Checklist: Making Plans to Care for Aging Parents

When your aging parents need help—physically, emotionally and/or financially—both generations may feel uncomfortable with the changing family dynamics. Your parents have spent your lifetime watching out for you, and when roles start to shift, it can lead to avoidance or outright denial of the new situation.

But broaching difficult conversations with your parents and compiling the information about their lives—from health directives to finances—is always better done before anyone is in dire straits. “Try to have conversations early and often, and not wait for a crisis,” says Jennifer L. FitzPatrick, who holds a master’s degree in social work and is the author of Cruising Through Caregiving: Reducing the Stress of Caring for Your Loved One. 

Also, remember that care for the elderly can be costly, so advance planning and knowing what care arrangements will be financially feasible will help you in your conversations and decisions.

Preparing to take on a caregiving role for your parents is stressful, but you don’t have to reinvent the wheel. This checklist can help you (and your siblings) move into a caregiving role, and do the job well.

❏    Start early. Before you’re facing urgent decisions about healthcare or living situations, find out your parents’ wishes. Ask how long they want to live at home, whether they’d want home care or would prefer to move into a facility for the aging, if needed, and what insurance coverage they may have for long-term care. Ultimately, this will make tough decisions that may come in the future easier on you, as you’ll know what your parents want.

❏    Prepare essential documents. As FitzPatrick points out, it’s not just older people who need to have medical power of attorney and a living will: In fact, every adult over 18 should have such paperwork in place. FitzPatrick suggests talking about how you’ve gotten your own documents in order as a great way to begin the conversations with your parents. “Talk about your own wishes, your own advance healthcare directive, mention how you’ve updated your will,” she says. For people averse to thinking about their own mortality, you can avoid an impasse because you’re not implying that the paperwork is only for the old or the dying, FitzPatrick points out.

❏    Discuss healthcare wishes. In the instance of an illness or health situation that renders a person unable to speak for herself, the power to make healthcare decisions will default to the next-of-kin, a spouse being first in line. It’s smart, however, to first make sure this default person is up to the job and knows the individual’s wishes, which should be discussed and also spelled out in writing. Fitzpatrick notes that you can be very specific about your wishes. “You can write anything you want in your care plan, in an advanced healthcare directive, or have an addendum,” she says. It’s always wise, FitzPatrick adds, to have a backup medical power of attorney. Make sure all siblings are aware of your parents’ advanced healthcare directives, and have all of these documents in one folder for access in emergencies.

❏    Make housing adjustments. Your parents may need to make changes to their home in order to safely live there, from simply replacing loose carpeting that could cause falls to completely remodeling bathrooms for wheelchair access. If moving to a smaller or simpler home—or one closer to family—would help them stay in their own home longer, ask your parents to consider downsizing.

❏    Start money talks. If you have a clear picture of your parents' finances before you have to make decisions, you can make better ones. “Have a candid conversation about money,” says FitzPatrick. Do your parents have enough money for whatever living situation or care situation they are envisioning? What assets do they have, and how would you access those resources if anything happened to your parents? 

Even if your parents don’t want to share full financial access with their kids, as can happen, ask them to at least have the paperwork in place. They should appoint a financial power of attorney, and put your name—or another trusted person’s name—on file with all financial professionals managing their accounts. As a bonus, financial professionals now have the legal authority to contact the person on file in the event they become concerned about a client behavior or transactions. 

❏    Be a healthcare advocate. If you can, attend doctor’s visits with your parents—or ask to be called in—so you can take notes on their medical conditions and medications. Keep a calendar of your parents’ visits, and a journal of your parents’ symptoms, if needed, that will let you document changes in their condition.

❏    Create a team. It’s rare that one or two grown children will be able to do all of the caregiving work alone, so plan to have help. Your team can be anyone who you and your parents trust: your siblings, your spouse, your parents’ siblings and spouses, friends or neighbors. Don’t hesitate to tap into public resources, which may offer free services for the elderly. Caregiving is an immense task, so don’t go it alone.

❏    Make a contact list. Gather contact info for your parents’ doctors, clergy, lawyers, financial advisors and family. Even if they are not involved now, having their information handy—there are tools available to help you—will be helpful when you need it down the line.

❏    Keep your parent involved. Remember, even in declining health, he or she has the rights of any other adult. All decisions must come from them while they are competent—and for many people, that is right up until the end.

❏    Keep a life. Organize your team in a way that gives you time to take care of yourself—to socialize, exercise or just read a book. The Family Caregiver Alliance estimates that 20% of long-term caregivers battle depression—so consider counseling if you need help coping. 
 
Getting a plan in place before you need it is the smartest move when it comes to caregiving—especially as you, your parents or your siblings might not always be in agreement on the best course of action and will need time to discuss and work out your differences. Even if you feel behind, however, it’s not too late—facing a daunting conversation today can make your tomorrow much easier.

Tim Mullaney is a New York-based financial writer whose work has appeared in Business Week, The New York Times, USA Today, The Washington Post magazine and many others.

Photograph by C.J. Burton. 

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