances and loans to family members/friends
• Liabilities, including mortgages, personal loans and credit cards

Should it be necessary, you might consider taking over some or all of their financial responsibilities. You may ask your parents to have utility companies, landlord or mortgagee, and others arrange for bills to come directly to you. Alternatively, you might ask to be notified if bills aren’t paid on time. You may also want to look into getting a power of attorney for finances, which would provide you the authority to make financial decisions on your parents’ behalf.

Legal Issues

There are a number of legal documents that can allow your parents to put their wishes in writing and put their minds, as well as yours, at ease. You may wish to consider some of these depending on your and your parents’ needs:

• Joint bank account ownership – Being joint owners of a bank account with your parents allows you to act on your parents’ behalf in an emergency.
• Durable power of attorney for finances (DPA) – A DPA allows your parents to give you the legal authority to make all financial decisions on their behalf.
• Health care power of attorney – Allows your parents to give you the legal right to make decisions regarding their medical treatment when they are temporarily or permanently unable to make their own.
• Living will – Once in place, this directs the doctor to withhold or withdraw life-sustaining treatment should a parent be diagnosed with a terminal condition and be unable to state his or her preference.

Healthcare & Insurance

If your parents are 65 or older, they are eligible for Medicare. In some cases, Medicare won’t cover enough medical expenses and a Medigap policy may be needed to supplement coverage. Offered by private insurance companies, Medigap provides different standardized plans to suit your parents’ needs.

For those who don’t have the resources to pay for their own care, Medicaid offers its services, including full or partial coverage of the following:

• Inpatient and outpatient hospital care
• Prescription drugs
• Skilled care
• Nursing home care
• Transportation to medical treatments

As eligibility requirements are intricate, it is recommended that you or your parents speak with a Medicaid planning specialist before applying. A quick summary of the Medicare, Medigap, and Medicaid programs can be seen in this helpful comparison chart.

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Housing

As your parents grow older, they may need to reconsider their living situation due to health problems, mental lapses, or the natural waning of physical strength. A frank discussion with your parents and any siblings should ensue.

If your parents remain at home, evaluate if they are in a safe environment that’s suitable to their physical abilities. Renovating your parents’ home to adjust to their changing physical needs could help them remain in a familiar and loved environment. Adding grab bars in hallways and bathrooms, installing an emergency alert system or a first-floor bathroom could make an invaluable difference to their quality of life.

Should your parents move into your home, be sure to discuss your expectations in advance, and address privacy and space issues. Should their needs become more than you can handle, there are a range of options to meet the varying needs different people experience:

• Retirement communities
• Active senior communities
• Adult day-care services
• Home health care
• Continuing care retirement communities
• Assisted-living communities
• Nursing homes
• Alzheimer's/dementia care specialty facilities
• Hospice care

Long-Term Care Options

One of the biggest worries of those caring for aging parents is how to pay for the needed care. If you provide more than half of a parent’s support, you may qualify for a tax exemption by claiming them as your dependents. You may also be able to claim a federal tax credit, enabling you to deduct a portion of the cost of in-home day care. Check with your tax advisor for specifics.

If sending your parent to a nursing home is inevitable, research each home extensively. Do not be surprised to find a lengthy waiting period. In general there are three ways to pay for nursing home care:

• From their own savings: If your parents pay for a nursing home themselves, keep in mind it can be risky if they need long-term care.
• Government Benefits: If your parents have little income and few assets, Medicaid may pay for their nursing home care. Medicare, however, covers only short-term stays in a nursing home for the purpose of rehabilitation after a period of hospitalization.  Remember, should your parent be a veteran, he or she may be eligible for care in a VA facility.
• Long-Term Care Insurance (LTCI): LTCI may be worth considering, but it’s important that it be purchased well in advance of needing it. The premium can be high, depending on your parents’ age at the time of purchasing the policy and the type of benefits they choose. When shopping for long-term care insurance, pay close attention to the daily benefit, among other provisions. LTCI pays a fixed dollar amount of benefits per day, which may not cover the entire cost of nursing home care.

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Estate Planning

If your parents haven’t already planned their estate, you should encourage them to do so. It is important to ensure that their wishes concerning their assets and belongings are fulfilled. A good estate attorney can help them update their wills, or create them if this has not yet been addressed. You will also want to discuss the benefits of trusts and other estate planning options they may have.

For more information about this subject, see our Transferring Your Estate Life Events page.

Resources & Services

For more information and support to help you and your parents cope with the problems of aging, please consult the following:

• Aging Parents and Common Sense – This award-winning guide has over 30 pages of practical information on the financial, legal, emotional and lifestyle issues of caring for aging parents. Order a free guide
• A Directory of Resources for You and Your Parents – This 24-page directory lists information on organizations and publications that can help you and your parents cope with the problems of aging. Download a free directory

  It’s not easy switching roles with your parents. There are many complex financial, legal and insurance-related issues that may need to be addressed. It’s important to know what your parents’ wishes are, and to know all your options so that you can truly make the best possible decisions in their interest.

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  Articles	Helping to Care for Aging Parents