As more of my friends enter middle age, they’re talking less about how to care for their kids and more about how to care for their parents. Our mothers and fathers are nearing (and, in some cases, surpassing) seventy years of age, and not all of them are financially prepared.
A GRS reader named Shauna recently wrote with a typical scenario:
My husband and I are in our early thirties and finally getting our finances in order after years of piling up debt. We both have parents who were never particularly good with money, and they’ve entered their early retirement years with no savings or assets to speak of — no houses, no savings, no emergency fund. We’re looking down the road, and realizing that we will probably be financially responsible for all of them at some point in the not too distant future. Do you have any advice for us?
Actually, I don’t have any advice for Shauna. Why not? Because I’m in a similar position, and I have similar questions.
Close to home
In the past, I’ve hinted at my mother’s ongoing health problems, but I’ve been coy about their precise nature. I want to respect her privacy. At the same time, she faces very real issues that have equally real implications for her personal finances, and for the finances of her three children.
My mother is 62 years old. For fifteen years, she’s wrestled with severe mental illness (which makes her uncomfortable interacting with the outside world), as well as a host of chronic physical ailments. Every day, she takes a finely-tuned cocktail of over a dozen prescription medications to help her cope with these problems.
I’ve mentioned a couple of Mom’s health crises in the past, because whenever a severe mental or physical problem occurs, it disrupts my ability to work. For example, I spent much of the past week helping Mom after a minor surgery during which her normal drug regimen was interrupted, causing her to descend into confusion.
I drove Mom to the hospital, saw her after surgery, bought her groceries when she returned home, and have been dropping in to be sure she’s okay. Last night, Kris and I delivered dinner to her.
I find all of this stressful. Whenever Mom has an acute crisis, it doesn’t just affect her — it affects me, too. I do my best to help her, but I feel like I’m just not very good at it. I don’t know how to reach her, how to help her, how to let her know I love her.
Facing reality
My family has talked a little about what Mom will do in the future, but not seriously. Plus, we’ve mostly been re-active instead of pro- active; we deal with trouble when it arrives instead of before it happens. Now, though, I think we’re beginning to realize that we need a plan.
As a family, we need to decide what is best for Mom, both now and five years from now. And we need to juggle the following factors:
- Mom has minimal cash savings and a modest retirement account (through the box factory). The box factory also pays her a monthly salary, which will be her primary source of income for the rest of her life. Plus, she’s eligible to receive Social Security benefits soon. (And I think she’s eligible to receive Social Security survivors benefits for my father; I need to research that.) So, her financial situation isn’t fantastic, but it’s okay.
- For now, Mom is capable of living on her own. But when she gets off her meds, she becomes increasingly confused and uncommunicative. She misses one pill, and then she misses three, and then eight, and before long she’s not taking any, which means self-care goes out the window.
- Mom doesn’t advocate for herself. At her medical appointments, she doesn’t ask questions. If she’s confused, she doesn’t ask for clarification. She doesn’t follow through with recommendations for group therapy and other ways to work through her fears. She’s apprehensive about social situations, even grocery shopping or family Thanksgiving dinner.
If Mom’s age-related difficulties were only physical, a residential facility might be the answer as her independence declines. But how do you ask a person who doesn’t like to leave the house to permanently move to a place where she has “strangers” around her at all times?
Our family has to sit down with Mom and hash some of this out. What can she do for herself? What does she need help with? Should we hire somebody to check on her once a day? Once a week? Should she move in with one of her three boys? And how do we pay for this? Pull money from the box factory? Chip in ourselves? What about long-term care insurance? How does that work? Is it too late to buy it?
Basically, we have a lot of questions, and we don’t really know whom to ask.
Seeking help
On Saturday, I met with Lane, a long-time GRS reader who has become a friend. Lane and his mother went through similar issues, and I hoped he could offer some insight. I told him I felt inept at this — that I didn’t know how to help Mom. “It’s almost like our roles are reversed,” I said. “Like now I’m the parent and she’s the child.”
“Having to be the adult of your parents isn’t easy, but sometimes that’s what’s needed,” Lane told me. He described the steps he’d taken to help his mother, the things he did that she could not. (For example, he paid bills for her every weekend.)
Lane explained the difference between independent-living facilities (which sound kind of like college dorms) and assisted-living facilities (which are similar, but with individual supervision and monitoring). “If you think your mother might need an assisted-living facility, don’t wait until the last minute,” Lane said. “There’s usually a long waiting list. If you think she’ll need it, act now. Talk about it with her, and make a plan.”
Lane asked what sorts of legal preparations we’d made. “Has your mother drawn up a Power of Attorney?” he asked. “Does she have an Advance Directive? What about a will or a trust?”
“I don’t know,” I said. “I know she’s given me Power of Attorney, because we arranged for that after the last time she was in trouble. And she drew up an Advance Directive before her surgery, but I don’t know about a will or a trust.”
“You need to find out,” Lane said. “These are the shittiest conversations, but you have to have them.”
Moving forward
There’s no real climax to this story. I don’t have any answers. All I have are a lot of questions.
Mom seems to be recovering well from her surgery. She’s certainly doing much better than she was a week ago, when she was off her meds. So, last night I asked her about her preparations and preferences for the future.
She told me she has a will, and that she wants to stay in her house. She’s not opposed to having someone come help her on a regular basis, but she wants to stay put. And to be honest, when she’s as lucid as she was last night, it almost seems absurd to be thinking about this stuff. But every time Mom’s doing okay, we put off this discussion, and then we regret it the next time there’s a crisis.
I’d really like to hear your experience, though. Have you helped your aging parents? Are you doing so now? What advice do you have? What can you tell me about my situation and/or about Shauna’s situation from the start of this article? What financial considerations do we need to be aware of?
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Not much advice and here are our plans. If my Mum gets too bad, her request is to send her back to England to live. She worked for 8 years in the UK before coming to the US…in 1967! She worked here in the US and her benefits in the UK are still better. Her current US Federal pension was cut and her insurance coverage changed to not cover some of her prescriptions – so a double hit this year. In the UK, she can ride the local bus for free – here, we just got local bus service two years ago. Plus, she gets her UK pension wired each year.
So, not much advice, but something is definitely wrong with our system – health, retirement, etc.
Also, kudos to you JD for noting that mental illness is just that — an illness.
JD – does your mom qualify for any visiting nurse type service?
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Since I’m still young, I do not have parents that I need to care for yet, but I am seeing the situation play out with my grandmother.
She is my only living grandparent, and she has developed alzhiemers. I know that all of her money is gone, and that may parents are footing the bill for the alzhiemers retirement home where she currently resides. Since they are not “made of money” themselves, I’m sure that this is not easy for them to do. I’m sensing that history is bound to repeat itself when they get older…
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JD – Thank you for being brave enough to talk about your mom’s mental illness. You are absolutely right, we as a society need to talk about it openly.
I have a family member with schizo affective disorder. I try to talk about him openly and dispel any stigma that I can, but it can be pretty upsetting to be met with other people’s ignorance.
Your mom is very lucky that she has a son who #1 is willing to care for her and #2 is able to care for her.
Have you gone to her doctors appointments with her? You might also consult with them and a social worker who can help organize her care.
Thanks again for talking about this tough (and very personal) subject.
J.D.’s note: Yes, I’ve gone to Mom’s appointments with her before. But, as I say, I’m not very good at dealing with this. Mom may not advocate for herself, but I’m not the best advocate, either. Today, my youngest brother is going to an appointment with her. I suspect his may be a role that he’s better able to fill.
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Rather than going into a Medicaid funded nursing home, my MIL moved in with us until her death 3 years later. My husband is one of nine siblings, 4 of whom live within a 10 minute drive from us.
My advice would be to get your siblings on a schedule. Have assigned days and assigned tasks. We didn’t do this and with the exception of one sibling who occasionally helped out, we did ALL of the caretaking.
The reality is one of you will become the primary caretaker, but don’t assume your siblings will chip in with some help, because if our experience is any indicator, they won’t.
By the way, the siblings had no particular grudges against their mother and no good reason to let the burden fall on us. It’s a story I hear time and again.
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J.D. – I hope your Mum is feeling a bit more like herself in the near future.
I don’t really have much to add on specifics, but Lane was entirely right about having the shitty conversations while you still can.
My fiancee’s grandmother suffers from senile dementia and her daughter put off some of the practical arrangements (power of attorney etc.) until it was too late.
Since then her grandmother has developed a real sense of paranoia and distrust as regards money (obsessive natures seem to be brought out by the illness) and refuses to even contemplate it. Which is sad, as if she was in her right mind she’d realise that her family were best placed to look after these things.
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Have that discussion. It’s not pleasant, but it saves a lot of heartache further down the line. My grandfather sewed everything up very neatly, even down to badgering the ministers in his last days so that he could have the funeral he wanted. When he finally went, all my mother and uncle had to decide was the wood for the coffin. Literally. Everything else was organised, or at least decided. It gave them space to grieve, but also assured them that they were abiding by his wishes.
I’ve had some of these discussions with my parents (now in their early 60s). In a lot of ways, they’re not as unpleasant as you imagine, as it can be about making sure their wishes will be heard.
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I’m sorry to hear about your mother’s health difficulties. And, unfortunately, I have nothing to offer in the way of advice there.
Regarding Social Security though, I’d suggest reading the relevant chapters in The Bogleheads’ Guide to Retirement Planning and/or Swedroe’s Only Guide You’ll Ever Need to the Right Financial Plan.
Also, I’d look into annuitizing what savings your mom does have (or a portion of them) via a single premium immediate fixed lifetime annuity–likely one with inflation adjustments. It eliminates the chance that you or your siblings will inherit the money involved, but it increases the amount she can safely withdraw from her savings per year. They can be very helpful tools for people who have under-saved.
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My sympathies. We’re not going through this right now, but we’ve watched my parents (and uncle) deal with this with my late grandma, and my husband’s parents with his grandmothers.
It is definitely true about the waitlists for independent/assisted living facilities. We delayed too long on my grandmother, and by the time she had to go to one, she could not get into a good one (or the excellent nursing home that only served people in the assisted living home). At some point my parents, in their 60s could no longer lift her (when my sister went to college), so she moved in with my uncle and his new wife (who are both saints). Their lives revolved around caring for her and her Alzheimers for over a decade.
One of my grandmother in laws fell, which caused my MIL, a nurse, to move her directly to an independent/assisted living community in MIL’s town. This one is nice because the apartments are all separate one story places with garages and so on… she still has her car. My MIL goes with her to all doctors appointments. DH calls her every weekend. She currently has shingles.
The other grandmother is still living in the house where she raised her large family. Since they almost all live in town, they check up on her daily. But as her breathing gets worse and she gets more frail, they worry. There’s been talk of trying to move her someplace newer and cleaner, but that will be very difficult. The current compromise has been buying her an Austin Air Filter and seeing if that improves anything.
As for advice… definitely look into all the things you mentioned. She may be able to qualify for disability if you think you will need the medicare sooner than age 65, though that will only buy you a year, I believe (as there’s a 2 year wait for medical, I *think*).
There are all sorts of amazing pill boxes on the market… ones that make noise and flash or even page you when a pill hasn’t been taken on time. Hiring someone to check up on her could save you a lot of peace of mind.
Good luck with everything. These issues are very difficult.
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My parents are still working and very capable of caring for themselves presently. Like many parents, however, they have given too much to their children. Weddings, college, help towards first cars, car insurance through college, spend money during high school and college, and on and on and on.
I know that when their time comes to retire, they will not have saved enough for themselves. I can only help that by then I am doing well enough to help them like they have always helped me, and to the extent they deserve.
Best of luck, I watched both my parents go through it (dementia/alzheimers) with their parents as my grandparents aged.
The cycle of life can be very trying.
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JD,
My advice is to get professional advice. I took a class in estate planning last year from an estate planning attorney. There are so many considerations that must be made regarding long term care and eventual mortality. An estate planning attorney will better be able to tell you the most cost effective way to pay for care, the tax implications of the existing estate (and how to minimize them) and helps you navigate the legal and financial aspects of aging. The attorney that taught our class actually received permission from a few of his clients to allow us to sit in on a planning session. It was one of the most beneficial learning experiences of my life, both educationally and more importantly personally. Good luck in your efforts. I know this wasn’t an easy post to write.
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Happily my parents have done pretty well for themselves and planned ahead regarding money, both are also in pretty good health.
But I have had the conversation with my Mom, who lives in the same state but 4.5 hours away, that the next time they move they might want to consider moving closer to us. My Mom, who took care of her parents in their late years recognizes how hard it was for her with her parents 7 hours away, so she is thinking about that issue. She is also thinking about downsizing and moving to a retirment community that also might offer assisted living type facilities and she is also thinking about moving much closer to me, which she would do if her husband died.
My husband and I have also had a very frank conversation with my husband’s father. My FIL is single, not in the best health and lives in Pa. He came down last winter and he is here again, staying in one of rental properties, and thinking about moving to Fla. Basically we told him that we will take care of him in his later years but he has to live within two hours of us which means he needs to move to Fla. We think Fla. would be a better fit for him anyways since right now he is very isolated in an almost rural setting where his interactions are limited.
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I went through a very similar situation…my mother was also mentally ill (Dad more or less looked after her), and her problems exacerbated when Dad became unable to move or speak. (We put them both in care. There was no choice. But the problems do not stop at that point, I’m sorry to say.)
I also have an aunt with schizophrenia (who is capable of living on her own with help), and although she doesn’t live nearby, we talk every day and she will probably move here when her physical health deteriorates.
There are no words to describe how hard this is. You have my sympathy.
A few thoughts, though: if your mom is having trouble remembering her meds then she is not capable of living completely by herself. (that’s experience talking btw.) A daily caregiver stopping in might help. Even for an hour or so. And that way you’d know if any potential problems are developing. If $$ is a factor you can schedule family members to do this.
I sympathize with her preference to live in her home, but at some point other arrangements may have to be made. Or she can come live with a family member.
and to make it all more complicated, depending on her illness assisted living places may refuse to take her. This happened to my aunt, although Mom didn’t have a problem.
Do you have medical POA? I assume you’re on her HIPAA list. A living will is highly recommended; I can send a copy of my parents’ which was excellent, if written for AZ laws.
Scheduling sibling help is critical. If you assume all the burden yourself (because you work more-or-less from home) you will regret it later.
I have lots more advice if you want it. Email me if you have any questions.
J.D.’s note: Thanks, Annemarie. We’ve been working with Mom to find a system that works for her meds. For a long time, she didn’t use a pillbox of any sort. Now we have a big one (but without lights, etc.) that she seems to be using. But my brothers and I have learned that we need to check it every time we’re at her house to be sure she’s taking her meds. Yes, I have medical POA and am on her HIPAA list. We’re hoping to get my youngest brother on her HIPAA list today. Balancing family relationships while helping Mom is interesting. Each of us three boys have different strengths and weaknesses, and we need to figure out who can help her with what when…
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Have you checked into medication monitoring by a visiting nurse? Some health plans cover it. And it may give you a break.
Going through a very similar situation helping a parent with controlled/treated mental illness and multiple physical ailments. There are, of course, multiple daily medications that must be sorted out.
The biggest problem I see in my parent’s situation is family abandonment, this at a time when my relative could benefit from the MOST emotional support right now.
So, social/emotional support is provided by me, and one other caretaker, who I’ve hired.
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One thing to check on, she says she has a will – do you know where it is? Can someone check to make sure it is still valid etc?
My parents are hitting their 70s. I’m not really concerned at the moment about health, they’re in good shape (can cycle/walk for 2-3 hours), and they seem to be ok for money (able to save up and pay cash for a kitchen + 3 bath renovation), and both sides have a history of hitting 90 in pretty good shape (should they avoid poor lifestyle decisions).
So I can’t decide if I am being premature about my concerns that I don’t know what they want (decisions made now will make no sense in 15 years), or if I’m just putting things off that I shouldn’t.
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I’ve seen my parents go through this with my grandparents (We’ve done Alzheimer’s twice now).
I’m not in the U.S., so I can’t speak to specific services, books and blogs that would help (though I know there are many!) But one thing I would suggest is to have a have a life line.
In other words, regularly meet up with a friend who has gone through or is going through what you’re experiencing. People who aren’t in the position of being a caregiver often don’t know what it’s really like, and it helps to have someone who truly understands. I know this is a huge boon for my mom, though it was very hard for my dad to reach to others outside the family.
Caregivers have to look after themselves too, and there are a whole lot of emotions that factor in — a big one being guilt! (Caregivers often feel they are never doing enough).
Thanks, J.D., for calling attention to this important issue. I hope you’ll post more about this later on.
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My main lesson/”advice” is to make choices before life makes them for you. As our parents age, some will want to stay put but that’s not always a good idea and can be dangerous. We realize and appreciate that our parents want to continue in their own home but that should not happen if it’s too much on the family or potentially dangerous for them. I think it would help to have agreed upon triggers for when it’s time to move, i.e. on oxygen, X number of doctor’s appt per Y period of time, etc.
As a daughter of someone with mental illness, I strongly suggest that someone ALWAYS attend doctor’s appt with her and speak up, ask the questions, don’t leave until you understand what is going on, what the pills are for, what to expect, etc. If attending the appts is split among the kids, then keep good, detailed notes in a journal and review with each other as soon as possible so that all the siblings are aware of her current medical condition.
Also, try to work with the natural abilities of each of her children. If one is best with taking care of the finances, let him do it. If one is best with the medical appts, let him do it. We found that it got harder to take care of my mom as she got older due to the increased medical problems and eventual cancer and hospice but we worked as a team. To this day friends and other family members comments on how well we took care of our mom. Try to embrace the change and not let it overwhelm you. Wish you the best of luck
J.D.’s note: I love the journal idea. That’s a good one. It’d help us all keep everything straight. And you’re right that each of us needs to play to our strengths.
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Mom will never want to leave her home, so you are right to want to try and prepare ahead of time as you and your siblings will be the ones making the decision.
It is so hard when your loved ones have complete lucidity one day, and ‘not so much’ the next. The ‘dorm’ type living arrangements usually won’t assist with medication, so if your mom fights meds, she may need somewhere with more ‘help’ if she deteriorates. Assisted Living is very expensive.
There are not good answers. As great as it is to plan ahead of time, some things cannot be planned completely ahead of time. You can get the advanced directive and have conversations with your siblings, but your mom will be the driver in all of this (obviously), as her situation seems somewhat erratic.
Getting someone in to help would be a great first step.
For Shauna, I would look into government subsidized housing options for her parents. There is usually a huge waitlist for that type of housing, so I would start preparing now.
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Thanks for the open, understanding advice so far, everyone. Kris and I agonized for hours over sharing this story today, but your responses have been great. And some of you have the experience to read between the lines very well regarding the specific issues Mom faces, and it’s helpful to hear your advice with similar situations.
If you have advice for Shauna, please share it, too. I used her question as a launching point, but then let my own situation take over. I feel bad about that, and want to be sure she gets answers to her questions about preparing financially for parents who haven’t.
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I just want to say that finding a medical practice with completely electronic records is a godsend in these cases. My ex-husband had a seizure disorder and was a poor reporter of his own medical history. Having every doctor who saw him be able to look through his ACTUAL past history and which medications worked or didn’t really made a huge difference in his care and health.
I went to a lecture by a psychiatric researcher once where she said that the next big breakthrough in the treatment of mental illness was going to be lifetime medical records. Relying on patients to self-report may make people feel better about their care but it also gets in the way of their getting well.
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Shauna, I don’t have any good advice for you except to save, plan, and save and plan some more. It’s good that you’re anticipating this problem now so you can plan ahead. I’ve been saving aggressively and also purchased long-term care insurance for my Mom (my Dad couldn’t qualify, unfortunately). The tough part is balancing this with planning for my own care as well since I’m single and an only child. I’m scared that I won’t have any support, even emotional support, to fall back on either now or in the future. It’s not fun to think about, but it’s better to plan now instead of reacting to surprises later.
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I’ve cared for both of my parents in various ways. After an aneurysm my mom experienced severe brain damage resulting in physical paralysis, dementia and memory loss. Because I didn’t have any debts (except student loans which were deferred)I was able to quit my job and be her full time caregiver for three years. After her death she left me $$ that I used to pay for my father’s medical expenses (those were her wishes).
I identify strongly with your comments about wanting to help and feeling inept. Like anything else you get better with practice but it is incredibly overwhelming at first. In the end I just did my best & tried to let my decisions be guided by love. I made lots of mistakes & was far from perfect – but then so did my parents when they were raising me & I turned out OK.
Becoming informed and having those shitty conversations is a good step. Another conversation I would recommend is about end of life decisions. I’m ever so grateful that when the time came I didn’t have to guess what my mom’s wishes were because she had been quite vocal before becoming disabled.
As far as financial aspects. Before moving in with my mom, brother #2 agreed to pay me a small monthly stipend/salary. Brother #1 was in financial trouble so he agreed to stay with mom on Mondays to provide me with respite. Caregiving is tough work and after a year brother #2 rescinded his agreement so we found an adult daycare facility because I firmly believe if I don’t take care of me then I won’t be able to take care of you. I was able to claim my father as a dependent on my taxes and deduct his medical/insurance bills.
If I was interested I could calculate how much $$ I lost by leaving the workforce and suspending my retirement contributions. Ultimately though I made the right decision for me – and I believe it was also the right decision for my parents. Although incredibly challenging, I’ve never regretted the choice I made to stay with mom and later support my father.
Keep having those conversations with your family & enjoy the moments you have together. I wish you the best.
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“My mother is 62 years old… she’s eligible to receive Social Security benefits soon”
Soon? Isn’t she eligible right now?
SS says “You must be at least 62 for the entire month to receive benefits.” (http://www.socialsecurity.gov/retire2/agereduction.htm)
J.D.: You’re right. What I ought to have said is that she can begin drawing benefits, if needed. Again, I need to talk to her about this. (It’s better to wait, if possible.)
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One recommendation for Shauna (and others), I’ve noticed a huge difference on medicaid nursing homes based on location. Near my parents, they are really good (small town). Near me (suburban city)…not so good and you need to pay OOP for good care. It might be helpful to look around now at the options. Just a thought.
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J.D.: You rock, Jessica! Great suggestion.
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Your friend has given you some very good advice. I can add two more things to your list that will help.
First, as things come up, contact your local Area Agency on Aging. Our local group was my lifeline while I cared for my mom. Through them we were able to get a housekeeper, who came in three days a week, a home nurse, help with insurance, ect. She lived in an independent living facility.
I did all her shopping, laundry & took care of any dr app., ect. The nusre came in to do needed treatments, sometimes on a daily basis, so I didn’t have to keep up with it every day. The housekeeper helped with personal hygiene when she reached the point to need help & cooked meals. She was able to stay alone at night.
The Area Agency on Aging can tell you what’s available in your area, how it can be paid for, help with your insurance, ect. They give you a ‘boss’ to call if you have any problems with anyone who works with your mom. They went out of their way to find a housekeeper that fit my mom’s personality. If she was uncomfortable, they sent someone else until they found someone she was comfortable with.
The 2nd thing is to take advantage of funeral planning if you can afford it. I helped plan my first funeral when I was 17(my dad). It took yrs for us to pay it off. My mom chose to prepay when she sold her house & moved 1000 miles to live near me. She had almost no income so she used money from her house to prepay & it was one of the best gifts she ever gave me. It took such a load off of her too. She talked about it often, telling me she was so glad not to add that burden to me.
It is never easy. Sometimes I had to tell my mom no to things she wanted me to do for her when I could get someone else to do it. My son was about 7 when I started caring for her & I had obligations to him so I had to choose between them many times. Just do your best, ask for help when you feel overwhelmed & try to enjoy the good moments between the hard ones. Those are the ones you will cherish years down the road. HTH
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Sometimes the greatest gift we can give to ourselves and our children is the chance to have your elderly parent move in. I was able to get to know my grandmother this way. In some ways this does put a burden on the middle generation, but there are some benefits that help to compensate for the additional work. For instance in this case JD would be able to moniter his mothers daily pills, JD and his siblings could start the process of sorting his mothers bills and less important items, and finally you have the chance to spend the golden years of your mothers life with her. Since most people have insanely huge houses, there is a good chance that she can be mostly independent and still have you all keep tabs on her. I would consider assisted living for a elderly relative who is so difficult to live with that the potential arguments outweigh the benefits.
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If you can afford to hire a geriatric care manager that would be another great resource to review your loved ones’ needs and identify potential care options. In my area the cost is probably in the $150-$200/hour range, not sure what they cost elsewhere. You can locate on here: http://www.caremanager.org/
The National Council on Aging offers an online screening for subsidized programs at http://www.benefitscheckup.org/
Every state runs different programs and regulates elder care resources differently. I suggest you contact your state’s agency on aging and your local area agency on aging to learn about what is available in your area. Many states are now offering Medicaid Waiver programs which allow Medicaid-eligible elders to receive care in their homes. However the wait lists are quite lengthy. If you think you might be interested then get on the wait list.
Other care options not mentioned here are adult day health care and the Program for All-Inclusive Care. ADH offers a center where older adults can go one or more times per week. Many offer some assistance with person care (such as foot care, which can be a major issue for elders), a meal, activities, and support from a nurse and a social worker. Cost is around $40-50 per day, plus more for transporation if available. Gives respite for a caregiver, and allows the elder to remain at home. May be covered by Medicaid for eligible elders. Locate one at http://www.nadsa.org/
Program for All-Inclusive Care (PACE) is not available everywhere, but is a godsend to those who have it. Learn more here: http://www.npaonline.org/website/article.asp?id=4
JD, I’m sure you know that older adults metabolize medication differently than mid-life adults. Please keep this in mind with your mom. You might consider seeking out a geriatrician (physician specializing in care of older adults) in your area. They are hard to find, because there are so few and the work so intensive. But with their special training they might be able to help you keep on top of the med issue.
Good luck!
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My husband and I are in the midst of struggling with our parents’ aging. I am also a gerontologic nurse practitioner working with elders in the community, assisted living facilities, and nursing homes, and worked previously as a geriatric care manager. You’d think that would help me, and it does, but there is so much emotion when caring for one’s own parents.
I suggest you look into professional care management services. These can be found through your Area Agency on Aging, many local groups such as Jewish Family Services, and if your parent’s income is low enough, and her needs high enough, through your County Social Services department Home and Community Based Services. A one time evaluation of your parent’s needs and care plan done by a professional who knows the local resources is not as expensive as you think, can relieve stress for you, and can save you money in the long run. You are not alone in this!
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My grandfather was a supreme court judge, and when he died, everyone assumed that his will would be (1) easy to find, and (2) airtight. Not so. Had we not been a very close family, the state of my grandfather’s legal affairs would have very problematic. Make sure you’ve asked where the documents are, at the very least.
Be prepared for your parent(s in Shauna’s case) may not want to have these conversations either. That’s hard, but forcing them leaves you both feeling guilty and sad. If that happens, continue to keep communication open but start making plans financially to put money on reserve. It’s better to have an emergency fund capable of softening this blow then to continuously stress yourself and them out wondering if it’s going to happen. So if at all possible, review what it is you would and could contribute, and save for it as you would your kids. Best case, you don’t use it, but this is the reality of your family and your peace of mind is worth it.
It’s easier to be a health advocate if you’re informed. Next time at appointments, ask for advice on resources. Hospital or Uni libraries and searches through engines like google scholar can be good steps towards informing yourself to the point where you feel like you know what questions to ask. When in doubt, ask the doctor, “I sometimes help my mom with this medication – what do i need to know?”. Another good approach is to say, “can we review the medications my mom is on?” to make sure you understand dosage and consumption guidelines and side effects.
Finally, lead by example. If you raise the topics and apply them to yourself or ask your parents for advice on finances, they may be more ammenable to talking about it then if you just came out and asked “what do you have saved for retirement?”. Parents are parents always, and they want to be there for you. By recognizing that emotional need, you may fare better with the hard conversations.
Finally, I echo researching facilities well in advance. It may also help your mom by giving her time to process the idea.
Those are my thoughts for what it’s worth. I wish you all the best.
I very much agree with keeping records of conversations with health providers, as your mother may become less reliable as time goes on.
Look at getting connected to your mother’s banking if you aren’t already rather than just assisting her with her bills; should something happen unexpectedly, you may find it hard to pay debts or get access to accounts – my friend’s mom is going through that now with her husband.
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I have never commented before but this one hits close to home. Since March 2010 my husband and I have been assisting my very ill father and my mother who is his primary caretaker. All of the challenges that Mr. Roth explained above exist but in addition I am located in Chicago and my parents are in St. Louis and none of my siblings are close. We have taken over all of their financials. They have wills, durable power of attorney and livings wills established which is good. The single most amazing discovery to me since March and through this journey is that there is not a SINGLE organization that is designed to assist in these situations other than facilities or hospitals. Even if I wanted to pay (which I would…) a consultant or organization to help advise and guide me through finding live-in caregivers, vetting facilities, attending doctors apptms, managing meds, etc. it is impossible to find truly reliable professional help – at any cost. I think there lives and breaths a new business model in there somewhere. In any case, I agree that are are no easy answers and we have figured it out as we go by making sure one of us goes home once a month, managing all financial decisions and making sure caregiver mom does not become overburdered and sick herself. Good luck to you with your mom…
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I’m 30 and live at home so that I can care for my mother (who is in her 60s and terminally ill due to a medical mistake), as well as my grandmother who is 94. My father works the night shift so I never see him but he is around during the day and I am there in the evenings.
Aside from the remarks from family members about my “free ride” (yeah right) from living at home, things aren’t that bad. We have a small house that should have been paid off years ago but my parents are terrible with money and it’s only gotten worse. Everyone has insurance but my mom’s bills exceed $40K per YEAR over and above what the insurance covers. I have paid what I am able to, and begged and borrowed to keep us afloat but it’s getting to be a situation that I do not see a relief from.
I am in debt because of my family, I carry no personal debt other than credit card payments that I made to my mom’s doctors so they would continue to treat her. I have $20K in student loans that would have been paid off long ago if not for trying to keep everyone else financially stable.
I have an older brother who is married with kids (I am single/no kids), and he does yardwork and such but is not asked to contribute because he “has a family”. I am starting to resent my role in the family and equate it to a prison sentence.
Everytime I build up my emergency fund, vacation fund, or even just pay off my credit card some catastrophe comes up and since I’m the only one who actually has money, I end up paying.
I want my life back but at the same time I don’t want something to happen to my mom or my grandma and then I will feel guilty forever for not being there or supporting them. I have a very understanding boyfriend who is supportive but I know that I want to move out within the next year and I can’t/won’t take them with me.
I have no idea what to do from here, there is no way this house will sell right now and even if it did we would probably lose money because of the medical bills still owed. I feel like my life is going to be forever on hold and I’m struggling to do the right thing for everyone.
Sorry for the long post, I was just hoping someone would have advice. Best of luck JD, it’s such a difficult role to fall into.
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I’ve thought about this issue a lot. My mom took care of my grandma. She lived about 2 hours away and drove over all the time, coordinated medical visits, etc. She is also fortunate enough to be self-employed in a role that allowed her to schedule as needed and still be a caretaker.
This makes me nervous. With our cultural background, it is traditional for the eldest to take care of the parents. This is not always the case now, but my mom is the eldest, and she fulfilled her role quite admirably. I am the eldest, too, and there is an expectation that I will do the same for my parents. I do not see ever doing anything like the job my mom is. My career does not have nearly the flexibility that hers does. I also get along terribly with her. I love her, but we communicate very poorly.
It sounds absolutely dreadful, but I don’t think I could deal with having her live with me. She doesn’t make much money and gets very agitated if I inquire. I want to make sure she has enough to live elsewhere when she retires. I am not sure what financial burden will fall on me, but I am sure there will be some expectation. I am high (and youngest) on the list as health care proxy and I do want my mom to have her wishes carried out, but it is very difficult to have this sort of conversation.
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I am so sorry. My husband and I haven’t had to deal with this yet, but everybody in these circumstances has my complete sympathy.
I can only imagine how difficult it would be to approach my mother if she was feeling so vulnerable…she’s a strong woman who will not age gracefully in my opinion and will not let anyone help her…
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Jen gave great advice on contacting your local agency on aging, or whatever it’s called in your area. My mom was a geriatric nurse, my sister is an in-home care provider, and I took care of both of my grandmothers for the last several years of their lives. One thing we’ve all noticed is that family members are usually poor judges of an elderly person’s state. Hope, and history, seem to blind people to the ever-changing realities of aging and illness. What works for a few years, or months, will stop working and you’ll need a new solution. Care workers know the signs of more serious problems that you will miss, and they can share their observations with you, which will allow you to make better decisions. I strongly recommend switching to a psychiatrist who specializes in geriatric patients, and replacing her normal doctor with a gerontologist, because they’re used to tweaking prescriptions to accommodate other aging-related drugs, and they’re much better diagnosticians for the elderly. Normal doctors will miss a ton and drive YOU crazy. Her issue with taking meds is a serious one – it’s the main reason my sister has a job. People can often manage everything but that. You are thinking about this in good time – before a catastrophe. Keep chugging along, and learning about her options, that’s all anyone can do.
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Thank you, JD, for sharing your experiences coping with a parent with a mental illness. I appreciate your openness–this is how we begin to break the stigma that surrounds mental illness and actually help each other.
Have you tried reaching out to your local affiliate of NAMI (National Alliance on Mental Illness)? They may have resources for you that could help you meet the needs of your mother’s physical and mental disabilities. Many also have support groups for family members.
As to Shauna’s question, I think this requires a frank, uncomfortable conversation with her parents regarding the future and how EVERYONE’s needs can best be met.
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I’m already in a lousy mood this morning, so I probably shouldn’t even post about anything. My dad is almost 84 and has been steadily declining mentally for more than 9 years. Mom died about 14 years ago. Dad has done really well on his own and is pretty well set financially thanks to a lot of planning he and Mom did earlier on in their pre-retirement lives. Dad’s financial adviser, of all people, noticed Dad’s decline and contacted me about it a few years ago. Then, with my profuse thanks – because I really had no clue what to do – the financial adviser met with Dad a number of times (and I’m sure they were difficult meetings) and convinced my father to sign a POA (naming me) should things continue to get worse. I’m relieved it’s in place but scared to death about what I’ll actually have to do when the time comes. Dad’s always been the pillar of strength and knowledge in our family. He’s also an Irish redhead
and exceedingly stubborn, short-tempered and independent. It’s not going to be pretty, and I’d love to keep sticking my head in the sand. My sister, who lives across the country, is yakking at me to DO something because the last time she talked to Dad, he didn’t recognize her voice (he doesn’t recognize mine at times either) and it freaked her out, so now I have to DO something about it. Dad lives about 2.5 hours from me, which is just far enough to make commuting sort of a PITA (esp in the winter – going over two different mountain ranges), and my visits with Dad have gotten increasingly awkward and unpleasant.
Meanwhile, my husband said Dad will never come and live with us. Period. End of discussion. Which doesn’t really help me a whole lot in the stress department, since I would normally think of that as one option.
I’m just as lost as anyone in how to deal with all this because it keeps looming closer and closer like a train bearing down and there’s no way to get off the track
So I read your post with complete sympathy for your and Shauna’s situations, and not a speck of help to suggest. Profuse thanks to everyone who has commented, and I hope there will be more – I’m taking lots of notes!
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Here are just a few things I learned in the process that may be helpful to Shauna, JD, or your commenter, Supporting Parents.
1) Keep your personal finances separate from your parents as much as possible. Although you want to help, you are not responsible for someone else’s choices and you don’t want to be bullied by collections agencies into paying bills that are not yours.
We have payed some of my mother-in-law’s debts but they were much greater than we could manage on our income. Sometimes you just have to allow things to take their natural course, even if that means bankruptcy. It is not a judgment on you.
2) Connect with local social service agencies. Sometimes you can get good advice and your parents may hook up with lots of other help. Having someone come in to clean Barbara’s apartment meant we had more time to deal with medication and health issues and bill paying.
We are very thankful for the many services in our community. We could never have done everything we did for Barbara without their help.
Since Barbara’s death, we have allotted a significant portion of the money we previously used to support her to charitable gifts to agencies that helped.
3) Recognize that you can’t make your parent happy. We alternated between running every detail of Barbara’s life so things would run smoothly to just letting her do what she wanted. Neither worked well. But sometimes we just had to recognize that Barbara was responsible for her own happiness and we couldn’t make everything perfect for her.
4) Ignore advice from well-meaning strangers. My husband was deeply hurt when doctors, priests, neighbors, and others would tell him what a terrible job he was doing caring for his mom.
Inevitably, they would step in to try to make positive changes in her life to give up after a short time when they realized Barbara was her own person and no amount of support was going to make her live the way others thought she should.
I know that only the first two suggestions address financial concerns and may be the only ones helpful to Shauna. But the strength of this blog is its recognition that our financial choices are not all about the money.
Thank you, JD, for being so transparent. I would have really appreciated hearing about your struggles a few years ago when I was sharing them. I hope other readers benefit today.
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completely agree with the plan ahead thoughts – you could use the health crisis of a family friend or even celebrity as an excuse to bring it up. Siblings may surprise you, when we did this with the healthy in-laws a few years ago, my social worker SIL had the most challenging time with it.
Most of my comments may be more crisis-oriented or start-of-process (could someone write the “Dummies’ Guide to Family Health Crises”?), since that’s where my experience is so far…
1-if you are lucky enough to have nurse or medical professional friends, ask if they would be willing to come to appts with you & your parent. IF your parent would be open (tricky with mental illness, but worth at least thinking about). My mother was adamant about NOT involving her sister in care decisions, but happy to have a nurse friend come with her & my father to appts. Yes, it’s more paperwork (HIPAA) but can be very helpful, especially since as non-family members their emotions are less likely to blot out info flow/retention
2-Some time/effort spent to coordinate across different health care providers of the parent is worthwhile imho. electronic records are great, and may surmount this issue we found – some physician’s notes may get stuck with individual specialists if the note doesn’t rise to the level of diagnosis – in my mother’s case, an attending nurse didn’t realize that she had cancer (she wasn’t in the cancer ward, had been admitted for adrenal failure, and the cancer hadn’t been specifically diagnosed – they knew she had cancer, but not what type). Many folks have multiple health issues as they age, and sometimes it is unclear which one is more important (once at the emergency room the attending physician put my mother back on her heart medication, which she had been taken off to address the adrenal failure – in the vast majority of cases putting her back on the heart meds would be the right thing, but not here – luckily was rectified within hours).
3-anytime a parent is at a hospital or residential care center, try to connect with the social worker on duty (term used to be ‘case worker’) their job is to help families work through health care issues, and they can refer you to community resources that will help long after your parent leaves the facility
4-see if your parent’s doctor practice has a gerontologist/senior specialist – my mother’s did (an RN), but we didn’t know this until her health was quite deteriorated – because her decline was quick, and she was relatively young, she didn’t have reason to know there was a gerontologist at the practice. Even late in the game, was very helpful – the RN came to the nursing home to help my parents make care decisions, etc.
5-in terms of skill sets, and depending on family/community, reach out as far as you can. I am an only child, and many of my cousins were very helpful (especially once I started communicating directly, rather than through my Aunt). Even found high school classmates of mine at the hospital – I’m sure they would have been helpful to any patient, but it did make me feel better! See #8 below, as well
6-don’t ignore baseline tests, it’s the only way we found out about my mother’s physical brain deterioration (we were too close to it to realize what was happening, I know that sounds incredible but it was true-we just chalked it up to my mother’s “strong” personality)
7-most communities do have great public resources (council on aging, etc) definitely seek them out – also, local clergy can be helpful in terms of knowing what resources there are, and depending on how close your relationship is, as counselors/advisors. Also, most communities have at least one non-profit visiting nurse organization, they often have great advice even if your parent may not need or qualify for the service
8-consider reaching out to high functioning friends of parents (could be tricky or less helpful in case of parents with mental illness, use your judgment) – with my mother’s illness, my parent’s friends were incredibly helpful – one woman became the care/visiting/dinner for Dad scheduling point person because she was happy calling people but not comfortable being with my mother
9-be very aware of the health of the caregiver parent; sometimes personal observation is the only way to keep close tabs (especially if your parent/s are of the uncomplaining type)
10-more of an aside than a tip, but in my mother’s case she would not admit to pain if a family member was in the room. I learned to clear out all but health care professionals when any came to check on her status (we could still eavesdrop from the hall). Also, I noticed my mother would get a bit squirmy/raise her arms when she was uncomfortable, and told the nurses to look out for that.
11-not sure if this is helpful to the parent necessarily, but I felt better gathering as much info as I could, so I talked up any warm body in whatever facility my mother was in. Nurses and physician’s assistants often have more time to talk than do Drs.
12-funeral costs, luckily my family is comfortable with cremation. In many areas of country you can pay a membership fee while alive and get drastically reduced fees for a simple cremation, then you can hold a memorial service at your leisure. Obviously this helps ONLY if your parent is solidly okay with cremation.
Good luck to us all!
J.D.’s note: Wow. What an awesome comment. Thank you.
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My daughter is only three, and we’re in our thirties, but this is something that I’ve been aware of for a long time. In fact, a year after my daughter was born, we bought a house with my mother.
My mother still works (22 days of 28!) but she’s getting older (58 this year). This is a great way for my daughter to know my mother, and I know that I can keep an eye on her as needed. I cook all her meals, help her with her cleaning, run her errands, etc.
In my grandmother’s (97 this year!) case, her oldest son moved in with her after my grandfather died. However, my uncle is in his 70s, and it turned into a no-win situation. They ended up hiring a caregiver 4 days a week. Eventually my grandmother fell, and my aunt (who lived across the street), helped her find space in a nursing home. My grandmother hates it, but for my aunts & uncles, it was the best solution. My aunt has the power of attorney, and durable medical power of attorney.
My grandmother, however, has already taken care of the funeral, and there are no possessions worth speaking of.
My mother has a pension from two sources, and social security, so she’ll actually be taking in only slightly less than her current earning power when she retires.
My in-laws, on the other hand, are a mess. My MIL has a severe genetic illness and has social security-disability & Medicaid, but my FIL has nothing, and doesn’t quality for social security. It’s likely that she’ll die first, and then we’ll really be SOL, because he’s untreated, severely mentally ill.
And then there’s my social security-disability sister-in-law who is also severely mentally ill. Both she and my FIL are anti-social, to boot.
And then there’s her kid….
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All of the comments have excellent suggestions. Speaking from experience, I would say that the most critical part of this is a plan for backup assistance for YOU that protects your livelihood.
If you know that you can be called away at a moment’s notice to assist your parent, you need to make sure that your work continues smoothly. You should have easily accessible/understood notes and work flow docs for current and pending projects that you can direct a co-worker to by phone or email. If you feel comfortable discussing your situation with your employer, work out a specific plan for short term emergency telecommuting and access to your company files through secure intranet.
If you are an independent free-lancer or have a small business, this is the time to have a trusted family member or friend develop a knowledge of how to keep your projects and business going temporarily without your 24/7 attention. As above, have notes, docs and work flow plans and client contacts immediately accessible. Set aside regularly scheduled time to go over with them, what is current with your work. If you can afford it, hire someone part-time who you can have handle some of the smaller client contact aspects of your work before your anticipated absences. An already familiar assistant who can handle calls, pick up/deliver critical documents and generally prevent/soothe client nerves will provide protection to your work. If appropriate, now is the time to develop a partnership with a colleague who can provide coverage as in a doctor’s practice.
I’m in a similar situation. Having dealt with the decline and death of my husband’s parents and my father, I am now dealing with my 82-yr old mother’s health and household issues. I am currently searching for a partner who can start working with me to cover some aspects of my freelance projects for the times that I must be away.
To use the already worn airplane oxygen mask analogy, protecting your ability to stay financially solvent is the best thing you can do for yourself, your spouse/partner, your aging parents and your kids. You don’t do anybody any good if you lose your job or your career.
J.D.’s note: Even though I haven’t flagged it, this is a great comment, too. I’m fortunate that Get Rich Slowly is now a team effort, so I know the blog can function on its own, even if I’m distracted for a week or two. HOWEVER, I really need to get a small supply of backup articles for emergencies. Right now, my solution is to ask for guest posts or to re-run articles from the past.
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This was an interesting article. This is a difficult subject and I’m interested in everyone’s answers.
My 87 year old mother (Happy Birthday today!) moved in with my husband and I a year ago. She had not been taking good care of herself, got run down and had a fall. It was determined that she didn’t need a nursing home, but could no longer live alone in her elderly housing apartment. She was also a six hour drive away and it was becoming apparent she couldn’t be alone.
We live in an apartment , so we got a larger one, with enough room for her to get about with her walker. She pays us room and board.
I have POA and take care of her bills. She qualifies for a personal care care attendant to come bathe her and do little odds and ends for her 3 times a week.
She is in pretty good shape physically, but I’ve noticed the dementia has increased and I dread the day we are no longer able to care for her.
Nursing homes and assisted living centers are very expensive. Just not in our budget. Mum’s income couldn’t afford and neither can ours.
While day to day life has its trials I feel that we made the best choice and I feel confident that we will continue to do that, whatever may come down the road.
I should add, that I am disabled due to a heart problem, and while I am fortunate to be home, it can be difficult.
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Get a trusted family attorney who can assist you in development of a plan. I am not an attorney, so this is an unbiased opinion.
You need an understanding of certain legalities that I learned the hard way. Health directives are imperative and take strength to execute. Make sure the appointed person has the fortitude.
Power of Attorney expires at death, and an estate executor takes over. Give thought to this assignment. The “oldest” isn’t always the most qualified. Best way around this is to make sure you are listed as an owner on all bank accounts.
Consolidate bank accounts to simplify things. Review all beneficiary designations. When banks are bought out and accounts transferred, beneficiaries are often not applied to the new accounts at the new bank.
Don’t rush in to creating trusts etc. These are expensive and are way too complex for a typical situation with limited assets.
If vehicles are involved, set up transfer on death designations on the car titles. This is accomplished through your local DMV.
Keep in mind lots of people go through this, so your particular situation (whatever it is) has probably been dealt with before. Again, this is where a trusted attorney can provide peace of mind that you are handling it in the proper fashion.
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I’m in a similar situation; my mother is mentally ill and failing physically, and is flat broke. I’ve been caring for her in various ways since my early 20s.
It’s been said above, but to reiterate, there are two major, major steps to take:
1) Gather a support system. Get other family to help. If she has friends, have them visit. Is she a member of a faith community? Get them to set up a rotation of visitors and helpers. This is not the time to be shy. ASK.
2) Look into what she’s entitled to from the government. I pay my mother’s bills myself now, but when I was just out of college, I looked into her SS, SSI (which your mother is entitled to if she was disabled from working, as mine was), SS from a deceased spouse, etc. Get her on food stamps. Get her on Medicaid. Find out from the Agency for the Aging (as someone suggested above) if she can get an aide a few days a week to help with daily tasks (cleaning, cooking) or living necessities (bathing, going to the bathroom, etc. – these are two different kinds of professional caretakers.) My mother’s medical bills are over 100K/year – obviously I don’t have that stowed away under a couch cushion, and Medicaid has been a huge help.
The hardest part of all of this is that although you’ll want to respect your mother’s wishes, at a certain point you’re going to have to make decisions she doesn’t like – meds that help her but make her feel shaky, having a nurse “intrude” in her home. Sit down with your family brain trust, decide what has to happen, and do it. It’s hard, but you won’t do her any good – and will drive yourself nuts – by convincing yourself to agree that she shouldn’t take her meds or have necessary help.
I would definitely suggest, if your finances allow, hiring an eldercare consultant – there are folks who can help you find resources and make decisions. My office hooked me up with one, and it was a HUGE help.
Good luck, Shauna and JR.
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J.D.’s note: Hey, everybody: Crystal is looking for advice, too. If you have any tips for her situation, feel free to add them to the comments.
My MIL had her kids very late in life- my husband (the youngest) is 35 while I’m 32 and my MIL is near 80. We are not financially stable with 2 kids under 5 and I’m terrified what will happen in the near future. His 2 older siblings (40 & 45) are severe meth addicts and as of now SHE at 80 is still caring for both of THEM in her home as they cannot function in society. We know we cannot count on them to help as she declines..but the reality is if WE shoulder the financial burden she will create soon (no savings and is currently losing her house)that will mean both ourselves AND our kids will suffer- both now and in the future when. Do we help her at our kids expence? And what happens to my dear junkies-in-law? Certainly we cannot take them into our home as well (WILL not is more the truth). What are our options in regards to the 3 of them? Help my MIL and tell the junkies ‘onto the streets with you!’? Just let the state take over? I feel evil saying ‘well she had her whole life to prepare for this-let her sleep in the bed she made’ but at the same time….the path she chose was her decision. Should we have to go into debt over her life choices? Should OUR kids suffer for a sence of maternal duty to her?
JD you touched on a very raw subject but I thank you for it. And ANY advice ANY of you have would be so greatly appreciated
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Hi JD,
Hope you guys can work this out. The Mrs’ grandma was in a similar situation and they arranged for her to live in an assisted living center. It was expensive, but I think it was worth it.
My parents are still doing pretty good. They live in Thailand so they have public health care. I helped purchase a rental condo for them so they can have a stable income to help pay the bills. I know it will get more difficult, but for now we are doing ok. Hopefully they can move in with us at some point.
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Great post J.D. — very real and vulnerable. My husband and I are in a somewhat similar situation (some variables are different).
My husband is an only child and his mother is a widow. Lives on her own, but no longer drives, so we are her main support for all the necessities of life.
While we feel honored and blessed to care for her, we too find it overwhelming and stressful at times. We basically care for two houses and we still have young children at home. We are the sandwich generation.
One thing we find hard is the lack of time to sort out some of our own things (like budgets, etc.) I know that sounds like an excuse…and we are trying to do all we can to focus on our finances and planning… but the reality is there are only so many hours in the day.
We do the best we can. We love my mother-in-law dearly. But it is hard at times. Anyway, thanks for writing to it!
We did get pro-active and worked with my mother-in-law and a lawyer to make sure all the necessary paperwork is in order to help her last years go smoother from that standpoint. Also, I drew up a master grocery list for her, so she can simply mark the items she needs. Little things like this help.
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Thanks to all for sharing their own stories and advice. I’m looking forward to more discussion on the topic. Whether your parents have planned financially for this or not, at some point the kids definitely need to be involved in long-term care decisions.
My parents have prepared fairly well financially and legally — they have at least a partial plan — but they live in another city and my brother and sister live even farther. Most of the responsibility will fall to me, I’m sure, and I don’t know what I’m going to do logistically when they need long-term care.
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JD – you seem like a wonderful son to your mother. She is blessed to have you caring for her and worrying about her future.
My own parents are as you describe in this post, they have no savings and no retirement plans. Both have remarried and both are in similar situations, but my dad will see a substantial inheritance from my grandparents and his wife is much younger than he is so I don’t worry too much about him.
My mother and her husband on the other hand are a constant source of concern. I have more than once paid for their health insurance (they are 62 now) premiums because they couldn’t afford it and I didn’t want them to be cut off in the event of an emergency. I have given them money to their mortgage when they would have missed a payment. They have no credit as it has been trashed. I had to pay in full for a car that was repossessed after they missed 3 payments in a row.
Were the situation reversed, there is tons of advice for parents with children who depend on them. I never see anything about children who bail out their parents constantly. And there is no health problems or gambling or drug addiction, they are simply bad with money (making too little and spending too much). I don’t give them money for luxuries, but I do for as I said, mortgage or health insurance.
Suze Orman’s books do discuss this and say that you should give money to your parents. That’s about the only advice I’ve seen out there.
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For anyone whose aging parents are veterans, don’t forget the “Aid and Attendance Benefit.” The application process is time consuming but it can be extra help for vets or spouses of vets. Check with the VA for specifics. It’s a benefit that is not well publicized.
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I don’t have any advice, but I wanted to say thank you for this post. I hope you’ll do a followup (or several) that summarizes everything you learn, through advice or through experience.
My last surviving grandparent has recently been diagnosed with Alzheimers, and has had a few scares lately. Luckily, she had 11 kids (half of whom live nearby), who alternate the responsibility of taking care of her. My dad has done her taxes/etc for years, so he he knows all the details about her finances, which makes a big difference. My gram is a very independent person, so consenting to all this help and all the restrictions (no driving) was the most difficult part.
But I worry about what my husband and I will be responsible for in the future. My FIL is only 50 and already has terrible lung problems from smoking, and he is/has been the sole provider for his family. When he is unable to work someday, or racks up terrible bills from (likely future) lung cancer treatments, I worry about what will happen with my MIL – she won’t be able to support herself (SAHM for 20+ years, with small side income but no career), so will we have to support her? Who knows?
My parents are another story. My dad is great with finances and saving, but my brother and I have never had to discuss any of it with him. If heaven forbid something happened and they were in a car crash or otherwise incapacitated together, I don’t know if my brother and I would know how to sort it out. I don’t know who is their power of attorney or whether they have a will (or where it is stored).
These are intense and uncomfortable things to think about. It is kind of depressing to think about these things while we are so young (mid twenties), but it beats stressing about them in the heat of the moment when something bad happens.
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I helped take care of both my parents during their last years, and without a doubt it was the most difficult job I have ever had. The dynamics of the role reversal can be draining, let alone the tasks involved. We were lucky that neither one required nursing homes nor they had more than adequate insurance coverage. My advice would be to ask questions. There are many services available to seniors that most simply are not aware of.
What I can stress to anyone facing this task is to get things in order while your parents are of sound mind and relatively good health. Ask those difficult questions of what they want to happen if and when such decisions need made. Have legal documents in place before you need them. Pennsylvania has Area Offices on Aging to assist older adults (62+) and their families with a number of issues. They refer to a non-profit legal group as necessary and can help in evaluations for in home care, assistance and facility placement. I am certain other states have similar agencies. Many don’t realize that utility companies offer special programs for seniors and folks with chronic illnesses that can be a little break on paying those mounting bills. Do not be too proud to ask for help!
If your loved one has been diagnoses with a specific illness, contact the agencies devoted to care, information and research for said illness. They have done the legwork to put together things that you may need help with, specific to that illness.
Lastly, and most importantly I have got to mention to think outside the box. Not just for help for parents, but what about friends and family members who are alone. As I have said, don’t be afraid to ask questions. Sometimes you have to push the medical professionals to run the right tests, order the in-home care, whatever the situation may require.
I have a situation with a friend 56 years young who never married, has no children and who is estranged from some of his siblings. Going back two years now, I recognized some startling changes in behavior and after several months of trying to get him to seek medical help, I finally got family involved. Two long years later the diagnosis is bleak – he has ALS and dementia. Within a few short months of the diagnosis he is in a special facility that will provide care for him. His brother who finally stepped in and began helping him had the fear that he would have to carry the financial burden for all of this. Not true in a lot of ways. He finally put his fears aside and began the process to apply for Social Security benefits. The process to attempt to get Social Security Disability benefits for my friend was exhausting. On top of this, he had no will, no power of attorney, nothing in place for such things as were happening to him. We think are all invincible, and we think have many tomorrows, but truth be known, we are not invincible and those tomorrows never come.
After going through all of this with my friend, I have urged my other friends and family members to take stock, get things in order and set things in writing. Here, a local community college offers an estate planning class. Own a car? Have a bank account. Congratulations, you have an estate. For a small fee an attorney can draft a will, a living will and set up power of attorney paperwork. One of the best investments you will ever make.
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