When I talk with families about concerns that arise when parents transition to assisted living or a care facility, it is normal that they feel overwhelmed. I have found that the following tips can help alleviate the sense of anxiety and helplessness and frustration that can arise during this time.
1. Take care of your own physical and mental health. You can’t help others if you are struggling with your own unresolved issues. Additionally, the last thing a parent wants is their own child to struggle needlessly because of stress caused by the parent’s current situation.
2. Seek assistance from professionals. Doctors, nurses and nursing home administrators have dealt with these issues many times and should have developed protocols’ that can assist. Hospice workers are a great source of information and comfort. This is not to say you should blindly trust – you should not – and I suggest that an adult be with their parent at every appointment except routine exams. You should be able to ask questions and accurately convey concerns.
3. Focus first on the quality of daily care for your loved one. There is still time for joy and happiness. Don’t miss the small opportunities. A short daily phone call or two can be a real mood booster for both parent and child.
4. To the extent possible, retain the parent-child relationship. If a care facility can provide the daily care, there is more time and energy for phone calls, visits, and happy conversations.
5. For the parent that may complain or be negative, plan ahead for topics to discuss that may be more pleasant. Sometimes people complain because they cannot think of something else to talk about and they just want to connect and keep talking. Giving them another idea or option may refocus their conversation and possibly their mood. On a similar note, providing positive topics for conversation may increase siblings willingness to call the parent as well. Some examples would be a book of photographs or paintings you could share; favorite recipes, hobbies such as fishing, woodworking, or gardening advise.
6. Do not be surprised that a parent wants to talk about death or what will happen with their property. As we reach certain stages of our lives, topics that we were never comfortable discussing may become something that we want to convey to our family. While we as the adult children may be uncomfortable, imagine the feelings of the parent that cannot share something so important to them.
7. Keep siblings informed and medical and financial issues transparent. Ask siblings to communicate openly and honestly. Do not air sibling grievances with the parent. The parent does not want to take sides or to referee disputes. Everyone should try and understand emotions can be raw, and anger misplaced at these times. Try to adopt an attitude of seeing the best in people. At times, arguments among siblings can be resolved or deflected by refocusing the question on what will bring the parent the most happiness and comfort.
8. A Durable Medical Power of Attorney should be prepared to allow an agent to make medical decisions when person signing is no longer able to make their own decision. This recommendation applies to everyone – not just the elderly.
9. Turning to the financial issues a Durable Financial Power of Attorney should be prepared for the same reasons a power of attorney is utilized for medical decisions.
10. It will be necessary to make an accurate determination as to the nature and extent of assets. There is no “one size fits all” plan. Once a list of assets/debts and approximate values is prepared, it is worthwhile to consult with tax, insurance and legal professionals. Assets need to be protected-both from misappropriation, but also from hazards such as fire or water damage. For example, if a parent’ home is left unoccupied for a period of time, their regular homeowner’s insurance may not provide coverage.
11. At certain asset/income levels, a person may become eligible for Medicaid. Those determinations are complicated. Iowa has a good explanation of how these benefits work on their website.