Parent’s needs and care can change in an instant
by Pamela Bergman-Swartz
It was a week before Christmas. I just had a large holiday party, there were still dishes in the sink from the night before and unwrapped presents in the spare bedroom. It was the phone call you never want to receive.
My aunt telephoned me from Hawaii telling me that my dad had gotten up in the middle of the night, got disorientated and fell. At the time, my dad lived alone, so he lay there on the floor throughout the night and into the next day, unable to reach the phone, too weak to get up from the floor, calling for help. Fortunately, the young girl I had hired to come in once a week to help my dad with cooking and cleaning came by as it was her scheduled day. She called for help, just in time.
I dropped everything and booked the next flight out. As doctors would soon discover, my dad would need emergency open-heart surgery. Due to complications with the surgery, my two-week stay turned into six months. I remember laying on the bed in the room I grew up, realizing I was now caring for an aging parent.
Through those months that followed, I was now tasked with paying my dad’s bills, reviewing his checkbook, bank and investment statements. Upon reviewing my dad’s checkbook, I discovered he had made several errors, gotten into a couple of fender benders with his car (according to my dad, it was always the other person’s fault) and the Trust Department handling his investments had made a huge error and failed to disburse the Required Minimum Distributions from his IRA account for two years in a row.
My dad told me the months leading up to his heart event that he had not been feeling well, he sometimes couldn’t remember where he put his keys, was misplacing things and not eating much. As it turned out, he was in the early stages of dementia and over a period of time, had been having mini-strokes. However, since he lived alone, there was no one to detect any changes in his health.
I was fortunate enough that my dad was open to engage in “the conversation” with me. Since my parents were divorced, there was no one to manage his care or his finances for him. We began having conversations around various topics such as: did he have long-term care insurance? Was there a trust in place? Did he have a power of attorney or an advance medical directive? Did he have any other accounts with any other financial institutions?
Through time, my dad’s physician declared he was no longer able to make medical or financial decisions for himself. I had to go through the process of removing my dad from his trust, getting my name added to bank accounts and coordinating with my dad’s financial planner, CPA and the myriad of doctors to continue providing the best care. We needed to insure that his money would last for as long as he needed it. Thankfully, my dad had always been frugal with his money. Little did I know at the time, I would need to stretch his monies for 13 years.
As an adult child who cared for an aging parent, and as a real estate professional specializing in helping families transition through this process, I am passionate about educating others about planning for this time in your lives. I see it all the time in the work that I do, families are unprepared and are left scrambling at the last minute when there is a major life event. As a result, medical decisions need to be made but no one is authorized to make them, and bills continue to mount as no one has been given the authority to pay them. Oftentimes, adult children find their hands are tied because there was never a simple power of attorney or advance medical directive in place.
What can you do?
The Conversation: I can’t stress enough the importance of beginning to have a conversation with your parents while they are still cognizant enough to express their desires and wishes with you. Ask if they have long term care insurance, what type of health insurance do they have? Was your Dad or Mom a member of the Armed Forces, are they eligible to receive the VA Aid & Attendance benefit? Do they have a list of their accounts, life insurance policies? Where do they keep this information? If you find it difficult to have this conversation, check out theconversationproject.org. It is a great resource to help take those first steps.
Educate yourself: Something I learned very quickly while searching for a care home for my Dad was the different levels of care each facility offered depending on the overall needs of the individual. After a couple of years, my dad’s level of care increased and had to be moved. I had 48 hours to locate a bed in a skilled nursing facility. We never ended up having to move him as he then went to a hospice facility. Take the time to visit different facilities, ask questions about monthly fees, fees for transportation to doctor’s appointments and fees to administer meds. Do they have the room and the capacity to handle it if your parent’s level of care increases? What is the patient-staff ratio, cleanliness of the facility, complaints filed with the Board of Health?
If you are caring for an aging parent in your home, educate yourself about the local senior services that are available for help. The city of Claremont has some wonderful organizations that provide great support—the Joslyn Senior Center and Community Senior Services are two local agencies that provide excellent resources to seniors and their families.
Evaluate costs: When evaluating costs, first consider the cost to continue to maintain your parent’s home and the overall health and safety of them being able to stay in their home. My dad wanted to stay in his own home and I wanted to make sure this happened for him. But, in the end, it was costing him $7,000 a month for a part-time caregiver to come in 12 hours a day. When he needed full time care, I moved him into a care home where the cost was $4000 a month for round-the-clock care, meals and medication administration. Modern medicine is causing people to be able to live longer but the truth of the matter is people are outliving their money. So as much as you want to honor your parents request about wanting to stay in their own home, this can make all the difference in making sure your parent does not outlive their money.
Alternatively, be sure you have your own personal Financial Plan B. What costs will you incur as the caregiver for your aging parent? I cared for my dad over 13 years and he lived in another state. I spent thousands of dollars on travel, time away from my job, loss of income and, eventually, loss of earnings to contribute to my 401k. Make sure you are planning for yourself. Have a Plan B financially, in the event you can no longer work because you are caring for your parent. In addition, take into consideration proximity so you can easily check in to see your parent. Consider the change of doctors, easy access to shopping, banking and if they are still active in their social circles.
Assets: Ask your parents to speak with their financial planner about which assets to spend down first in the event of a catastrophic health event. This was imperative for tax planning purposes. A recent interview I had with Carlos Arcos, an elder law attorney, revealed that he is seeing a rise in clients that now need care, who have lived in their homes for many years but, if they sell the home, could suffer huge tax implications, sometimes in the hundreds of thousands of dollars. In these circumstances, sometimes the adult children may take a second mortgage on their own home to finance the care for their parents until the parent has passed and the estate pays back the loan to avoid paying the huge tax burden for the parent.
Lastly, I would have to say the one item that helped make my life easier was having a notebook with all of my dad’s important papers, i.e., Driver’s license, Social Security Card, account numbers, names of all of his doctors, including telephone numbers, list of medications, etc. I did not know it at the time but I was providing Case Management and Prescription Management services for my dad.
Today’s parent looks much differently than they did before. My experience caring for my dad changed me in many ways and left me with a passion to educate others who are going through the same experience.
If you are an adult child who is caring for an aging parent, I hope this article has been helpful for you. If you have questions, need resources or would like a list of the documents you should have in place, feel free to contact me at (909) 636-2744 or email me firstname.lastname@example.org for more information.