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by Jody Gastfriend
February 14, 2019
by Jody Gastfriend
February 14, 2019
Not long ago, I was invited to speak—virtually—to an audience that you wouldn’t normally think of when you think about aging: young professionals. And yet this group, just beginning the arc of their careers, turns out to be incredibly thoughtful and curious about what awaits them at the end of their careers, as well as how they can plan now for supporting their aging parents. We shouldn’t be surprised: Millennial caregivers now make up 25% of unpaid family caregivers—or about 10 million nationwide. But those employing and managing Millennials in the workplace may be startled by just how deeply their young charges are already thinking about planning ahead. And their questions, below, may offer as much insight as my answers.
Q: As a millennial who might not have children of my own, I have a lot of anxiety about who will care for me when I get old. How can I prepare for this? I know money is a factor, but money can’t buy the level of genuine love, care, support, and advocacy that family provides. I look at how much my mom does for my grandmother, and I panic thinking about what will become of me if I don’t have someone to do those things for me.
A: Thank you for this very important question. You are not alone. There’s even a term for it: elder orphans, or someone who is aging without family available to help with caregiving. The majority of people over 65 will need some type of long-term care in their lifetime so it’s good you are thinking ahead. Yes, finances are important. Planning for the financial aspects of care by considering long-term care insurance or saving for your care needs down the road are worthwhile options to consider. It might be helpful to work with a financial advisor to make the best choices given your particular situation. As you age, you may want to think about living in a community that will provide you with support and emotional connection. For example, there are communal living options such as taking a roommate (sometimes in exchange for household or caregiving duties) as well as senior living communities with built-in services that cater to a wide range of needs. You may also want to develop a network of friends and neighbors who can mutually support one another and pitch in when someone needs help.
Q: My parents are the type that always say, “I never want to be in a nursing home.”What if my parents need a nursing home and they refuse to go? How do you balance the requests of your parents with what is actually best for them as they get older?
A: I just wrote an article that addresses this issue—it’s called, “We are not our parent’s parent.” Great that you are thinking about your parents’ needs. Most people don’t want to go to a nursing home. It may be the best option for some people with dementia—like my dad, who spent six years in a nursing home. But if your parents are functioning reasonably well and need some in-home care to help them out, a nursing home is not the right choice. Maybe they could benefit from a professional caregiver who can help with household and personal care needs. Perhaps a senior care community like assisted living might be worth considering. Ultimately, however, it is your parent’s decision what works best for them. You can support and guide them, but they get to be the deciders.
As I wrote in that article: “Beware of one of the common pitfalls of being a caregiver: the super-woman (or man) syndrome. Keep your guilt in check and recognize that there is only so much you can do if your parent does not want help. Our parents have the right to make their own decisions—even bad ones, yet we love them anyway. ”
Q: Do you have a sense of how much it costs, on average, to support a parent? I’m sure it depends on a variety of factors, so I guess my question would be how should I anticipate planning for that from a financial perspective? Does insurance help?
A: Kudos to you for thinking ahead about the practical and financial aspects of long-term care. Costs vary significantly depending on the type of care as well as location. For example, the hourly rate for in-home care through a home care agency is about $22 per hour. It is often less expensive if you hire on your own through an online marketplace like Care.com. Nursing homes run about $85,000 per year on average but are more than double that in some states. If you want more specific information about long-term care costs, look for Genworth’s annual Cost of Care survey. Keep in mind that Medicare primarily pays for health-care expenditures, not long-term care.
Q: I’ve watched my mom play caretaker for her parents, siblings, and several others over the years and it seems she’s always the one people are relying on (probably because she’s so good at it!). Do you have any tips for how the people around her (like me) can help and support her while she’s supporting everyone else?
A: Oh boy. This happens a lot. Read the chapter in my book called, “The Imperfect Caregiver.” The problem is that many family caregivers feel that they need to care for everyone else, but neglect caring for themselves. They are not good at asking for help and take on much more than they can comfortably handle. This is a common challenge. It also shows that your mom is a very caring person who many people rely on. But she may need to get better at saying no and carving out more space for herself.
Q: My mother was recently diagnosed with early onset Alzheimer’s. She just turned 60, I just turned 27. Thankfully, she still has my Dad around to help her out, but I just don’t know what to do or how to help, especially because I am six hours away right now. What advice do you have related to Alzheimer’s and young adults caring for their parents? Most people I know who have parents with Alzheimer’s are my parents’ age and it can be hard to relate. Also, do you have any advice on places that would be good to take her for a vacation before it gets much worse? She desperately wants to travel and I am scared the clock is ticking very quickly on this.
A: I am so sorry to hear about your mother. Early onset is a devastating disease and tragically impacts people like your mother who are still quite young. I strongly recommend that you contact the Alzheimer’s Association: www.alz.org. They have a 24/7 free hotline and can give you information about resources in your area as well as caregiving strategies. They may be able to direct you to communities that might be appropriate for a vacation. I commend you for wanting to still enjoy life with your mother. All too often people focus only on what’s been lost and not on the person who is still there. Finding moments of joy, even laughter, helped my family handle the years that my father struggled with dementia.
Q: As my parents get older, they still work like they’re much younger people. For example, my Dad still does all of the yard work, heavy lifting, and other questionable jobs for his age and health. He is constantly throwing out his back and injuring himself. How can I gently approach him about this without coming off over-the-top/patronizing?
A: That’s a tough one. Many adult children worry about this type of thing, but our parents get to make their own decisions and take their own risks. I would encourage you to discuss your concerns with them, even research options for help. Care.com has caregivers and household help available. Sometimes the trick is finding a caregiver or handyman who is the right fit. Ultimately, we have to be our parents’ care partners rather than enforcers. Good luck!
Q: When my mom got sick a few years ago, I was blessed to have several nurse friends who drilled into me the importance of being her advocate and not being afraid to push back against doctors when needed. Do you have any advice to add about being a family member’s advocate in medical/aging situations?
A: I worked for 15 years in hospitals and health care systems and believe me, it makes a big difference when a patient has a strong family advocate. Many people don’t ask enough questions or know how to appropriately push back on the health care team. I talk about these strategies in my book under a chapter called “The Care Maze.” I also include a checklist of questions to ask when you attend a doctor’s visit with your parent or loved one. I recommend that one family member be designated as the primary contact for health care professionals. When too many family members try to communicate at once, things can get more confusing. You will also need to get permission from your parents to get information from their doctors and will probably have to have them sign a HIPAA release form.
One final thought: Keep in mind, when it comes to caregiving, planning ahead can make a big difference for you and your parents. Get the help and support you need and make sure to take care of yourself too.