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Caregiving

Caring for an Older Relative: Preparing a Game Plan

By Sue Weiss-Cedillos and Bobbi Diamondstein as told to Amy Hughart

In our experience, few people like thinking about getting older.  After all, so many of us equate aging with loss.  Loss of health.  Loss of abilities like driving. Loss of our friends and loved ones as they age.  But most of all, loss of control.   
 
Most of us also change the subject rather than deal with the specifics of how we want things handled when we’re not able to do the things we once could.  It’s uncomfortable to think of handing someone else the reins.  It’s equally uncomfortable to imagine taking those reins from someone.
 
Yet aging is inevitable.  The importance of planning ahead can’t be overstated.  Your parents or elderly family members should have a plan for handling the various situations they’ll face as they age.  Also, if you are their adult child and likely caregiver, you need to understand how they want various care aspects handled. 

Key Areas to Consider

When you see a potential need for intervention, it’s time to encourage your parents or elderly relatives to get their game plan together.  How do they want to manage these key aspects of care:
 
  • Housing:  Where will they live later in life? How long do they want to stay where they are?  Will they stay if a spouse must be moved to another location or dies?  Have they thought about retirement communities or long-term care facilities?
  
  • Finances:  Have they spoken to a geriatric care manager, financial planner, elder law attorney, accountant, or other advisor about planning for care and its financing? Have they organized all financial information so it’s readily available if needed?
 
  • Healthcare: Have they documented essential healthcare information?  This should include:
    • physicians and physicians’ phone numbers
    • medical history and notes on current medical issues or conditions
    • current prescriptions 
 
Also, have your parents or relatives determined who will make healthcare decisions when they are no longer able to do that for themselves? 
 
  • Transportation:  How long will they continue to drive?  How do they anticipate handling transportation when they can’t drive? Will they move to a place that provides transportation?
 
  • Legal Issues:  Have your parents/relatives written wills?  Do they have “living wills,” or advance healthcare directives to assert end-of-life desires?  Have they established a healthcare proxy to make decisions when they are incapacitated?  Where can all these documents be found when needed?
 
  • Long Term Care Insurance:  Have they investigated long-term care insurance options?  If your parents or relatives are in good health and act early, before their situation deteriorates, long-term care insurance may be a wise choice to protect their financial resources.
 
These and other questions are important to answer when establishing a plan for when you’re the person for whom you are providing care can no longer be completely self-sufficient. A geriatric care manager can assist a family in creating a game plan.  It is always easier to have a plan in place before a crisis occurs.

Starting the Conversation

Many people are reluctant to talk to their children or other close family members about their late life plans.  After all, it can be a difficult, emotional topic and can also mean delving into very personal information.
 
Depending on your relationship with your parents or relatives, the conversations about late-life decisions may be effortless or quite uncomfortable.  You might be pleasantly surprised at the thought and planning the person for whom you may be providing care has already given to the subject. 
 
Or you may find a complete reluctance to even discuss it.
 
It’s best to know early on which of these scenarios you’re dealing with. Open the lines of communication as soon as possible so when you’re faced with difficult decisions, you know how to best accommodate your parents’ or relatives’ or others’ wishes. 
 
The best approach?  Be respectful and collaborative.  Let them know you have their interests at heart and that you want them to make important decisions while they’re still able. 
 
With those who are receptive, you can start the conversation with open-ended questions: “Have you thought about…” or “When do you think you might want help with…”  Provide reassurance that you want things to go well for them – and that you want to help in whatever way possible.

Share Your Concerns

If you’ve got particularly resistant family members, communication is even more important. Listen for the right moments to start the conversation – perhaps when they themselves bring up issues of aging.  Offer your own concerns about aging, retirement, and planning as a means to open the door. 
 
If they won’t talk to you about their situation, ask if they’ll talk to someone else about it and connect them with a geriatric care manager or an elder law attorney who can ask the right questions and help put plans in place. 
 
Another good resource is your local Area Office on Aging; a good starting point for connecting with them if you are new to caregiving is the Administration on Aging’s How to Find Help or Eldercare Locator.
 
If those you are caring for have specific medical conditions, learn more about them and how they are likely to progress over time.  And be sure to consult the many excellent resources listed here in the Caregiving Section of the Coming of Age site.
 
Finally, plan ahead for yourself. Take a cue from how prepared (or unprepared) those you are caring for are.  You, too, will need to have this information available someday. Planning ahead is empowering and can help reduce stress for everyone concerned.