Face the Facts: Topics to Discuss Now with Your Aging Parents
Key Considerations…
It is said that love is the greatest gift of all. As
many families gather together during the holiday seasons, they may provide a
good opportunity to express how much we care through a frank and open
discussion with older relatives about their well-being. As we age and live
longer, financial, legal, health care and long term care issues affect
families, not just individuals. The Eldercare Locator, a nationwide service
funded by the U.S. Administration on Aging that links older consumers and
their families to local aging services, produced this guide to help families
"face the facts" about these important topics. The overview below addresses
some key areas of concern, suggested questions to ask, and ways in which
families might initiate conversations about these often difficult to discuss
topics with their aging parents.
Key Considerations
- Find out what financial benefits are provided by
your parents' Social Security and pension. Determine if they are
eligible for other financial programs.
- Be certain each family member has a living will.
Know where all your parents' insurance policies, wills, trust documents,
tax returns, investment and banking records are located.
- Understand that Medicare generally does not cover
long term care (e.g. nursing home or extended home care), and Medicaid
pays only for low-income individuals.
- Investigate what type of long term care insurance
coverage may be best for your parents or for yourself! Generally,
premiums are lower when policies are purchased at younger ages.
- Identify what community services are available
that can help your parents maintain independence in the home for as long
as possible-such as home modification programs that can install
assistive devices (i.e., bathroom rails and entry ramps), and home
health and chore assistance. Learn whether housing options are available
to meet their changing needs.
Family members may not understand how their parents'
estate planning could impact their own financial status as well as that of
their children.
Conversation Checklist
Families may avoid potential problems and be in a good
position to deal with later life needs by understanding and being prepared
to face the following issues.
Financial Organization
There are many financial resources that your loved one
might already be receiving or be eligible for. Social Security is the
federal program that provides retirees a regular income based on work
history, and benefits to disabled workers. Long-time workers usually have
pensions that are retirement compensation plans either fully managed by the
employer, or involve employee contributions, such as Tax-Deferred Annuities
(TDAs) or Individual Retirement Accounts (IRAs). Some people have "lost" a
pension they earned, while others forget about a retirement account set up
many years prior. Low-income and disabled individuals age 65 or older could
also be eligible for monthly cash benefits through Supplemental Security
Income (SSI).
Legal Preparation
Wills and power of attorney may not be topics your
relatives want to discuss. However, these issues need to be addressed before
it's too late to make sure that their assets are properly taken care of and
that their medical treatment preferences are known. A will directs how a
person wants property to be distributed after death and appoints a trusted
person to be the executor; and a durable power of attorney provides written
authorization for a person you name to act on your behalf for whatever
financial or health care purpose you spell out. An advance directive is a
legal document that provides directions for your health care if you are
unable to speak for yourself.
Ask…
- Are pension savings from all jobs over the years being collected?
- Is there a need to apply for Supplemental Security Income benefits?
- Who can access your important financial information in case of
emergency?
- Where do you keep these important documents?
Ask…
- Do you have a will?
- Have you executed a durable power of attorney or considered who you
might want to handle your finances or health care decisions in the event
that you are unable to so?
- Are important legal documents up to date?
- Where are these important documents kept?
"Thirty percent of adults do not know where their
parents keep important papers such as their health insurance card, financial
statements or will."
- Family Circle and Kaiser Foundation
Community Services
One of the most useful forms of help that adult
children can provide for their parents is information about community
resources that are available to enhance their independence. Services like
home modification are available to help reduce the risk of accidents and
make daily household activities more comfortable to perform. Emergency
Response Systems not only summon emergency help quickly, but can also
increase the feeling of security within the home. Transportation services
may be available to assist older adults who need help getting to
appointments with their doctor. There are many community resources to help
older persons by providing information or a needed service. Find out about
these and other services available through your state, area agencies on
aging, and local aging services providers by contacting the Eldercare
Locator at 1-800-677-1116 or
www.eldercare.gov.
Health Insurance
Health care is a high-cost necessity, so it is crucial
to know what is available to meet your family member's needs, and what they
are eligible to receive. Most adults over age 65 are covered by Medicare,
the federal health insurance program that helps pay medical expenses for
older Americans and younger people with disabilities. But Medicare does not
cover all needs, and Supplemental Insurance (also called Medigap insurance)
might be necessary to cover additional health costs. Medicaid, on the other
hand, is the federal and state insurance program that helps pay the health
care costs of low-income individuals of any age. Long term care insurance is
available through the private market to assist individuals to cover the cost
of long term care services such as home health and nursing home care. These
policies are often expensive, however, premiums are usually lower if the
policies are purchased at a younger age. Having a long term care insurance
policy ensures that your loved one can make their own choices about what
long term care services they receive and where they receive them.
Ask…
- As your health status changes, are you prepared to meet your long
term health care needs?
- Do you have proper health insurance coverage (not too much or too
little)?
- Are you comfortably able to pay for prescription drugs and other
out-of-pocket health care costs?
- Who are your doctors and how can they be contacted?
- Where do you keep your insurance card, Medicare information, and
other important health care documents?
Ask…
- Are there house repairs or modifications needed that will help you,
such as installing bathtub railings, an emergency response system, or
other assistive devices?
- Do you need assistance with housekeeping, shopping or personal care
activities?
- If you become homebound, would you need home-delivered meals?
- Do you need transportation? What services are available in your
community?
- Do you anticipate needing other living arrangements in the future?
Contact the Eldercare Locator at 1-800-677-1116
Monday through Friday, 9:00 a.m. to 8:00 p.m. EST or through the Web site at
www.eldercare.gov. The Eldercare Locator is a public service of the U.S.
Department of Health and Human Services Administration on Aging and is
administered by the National Association of Area Agencies on Aging in
cooperation with the National Association of State Units on Aging,
Eldercare Locator
1730 Rhode Island Ave., NW, Suite 1200
Washington, DC 20036
Tel: 202-872-0888
Fax: 202-872-0057
Here are some services that can assist your family
members:
Adult Day Care
Social, recreational and health services provided in
a protective setting to individuals who cannot be left alone because of
health care need, confusion or disability.
Information and Referral/Assistance Information
Services (I&R/A) Specialists provide assistance and linkage to available
services and resources.
Case Management
Case managers work with family members to assess the
needs of seniors and arrange for services to assist them to remain
independent.
Elder Abuse Prevention Programs
Allegations of abuse, neglect and exploitation of
senior citizens are investigated by protective service specialists.
Intervention is provided in substantiated cases of abuse, neglect or
exploitation.
Emergency Response Systems
Provides in-home 24-hour electronic alarm systems
that enable homebound persons to summon emergency help.
Employment Services
Helps older adults explore employment opportunities.
Financial Assistance
Benefit programs include energy assistance, financial
management counseling, food stamps, prescription drug assistance and Social
Security.
Nutrition Services
Nutritious home delivered meals (known as "Meals on
Wheels) are provided to older persons who are homebound. Congregate Meals
provide the opportunity for older persons to enjoy a meal and socialize with
other seniors in the community.
Home Chore Services
These services include housekeeping, shopping and
home maintenance.
Home Health Services
Includes such activities as changing wound dressings,
checking vital signs, cleaning catheters and providing tube feedings.
Legal Assistance
Advice and representation is available to persons
aged 60+ for certain legal matters including government program benefits,
tenant rights, and consumer problems.
Personal Care
Services assist functionally-impaired individuals
with bathing, dressing, walking, supervision, emotional security, and
eating.
Respite Care
Offers caregivers a break from constant supervision
and personal care of a person with a functional impairment.
Senior Housing Options
The variety of options available include: assisted
living, retirement communities, nursing facilities, government assisted
housing, and shared housing.
Senior Center Programs
Offers a variety of recreational and educational
programs, seminars, events and activities for older adults.
Telephone Reassurance
Trained volunteers provide regular contact and safety
check to reassure and support homebound senior citizens and disabled
persons.
Transportation
Services are available for older or disabled
individuals who do not have private transportation, or who are unable to
utilize public transportation to meet their needs.
Volunteer Services
Volunteers provide daily telephone reassurance,
friendly visiting and insurance counseling to older adults. Prepare yourself
to be open, honest and not argumentative. Be ready to listen and hear what
is being said to you. Have some knowledge about the topic you're talking
about. Direct If the care recipient is a 'no-nonsense, get-to-the-point'
personality, openly express your concerns and ask questions for information
you need to address specific situations that might arise.
Conversation Approaches
- Prepare yourself to be open, honest and not argumentative.
- Be ready to listen and hear what is being said to you.
- Have some knowledge about the topic you're talking about.
Direct
If the care recipient is 'no-nonsense,
get-to-the-point' personality, openly express your concerns and ask
questions for information you need to address specific situations that might
arise.
Educational
For the relative who might need a delicate push, you
might begin by sharing an experience of another caregiver you know about
their own personal situation, and explain how it made you realize the
importance of discussing issues now that will help you be of better
assistance to them in the future.
Expert
For the relative who refuses to talk about personal
issues or tends to accuse their children of trying to take control of their
life, seek to make them the expert by asking for their advice about a
particular issue - for example, "what type of long term care plan should I
look into," or "can you recommend someone to help me prepare my will." This
strategy is non-threatening and could lead to them sharing personal details,
or at least letting you know where they stand on the subject.
Resources
Organizations/Publications
Eldercare Locator
www.eldercare.gov
1-800-677-1116
WISER
5 Questions to Ask your
Mother or Grandmother
www.wiser.heinz.org
202-393-1990
Medicare
www.medicare.gov
1-800-Medicare
Kaiser Family Foundation
Talking with Your Parents about
Medicare and Health Coverage
www.kff.org
650-854-9400 or 202-347-5270
American Bar Association
Commission on Law and Aging
Health and Financial Decisions:
Legal Tools for Preserving Your
Personal Autonomy
www.abanet.org
312-988-5000 or 202-662-1000
Pension Benefit Guaranty Corp.
Finding a Lost Pension
(on Web site, see publications/
Pension Participant Publication)
www.pbgc.gov
202-326-4000
Social Security Administration
www.ssa.gov
1-800-772-1213
Eldercare Locator
www.eldercare.gov
1-800-677-1116
Father's Day is great time to tell Dad just how much
you care by share some health tips to help him age well and live longer, see
www.eldercare.gov
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