Caring for aging Parents

by Allie

I’m curious about what people have done to financially care for parents when there are multiple siblings of various financial abilities and life stages (DINKS, married with young kids, single), most geographically separate from the parents.

How do you best structure financial and practical assistance to your parents when there are financial and geographical issues affecting all options?

My siblings and I (4 of us!) have expected financially assist our mother in the future and/or have her live with one or more than one of us. However, after multiple falls, bone breaks, and other health challenges and a lack of ability to maintain a single family residence, it’s obvious something has to change sooner, even though she is only 62. The question is how? Obviously the focus is on keeping mom safe, healthy and happy, but I’m sure there are ways to set up this process for the least friction between siblings.

AARP and other places have checklists for this process, but they focus on getting the senior into long term care, not general at home care that might include living with adult children or similar. They also seem to focus on documentation, and I am interested in the more practical day to day realities, as well as later implications for financial assistance structures set up in the moment.

Click to access prepare-to-care-guide-english-aarp.pdf

What steps of this process are going to be the biggest surprise or roadblock that is not mentioned in these cheery checklists? If the assistance requires help with a property purchase, like a condo with elevators and an HOA for outdoor maintenance, how best should that be structured?

82 thoughts on “Caring for aging Parents

  1. We (my sister and I) do not have the financial concerns Allie mentions, but all the rest of the stuff weighs on me. Sis and one 27yo granddaughter are nearby, so they get a lot of the day-to-day burden I avoid. Mom is 86, fully functional in all aspects, including resistance to even lining up a Senior Care Manager on retainer for the inevitable day. I am interested in what everyone has to say.

  2. We have not crossed this bridge yet, but I think this is a great topic. DH is an only child and I have only one sister, so our situations aren’t as complex as Allie’s. The good news is that both sets of parents are living in very elderly-friendly situations, in single floor dwellings and very close to doctors/hospitals.

    I’m looking forward to hearing what everyone has to say.

  3. Fred, how do you manage the burden with your sister, given that she is closer to your mother? This is the situation I’m in, as well.

  4. I don’t have concerns on my side of the family as we all live in the metro area and there aren’t financial concerns. My sisters will probably boss me around with what they think needs to be done, and I’m mentally preparing myself to bite my tongue.

    DH’s family will be a mess. His brothers and us live 2-4 hours away from the in-law’s small town. DH and I are the only ones with any financial resources. One struggle will be that DH isn’t close to his parents or his siblings, so he will probably check out, but I’ll feel guilty about not doing anything. I’m pretty much putting my head in the sand about having to deal with it, because it is all outside my control.

  5. Trying again. (Sorry if this ends up being a double post.)

    My mother had enough money to support herself, so my brother and I didn’t have to think about providing for her financially. However, during the years that she had Alzheimers, she needed a lot of practical and day-to-day support, and that fell entirely on me, because (1) I was local, and (2) I’m much better at dealing with those sorts of things than my brother. On the one hand, I did feel resentful from time to time that everything was on me. On the other hand, my brother did me a huge favor by not butting in or second-guessing the choices I was making on behalf of my mom. That was huge.

    So I guess my advice would be to try to get everyone to agree that the sibling who is going to be charged with providing the most assistance (be it practical and/or financial) is the one who gets to have the final say in the decision-making process, and that once a decision is made, the other siblings will not second-guess it or try to undermine it. (Of course, getting siblings with certain personality types to agree to such an arrangement could be challenging.)

  6. I could write about this for days and I still wouldn’t get through everything that I have to say.
    I have lived through this already with my dad and his brother. Then, with my mom and her sister. Still going through hell with my DH and his brother/his nephew. Plus, I know that I am going to be responsible for my mom since my brother probably will claim that he can’t help at all. In every single one of these cases, one sibling was financially responsible for everything because the other sibling had no money. So, I think the answer is that it is unfair in many cases. People that do the right thing by saving and working hard seem to get hurt by the sibling (s) that always don’t give a crap. The only exception is when the parents save enough (or die young) so there are no financial issues.

    I always worry about DD being an only child, and dealing with us without a sib as we get older. I’ve changed my mind about this based on what I saw with DH’s stepmom. Her daughter traveled to the east coast one (!!!!) time in three years to help with her mom’s care. Her mom had terminal cancer in four organs and we took care of DH’s stepmom, but it was his cousins that really did the heavy lifting of the day to day care since they live closer. My BIL’s ex wife even stepped up to help. I learned that close cousins and friends can be wonderful sources of support and without the BS drama of a sibling. Unfortunately, the drama in this case came later when her daughter learned what was in the will, but that is a whole other story.

    I find elder care to be one of the most stressful and unpredictable parts of my life. I am blessed to have grandparents, step parents and even inlaws that lived to old ages so I’ve seen a lot, and it is a very long and complicated process. I still have my parents and a step parent so I probably have at least another 10-20 years ahead with elder care issues.

    Some good news ….my dad was scheduled for the vaccine in mid March and he got it today!! They kept checking different web sites and i sent them one for a large NYC hospital system and appointments popped up so they both vaccines today!!! I took my mom last week so I finally feel like I can breathe a little easier about all three of them.

  7. Houston –
    for now my sister takes the local burden which, fortunately, has not been much yet. I provide financial management and advice to keep things stable and my mom doesn’t have to worry about keeping enough in the checking account to run the house. Step dad has never had interest in things financial and now (the past 10? years) is mentally incapable of really doing anything helpful in that regard. Mom runs everything re the house and is fully capable. Fortunately healthwise step dad has been ok, no care really needed since his kidney “failure” episode in the summer. Everything is in status quo and we’re all waiting for the next episode, whenever that comes.

    I’d like to go see them, do a personal check in, but until we’re all vaccinated mom isn’t hearing any of that. Last I was there was Sept 2019, had planned to go there in March, but Covid locked that down. Used to be annual trips for me, was planning to increase to 2x/yr, but maybe once travel becomes more normal again it’ll actually be more like 3x/yr until needs increase.

  8. Following with interest. Right now, all of our parents are relatively healthy, and I don’t anticipate major financial issues. But it is going to get complicated.

    On my side, the sibling local to my parents is a bit of a dope/unreliable. I am close-ish in that it is driving distance, but not close enough to be there day-to-day. Other sibling is a plane ride away and I suspect from conversations we’ve already had – will want to defer to me. Part of the reason that I would like to have financial options for early retirement is if my parents need me. Juggling frequent drives/time off with a demanding job would not be ideal.

    DH’s family is large and opinionated, but not actually all that practically helpful. Only some are local. It could get ugly fast.

  9. I think about this a lot. I do not live near my parents and all the little things have fallen on my brother, who lives 10 minutes from them. I know he is annoyed by it, but I can’t do anything about it. An example, last week he had to drive over in the middle of the day to help them get an app on their iphone. Yes, just an app to download from the apple store. They couldn’t figure it out, and my dad would not let it go until the weekend. He also does a lot of other stuff for them in bits and pieces. Eventually these little things will become big issues and resentment that I live so far away will increase.

    I suggested having my parents use Geek Squad for their tech needs, or finding a kid in the neighborhood to pay, but my parents resist, and my brother doesn’t push it. Good advice from NOB to just let the sibling in charge have all the decision making.

  10. Oh no, it’s my topic and today is super busy at work! Forgive me if I don’t reply super quickly to all of the amazing comments already here.

    We’re lucky — at least we have 4 siblings with the same end goal in mind, and we all give each other grace and assume the best about our thoughts and abilities, in regards to practical and financial care.

    NoB, great tip about the final say.
    Lauren, so glad your mother got vaccinated!

  11. I will give my sister credit — she was completely worthless when it came to helping with Mom, but she never once challenged me on any of my decisions. “I’m putting Mom in XYZ long-term care facility.” “Okay.” “I’m putting Mom on hospice.” “Okay.” She knew better than to push me even a little, and besides, our family ethic was always that the person doing the work called the shots.

  12. You could start the process by meeting with the sibs and seeing that everyone is on the same page, and coming up with an agreed-upon means of communicating to all parties. Just keeping the lines of communication open (even if not all agree on a course of action) has seemed to be the key to keeping family speaking to each other after the loss of a loved one.

    From past personal experience and the experience of many friends: getting her to sell that single family residence that she can no longer maintain may prove more difficult than it would seem. We ran into that issue with our otherwise entirely rational mother. If you suspect this may be the case with her, my advice would be to start the process very early. On the other hand, if it makes sense for her to age in place, you should be clear with the sibs who has responsibility for what tasks, and which you will agree to be outsourced – and that’s just for the home, not the person.

    The journey is different for everyone and every family, best of luck to you in caring for her.

  13. My plan is two-fold:

    1. Denial.

    2. Throw money at it.

    There is no doubt that I am going to be responsible for my mom. There is also no doubt that she is one of the most obstinate, independent people I’ve ever known, and a total control freak. She does NOT want to move out of her house, ever, and that house is not remotely suited to old age. So when the time comes, I will hire a live-in caregiver and a senior-care specialist to help us navigate all the decisions and such. She has plenty of money to afford it, and even if she throws a total hissy and refuses, I will pay for it myself, because I have neither the ability nor the patience to care for her personally (love her dearly, but it is SO good that we live in different houses!). I am just hoping she will stay well for many many years and then get hit by a bus or something — she’s 74, runs every day, and takes no meds at all, so the lifestyle and genetic factors all seem to be there, which means I am still allowed to remain in Phase 1 for the foreseeable future. But she’s going to have a decline at some point, and I’m going to have to deal with it.

    I am assuming that my stepmom may well pass before my dad, given her cancer. If she does, I imagine he will go back to Houston, and my SIL/brother will take the lead managing that (she’s a MS teacher — and married to my brother — so very good at managing obstreporous types). We will send money as needed. Again, though, he is a very healthy 75 so far, so it may not be for a while yet. If my dad goes first, my stepmom has a lot of family nearby who would likely take the lead, but I would be more than glad to provide support and relief care.

    My FIL is easy: we will just let my SIL take care of things as she sees fit, show up when we are scheduled to do so, and pay whatever amount we are invoiced. He is mid-80s, so that time is likely much nearer. But given that SIL once pitched a giant hissy because DH showed up at their mom’s hospital bed post-surgery when it was SIL’s “turn” on the schedule, I am not remotely concerned about being asked to shoulder a big burden.

  14. Ive posted enough on all this recently, but to those of you who have not yet been on the front lines I have a few more non financial words to say about elder reluctance to accept help or evaluation, especially if one is caregiver to the other.

    1. Toileting. Many caregiver spouses or semi independent solos are dealing with the aftermath of accidents on a regular basis. Preserving dignity is paramount. Dont assume thats not an issue Your parent/auntie/stepparent, Those smiling late middle aged people happily buying depends are as realistic as the assisted living brochure models.

    2. Car keys. There are few non urban elders who dont dread the day the kids take away the car keys. Keeping folks at arms length staves off that day.

    3. Falls/balance. They will lie outright about episodes. If face to face visits are few and far between, the bruises arent going to be noticed.

  15. Oh yes, the falls and balance. That’s certainly an issue, especially with snow and ice.

    My mother’s local hospital system has a balance class available, and she’s been told to go by her GP. However, in between the space of time she was told to go, and now, she 1) fell and broke her foot and couldn’t go for 6 months and 2) fell and broke her arm and shoulder and 3) covid.

    On the plus side, I was able to teach her how to search YouTube on her TV (not the computer, mind you) for “chair yoga.” She still refuses to wear an Apple Watch with fall detection, which was our plan for some reassurance.

  16. The only eldercare situation in our family is 97 year old MIL, who lives by herself. While she is not as mobile as she once was, and hasn’t driven in several years, she is completely lucid, able to take care of herself, and happily will discuss politics, what she has watched on TV, and family gossip with anyone who wants to chat. She is able to live on her own because the three SILs all live in the vicintiy, plus 3 adult grandchildren in the same town. Before the pandemic, she had a great setup – they would come over and help her clean and do grocery shopping and so on, and hang out and chat. The pandemic has been a real problem because she, and the entire family frankly, take quarantining very seriously. They drop by and stand in the yard to talk to her, and the SILs deliver groceries and things she needs. She also does not have any Internet service or a smartphone. In December we discovered a device, called a Grandpad, that is basically a tablet with a data plan that is optimized for the very elderly. We got her one of those, and now we can do video chats, post photos and send email. It has games and a few sites on it so she really likes it. In addition, DH calls her every evening so they can catch up.

    She more than qualfies for a vaccine dose in CT, but none of the SILs seemed to be helping her get one, so a few days ago I told DH to bring it up with her. It turned out she was waiting for her doctor to contact her. Since she has a virtual appointment today, DH told her to bring it up and find out how to get the vaccine. If she doesn’t get information that way, I want DH to figure out how to get her an appointment in CT.

    One problem in general is that she has been completely relying on virtual visits for all of her healthcare and has some issues that need to be looked at in person (foot problems mainly) but she is too scared to go. And she says she only wants a vaccine if it is a driver-thru setting. Personally, I think the risk of going in person for the vaccine is worth it. She likely doesn’t have many years left, and I would like her to be able to get out and about.

  17. My parents are right around 70, so not ‘there’ yet, but I can tell the decline is beginning (they have started to call me and my brother on tech issues). They did move out of my childhood home, but didn’t downsize, so there is still a lot of stuff that will need to be dealt with at some point. I am the most local child (my siblings are about a 3 hour drive in opposite directions, I am 30 minutes) so will probably need to be the point person. I *think* that my siblings will be fine with letting me be in charge, but we’ll see how things play out – hopefully it will be another 10 years before they move into assisted living or whatnot. We don’t have the financial issue, luckily.

    LfB, love the honesty! :)

  18. Many caregiver spouses or semi independent solos are dealing with the aftermath of accidents on a regular basis.

    When I started dealing with Mom in my home, I remember reading in one of the myriad “How to care for your Elder” books and articles that incontinence is the biggest reason families put the elder in assisted living. Everybody thinks they can deal with Mom sitting in her rocker knitting and sharing bits of elder wisdom, but aren’t prepared for the pervasive smell of urine throughout the house.

  19. My dad is starting to decline due to parkinson’s. Right now he lives in the middle of nowhere 45 minutes from Tucson. He was starting to look for a continuing care community and then COVID hit. Now his plan is to move to a private residence in Tucson and then bring in care as he needs it. He’s afraid of getting stuck in a facility in another pandemic. Fortunately finances are not an issue. This will also significantly reduce his need to drive, right now it’s 20 minutes on the highway to get to grocery store. He’s actually going to look at some places this weekend.

    One big issue I’ve seen with eldercare is when one person is local so all the work falls on them. My uncle lived in the same apt complex as my grandparents and my dad was out of state, so my uncle had to deal with all the day to day stuff and he became pretty resentful.

    My brother, sister and I are all out of state from my Dad, but I’m the closest so I’m sure I will be the one flying out to deal with things and such, and I’m okay with that, at least in theory. We’ll see how things go. He has a lot of friends and support in the area who can help with emergencies.

  20. The SILs themselves are getting to the age of being elderly (they are a lot older than DH). They are starting to have niggling health issues, and one BIL has serious issues due to diabetes. He is a craftsman with a successful business, but he is having to hand it over to his kids, who thankfully are really interested in the business.
    I am not too concerned, overall, about eldercare for anyone on that side of the family. There are so many adult kids in their 40’s and a new crop of grandchildren coming up, who all live in the same town and have a strong tradition of helping out. And they all have good finances. I am more concerned about my own sib. Although she is younger than me, she presents as quite a bit older. She is very overweight, has lots of odd health problems, has had issues with injuries due to falls, and most importantly, lives by herself with no relatives or family around. She is a recluse by nature, and also suffers from anxiety so she is often not very adept at figuring how to do things. I learned recently that she has never done online banking and still uses physical checks for everything. So I am concerned that when something really debilitating happens, I will be the only person who can help out.

  21. You want honesty? I got a little bit right here.

    When Mom first moved in, her room was carpeted. She wore diapers, but they leak. So the carpet started to smell like urine and…well. You know what else. And THEN the cats and the dog decided that her room must be the bathroom, so they added their output. The carpet shampooer got a daily workout and the SpotBot ran all the time.

    After I shifted her to assisted living, we got the carpet torn out and replaced with hardwood. We also kept the door to her room closed so the dog and cats would relearn about their litter boxes and the back yard.

  22. I’ll go Anon, so I can share real facts and figures.

    I am local to my parents, my brother is not. My brother is a pain in the ass and a total taker, not a giver. My parents have no illusions although of course they love him and do what they can to maintain a loving relationship. My dad also has a family history of significant dementia (both parents, one sibling) and a personal history of cancer. My mom is healthy. Both are in their 70s. My dad occasionally exhibits signs of dementia, although he’s had several evaluations and so far seems stable.

    My parents are pretty well off, but they worry about the ‘worst case’ scenario – something unexpected happens to my mom and my dad slips into dementia and can’t handle their finances or lets himself be manipulated by my brother. So, they have set $1 million into a trust for which I’m the executor. No matter what happens to the rest of their estate, I control the trust and the $$ is for their benefit. This gives them peace of mind that $$ will always be there for their care (or particularly, for my dad). On their passing, the balance of the trust passes to me. The rest of their estate is split evenly between my brother and me. Of course, I will spend it down to the last dollar to make them comfortable and happy (and my brother would spend none of it in order to benefit himself, which is why I’m the executor) – but they consider it a source of funds of last resort, and have asked none of it be spent until they truly need it or their other funds are exhausted.

  23. I’m going anon for this:

    I find this topic fascinating in that everyone talks about helping their parents as they age. Does anyone feel no obligation to help? My partner has very little interaction with their parents. It isn’t that there was a falling out, but they rarely have talked since partner went to college. The financial component isn’t an issue. The issue is that there isn’t a relationship.

  24. 12:27 – I would say that DH feels no obligation to help his mom and her husband. They live far away and have had a fraught relationship since DH’s parents got divorced when he was a kid. Pre-covid we saw them once a year when they came out here. They are far closer, geographically and emotionally, to DH’s step-brother and his siblings, and those people are more likely to step up and take care of them, but if not I don’t think DH would feel like he needed to help.

  25. re no obligation to help — I don’t feel the same level of obligation to my father, who moved out of the country after divorcing my mom when I was five. We barely have seen each other. However, I don’t know who else will handle that, so that remains to be seen. That will be complicated by the sheer distance.

  26. Same Anon for this as 12:18. I also have an uncle who has step-children but no children of his own. He has a warm relationship with them but also has concerns about how they would access or use his $$ if he passes before his spouse (since it was a later marriage, he came into the marriage with significant assets that are separate from marital assets). So, he’s also set up a trust. If something happens to him, his $$ goes into a trust for the benefit of his spouse – there’s very specific language about how it can be used. I’m the executor of that as well, along with their bank. On the death of his spouse, the $$ remaining in the trust is split among certain beneficiaries (I am not one of the beneficiaries).

  27. I set up my financial affairs to make sure that if anything happened to me, death or serious disability, DH would not linger in the house and get placed in a facility asap. The house has always been mine and is in a trust that goes to my kids. All This was set up before DD1 moved in with us for 3 years, established a relationship with her stepdad, and now is next door in her own home, but now is simplified. There are funds allocated in a separate trust for which she is successor trustee to be spent for his benefit, residual to his son. He also has a generous pension and SS income, enough to cover modest assisted living fees. This is not foolproof, son could decide to take over his dads affairs, appoint his own trustee, house his dad elsewhere, but then my kids would be out of the picture. Since the odds are very great that he will die first, not foolproof is okay.

  28. I have two siblings. One sister lived local to my parents and the other is 2,000 miles away. I’m about 3 hours away. When my parents decided to move out of their house (in the middle of the woods) and into a retirement community, the nearby sister was offended. She felt the new place was too far away and she could’ve take care of them right where they were. But the problem was, she didn’t take care of them. She made a lot of promises but didn’t follow through. Their driveway didn’t get plowed for days after a storm, the roof was leaking, the rain gutters were falling down, and she didn’t check in as often as she should have. My mother was never responsible for maintaining a house and she wasn’t going to start in her 80’s. And, my sister’s husband was talking about retiring soon and moving to a warmer climate, so they wouldn’t be around anyway. I totally supported my mother’s plan to move into a CCRC.

    So my parents ended up following some friends to a CCRC about 2 hours away from where they were living. It’s a really nice place. My siblings think it was all my idea but I had nothing to do with choosing the facility, other than I drove them to a number of different places when they were checking them out. Again, my sister who lives right near them couldn’t find the time to drive them around, so I stepped in.

    My parents were in the CCRC for about 2 years when my father declined to the point where he had to be transferred to the skilled nursing facility in the community. He also had advanced dementia at that point. Initially, my mother had aides coming into the house to help with his care for part of the day but it was still very hard on her. The toileting issues, showering, cleaning up after him, helping him eat. He spent about 4 months in the facility before he passed away. The nearby sister was in agreement that he belonged in a facility; the distant sister disagreed (the one that lives far away and visits every couple of years). She felt we should bring in more aides, but my mother was adamant that she didn’t want anymore aides around.

    Before my father went into the facility, I did a deep dive into my parent’s finances because I knew it would be self-funded. My mother will be fine; her are funds are more than adequate to last her lifetime. She requested that I not share any info with my sisters. Of course, they are hounding me for details, but all I say is that Mom is set financially. My distant sister has alluded to the “terrible things I’ve done” (I honestly don’t know what she’s talking about – financial? moving?). My parents have a financial planner and I had the opportunity to meet her when my father died. I included the nearby sister in the Zoom meeting with the planner just so she can get more comfortable. We didn’t get into details with investments, balances, etc.

    I’m also the executor of my mother’s estate. I’m not looking forward to dealing with my distant sister when the time comes.

  29. Reading this, I am thankful that both of our parents have moved out of the family homes & into low-maintenance communities where they can age in place more easily.

  30. My mom’s husband went into hospice several days ago. His daughter has been not been close with them for the last 10 or so years (but has occasionally called and made a couple of visits) and continues to be of no help to my mother. It’s hard right now with covid but when my mom called and asked if she could quarantine if she needed help (daughter doesn’t work and has only a 23 yo son), the daughter said it wouldn’t be possible. My mom is 70 and he’s a very tall man and she was physically struggling. They moved him into a hospice home yesterday thankfully. As my sister and I were just talking though, we don’t really know the history of their relationship (his and his daughter’s). Maybe he never showed up for her and he’s just reaping what he sowed.

    My DH is an only, so that simplifies things. I have a sister, we’re both about an hour from our mother. Financially that will be complicated. Undoubtedly I am more able to assist, and my mom is not set financially. I think that may make it easier to let it all fall to me than to figure how my sister can participate. Which will annoy my DH but it could always be worse.

    My mother can be a lot of drama and I am already dreading her being by herself and needing a lot of attention. Not physically, she’s completely fine physically. I feel like I have been the adult the family since I was about 9 or 10, and it’s exhausting.

    Allie specifically, there was a recent column in the WSJ titled “Financial issues to consider when an elderly parent moves in with you” that you might find helpful. If you can’t get to it, reply back and I’ll copy and paste here.

    Also Allie specifically, 62 seems so young, I’m so sorry. My DH is turning 60 and I can’t imagine my kiddos having to think about that – of course they’re 23 and 25. I think the advice to open up some routine lines of communication is really good. This could be a long term “project” for you and your sibs given her relatively young age. Also, some kind of standing check in (maybe quarterly now, monthly eventually) provides a forum to bring up issues before they’ve snowballed into something too big/too late to recover from without anyone ever having to be the one to say “we need a family meeting”…..which depending on the topic can be the thing that forces people to pick sides and fracture the family.

  31. no obligation to help

    For my dad I wouldn’t, as they say, piss on him if he was on fire. Which isn’t technically true as I donated old clothes and an old TV when he was moved to elderly housing. My brother helps him out with things even though my dad stole a large sum of money from my brother’s business. He’s better man that I.

    As for my mom, I’m happy to help with tasks. In terms of finances, her and Meme have a very similar life story including doing well financially after going back school later in life. The most likely scenario is I get a call (when I’m 72 and she’s 93) that she’s passed away after a fall…off the roof that she was reshingling.

  32. I am an only child and dealt with both parents attempting to age in place, then to continuity of care facility – independent living, then dad passed and shortly after mom was in skilled nursing until she passed. I did not have anyone else to help or make/argue about decisions. SO is has a sister and due to distance she did 95+% of everything. He has hard feelings about how everything came out in the end, but I do not feel that those are justified.

    Suggestions:
    1. Be realistic about if and how long your parent(s) can remain in their own home. As Meme said, if you aren’t physically there A LOT you will miss the slow deterioration.
    2. Be realistic about getting services to them in their home. Someone has to coordinate the caregivers, what they provide, and the schedule. That is not a minor commitment. Plus, what happens when someone doesn’t show up like they should? And, you still need to keep an eye on what is going on. (FYI – I told my parents this in-home care coordination done by me was not an option. You also get to set some boundaries.)
    3. If you are thinking about this, you should be looking at facilities now and finding out how long their waiting list is and how it works, and getting on the list of your first and second choices. (In my area, you get on the list and when a spot opens they call you. If you aren’t ready or the “floor plan” , when they have options, doesn’t work for you, you can decline. Next opening they start at the top again.) OR, deciding which child the parent will live with, and what happens when they can no longer spend a portion of the year with each one.
    4. Decide who will be the main spokesperson for the parent. Things seem to go smoother when there is one point of contact for the facility, doctor, other providers. I would suggest that person is the one who is going to take on most of the day-to-day stuff because they can best answer questions or notice the small differences in health, behavior, etc. OR, if the parent is moving on to the next child’s house every few months, how you are going to transfer information.
    5. Decide how the caregiving work/finances will work between the siblings and what the backup plan is if a sib can’t or decides not to follow through. A friend is the main caregiver and each of her sibs deposit various amounts money into an account used just for the parent. Her brother maintains the house (mows lawn, does home repairs, etc.). The other two sibs live far away.
    6. Look at apps for keeping track of the parent’s information – MPOA, medication taken, vaccinations received – that can be shared so if “mom” happens to need hospitalization whoever goes in to the ER with “mom” has the information needed.
    7. Be prepared to ask questions that they should, but don’t ask as well as what you as a caregiver should be looking for. Most of us know this, but we tend to defer to our parents.
    8. Be prepared that their choice may not align with your choice, whether it is to continue or refuse care, and to support that choice.
    9. Again, if you are thinking about this, you should be thinking about how to handle their finances and other personal business. If they are in the hospital/rehab/skilled nursing for an extended period, do you have access to pay their bills, deal with the insurance company, etc. because they are not able. Along the same line, do you know where important things are – will, durable POA, medical POA, safety deposit box keys, etc.
    10. Remember to take care of yourself as well. When you are exhausted, you are not able to do your best for them.

  33. I’ve observed three families with four siblings deal with decline in the past decade, in two of three cases the decline to death duration was mostly months, not years.
    1) The nearby siblings bore the brunt of the logistics but the far-away siblings did stuff like financial management and traveling in for intense periods.
    2) The retired siblings did more work than the still-employed-full-time siblings.
    3) People all completed what they agreed to and were willing to make changes when the load was unsustainable. The elders were realistic and agreeable about the general decision (need to move to assisted living because children can’t continue to support parent in their own home).
    4) People with young children did (and were expected to do) the least, due to the logistics of that stage of life.

  34. 9. Again, if you are thinking about this, you should be thinking about how to handle their finances and other personal business.

    Also if they pass away or are moved into memory care do not cancel their phone plan for at least a year. With so much dual factor authentication, if you no longer have access to that phone and number you’re going to have a lot of problems trying to manage their affairs.

  35. Obligation – I may have a slightly different take. Think about the message you are sending your children. I don’t care if they are 15 or 35, they will remember what you did and consider it when it is time for your care. If you have really strong reasons for not helping out (at whatever level you can), you should make them known – such as he moved out of the country when I was 5 and I have not had a relationship with him.

  36. “The most likely scenario is I get a call (when I’m 72 and she’s 93) that she’s passed away after a fall…off the roof that she was reshingling.”

    Yeah, this is my mom. Except substitute “hit by a car while running a 5K” or “broadsided by a van on her drive between client meetings.”

    If we’re all very lucky, she will have a heart attack at her desk at 97, because she got so excited that they just won a big new contract.

  37. On the obligation – we have strong relationships with all 4 of our parents, so we do feel obligated for sure. What boundaries will need to be set will remain to be seen. But I can definitely think of some situations among my friends and extended family where that may not be the case.

  38. Austinmom – what a great point. It made me recall someone I worked with until he retired last year. His and his wife’s philosophy was that they were teaching their kids how you take care of your relatives (while they were taking his dad’s wheelchair on cruises and making long visits to his care community). I also think, ahem, part of it was driven by the big inheritance he was leaving to them.

  39. My in-laws will be like LfB’s and Rhett’s moms. They are in their late 70s and still in great shape physically. FIL has some cognitive issues from a brain injury 25 or so years ago but MIL is completely with it. If anything does happen to them, we’re pretty sure SIL will handle everything because she is the one they trust.

  40. I am very fortunate that my sister and I work well on elder care issues for our father (87). He had a stroke 2 years ago, and we really pulled it together as a team. We were living in the same house at the time and were able to make decisions easily, visit him in hospital, and manage issues. We also moved him in with us for 2-3 months while he recovered…his house was 2 story with no downstairs bath or bedroom. He HATED it and was very angry with us (and depressed). We were able to get a caregiver during the week so we could function. He was able to uber to his house to “office” towards the end of staying with us. Officing included paperwork, reading newspaper, some packing/purging, and physical/occupational therapy. Both of us were called a few times during those months when he was stuck on the toilet. He’s on his own in a 1 story condo that is chock full of seniors. The caregiver comes 1-2 times a week, restarted a few months ago when an arthritis issue flared up. She is great and cooks and cleans for him, so we know he’s ok. Dad is also a retired doctor, so knows all the tricks to get what he wants from his doctors, but also has made his wishes known — on paper and by speaking with us.

    One big issue is finding a good caregiver. We have a family friend who has a caregiver who no one likes or trusts, but since friend has no kids (only step), she relies on this person. Ours is really kind person we do trust, but I think we really lucked into her.

    On the financial side, my dad was really good about teaching us finances. He’s been open with us and set himself up well.

  41. I wanted to second the comment about the challenges involved in using aides at home. Beyond the expense (which is considerable for those needing daily or 24 hour hour care), it really does require close management by the family or a hired care manager. Caregivers are a diverse lot and many women turn to this work because they simply don’t have the skills or immigration status to get a better job. The work is hard and isolating and so those who can find something better move on and the senior has to adjust to a new set of faces. Personality and culture clashes can make it very hard for many seniors to tolerate the intrusion into their private space that infirmity has thrust upon them. Sometimes the caregivers just don’t show up, or they spend every possible moment on their phones or sneaking outside for a smoke. There can be issues with accents that are difficult for hard of hearing seniors to understand. Seniors who have lost their filter may unwittingly offend caregivers. Etc.
    It can be a great solution for many situations, but it is not always preferable to a senior community setting.

  42. It has been at least 5 years since we tried to help my in-laws get their spending under control so that they could live comfortably on SS + pension. Our efforts were rebuffed, and other than pre-COVID observations of the numerous boxes and catalogs that were delivered to their apartment, we don’t have visibility into their activities. I don’t know what obligation DH will feel when they get to the point of needing financial support.

  43. Thank you all for sharing the challenges of home health aides. I am guilty of trying to throw this out as a possible solution for my in-laws, without realizing it comes with its own new problems to manage.

  44. I don’t want to pile on, but yeah, caregivers require as much supervision as the seniors themselves. And finding “live-in” caregivers is extremely difficult. Would you want that job? Your best bet is to have cycles of 8-hour shift caregivers, and that becomes expensive quickly.

  45. My grandmother required a lot of care, and at the point where it became 1-2 people during the day and 1 at night, it was hard for the home care agency to staff, just because it was a pretty small town and they didn’t have that many people available. That’s when my parents put her in a home – IIRC it was straight to the skilled nursing unit.

  46. Thank you for the at home caregiver information — we’re not at that stage, but it is important to prepare for, definitely. It doesn’t look like a fun stage.

    In regards to the obligation question, I don’t view taking care of my mother as an obligation, necessarily. Her safety and happiness (those two might conflict sooner than I want) are just a desired goal for her benefit, not a forced obligation.

  47. DH’s grandmother needed help with medications, cleaning and cooking and had a great experience in an adult group home where she had her own room and bathroom. One of her sons managed her finances remotely. DS1 learned to walk in the dining room there- he was on the verge of walking and took advantage of all the walkers and railings to take off the weekend we visited her.

    We didn’t expect to eat any meals at the group home but the manager invited us to stay for a couple meals and all the residents enjoyed watching DS1 (14 months).

  48. On caregivers: on my daily walks I see a nurse with an elderly gentleman who seems almost non responsive. She hums to him as they stroll in the wheelchair. She brings him to various spots with a view, like to see the kids in sailing camp or a shady garden. She strokes his hair. I know she is not family, because she is wearing a uniform. I think she’s some kind of angel. I’m dying to ask her for a card in case I need her for my parents one day.

  49. I’m in this spot today. My father (90) is in the early stage of dementia. My mom is 84 and sharp, but still 84. My dad insists on doing the taxes but he doesn’t do them right. My mom is worried about their money (they have enough but she’s worried he will mess it up) but more worried about his reactions and not making him feel inept. He’s also been doing sweepstakes and stuff online that is worrisome. Both my brother and I live on opposite side of the country. So we’re in this place where we don’t really know what’s going on because we can’t travel due to covid and even if we decided to travel they are so afraid of it they wouldn’t have us come. Going to look into some kinds of computer controls that my mom might be able to have set up on his machine so he can surf the net but not give money away. Mom is going to talk to their banker (small town so they know her) to see about setting alerts on their accounts. This is all a bit of a reach for her since he always did the money stuff. They were set to move into AL but then covid so they are afraid to go now which makes sense. They won’t get a housekeeper because of covid. It just goes on and on. Oh and their dumbass, small town phone company doesn’t work with roboblockers or have one of their own so my mom has to get on the phone every time the phone rings to make sure he doesn’t agree to something. I have to keep reminding her to take care of herself and she won’t talk to any of their friends becuase she is worried they will see him differently.

    Feeling super worried, super ineffectual, hating all privacy laws (HIPAA especially) because even when you have a waiver signed, they can find it or still don’t want to give you info and it is hard to talk to a doctor when you are a patient – imagine how gladly they talk to family members for which they do not get a payment. Anyway, just wanted to vent. Tired today.

  50. Thanks Rocky, cried a bit today. We’ll make it though. The inability to really do is the hardest thing I think for everyone. we are a nation of doers. Not doing sucks!

  51. My great uncle had a live-in caregiver the last 5 years or so of life. She treated him well, but I’m not sure she has many employment prospects in the small town. He had outlived 2 wives and had no kids, but many nieces and nephews. My uncle was one of his main helpers. He died a bit over a year ago, and he gave his caregiver the right to live in his house for 3 years after his death. (It was originally going to be 8 years, but my uncle & the lawyer suggested less) She isn’t doing a great job taking care of the place (my uncle goes out regularly to check in and look after the farm), and I think her son also moved in. I have a feeling in ~2 years she may be hard to evict.

    My other advice is to get the business power of attorney worked out far ahead of time. In the case of sudden illness, the person may be incapacitated or have difficulties writing. (really a problem if they pay all bills by check) The bank was a real pain when I had to put one in place when my dad was in the hospital a few years back. On the upside, I can check on my dad’s account as needed as I have access in my profile.

    So sorry about your situation, Lolly.

  52. This is a topic of concern for me, too. I am an 8 hr drive from my parents, and am closer than my two siblings. One sibling is in a tight financial situation and cannot afford to fly home much. Pre-COVID, we made sure one of us visited them at least every 6 weeks. In 2020, none of us saw them in person until Thanksgiving. They will move to a CCRC once they are able to get the vaccine. I desperately wish I lived closer and could be more help. They are not complainers and I know they keep information from us so we don’t worry about them. My mom handles everything for the two of them, so I worry a great deal that she will get the virus and the very carefully orchestrated life they manage will collapse.

    I am MPOA and executor, but I have immediately told my siblings everything that is shared with me and gave them copies of the healthcare proxy stuff. My dad is 83 and has a degenerative disease, and has made clear he does not want a feeding tube or anything. I wanted my siblings to have plenty of time to absorb that and have told them that if they object to raise it with my parents now, while they’re healthy. I’ve also shared what I know of their finances, the cost of the CCRC, etc. I think we’re all in agreement with my parents’ requests. My parents’ finances should be fine, and I expect my mom to survive my dad. At that point, I’d like to see her move close to either my sister or me, but we’ll cross that when we come to it. At 83, she takes no medicine and is very healthy. The first of her five siblings passed on Monday, but was 91 and still living in her own home at the time. I expect my mom to live for another decade.

    The hardest part for me is not being close enough to provide daily support. I appreciate the comments you all have shared on the problems of home aids. That is a solution one of my siblings has been championing so that my parents could stay in their house. The point I keep coming back to is they really need the help if/when my dad falls. How do you schedule that? The CCRC will be the right thing for them, but they really need to move soon.

  53. Allie and others in similar situations, another option available in many places is adult day care. It’s typically less expensive per hour than in-home care, as the caregiver:patient ratio is typically well under 1.

    There are also potential social benefits, especially in homes that combine geriatric and pediatric day care. And because they don’t involve moving out of their homes, it may be easier for for parents to accept than options that involve moving out.

    This option also does not preculde in-home care for any of the hours outside of the day care hours, which typically coincide with work hours. E.g, you might consider in-home care for some of the hours not covered by day care, so whoever is providing care can have breaks.

  54. “Think about the message you are sending your children. I don’t care if they are 15 or 35, they will remember what you did and consider it when it is time for your care. “

    And not just how you treat your parents. IMO, how you treat your kids tells them how you want to be treated when your roles reverse.

    I’m concerned that DW is burning some of these bridges with the kids. As they’ve gotten older, she’s had a hard time cutting them more slack and not trying to micromanage their lives, and more generally, to make the transition to treating them as adults.

  55. Our siblings go along otherwise we will gladly transfer the responsibility of the seniors to them. No one wants that so they don’t ask questions. The second thing is, if anything were to happen to either of us, responsibility for that set of parents would transfer to our respective siblings. They will have to deal with it the best they can.
    We don’t expect the surviving spouse to take on the in laws. The seniors continued good physical and mental health is important, at least till our kids are off to college.

  56. Falls are a real concern with many fragile seniors, especially those who need to use the bathroom during the night. A call pendant can help, but only if the senior will agree to and remember to use it AND if there is someone in the same household or maybe next door who is in the position to respond. You can arrange for 24 hour home care to deal with this, but that means you are paying a person for an 8 hour shift to simply be on call.

    There are other tech solutions that provide some help, but they all require the ability of someone (strong enough to lift the senior from the floor) to respond.

    The fall risk issue is often what drives family members to some kind of facility option.

    On finances, one possibility is for the responsible adult kid to be added to the main checking account, either with signing authority or as full co/owner. There can be legal issues to consider before doing this, but it can be an easier pill to swallow for a stubborn senior than a full POA. It can be presented as a way to make his life easier by allowing you to handle daily finances if he is temporarily out of commission.

  57. So sorry I missed this topic. My experience was that my tote bag parents expressed perfectly reasonable aging plans and then refused to make the changes when the time came. (Well, mom did move into a CCRC after dad died, which was a gift, but only because her best friend already lived there and talked her into it.). My siblings and I were in complete denial about what comes along with advanced age, not least of which, as Meme suggested above, is how toileting issues dominate life. And for those who think “they changed my diapers when I was a baby, I’ll return the favor”, oh honey, not the same. At all.

    Our denial was aided by the fact that none of us was local. We could fall for the half truths and rationalize the evidence and that worked for us as we put off the hard part like taking the car keys and insisting on moving. Honestly, we had all been trained over a lifetime to please our parents at all costs and I could not get a single sibling on board for the car keys, even though we all agreed it was time and back in the day, our parents had talked about their very reasonable plans for giving up driving when the time came. It took a broken hip to achieve that.

  58. Actually I think it was RMS who so eloquently detailed the toileting issues. Credit where due.

  59. Lolly, I’m sorry you’re going through this. Covid has made me reconsider how I want to age, but it still can suck because there are no easy solutions.
    Finding reliable home care aides can be very difficult, particularly during a pandemic or other national crisis.
    Institutional care is not always a good solution because you lose control of how you want to live.
    Living far from children presents its own problems. We can’t assume traveling will be easy.

    I don’t know what I’ll do, but I’m probably more inclined to prepare in advance for some kind of institutional care then I was before the pandemic.

  60. When my mother redid all her paperwork at 85 or so, she set up a joint bank account with me. I set up online bill pay and held a checkbook. She gave me the second key to her safe deposit box. Plus all poAs. I set up the online password for her one credit card as if I were her, not realizing that was illegal. The lady at the bank branch let me go in and out of the safe deposit box just waving the PoA, also not legal. Most of her assets were in a revocable trust. When she started to fail she went to a notary and relinquished trusteeship to me, the successor trustee. That was legally okay., accepted by all but one account that wanted a medallion not a notary. By then she couldnt execute that any more, so finally they just took her verbal word for it on the phone. 2006 -2008. World has changed a bit.

  61. HFN, a close friend recently cared for her mother as she died from cancer, and had dementia as well. What stuck with me the most was her comment “and changing your adult parent’s diapers is every bit as horrifying as it sounds”.

    I’m really hoping that my the time I get to a situation like that it will be easier to skip the final chapter.

  62. It’s not just incontinence to deal with. Seniors with full control over their bodily functions but who have mobility issues may need help to get to the toilet and tidy up afterwards. This is a major challenge for seniors who have to plan their days around bathroom needs and who may need help in a public restroom during errands or travel. And who aren’t really at the Depends point yet. Like moving through the day with a child being toilet trained, except far worse on every level.

    Bathing is also an issue for those in this category and the need can arise suddenly from an accident or surgery. It’s mortifying for all parties but especially hard for daughters helping their dads.

  63. Meme brings up a good point – in states without RUFADAA (MA is one of the few holdouts), or if the person’s POA doesn’t mention it, setting up online accounts for another person (even if you have a POA) is a violation of the federal ECPA. People do it all the time! But having your POA and your will specifically provide for online access should be helpful, assuming the documents are worded correctly.

  64. I’ve mentioned before my grandma was in a CCRC. When she got to the point that she need help most of the day, the assisted living side did not have space for her. My dad and his siblings arranged aides to come, but they were always a routing bunch, and my grandma became very racist, causing further strife. She didn’t have an aide at night, but was continuing to fall the middle of the night. She was uninjured, but too weak to lift her self up. She was found sleeping on the floor, or sleeping on a chair that she crawled up to. A few times she crawled to the phone to call my dad at 3am because she didn’t want to bother the CCRC staff (although that it what they are there for). She also had one of those “I’ve fallen and can’t get up” type of bracelets and necklace that the CCRC offers, but she would never wear it at night, when it was needed most. Eventually she fell, injured her hip, landed in the hospital and moved to a nursing home.

    What is interesting is that my dad was dealing with this only a few years ago and every time I bring up the idea of downsizing, moving to a condo to make living easier for everyone, he completely shuts the conversation down.

  65. L & NoB,

    Your thoughts on Epstein’s estate planning fees?

    Obviously Mr. Black was being blackmailed, right?

  66. Rhett – I should think so! I can’t imagine the ‘tax advice’ being worth that much unless it was paired with blackmail. GRATs are very common vehicles and the Apollo guy’s actual T&E lawyers were probably recommending them to him at the same time as Epstein’s ‘recommendation’.

  67. L,

    You mean you don’t charge 10% of the potential tax savings?

    But in terms of a blackmail scheme, having some plausible rational for the payments is brilliant. You, being in that business, would know the fees are ridiculous. But to a juror 10% of the tax savings might seem reasonable.

  68. Another thing to check at a CCRC is HOW moving to AL works. I didn’t know at my mom’s until it was too late. Again, hers was set up where you get on a waiting list. Each time a spot came open they started at the top and worked down until they had a taker. Only after my mom passed did another resident mention they put themselves on the AL wait list the first day they moved into independent living.

  69. If you have LTC, even a good one which my parents have, you will be spending a great deal of time dealing with the insurance company for reimbursement. The agencies all have policies that you pay them and then get reimbursed by the LTC because they take their sweet time in doing so. Expect to pay $20-30 an hour (or perhaps more depending on your COL) for an aide. Many people try to then steal or find cheaper but those people are not insured an bonded and the penalty for converting the aide to a side gig is steep.

    And as AM noted, your kids are watching how you take care of them. And siblings/in-laws who are not necessarily helping have the loudest opinions. Since I live out of state, I back whatever my sister wants to do as the primary caregiver/responsible party.

  70. 10% for recommending a GRAT — and then not even doing the work himself? Holy cow, that’s ridiculous.

  71. I realized that I had avoided sharing the recent DH issues with my daughters. I am very proud, always need to “do it self” as my preschoolers used to say, and protective of him. But until this topic went up, thank you Allie, i didn’t see that I was the elder actively concealing. So I sent an email. Here is DD1 next doors reply. I dont want to impose on them in prime of life, but I dont give them enough credit, or perhaps the modeling of how I cared for my Mom really does bear fruit..

    Mom – Thank you for sharing. This is a lot for you to deal with & DH’s natural inaptitude for self-preservation doesn’t do you any favors. I’m here to help in whatever way is appropriate including staying over with him if you want to take a vacation or even taking him out for dinner if you need a break once he’s gotten vaccinated.

  72. Meme that is lovely of her. Her idea of taking him out to dinner sounds great to me. I love a couple of hours home alone. I suspect you rarely get that.

  73. Meme, that’s great.

    What is interesting is that my dad was dealing with this only a few years ago and every time I bring up the idea of downsizing, moving to a condo to make living easier for everyone, he completely shuts the conversation down.

    People don’t want to admit their own mortality.

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