It can happen in an instant. One day your dad is living on his own, independent and mostly healthy despite advancing age. The next he’s in bed with a broken something, dependent on his grown children and forced to move into a long-term care facility because you don’t have time to research alternatives. I’m not exaggerating when I say I’ve seen it happen hundreds of times.
Dad can’t avoid the getting older part, at least not if he’s lucky. But it’s not inevitable that he’ll have to give up his home, whether it’s an actual house or an apartment in a senior building. That’s why it’s so important to be proactive rather than reactive, and to find a professional who can help you and your father (or mother) figure out how to remain at home as long as possible, even if injury or illness comes into play. The benefits of staying at home can be both economical and psychological.
First off, it’s almost always far less expensive than a nursing home, which can run upwards of $100,000 a year for a shared room and sometimes double or even triple that for a private one, depending where you live. Before Medicaid kicks in, you’ll have to spend down almost all of your savings and provide years of detailed financial statements. Assisted living is less costly, but still pricey and not fully covered by Medicaid.
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Seek Help Sooner, Rather Than Later
That’s why one of my top recommendations to anyone who asks about elder care is: Do not go it alone. Another: Start exploring options before your parents need them. You want to be acting from a position of strength and health.
Thankfully, there are folks who do this sort of work. Called geriatric care managers (GCMs), life managers or even aging life care coordinators, they’re typically social workers, occupational therapists or nurses who specialize in helping older people figure out what they need and how to get it – sort of like a professional relative without the built-in family dynamic. I’d say anyone over 65, and certainly by 75, should be having this discussion with a pro. It’s not about dependency but independency.
A GCM’s job is to discover what’s important to a client, identify limitations (actual and imagined), locate resources, and put a plan in place. Maybe a bar in the bathtub before balance worsens, or moving dry goods to lower kitchen cabinets before the arthritis gets too bad. They can help with everything from interviewing home health aides or personal care attendants well before one’s needed, meaning you can be picky and thus more likely to find a good fit, to finding a local group with similar interests, lessening the anxiety that can come from isolation.
GCMs take the burden off both parents and adult children, and let the person impacted decide what life will look like going forward. I’ve asked a lot of 80-year-olds what they’d have done differently over the course of their lives, and a surprising number of them say they’d have taken more risks. So why not now? Why not let them live as full a life as they can, and thrive rather than just survive?
Where to Find Help
The U.S. Administration on Aging has a directory to help you and your parent get going, with a caregiver corner packed with easy-to-understand information and links to resources. That’s a good place to start if you’re already feeling overwhelmed or don’t have the money to hire someone. A local health department or primary care physician might also be able to point you in the right direction. Religious and community organizations can sometimes help, too. Don’t ever be embarrassed to ask.
Still, the best-case scenario is a certified GCM. You want someone you can build a relationship with over time – rather than destroy one by reversing parent-child roles. It’s important to have someone who will tell Mom or Dad the truth and who understands the trajectory of aging. A GCM isn’t cheap – typically $50-to-$150 an hour – but, trust me, it’s money well spent, even without taking peace of mind into account.
A good GCM will give you sound advice and stay out front of issues you might not even see coming or occurring. They can even help clients figure out where to volunteer – read to schoolchildren or bottle feed shelter kittens? – as well as make sure they keep in touch with their own siblings. (Working with a GCM is, by the way, an expenditure that insurance doesn’t usually cover, but be sure to double check anyway.)
Cost aside, I can’t overstate the importance of how much this can help families maintain happy ties. I know one elderly mom who hired a GCM because she saw the stress arranging her care was causing her daughter. Now? Daughter is breathing easy, and Mom is hosting yard “sales” for the grandkids and other relatives, sharing stories about the items, and enjoying her final years because she got the help she needed to live them on her terms.
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