We Forgot to Plan for This: on Assisted Care for an Aging Parent

Failing to plan is planning to fail. So, who failed?

We Forget to Plan for This Moment: On Realizing the Need for Assisted Living
We Forget to Plan for This Moment: On Realizing the Need for Assisted Living

My dad left my mom on their 31st anniversary. We were each living our own young adult lives – my brother in Texas earning his Master’s, working full-time, and awaiting the birth of his second baby; my sister in NC enjoying her first year of marriage, finishing her B.A. in Education; and me in Colorado carrying a full graduate-school load, working full-time at the hospital and living a footloose single life in America’s playground.

We were each happy. We were each grounded. We came from a long-line of love – or so we thought. My parents’ divorce was completely a shocker to us.

Mom had just lost 40 pounds and finally on a road to health that we had always dreamed she would find. As a family, our future looked bright. Family holiday reunions were going to be amazing. But, there was underground plumbing that was about to burst. There were years of emotional pain. There was a double-life of escape being lived and undiscovered.

Until then – that day he left. And, living 1200 miles away, the hurt was no less felt. It was as if the fabric of who I thought I was in terms of my family came unraveled. The rug pulled out from under us. We reeled. For years, we each reeled in our own crazy ways. Then, there were health problems throughout the family and, most specifically, Mom. We tag-teamed who was going to be where for which surgery and for how long and whose job and future would be sacrificed this time. And now – here we are. Twenty-five years later, we “suddenly” are dealing with Mom’s declining health and totally without a plan.

Now what?

Getting the help you need right now.

1. Come clean with someone you trust.

A pastor, a teacher, a counselor, a small/support group, your spouse – any of these are good sounding boards and great support.

YOU have to deal with the reality of how your world is changing, too. Not just your aging parent. Recognize your need for support for the strength you will need to be supportive to your parent.

2. Call a senior living placement specialist.

Support and sounding boards are great for your own psyche throughout this process. But, for me, real actionable ideas came from my A Place from Mom contact. I couldn’t believe I was actually calling the number. I felt ridiculous – “as if ” they could really do ANYthing for our helpless situation.

Lauren didn’t just give me a pat answer and jump off the phone. She really listened to me. I felt like I was in a therapy session. When I got off the phone, I collapsed in tears. I didn’t even know I needed to cry. It was the shift of burden from my confused head to her well-informed bag of ideas that gave way to a release.

After nearly 8 months of waxing and waning in my urgency – the ambivalence from “she needs a place right now” to “oh – she’s getting better, I don’t think we need to do anything” to “she is not healing well” to “she is going to be fine” to “she really is going to need more help than I can give long distance” and then,

“Oh no – my brother just had a stroke and can no longer be the main caretaker – What do we do!?”

Lauren has been patient and has given me so much information I knew NOTHING about. There is hope.

3. Know that everyone involved is as important as the aging parent.

This was probably the most eye-opening, guilt-releasing point Lauren made when we first talked.

My son’s future. My brother’s marriage. My sister’s fulfilling and life-affirming work. My limited time with my husband. My sister’s husband and limited time with her 3 growing children. My sister-in-law’s years of stress caring for an ill child. My growing piano teaching practice.

Each needs to be considered.

There are 14 people whose lives are being affected by the growing stress of “what are we going to do” and “how do we get mom the help she needs”.

4. Start the conversation with your aging parent.

That introductory conversation was a doozy for my brother and me! My sister wasn’t there and we were not going to be overlapping in our visits to take care of her the weeks following her 3-month rehab stay.

It was miserable.

How could she possibly be so shocked? Her resistance was beyond difficult.

But, experts say that it takes many and consistent talks with your aging parent before a big move can occur. She will have to start with the Death of the Dream process.

Expect this to be difficult. Prepare yourself to take it. Let her lash out. Let it go down the tubes.

The conversation has started and may go on for some time before it gets better.

5. Begin regular conference calls or meetings with your siblings.

Unity in messaging and agreeing on that message is key to making this difficult transition as smooth as it possibly can be for your parent and will keep their dignity intact.

Splitting can derail any progress made and cause more pain and confusion than is necessary.

6. Call and visit the places on your list: Footwork

Your senior living placement specialist will send you a list – like a realtor does. Keep a log of all the places you contact and go to so when you set up your sibling conference calls, you are able to present the options clearly.

See the next point for a free download to help you with this.

7. Keep track of your findings.

Having all your findings in a consolidated format to share with your siblings will help everyone involved be confident that any and all potential helps are researched.

Here is the spreadsheet I created to keep track of our options – 2 worksheets are included: 1) Overview, 2) Cost/deficit comparisons on the 4 options we considered:  Parent Living Options.xlsx

8. Consider a facility that offers Medicaid after assets are spent.

If it is likely that your parent will spend all assets in a private, self-pay assisted living (ranging from $2900/mth – $4500/mth) and you and your siblings are unable to cover these costs, be sure to find a facility that will allow Medicaid to kick in once your parent’s assets are gone.

Research more here to understand how Medicaid assisted-living pay works: Medicaid guide to Senior Long term care.

9. Discover your financial resources.

Download this worksheet to estimate your financial sources: Resource Discovery and Budget Worksheets.xlsx

Is your aging parent eligible for VA benefits?

If so, this could mean up to $1200/mth in paying for assisted care. If your parents are divorced, only the actual veteran is eligible for benefits. I was born in the Army; but, although it was my mom who scraped and made a home for the soldier, she gets no benefits because my parents are divorced. If the veteran was in the reserves, they need only to have served one day during wartime to be considered eligible. Find out if your parent is eligible by contacting: http://explore.va.gov/

Does your aging parent have Long-term Care Insurance (LTC)?

If so, this could mean anywhere from $50-$100/day in paying for assisted living until it reaches its max lifetime benefit.

Does your aging parent have a life insurance plan with a cash-out option? 

I would rather use the money right now to provide the best care for my parent than to have any windfall at her death. Ask your parent’s insurance agent what the policy allows in this regard.

Does your parent have any assets? 

Property, home, valuables, antiques, cars, boats – anything that can be sold to help pay for quality care will be expected to be exhausted prior to being allow to go to a Medicaid status. Consult a lawyer before transferring any assets into a family members’ ownership to save it from being liquidated. This can and should be done if it does not adversely affect your aging parent’s ability to stay in a quality assisted-living facility.

10. Relax and let the plan fall together.

There comes a point when you can’t push anything past where it will go. I am certainly not suggesting that you do nothing. I am just saying that it won’t necessarily come together in a neat little package and you will be done with it.

Depending on your set of circumstances, progress and the sense that things are moving along will ebb and flow. A simple work-energy principle states that the change in the kinetic energy of an object is equal to the net work done on the object.

Keep putting in the energy. Keep doing the work. Stay loving and prayerful.