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What You Need To Know About Caring For An Aging Parent
And What You Should Do
My Dad had shit himself.
He was lying on his back, legs up in the air, palms out and up as he stared vacantly at the ceiling.
He needed a nurse to clean him up.
I walked into room 136 of the rehab facility to see him. He’d recently had a stroke and needed round the clock nurse care while he recovered. He didn’t see me walk in and doesn’t know I saw this.
Even if I told him, he likely wouldn’t remember.
My Dad is an old-school, capital-B Brooklyn guy from the 60’s. Grew up the youngest of seven in a tough neighborhood in a tough borough during a tough time to live in New York City. Quick witted, wise to the world, street smart.
And here he was getting changed like an infant.
While nothing is worse than losing a parent unexpectedly, watching your parent go through a slow and painful decline is a close second.
While I can only speak to my own experience, here’s what I’ve learned.
Nursing Homes Are Expensive
“We want the best care money can buy!”
OK buddy. Get ready to pay $10,000 per month- if you’re lucky.
Depending on your parent’s level of independence, their medical needs, and other factors, you could be looking at a massive monthly bill to make sure they’re taken care of. That $10,000 could be the floor, not the ceiling.
A “budget” nursing home will still run you $5,000 or more per month, and that’s if you can get a spot.
“What about insurance?”
Insurance Won’t Cover It
Being over a certain age, Dad qualifies for Medicaid. Great news.
What they don’t tell you is that Medicaid doesn’t apply for home nurses or senior care facilities until you’ve “spent down” your assets and are under a certain threshold.
Literally called “Medicaid Spend Down”, you have to pay for senior care yourself with your own income and assets. Once you’ve spent it all and have nothing more to give, Medicaid comes to the rescue.
Most private insurance will only cover a small portion of long-term care costs, not nearly enough to make it affordable. So Medicaid it is- after you’ve spent everything you own to get under the threshold.
Work your whole life to save and invest properly only to die penniless because you chose to live too long and Medicaid doesn’t apply to you as a middle-class American. From the New York State Medicaid website:
“Allowed to keep”
Can you imagine?
The Claws Come Out
Say, for example, there are three children.
One lives on the opposite coast and makes much more than the other children combined
One is married with two kids and lives locally in a mid-sized house
One is single, child-free, and lives locally in an apartment
How do you distribute responsibility for care among the three children?
Does the responsibility of paying for a senior care facility fall on the wealthiest child? They have the most and can cover the majority of the expense.
Should Dad should move in with the local child with the house? They have the room, and senior care is expensive.
Maybe Dad stays in his house, you get part-time home nurse care, and the single child goes over several times per week to parent-sit after they leave.
Are any of those fair?
Should the child that takes the burden of responsibility receive preferential treatment in the will?
Discussing who does and pays for what while caring for an aging parent can get heated quickly and has the potential to ruin otherwise strong relationships.
If you ever hear stories about adult siblings who went no contact, it’s likely over disagreements about arrangements for aging parents and/or resentment over inheritances.
Heated arguments can, do, and will break out. You may even start hearing from uncles and cousins who played small roles in your life up to this point but now feel they know best.
So what should you do to take care of an aging parent?
Hire An Elder Care Attorney
An elder care attorney knows the laws regarding taxes, gifts, and setting up wills. If your parents don’t have a will set up upon their death, prepare for even more heartache as you sort everything out.
Most importantly, an elder care attorney will show you how to move/hide assets legally so you can qualify for Medicaid.
Liquidating assets and giving lump sum gifts can be taxable events, and your aging parent’s generous gift “so you can enjoy it while they’re alive” can leave you/them with a hefty bill come April.
An expert in the matter is worth their weight in gold.
Discuss End Of Life Plans TODAY
The dramatic reading of the will in an attorney’s office where the children sit around and wait patiently to find out what they’ll get is a cliche TV trope.
This should NOT be how it’s done in real life.
Before your aging parent passes, you should know…
what accounts exist, how much is in them, and how to access them
who gets what (especially important if real estate or a business is involved)
end of life preferences (do they want to be cremated or buried? Where?)
The first point is especially important. Imagine grieving your parent while trying to log in to their brokerage account or 401(k) to figure out how to transfer assets, or your Mom finding out your Dad had a secret account he never told her about.
“But my parents are in perfect health!”
Great, that means they’re in the right state of mind to make rational decisions about end of life care and last wishes.
Set up a will today if you haven’t done so already.
Talk To Your Parents TODAY
This is one I missed out on.
After his stroke, while my Dad is lucid and aware of his surroundings, he struggles with recalling memories of his past.
What was it like growing up in Brooklyn in the 60’s? Was it like on TV?
What was it like seeing the Giants play at Yankee Stadium in the 70’s? What was Grandpa like at the games?
Did you ever get suspended from school for fighting? Did the other guy deserve it?
Simple questions that I could have asked at any point in my life, but I didn’t.
And now it’s too late.
A lifetime of memories trapped in the vault of the mind, lost to time.
Maybe you don’t have the best relationship with your parents.
But hopefully, you do.
They will get old.
They may die suddenly and without warning, or experience a slow and painful decline like mine.
They will die.
If you can, call your parents and say hello.
If you can, visit your parents and say hello.
It’s later than you think.