When we were young children, we looked to our parents to tell us right from wrong, to make decisions for us and to protect us. As we became young adults, our relationships with our parents changed. We still turned to them often, but more for guidance and support. Never did we imagine or expect that one day we would be caring for Mom and/or Dad. Now we are the ones in the “worry seat.”
As a geriatric social worker, I get calls from adult children expressing concerns about their parents and looking for guidance. My clients say things to me like:
“I’m so worried about my mom living alone. She keeps falling.”
“Last time I was at my dad’s house, he asked me to look at some of his mail. I saw that he hasn’t paid his power bill in three months.”
“I’ve tried to talk to my parents about getting someone to come in and help them at home, but they just refuse to discuss it.”
These concerns represent a major shift in parent-child relationships and can be difficult to deal with both logistically and emotionally. Many adult children are left wondering about their responsibilities as a caregiver and where they should start when taking on the role. Fortunately, a few steps can set you on the path to success as a family caregiver.
5 Steps to Starting Care for an Aging Parent
1. Conduct a Needs Assessment
First, you will need to take a detailed inventory of all the areas you have observed to be of concern. Assessing both activities of daily living and instrumental activities of daily living will help you gain a thorough understanding of your parent’s situation and enable you to make a comprehensive elder care plan.
An in-person visit is the best way to get a realistic evaluation of an elder’s needs, but this can be difficult for busy and long-distance caregivers. You can conduct a do-it-yourself needs assessment using our printable ADL Assessment Checklist. This is a good option if you feel your parent will not respond well to being scrutinized or be open to accepting help. If you know what signs to look for and questions to ask, you can quietly record your observations and findings without causing a stir. You can also contact your local Area Agency on Aging (AAA) to request a referral for a formal assessment if your parent is willing to participate.
A primary care physician or geriatrician can perform a comprehensive geriatric assessment as well. In addition to evaluating a parent’s functional abilities, this assessment also addresses their physical health, medication regimen, mental health, and other important social and environmental factors that impact their quality of life. Some seniors are more comfortable with this suggestion, especially if a trusted long-time physician is handling the assessment.
2. Research Caregiver Resources and Elder Care Providers
The next step is to look for resources that will support your parent(s) and you as their caregiver. Again, your AAA can be an excellent resource for finding programs sponsored by local organizations and the local, state or federal government. AAAs can assist with filing Medicaid applications, understanding Medicare coverage, finding respite care programs, getting nutrition counseling and much more.
You can also hire a private elder care professional, such as a gerontological social worker or a geriatric care manager (also known as an Aging Life Care Professional), to assist you in accessing appropriate elder care resources. This is a valuable addition to your care team, especially if you do not live in the same city as your parent(s). Not only can these professionals guide you through the initial steps of caregiving, but they can also keep an eye on your parents in your absence. You can search for an Aging Life Care Expert on the Aging Life Care Association website.
Researching elder care options is important as well. Even if your parent may not require outside help just yet, it’s helpful to know what signs to look for that indicate they need help at home or that they may need a higher level of care in some sort of senior living community. It is best to get a feel for the full spectrum of long-term care, what services and amenities each type provides, how much it costs, and how it can be paid for. This knowledge will ensure you are prepared if your parent’s care needs change (or your ability to support them changes), which can happen suddenly and unexpectedly.
3. Communicate Your Concerns
Talking to aging parents about their current and future care needs can be tough. I find that with most of my clients, this is the most difficult area for adult children to handle. How you approach this delicate topic depends on the kind of relationship you have with your mom and/or dad and their attitudes toward aging and long-term care. Some family caregivers can have frank, easygoing conversations with their parents about changing abilities, estate planning and end-of life care. Others have parents who vehemently refuse to acknowledge any of these important issues.
You know your parents best, so deciding when and how to broach the subject is often unique to each family. While some lucky children are able to voice their concerns immediately with little pushback, a good rule of thumb for most is to do your research first. Make some quiet observations while visiting, suggest a thorough check-up at their next doctor’s appointment and get a feel for the elder care industry before diving in. In this case, you will be able to open the conversation fully prepared and ready to suggest viable solutions to any issues your parent may be dealing with.
The sooner you educate yourself and share your concerns with your parents, the better. A senior’s mental and physical health, preferences, and care needs can change very quickly. Caregiving is much easier when you’re aware of the possibilities that may lie ahead and as prepared as possible to handle them.
4. Create a Legal and Financial Plan
Ideally, your parents will have taken their own steps to plan for retirement and the possibility of needing long-term care. If they were proactive about saving and estate planning, then this is one major task that you can cross off your list. All you’ll need to do is confirm that they have covered all their bases with the appropriate legal documents, discuss how these papers reflect their preferences, inquire about how you fit into their plans, and gather any important information pertaining to them. For example, if Mom has named you as her agent in her power of attorney (POA) documents, then you’ll need to know where the original is kept and obtain a copy for your files. Collecting the names and contact information for their legal and financial professionals is advisable as well.
If your parents haven’t engaged in any legal or financial planning for their golden years, then you must encourage them to do so before it is to late. They will need to consider drafting medical and financial powers of attorney, advance care directives, wills and other important legal documents to ensure their wishes are respected for their health care, finances and final arrangements. Without these provisions, it will be difficult, if not impossible, for you to take an active and informed role in their care should they become incapacitated. Skipping this step can result in costly, time-consuming and stressful surprises down the line. It is best to work with a reputable elder law attorney who is experienced in these matters sooner rather than later.
5. Find Caregiver Support
Since your new responsibility is to help support your aging parents, that means that you’re going to need some additional support, too. Many family caregivers dive into this new role out of love and find their experiences very rewarding. However, elder care is undoubtedly both physically and mentally demanding. If you’re not careful, caregiver burnout can take hold and wreak havoc on your own health.
Two things that are crucial for preventing caregiver burnout are social support and respite care. Both in-person and online caregiver support groups are excellent resources where caregivers can connect, share experiences and receive guidance. Many adult children tend to feel isolated and misunderstood while caring for their parents, but compassionate social support can be very restorative. Respite care comes in many forms and can meet a wide variety of needs. Every care plan should have regular breaks built into it from the start. Without a reprieve from the stress of caregiving, burnout is sure to set in.