How to Help Aging Parents Without Going Broke?

I recently found a great resource in March 12, 2009 issue of Good Housekeeping by Kate Ashford which states if your parents are mobile but show mild signs of dementia or forgetfulness, you may want to investigate the following services (I have augmented her research with my own knowledge as to what's available in the State of Florida):

1.  Supervised adult day services allow the elderly to socialize with other seniors and may have nurses to give out shots and medications.  You may go to Area Agency on Aging for names of reputable, convenient programs or contact staffs of nearby senior centers, churches, and synagogues.  

2.  If a parent is less independent and needs help getting in and out of bed or forgets to turn off the stove or running water, home care may be needed.  Start at the website of the Family Caregiver Alliance http://www.caregiver.org, which has put together the first comprehensive, 50-state online directory for caregiver support.  If you can get by with a live-in caregiver and not an hourly, you may be able to get more assistance for less expense.

3.  For a personalized, overall-care plan, hire a geriatric care manager, usually a nurse, social worker, or gerontologist trained in helping the elderly.  Geriatric-care Managers have their fingers on the pulse of services available locally.  For an additional fee, the GCM can also make all the arrangements.  Expect to pay about $80 - $200 an hour for this service, depending on how much attention your parents need; cost isn't covered by health insurance, Medicare, or Medicaid.  Go to Professional Geriatric Care Managers (PGCMs), who are trained, experienced professionals, by visiting their website, http://www.caremanager.org

4.  Medicare usually pays for some short-term, in-home medical help prescribed by a doctor for persons 65 and older but it won't pay for long-term custodial care.  If your loved-one does qualify for that, first see your primary doctor then check http://www.medicare.gov to find local Medicare-certified in-home health-care agencies that may help with licensed nurses who can administer insulin and do diabetic training or licensed therapists to give physical, occupational, and speech therapy (in-home).

5.  Facility Based:  The same program (Medicare) may cover nursing services in a care center or out patient day service if your 65-plus parent  requires  rehabilitation after a 3 day hospital stay. For long term custodial care in a nursing home however, your parent needs to meet low income requirements for Medicaid eligibility.  If a parent needs constant surveillance, Medicaid would likely be the payor in a nursing home or similar facility.  Check http://www.govbenefits.gov for details.  In Florida, a senior parent may be eligible for a Medicaid waiver to pay for Assisted Living.  The Veterans Aid and Attendance program may also pay a monthly stipend towards Assisted Living.  For a parent or spouse to be eligible one or the other senior must have been a veteran.  For more information go to: www.veteranaid.org/program.php

6.  Elder Law:  If you will have to exhaust your parent's resources before turning to Medicaid for help, consider consulting an elder law attorney to help navigate regulations and discuss asset-management planning before your parent's health declines.  Find a specialist at the National Academy of Elder Law Attorneys site http://www.naela.org

7.  Other:  You may lower independent living expenses through local senior programs.  Some utility companies may offer a break on energy bills.  Give them a call and ask.  Church or synagogue volunteer programs might provide companions to keep your parent company periodically.  Some counties have door-to-door wheelchair-access vans or sedans for $2 a trip.  

With some delicate conversations and aid from the right places, you can help your parents stay in their homes for as long as possible.  Research obtaining a Reverse Mortgage if your parent has equity in their home and would like a steady stream of income to pay for daily caregiver assistance.  Whatever your decision may be, respect the fact that mom or dad want to control their lives as much as they can.  Being compassionate will lead you to the right decision.  If you would like to find out more available resources you might enlist the help of a Certified Geriatric Care Manager to conduct a comprehensive Assesment and provide recommendations with specifically tailored resources for your family member.  

Olga Brunner is the President and Founder of A Good Daughter Elder Care Management in Boca Raton, Florida.  She is a Certified GCM and has a Masters degree in Gerontology and HealthCare Administration from Lynn University in Boca Raton.  For more information go to http://www.AGoodDaughter.com