There are many options for the care of our aging parents, but most of them are costly. There was a stretch of time during my parents’ lives when Dad needed nursing home care, but Mom was getting by living independently in her apartment with my help. Since she had access to an elevator and she wore a medical alert device to call for assistance, she was generally okay. However, it was clear her needs were escalating, so we started looking at assisted living communities. The cost of different facilities varied widely.
Many families are faced with these difficult decisions. Aging parents, whether in the old family home or an apartment alone, come to a point when they are no longer safe living on their own. They need some assistance but do not require nursing home care yet. So, the search for assisted living begins.
Assisted living facilities range from small adult foster homes that care for three or four seniors to swanky retirement campuses with several options for aging in place, meaning that different levels of care can be purchased as needed. Seniors with good pensions and investment income often opt for the more opulent settings and can pay for the services. It’s wonderful to see people be able make these choices without a lot of worrying over their finances.
Unfortunately, the average aging couple relies on some savings and their meager Social Security retirement benefits to fund their care. This usually isn’t sufficient to pay for assisted living for more than a year or even a few months. Upon making this realization, families begin researching options for financial assistance and contemplating how their aging loved ones are going to afford the care they need.
Programs to Help Pay for Assisted Living Are Limited
Many people mistakenly think that Medicare will help cover these costs, but Medicare does not pay for assisted living. On the other hand, Medicaid does cover certain types of long-term care services. Specific programs vary by state, but most state Medicaid programs offer some sort of financial assistance with the costs of assisted living. However, Medicaid uses strict eligibility guidelines that also vary by state. For more information on qualifying for Medicaid, contact your local Area Agency on Aging or your state’s department of health and human services or department of social services.
Should Family Help Pay for Assisted Living?
The reality is that when it comes to assisted living, most families pay out of pocket. If the adult children have the resources, they will often contribute to their parents’ care if Mom and Dad don’t have sufficient funds. This, of course, can cause issues within the family, especially if some siblings are wealthier than others. How do families decide whether the children should financially contribute to their parents’ care, and, if they do, who pays how much?
Over the years, I have made the following suggestions to families who have grappled with these questions:
- Family meetings can help move things along. Sometimes that means siblings must grow up enough to put aside sibling rivalries and old family dynamics for the benefit of their parent(s), but if that can be done, a collaborative plan can be devised.
- There are options other than splitting the cost evenly. One sibling may have a substantial income but live far away from their parents. This sibling could contribute more financially, while another sibling who lives closer and has a more limited income can take on a larger part of the hands-on care that may, in turn, keep down some of the costs. A third sibling may do a little of each.
- Unfortunately, some siblings just plain don’t get along and issues with parent care often bring out the worst in their relationships. In particularly difficult scenarios like these, a mediator can assist families in finding an elder care plan that everyone approves of. Having a neutral party present to weigh in during family meetings can help siblings put aside personal differences, find compassion (or at least tolerance) for one another and concentrate on the wellbeing of their parents.
Adult Children Must Save for Their Retirement and Long-Term Care, Too
Another less popular option is deciding not to contribute. Not every adult child is in a position to help their parents financially. You’d like to see Mom and Dad get top-of-the-line care, but you may all have to agree that more humble surroundings are all the family can afford. After all, your parents have had their whole lives to save and spend wisely. Whatever money they have set aside should be used for their care. Not only is making major contributions difficult for an adult child to budget for in the first place, but it also results in less savings for their own children, their retirement and their long-term care. Relying on parents to leave an inheritance after they pass is never guaranteed.
Rather than making financial contributions, offer your parents emotional and logistical support. Help them research long-term care options, financial assistance, and other federal, state, and local programs. Help them plan to spend down their assets and apply for Medicaid. Having your emotional support is often more important to your parents than having your fleeting financial support.
There is no telling how long Mom and Dad may reside in assisted living or how much their care needs may increase. Many adult children agree to help cover costs only to realize that they’ve committed to paying for long-term care for many, many years. This can be a financially devastating decision that is difficult to back out of, especially if the children have signed binding contracts with a facility regarding payment.
Many families balk at the thought of a parent residing in senior living, especially a Medicaid facility. Understand that many beautiful facilities put more emphasis on their surroundings than their staffing ratios, while some facilities that are humbler in appearance may actually give better care. Keep in mind that looks can be deceiving. In the end, it’s the quality of care that matters most at a senior living facility, not the decor and amenities.
The need to care for our aging parents always presents difficult choices. There is no one-size-fits-all solution for everyone, and there is limited financial help available from outside of the family. If you find a fairly affordable assisted living facility that offers a caring staff, then that may be your Mom or Dad’s best option. Don’t feel guilty that you can’t provide more support. Whatever reasonable contributions you decide to make will have to suffice. Understand that you can’t do any better than your best.