As parents age, their adult children often assume greater responsibility for their care. As part of caring for elderly parents or "senior care," caregivers should assess their parents' needs and begin collecting information about their legal, financial and medical status. Here are some additional ways children can prepare to care for elderly parents as gracefully as possible.
Begin the conversation early
It's not always easy to raise the subject of elder care with an aging parent. Waiting until after the need becomes acute will only make important decisions more difficult. Elder care experts suggest holding a family meeting where parents and caregivers can openly and honestly discuss options regarding daily living needs, health care, financial security and legal rights. Opening these lines of communication early lets seniors know that their wishes are being heard and gives caregivers time to define and prepare for their new roles.
Collect key information
As you assume greater responsibility for caring for your elderly parents, you'll need access to important information about their health and finances. Begin to collect or make copies of documentation for your parents' insurance policies (health, home, auto, life), Social Security benefits, housing (leases, mortgages), retirement and bank accounts. Ask your parents to help you compile a list of their doctors' names, preferred health care facilities and current medications and conditions. Also check to see if they have a Medical Savings Account, are covered under Medicare Insurance, and/or have any Medicare Supplement Insurance. If so, ensure you have copies of those documents.
Review legal options
Well-constructed legal provisions can help ensure that your parents' wishes regarding their property and care are followed, while giving you the power to step in if they become unable to make decisions for themselves. Make plans to discuss the following legal provisions with your parents and a qualified attorney:
- Wills provide for the transfer of property when a person passes away.
- Living wills communicate end-of-life health care wishes.
- Durable power of attorney gives you the ability to make medical, financial and legal decisions for your parents.
Seniors may need access to a number of different resources, ranging from daily needs such as meals and personal care to quality-of-life issues such as social activities and transportation aid. The Department of Health and Human Services' Administration on Aging offers an online Eldercare Locator that can connect you with senior services in your area.
Caring for your elderly parents
Caring for elderly parents in your home can be a big change and a challenge. One way to help ease the transition is to make physical alterations — some minor, some potentially major — to your living environment in order to make things easier, safer and less stressful for everyone.
Different people age differently, with different concerns and needs. The alterations you may want to make to your home will depend on things like the mobility, vision and cognitive ability of your elderly parents. Other factors, such as your financial resources and your home's structure and layout, will also affect how much you can do.
Get a sense of your parents' abilities and needs
- Observe them around their home or yours.
- How steady are they when moving around?
- How comfortable are they navigating stairs and in the bathroom?
- Do they have trouble seeing and finding things?
- Are they able to easily do things you might take for granted, like opening doors, turning on faucets and reaching shelves and cupboards?
- Talk to their physician or other caregivers. Learn more about their specific health issues such as mobility, vision, hearing and cognition. (Note: You'll need to check with their health care providers to see what type of permission or documentation they will require in order for them to share your parent's private health information with you).
- Take specific steps when dealing with dementia. If your parent suffers from some degree of dementia or cognitive impairment, you may need to take more intensive steps to make your home safe and comforting for them. It could mean drastically altering access around your home to things like automobiles and appliances.
Determine what changes may be needed in your home
It may be useful to hire an occupational therapist or other expert such as a nurse or physical therapist to assess your home. If that's not possible, consider asking another elderly person to take a look at your living area through their eyes.
Getting a third party's insight into needed changes can be more honest and useful than what you may or may not hear from your parent, who might be unaware of or embarrassed to admit their limitations, or afraid of being too much of a burden on you.
Some modifications to consider making:
Around the house
- Find out which doorways and hallways in your home are wide enough to accommodate wheelchairs and/or walkers if necessary.
- Use strong, high-wattage bulbs and consider replacing older fluorescent lighting with incandescent lighting. (Fluorescent lights that flicker or create glare can be hard on aging eyes).
- Replace round doorknobs with lever handles that are easier to open.
- Consider removing or covering up floor surfaces that could become slippery or cause tripping, including tile floors (especially in the kitchen and bathrooms), raised doorway thresholds, loose rugs, and carpet with a deep or uneven shag.
- Move power and extension cords well out of the way and tape them down to avoid tripping.
In the kitchen and laundry room
- Make sure light switches, cabinets, drawers and appliances are at a comfortable level for someone who is seated and/or cannot easily bend down or reach up.
- Put strip lighting under cabinets to provide more counter-top light.
- Get clocks, phones, thermostats and appliances with larger, brighter buttons and numbers or digital displays.
- Lower your water heater temperature or install scald-proof faucets.
In the bathroom
- Replace fixed showerheads with flexible, hand-held heads.
- Replace glass shower doors with curtains.
- Put shower seats in the bathtub or shower as well as non-slip mats or tape.
- Make sure there's a night-light in place and a well-lit path from your parent's bedroom.
- Install special rails or equipment in the bathroom, including raised toilet seats and bars and handles to aid with getting up and down.
In the bedroom
- You may need to buy a new bed for your parent, rent or lease a hospital bed, or install bed rails and/or grab bars.
- Set up an intercom or communication system, perhaps using a baby monitor.
- Have working smoke alarms and carbon monoxide detectors near the bedroom and a special firefighter alert sticker for the bedroom window.
- Make sure you can keep their sleeping area warm enough without using a space heater.
- Decide if you can convert a ground floor room into your parent's bedroom, or if you may need to install an elevator or motorized stair lift chair to an upper floor.
- Check to see if you need new or additional handrails on stairs. If you already have handrails, make sure they're strong enough.
- Have two-way light switches at the top and bottom of stairways.
- Put down special bright-contrast tape at the edge of each step.
Outside the home
- Fix uneven, cracked or damaged outdoor walkways and consider replacing cobblestones or stepping-stones in the yard or garden.
- Install wheelchair ramps in the garage or driveway as necessary.
- Make sure entranceways, locks and doorbells are well lit at night.
Go over your budget to see what modifications are financially realistic. Those checklists can be daunting, but chances are you won't have to do everything and certainly not all at once. Not everyone can afford to completely remodel when caring for elderly parents in their home, but shop around and compare contractor and building costs as well as the cost of new or used equipment and its installation.
Research what Medicare covers and then talk with your financial advisor to see if grants or loans are available for home adaptation. Also remember that having an extra person living in your home will affect your family's usual monthly budget when it comes to food, transportation and supply costs.
Enlist professional help
The emotional and administrative complexity of caring for an aging parent can overwhelm even the most conscientious caregiver. No matter how many physical modifications you make, caring for elderly parents in your home can be an emotional strain on both you and them. You will both be sacrificing some of your independence and privacy. They may also be worried about being a burden, while you might fear you don't have the proper knowledge or experience to properly care for them. Be sure to communicate with each other as much as possible and don't be afraid to ask outside experts for advice, support or counseling.
An Aging Life Care Professional can help you assess your parents' needs and design a care plan that addresses their wishes and abilities. Here are few helpful resources:
- AGE in place: Making Your Home Senior Friendly
- AgingCare.com: Adapting Your Home When an Elderly Parent is Moving In