Caring for Aging Parents

What is it?

Caring for your aging parents is something you hope you can handle when the time comes, but something you probably hope you never have to do. Caring for your aging parents means helping them plan for the future, and this can be overwhelming, both physically and emotionally. When the time comes for you to take care of your parents, you may be certain of only two things: Your parents need you, and you need help.


Start planning
Talk to your parents about the future

Start caring for your aging parents by talking with them about their needs and wishes if they are able. In some cases, however, they may not be willing to talk to you about their future, either because they are afraid to face it or because they resent your interference. If this is the case, you may need to do as much planning as you can without them, or, if their safety or health is in danger, step in as caregiver anyway.


Prepare a personal data record

The first step you should take is to ask your parents to help you prepare a personal data record (if they are unable to help you, you'll have to search for the information yourself). A personal data record is a document that lists information that you might need in case your parents become incapacitated or die. Information that should be included is financial information, legal information, medical information, insurance information, and information regarding professional advisors and the location of important records.

Example(s): When Marcia and her mother prepared a personal data record, Marcia realized that her mother did not have a durable power of attorney or health care proxy in case she became incapacitated and could not make decisions about her medical care. The next day, Marcia made an appointment with her mother's lawyer to discuss this issue.


Get advice

You can't know everything, and you probably don't have enough time to learn everything you need to know to care for your parents. That's why you should seek advice from professionals. Some advice will be free, and some you will have to pay for. If you live far from your parents or are too overwhelmed to handle all your parents' affairs, you can hire a geriatric care manager who will evaluate your parents' situation, suggest options, and coordinate professionals who can help. In addition, talk to your employer. Some employers have set up employee assistance programs that offer advice and assistance to people who are dealing with personal challenges, including caring for aging parents.


Get support

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 start finding help, call 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. Call the Eldercare Locator at (800) 677-1116.


What kind of advice will you need?
Housing and health care advice

If your parents are like many older individuals, where they live will depend upon 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. On the other hand, you may want them to move in with you. For a detailed discussion of housing options, see Housing Options for Older Individuals. In addition, you will need information on managing the cost of health care, long-term care insurance, major medical insurance, Medicare, and Medicaid.

Contact:

  • National Association for Home Care
  • Visiting Nurse Associations of America
  • Centers for Medicare & Medicaid Services (formerly known as the Health Care Financing Administration)
  • American Association of Homes and Services for the Aging
  • American Association of Retired Persons (AARP)
  • Health Insurance Association of America


Financial advice

If your parents need help managing their finances, you may need to contact professionals whose advice both you and your parents can trust, including one or more of the following individuals or organizations.

Contact:

  • Your financial planner
  • Your banker
  • Your investment counselor
  • Your tax attorney
  • The Social Security Administration


Legal advice

Legal advisors can help you plan for your parents' incapacity (including preparing documents such as power of attorneys, medical directives, and living wills), contact nursing home ombudsmen, set up and monitor guardianship, prepare wills, give tax advice, and provide bill payment and representative payee assistance. For information on these topics, see Planning for Incapacity. Many states provide funds for the delivery of free legal services to the elderly and many attorneys specialize in elder law, so finding legal advice shouldn't be difficult.

Contact:

  • Your attorney
  • National Association of State Units on Aging
  • American Bar Commission on the Legal Problems of the Elderly
  • Legal Counsel for the Elderly


What kinds of support and community services will you need?

Caring for your aging parents will be easier if you know what kinds of support and community services are available and where to locate them. The following is a list of the kinds of support and community services you can find locally and nationally, along with specific suggestions of who to contact for information. For other useful information and a more comprehensive list of organizations you can contact for help, see When You Need Help: Community Resources for Older Individuals.


Adult day care

If you need to work or run errands and you can't leave your parents alone, consider using adult day care. These programs are located in hospitals, churches, temples, nursing homes, or community centers. Many are private nonprofit organizations. Adult day care can be expensive but is sometimes subsidized by the government, and fees may be based on a sliding scale. In addition, Medicare, Medicaid, long-term care insurance, or your health insurance may pay part of the cost.

Contact:

  • Your local senior center or community center
  • National Institute on Adult Day Care
  • The Alzheimer's Association


Caregiver support groups (self-help)

Many self-help groups are available to provide information and emotional support on broad topics (such as aging) or specific topics (such as heart disease). You may find these support groups helpful if you know little about caring for your aging parents. Such groups might also provide an opportunity to help others by sharing your experiences.

Contact:

  • The Alzheimer's Association
  • Children of Aging Parents
  • National Self-Help Clearinghouse


Caregiver training/health education

You may feel better about taking care of your parents if you are armed with knowledge. You may want to complete first-aid courses or take classes in gerontology.

Contact:

  • Your local college or university
  • Your local hospital
  • The American Red Cross


Geriatric assessment

If you are uncertain of your parent's mental or physical capabilities, ask his or her doctor to recommend somewhere you can take your parent to undergo an assessment. These assessments can be done at hospitals or clinics. Your parent will be evaluated to determine his or her capabilities. The evaluation determines whether the individual can take care of himself or herself on a day-to-day basis, including such things as bathing, dressing, eating, using the telephone, doing housework, and managing money. Based on this evaluation, you and your parent will receive advice regarding care options.

Contact:

  • Your doctor
  • Your lawyer
  • The National Association of Professional Geriatric Care Managers
  • Aging Network Services


Respite care

When you are caring for your aging parents, you may feel guilty or even resentful because you don't have limitless energy. Taking care of your parents is hard work, however, and everyone needs a break once in a while. If you are caring for your aging parents, look into respite care. Medicaid may pay for some respite-care services.

Contact:

  • Your doctor
  • Your local hospital
  • The Alzheimer's Association
  • National Association for Home Care


Financial and tax considerations for you

Caring for your aging parents is not only an emotional burden for you but may be a financial one as well, depending upon how well off your parents are and how much caring for them costs. Because many adults today are becoming first-time parents in their thirties, and others are remarrying and rearing second families, increasing numbers of adults are finding themselves in the "sandwich generation." They face having to pay expenses of growing children (including college expenses), plan for their own retirement, and support their aging parents financially. Thus, it's important to plan not only your parents finances, but your own as well.


Financial planning for your parents

Making sure that your parents won't outlive their money is a critical step in ensuring that your own finances will remain sound. In particular, you'll need to make sure that your parent is receiving all the benefits to which he or she is entitled and that his or her money is invested wisely. You'll also need to create a financial profile for your parents, a statement that includes income, expenses, and net worth. For information on how to do this, see Budgeting. If, after considering your parent's financial condition, it's clear that they won't have enough resources to pay for their own care, you'll need to find ways to supplement their income. You may need to look at Supplemental Security Income (SSI), for instance, or ask other relatives for help. You'll also have to determine how much financial support you can give your parents (see below).


Financial planning for you

Besides caring for your parents, you have a lot of other financial obligations. Before you can determine the best way to help your parents financially, you'll have to look at your own financial picture. Not only will you need to consider your current expenses, but you'll have to look down the road a few years, considering how much you'll need to save for your own retirement and, perhaps, for your child's education. For more information on this subject, see Saving for College and Retirement and Determining Your Retirement Income Needs.

Tip: Due to the complexities inherent in providing adequately for several generations in the same family, consider seeking the advice of a financial professional.


Tax benefits for children supporting aging parents

Federal income tax law provides several tax benefits to you if you are supporting your parents financially. If you have a dependent care account at work, you can put pretax dollars into the account that you can use to pay for some costs associated with caring for your dependent parents. You may be able to claim an exemption for your parents as dependents, and you may be entitled to claim a dependent care credit. In addition, you may be able to file your taxes as head of household and deduct medical expenses you paid for your parents. For more information, see Deductions and Exemptions and Child and Dependent Care Tax Credit, and consult your tax advisor.



Questions & Answers
If you are financially supporting your parent, is he or she entitled to receive Social Security benefits based on your earnings?

If you are providing at least one-half of your parent's support at the time of your death, and he or she is age 62 or over and is not entitled to a retirement benefit that is equal to or larger than the amount he or she would receive based on your earnings record, then he or she may be entitled to receive a parent's Social Security benefit equal to 82.5 percent of your primary insurance amount (PIA). For more information, see Social Security Survivor's Benefits and the Lump-Sum Death Benefit.

 
Life Insurance

Life insurance is an essential part of financial planning. The main purpose of purchasing life insurance is to ensure that your dependents are financially protected in the event of death. Life insurance is a way to plan for the future so you need to be sure that the coverage you purchase fits your needs.

"44% of all U.S. households, 48 million don’t own life insurance and believe they should, or own life insurance and know they need more. "

There are many options available to you when purchasing life insurance. Some policies provide coverage for your lifetime and others provide coverage for a specific number of years. With certain policies, you are able to combine different kinds of insurance and even build up your cash value. Your choice should be based on your needs and what you can afford.

"Nearly three out of four Americans agree that life insurance is the best way to protect against premature death of a primary wage earner. "

Term Life Insurance

Term life insurance is an insurance policy that is in effect for a specific period of time. If the insured dies within that timeframe, the beneficiary of the policy receives the death payment. However, if the insured survives that period of time, the beneficiary receives nothing and the policy is closed. Term life also provides the ability to convert to a permanent kind of coverage at a later time. The main reasons people buy term life insurance include:

  • Coverage for a specific amount of time until they are able to build up their assets.

  • Coverage for the amount of time the mortgage is for so in the event of an untimely death, the mortgage is taken care of.

  • Coverage for those that cannot afford a permanent policy, especially newlyweds and new parents.

"Twenty-four million households have no life insurance protection at all. Almost one third of adults have no life insurance protection."

Some uses of term life insurance include mortgage life insurance, key man insurance, business life insurance, and family insurance protection.

Permanent Life Insurance

Permanent life insurance covers a longer period of time than term life insurance or for the entire life of the insured. This kind of insurance combines death benefits with a savings component. The amount of money that is not used to cover the amount of the insurance is invested by the company and builds up a cash value that may be used in a variety of ways. You may borrow against a policy's cash value by taking a policy loan. If you don't pay back the loan and the interest on it, the amount you owe will be subtracted from the benefits when you die or from the cash value if you stop paying premiums and take out the remaining cash value. The cash may also be used to increase your retirement income or to help pay for needs such as a child's tuition without canceling the policy. However, to build up this cash, you'll pay higher premiums. There are several types of permanent life insurance, including whole, universal, variable universal, and survivorship universal.

 
Long Term Care

What is long-term care insurance (LTCI)?

Long-term care insurance (LTCI) is a contractual arrangement that pays a selected dollar amount per day for a selected period of time for skilled, intermediate, or custodial care in nursing homes and other settings (such as home health care). Because Medicare and other forms of health insurance do not pay for custodial care, many nursing home residents have only three alternatives for paying their nursing home bills: their own assets (cash, investments), Medicaid, and LTCI. For information about Medicare and other government programs that cover only a limited amount of long-term care expenses, see Coordination with Government Benefits. For details about Medicaid, see Long-term Care Insurance (LTCI) as a Medicaid Planning Tool.

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