“Preparing For A Future That Includes Aging Parents” (NPR)

This post may be of interest to adult children and parents with children, or those interested in the costs of long-term care (adult day services, home care, assisted living, nursing home).

As part of an NPR series on multigenerational households, “Family Matters,” there’s an article about the adult children assuming the financial costs of caring for aging parents.

You can find the “Family Matters” series here:
www.npr.org/series/150002308/family-matters

Here are key excerpts from the article “Preparing For A Future That Includes Aging Parents”:

* “While aging is inevitable, planning for the costs associated with dependency in the latter phase of life doesn’t come easily to most Americans.”

* “People dread talking about it because we don’t like to face our mortality,” says Jack Hetherington, a certified elder-law attorney in suburban Philadelphia. He estimates that fewer than 1 person in 5 takes even the first steps needed to prepare legally and financially for taking care of an incapacitated parent.

* “But with Americans living so much longer now, the younger generation has to do more thinking about how they might care for parents who have exhausted their savings.”

* “Experts say any serious plan for caring for aging parents must begin — not with discussions about money — but with a legal document designating someone as having ‘power of attorney.’ That paperwork grants authority to another individual to handle decisions if a loved one can’t make them as a result of illness or memory loss.”

* “Once the legal paperwork is done, families can turn to an array of sources for legitimate advice on boosting savings, buying appropriate insurance and maximizing home equity.”

A link to the article and the full text are below.

At the very bottom of the online article is a chart on the costs of elder care, according to the MetLife 2011 Market Survey of Long-Term Care Costs.

Robin

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www.npr.org/2012/04/24/150587638/preparing-for-a-future-that-includes-aging-parents

Preparing For A Future That Includes Aging Parents  (Part of the Family Matters series)
NPR
by Marilyn Geewax
April 24, 2012

Planning a wedding is exciting.

Mapping out a vacation is fun.

Figuring how to afford care for your confused, elderly father? That one may never cross your mind — at least, not until you need more money to care for him.

“Never thought about it,” Natasha Shamone-Gilmore, 58, says about her younger self. “Never ever.”

She thinks about it a lot these days. Shamone-Gilmore, a computer trainer in Maryland, now shares a modest home with her husband, 24-year-old son and 81-year-old father.

Like millions of other middle-aged Americans, she had long regarded her parents as robust adults, more than capable of managing their own affairs. “My mom was a very active woman; my dad … was a Safeway employee for 40-something years,” she said.

But time does what it does, and today, her father needs a caretaker. So she has had to step into that role and figure out how to make it all work financially.

Shamone-Gilmore’s family is one of three multigenerational households being profiled by NPR this spring. Their stories will help highlight the importance of family financial planning. The series, Family Matters, began last week and will continue in installments each Tuesday into June.

While aging is inevitable, planning for the costs associated with dependency in the latter phase of life doesn’t come easily to most Americans.

“People dread talking about it because we don’t like to face our mortality,” says Jack Hetherington, a certified elder-law attorney in suburban Philadelphia. He estimates that fewer than 1 person in 5 takes even the first steps needed to prepare legally and financially for taking care of an incapacitated parent.

Consider this contrast between expectations and reality:

Only 13 percent of some 4,000 U.S. workers surveyed for the 2011 Aflac WorkForces Report believe that the need for long-term care would affect their families.

And yet providing long-term care is, in fact, common. Nearly 10 million adult children are caring for aging parents, according to the MetLife Mature Market Institute. Other adult children are contributing to the cost of a parent’s assisted-living care, which MetLife says averages about $3,500 a month.

“The percentage of adult children providing personal care and/or financial assistance to a parent has more than tripled over the past 15 years,” the research group found.

Of course, in today’s tough economy, it also is common for elderly adults to be supporting their adult children. But in some ways, that’s easier to accept: Parents often plan to leave whatever wealth they have to their children anyway. The flow of wealth from older to younger generation feels natural to many.

But with Americans living so much longer now, the younger generation has to do more thinking about how they might care for parents who have exhausted their savings.

“That’s a tough one,” says Paul Taylor, director of the Pew Research Center’s Social and Demographic Trends project. “You have lots of uncertainties in your own life, let alone worrying about paying for your parents’ care.”

So like many other baby boomers, Shamone-Gilmore is struggling with bills, and hoping to reform her family for the future.

“Now that it’s happened to us, and I am the household coordinator, I am now trying to educate the entire family that: You guys need to get in line,” she says. “We’re not thinking. No one is thinking.”

Experts say any serious plan for caring for aging parents must begin — not with discussions about money — but with a legal document designating someone as having “power of attorney.” That paperwork grants authority to another individual to handle decisions if a loved one can’t make them as a result of illness or memory loss.

“The purpose is to provide a safety net in case of incapacity,” Hetherington says. “If you wait too long and you don’t have the capacity to make decisions, you end up in guardianship court, and that could involve lawyers, doctors, judges, time and money.”

Once the legal paperwork is done, families can turn to an array of sources for legitimate advice on boosting savings, buying appropriate insurance and maximizing home equity.

For example, many employers offer workplace benefits that include free financial planning services. Credit unions can help, too. Public library shelves are loaded with books on how to get started making a financial plan, and websites, such as HelloWallet (hellowallet.com) and Mint.com, offer help.

Individuals can ask for professional referrals from the National Association of Personal Financial Advisors (napfa.org).

Hetherington says taking those first steps can be difficult. “But it’s the only way of avoiding problems down the road,” he says.

Helping caregivers “find their way back into society”

My online friend Lynn, whose mother with Lewy Body Dementia (autopsy-confirmed) died a few months ago, shared this article in her local Tampa newspaper with me today.  She said it rang true for her.

The author of the newspaper article is Gary Joseph LeBlanc, who wrote the book “Staying Afloat in a Sea of Forgetfulness: Common Sense Caregiving.”  I shared some book excerpts on caregiver guilt in February 2012.

In the Tampa Tribune article, Mr. LeBlanc says:

“Reportedly, 45 percent of caregivers will go through mild to severe depression for up to two or three years after a loved one has passed. Many will never fully recover and once again enjoy a functional social life. They must learn to slowly accept the up and down changes one day at a time. It’s highly unlikely that those who have traveled down the rough road of caregiving will ever look at life in the same manner, but I mean that in a good way. Most come away with tremendous growth in their emotional and spiritual inner being. But there’s no question that there is a recovery stage one must go through. So, if you know of any caregivers who have recently lost a loved one, help them find their way back into today’s society. Take them to lunch or to an uplifting movie. Simply getting them out of their house may bounce them back on the right path to start enjoying life again.”

Here’s a link to the full article:

www2.tbo.com/lifestyles/health-4-you/2012/apr/21/4unewso19-offer-friendship-to-lonely-longtime-care-ar-394361/

Offer friendship to lonely longtime caregiver
Tampa Tribune
By Gary Joseph LeBlanc | Special correspondent
Published: April 21, 2012

Beers Criteria – what medications older adults should avoid or use with caution (updated March 2012)

This is an important New York Times article about a “crisis among the elderly” — they are being prescribed too many pills.

With the support of the American Geriatrics Society (americangeriatrics.org), a panel of 11 experts has updated what is known as the “Beers Criteria”:

“[These are] guidelines long used to minimize…drug-related disasters in the elderly.  … The team highlighted 53 potentially inappropriate medications or classes of medication and placed them in one of three categories: drugs to avoid in general in the elderly; drugs to avoid in older people with certain diseases and syndromes; and drugs to use with caution in the elderly if there are no acceptable alternatives.”

The article’s author notes that:

“[Just] because a drug is on one of the lists in the Beers Criteria does not mean every older person would be adversely affected by it. The drug may be essential for some patients, and there may be no safer alternative. When all is said and done, a doctor must weigh the benefits and risks.”

Here’s a link to the full article:

well.blogs.nytimes.com/2012/04/16/too-many-pills-for-aging-patients/

Too Many Pills for Aging Patients
Personal Health
New York Times
By Jane E. Broady
April 16, 2012, 5:41 pm

Here’s a link to the lay description of the Beers Criteria, updated in March 2012:

www.americangeriatrics.org/files/documents/beers/BeersCriteriaPublicTranslation.pdf

That PDF is important to print out and keep with your medication lists and medical records.

“Really? Constant Stress Makes You Sick” (NYT)

In this short post to the Well blog on the New York Times, the author asks what the facts are in answering whether chronic stress makes you sick.  The author concludes that “chronic stress may raise the risk of sickness by fostering resistance to cortisol.”

How does this happen?  The answer:

“Released in greater amounts in times of stress, [the hormone cortisol] provides the body with a burst of energy.  It also helps suppress the body’s immune response to infections like the flu, keeping inflammation responses like coughing, sneezing and fevers in check.  But when levels of cortisol remain elevated, the body may become less sensitive to it, in the same way that elevated insulin levels can lead to insulin resistance.”

Obviously this is not good news for caregivers who often live with chronic stress.

The full blog post is here:

well.blogs.nytimes.com/2012/04/09/really-the-claim-constant-stress-makes-you-sick/

Well Blog
“Really? Constant Stress Makes You Sick”
New York Times
by Anahad O’Connor
April 9, 2012 12:08 PM

“The Caregiving Wife’s Handbook” – coping strategies

This New York Times article is about the new book “The Caregiving Wife’s Handbook” by Dr. Diana Denholm, a psychotherapist who was the caregiver to her husband for over a decade.

The book lists 50 dos and don’ts to make caregiving easier.  The author of the NYT article provides 16 of the 50 at the end of her article.

Here are a few excerpts from the NYT article:

* “It is no surprise when serious illness or severe pain results in feelings of anger, helplessness and depression, all the more so when the illness is terminal and the afflicted person loses his sense of self. After many years as ‘the man of the house,’ the sick husband is once again a child who must be cared for, often by the very person he signed on to protect.”

* “In her book, Dr. Denholm discusses a series of coping strategies that she developed with her husband during his long illness. The most important of these is to adopt communication tools that avoid red flags, accusations and self-pity, and instead “create expectations, agreements and understandings, including some that may involve agreeing to disagree,” she said.”

* “Never start with, ‘’We need to talk.’’ … Always use an ‘”I”’ statement “­I need,’” “‘I want,” “‘’I’d like to’.”

* “One tool Dr. Denholm found to be especially helpful is to create written understandings, some of which may need to be modified as circumstances change. The understandings might involve finances, individual responsibilities or issues to be avoided.”

* “For example, the waitress, whose husband refused to review finances with her, came to realize it was pointless to keep asking. Instead, she ended the screaming and arguing by going to the bank, the Social Security office, the Veterans Affairs office and even the Legal Aid Society to determine her rights regarding what she and her husband owned.”

Here’s a link to the full article:

well.blogs.nytimes.com/2012/04/09/caregiving-as-a-roller-coaster-ride-from-hell/#more-74693

The Well Blog
Caregiving as a ‘Roller-Coaster Ride From Hell’
The New York Times
By Jane E. Brody, Columnist
April 9, 2012, 3:09 pm