Financial advisors frequently help their clients prepare for the potentiality of a nursing home stay, for themselves or perhaps for their parents. The reality of our world today is that this is part of the normal experience. Medicine has done a better job at keeping people alive for longer than it has done at keeping them able to care for themselves. Physical and mental challenges abound, and adult children often struggle with the idea of not being able to care for their aging parents.
The Care Challenge
The care challenge is a real problem. Not everyone is able to care for an aging parent at home; those who can often have limits. There may be a need for 24-hour care, for skilled care, for physically demanding things that not everyone can do. And the typical situation is a deteriorating one; the care needs become more as time moves on. So considering a nursing home is not a bad decision.
A big emotional aspect of the care challenge is guilt. The adult child often feels they should be able to provide the care, or that they are somehow remiss in their duties if they are not the primary care provider. This may be worsened by the adult child perceiving benefit, time or otherwise, from placing their parent into a facility that is equipped to provide the necessary care. The adult child may feel guilty of feeling selfish for not being able to do what they cannot reasonably do.
Caregiver stress is real. There is an emotional toll in addition to the physical and mental demands. Guilt and other complex or challenging feelings are normal.
Considering the Options
Consideration needs to be given to the physical, emotional, and financial options. These considerations are complex; they’ve been further exacerbated by COVID-19 fears. In each of these realms, the adult children, and others involved, such as the spouses of the adult children, should give objective consideration to the reality of the situation. How realistic is it to try to do this at home? What is the cost physically? Emotionally? Financially?
Two considerations should be kept at the forefront of this exercise.
The adult child or children involved did not create this situation. You’re not the cause of your parent’s health situation.
You’re also doing the best you can. Otherwise you wouldn’t be struggling and doing the work to make sure you’re doing the right thing. What you’re doing is the evidence that you’re trying your best. And that’s the best we can ever do in any situation.
Change Is Inevitable
Ultimately change is inevitable. The objective is to be proactive in the change and to guide and inform decisions to be the best they can be under the circumstances. There may not be an ideal solution, but there are always solutions that are better than others. Do the best you can, acknowledge that you are doing the best you can, and let go of the guilt.
Financially you can pre-prepare. You would generally do this with the assistance of one or more professionals, depending on the specific situation. In an ideal world, the pre-preparation would occur long before necessary, include the parents, and would give consideration to the possibility of a stay in a nursing home or other facility and the wisdom of insuring against the cost of such an event.
There will likely be additional documents that should be taken into consideration in advance: health-care proxies, trust options when appropriate.
More options are available when pre-planning is done while everyone is still healthy and can be involved in the decisions. But there are nearly always some pre-planning options or steps that can be taken. They may be small, but still worthwhile.
In many cases, professional guidance is appropriate.
And not every professional is the appropriate professional; this is a case where knowledge and experience are essential when there are significant assets or significant issues involved. Not every financial advisor nor every lawyer is sufficiently familiar with estate issues to give comprehensive advice. Many will steer you toward someone who can.
The Bottom Line
Caring for an aging parent can be one of the most challenging things a person will ever do. It can be physically exhausting, emotionally deflating, and financially draining — all at the same time. A trifecta of troubles. On top of that, the adult child is often challenged by guilt while trying to do their best in a difficult situation.
Financial preparation and pre-preparation can help make the financial aspects of the challenge more easily navigable. This should be done as early as possible if you want to send your elder to a nursing home.
But it can’t always be done in advance. Not every parent can or will sit down and have this discussion. Sometimes they just tell the child it’s all taken care of — until you find out it’s not. Nor is it something we may even think of with everything else life has us engaged in.
But the ones who need to make the decisions are not the cause of the problem. Aging happens. And with aging come new challenges. We meet those challenges by doing the best we can with the knowledge and information we have available at the time. And that’s the best anyone can expect us to do. We can get professional help for making the decisions. And professional help for ourselves if we need to, to release the burden of guilt.