Facing Elder Care Decisions – Five Things to Know – From Sixty and Me

In my recent HuffPost50 article, I wrote about things to look for when visiting older relatives during the holidays. For many, the holidays are one of the few times during the year when you get to really see how they are faring. And if you have not seen someone for say six months, declines in mental or physical health can be readily apparent.

Over the holidays, my kids called me to get advice because my former mother-in-law was in the hospital. She is 94, lives alone in a two-story house with the bedroom upstairs and has macular degeneration. She is cognitively fine.

Every hospitalization, however, opens up a new discussion about what to do about grandma. Of course, they want her to go into assisted living and I was glad to provide some guidance and referrals. But there are bigger issues in play as I told them. Here are five things to know when dealing with elder care decisions and a declining older relative.

When They Are Cognitively Fine, It’s Their Decision

My former mother-in-law refused any help until recently when she agreed to have home health care come in for four hours a day. It’s apparent she will probably need them for even more time.

When you look at the cost and also the environment she is living in, it is easy to suggest that assisted living would be about the same financially in an environment much more conducive for better health and safety.

Yes, that is what you or I might think. But it is ultimately her decision. And in this case, she does not want to move out of her house. And that brings us to number two.

You Are Never Too Young to Prepare for Aging

For my former mother-in-law, frankly, her three daughters have played hot potato. No one wants to deal with her situation and it has fallen to my son and daughter-in-law to pick up the slack. The discussions about aging should have happened years ago in a rational environment, not in a crisis.

Now I am afraid they will try to strong-arm her into doing something. You can prepare for aging and soften the blow. And often it simply starts with a conversation well before elder care help is needed. That in turn can spur action like preparing advance directives and living wills and so much more.

When it Comes to Elder Care, You Can’t Ignore the Finances

When you have the discussion of needing assisted living or more home health care, it naturally begs the question, “How will we pay for this?”

From what I know, my former mother-in-law has a decent pension and Social Security but is it enough to pay for long-term elderly care? I’m not sure. Certainly, she would have to sell her house and that may take a while as it has been left in disrepair for years.

As you look at your own aging, realize that in the U.S., care in assisted living facilities is by and large paid out of pocket. And from what I know about other countries, to secure better care also means paying more for it from your own money.

It’s great that people are saving more in their retirement accounts. But you also need to realize that some of that money may not be paying for cruises but for health care.

Don’t Be Afraid to Ask for Help

If you are the sole family caregiver, as I was with my mom, realize it’s OK to ask for help. And if you have siblings you need to talk to each other about the care scenarios well before mom or dad needs care. Everyone should step up.

Unfortunately, it often falls on one sibling to carry the burden. There are free resources in virtually every community. And if you can afford it, professionals such as geriatric care managers can be hired to help coordinate care.

Know That You Will Get Through It

When you are in the midst of dealing with a situation, it can seem like a nightmare. I know. When my sister passed in January of 2014 I was thrown into a caregiving situation that I never thought would happen. Yet I knew the statistics on caregivers passing before the one they care for, and my sister, who could never kick her smoking habit, died of lung cancer.

Mom passed in June of last year and now that I have had time to reflect, I realize that it is true that God doesn’t give you more than you can handle. Caring for mom was tough. She was a stubborn Italian woman with all of her cognition. Demanding doesn’t begin to describe her needs. But you know what? You do what you have to do and you survive.

Now that I am removed from the caregiving, it is sometimes hard to adjust to the newfound freedom presented.

The most important message is that you can prepare for aging sooner. Do so. Keep yourself physically fit. Tend to your finances. And learn the lessons our elders can teach us. In the end, we can all age with quality and not in crisis.

What are you doing to prepare for your own aging? Are you in the role of a caregiver for an aging relative? What are the most significant challenges you are facing? What is your perspective on elderly care? Please share in the comments.