There are many options for the care of our aging parents but most of them cost money. There was a stretch of time during my parents' lives when Dad needed nursing home care but Mom was getting by in her apartment with my help. Since she had access to an elevator and she wore a personal alarm to call for assistance, she was generally okay, but her needs were escalating so we started looking at assisted living facilities. The cost of different facilities varied widely.

Many families are faced with these decisions. Their parents, whether in the old homestead or an apartment alone, come to a point when they are no longer safe on their own. They need some assistance but do not require nursing home care. So the search for assisted living begins.

Assisted living facilities range from "mom and pop" homes that care for three or four seniors, to swanky retirement centers with options for aging in place, meaning that layers of care can be purchased.

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 finances. However, the average aging couple will most likely have some savings and possibly a pension to augment Social Security income.

Programs to Help Pay for Assisted Living are Limited

Many people think Medicare will help with these costs. Medicare does not generally pay for assisted living, though some states have programs where seniors who qualify can choose how to spend the money allotted to them through some hybrid programs involving Medicare. Medicaid doesn't often pay for assisted living either, though again, some states have programs where Medicaid can help. To find out if the state where your elders live offers any programs that may help pay for assisted living, I'd suggest that people start their search on their official state website. Search for your state department of aging affairs. Links on the site will take you to any programs your state may provide.

Deciding on how Siblings Can Assist with Paying for Care

The reality is that when it comes to assisted living, most families pay their own way. If the adult children have the resources, many times they will help out if their parents don't have enough income. This, of course, can cause issues within the extended family context, especially if some siblings are wealthier than others. How do families decide whether or not the children financially contribute to their parents' care, and if they do, who pays how much?

  • Family meetings can move things along. Sometimes that means siblings must grow up enough to put aside sibling rivalry, but if that can be done, a plan can be devised.
  • There are options other than splitting the cost. One sibling may have a good income but live at a distance. This sibling could contribute more financially, while another sibling who makes only enough money to get by on can help by providing hands-on parent care that may keep down some of the costs. A third sibling may do a little of each.
  • A family mediator can assist. Unfortunately, some siblings just plain don't get along and issues with parent care often bring out the worst in their relationships. The presence and training of a family mediator can change the family dynamics enough so that siblings can lay aside personal differences and concentrate on the wellbeing of the parents.
  • Compassion is important, not only for the parents, but for siblings who are struggling with their own issues. In a family with several adult children, it would be unusual for everyone to have similar living circumstances. If compassion and understanding for one another isn't already in place, again the best hope for agreement would be to involve a mediator.

It's not always possible to help one's parents financially. You'd like to see your parent get top-of- the-line care, but you may all have to agree that more humble surroundings are all that can be managed financially. If a parent must live in a subsidized apartment for low income people, you can help with the paperwork to get them on the waiting list for housing, and stay involved by giving your time and care. Having your emotional support is often more important to your parents than having your financial support.

Take comfort in the fact that many beautiful facilities put more money into surroundings than into staff, while some facilities that are more humble in appearance may actually give better care. This is not to say that a beautiful new, state-of-the-art facility wouldn't also give good care. I'm just pointing out that in the end it's the care, not the decorating and amenities that really matter.

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The need to care for our aging parents nearly always presents difficult choices for the family. There is no one solution for everyone, and there is limited financial help from outside of the family. If you find a fairly affordable assisted living facility that offers a caring staff, that may be your answer. Otherwise, you may need to look at other options for helping your parents until they reach the point where a nursing home is needed.