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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There are 157 comments to "Caring for aging parents".

  1. s says 18 January 2011 at 04:21

    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?

  2. Derek says 18 January 2011 at 04:37

    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…

  3. Kate says 18 January 2011 at 04:57

    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.

  4. Mom of five says 18 January 2011 at 05:40

    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.

  5. Luke says 18 January 2011 at 05:41

    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.

  6. SF_UK says 18 January 2011 at 05:45

    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.

  7. Mike Piper says 18 January 2011 at 05:46

    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.

  8. Nicole says 18 January 2011 at 06:03

    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.

  9. brokeprofessionals.com says 18 January 2011 at 06:04

    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.

  10. chett daniel says 18 January 2011 at 06:07

    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.

  11. Sam says 18 January 2011 at 06:17

    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.

  12. Annemarie says 18 January 2011 at 06:18

    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…

    • Sheila says 15 April 2012 at 03:25

      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.

    • Jennifer Chamberland says 16 January 2020 at 06:34

      It is so important that you discuss what your elderly adults want. You want them to feel their “wants” are respected. Just placing them , takes away any independence they have left and may make them resentful. My mother who died at 84years of age lived in our family home until she died. She had a housekeeper, gardener and all of her 7 children checked in on her regularly and were able to spend time with her as well. She did not want to be placed in a home ! All the money she saved by not going into a home was spent on services that helped her stay in her home. Yes we worried but she was a smart lady, kept her independence and was happy in her home.

  13. sjw says 18 January 2011 at 06:21

    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.

  14. Elizabeth says 18 January 2011 at 06:25

    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.

  15. Dawn says 18 January 2011 at 06:29
    My mom also had mental illness so I can relate to this. She was schizophrenic and when she moved into a nursing home, we had to move her out due to her paranoia with “strangers”. She has passed on but her older sister is going through the transition of moving from her house to her daughter’s house so I’m witnessing this again.

    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.

  16. Everyday Tips says 18 January 2011 at 06:30

    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.

  17. J.D. says 18 January 2011 at 06:34

    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.

  18. MR says 18 January 2011 at 06:38

    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.

  19. Cara says 18 January 2011 at 06:43

    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.

  20. Amy says 18 January 2011 at 06:48

    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.

  21. Dangerman says 18 January 2011 at 06:58

    “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.)

  22. Liz says 18 January 2011 at 06:58

    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.

  23. Jessica says 18 January 2011 at 06:59
    J.D. – Another thing you can do is ask the doctor if you can audio-record what she/he says during the visits. Sometimes it’s hard to listen to what they’re saying when you’re trying to think of questions to ask the doctor (especially since I know I always feel rushed at the doctor).

    J.D.: You rock, Jessica! Great suggestion.

  24. Jen says 18 January 2011 at 07:00

    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

  25. asdf says 18 January 2011 at 07:04

    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.

  26. HollyP says 18 January 2011 at 07:40
    I’ll second the other commenter about contacting your local Area Agency on Aging (AAA). You should be able to find the one for your area at http://www.n4a.org/ .

    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!

  27. Nisa says 18 January 2011 at 07:41

    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!

  28. jessie says 18 January 2011 at 07:46

    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.

  29. Gail Steffen says 18 January 2011 at 07:47

    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…

  30. SupportingParents says 18 January 2011 at 07:52
    I am in a similar situation and wish I had some advice for you but I was actually about to write in this week seeking advice.

    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.

  31. xocolatlklc says 18 January 2011 at 07:56

    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.

  32. Crystal@BFS says 18 January 2011 at 08:02

    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…

  33. Julia says 18 January 2011 at 08:05

    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.

  34. Rachel says 18 January 2011 at 08:11

    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.

  35. fairy dust says 18 January 2011 at 08:16

    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!

  36. Pamela says 18 January 2011 at 08:30
    This is a question I have lived with for a long time. My mother-in-law, Barbara, was bipolar and my husband and I were responsible for helping her with financial and other support for the 20 years we’ve been married until her death from lung cancer last year.

    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.

  37. babysteps says 18 January 2011 at 08:30
    I have parents along the entire spectrum – mother passed away at 75, father 80/healthy/remarried/independent living campus, MIL & FIL healthy for late 80s but face aging issues and in own home almost 4hrs from nearest relative.

    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.

  38. Courtney Ostaff says 18 January 2011 at 08:32

    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….

  39. Birdwell says 18 January 2011 at 08:34

    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.

  40. Kate says 18 January 2011 at 08:39

    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.

  41. Steve Reilly says 18 January 2011 at 08:42

    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.

  42. Liz says 18 January 2011 at 08:43

    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.

  43. Crystal says 18 January 2011 at 08:45

    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

  44. retirebyforty says 18 January 2011 at 08:51

    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.

  45. Julie says 18 January 2011 at 08:57

    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.

  46. Erika says 18 January 2011 at 09:01

    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.

  47. Adam says 18 January 2011 at 09:05

    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.

  48. Carol says 18 January 2011 at 09:27

    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.

  49. Jen says 18 January 2011 at 09:37

    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.

  50. Cindy G says 18 January 2011 at 09:38

    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.

  51. Sonja says 18 January 2011 at 09:41

    To Shauna – I feel for you! I think you and your husband need to have frank conversations with both your parents and your in-laws. Tell them your personal goals (paying off your debts, saving for your children’s college, paying off your home, saving for your retirement, etc.) and let them know NOW that you have a big challenge in front of you and you don’t see how you will be able to meet your goals AND help them financially in the future. Offer to help them come up with a plan for themselves – but insist that they take responsibility. By all means offer to help them as they age with relocating, transportation to doctor appointments, visiting regularly, including them in the children’s lives, etc., but do not offer financial help. Personally – as a parent and as a grandparent – I cannot imagine expecting my kids to take care of me monetarily, or having my care take away from what my grandkids need. I would certainly respect my childrens wishes to be the best parents they can be, even if it means they cannot help me.

    To JD – I agree with the commenter that suggested a journal. I was the main one to help my dad when he was fighting his losing battle with cancer. We had a 3-ring notebook we called “The Doctor Book”. We had sections for medications (name, dosing schedule and amount to take), chemo schedules, lab reports, and I would write a summary of every doctor visit and put it in the book. Nowadays I take my FIL to many of his doctor appointments as he can no longer drive. He does not want to be bothered with a binder, but I keep notes at home and mark on the calendar which doctors I take him to and when and I email my brother-in-law and keep him in the loop. I always ask him “What is the objective of today’s doctor visit?” This helps us both. The main thing with my FIL is all the medications – we all work together to make sure there is a current list of medications with dosing instructions in his wallet, along with any medication he is allergic to. We also got him that Life Alert system since he lives alone.

  52. Charity says 18 January 2011 at 09:44

    My 82 year old grandmother has Alzheimer’s. I (her only granddaughter and 32 years old at that) am her Power of Attorney and executor of her estate when it comes to that. My mother and grandmother did not talk for 10 years so that is the reason I am the POA though now they are talking and doing well.

    My mother now helps a lot and lives 5 minutes from my grandmother in Indiana. I live in Chicago, Illinois so doing everything by long-distance or driving in was really tough at times.

    I have to admit in the past it was really hard and stressful helping my grandmother, but I tried to take each day in stride. I took over paying her bills years ago after she forgot to pay the electric bill and lived in the dark for a few days! I filed her taxes for her after I realized she had not paid taxes in 5 years! I called her everyday to make sure she ate something and arranged for in home care for food and cleaning since she would go days without eating and weeks without cleaning.

    I used CVS’ module in trying to find the right Medicare Part D plan for her, my fiance now husband has helped me clean up her old apartment (she was a big hoarder but now is in assisted living facility), and I depended on her lawyer to help with the legal documents. My boss has also been very understanding when I had to take last minute days off.

    My biggest suggestion? Ask for help and advice whenever you can! Then shift through it to find what works best for you and the person you are taking care of. I have found so many doctors and nurses that were willing to take a little extra time to answer our questions. Love them! I found a lot of helpful people in Social Security and local government that were willing to help us out too.

    As far living facilities, be prepared. There is a huge diversity in the level of care. Visit every place you can. Meet the staff and nurses. Really look at the residents, do they look active? Do they look happy or like they are enjoying themselves? (Will depend on age and any illness they may have though.) Ask your relative’s doctors or nurses if they have any ideas or input since they will have probably visited a lot of these places professionally.

    Trust your gut instinct when choosing a place. And of course ask for your relative’s input (since they are going to be living there!) as you/they can. (Depending on their level of care and need. My grandmother could not give her input too much due to her disease.) Many places will invite you and your relative for meal or two to get to know the place more. I really encourage you to do this.

    My grandmother in an assisted living facility now and doing well. It is expensive (about $4,000 a month) but in my opinion worth every penny. It took a long time to get there (she fell walking her dog, had shoulder surgery which caused issues with her Alzheimer’s, went to physical rehab, had to adopt out her dog to a great family, etc.) but it is a good place.

  53. Kandace says 18 January 2011 at 09:48

    I’m in a similar situation. My parents are 88 and 85 and doing relatively well, but getting forgetful about taking pills. They no longer drive and rely on the kids for their social lives and everything else. I take dinner to them once a week and on vacation a few times a year. It’s tough–and it’s only going to get more difficult when one of them dies.

    Fortunately, my parents have the financial means to cover their expenses for now.

    Would love to see more posts about this issue.

  54. Chickybeth says 18 January 2011 at 09:55

    I am currently in the same situation as Shauna and my mother refuses to have discussions about finances so I have no advice for her and could use some myself!

    As for dealing with an aging parent with mental illness, I used to volunteer for the Alzheimer’s Association: http://www.alz.org

    which is a great organization. If you call them, they can give you info on all the support in your area including the info for the AAA near you. The best service (in my opinion) that they offer is a caregiver support line. The patient doesn’t have to have Alz for the caregiver to get support and both patients and caregivers can call in for help. The support people are very kind and understanding and are an open ear for when things get really tough. They will even do follow-up calls for as long as you need the support.

  55. Second Nature says 18 January 2011 at 09:55

    My husband’s mother and her husband are both 89 years old. They do not have long term insurance, and both are failing in either mind and/or body. They live in the home that my husband’s father and mother lived in for many years before she remarried her current husband and it is paid off. She desires to stay in the home, so they are paying for a caregiver that lives there and is on the clock 24/5. There is a part time caregiver that comes in 24/2 to give the full time caregiver a break. This care runs about $6000/month (yes..YIKES). But they want to stay in their home as long as they can. and we have to honor that. But, yeah, do the math…. EXPENSIVE!

  56. J.D. says 18 January 2011 at 09:58

    Thanks to everyone who has shared their story and advice so far. You’re wonderful.

    As some have requested, I’ll do my best to compile the advice from this discussion for a future post. I think it’d be valuable for others down the line. (But don’t hold your breath. I’m notoriously slow with this. It’s been six months or more since I promised to compile the list of GRS readers favorite credit cards, and that’s an easy one…)

    I’m truly grateful for this community.

  57. Deb says 18 January 2011 at 10:03

    JD, I want to thank you for sharing your story. I’m so glad that you did. You have my full sympathy with your situation. Your mom is fortunate to have such caring kids.

    I am an only child, and my mom has suffered mental illness my entire life. She is controlling, secretive, self medicates, and is extremely resistant to input or management. It’s very frustrating to deal with someone who is so obstinate. I also have an aunt who is suffering sequela from a distant stroke, and her sons aren’t very helpful. I expect her to increasingly become my responsibility as well.

    We are building a small studio apt behind our home just so we have an option for housing and caring for my relatives. I work from home and will be able to help with their care, but do expect to have hired hands as well.

    I don’t have any advise, but I do want give people here my most sincere thanks for sharing their experiences and advice. And thank you for the invaluable resources you have provided! I’m saving this info for posterity!

  58. Carla says 18 January 2011 at 10:03

    No advice from me. My parents (divorced) are in their early 60’s and I know its a matter of time before they will need assistance. I have a chronic illness and I’m working on my own financial present and future (not to mention health, etc), so I’m honestly not sure what I will have to offer for my parents given my own healthcare expenses exceed $600/mo.

    Thankfully my mother is more or less financially stable, always been wise with her money and has a few assets. My father, not so.

  59. Tyler Karaszewski says 18 January 2011 at 10:08

    My wife and I are in a similar situation, although probably not so frustrating as yours. My father-in-law had a stroke about two years ago, and he never fully recovered. Mentally, he’s OK, but physically he’s no longer able to get around or take care of himself very well. He walks with a walker now, and has difficulty doing normal household tasks.

    When this happened, he was living in Orange County, which is about 400 miles south of here. Three of his children live in the San Francisco Bay Area (including my wife), and the fourth lives in Phoenix. He was divorced from my wife (and all her siblings) mother, and was living with his girlfriend in her condo.

    Well, as soon as he fell into ill health, his girlfriend really didn’t want anything to do with him anymore. We also discovered that he’d been living well beyond his means and financing the whole thing on credit cards and other forms of debt (he had *two* concurrent car loans, just for himself. His girlfriend had her own separate car!).

    We ended up moving him up near us, selling his cars, and trying to get him to a point where his monthly expenses were less than his social security check. We managed to do that, and now he’s better about not spending money he doesn’t have (also, he can’t drive and I don’t think anyone would give him a credit card at this point, so that helps).

    He hired a girl to come by for an hour most days and help with things like cleaning, cooking, getting groceries. My wife also does some of this, but it’s a real lifesaver to have someone else helping, so she doesn’t have to go over there every single day.

    The person he hired isn’t a licensed nurse or anything, but he doesn’t need medical care, just help around the house, and so hiring a college student was much more affordable.

    This doesn’t really help with your problem J.D., but I’m sympathetic. It can be stressful trying to sort out someone else’s affairs.

  60. SupportingParents says 18 January 2011 at 10:12

    @Adam #47
    “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.”

    This is so true and I’ve looked everywhere for information on what to do about supporting my parents and grandparent without selling my own future for their present.

    I didn’t mention in my earlier post that my mother can no longer work, my grandmother has a very small SS benefit, and my father has a full-time income. Since my grandma is not quite as spry as she once was I take care of her bills and banking information but she is in control of her spending money, etc.

    I do all the budgeting and bill payments for my parents (they have always been bad with money, worse now with a single income), so on top of the stress of healthcare and bills everyone resents me for reining in the spending to absolute essentials.

    I feel strongly about paying the mortgage no matter what so that I don’t end up with the homeless band of needy gypsies to care for but I play due date games with all the rest of the bills.

    There is no financial advice I’ve ever read with how to deal with this type of situation. Some people say let them sink or swim on there own but I ask you… would you be able to live with yourself if you took the same attitude? The other advice I’ve received is hire care or have them move into an assisted living facility but right now there is just no money to do any of this.

    I can’t even imagine having a family or even a social life right now. This situation is no ones fault (my mom didn’t ask to have this problem and my grandmother is just aging naturally) but it’s quickly become my problem.

    I really wish there were financial books out there for the “sandwich” generation as someone else mentioned. It would be so helpful.

  61. rene says 18 January 2011 at 10:12

    Grandma is 92 yrs old and still lives at her own house for the last 60 some years now. My cousin sees her on a daily basis with her son and my mom goes to her doctor’s appts for the most part. My cousin goes once in a while but not all that reliable as she exagerates or forgets something. Can’t be helped, sometimes Mom can’t go to the appts. Grandma still writes the checks but my uncle has the power of attorney and keeps an eye on her finances. She is probably going to live in this house until she passes away.

  62. Michelle says 18 January 2011 at 10:21

    Wow, J.D., thanks for a great post. This is a real problem, and I can relate. My father and stepmother have a solid plan for their retirement, but my inlaws do not. I anticipate being in the same position.

    Mental illness is just that — an illness. Not talking about it just feeds into our society’s “taboo” about the subject, and it doesn’t do anyone any favors. Kudos for your honest discussion about your mother’s health.

    Random point: Sometimes people with mental illness have trouble remembering to take their medication, as you mention. If it is forgetfulness instead of deliberate refusal, a digital pill reminder can work wonders. You will probably have to set it up and you’ll probably keep it updated as medication changes. But it could be a simple way to prevent crises related to her medicine.

  63. Jen says 18 January 2011 at 10:23

    For what feels like a Monday morning, this is a big topic. I’m lucky to have a currently very healthy 88 yo mother with at least enough savings to get her through some care. But my siblings are older than I am (they’re 60 and up) and haven’t been the best of savers — or rather, they’ve been ordinary savers and have watched as the last ten years have eliminated their jobs (several times for one of them) etc. They also all live near enough each other, but quite far from me and my mother.

    ANYWAY, looking through these comments there is a sub-topic that would be great for you to explore, JD — the number of people who seem to be bankrupting themselves for their parents. Which of course, will lead them to put their own children in the same or worse situations. Looking at the limits of what can be asked of children monetarily would be very important.

    Bill collectors will surely take money from anyone that gives it to them, but people shouldn’t be putting themselves in danger as well. The poster above who has charged her mom’s medical care to her own credit cards to get treatment — needs to tell the doctors that she doesn’t have any money either, none, zippo, no credit left.

    One of my siblings unknowingly paid off a credit card debt of a late spouse — before realizing that it shouldn’t have been done. That’s another couple thousand that could have gone to her retirement that didn’t.

  64. Jonathan says 18 January 2011 at 10:30

    I have been taking care of my mom and my dad for the past 4 years. My mom has a heart issue that led to her being placed on disability at 62. My mom never saved a penny in her life, and even now trying to get her to budget her fixed income is a monthly struggle. And my dad is just a moocher. While my parents were never married, my mom can’t find the heart to let him go back to living on the street. So he lives rent free and his criminal record prevents him from getting a job anywhere, even minimum wage. So after the 723 dollars my mom gets a month I pick up the rest to take care of them.

    Some advice I offer from my situation:
    1) I have been lucky that the majority of my mom’s medical expenses were picked up by medicare/medi-cal. But she has some outstanding medical bills she can’t and doesn’t intend to repay. While paying back your parent’s debt shows character, it is their debt. Don’t feel obligated to take care of your parents debts. It will drive you into debt.

    2) There are many people out there preying on senior citizens. My mom was all but convinced to get a reverse mortgage after a banks pitch she received. This was in 2007 when the value of her home was 150k. Three years earlier it was worth 54k. Today 48k. Fortunately I was able to convince her not get the mortgage, not only for my sake in paying it back, but for hers if she ever had to move for medical reasons.

    3) If your parent has no money, which many stories show the baby boomers do not, it is hard living on a fixed income. It is better to wait for social security when you 65 or 67 (depending on birth year) than when your eligible at 62. If your parents have a source of income to get by on at least until they get closer to 65, they could receive a 10-20% more a month than taking it at 62. My mom took the money at 62 as she had no other source of income and lives on 723 dollars a month. After her food expenses of around $350-$400 and utility bills, there is not much left over. My mom lives in a rural area so she has to drive 80 miles round trip to see her doctors, so gas adds up quickly. This is where my money comes in and I set aside a set amount each month for her. In this aspect you have to be careful on how much you give your parents each month. Not all might be the same but my mom began to see me as an ATM at times asking for money to pay utilities when she was using her money to buy DVD’s or other non necessary items. So ensure that your parents know that your money isn’t limitless. I used to tell my mom how much I would give her, now I only give it to her if she asks for it, which has cut down her spending drastically.

    4) Budgeting. They know exactly how much they are getting each month. My mom is still a work in progress. If she didn’t waste money on frivolous things she would have 67 dollars left over each month (sans gasoline for the car) to spend as she pleases. So ensure your parents know how to and are utilizing a budget, it helps your pocket book.

    5) Preparations for death/Legal stuff. Having this done while the parent is alive is very helpful. My mom has told me exactly what she wants, took out a life insurance policy to help pay for the expenses. Has a will set up and everything. It sucks to talk about these things with a parent, but you will be glad you did in case death does occur suddenly. Also make sure an executor of the will is appointed. The last thing you want is the court appointing one and that person taking up to 10% of the assets in fees.

    Great topic J.D. I think many more will be experiencing this in the near future.

  65. babysteps says 18 January 2011 at 10:31

    one financial thought – even parents who have savings and insurance and are living independently, when one spouse gets ill and/or dies, the other spouse may let bills & such go. Not sure if there’s a great way to face this other than inserting yourself in your parent’s finances *or* completely wiping one’s hands of them…

    One of my aunts didn’t file taxes for several years after husband died (resolved now, but ask my cousins how much fun it was dealing with the IRS).

    My father didn’t open his mail during my mother’s 4 month final illness – initially he said he’d get to it, but 3 months in I finally, and as gently as possible, said “you haven’t gotten to it yet, do you mind if I take the pile of bills and go through them?”.

    Thank goodness my mother’s health insurance hadn’t irrevocably lapsed yet (and, not sure if this always is a good idea, but the rep told me it would be better in my father’s case to get him new insurance than catch payments up to date).

    Basically I became my father’s book-keeper for about 9 months. I took my father to the bank for him to sign up for online banking; he let me use it with full disclosure (I’d call and tell him what I was going to do before I did it). I got as many of his bills as possible on automatic payment (either “push” scheduled payment for static bills or “pull” automatic debit for variable bills), and signed him up for overdraft protection (not usually a fan) in case we miscalculated.

    I did impersonate my mother in calls to some creditors (when checking current balance &/or making payment). Oddly, the toughest was the trash company, they would talk only to the account holder (for some reason was in my mother’s name only), but it all worked out eventually. Next most challenging was the city storm drain assessment, it was a different amount every 6 months with a short window from bill to overdue – but at least the city office was very pleasant to deal with.

    Oh, and on wills – when my father retired, my parents set up a will and let me know what was in it. I thought they were all prepared. Come to find out that they didn’t ever *execute* the will, so my mother died intestate. Thank goodness her finances were relatively simple and most accounts were joint (that is, still functioning for my father without legal wrangles or hassles). So when you ask parents about a will, you might want to be very specific and ask if they have an “executed will”

    And, watch out for older folks putting checks and important documents in a “safe” place – so safe that no one can find them. We paid to cut into my parent’s safe deposit boxes (14 months after she died we still didn’t find the keys, which my mother controlled). I had to get the life insurance company to cut a replacement check for her death benefit (never did locate the original check). It all worked out in the end, but was more of an adventure than I expected!

  66. Quest says 18 January 2011 at 10:35

    Caring for aging parents is something we must all face, one way or the other. I have been thinking about this a lot lately mainly because I wonder what will happen to my mother (who lives on a different continent) should my father die first. Like you, I’m not sure what her finances are like. I have no idea whether she has any savings and I’m erring on the side of not.

    She, too, has suffered from mental illness in a milder form than your mom’s by the sounds of things but nevertheless, she too has had a fear of social situations. It’s a lot like agoraphobia. It is true too that the older a person gets, the more likely it is that he/she will self isolate.

    Anyway, I wish I could add more insight but I am not yet at the same point that you are. I want to say, however, that you sound as if you are doing the best you can. You are there for your mom, you’re helping her in every way you are able to, and that counts tremendously. I understand the feelings of ‘helplessness’ but do not underestimate the power of just being there for her.

  67. Jen says 18 January 2011 at 10:36

    Supporting Parents —

    Have you looked into the Agency for Aging type places for help? It sounds like you need someone from outside the family to be able to look at the situation, tell you what resources are out there, etc. Then, you can come up with a plan — one that takes your own needs into account just as much as anyone else’s! For instance, if you are contributing to paying the mortgage, it needs to be documented or better yet, made official with you owning an increasing percentage of the house.

    Similarly, if there are wills, make sure that you aren’t going to split the house with your brother and end up having to sell in the end anyway. Obviously, if there aren’t wills, and POAs and all, that’s a big problem as well! Is your brother close enough that he can take more of the work off your plate, even if he isn’t contributing monetarily — adding in paying bills for your grandma or taking people to doctor’s appointments, etc.

  68. Thrifty advocate says 18 January 2011 at 10:37

    @60 SupportingParents – you say the bulk of the work falls on your shoulders and your brother is exempt because he “has a family.” I’m sure you’ve thought of this already, but by devoting your life to your elders, you are increasing the chances that you won’t get the chance to have your own family for quite a while.

    Would your parents/grandmother be more careful if you explained to them this impact on your life?

    I’d think this applies to everybody else here – if you sat down with your needy loved ones and told them honestly how their behavior was affecting you, would they be more open to considering needs other than their own (and altering their behavior accordingly?) Again I know many people can be self-centered. It’s just – if you call them out on it nicely, perhaps that would help.

    As for concerns about legal documentation… Personally, this is how I’m handling it now: I’m in my mid-30s, my parents are in their late 50s and early 60s. Every time I come across good information, such as what you should have in a fireproof safe (mortgage docs, POA, will, etc.) I bring it up casually to my parents – “Gosh, I just have to do this! I’m sure you’re way ahead of me on this.”

    To date, I’ve developed my will, POA, etc., and given them copies of all those documents.

    I also modified the durable POA doc developed for me by an attorney to make the document personalized to them, printed out copies for them, and told them to get it notarized. They did.

    I have a huge advantage in that I can trust my parents with my documentation and in that they’re eager to prepare for their retirement. I know that many people have difficult family situations where they’re unable to bring this up with their parents and/or cannot trust them with a durable POA, etc.

    My point is that I’m doing all this while my parents are still employed and active, and I’m doing this for myself as well so this doesn’t become about “them.” That way, I’m reducing the frustration I will experience down the road with health care POAs, durable POAs, etc.

    Again, I realize I’m fortunate to have parents who want to do “the right thing.” I know not everyone has parents that are easy to work with. That said, even IF you do, you should be starting this now.

  69. Jeff says 18 January 2011 at 10:39

    Good post, JD – very timely. Lots of solid advice in the comments too. One thing you may end up facing is the need for 24-hour in-home care if your mom insists on living at home. It’s expensive (min. $10/hour), and you don’t know what you’re getting in terms of help. In my mom’s case, the in-home agencies in the area get their aides from Shanghai, Hong Kong – or Mongolia. And this is in the suburbs north of Chicago, not some backwoods area. The aides have to rotate, so you might end up with strangers over whom you have no control. A friend’s mother in Rochester NY just lost $20K to an aide who convinced her to go to the bank and withdraw cash – for the aide’s “sick daughter”, her ailing transmission, etc., etc. This took place over 2-3 months. You just don’t know what you’re getting.

    Assisted living was the answer for my mom, not that she wanted to go there. She still wants to return to her house and refuses to consider the cost and dangers to her safety. Her assisted living runs about $4,400 per month, but in-home care would run about $7,200 – plus food, utilities, etc.

    Good luck with your mom. We’re all in this together.

  70. David says 18 January 2011 at 10:40

    Great article. I totally get “Having to be the adult of your parents isn’t easy”.

    My mother has required full-time care since 2007, and it’s been a challenge for my sister and I.

  71. Kathi S says 18 January 2011 at 10:44

    Welcome to the sandwich generation – where we are taking care of both our parents and our kids. We stayed in our current town to stay near and help my in-laws. My MIL had asthma and glaucoma and many issues. At one point she had a bad fall requiring a shoulder replacement, plate near wrist and 3 months later a hip replacement.

    MIL would try to self prescribe – if something worked she would take more – or if she waited to take something she felt like she was “doing great”. Definitely the pill boxes – we got the two week one and loaded it and checked on her multiple times a week.

    When MIL passed away it became apparent FIL had dementia which MIL had masked. We had him move in with us and handled all bills, probate etc.

    If you still have both parents make sure everything in is both names with an “OR” in it. They did not have much – but FIL had no access to his own money until it was all straightened out. If you only have one parent consider putting yourself as the “OR” on the account.

    My FIL ultimately went to live with his oldest daughter accross the country. We still manage his house and bills. Look at all of their bills!! They had liability insurance – but no assets to protect. They paid $700-$900 EACH for health insurance – we brought down to $250 per month for FIL.

    Recently FIL had to go to assisted living, then after a few months a nusring care facility. Look for a place with BOTH types of care – you don’t have to “move” except to the “other side”. Also most places if you can pay for 18-24 months then you can qualify for a medicare bed.

    FIL has enough for that – we are also prepaying for funeral expenses – split between where he is now – and here where he will be buried. To qualify for medicare bed resources must be gone. But it is OK to pay for his future expenses to deplete that, and it is not a cost the kids will have to pick up.

    Get professional advice! Someone else said that – every case is different, and every state is different.

    My parents (10 years younger than in-laws) are planned out – My father was career military so they decided to be buried at Arlington National Cemetary – they have long term care insurance (another thing to look at) they have trusts, wills etc. If they go on a long trip they leave the “funeral folder” on the dining room table just-in-case.

  72. billie says 18 January 2011 at 10:45

    Here’s our situation: My husband’s parents retired “Up North”, 5 hours from any family members, in a major snow belt. They are both in their 80’s, and are in fairly good health but have a terrible time getting around because of arthritis and back problems. Both have had recent heart surgeries. Because they live in such a remote area, they have to drive 2 hours to see their doctors. The nearest emergency room (if you can call it that) is 1 hour away. They have nice neighbors but only a couple live there full time.

    Each time any family goes to visit, pretty much 100% of the time is taken up with cleaning the house, repairing something, running their errands, etc. Everyone is getting mad about this, as while we don’t mind helping out, its nice to be able to have some down time to actually visit with them. The parents REFUSE to hire anyone outside of a person to plow the driveway. They have the money to pay for everything to be done. They are not able to keep the 5 bedroom, 2 story house clean themselves.

    When the subject of future plans is brought up (as it has been for the last 10 years), they clam up and refuse to plan for anything. We all with they would move closer to one of us, and there is no chance of anyone moving to them, there are no jobs in the forest. We realize it was their dream to live there, but they are creating so much tension with their refusal to accept that they are not able to live like they used to.

  73. Penelope says 18 January 2011 at 11:02

    So many of these family issues are only obliquely financial ones. I am fortunate that my 80 year old mother who lives at the other end of England is still hale and hearty. However she lives in what we call ‘sheltered accommdation’ with my 54 yr old sister who has some learning disabilities. My mother effectively still cares for my sister and manages the household. There are many questions around how the future will pan out. I would like to think that we could all remain independent…

  74. lynda says 18 January 2011 at 11:10

    There are some fantastic posts here.

    I’d like to offer a word of warning to reply number 1: at the time of writing, there are massive, wide ranging changes planned for UK healthcare. The changes could go well, could go badly, it’s too early to say. Please check this out and stay up to date with the UK news as the changes in the health service, and hassle of relocation, may mean your Mum may be better off in the US.

  75. Mike B. says 18 January 2011 at 11:11

    My parents gave us preemptive permission to put them in a nursing home or assisted living facility (against their wishes, if necessary) if my brother and I agreed it was necessary for all of us. That will be some consolation, should it become necessary.

    I do feel bad about the prospect of their care as they age, though, because I know the bulk of it will fall on my brother. My wife and I live about as far from my parents as is possible in the US (location-centric job), and we’ve discussed how best to handle that for a while now. No great revelations, unfortunately. That’s one of the reasons we’d like to move home, but….

  76. Jeremy G says 18 January 2011 at 11:12

    After watching grandparents on both sides of my family go through this, and now facing this with at least one of my in-laws, I definitely feel for you both. I have no magic answers, but I do have a few things I’ve learned along the way.

    1. We bought our home about 4 years ago knowing that eventually my mother-in-law would not have any financial means to take care of herself. So, we made it a priority to buy a home that could accomodate her as well, down the road. Our preferences were to live closer in to the city, having a “newer” home with little maintenance, etc., but by looking further out we found an place that included a guest house. it sounds like a “luxury” – but it’s really just a set of big tradeoffs for us. That said, we still feel it was the right decision to plan ahead as much as we can, and the benefit is it has made it easier for friends and relatives to come to visit.

    2. While I have the deepest respect for anybody who can devote years of their life to caring for their aging parent, there is no shame in asking for help from anywhere you can. Caring for an aging parent, particularly when mental health enters the picture, is likely the hardest thing you will ever have to deal with. My grandmother suffered with this in her last few years, saying horrible things to the ones she cared for most out of confusion, anger, and grief over her own condition. By the end it aged all of her children by many years. The saving grace for all of them was finding an in-home assistance where a professional was responsible for much of the health administration. They are able to detach from the words and actions of the parent in ways that are nearly impossible for the children to accomplish.

    3. A will (and other necessary paperwork) is the most important thing you can arrange for the future health of you and your extended family. When my wife’s grandmother died, even the closest of brothers, sisters, uncles and aunts had severe squabbles over possessions and what each deemed fair from their own perspective. Things disappeared from Grandma’s house; accusations of unfairness surfaced and did damaged, and on and on. A will eliminates much of that, and leaves the family intact. If you think your family is above such things, think again. No matter how strong your family is, loss of a family member will affect your family in ways you cannot possibly anticipate.

    4. Plan for your own retirement of course, but do not put off living your life now under the assumption that you will do all of the “real living” later when you approach retirement. My wife’s mother made this mistake, and by the time she reached those “golden years” where she had planned a rich life after her children were raised, she wound up as the caretaker for her own mother, unable to leave her home for more than a couple days at a time. Be responsible for your future, but live today.

    5. Start a savings fund – for your parents – as early as you can. It doesn’t have to be much, but earmark the fund specifically for this purpose. It is rarely cited as something you should save for (that I’ve seen), but as our life expectancy on average moves up, it seems like this should be talked about more in financial planning. It would be great if all parents didn’t need this later in life, but I would guess that more often than not this is not the case.

    I know we’re facing this situation in the next 10 years or sooner, so I again really feel for you. Hopefully the deep pool of knowledge surrounding the site can uncover new techniques as it usually does 🙂

  77. MutantSuperModel says 18 January 2011 at 11:19

    My grandmother also has mental issues and like your mother, problems arise with the forget one pill, two pill, four pills more syndrome. It’s even led to hospitalization. However. She lives alone and has been since the death of my grandfather almost eleven years ago. She is in her 80’s and honestly looks strong as an ox. Recently, one of her sisters-in-law passed and my dad had power of attorney. One thing I know he went through the hard way and has been working diligently with his mom now is getting a full grasp of everything and that includes really small stupid questions like “Hey where IS your will? Who are your creditors/ What are your assets? Do you hide cash or valuables? Where?” It also helps to make sure you have a list of all accounts she holds and account numbers plus her ID information so you can access it in case of an emergency. Also, you have to make sure there’s direction on how she wants her care handled so you guys aren’t left making REALLY hard decisions in times of crisis. Basically, talk to your wife about all of the things you guys want to do for each other in case things go wrong and then get the same answers from your Mom.
    Personally, I’m still young enough to witness my parents in the role of adults to their parents but with my dad turning 61 and my mom just turning 55, I know these kinds of things are going to start to come down the line eventually. Even things like what the retirement situation looks like (kinda vague on the details but not thrilled– hoping they’re being their typical pessimistic selves LOL). I too would love follow-up information on this. This is another great reason to add to the ever-growing list of reasons to be debt-free and financially independent!

  78. Claire says 18 January 2011 at 11:33

    Thank you for this article. This subject actually scares me for when it starts to affect my life. As two only children, my husband and I will be responsible for not two, but FIVE aging adults (my parents, husband’s parents, and my step-father). Since we both have VERY small families, I don’t see how we can reach out to anyone else for help when this issue comes up. Thank GOODNESS my parents and step-father are all in FANTASTIC health right now. My in-laws are a different story.

  79. Kathryn Fenner says 18 January 2011 at 11:34

    Some financial guru recommends that before anyone starts covering someone else’s expenses–be it parent or child (as in college), he or she should make certain his or her own finances are in order. Are you on track to have saved enough for retirement? Obvi, if you can cut back (and you are thinking about this, or you wouldn’t bereading this blog), you should, and possibly be able to give more, but first, absolutely you must make sure you are in good shape!
    Your aging or disabled parents have social services (that I gladly pay taxes for), so make sure you are taking maximum advantage of them (just as you should make sure your children are getting whatever financial aid they can get). If your parent is seriously unable to take care of his/her finances and has not designated someone to act for her/him (and please, everyone, make sure you and your competent loved ones have done so), consult an attorney or your local bar association about legal recourses in your state (I am a lawyer, but this is not the place to give specific legal advice). Some states may impose some costs of care on adult children; my state does not.

    There is a social safety net for the elderly and disabled in America — not a great one, but at least there is one. If you imperil your own financial safety net (and it may be stretched to help out, but do not poke holes in it), and you are too young/healthy to qualify for aid, you may end up in a very bad place down the road yourself.

    I realize this sounds heartless, but unfortunately, some situations call for hard decisions, and putting off making them because they make you feel bad doesn’t make them go away. Buck up and do what needs to be done, not what seems like it might assuage your guilt. Do all that you can do, but not more than you really can do.

  80. Glen says 18 January 2011 at 11:41

    I’m in a similar situation. My mom, 62 has epilepsy and schizophrenia. She has no savings or investment of any kind, and no insurance, too. My father abandoned her, and she ended up living with my grandmother. My grandmother took care of her for a while but she died 3 years ago. We (4 siblings) sent her allowance monthly to cover for medication, utilities, and food. She tried to live on her own, but her conditioned declined and we took her in. We cannot afford nursing homes etc.

    Things to deal with IF you decide to let your parent or someone live with your family, (based on our experience):

    1) If you have siblings, discuss how to help out, share either financially or to take care of her, doctor visits etc.

    We did this and see if mom could live several months from one kid to another. Siblings ended up arguing. My younger sister hated having her in their house because the effect on the kids etc.

    My own family ended up doing everything. But everyone tried to help financially.

    2) Supportive spouse. If your spouse will support the idea of caring for your sick parent, this is a huge plus.

    No matter what happens, the whole family can deal with the stress if everybody understands why your mom/dad is not behaving or not recognizing family member. I am lucky, my husband wholeheartedly accepts the responsibility. He was even more caring than my own younger sister.

    My older sister, on the other hand, won’t take her in because her husband does not want to do it. Have all the reasons not to.

    My younger brother, has a very understanding wife, my mom stays with them now. We hope to take turns in doing so, but so far supportive spouse is the key, I think.

    3) Talk with kids. Before the move, talk and explain to the kids. Explain to them that grandma/pa needs help and cannot live alone.

    With my daughter, we talked even the details of the illness. I saw the pressure on her whenever my mom would have a seizure and on her college essays I realized how much unnecessary worries she had to go through. But, she understood and she still loves her grandma eventhough she does not recognize her once in a while. She even researched about all the support group, medical studies about schizo and epilepsy, insurance, etc. And she saw all the sacrifice we are making, why we are doing this. Its our family. I am so proud of her.

    With my younger sister’s kids, they became scared of my mother. My sister is a nurse. But she said she is protecting the kids from my mom. So, the kids moved away and became wary of what would happen everyday because my mom would have seizure almost everyday, sometimes 3x when she is sad and depressed.

    4) Discuss the routine at home. With me and my family, we discussed our work schedule and school schedules. My mom has a bunch of pills to take and she uses the 7-day box with am/pm.

    My husband and daughter leaves early for work, so I make sure that my mom takes her meds for the morning. By 2pm, my daughter comes from school and she does the afternoon check.

    My husband’s work allows 2 days-off during weekdays, so he takes care of mom the two whole days. Me and my daughter do this during weekends. We have someone stays with her during the other 3 days from 9am-2pm. Just sit with her and talk to her, with a baby-sitter fees for now. I am sure it would go up once her conditions worsen.

    5) Activity for mom/dad. S/he would always ask to be brought back home, lucid or not.

    My mom was a stay at home wife, never had a job but she has lots of creative hobby. To distract her attention from not being in her own house, we setup activities for her. Crochet or knitting, some TV and lots of afternoon walks, going to parks, choosing thread colors, lots of garage sales and flea markets. But once in a while, she would wake up and packs her clothes and wants to go home. Be ready to tell her lots of things thousand of times.

    6) Financially, if you are expecting this to come, discuss early with siblings, someone has to make the decisions.

    In our case, I’m the second child and culturally the eldest is suppose to make the orders/decisions. But i don’t know what happened, I ended up doing and making decisions on how to handle this financially and emotionally speaking.

    We discussed the total amount of expense, meds and food and doctors’ fees. Our current setup is everyone send the amount to the family who takes care of her. Prior to this, when she was with us, the other siblings only contributes to the meds expense. But since my brother has smaller salary, we send financial support in a rotation basis.

    In such a case, its not so hard. But the problem arises when she needs to be brought to the emergency room. It happens maybe 2-3x a year. The expense was huge and we have to share this as well. Sometimes I pay using my credit card, and pay it gradually depends on how much my other siblings can give to me. I try to pay it on time, but sometimes its really difficult.

    7) In case of emergency, and if you have no other option, use your credit card to cover the medical expense. I don’t know any other way. Or else, save up for this.

    This is the few times that I had racked up thousands of dollars on credit card. Have a credit card with at least 10k credit on it. Emergencies can ruin you financially, especially from hospital bills. Without the credit card, I don’t know where I would get that amount of money. We have some emergency funds stashed away in the bank, but having the credit card gave us more leeway. The good this is that my other siblings stick to their promise of helping me pay for the their quarter share.

    This road is going to be hard. Having people around you that understands your situation makes a lot of difference. I have lots friends and including my own real estate agent volunteer to stay with my mom or bring her to her doctor’s appointment so that I won’t be absent from my work. These are the kind of people that made us stronger along the way. I call them angels!

    8 ) Schedule a day-off from it. If you have siblings, you can take turns in taking care of her. Or have someone stay with her for several days so you can relax.

    9) We use the diary or logs, too.
    Its hard to remember everything especially when you do the doctor’s visit. Our log had columns,too. For different med schedules. And all other observations. Tell everyone what details to put. The columns make it easy for everyone what to write down, what happened, what she was doing prior, time, duration, even the things she was saying or watching. At some point, we were able to note a pattern that the doctor was not able to see.

    The whole thing would be very exhausting and emotionally difficult. Just having a dinner or camping trips and kayak outing made us through. Don’t forget to take care of yourself. You deserve to have some fun, too!

    Good luck JD, Shauna and to everyone going through the same thing.

  81. Chett says 18 January 2011 at 11:42

    JD,

    I posted earlier today but wanted to check back in to see what type of comments were coming in. The reason why I have read GRS for the past five years is because of the community you have created here.

    As I read through the comments I see people sharing stories of their own lives, helping where they can and seeking advice and receiving encouragement from the other members of the GRS community. I am drawn to this site in a small part because of the content that is posted each day, but more importantly the discussions that ensue with real world advice that doesn’t seem like some shyster is trying to push a product or sell an idea.

    The discussion from your readers today is emblematic of the community that is GRS.

    J.D.’s note: Thanks, Chett. I agree. There are times that folks can get feisty, but generally they’re thoughtful and considerate. That’s why I love the GRS community, too.

  82. babysteps says 18 January 2011 at 11:42

    curious, does anyone have thoughts on the bigger picture of elder care & independence?

    As far as I can tell, the ability to live in your “own” home when elderly, whether 100% independent or not, is a new thing in the US – say possible only last 50 yrs or so (combo of, among other things, modern conveniences and standard of living). It is obviously very attractive, just about everyone I know age 70 or older that is their goal.

    I don’t see us going back to the prior era, where most elderly moved in with children or siblings, but somehow the rest of our infrastructure hasn’t completely caught up. Not to mention our cultural attitudes, as reflected in all our emotional turmoil (me included) over how to care for parents without challenging their vision of independence.

    Any thoughts?

  83. chacha1 says 18 January 2011 at 11:44

    It seems there is definitely a potential book in this topic. How sad. My sympathies to all who are directly affected.

    I am lucky so far. My parents are still healthy and whole in their early 70s. My in-laws, a few years older, are still living independently, though less healthy. My parents own their home but are on the opposite coast from me and 10+ hours’ drive from my sister. My in-laws have a reverse mortgage so must stay in place as long as possible.

    DH and I have already told both sets of parents that while we will do whatever we can to assist them later in life, we will both still be working, in some capacity, for the next twenty years – so if they need frequent contact, they will have to move themselves near to us, as we cannot just pick up and reinstate ourselves where they are and maintain our income. Not to mention we don’t want to live where they are living.

    I have one remaining grandparent who is in an excellent facility that offers a full range of care (residents move from senior apartments to assistance-as-needed to full-time care to hospice). These are hard to find and expensive. If a person is under 65 and relatively healthy, a long-term-care insurance policy may be a good investment for the family as it will cover the bulk of expenses in the last three years of life (which is when the bills tend to go into orbit). My granny is 94 now and may last a few more years. Good thing for everybody concerned that she had such a policy.

    My other grandmother suicided (stopped eating) in hospice after losing her independence to Alzheimers. She was a tough-minded old lady and was diagnosed early, got herself into a study, and was consequently given a lot of care for free. So my advice to those with mental-illness or chronic-illness issues would be to seek out ongoing studies that might permit your elder to receive free or discounted care.

    Full body donation is also an option in most states and costs the family nothing. Funerals with burials are a pure vanity IMO; though I know some cultures place a very high value on them, given that the costs can run $3000-$10,000 it is very much worth having that particular difficult conversation.

    On the money question, I’m firmly in the AOMA group (airplane oxygen mask analogy). It is much better to let the elders go bankrupt if necessary, and save your own home, health, and sanity.

    The sad fact is that our society provides only minimal support for the aged and ill, and that support is available mostly for people with no other personal resources. So sometimes we have to let the other resources run out.

  84. nonegiven says 18 January 2011 at 11:44

    You don’t just need a POA you need a durable power of attorney.

    My parents set up a trust, it spells out how we can put them in a home if we need to, over their objections. All we need is to get 2 doctors to agree they, or probably one of them needs to go.

  85. Shauna says 18 January 2011 at 11:50

    This has all been very useful. Its striking how many people are struggling with this, and how little info appears to be out there to help.

    One of the things I’ve struggled with is that (in America at least) we have no cultural guidance for this time of life. It seems like other countries at least have standard expectations around what SHOULD happen, which provides a starting point for the conversation. I spend a lot of time wondering what the ideal scenario is.

    The other dilemma for me is how to maintain healthy financial boundaries if your parents need financial assistance. A lot of the advice we hear assumes our parents have a healthy relationship with money to begin with. In reality, our parents (mine and hubby’s) have a devil-may-care attitude toward money and have taken advantage of us in the past when they’ve made mistakes and we tried to help out. With that precedent in place, we are really struggling with the idea that we may someday have to decide which of their expenses are “legitimate” and which ones are just taking advantage of our willingness to open our wallets… It sounds harsh, but we’ve been burned several times. I don’t want to micromanage my parents lifestyle later in life, and I want them to be comfortable in their later years, but I’m also dealing with major trust issues that aren’t likely to go away.

  86. Adam says 18 January 2011 at 11:54

    Blown away by all the great comments today.

    @SupportingParents – it looks like we have a lot of company in respects to taking care of our parents. I think why I became a Chartered Accountant and have made personal finance a hobby is to combat what I have lived with my whole life: parents who are irresponsible with money.

    And now that I am secure and my siblings are not (unemployed brother + sister in law with 4 kids under 12, unemployed sister with 2 kids) it falls on me to give them “loans” which are not loans, but bailouts.

    My advice is to make sure their medical insurance is always paid, the mortgage is always paid, and the heat and water stays on.

    JD – what’s your opinion on taking out LTC insurance for parents like mine?

  87. Kristen says 18 January 2011 at 11:54

    J.D. – this kind of real honesty and struggle is why I check your blog daily. Best wishes to you and your family, as well as those of the commenters. I learned a lot today in reading the comments.
    I think were I in your place, I would record in writing any decisions made by you and your family to re-read when you question your current actions. Being able to refer to your set guidelines might help you stay the course. Thoughts are with you…

  88. Rob Bennett says 18 January 2011 at 12:00

    My mother recently died. My father died five years ago.

    My mother felt bad in the last year or two of her life. She felt that she had become a burden. She was afraid to die. But sometimes she would say “I don’t know whether I should pray to live or to die.” I told her that I understood the feeling but also pointed out that the reality is that she was affecting people’s lives in a positive way.

    For example, me and my two brothers had to work together to help her and it forced us to try to get along better with each other. She often worried about her grandchildren and made suggestions to help them that would not have come from others (who grew up in different times). Seeing her difficulties and her courage in facing them often humbled those of us in better circumstances and made us feel more grateful for what we have and more reflective about the purpose and meaning of life.

    You obviously love your mother, J.D. I am making the point I make here just because it is not always obvious how people in bad circumstances are adding something positive to the world. We know somewhere inside that they are but it can he hard at times to articulate how. They need to know this and all others need to know this. So I am just trying to pass along what I came up with in my effort to struggle with understanding the situation.

    My prayers are with you and your mother. I agree with you that it is good to violate the social taboo against talking about this sort of thing. Good for you re that.

    Rob

  89. Merrily says 18 January 2011 at 12:00

    Just a quick comment about social security. My mother just recently got divorced and was a stay at home wife of 20 years with my ex-step-father.

    I was really stressing out because her social security on the few, low-paying jobs she held over the years would be a pittance, about $400/month.

    However, by researching I found out that an ex-spouse can claim 50% of their ex’s social security benefit if they were married for 10 years or more. The only caveat that I can see is that the ex-spouse has to be at retirement age or deceased for her to claim it. Unfortunately she likes younger men so she would have to be almost 70 before she could claim it and she is 57 now.

    If I got any of this wrong, please, let me know. I am pretty certain that this is the case so I imagine your mother qualifies for your father’s benefit and perhaps more so because they were still together.

  90. Jen Schneider says 18 January 2011 at 12:04

    J.D.,

    I’m feeling really grateful for this post. My parents both have health challenges, and my mom also has mental health challenges. I realized after reading this that next time I go visit, my brother and I need to sit down and have a real conversation with our folks about their future. Like you said, shitty, but needs to be done. Thanks for this great post.

    Jen

  91. Tom says 18 January 2011 at 12:06

    One piece of advice that seems to be conspicuously absent – if your parents are retired or approaching retirement age, make sure they get long term care insurance. Nothing will drain a retirement nest egg faster than unplanned-for assisted living or full time care.

  92. Tara C says 18 January 2011 at 12:27

    I am immeasurably grateful that my parents are both extremely good with finances and have planned all of their retirement down to the last detail, including all the legal documents (POAs, wills, trusts, long-term care insurance, prepaid funerals, etc). In fact in their retirement they have more money coming in every month from pensions, SSI and investments than I earn. There are two children, me and my brother, and my brother lives 5 minutes away from them, so he will likely be the main caregiver. I doubt they will need any financial help, but I will provide backup respite for my brother when needed. I am not looking forward to the future care issues, but at least I feel fortunate not to have financial worries compounding the stress of seeing my parents decline and become ill. Thank you, mom and dad!

  93. Tyler Karaszewski says 18 January 2011 at 12:31

    I had to come back with a second post on this topic, or rather, on a similar topic. I think that a lot of us, especially, the younger and healthier among us, tend to not really appreciate the value of having family close by. I lived away from my family for several years, during and following college, and it seemed fine at the time. Eventually, I missed the place I grew up, and around the time I got married, my wife and I moved back. I shouldn’t say *she* moved back, since she grew up somewhere else, but she moved back with me.

    Recently, I broke my leg, and so for the next couple months, I can’t walk on it. My house has stairs in it, and up until I broke my leg our bed was upstairs. Stairs are tough to negotiate on crutches, and so I asked my brother to come by and move the bed down to the ground floor bedroom. I was amazingly grateful, because there’s no way I could have done that on one leg, and my wife simply isn’t string enough to do it by herself. I also got my brother to bring in a stack of wood from the woodpile, because I can’t carry that on crutches, either (our heater was broken, so we were heating the house with wood. It has since been fixed).

    This morning on her way to work, my mom brought over a quiche she made last night. I had some for breakfast.

    The fact that we were able to move my wife’s father up here after his stroke made it even possible to help care for him. If he had stayed in Southern California, that wouldn’t have even been an option.

    Anyway,this is just a collection of anecdotes, but the point I’m trying to make is that having a family support network nearby is extremely valuable, and it’s something I think we tend to forget when everyone’s doing OK. It’s only when someone gets sick or injured that you really realize what that support network does for you. It’s something to consider for anyone considering making a long-distance move, or who might be contemplating what will happen as his parents age.

    Through the first half of my twenties, I think I took my family largely for granted, but now, as I’m about to turn 30, I can’t imagine living outside of driving distance from them.

    J.D.’s note: Tyler, I never did add to the chorus of best wishes for your speedy recovery. Did you break your leg while surfing? And I think what you’re describing is what I call social capital. I’ve written about it some in the past because I think it’s very, very important. Social capital can be more valuable than financial capital.

  94. AMANDA says 18 January 2011 at 12:52

    @9 broke professional-we are seeing this with my MIL. Currently she is paying the car payment and insurance on a car for her daughter who’s at least 25 and has a child of her own. She puts $25 a month to her retirement. My husbands siblings can barely care for themselves and I know we’ll be taking care of her. Thankfully, there’s time to help her set aside more for retirement. As soon as this car is paid off I think it’s got to come from there! She is very interested in finances now (finally) and she got out of debt! Then she made another bad choice of that car payment so that will be what we deal with next!

  95. Kevin M says 18 January 2011 at 13:02

    Good luck, JD, I don’t have much advice other than what Lane said – make sure her will, PofA and other legal documents are in order. My wife’s parents are going through something similar and it is not easy. Just be there for her and do what you can, that’s probably what she’d want.

    Also, if she’s the owner/part-owner of the box factory they will probably want something in place too to ease the transition – like a buy-sell agreement.

  96. Beckie says 18 January 2011 at 13:12

    @Crystal: I feel your struggle. I truly wish the best for your family. May I suggest that you and your husband have to put your young children first before anyone else, including your MIL. Secondly, as others have posted, contact the local Area Agency on Aging in your city. They have experience in providing long-term care and can provide advise and assistance for your MIL. As for your husband’s siblings, you cannot help them until they are ready to help themselves. The reality is you have growing children who have a right to thrive, regardless of anyone’s illness or disease. Lastly, either through Area Agency or another social service organization, I would suggest finding a support group for families dealing with drug abuse. You and your husband are making tough choices and the both of you need as much support as you can get. Best wishes to all of you!

  97. Tyler Karaszewski says 18 January 2011 at 13:19

    Yeah, J.D., I broke it in a surfing accident. It’s a fairly uncommon surfing injury. With surfing, falling is just part of the sport, but luckily you land on water so injuries are actually fairly rare. In this case the wave, my board, and my leg came together just exactly wrong, though.

    I broke it at this same spot probably within an hour after taking this picture: http://www.flickr.com/photos/tylerkaraszewski/5332486840/lightbox/ I was on a similar, or maybe slightly larger wave to the one in the photo. (On a related note, if my occasional in-comment photo links ever get annoying, I can stop them. I know that the self-promotional “I have recently written about this topic on my blog, too” comments annoy many, including myself, but I feel like the photo links aren’t done in the same spirit.)

    And yeah, I think you’re right about “social capital,” where this could be “family capital” which is a sort of special case of social capital in general. Though I feel “family capital” runs deeper than most other forms of social capital. It takes a different (higher) level of closeness to come move someone’s bed downstairs than it does to pass along a resume to the HR department, for example.

  98. Alice says 18 January 2011 at 13:37

    I’m not sure if this was mentioned already but it is possible to have someone come and live in as a caregiver M-F and have the kids take care of mom alternate weekends.My family member is such a caregiver and they are not too expensive, provide continuous care of one person (instead of an army of strangers at a live in facility) and can also provide your mom with some companionship. From my experience, these are often immigrants from other countries, most very compassionate and working for $450-650 per week. I think it is a wonderful alternative to live in or assisted care, as it is more personal and allows mom to live at home as she desires.

  99. Kristen says 18 January 2011 at 13:47

    Sonja’s(#51)advice for Shauna hit the nail on the head in my opinion. Of course, it is such a personal choice but I agree that they need to have a discussion with their parents about the parents’ responsibilities and what their plan is. The “burden” (I am not sure if that is the best term in this situation but it could turn out to be) shouldn’t just be on Shauna and her husband. The thing to consider is if Shauna and her husband help financially, could that put them in financial risk and then the cycle continues. (this is actually a question that I am considering for myself right now)

    JD, I appreciate you sharing about your own mother and can’t imagine the stress of that. It sounds like your mother was blessed with three good sons and I am glad to see the support on here for you.

  100. eleni says 18 January 2011 at 14:06

    In retrospect I would have allowed my mom to die naturally, 1 year earlier, without brain surgery and nursing home care. Sadly, the one year of extra life we gave her was horrible.

    Dad had a union insurance plan which covered everything for both of them, and I mean EVERYTHING! Money wasn’t an issue. Home was paid for, pension/SS was adequate.

    My mom had been randomly falling at home, so we thought she should see the dr. She was adamant she didn’t want to go. She was afraid she’d get left there. Immediate surgery was recommended or death was imminent. We talked her into surgery. She was right, she never saw her home again.

    My mom, a dignified, private woman became a nursing home patient after radical brain surgery. Her nursing home expenses alone were $24,000 a month!!! She ended up dying 1 year later in a hospital bed, with a “jason mask” forcing her to breath, my brother and I by her side. My dad died just 3 months after she left their home for surgery.

    It’s a moral question…very personal. We learned “life saving heroics” in elderly care doesn’t guarantee quality of life. We did the best with what we knew. But if I had a “do over” I’d have kept her at home and allowed the process of dying to naturally occur.

    Although this doesn’t address the original question, it may assist someone reading today. It is just one issue, among many, to consider.

  101. Kathy says 18 January 2011 at 14:36

    I second the idea of a geriatric care manager. They can make recommendations for your mother and your area that you might not have thought about. We went through this with my in-laws — definitely worth a one-time expense.

  102. SupportingParents says 18 January 2011 at 14:40

    @Adam #86:

    It’s nice to have someone who understands although I wouldn’t wish the situation on anyone.

    It’s really sad when you have fantasies about just walking away, changing your name, and going off to live your life like other people who either don’t care or choose not to be involved with their families. That said, I wouldn’t change the time I’ve had with my grandmother or parents for the world. It really takes a dramatic event (in my mother’s case a horrible accident during routine surgery) to make you appreciate that time is short. However, when you are broke and tired and being pulled in 20 directions that same time can be very loooooong and stressful.

    This is the sort of topic that a message board or email group could really help, but it is one of the topics that is not discussed enough.

    There are very limited resources for elder care, and I think it is only going to become a bigger issue as people live longer and healthcare gets harder to acquire/keep.

  103. RandyC says 18 January 2011 at 14:46

    Shauna:

    Consult an Elder Care Attorney (google the term for one in your state). These attorneys are specialists in Medicaid, etc. This is especially important if both parents are alive – so that the surviving parent isn’t impoverished by paying for care for the ill one.

    I used one to advantage to arrange for my mother to receive Medicaid assistance in the nursing home. (Unfortunately Dad didn’t provide for Mom). Elder Care attorneys can navigate pay-down requirements, how to handle IRAs and other resources, what the person can keep (house, car, etc), what they can ‘gift’ to the family, etc. I know people who consulted unspecialized attorneys and were given wrong information that cost their loved-ones tens of thousands of dollars and impoverished the surviving spouse.

    Our taxes pay for Medicare – use it!

  104. Kathryn says 18 January 2011 at 15:07

    Thanks so much for opening up about your mom’s mental illness; your willingness to cover “taboo” topics (and how they affect our finances) is one reason I love your blog.

    My parents are still relatively young, but I was closely involved in dealing with my grandfather’s final illness, death, and estate about 5 years ago. My grandfather was extremely well prepared for the end of his life, documentation-wise. However, his final weeks and the resolution of his estate involved a lot of unnecessary conflict and confusion because his primary caregiver (a family member who was also his executor) was hampered by denial, grief, and poor interpersonal and financial skills. Things would have been so much easier if this family member had faced the reality of my grandfather’s advancing age, accepted my grandfather’s repeated invitations to familiarize himself with the estate and discuss end-of-life plans, and accepted input and help from other family members in carrying out my grandfather’s wishes.

  105. Andrea says 18 January 2011 at 15:13

    I have gone through this. I wish you strength, patience and good people to deal with. You need to get professional advice(paid or free- however you can get it), you need to have all of her paperwork in order and up to date- a will , power of attorney – medical and financial and an advance directive. Make sure you & your sibs know where every important paper is and everything about your mom’s finances(this can take a lot of time if it is not currently organized- took me close to 2 years to find everything) According to your story, your mom does not take her meds regularly and this creates a medical crisis. Someone must monitor her meds every day- not occasionally. If you and your sibs feel you cannot be her best medical advocate- you can hire an eldercare consultant(who could also advise you about other kinds of resources)to go with her and you to the appts. If you do decide the family will care for your mom, consider occasional paid respite care. AND(although I suppose you know this) regular medical insurance and medicare do not pay for longterm facility care or in home long term care. good in home or facility care is horribly expensive(around here) so Long term care insurance made a big difference for my mom- 24 hour care at home for 3 years( in her 90’s). The conversation and the work is tough but do it now- it does not get easier- especially if your mom deteriorates mentally.
    The best of luck and my prayers too!

  106. Niamh C says 18 January 2011 at 15:39

    These are very difficult waters to traverse with a parent. I am the youngest of four siblings and none of us had tried to broach the “difficult” topics with our parents. However, my Dad became ill a little over a year ago. We all assumed that since they are over 70, my parents had wills and such in place. That was not the case. We also discovered my Dad’s finances were in bad shape. My dad’s mental capacity failed quickly so he wasn’t able to help us sort through most of it, other than to show us where he kept the files. My mum fortunately was very willing to accept our assistance. She is actually good with her money, but it was overwhelming for her.
    I would advise dealing with these issues while your parents are still healthy. It is stressful for all parties at the best of times, let alone during a crisis. While my mum’s situation is not as financially secure as she would like, at least she understands it now and can plan accordingly. As my father recently passed away, my mum and I have made plans to review her budget and finances once we sort out his Social Security and pensions and such. And we will review her retirement portfolio to make sure it is balanced correctly. I feel lucky that she is willing to accept help. Many children will find their parents much more resistant. My father was ashamed of the state of affairs, so kept the truth from my mother. He resisted our initial attempts to uncover the truth, just as he swore he would never stop driving. As he had a brain tumor, driving was a grave concern. We got around that one by having his doctor inform him in no uncertain terms that he could no longer drive.
    Everyone will encounter different issues based on the situation. It is a fine line between protecting your parents’ pride and getting these issues on the table. One way to start the discussion is the matter of wills and such. Having estate documents is a necessity for anyone, regardless of any other issues. If that process goes well, it is a bridge to discussions about finances and long term care – since these issues will be touched upon when drawing up estate planning documents.
    These matters are not fun, but you will sleep better at night.

  107. Mom of five says 18 January 2011 at 15:48

    I also want to make a second post on this topic dealing specifically with finances. Even though my MIL lived with us for more than three years, I could hardly call her a financial burden. Ironically, I think she cost us so little because of her poor financial state – everything for her was basically free – prescriptions, county paid for a home health aide 3x a week, even a music therapist would come by occasionally to break up her routine.

    We did pay for her food, and I suppose the fact that she lived with us made her ineligible for food stamps, but a woman in her 80’s doesn’t eat much, so I can’t say I really noticed the extra expense. Because she had no other expenses, her tiny SS check would pay for her adult diapers, vitamins, etc. She even had a little spending money leftover to get her hair done or give little birthday gifts to her grandchildren.

    The only outlay of cash we incurred because of her was respite care. Had the nearby siblings chipped in more in that area, we wouldn’t even have had that.

    Also, I wanted to address playing to the children’s strengths in regard to caretaking. While one adult child may be best suited for overseeing personal care, it is not fair to equate that emotionally and sometimes physically draining task to the task of overseeing the finances. Not that anyone here is equating the two, it’s just a particular sticking point with me.

  108. Russ says 18 January 2011 at 15:55

    When my mother was diagnosed with cancer, she went out and created a trust and did a great deal of estate planning for me. It was amazing and refreshing to be able to talk with my mother about her final wishes. A trust is a wonderful thing, I made one as soon as my mother passed. If you can have a trust made up, it skips probate and saves a ton on taxes. Sorry to seem cold.

    One other thing, and this is difficult for all, ask how she wants to be buried and make sure the whole family is on board. This might save you heartache.

  109. Regina says 18 January 2011 at 16:44

    seek out an elderlaw attorney (look into NAELA.org) for advice on not just advanced directives but resources for help in planning care such as geriatric care management. I’ve lived thru the care of an elderly parent as well as worked for an elder law firm and witnessed many families transitions. Get all the documents in order and learn what she may be eligible for and go from there.

  110. sarah says 18 January 2011 at 17:05

    Your mom is in a unique situation due to her mental illness. She may be eligible to have a social worker that can help her with some of these things. It works differently in different states or I’d give more information.

    I’m a clinical social worker in Chicago and I work with people exactly like your mom (some in better shape, some in worse) and I basically meet with them once per week or so to check in, see how they’re doing, help them process what’s going on, do some counseling, advocate, provide referrals, and I also accompany people to the doctor or to social security if they find it confusing or overwhelming.

    Maybe you already know all this, but if not I’d look into it. She may be able to get a referral from her psychiatrist or you could just make some phone calls:

    http://www.oregon.gov/DHS/mentalhealth/cmh-programs.shtml

    And thank you for dealing with this the way you are – so many family members are afraid or embarrassed and avoid the situation entirely.

  111. Jan says 18 January 2011 at 17:09

    Courtney- your FIL may be eligible for spousal benefits on your MIL’s wages! It may not be much- but it is worth checking.
    JD- you should check out your father’s SS. Your mother could start hers at 62 and add on the 1/2 of your dad’s at 65. She will get the higher amount in the end. Worth checking as well. I’d go to SS and talk to someone in person.

    Dsdf- It is nice to think that everyone has the capacity to care for their elderly parent- but it is not true. A mentally ill person can be way beyond difficult. I know. My mother cared for my father until he became violent. Never judge another’s position of strength. I don’t wish elder abuse on anyone- on either side.

    Shauna- check the laws in your parent’s state if you are financially responsible for their care and debt. That might help with some of your answers. You might be better off giving an allowance than trying to take it all on. There are great social programs out there. AND believe it or not- MANY people survive on SS alone. Check into food ministries in your area and medicaid.

    This is a tough topic. Thank you for opening it up. Because of my father’s terrible decline into mental instability and death my siblings learned a great deal. We learned our strengths. We learned that I could do many things 2000 miles away that my sister, who owns a business ten miles away, could not do. We also learned who is in denial the most and isn’t much help.
    My sister now has my mother’s (80 yr) finances and business affairs well under control. I am prepared for living near my mother for several years when the time comes. My older brother is more stable about the heavy lifting (selling houses/ moving things/ doctor visits). The other two- well hopefully they will step up more next time.
    We have learned to work as a team- double teaming in the case of “med alert” buttons and soon the dreaded “you can no longer drive” talk. Mom’s doctor calls us when he is worried (yup- even in a big city he makes house calls). We found a FANTASTIC physical therapist who is now her case manager. We are lined up.
    Does that mean we are ready- nope. Never will be.
    Makes me worry that I only had two children though!

  112. Erin says 18 January 2011 at 17:13

    My husband and I are in a similar situation to what SupportingParents (#60) described. My husband’s parents have made poor financial decisions for their entire adult lives, owe the IRS a lot of money, have a lot of consumer debt, yet continue to live above their means. We have bailed them out several times with their rent and general living costs. The hardest part is that so many of their expenses are unnecessary. They rent a 3,000 sq foot house for just the two of them, and refuse to consider less expensive options. FIL is self-employed, and he just doesn’t bring in the kind of income he did 10-15 years ago. They’ve cut back a LOT in recent years — but nowhere near enough. They have zero savings. When the family suggests that they scale back, they insist that they will have more income “soon”. They’re in complete denial, which is frightening. They have even alluded to having “nothing to live for” if they have to cut back any further. It’s just a rotten situation.

    The problem my husband and I (and his siblings) struggle with is, how should we handle this situation? His sister and brother both insist that they don’t have any leftover income to contribute to their parents. They each have children. Since my husband and I both have decent jobs and do not have children yet, we feel like there’s an assumption that we’re better equipped to help out financially. There seem to be very little resources/advice on situations like this. We’ve agreed to not dig his parents out of any financial messes in the near future… we feel they need to hit “rock bottom” before they realize that they cannot afford the large house, dinners out, new clothes, etc. But it’s hard to be the one telling your parents that they need to change their ways — that they cannot afford anything more than the basics. Friends all say that we shouldn’t provide any financial assistance at all, but it’s so much easier said than done. Who really wants to see their parents go through this? If they get evicted, where do they go?

    Reading through the long list of comments for this post, the problem of aging, financially-challenged parents seems to be pretty huge. I agree with the poster who said that a book could/should be written on this topic!

  113. jdwa says 18 January 2011 at 17:21

    My sympathies to all of the posters here who have cared for aging parents. I helped my mother care for her parents at the end of their lives, both suffering from dementia. My father died unexpectedly after a catastrophic headbleed, and my family made the decision to allow him to die a natural death, rather than keep him alive in a persistent vegetative state, a quality of life he would not have found acceptable. Very difficult decisions.

    I am a physician, and I split my time between working as a hospitalist (including ICU care) and in home hospice. I cannot stress enough how important it is to discuss your wishes with your loved ones, regardless of your age or your health. Many living wills and advance directives are too vague to be useful. Specifying that you don’t want to end up “like a vegetable” or that you don’t want “heroic measures” is difficult to translate into meaningful action.

    The most useful framework is to consider what makes your life worth living. Is it spending time with family? Is it caring for your own needs independently? Is it engaging in intellectual pursuits? Is it being physically vital, able to hike/fish/run? What are your spiritual beliefs about the end of life? Is there anything you are afraid of? Is quantity more important than quality? Which is more important, being alert or being free of pain?

    Once you can identify what you consider a life worth living, work with your doctors to choose tests and treatments based on their likelihood of helping you attain those goals. There’s a lot of research on the outcomes of people who receive CPR, ventilators, tube-feedings, etc., and that information can help guide what treatments are most suitable for each of us.

    As mentioned above by several other posts, social workers (aka “case workers”) can also be terrific resources in having these discussions. Palliative care physicians and nurses specifically focus on supporting families as they work through these issues as well. As I’m sure many of you have encountered, some doctors aren’t comfortable talking about these issues, which makes things far more difficult for families.

    I realize that the major focus of the original post was on financial support for aging parents, but I encounter so many families struggling in heartbreaking circumstances. I apologize if my post comes across as proselytizing.

  114. margot says 18 January 2011 at 17:25

    My best advice is to have lots of discussions early and often – meaning now – involving your mom, your siblings and your siblings’ spouses. It’s so important to put everything on the table and talk about it all, especially before your mom’s mental health gets worse and before you’re just responding to the next crisis. Also, it helps a ton to have clear, frequent, honest communication among siblings to make sure that mom is being cared for and that none of her children are being too overwhelmed or taken advantage of. I’ve seen siblings (with healthy relationships) divide care for parents either by day or by task. By day would mean, for example, that each of you takes two days of the week and does everything that your mother needs on those days. There would be an agreed upon minimal list, such as checking on meds, tidying up the house, making sure she has food, etc. And there are also special tasks like going to a doctor’s appt. The other model is to divide tasks by the abilities of each person. An alternative if one sibling ends up doing most of the work is to all agree that that person will be paid a certain amount out of mom’s income to reduce resentment and make sure everyone is being fair.

  115. Laura says 18 January 2011 at 17:38

    For folks who mentioned helping with their parents medical bills–

    I work in non-profit fundraising and received an article today that mentioned there is a way to make a “charitable gift” by paying another persons medical bills directly to the service provider.

    Here is the article (audience is people who work in gift and estate planning- link to source at the end):
    “A bedrock principal of estate plans is that the more you give away while you are alive, the less that might be vulnerable to taxes. You can leave more to you heirs and charity. Its called “Strategic Gifting” and you and your spouse can each give up to $13,000 a year to each of as many recipients as you wish. Acting jointly you and your spouse can give up to $26,000. Any year you top the $13,000 limit you must file IRS gift tax Form 709, but you will not owe a tax until you exceed the lifetime exemption on total gifts and estate asset transfers.

    Individuals can stretch the annual gift caps by paying for someone’s medical expenses and/or tuition if the payment goes directly to the service provider.

    By giving gifts now you remove assets from your estate and also remove any appreciation on the asset, a major benefit if you gift stock that has appreciation potential.

    If you are working with a prospect who has a taxable estate under the current regulations suggest to them both individual and charitable gifts are a good method of getting under the exempt amount.”

    Here is the original link if you’d like to read the rest of the newsletter: http://www.connellandassoc.com/Newsletters/January2011issue.htm

  116. cherie says 18 January 2011 at 18:09

    JD I just wanted to send my support – I have no other advice – there’s so much above – but I know this is a hard, hard thing to deal with – and I thank you for sharing your story – I hope it helped to write it down

  117. Michael says 18 January 2011 at 19:14

    I didn’t look through absolutely every post, but I wanted to address something J.D. mentioned earlier about taking Social Security at age 62.

    Yes, it usually makes sense to wait until an older age, since the government increases social security distributions at a fairly healthy rate. However, there’s a loophole in place that allows a person to begin taking benefits at age 62 and still get a higher benefit at a later age (let’s say 70).

    Let’s say a person starts taking the Social Security benefit starting at 62 because they would rather have monthly income than waiting. If, at some later age (in this case 70) that person pays back all SS benefits received from the government, they can reapply for Social Security and receive the larger benefit they would have received if they had waited until 70.

    Basically, the person can have their cake (sort of) and eat it too. Yes, they have to come up with a significant amount to repay the benefit, but I don’t believe that it’s increased for interest or inflation, so it really amounts to an interest-free “loan” for a number of years. And if the person passes away young, then at least they’ve received some Social Security benefit rather than missing out because they waited.

    No idea if this loophole of sorts is going to stay in the long-term Social Security plans, but I would definitely talk to an advisor about it to see if it makes sense. If I remember correctly, this strategy can make tons of sense if both parents are alive and one begins taking Social Security at an earlier age.

    Note: I have a CFA and work in finance, but I’m definitely not an advisor and people should talk to a professional regarding the timing of taking Social Security benefits.

  118. SLCCOM says 18 January 2011 at 19:25

    JD, make sure that all the kids have HIPAA rights to get information about the parent. If something happens to the two that do, then nobody else can get information if the parent has dementia.

  119. ellie says 18 January 2011 at 19:28

    I don’t have advice – just a question/comment. I wonder why its better to wait before taking social security? I took mine at 62. It was less than if I had waited til 65, but it has worked out well for me (I’m 76 now).

    J.D.’s note: That’s the only reason I know of, Ellie. The longer you wait, the greater your benefits are. If you need to take it before 65, take it. But if you don’t, then you’re better off waiting so that you can get the maximum benefit.

  120. Tina says 18 January 2011 at 21:10

    My mother, in her early 80s and frail, lives about 2,000 miles away in an assisted living center. I’m her POA and handle all her financial stuff and any random crazy stuff that comes up. After some bad experiences, we found a wonderful personal-care helper; she handles doctors’ visits & making appointments and even stuff like steering my mother (a terrible spendthrift and shopaholic) toward inexpensive clothing stores rather than pricey boutiques. I don’t know what I would do without this woman.

    I had to take over the finances and bills all at once due to a medical situation. I wish I’d had access to my mother’s checking account prior to the emergency; once I had online access, I could pay bills electronically and monitor the balance. I also wish I’d had information about all of her accounts ahead of time. I had to gather it from her massive, unorganized mess when I was still trying to sort out her housing options. Now I have most of her bills coming electronically to my email account. I’m not a co-signer on any accounts; I just have the access so I can handle transactions.

    It has been invaluable to have photocopies of everything in her wallet. Get photocopies of recent tax statements if you can; I found I had to have that in order to get eligibility for the assisted living center’s financial aid (once you live there x years, you can apply for reduced fees, but they want all your financial data annually prior to that.)

    One of my primary reasons for choosing this assisted living center is that it’s part of a “family” of care facilities with progressively higher levels of care. If my mother needs more care at some point, she will get priority over those outside the “system.” Trying to find a room/bed in a decent place at the last minute is really, really rough.

    I also put limits around how much time I spend on her stuff. We were never close and she always refused to deal with practical issues that would have taken the burden off me. So I do what needs to be done, make sure she’s safe and cared for, and also make sure to make time for myself.

    Good luck, all.

  121. Jessica says 18 January 2011 at 21:20

    What do you all think about buying long term care insurance for your parents?

    My mother has no resources other than social security. I’ve moved her into senior low income housing near me and for now her social security covers most of her expenses. I gave her my older car when I replaced it and pay for her cell phone and some clothes but she handles most day-to-day costs.

    I recently researched LTC insurance and the quotes are around $3,000 a year. I decided to look into LTC insurance because I am an only child and work full-time so when she needs full-time care I don’t know how I will handle it. There are government programs that pay for nursing homes for low income people but, based on watching as my grandparents age, I know there can be years between the time when elders can live independently and when they need (and qualify for Medicaid to pay for) full time nursing care. During that interim, semi-independent period my aunts have stepped in for my grandparents but there are several of them and they don’t work outside the home, so they aren’t juggling elder care and a job.

    Most advice on the web is that LTC insurance should be for folks with resources to protect. My mom has none but since I know I will step in to take care of her if necessary, I am considering buying the insurance to protect myself. The annual cost of $3,000 is painful but manageable. But assuming she doesn’t use the insurance for 20 years (reasonable, given her family history) I am pondering whether I’m better off just creating a savings account and depositing that amount each month.

    I guess this is really just a question about self-insuring but I’m curious what others are doing or would do in this case?

  122. E says 18 January 2011 at 21:56

    I believe a poster mentioned filing for Social Security retirement at 62, then repaying it all at 70 and refiling at the higher rate. Social Security just changed its rules in the past weeks and this is no longer allowed. It amounted to an interest-free loan that very few could take advantage of, since most folks can’t pay back all their benefits in a lump sum.
    http://finance.yahoo.com/focus-retirement/article/111550/social-security-payback-option-eliminated?cat=fidelity_2010_managing_wealth&mod=fidelity-managingwealth

  123. Jan says 18 January 2011 at 22:07

    Jessica- I have heard the people in the middle need the insurance. People at the top have money to handle their care. People at the bottom have medicaid and cannot be turned out of a home once they are in it. People in the middle might spend every penny on long term care- leaving nothing in the end. My kids know that we are in the middle- but don’t plan on long term insurance- that is what our savings are for.

  124. Lisa says 18 January 2011 at 22:20

    Hi all –
    This is SUCH a powerful discussion, I am right there with you coming off of helping my mother care for my father who died of Parkinsons and complications last year. Definitely recommend finding people to help offer perspective and guide the way. Here is my eldercare coach who was a lifesaver: http://www.caringforcaregivers.com

    My heart goes out to everyone grappling with these challenges. Overall the process with my dad went well and we had enough in place to be present with him at the end.

    Based on my experience now I am creating a workbook to help people prioritize everything that needs to be done and create a team of family/friends/professionals as suggested in other posts. If you’d like to stay in touch and learn more as this offering develops, please email me: [email protected]

    The experience of caring for a deteriorating loved one can be the best of times and the worst of times. Thanks again to JD for raising this important topic.
    Best wishes to all~
    Lisa

  125. calliope says 19 January 2011 at 03:05

    In my country (Greece) parents are always (well…the norm anyway) taken care of by their children should the occasion arise. That means that the most usual arrangement is that the care is divided in all the children involved.
    For example, if my sister has the room to take them live with her, I’ll help more either economically or by physically going there to help bath them, feed them, etc.
    My cousins have hired a woman that stays in my aunt’s house 24/7, but they share the cost, the visitations, the cleaning of the house, the weekly chores etc
    It’s not at all uncommon for the child to build an extra room/rooms for their parents for future use

  126. SA Esterly says 19 January 2011 at 04:01

    My parents stayed in their home until ages 89 and 92. My father, the older of the two, continued to drive until 92. It took my brother and I two years to get them to move into assisted-living. They are in a very nice and affordable place now and they like it. This was a long journey for us. We tried meals on wheels, caregiver coming to the house, merry maids…all rejected. We finally persuaded my father to look at the place they now live. The transition was and is still hard. After 60 years in one place, it was very traumatic for them.

    My advice to others – do not give up. Do what you think is right. It will work out.

  127. R says 19 January 2011 at 04:40

    My mum recently passed away last year from a terminal illness in her early 60s and I still lived with her and took a year off to care for her.
    I would definitely recommend a will, Power of Attorney, Advanced Health Directive, etc, and also think about funeral planning/costs. Plus make sure you can access or have her account details, utilities and other bills details, tax file number and financial info like that.

    I can understand your situation: my mum used to joke that we had reversed roles: she was the sickly child and I was the parent! She was always so capable and strong before she became ill.

    I am from Australia so aged care here is subsided, a person with high care needs on the age pension would pay 85% of their pension for aged care and recieve 24 hour nursing and care in an aged care facility. Low care (assisted living) is more expensive but you can receive community care in your own home at a low cost. We also have a Carer’s pension, so people( like myself) can receive income support for caring for a relative or someone fulltime.
    We also have excellent low cost community nursing/personal & social support through subsidised programs for elderly persons, even for things like helping with the shopping or house maintenance, or transport, or just a phone call or a visit. I would look into community nursing or organizations like the Salvation Army for their programs for support and care of the elderly
    Perhaps if a family member or someone could go along to her appointments and be an advocate for her: I attended mum’s appointments and hospitalisations and learnt so much about her illness, medications and treatment as a result and so was able to be an advocate for her, especially when she was too ill to be able to ask about things for herself. I also kept records of appointments and medications and key events and things like that.

    Thanks for sharing your story JD and I sincerely wish you the best in planning the care for your mum.

  128. Bluemute says 19 January 2011 at 04:58

    Although I didn’t read all of the comments, there’s an aspect missing in J.D.’s narrative: disability. If your mother’s psychiatric and physical conditions cause her to be unable to work, look in Social Security Disability (SSDI and SSI) benefits. You don’t have to wait until she’s retirement age. All of the information can be found at http://ssa.gov/pgm/disability.htm. This is an excellent disability program for any age. It’s helpful to have an attorney guide you through the steps after the initial denial step, benefits do get awarded.

    Although you may see TV ads for the aggressive SS disability lawyers, there are many lawyers who do an excellent job without all the advertising. Social Security allows lawyers to charge only a certain amount if benefits are awarded (in 2010 the maximum was $6,000, which is usually taken by the SSA from the disability benefits). Lawyers don’t receive any payment if benefits are not awarded.

    The story was unclear whether your mother receives a salary because she’s still working, or whether this “salary” was some other type of employer benefit.

    Regarding patient confidentiality, even though it’s your mother, I have to wonder whether you have her permission to discuss, even in general terms, her condition in such a public forum. I think confidentiality is more the issue than mental health issues being taboo.

    Lastly, I object to you quoting a profanity in your post. It would be fine to have paraphrased how the lawyer characterized taking care of wills and advanced directives. In fact, the disabled or elderly person you’re trying to help may find it a relief.

  129. Chris says 19 January 2011 at 07:42

    My widowed mother started collecting Social Security as a surviving spouse when she was 60. She had determined that because Dad had been on disability before he died, she would get more drawing half of Dad’s Social Security than drawing her own when she got older. I think overall this ended up being a wise decision because my mother died at 63. But widows can either collect on half her husband’s, or her own, but not both. There are also income limitations until they reach a certain age (I’m not sure about pensions). You all will need to review that with Social Security to see which scenario will be the best for her.

    And instead of wondering whether it’s too late for long-term care insurance for your Mom, find out. It might be too late for it to be cost effective, but the longer you wait, the more likely it’ll be too late when you get around to it.

  130. PB says 19 January 2011 at 07:57

    JD — I think you have found your next book!

    On a personal note, my youngest is dating (and talking marriage with) a very responsible young man who in response to his parents’ inability to manage money is very careful with his. His parents have recently “borrowed” over $ 6,000 from him, have borrowed in the past, and probably will in the future.

    My daughter and her BF have already started to discuss how they will handle this situation in their married life. The good thing about it is that they are talking seriously about their goals for education, housing, children, and so on. The sad part is that they, barely into their 20s, have to consider this in planning their lives together. At least their eyes are open.

  131. Audrey says 19 January 2011 at 09:27

    I have not had to deal with this as my parents are very active and do not have many serious medical issues yet. I won’t have to deal with a lot of the money issues because my parents have always been frugal and have large retirement funds (my mom is diabetic, and they’ve always known she will have larger medical bills later in life).

    My parents will have plenty of money for their funeral, but they think paying thousands of dollars for a box or to be cremated is ridiculous. They are being frugal to the end and donating their bodies to science, after which their bodies will be cremated at the cost of the institution.

    Their bodies could be used at a medical school for instance in an anatomy class. I did research at a medical school, and there was a memorial service held every year honoring those who did donate their bodies, and a flower arrangement was placed in the lobby for a week.

    This is definitely not an option for everyone. Lots of people think my parents are crazy, but it is a virtually no cost option for burial. This doesn’t really pertain to any of the questions, but I thought I would share.

  132. Laura W. says 19 January 2011 at 11:31

    This is the most useful article I’ve seen posted on the web in years. Many thanks to all who shared.

  133. shash says 19 January 2011 at 14:16

    I am late to comment, but I wanted to say thank you to J.D., Shauna and all who have commented. Although, I have no new ideas other than what has already been shared, I have been thinking about these things lately in relation to my parents and myself, so it happens to be a very timely post. The information shared here is something that I am still reading and taking notes on and it will definitely be a reference point for me in the future. Thank you, thank you, again.

  134. Meg says 19 January 2011 at 14:45

    Great you’re putting this out there, networking, and gathering information. I entered this role young, like you, and my mom’s decline has progressed quickly.

    I loved your bare honesty about family mental illness. My mother also has that aspect to deal with.

    Local and online family/caregiver support groups can be immensely helpful (though you’ve now created your own with this post!), and I’ve also benefitted a lot from the caregiver blogging community- so much that I was inspired to join them and share my own story publicly and regularly.

    Sounds like you’re on the right track and aren’t wasting any time.

    Although it doesn’t sound like it will apply to your situation, a great future topic for your blog would be how Medicare law for aging parents affects family finances, and what you can and can’t do to plan for that. A quagmire at best, but lots of people need more information on that topic.

    Glad you shared this,
    Meg

  135. First Step says 19 January 2011 at 15:20

    I was in a similar situation about 2 years ago. Although my mom didn’t have a mental illness, she had a brain tumor and lesions that at times impaired her ability to communicate. I wasn’t able to go to all her appointments because I lived 5 hours away. My dad is hard of hearing, and because of his hearing loss and my mom’s diminished mental capacity, diagnoses and doctors’ instructions were not always understood. Looking back, I wish I would have asked someone to go to the appointments with my parents.

    I had my mother sign a pile of “permission slips” so that I could get medical information as needed. A nurse at the oncologist’s office was a wonderful advocate for me and my mom in getting information from a variety of locations (Kaiser Permanente – ugh!).

    POAs and wills were already in place, so that definitely made my life easier. There was no probate because everything was joint with my dad.

    My mom kept organized records so it was easy to find all of their financial information, but mom was always a spendthrift, and there were almost $100K in debts. She had an insurance policy that covered about $90K; however, we only paid off the credit cards ($30K) immediately after her death until I had a better idea of what my dads regular expenses would be.

    Although Mom and Dad weren’t happy at first, I called in hospice, and once the nurses and social worker met with them, my parents were relieved to have their help.

    To SupportingParents, if you’re mom was injured due to a medical mistake, are you able to sue for compensation? Also, if there is truly no money left or you’re about to run out, apply for Medicaid. My cousin is applying for her mom because her parents have depleted their resources and are unable to live in their house.

    Best wishes to everyone as you handle your individual situations with your parents and family members.

  136. Artist says 19 January 2011 at 16:05

    Thank you for a much needed topic of conversation & for both your & Shauna’s openness. I have been through this with my father who frittered his nominal savings away fairly quickly after retiring & lived on just his social security & medicare. I was fortunate enough to find him a really great secure independent living senior apartment where the rent was based upon his income (social security), assets (10-yr old car), & his medical costs. His apartment was much nicer than my house was! When his alzheimers became such that he had to move into assisted living, the state elder-care social worker was invaluable in helping to transition him from medicare to medicaid & my other siblings researched quickly & carefully, available facilities & worked hard to get him qualified & accepted in one of the best that accepted a certain number of medicaid residents. The worst was the transition from assisted to hospital to hospice. We couldn’t actually get him into a hospice facility so he had to go into a nursing home that designated him hospice care. Luckily a couple of my siblings were able to take time off work his last couple weeks of life to advocate for the best compasionate care during the end stage of life. I researched cremation options & arranged most of that over the phone. While the research, the dealing with doctors & beureaucrats is often exhausting & seems overwhelming, if you just keep asking questions & pushing for “better”, quality care can be had with little or no cost to the children. But you have to be proactive & sometimes pushy & access to internet for researching is essential!

    When my step-father developed alzheimers as well, it went much more smoothly as he & our mom had planned well & had trusts, & wills, & directives all set up & in place. Luckily, they were in much better shape financially to deal with the progression.

    Now my mother is in her 80’s, lives in her own home & recently had an incident that involved a trip to the E.R. & a short stay in the hospital for tests. As it happened I was the only child in town, so I ended up having to drop everything for three days to be with her. Thankfully, I have a boss who is understanding. She is okay & home again, but the event prompted her to update her trust, double-check her proxy documents & look into getting an alarm system & health monitor installed. She had been resisting that until now.

    Depending on where you live, it is possible to obtain excellent care at highly rated facilities, even when the person is only on medicare or medicaid. Most cities, counties, or states have senior services divisions or non-profit elder-care organizations that are very helpful in navigating your way to finding clean, safe, & affordable housing, doctors, health care services, etc.

    The best advice I can give is this:
    1. Absolutely start asking the tough questions now.
    2. Do lots of research on present day issues & future issues. Start a folder/notebook that contains key information, contact organizations, names, numbers, websites. And update it periodically.
    3. If you have other relatives (siblings, kids, cousins, etc.) or close friends willing to participate, play to their strengths. Example: one of us has a legal background, one of us has a number of friends in the medical profession, one of us is great at research & organization, one of us has a more flexible schedule.
    4. Develop a communication chain. It is exhausting for the primary caretaker at any given situation to keep all the involved parties updated & care for the parent(s). The primary calls A, A calls B, B calls C, and so on.
    5. Too many cooks spoiling the soup only happens if you haven’t planned. If you each know your roles, more is better.

    Good luck. And thanks again for the subject.

  137. Monica says 19 January 2011 at 16:52

    I CAN HELP YOU!

    I am a social worker who works with elderly people every single day.

    yes, your mother should be eligible for a portion of your father’s SS benefits. She is eligible at age 65, and they should be sending her paperwork in the mail. If you have any questions, please call your local Social Security benefits office.

    If she is on Medicare, she is eligible at NO out of pocket cost to home health care. This involves a nurse coming in a few times a week, depending on their assessment, and doing things like setting up her medications for the week, making sure she is taking everything correctly, checking blood pressure, checking blood sugar, monitoring wounds and changing dressings, etc. She can also receive Physical, Occupational, and Speech therapy all in the home.

    They can direct you to a private duty agency in your area, which you can hire to help her do the shopping, cleaning, bathing, etc. They usually require a minimum number of hours a week (usually 4-6), but it may be worth it for you all to have some of that stress taken off of your backs.

    Please email me if you want to talk. I know what a stressor this can be, and I’d love to be able to help. :o)

  138. Chere says 20 January 2011 at 04:08

    Two books helped me with my own mom and, now, my mom-in-law.
    “How to Talk to Seniors” and “36Hour Day”. Both written by folks that understand what is going on.
    Mom lived with dementia only a yaer and passed on. We are watching dementia take over the life of my mom-in-law.
    As is its way, some days are good, some days are not so good.
    Luckily she trusts her son – he can take her to appts, do banking, etc. because she trusts him. I cannot imagine how to make it happen if she was paranoid.
    We have found having her live with us rather than 1000 miles away alone in the snowy environment lets us sleep better at night.
    She did great when we were able to get her to the gym regularly – I think she gained years of mental and physical capability. But she put her foot down and doesn’t want to do that again.
    EXERCISE is a big key to mental health. Keep the blood pumping to your brain. We’ll keep trying to take her for walks. But at 92yrs, we are trying to let her rule her own life as much as possible. Some days are easier than others.

  139. Mark Gavagan says 20 January 2011 at 04:41

    “End-of-Life Decisions Take Longer If Patient Hasn’t Shared Wishes With Family, Study Finds

    ScienceDaily (Jan. 19, 2011) – Family caregivers who had not discussed life support measures with critically ill patients took nearly two weeks longer to decide to forego further medical intervention than those who had prior conversations about the issues, according to researchers from the University of Pittsburgh School of Medicine and the Graduate School of Public Health…”

    Link: http://www.sciencedaily.com/releases/2011/01/110119120413.htm

  140. JTG says 20 January 2011 at 08:27

    I know this subject is about aging parents, but I have a similar situation to which I can relate. Sad to say, but hubby (53) just went on medical disability for depression and severe memory loss. The way he behaves it may be some form of dementia or mental disorder (brain scan did not show Alheimer’s)He has always tried to control everything, so nothing is in my name (which may not be so bad for now). I need to get him to give me power of attorney or joint access to bank accounts. His bills are behind and he just totaled his car. He’s going to the psych, but he only wants pills and no other therapy. No one wants to hear about it because I should be very happy (he looks good from the outside, i.e, house, car, money in the bank). No one really sees him act out daily, so it’s like a dirty little secret. Will work on him through March, but after that I will have to find a way to make him do what is necessary, as he’s not getting any better.

  141. marian says 20 January 2011 at 09:18

    One overlooked solution for aging parents who have little retirement savings is public housing. The typical picture of public housing is a poorly maintained high rise building in an unsafe city neighborhood. Indeed, this is much of what public housing is. But I know firsthand that there are many well kept public housing facilities in small towns. Many of these apartment complexes link up with the local council on aging and have meals, trips and other activities for the residents. If someone has significant health issues, this is not an option for them. But many elders are able to age in place in public housing because not only do they have the above services but they may qualify for home health aides to come in once or twice a week. The thing to do is to contact your state’s Area Agency on Aging which receives federal funds to coordinate these services.

  142. Bella says 20 January 2011 at 15:22

    I had to comment
    1) Thank you JD for bringing up such a great topic, I read the post on Tuesday and knew I had to make time to read the comments because I was sure there would be some really good discussion.
    2) Thank you to everyone who posted links to agencies that can help, I can see several coming into play in the next few years as my parents and my in laws continue to age.

    My best advice to Shauna is to make sure she is financially secure. Part of the problem I see with my parent’s generation and people a little older than me is this expectation of inheritance. My great aunt and grandmother both ended up in nursing home for the last 10ish years of their lives. My aunt went into a nursing home when she could no longer be cared for at home by my aunt. However, she had no money of her own except social security, so Medicare picked up the bill. The home wasn’t great, but it was clean and she was well cared for. My grandmother went into a nursing home facility when she could no longer care for herself, she had assests which were liquidated to pay for her care, when her money ran out – medicare picked up the tab for the home that she was in. Now, that means that her home was a little nicer than the one my aunt was in. But in both cases their long term care was significantly larger than either’s assests, but it didn’t bankrupt them or my parents’. This is how long term care works in the US. My parents (and their siblings) understood that. Now I know someone in my parents generation who did not save for retirment themselves, expecting their inheritence to fund their retirement. Well, the MIL took ill, was moved to a nursing home facility adn went through every last dime she owned (which I think quite frankly was her right) but now those same people are having to work significantly longer because they now have to fund their own retirement.

    The best thing you can do to protect yourself is to keep your finances seperate from your parents.

    As for the insistance on staying in one’s home. This just bugs me. My in laws live way out in the boonies, in a house they cannot take care of. It used to be that every time we would visit, we would spend the entire visit doing manual labor, I guess my MIL just expected her sons to continue keeping up the house like her husband did for his mom. Now, we call ahead and hire a gardener to take of things before we get there (thanksfully we have the $$), but there is still always a ‘honey do’ list waiting for my husband. But no amount of talking will convince them to move out of their ‘dream home’. Thankfully, my parents aren’t as attached to their house, though they haven’t sold it for a lower maintenence one yet, so I guess time will tell. The fact is that people don’t die in their homes in the US anymore. I think people who say – I want to stay in my home aren’t willing to see the reality that without help you don’t get to chose when to die, and most people (as the comments can attest) will not get to magically be hale and hearty at the ripe age of 80 (or 90) and then just have a massive heart attack (or something else that is relatively quick) and die. At 62 you and she may think that time is as far off as never, but you need to talk now about the criteria for when is the time. It’s not fair to expect you to figure out how to keep her in her home at all costs.

    The mental illness – kudos to JD for bringing it up, taboo and all. It is true that certain illness are exacerbated by aging and some fade as one gets older. Getting someone familiar with these effects to monitor meds is crucial. It does make things harder, sometime it’s what turns a normal healthy discussion into that ‘shitty’ one where people get defensive and mistrusting.

    It’s not just people who didn’t plan that need to worry about their parent’s money. My in-laws have great credit, so the bank keeps trying to get my MIL to refinance, ‘oh you’ll save so much money’, ‘oh, I’m your friend and trying to help you out’. We’ve at least convincered that she needs to run any refinancing through us and we’ll ‘check the numbers’ which means, call the bank person and let them know to stop trying to prey on my MIL, she has someone helping her she doesn’t need any friends like them. Invariably the paper doesn’t match the verbal promises and I get so angry that these people are allowed to continue to prey on unsuspecting women (to whom it never occurs that someone would call them out of the blue to take advantage of them ‘but she seemed so nice’).

  143. KS says 20 January 2011 at 17:32

    Widows are eligible for reduced widow’s benefits at age 60.
    http://ssa.gov/survivorplan/onyourown2.htm

    She can elect to take either her own benefit on her own record and delay the widow’s benefit until age 66, or to take the widow’s benefit now and delay her own benefit based on her own work record until age 70. Check out what the numbers are for each option.

  144. Kathy says 21 January 2011 at 06:41

    My mom passed away six months ago at the age of 90, but the last ten or fifteen years of her life were very difficult for us. She had vascular dementia, and some of the problems you are describing sound very familiar to me.
    I think you are wise to listen to others, as that’s the best education to help you deal with this.
    I think my sister and I were so overprotected that we really didn’t know if we were doing the right thing, half the time. We just kind of played it by ear.
    Plus, our other three siblings gave us zero support or help, so we were much overburdened.
    It took a tremendous amount of support from the two of us to keep my mother in her house, well fed, medicated correctly, and her many needs met. I would do it again in a heartbeat, but I will say it took total committment, and then some.
    She spent the last year and a half of her life in a rest home, which we swore we would never do. I came to see that as a blessing rather than something to be feared and shunned. Truthfully, we did the very best we could do, and still yet, after she died, we suffered from a lot of guilt as to whether we had done the right thing.
    The problems of the elderly are great! that is why many people don’t want to get involved with them, they don’t want to go through the bad/sad part of life. It really IS “for better, for worse”, and the true test of how much you really love that person.
    God bless you and good luck!

  145. Maggie says 21 January 2011 at 08:58

    I have been reading all these entries about aging parents and would like to share my experiences. My mom died 18 years ago in a hospital far from home. Mom was a church missionary and had no savings and very little income but she had Medicare and an AARP supplemental insurance but this was not enough. She made a small salary at the church but I tried to help as much as I could with groceries and bills. At the time, my family was young and my husband was not willing to have her live with us. One of my sisters and I decided to set up a savings account with all siblings contributing to this account as we could. I was the only one who lived in the same city as my mom so I was responsible for the bank account and could add or use the money as needed. My mom did not know about the account. My sister and I contributed about $20 per week or more as we could. The other 2 siblings contributed nothing. This account was really a lifesaver because I could use that for special things mom needed without using personal funds. It really helped my husband because we were not spending all our funds to help her. Mom died about 2 years after we set up this fund but it gave us some respite for some of her costs. Mom went to a hospital that could give her a transplant and it was very difficult for us to get there often. She got an infection and died with no family there at the time. The docs put her on a vent and said that they could keep her alive but she would eventually suffer from total organ failure. We decided to take her off the vent but it was a very hard decision. Medicare paid about 20% of her medical costs because of the way they pay. To this day, I wish we had kept her home and let her have family around. Apparently, the chances of her getting a transplant were very slim and we wish we had known that at the time. So, we still feel guilty that we could not be there but logically, we know we did the best we could at the time and try not to beat ourselves up for the things we could not do.
    So, to get to the point of this, my husband and I have set up wills, Durable Powers of Atty, Medical Directives and a revocable trust with our children knowing where all our information is kept and what their responsibilites will be. We left nothing for them to decide to make it easy for them.
    My husband’s mom is now ill and we are researching all the options available to her – the Social Security system and Medicare system stinks. They provide a lot of information but most of our parents who are in their 80’s & 90’s don’t have a clue how to do the research on a computer. I spent 8 hours just trying to find what plan would work best for my MIL for Medicare Part D. Anybody interested in setting up a company that just does this kind of research for seniors? Sorry this is so long but just wanted to let you know my story. Now, I have to sign up for Social Security and am still working. When and where do I get this information?

  146. Maggie says 21 January 2011 at 09:12

    JD,
    I saw your post that you would like to put some of these ideas in a format that everyone could use. This is exactly what we need. If there is any way I can help you do that, please contact me and I will be glad to lend a hand. Not only is this valuable for our parents but for us. The US govt really makes it hard to easily find out what we need and no agency is linked to another.
    -maggie-

  147. Kate says 21 January 2011 at 10:31

    My grandfather refused to leave his own home and lived on his own until death at 99 years old. He lived in the UK where they have great health services, but with his children living in the US and Canada it was a great concern to ensure his well being. Towards the last few years, he became much more affected mentally and there were several tips that worked really well to keep him living independently.

    1. We arranged for his lawyer and accountant to work together to receive his mail and pay his bills. He had been taken in by a few cons and given away a good deal of money at one point and so we set this up to ensure that would be avoided. All of his mail was sent directly to his lawyer who then discarded junk, sent bills to his accountant and gave personal mail on to my grandfather. The accountant also kept his accounts so that he had a maximum of $500 available in a checking account and checked in regarding larger purchases. As his mind became more forgetful, this arrangement was a godsend. Perhaps if you live close by, you and your brothers could take over this kind of task for your mom.

    2. He became increasingly distrustful of strangers so visiting nurses didn’t work very well until we found a neighbor that was glad for a part-time job. He didn’t need medical assistance but did need help remembering prescriptions, cleaning, cooking, etc. She came in for a couple of hours in the morning and then again at dinner time and ensured that he was taking care of his basic physical necessities. She also alerted his children when anything out of the ordinary was going on. Again, perhaps your brothers could work out a schedule of a similar sort.

    3. He appointed a non-family member as a trustee to his estate. This was a HUGE help after his passing, It’s quite amazing how grieving people can react after a loved one’s death and often it can be the catalyst for a lot of strong emotions to surface. Having somebody outside of the family dynamics to help sort out estate issues was probably the only way that his children were able to cope.

    This is a topic that I’ve already been in conversation with my parents about and the earlier it’s discussed, the better. It’s something that we don’t talk openly about often and I really appreciate that you addressed it. Good luck!

  148. A Knight says 22 January 2011 at 05:24

    Great post, and great comments in response.

    Mental health issues are a big part of many family’s daily lives and daily decisions. When my brother was diagnosed with schizoaffective disorder ten years ago, my family was forced to start talking about things that they had previously avoided discussing.

    Kudos for having the courage to discuss your mother’s illness, JD — I hope that others will feel more comfortable in following your example.

  149. Ann says 22 January 2011 at 17:01

    If one or either of your parents was in the service during war time there is a VA benefit if she qualifies financially. Aid & Attendance Benefits at va.gov

  150. Elizabeth says 23 January 2011 at 09:00

    I’m late to this converation but I wanted to chime in. If you have questions about Social Security, talk to a lawyer — it’s a really complicated system and you want to talk to an expert. NOSSCR, the association of SS claimant’s representatives (www.nosscr.org) can get you in touch with someone in your area. And most attorneys don’t charge anything unless they win your case.

  151. Sherwood says 28 January 2011 at 10:34

    J.D. if you’re looking for an idea for a spin-off blog, you just found it. There’s more info on this page – thanks to you and some great commenters – than I could find last month when I was Googling this topic to death. Adam’s right – there is nothing like this out there.

  152. Lana says 29 January 2011 at 22:23

    First, let me say I LOVE GRS and I’ve been reading it for a few years. This is my first comment because this article hits close to home. I’m not taking care of my parents yet (well, at least not full-time), but I often worry about it. I’m 29 and my mom has had epilepsy since I can remember, and I often worry about taking care of her now and as she gets older. Luckily my father is mostly taking care of her right now and is very responsible financially, but I often worry what will happen down the road. I want to start saving now for the possibility of taking care of them because I know I’ll have to help in some way, either financially or have her or both of my parents live with me. I felt very alone in worrying about this but not anymore. This article and the comments have really been a blessing. Thank you!

  153. Carol says 19 June 2011 at 08:10

    I just wanted to add a note here. I’ve been a caretaker for about five years now. It has a lot of ups and downs. Home Health Aides can be a real blessing. I wrote an article about how to go about hiring home help—if you think this might help you visit http://www.associatedcontent.com/article/6241258/how_to_hire_a_home_health_aide.html?cat=5

    Sorry, the whole article was too long to post here. Best wishes.

  154. Laurie Woodum says 25 October 2011 at 16:00

    I’m on the other side and there’s a few things I can tell you:
    1. Not everyone is good at care-giving. Your siblings may have limits (geographical, financial, or otherwise). That’s just the way it is. Some of you will be better at it and will carry the weight of it. Accept.
    2. Be as assertive now as you can be with your mother’s finances and legal paperwork before it becomes too tangled and she becomes too incoherent or confused to be helpful.
    3. As a caregiver, don’t try to live your life as you are accustomed to. Simplify. Sacrifices will be made. The stress only gets that much harder if you try to hang on to everything.
    4. There will be rewards beyond your expectations in the process. You will change for the better.

  155. Becky researching parent guardianship says 16 May 2013 at 08:08

    I think about this all the time and I’ve been doing a lot of reading about it lately. I feel like my parents might just be TOO stubborn for me to care for them sometimes. BUT I do still love them.

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