Caring for aging parents

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.

Note: In some circles, mental illness is a taboo topic. Just as many folks consider it gauche to talk about money, some think it’s best to keep discussions of mental health out of the public arena. That’s too bad. It doesn’t help anyone to hide these problems. It’s only through sharing our experiences honestly that we can learn to cope effectively with these situations.

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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