Caring For Aging Parents

Many adults have aging parents who are in need of health-care and living assistance. There are a number of resources today that can help them age gracefully, either in their existing home or in a facility, along with multiple options for financing the cost of the care.

Living Options

Living alone

Depending on the independence of your parents, living alone in their existing house may be an option. However, you may need to make several modifications — some of them expensive — to make their home environmentally safe and suitable for an aging person. For instance, important safety features such as a first-floor bathroom, additional lighting, grab bars in stairways and bathrooms, and an emergency response system may be necessary.

If your parent requires assistance with meals or chores, there are several services which can provide support, such as Meals on Wheels, which are free for anyone over 60.

You may also want to employ an in-home aide if your parent needs assistance such as stand-by for showering, light housekeeping, laundry, meal preparation, rides to appointments, or grocery shopping.

Other things to consider include:

• If there are two parents, is there a healthy parent able to care for the other? How long and what would the toll be?
• Can your parents maintain the home and property, or will you need to hire gardener, housekeepers, etc?
• How do you protect them from scams? You can use call-blocking, bank and credit card alerts, etc.
• Are your parents able to drive? If you are unsure if your parent can drive safely, you may confidentially submit a Request for Driver Reexamination (DS 699)  to the Department of Motor Vehicles (DMV) in California to review their driving qualifications.
• Are you, other family members, friends or neighbors able to provide support, i.e. online grocery shop for delivery to their home, drive to an occasional appointment, check in on them regularly.
• How can you address social isolation/loneliness?
• Are they able to manage their medication independently? 
• Do you have a Power of Attorney to assist your parents in their financial and medical affairs?

Living with Family

Some families choose to move an aging parent into their own home. If you can do this with minimal conflict, this can be beneficial as it avoids having to maintain a second home, facilitates closeness with your family member, allows you to monitor medications and, of course, it can be less expensive. 

Before making this arrangement, consider:

• Is your home set up to allow for privacy for both your family and your parents?
• Are there other family members, or can you afford to bring in a home health aide so you can have respite?
• Remember although the parent is living in your home, they may require additional supervision or involvement from you. If you are working, caring for an aging parent will require you to take time away from work.
• Talk openly with all family members - different routines, expectations, lack of privacy can lead to tension among family members.
• Do you need to make any home modifications to accommodate an aging parent? Is this an expense you can incur?
• Make a back-up plan and long-term plan if care increases beyond what you can provide.
• If your parent qualifies for home health services under Medicare, a social worker will be assigned to make sure their needs are covered, such as in-home lab appointments, podiatry, physical therapy, x-ray imaging.

Assisted Living Facilities

If your parents are independent and can care for themselves, they may be eligible to enter a continuing-care retirement community, where they can rent (or purchase) an apartment and be eligible for nursing care, if it becomes necessary. Some elders are mostly independent but enjoy the social engagement of a community and the security of having staff on hand should they need assistance. Many places offer services such as meals, laundry, and housekeeping. 

Unfortunately, the monthly cost can be high for assisted living facilities - $5,000 - $12,000 per month depending on location and services, which are not usually covered by Medicare. 

Other factors to consider:

• Moving away from home can cause emotional stress and feelings of displacement.
• The quality of care at the facility.
• Limited medical care at the facility.

Nursing Home

If your parents need more extensive care and require a nursing home, research the options extensively. Nursing homes in San Diego are among the most expensive in the US with costs ranging from $10,000 - $12,150 per month on average. In addition, nursing homes in San Diego are typically used for short-term rehabilitation after a hospital stay, so many homes do not have space for new residents. Waiting lists are often long at popular facilities and there is limited financial assistance for families paying for nursing home care.  Financing long-term care can be a tremendous challenge for many adults.

Financing Long-Term Care

Medicare will only pay the full cost of professional help if a physician certifies that your parent requires nursing care and if the services are provided by a Medicare-certified home health care agency. However, Medicare will pay for nursing home care for the short-term only, or Medi-Cal offers benefits to low-income individuals with limited assets.

You can offset some of these costs, as you can claim a federal tax credit up to $3,000 off the cost of in-home care or day care.

You can use a flexible spending account, too, which helps you pay for a certain amount of covered expenses with pretax dollars.

Consider purchasing long-term care insurance, which can help pay for nursing home, assisted living and the cost of an in-home aide. This insurance requires medical underwriting so you need to plan in advance of any chronic conditions. The best time to purchase long-term care insurance is up to you, but it is recommended it be purchased prior to age 60 to keep premiums affordable.

With the cost of elderly care continually on the rise, financial planning can be an important step in providing adequate support for your parents’ future well-being.

This material is for general information only and is not intended to provide specific advice or recommendations for any individual.