This is not an easy question to answer. It may be a very emotional one. But it does not mean you should ignore it. One’s health can change in an instant. It is not pretty. It can be very messy. It may cost a lot of money. But it is a lot easier to handle when you make plans well in advance.
So, what’s the answer? The simple answer is you must have a plan. But that is easier said than done. You’re perhaps not that far removed from college or you are starting your own family. At this stage, it seems unlikely that you’re going to have that talk with your parents about THEIR care.
You have other things on your mind – an upcoming job interview or a consulting project. Maybe you are interviewing a nanny or baby sitter for your children. How about interviewing a caregiver for your parents? Probably not the right time.
Your plate is full – changing your own daughter’s diapers, hoping your son will eat the food you prepared, and making sure our kids don’t fall down the stairs. The last thing you want to think about is who will change your dad’s diapers? Who will help mom take a shower or get dressed? Who will help your mom get dad back into bed because she isn’t strong enough to pick him up off the floor?
As uncomfortable as the questions are, there is this reality. If you don’t believe your parents will need help, you aren’t going to do anything. The same with your parents. If they don’t believe they will live a long life and will need some sort of assistance in their old age, they are not going to be receptive to a plan.
Ideally, you and your parents mutually accept the premise that help might be needed in the future. Now you can get down to business. Where will the care be delivered? If your parents are like most of the people I work with and help, the answer is they want care at home. But is their home suitable for care? If they are living in a one level ranch/rambler or apartment with no steps or only a small step to enter, the answer may be a resounding yes.
Even a one-story home may need modifications to make it easy for a walker or wheelchair. The bathroom may need modifications, such as a raised toilet or a curb-less shower. The kitchen may need some modifications, such as lower counters and easier to use fixtures. Quality contractors, carpenters, and plumbers, if you can find them, don’t work for free.
If the above is not possible, will your parents have to move in with you or one of your siblings? Will they have to move to a senior housing complex, assisted living center, or a nursing home? Will it be near you or other family members?
What about who will be the coordinator of their care? Who will be their healthcare proxy? Who will have a power of attorney over their financial matters? You should seek the assistance of a qualified legal counsel, with expertise in eldercare. Your parents may have a favorite child, but that sibling lives halfway across the country or maybe is overseas. The geographically closest child might be your sister who has been battling various addictions and is probably not in the right frame of mind for this. It’s now up to you.
So, after you and your parents have come to terms with the emotional, logistical, and legal issues, it’s now time for the rubber to meet the road.
How do your parents pay for all of this? Will they raid their emergency savings and assets? Retirement accounts? Do they have long-term care insurance? Will they use home equity? The answers may be one or all the above. To put it into something meaningful, if your parents needed $5,000, $7,000, or even $10,000 a month for their care, which of the options is tapped first?
What if they don’t have money? Are you going to help them get on Medicaid? Are you going to pay for their care? If Medicaid is the direction you are headed in, make sure you speak with an attorney who is well versed in this. Each state has its own rules with nuances that complicate them further. There are various financial as well as possible filial support laws to consider. That is when the state tries to recover Medicaid spending from adult children.
There are no magic bullets here. Some options may be better than others, and, sometimes, more than one option will need to be used. What is important is having a plan. The plan doesn’t have to be perfect, but you need to have one. As General George S. Patton, Jr. said many years ago, a good plan today is better than a perfect one tomorrow.