Caring for aging parents can be a complicated maze of managing personal care and navigating the healthcare system. Your involvement may start slowly or you might be thrust into a caring role due to a sudden change or exacerbation of a medical condition, or an accident.
Jump ahead to these sections:
- How to Prepare for Aging Parents
- Questions to Ask Your Aging Parents
- Preparing for Caring for Aging Parents at Home
- Preparing Parents for Other Types of Care
Most aging adults say they want to remain at home. Building a foundation of knowledge about the resources available and the costs associated with those resources can help guide your decisions. Above all, communicating with your parent in a collaborative and respectful manner is the best approach.
How to Prepare for Aging Parents
Understanding the lexicon of aging options is a critical piece of careful preparation. Scrambling to educate yourself during a crisis is stressful and may often lead to poor decisions. Our tips will give you the confidence to make informed choices.
1. Understanding health insurance
This is more important than you might think. People often make assumptions about what Medicare and other insurance will pay for and what it won’t. For example, there is a difference between traditional Medicare and a Medicare Advantage Plan. One way to start understanding is to review the explanation of benefits booklet.
Medicare doesn't pay for assisted living or memory care, so those costs will be private pay unless you have long-term care insurance. Medicare coverage for home health has tightened. We recommend talking with a home health company about the limits of coverage so that when the time comes you can make an informed decision.
2. Become involved in your parent’s healthcare
It is difficult to advocate for an aging parent if you don’t have the authority to do so. Start with advance care planning that involves setting up advance directives. Copies of advance directives should be given to all family members and healthcare providers. Consider making a list of all providers with their contact information.
Attend doctor’s visits if you can. It is common for older adults to misunderstand or not hear information clearly. If you can’t attend in person, ask for an aftercare summary. Consider being added to your parent’s patient portal so you can access healthcare information and communicate with the doctor.
3. Learn about diagnoses and medications
In addition, you might also want to keep an accounting of the following healthcare information:
- A current list of all medications and what they are for.
- Making note of any allergies to medications.
- Medical diagnoses with a brief explanation of what they mean.
4. Assess finances
Finances can be a tricky subject and we will talk more about this in the next section. However, if you don’t have a solid idea of your parent’s finances, it will be difficult to make decisions on care later. The cost of care can be shocking.
If your parents are struggling to understand their finances and/or pay bills, meet with an estate planning attorney to discuss options, like a trust and financial power of attorney. Some older adults are victims of financial exploitation from scams and fraud. You may have to put some additional precautions in place to protect their estate.
Questions to Ask Your Aging Parents
During the stress of caring for aging parents, it is convenient to want to make decisions quickly without your parent’s input. Take a deep breath and remember that your parent has autonomy and choice. Respecting their autonomy means involving them in all decisions. The following are suggested topics for discussion.
5. End-of-life care wishes
Discussing end of life care wishes can be very emotional, but it is a critical discussion to have. As the child of an aging parent, you need to know what their wishes are with regard to the medical treatment they want and don’t want at the end of their life.
These choices are very personal and should be respected by everyone. You can start by asking one of these end-of-life questions and take it from there.
6. Alternatives to aging in place
Most older adults report that they want to age in place. Yet, that is not always possible. Either caregiving becomes too difficult to do at home, or in-home care costs become unsustainable. Many people choose assisted living or memory care as alternatives to aging in place.
Given all the options available to replace care at home, what is their preference? It is common for older adults to equate assisted living to nursing home care. They are very different and one way to illustrate that might be to visit a couple of communities. This might ease their anxieties about a possible move.
A discussion about finances could take some time. Try being as patient as you can through the process. Here are some possible questions to ask:
- What is your total income?
- Is there a mortgage on the home?
- What are your debts?
- How much do you have in savings and retirement accounts?
- Do you have a will?
As part of this discussion, it can be good to talk about your expectations of financing care for your parents. Older adults will often forgo care so that their children will have more when they are gone.
Preparing for Caring for Aging Parents at Home
Caring for aging parents at home is possible, assuming they have the financial resources to support that decision. Perhaps start by broaching the subject with the following topics in mind.
8. Home modifications and accessibility
If an aging parent wants to stay at home, safety is important to maintain. An older home may have several flights of stairs or a step-in tub. Take a good look at what might need to be done to make the home environment safe and assess the cost.
Talk to your parent about those changes and consider other options like purchasing a one-level home or condo. The idea might be too overwhelming or complicated, but having the discussion gives everyone a chance to think outside the box.
9. Home maintenance
As your parent ages, home maintenance can become challenging to manage. This is everything from changing light bulbs, to mowing the lawn. To the extent possible, family members can often assume many of those duties. Other more time-consuming tasks can be hired out.
One possibility is to hire a home inspector to do a complete evaluation of the home to identify any safety hazards. Some older homes have very old electrical wiring that can be unsafe.
10. Caregiver responsibilities
Unless someone ages without any problems at all, everyone at some time will need help. How you plan for caregiving is for you, your aging parent and family to decide.
Some families divide caregiving duties among various family members. Others decide to hire outside help through an agency to provide that care. Others do a combination of both.
Preparing Parents for Other Types of Care
As your parent ages, there are other types of care to consider. People don’t always access other types of care in a linear fashion. Your parent might need rehabilitation followed by temporary in-home care. Or, your parent is in assisted living and requires rehabilitation after a fall.
11. Assisted living or memory care
Assisted living is a viable option for people who need a higher level of care that can’t be provided by the family. Assisted living has the advantage of nursing care, medication management, housekeeping, transportation, and other amenities. As mentioned previously, it is better to have these discussions early so that a decision can be made more easily.
Memory care is for people who have dementia, and preparation for a move to a community can be more difficult. People with dementia often don’t understand why they need to move. In these cases, it is best to take things slowly. Several visits to a memory care community before the actual move can make the transition easier.
Downsizing your parent's home is probably inevitable. Moving from a home to a small room in assisted living or memory care means significant downsizing. It can be a challenge to make decisions about a lifetime of mementos and personal items, but it is important to take the time to allow your parent to make those decisions.
12. Other senior living options
Assisted living is not the only choice for senior care these days. There are several alternatives to assisted living worth exploring.
Not every option may be available in your community, but for those that are, discuss these with your parent. They may have a preference for senior living other than assisted living.
Rehabilitation is a specialized setting designed to help someone recover from an accident or illness. The goal is to get someone back home safely.
Older adults are sometimes reluctant to agree to rehabilitation. Help your parent to understand the risks and costs of bypassing rehabilitation.
14. In-home care
The term in-home care refers to private caregivers hired to help with activities of daily living and home health care which is an insurance covered medical service. Home health care is time-limited but can be an invaluable support and transition to recovery. It includes physical, occupational, and speech therapy, nursing, and aide service. Since a doctor’s order is required, your parent may be more likely to accept this service since the doctor ordered it.
Private pay in-home care can be a tougher sell for your parent. The biggest obstacles are the loss of privacy and cost. Introduce the idea slowly by suggesting minimal hours a week and then gradually increasing. A collaborative approach will enable your parent to feel empowered to make their own choices.
Caring for Aging Parents Checklist
The senior housing and healthcare market is changing daily. Keeping apprised of these changes can take some time, but if you start with a good foundation of preparation, you can collect the proper amount of knowledge about your aging parent and the options available to them. This will make the journey a happier one for both of you.