Too often, adult sons and daughters scrambling to respond to a sudden change in an aging parent’s health – be it a fall, an unexpected hospital admission, or a mental health episode – wish they had specific guidance from their parents or answers to certain questions that would be helpful in managing care in the wake of such a health incident.
We are big believers in investing time before such a health emergency occurs to gather information that would be helpful in the event of one. Uncomfortable though these conversations may be, they can ensure that everyone’s needs are met as best as possible should unforeseen circumstances arise.
Power of Attorney
A good place to start is by discussing with an aging mother or father who should hold their Power of Attorney. A durable, limited Power of Attorney will help an adult child access information from a physician, hospital, insurance company and bank, among other institutions. This information that can otherwise be difficult to access due to HIPAA privacy laws.
Once a Power of Attorney document has been finalized, it is advisable to send a copy to any known providers or institutions where it may eventually be relevant, including a primary care physician, any regularly seen specialists, banks and any insurance companies including long-term care insurance.
Important Factual Questions
Here is a short list of information an adult child should have and keep updated about their aging parents:
1. Primary care physician or internist
2. The names of any other specialists (cardiologist, neurologist, oncologist, etc.) seen regularly
3. Any primary illnesses/diagnoses, medical history and allergies
4. Any regular medications taken (name, dose, purpose) and primary pharmacy
5. Medicare or Medicare Advantage plan and ID number
6. Social Security Number (at least the last four digits) and date of birth
7. If applicable, their long-term care insurance carrier and policy number. It can be helpful to have a sense in advance of the daily or monthly benefit and of any elimination periods
8. Bank name and likely location of any other important papers
9. Medical Surrogate
10. Whether they have made any end-of-life decisions for themselves, and whether these decisions are recorded in a legal document such as a medical directive, a living will or a five wishes file
11. Funeral plans, burial plots and other final wishes
Having this information and keeping it updated will make things a lot easier in a crisis situation. Some parents are likely to be more forthcoming about certain things than others, so adult children should be patient and persistent (and maybe a bit crafty). Breaking the list up over time and subject matter can help, as can explaining why these are important to share. Exchanging some of the items can also make the conversation feel less one-sided or intrusive.
Important Judgement Questions
The following are items that may change from time to time and which an adult child taking the lead in arranging care may wish to speak with his or her siblings or the other parent about:
1. Should the individual be driving?
2. Is there a friend who is local and can check in on them in person if needed? What is that person’s name and phone number?
3. Would the individual benefit from minimal in-home assistance for safety, nutrition, social contact, or cognitive reasons? Remember, this can even be on a temporary basis to help an aging parent get back on their feet after a medical incident
4. What their wishes are should they become incapacitated or cannot live at home?
Non-Medical Planning
There are several non-medical topics that are prudent to revisit on an annual basis. We generally advise the families we speak with to have a rolling plan that covers issues likely to develop over the next couple of years:
Non-Medicare Insurance: Adult children can look into long-term care insurance with (or for) their parents. There are many types of long-term care insurance and even more long-term care features built into life insurance policies. While most policies are purchased before an individual turns 80, it may be worth exploring if something has changed (the passing of one parent, for example) and the senior does not yet have a policy.
Finances: Several types of discussions that can be best had if both the aging parent and the adult child have a shared understanding of the senior’s financial position. There may also come a time when an adult child needs to take over their parent’s finances. Discussing budgets and desires while making sure the parent does not feel like they have been removed or marginalized can go a long way toward avoiding future distress, even if the outcome is as simple as setting up automatic digital payments.
Help: Many adult children feel they have to care for their aging parents alone, an overwhelming and unsustainable setup given the range of decisions that inevitably have to be made as seniors age. Professional services ranging from assistance with errands to support at doctors’ appointments that may not only keep seniors living independently in their own homes but ease the stress on adult children and create a more sustainable situation. Discussing with aging parents which types of assistance they would be most open to can help identify easy opportunities for relief for the adult child. Even bringing in a care expert to facilitate discussions about long-term care planning can ease the discomfort of these conversations and take an adult child out of the position of being the ‘bad guy’.
Lean on Experienced Senior Care Professionals to Help with the Planning
Boca Home Care Services offers more than just referrals of home health aides. We have been assisting seniors in Palm Beach and Broward Counties and their families coordinate their full spectrum of care for more than 25 years. We can connect clients with eldercare attorneys, geriatric care managers, assisted living facilities, Medicare-certified home health agencies, rehab and therapy centers and so much more.
Helping arrange care for seniors – at home, in hospitals, in independent or skilled nursing facilities – is simply what we do. Whether it is to set up home health care today or for help facilitating difficult planning discussions that will pay off years in the future, call us to see how our care experts can help.