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Talk to Your Parents About Long-Term Care

Plan for the practical and the meaningful for everyone’s benefit


Laurie Menzies is an attorney in Buffalo, N.Y. specializing in elder law. To most people, that means she helps with the basics: transferring assets and assigning powers of attorney. But Menzies has learned that it takes much more to prepare well for aging.

Good planning crosses the legal, financial, medical and practical aspects of aging. It involves everything from saving money and buying insurance to thinking through an advance health care directive. It requires deciding where you want to live and how your day-to-day needs can be met if you’re not driving, walking or able to keep up a home anymore.

And it necessitates talking with your family.

All the planning, Menzies says, opens up possibilities. Anticipating various scenarios helps make them manageable. “If we embrace this part of life, which is wonderful, we’ve got these bonus years,” Menzies says.

Of all the reasons people find it hard to plan for their later years, the hardest to overcome might be a degree of disbelief that life will change.

She uses her own parents, who died a few years ago at 96 and 90, as an example. “They had a wonderful 80s” of staying active, going out dancing and to ballgames, she says. A lasting memory is of her father at 91, singing Dean Martin at her wedding. When her parents’ health finally declined, Menzies was their main caregiver.

Even as they slowed down, they made the best of each day.

“When I had to care for them, it was great,” she says. “There is such love that you learn by giving.” Today, she gives clients a book of her dad’s cartoons and humor. He started to draw when he couldn’t walk anymore.

Menzies wrote a book of her own in the void she felt when her caregiver role ended, Embracing Elderhood: Planning for the Next Stage of Life. “It started as a survival guide for aging parents and their children,” she says. But in the end, Menzies notes, “my book is encouraging people to reflect that there’s a purpose for every stage” in life.

Options Beyond Nursing Homes

Of all the reasons people find it hard to plan for their later years, the hardest to overcome might be a degree of disbelief that life will change.

The parents of accountant Carolyn Kramer’s “were never going to go to a nursing home,” she says, because “nothing was ever going to happen to them.”

They worked hard, saved diligently and expected to live out their days in their home in South Wales, N.Y. They made it clear that if their children ever placed them in a nursing home, they’d take it as a betrayal.

But they never talked about alternatives, or a Plan B if living self-sufficiently at home was no longer possible.

“[Most people] have no clue that there are all of these different levels of care, and what’s provided at each level,” says Menzies, who helped Kramer’s family make a Plan B when the need became urgent. “They hear ‘nursing home’,” Menzies adds, as soon as there’s any need for help.

But there are ways to start investigating the whole range of support options early, including websites where you can search for local services, housing and care facilities.

Eldercare.gov is from the U.S. Administration on Aging. The nonprofit education and advocacy groups Leading Age and the Family Caregiver Alliance also have searchable directories at leadingage.org and caregiver.org. For help navigating all the options, you can also call the Administration on Aging at 800-677-1116. And for more resources to get started, see the SCAN Foundation’s “10 Resources to Help You Prepare for Aging with Dignity and Independence.”

Today, Kramer and her brothers visit their 84-year-old mother in a nursing home, where she lives with advanced Alzheimer’s disease. Before that, she lived at a facility dedicated to memory care. And before that, her family cared for her at home, until it was no longer safe; she wandered out of the house at 2 a.m. one cold January day.

They visit their father at an assisted living facility, where he moved after living in a seniors’ apartment building with housecleaning and meal services. He had suffered bouts of depression and severe weight loss. The day he fell down the stairs and broke his collarbone “was the best day of my life,” Kramer says, “because I was able to get him into the hospital and I got a doctor who said he’s not allowed to go home.”

“Are Mom and Dad in a place right now where we thought they would be? No,” Kramer says. “But they’re well loved, they’re well cared for and that’s what matters.”

Making Decisions Now to Help Later

Before there’s ever a need to move or bring in support services, Menzies says there are other ways people can lay groundwork that makes it easier for family and others to help them. One is to consolidate finances.

“Do you really need CDs at four different banks?” Menzies asks. You or someone else will have to travel all over town to keep updating those certificates of deposit. Instead, you could consolidate them into a single brokerage account that buys CDs, she suggests.

DIY investors should consider whether anyone else in the family has the ability and willingness to maintain those investment accounts. If so, share account information with them. If not, transfer those investments to a brokerage, too, she says.

The basic principles of making things simple and transparent can apply in many ways, from paring down possessions to adding low-maintenance features to a home to making sure someone has the passwords, keys or contact information to step in and manage things for you.

Kramer’s mother had always managed the family’s finances. But as Alzheimer’s took hold, that became problematic and so did trying to talk with her about a hand-off of responsibilities.

“We had to do things on the sly,” says Kramer, who used to live just around the corner from her parents. “When they left the house, I would go over and grab a box of [financial] stuff from under the bed” to sort through it.

Why the Conversations Are So Hard

One more reason it’s hard to plan for and talk about aging is that whatever else the conversation is about, it’s also about death.

Kathryn Lawler, who manages aging and health resources for the Atlanta Regional Commission in Georgia, says, “Even in my own family, as an aging professional talking with my own father, I find it remarkable how much anxiety I have about returning to this conversation that, yes, we had a couple years ago, but you have to keep having it: ‘Has anything changed in your plans, Dad? Do these documents need to get updated?’ I mean, who wants to keep doing this? It’s so hard.”

Maybe a way to get past the difficulty, Lawler says, is to stop seeing the changes associated with aging as simply a process of loss. We need to reframe aging as “swapping benefits you have now for new benefits in the future.”

The new benefits might include more opportunity to think about what defines you and matters to you, or the legacy of values you want to leave behind. To get that kind of conversation going with your family and yourself, see the SCAN Foundation’s list of 10 conversations to have with loved ones as you plan for aging.

Consider, Menzies says, that “if you live to be 95, your kids are going to be 70 or 65. Are they really waiting for your inheritance at that point?” Aging and planning for it are a chance to “break out of our old patterns of thinking.”

What did you accumulate your wealth or wisdom for?, she asks. Aging is your chance to share it.

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