GENERAL - AGING PARENTS
 
 

DEALING WITH AGING PARENTS

As longevity increases in the population, the degree of assistance needed by the elderly grows. With parents living longer, the demands on their children can extend even into the children’s old age. For those who must provide care for an elderly relative, the extra responsibilities can mean the disruption of personal plans as well as a financial drain. This problem is even more acute for those clients who have both aging parents and dependent children, the group referred to as the “sandwich generation.” However, careful planning and decision making can help to ease the burden.
 
 

Most cities have agencies available to meet the basic needs of the elderly, from home health care to companionship and escort services. The National Association of Area Agencies on Aging, (927 15th Street, N.W.,  Washington DC 20005, (202) 296-8130, lists local agencies. There Web Site address is:  http://www.N4A.org.
 

Services that can be arranged include:
 

v Emergency medical response systems
 

v Daily visits by local residents
 

v Home care (e.g., laundry, housekeeping, cooking, small repairs, errands, and snow shoveling)
 

v Legal assistance
 

v Hot meals (at neighborhood centers or delivered to the home)
 

v Transportation services
 

v Day-care centers

In many areas, exemptions from rent increases and low-cost telephone/utilities services are available for the elderly.

Further help can be sought through senior citizens centers, religious organizations, welfare services, nursing homes, local branches of the United Way, and major hospital social services departments or elderly outreach programs. If the elderly person requires substantial health-related assistance, a hospital-based social worker is often the best alternative. Of course, in choosing among these plans, parents should be included in all discussions to the extent possible.

Sometimes, hiring a consultant can facilitate the planning for care of elderly relatives. These consultants, known as “private geriatric care managers,” assume many of the duties normally carried out by the adult children of elderly people. In situations where the child is either unable or disinclined to do so, care managers accomplish such tasks as arranging for Medicaid and Medicare benefits, researching nursing homes, and screening and supervising home care services. Because the children of elderly parents often live out of state, care managers must also be prepared to assist in a variety of circumstances, including medical emergencies.

The majority of care managers have been trained as either geriatric social workers or nurses, and the costs of their services vary but may range from a few hundred dollars for a one-time consultation to thousands of dollars for supervising an elderly person throughout the year.

Finally, given the rapid expansion of this field, little specific legislation regulates the industry. Most practitioners, however, employ those ethical codes acquired from their nursing or social work background.

The biggest concern for many families is the economic strain of caring for an aging parent. Insurance and Medicare benefits can, in most cases, provide much of the needed resources to care for an elderly relative. Obtaining adequate health insurance, including Medicare gap insurance for elderly relatives is of utmost importance.

Stories abound of elderly people whose life savings were wiped out because of a long-term hospitalization or nursing home stay that exceeded Medicare and health insurance limits. Some individuals consider taking draconian measures to protect their estates and loved ones against uninsured health care costs. For example, some people attempt to remove assets from the reach of health-care providers by gifting assets to children or other relatives or by establishing irrevocable trusts. The theory behind either of these measures is that by rendering themselves penniless, they can qualify for Medicaid. However, you should be cautioned against using either of these asset-stripping techniques solely for the purpose of qualifying for Medicaid. In the first place, these are drastic measures to take, and history has shown that giftees (usually children) cannot always be trusted to return assets to giftors who may later need the money. In the second place, Medicaid authorities in many states restrict the use of these techniques for purposes of qualifying for Medicaid, or they enforce minimum time limits between surrendering assets and qualifying for government support.

There are no easy answers to the very real health care concerns of older Americans. Two other, less drastic measures that older people may consider include obtaining nursing home insurance coverage or purchasing a residence in a continuing care retirement community. Truly comprehensive nursing home coverage is quite expensive, if it is available at all. Most policies do not cover the full cost of nursing home coverage and may provide benefits only over a limited time period. The second alternative, the continuing care facility offers lifetime care in exchange for a large initial payment for an apartment unit, as well as monthly residence fees. While there are some excellent facilities available, you should be aware that many have experienced serious financial difficulties, with dire consequences for the residents.