A generation ago, it was common for extended families to live in the same area as their parents, or even the same neighborhood. Now families are spread all over the country, and beyond. This can become more difficult as parents age. A few visits a year, supplemented by phone calls and Skype can be enough to maintain a good social relationship. But what about when a parent gets dementia? What about a hip fracture that requires several months of rehabilitation. These are the times that families struggle. Worse, these things tend to come up in the years that adult children are most busy with careers and raising their own family. You want to be a good son to your parent, but you can’t take two weeks off to be the primary caregiver.
These issues are never easy, but there are some things you can do to prepare.
Heed the Warning Signs
There are some medical problems that crop up unexpectedly. Stroke and heart attack are good examples. But, there are many more that are not surprising if you think about them. Dementia and memory loss are generally slower in progression. If your parents are having falls on a regular basis, you can expect that they will continue and lead to fractures. Chronic pulmonary problems or congestive heart failure are longer term issues. The time to prepare for these things is when you first observe the problem. Don’t assume that this is a one time issue. Prepare for the long haul.
Get the basic legal documents in order
Everybody needs to make sure their parents prepare 3 documents: a will (or trust), a power of attorney for health care and a power of attorney for property. The will decides who will receive property at the time of death. The powers of attorney allow somebody to make decisions for your parents if they become incapacitated. Although people focus on the will, it is actually the powers of attorney that are more critical. If your father winds up in the hospital in another state and you call the doctor, they may not be able to speak with you at all, unless you have a power of attorney for health care. The same is true if you call his bank to make sure the mortgage is getting paid while he is in the hospital. If you don’t have a power of attorney, they won’t talk to you. Fortunately, these documents are easy to put in place. Law firms are accustomed to helping out of state relatives coordinate these types of things. Contrary to popular belief, many of us will even make house calls.
Establish “Toehold” contacts in the area where your parents live.
You need a point person who can give you advice and recommendations in the area. That person could be a lawyer, a geriatric care manager, a social worker or a friend. Over the last 10 years, there has been a explosion of services catering to the elderly. Unfortunately, most people don’t know about the services until they are scrambling to find them during a crisis. Worse, it can be difficult to tell a good service from a bad one, based on an internet search alone. Start working with somebody before the crisis so that you have resources available when you need them. Often we act as that initial resource for our out of state clients.
Plan for the next level of care
Most seniors want to continue to live at home for as long as possible. There are lots of good home care options and there are many good geriatric care managers who can coordinate these things. If money permits, consider having a senior assistance company (examples include Home Instead, Right at Home, Senior Helpers and LivHome) come in to provide some minimal help such as light housekeeping, even before it is really needed. Often seniors are resistant to in home help, but that resistance can be much less after they get comfortable with the people providing that help. When the needs increase, they will already be accustomed to the help. If you can tell that home care will not be enough, begin researching assisted living or nursing home care options before it becomes a crisis.
If you are lucky enough to have siblings or other relatives willing to help, divide up the responsibilities. Think about how helpful it is when a grandparent agrees to watch your kids one afternoon a week. Having a sibling, aunt, uncle or neighbor commit to stop by one afternoon a week can benefit everybody. If everybody is out of town, splitting visits can make good sense. Having everybody come into town for Christmas and Thanksgiving is not nearly as helpful as having more visits spread throughout the year.
It requires more planning to care for your parents if you live far away. The good news is that there are many more resources available than there were 10 years ago. if you can identify a few people that you can trust in the area where your parents live, they can help you line up some good resources. Having a plan will allow you to trust that your parents are safe and to enjoy your time with them.
Eric Parker is an attorney and partner at Stotis & Baird Chartered. He practices in the areas of elder law, estate planning, estate administration, probate, and litigation. Eric works with many out of town relatives of seniors who live in Evanston, Skokie, Wilmette, Glenview and the greater Chicago area.