For the past six years, I’ve been a caregiver for my parents. Fortunately, we prepared the best we knew how. However, we were never completely prepared for the illnesses or diseases that accompany old age. Sometimes, it’s not the financial stability or even health insurance that shakes your reality but diseases such as Parkinson’s and Alzheimer’s disease that rob you blind of emotional stability and the family ties that holds people together.
I recently spoke with a divorced female client who is a working family caregiver. She’s living with her son, holds down two jobs, and cares for her father who has Alzheimer’s. She has been paying her father’s $3,500-per-month nursing care bill in addition to her own bills. She told me that the stress is so overwhelming that she is about to lose both jobs because her presence on the job is distracted and disrupted. Her dad now lives with her because she can no longer handle all the debt created by the nursing home costs. They live in a two-bedroom apartment — and you can imagine what her life must be like.
Did her father prepare for his retirement? Well, he thought he did. His Social Security checks and pension add up to $1,600 per month. Five years ago, her dad never dreamed he’d develop Alzheimer’s. The fact is that most people never plan for the worst-case scenario. Consumers often shy away from reality or think a long term care situation will never happen to them.
How seriously should the boomer children of aging parents take this whole elder care issue? Coming from the caregiver world, working with colleagues who care for aging relatives, and hearing stories of family caregivers from around the country, it’s a very serious stage for all of us, especially for those of us who are not financially prepared.
How can you help your boomer clients avoid a meltdown? The answer is to help them plan ahead with good strategies and advice. Following are some easy ways to help your clients plan ahead for what may face their senior parents.
Begin the dialogue
The first step is to have your clients open up a conversation with their parents now rather than later. They should ask them, “How do you want to live the remainder of your life?” Keep the conversations light and easy. One way they can start a conversation with their parents is by saying, “Mom, Dad, I know you don’t want to discuss this and nor do I because it’s uncomfortable to talk about getting older. But because I’m concerned how it may affect my job and my family, I really need to get a handle on how you see living out your life.” Deep down, their parents will be grateful for your clients’ action in stepping forward.
Once your clients get the dialogue going, they should try to get the next point in their conversation where they say, “Let’s have a family meeting to discuss some important planning for the future.” Many families have meetings only when there is a crisis or to set some firm rules. Other families have them on the fly, at the dinner table or in the car. There is value to making family meetings a routine and somewhat formalized part of family life now as a planning step ahead. Many parents with grown children often look back and wonder why they didn’t do that. It’s hard sometimes to squeeze in a family meeting with busy schedules, sibling rivalry, adolescent rebellion, and a host of other distractions. But if your clients can build them into family life, they won’t regret it.
If your clients’ parents agree to a family meeting, they should try to follow these rules:
- Prior to meeting with the parents and siblings, an adult child or appointed family leader should decide on what topics and decisions are appropriate for discussion and which are off limits.
- Use the meetings to share feelings, but avoid “family therapy” to resolve deep or complex issues in relationships.
- Use the first couple of meetings to decide how to proceed — where to have the meetings, what topics to talk about, and what the meeting rules are.
Information gathering and preparation
The next step your boomer clients should take in planning ahead is to gather all the proper legal documents to ensure the quality of care their aging parents need and deserve. The following list outlines the basic documents they should have:
o Durable power of attorney for health care. This is also sometimes known as a health care agent or proxy and refers to an individual who has been appointed to make medical decisions in the event that your clients’ parent becomes unconscious or can no longer speak for themselves. A health care agent can be assigned as part of the advance directive form.
o Advance medical directive. This document informs the physician and family members as to what kind of care the parent wishes to receive in the event that they can no longer make their own medical decisions.
o Living will. This is an advanced directive that outlines what kind of medical treatment the parent wants in certain situations. It only comes into effect if they are diagnosed with a terminal illness and have less than six months to live or if they are in a persistent vegetative state. A living will does not, however, allow them to name someone to make decisions on their behalf.
o Do-not-resuscitate order. A DNR is a signed order directing that no efforts to restart the heart are to be undertaken in the event the senior parent stops breathing or the heart stops. This is a decision that should be made by the parents and nobody else. Advance directives, living wills, and durable power of attorney forms are all simple documents to complete, and your clients can obtain samples through a physician, hospital, attorney, or state’s attorney general’s office. It’s important that signed copies be given to the family physician. The documents must also be placed in the hospital chart each time the parent is hospitalized.
o Hospital checklists. In addition to having the vital documents mentioned above, your clients can facilitate their parents’ transition to the hospital by providing the health care team with the following checklist. Providing this information immediately upon admission to the hospital can save crucial time and improve communication. Often, hospitalization begins in the emergency room. Being prepared will ensure that in a busy emergency room setting, physicians are familiar with the parents’ case from the start.
o The patient’s medical history in writing
o A list of the patient’s allergies
o A list of current medications and dosages
o A list of all physicians and consultants who are caring for the patient, along with phone numbers
Know your resources
There are many resources available to help families who are already in a caregiving situation. The local Area Agency on Aging (www.aoa.gov) or the Eldercare Locator of the U.S. Department of Aging (www.eldercare.gov) and other non-profit organizations can provide helpful information and resources to assist the caregiver. Make sure your clients are knowledgeable about those resources that exist in their area to provide financial, social, and equipment support.
It’s important as an advisor to tend to the needs of your boomer clients, but often their needs are their parents’ needs, as well. As caregivers for aging loved ones, they may not know where to turn for help. You can help them sort out the mess and gain a lifelong and loyal client in return.
Carol Marak is the founder and CEO of WorkingCaregiver.com. She can be reached at email@example.com.