“Never too soon to talk about the future; it can be too late quite suddenly”

Local support group member and volunteer Denise is reading the book How to Care for Aging Parents. She is offering occasional reports on the highlights of the book. She has read the first chapter, which is about starting the conversation about future care. Here are Denise’s take-aways, which are not specific to adult children talking with aging parents about the future.



Denise’s Notes to

Chapter one – “Get Ready, Get Set”
of the book “How to Care for Aging Parents”
by Virginia Morris and Robert Butler

“It is never too soon to talk about the future, although it can become too late quite suddenly.”

Wise words from the authors. Chapter one, ‘”Get Ready, Get Set,’” begins by addressing how hard it can be to get these conversations started with any family member.

If you’re having difficulty, they suggest several ways of coming at the topic indirectly. Try, for example: “There was an interesting article in the paper about in-home care. Have you thought about what kind of help you’d feel comfortable with or where you’d like to live?”

It’s usually necessary to revisit topics you’ve already discussed. It’s not worth arguing between you. If you are repeatedly unsuccessful, ask another family member or professional to speak with them. As frustrating as it is, sometimes a person is more willing to have that conversation with another of their offspring, a sibling or in-law, even someone outside the family like a doctor, lawyer, or clergy.

If you get them talking, remember it’s all about them. Understand that they have fears about growing old, feeble, incompetent, and being a burden. Don’t be judgmental or dismiss their hopes. Instead, find out where they see themselves living, how they want to handle daily life when they can no longer drive, cook, bathe or dress, and if they are okay with relocating. Try to get a picture of their expectations. Your ultimate goal is to make decisions they will feel comfortable with so transitions will be easier for them to accept and adapt to.

You won’t be able to cover everything in one go or finalize some arrangements until a crisis occurs. If you’re already facing a crisis and haven’t yet made arrangements, the authors do an excellent job of identifying local resources to put services in place. Of course, they would prefer you familiarize yourself with these ahead of time.

* Area Agency on Aging – Call the Eldercare Locator 800-677-1116 or www.eldercare.gov

* Local Senior Centers, Community Groups and Religious organizations (Jewish Family Services, United Way)

* Local Hospital Discharge Planner

* Employee Assistance Plan eldercare information and referral (check with your HR department)

* State Long-Term Care Ombudsman’s Office represents residents of nursing homes and their families

* Medicare’s web site and hotline 877-267-2323 or www.medicare.gov

* Foundations and Organizations for a particular disease

* Geriatric Care Manager to assess needs or take over care almost entirely

* 211 – Many states are establishing human service information lines contacted by dialing 211.

If you’’re wise enough to be talking ahead of time you are in a good position to purchase long term care insurance, get on wait lists for special services, nursing facilities or senior housing communities; file paperwork requiring lead time, like VA benefits; prepare wills, powers of attorney, advance directives; protect assets; sign HIPAA forms; choose a health care proxy; or remodel a home to prevent falls.

All that advance planning produces a mountain of paper. The authors have an extensive checklist of documents and information to gather and file where family members can lay hands on them easily. Someone should organize them and keep them that way – and it doesn’t have to be you! Enlist the help of anyone you trust with personal documents who has the inclination and ability.

The remainder of the chapter are practical tips for keeping track of someone else’s healthcare details. This is especially important for long-distance caregivers. With at least 1/3 of family caregivers at least an hour away (usually more), their special circumstances are specifically addressed. Amid the list of good advice there are several suggestions as to who might be enlisted to keep an eye on things, including neighbors or relatives living nearby; post office, gas and electric companies, and people who deliver home-bound meals are sometimes trained to watch for trouble at homes where elderly people live alone; even a bank manager who could call you if accounts are being drained or sitting idle (indicating bills are not being paid).

Primary of this practical advice is to have a back-up plan for the primary caregiver. Arrange for someone else to step in on short notice, for your parent to go to a senior center or adult day-care center, or for her to go to a senior residence for a temporary stay. Too many caregivers don’t have a Plan B and are caught in dire straights when life takes an unexpected turn.