Be sure to have an understanding of these key issues:
Do your parents have wills and where are they kept? Seven out of 10 Americans do not have a will. Ten out of 10 are going to die. I know because I Googled it.
Make sure your parents assign durable (financial and legal) and health care powers of attorney. Encourage them to choose a practical, trustworthy sibling to make legal, financial and medical decisions if they are unable to do so. Although the forms are online for free, my cousin, the lawyer, says you should spend $200 and have an attorney draft it.
Be clear about the difference between Medicare and Medicaid.
• Medicare pays for medical care for seniors and some prescription drugs. It does not pay for long-term care. It will pay for up to 100 days of rehabilitation in a nursing home if the patient is making measurable progress.
• Medicaid pays for nursing home care for those who can’t afford the cost. It has strict limitations on income and a $2,000 limit on total assets, with the exception of a primary residence. Approximately 80 percent of Texas nursing home residents are on Medicaid. Medicaid generally does not pay for assisted living.
Encourage your parents to get long-term care insurance. Only about 8 percent of Americans currently have this coverage. Applying before health problems arise will mean lower monthly rates and less risk of being turned down due to pre-existing conditions.
As tactfully as possible, find out the state of your parents’ finances. Many of their decisions—and those of their caregivers—will be a direct result of what they can afford. The average cost of a semiprivate room in a skilled nursing home in Texas is $5,000 to $7,000 a month. That’s $60,000 to $84,000 a year and varies greatly depending on their location (metropolitan areas are costlier than small towns), amenities, and the condition and reputation of the home.
Assisted living facilities do not provide nursing care. They offer assistance with the tasks of daily living (taking medications, getting dressed, toileting) and are almost completely private pay. Costs range from $2,200 a month to $6,000 and up, depending on the number of individual services provided, as well as location and amenities.
End-of-life decisions: the questions we don’t want to ask, but must.
• What are your parents’ wishes if they have a condition that is terminal or irreversible? Do they want life support (respirators, feeding tubes) continued indefinitely? A living will (directive to physicians) is necessary to make their preferences a binding legal document.
• Finally, do they want cremation or burial, funeral or memorial service? When I got the nerve to talk to my dad about his funeral, he said, “Jim, do what you want to do. I won’t be there. Funerals are for the living.”
There are 2.7 million Texans serving as unpaid family caregivers.
You might be one of them. The ones who get through this journey with sanity and health intact are the ones who are willing to ask for help.
Don’t try to do it all yourself. Reach out to others and accept assistance and support gratefully. In addition to family, friends, neighbors, church and social groups, there are many governmental and private agencies that provide information, advice, referrals and services—usually at no cost.