Parent Caregiving 2.0

Nearly everywhere I turn these days, I run into someone who has either begun to care for their aging parent or are fearful that they may soon be asked to. I have noticed some recurring patterns with my peers as they begin to see their parents age, and become frailer. I started asking:

When an aging parent is no longer able to live alone in their own house, why is it that some people can get their parents to move, and they do it with grace and ease, while others struggle with that task, sometimes for years? Or…

Why are some caregivers able to deal effectively with their parents’ doctors and other healthcare providers, while others are simply swept away by the whirlwind of the healthcare system? Or…

Why are some families able to afford living into an advanced age with little or no change in their living standard, while others are struggling with how to make ends meet?

The current reality is that there are thousands of boomers that have one or both parents living with them. An even larger number have a parent that is living alone but probably shouldn’t be. Even more boomers have both parents still living in their family residence with one being the caregiver of the other, and it is obvious that he or she cannot adequately care for them both while maintaining the house, keeping the grass mowed, and driving the car safely.

Then there are those whose parents are living in an institutional setting, such as a nursing home or assisted living center, and it’s clear that that facility is inadequate for their present needs.

Obviously, living in the same house or even next door to an elderly loved one doesn’t solve all the problems of aging. In fact, it introduces a totally different set of issues. One of my dear friends said, “Oh, we could never do that,” when I suggested that her mother move in with her. “I would likely be charged with parricide.” That gave me an idea for a book title: “Let’s get through this without killing each other.”

But is that really the goal that we strive for as we care for our aging parents?

Throughout my career, nearly everyone who has expressed a goal about elderhood and longevity has said, “I just don’t want to be a burden on my family.” Because they are speaking to me as a financial planner, the burden they refer to is often merely financial. I gently remind them that we are all subject to becoming an emotional burden on our children. That’s because concern for our parents as they get older and become frailer is nearly universal.

Is not being a burden the real goal of our parents as they age? Hardly.

In answer to all this I have developed a framework for planning for elderhood. Hopefully, it will help those who face the prospect of parent caregiving do so with grace and harmony. At the very minimum, planning ahead should help head off potential crises. The framework addresses five areas and draws upon my training and experience as a planner, and as a chaplain, as well as my experience with my own parents. My dad developed dementia that was later diagnosed as Alzheimer’s disease, and my mother decided that she could be his caregiver and keep him at home. That worked, until it didn’t.

The five areas of successful aging must address what we can call the predictable predicaments. They are:

Housing – Where will they live as they become frail? Nearly everyone has told me that they wçant to live at home. And that is sometimes the best option. But is it realistic? Is it safe? What will be the triggering event that says it’s time to move? Where will they go?

Healthcare – Who will manage their healthcare? This readership knows all too well the issues of elderhood, particularly if cognition becomes a problem. Do I go with my mom to the doctor? Do I have a healthcare power of attorney that allows the provider to speak freely with me? Do I do know how to interpret what I am being told?

Money – How will we pay for the potentially exorbitant cost of aging? There is often a conflict between preserving assets for the future and spending on care today. One person told me that she felt greedy for even asking the question about paying for her mom’s care at the expense of preserving the assets. There are generally three ways to pay for long-term care: self or family pays, insurance pays, or the government pays. With skilled care now costing close to $9,000 a month, it is best to know where the money will come from, well before it’s needed.

Legacy – How will I be remembered? This is all about The Conversation, or as Tim Prosch says in the title of his book, The Other Talk. The legacy can be both financial and non-financial.

Saying Goodbye – Leaving this world with no regrets is a goal that I have heard repeatedly from our aging clients, and occasionally from their adult children.

I would love to hear your concerns about your aging parents, or about your own elderhood goals. Write to me.

Scott Neal, is president of D. Scott Neal, Inc., a fee-only financial planning and investment advisory firm with offices in Lexington and Louisville. Write to him at scott@dsneal.com or visit his new blog and comment at www.dscottneal.com