That’s the nightmare phone call for any child of a frail parent. While tussling with your job, your children or both, you can’t shake the fear that your parent needs more help.
A fortunate few can dial an eldercare hot line, like Work/ Family Directions in Boston, Mass., or the Partnership Group in Lansdale, Pa. These firms contract with employers to help employees get the health and homemaker help that their aging parents need. But the vast majority of children have to go it alone. Hence, the following checklist-to point you toward ideas and services you can use.
If your parent can’t handle the finances, get:
A durable power of attorney, which gives you the right to manage the money. Regular powers of attorney are no good. Only a durable power stays in force if your parent becomes incapacitated. Ask a lawyer to draw it up (the fee should be low). Then get it approved by all the financial institutions that your parent uses-bank, insurance company, stockbroker, mutual fund. Some institutions won’t accept a power of attorney not drawn on their own forms.
A list of all the income and assets. You may be able to squeeze more income from your parent’s savings by moving money out of a passbook account and into a certificate of deposit or by taking a loan against an insurance policy.
A joint bank account with your parent, for paying the bills. But this apparently simple strategy isn’t without risk. For example, says David Dauman of the accounting firm, Peat Marwick, if the child unexpectedly dies first, the child’s creditors might try to tap the account. Furthermore, when your parent dies, what’s left of that money will normally be paid to you-cutting out any siblings you may have. Instead of a joint account, Dauman says, use a durable power of attorney. Or ask your bank if it offers joint accounts “for convenience only,” not for inheritance.
Automated bill paying. Certain income, like social-security benefits, can be wired directly into your parent’s account. Many bills can be paid automatically, like mortgage, insurance and utilities.
A supplemental health-insurance policy, to cover the gaps in Medicare. There’s always a risk that an aging parent might forget to pay the premiums. To keep on top of this, ask the insurance company to send you duplicates of the bills. (Low-income seniors don’t need extra insurance because they’re covered by Medicaid.) To find doctors who “accept assignment”–that is, who don’t charge more than Medicare pays-ask the local Social Security office.
The insurance-claim forms for medical bills. Millions of dollars are lost every year by seniors who don’t file medical claims. Under the law, your parent’s doctor has to enter the Medicare claim. But it’s up to you to catch Medicare’s mistakes and to collect on private insurance.
If your parent needs health and household help:
Make a safety check of the house. Are the lights bright enough (older people need extra illumination); can you get rid of throw rugs; should the doorsills be removed (they’re a major cause of falls); does your parent need a stool in the tub, a higher toilet seat, a stair elevator?
Propose a living will and medical durable power of attorney to parents who shudder at the thought of living for years in a vegetative state. The living will expresses their wishes; the power of attorney appoints someone-spouse, child, doctor-to make medical decisions on their behalf. For free living-will forms, write to the Society for the Right to Die, 250 West 57th Street, New York, N.Y. 10107. The society would appreciate a small donation.
Identify your parent’s current support system-doctor, lawyer, banker, church or temple, friends, neighbors. Express your thanks and ask them to call you if something’s amiss. Certain friends may be willing to do a bit more, like trim the hedge or take your mother to the grocery store.
Arrange for health and personal care-a struggle even for children nearby, let alone those who live some distance away. Fortunately, most communities offer a web of services, both public and private. But it takes time, personal visits and, usually, money to line up all the help you need.
Start by calling the Office for the Aging in the capital of your parent’s state. Get the phone number of the local Area Agency on Aging (AAA), which is a mother lode of good advice. The AAA offers (1) free booklets on eldercare; (2) a directory of local services, like Meals on Wheels, adult day care, financial aid, senior-citizen discounts, transportation, visiting nurses, visiting libraries; (3) access to free care managers, who will visit your parent, assess any health or homemaking needs and suggest services that can help. There may be a waiting list for assessments, but give it a try. For other senior-citizen organizations, cheek the Yellow Pages. One good free booklet: “Miles Away and Still Caring,” from the American Association of Retired Persons, 601 E Street N.W., Washington, D.C. 20049.
Consider a private care manager. This new and rapidly growing field is peopled with nurses, social workers, psychologists and self-styled gerontologists. For a fee in the $150 to $500 range, they’ll visit your parent and make a report. For additional fees (perhaps $50 to $125 an hour), they’ll find home-health workers, recommend nursing homes, pay regular visits and handle emergencies. Your first stop for referrals: local nursing homes, doctors and hospital social-service offices. You might also call the National Association of Private Geriatric Care Managers in Tucson, Ariz. (602-881-8008). Or send $2 and a self-addressed stamped envelope to Children of Aging Parents (Woodbourne Office Campus, Suite 302A, 1609 Woodbourne Road, Levittown, Pa. 19057) for the names of some practitioners in your state.
Warning: This field is utterly unregulated. So check every claim on the manager’s resume to see if it’s true. Interview at least three clients, get a written plan of action, plus costs, and don’t choose anyone who rubs you wrong.
