Cantissimo Senior Living Blog

In our last blog, Talking to Your Aging Parents About Money – Part 1, we explored ways adult children could start the conversation about money with their parents. Once the ice is broken, an opportunity to deepen the conversation presents itself.

UNDER THE SURFACE

The "money" subject is the first of several layers of important issues aging adults need to address. The following are major ones adult children need to discuss with their parents.

Most adults with aging parents rarely look forward to raising the subject of their elders' money. It's a scary topic because it involves a role reversal. Parents are supposed to teach their young children about money, not the other way around. Years later, adult children and their parents sometimes find it challenging to break out of this family dynamic. Yet, there comes a time when children need to talk to aging parents about plans for their money and other end-of-life planning topics.

PLAN OR WAIT FOR A CRISIS

Ideally, the time to talk to parents should happen before any crisis. Injury or illness can happen fast. If plans are not in place, decisions may be made quickly without sufficient information. This risk of causing irreversible mistakes is high. Even if plans have been made, failure to share them with adult children may put an effective plan at risk. Talking when parents can physically and mentally hold their own in the conversation provides a better foundation for good planning. In other words, the sooner, the better.

Nearly half of Americans 65 or older will eventually require some form of long-term care, according to a 2016 study by the U.S. Department of Health and Human Services (HHS).

Of those needing long-term care, roughly half need it for less than a year. However, women are more likely to stay longer one year or longer.

Benjamin Franklin famously said, "…in this world nothing can be said to be certain, except death and taxes." A corollary to this could be, "It's a certainty that families hate to talk about death and money."

Discussing money seems to be a challenging subject for even the most talkative families. A study showed that 44% of respondents found money the most challenging topic to talk about, more than religion or politics or even death. Yet, talking about money with others, especially family members, could help avoid significant financial problems.

Parents of adult children face two crucial money conversations – your money and their money.

Whether from illness or injury, the chances of ending up in the hospital increases with age. A Center for Disease Control report showed that in 2017, 15% of those aged 65 years and older were admitted to the hospital in the past 12 months, compared to less than 6% of those aged 18 to 44 years.

Of course, the goal of hospitalization is for the patient to regain health and be discharged. However, not everyone leaving the hospital is ready to go home. Many patients still need continuing, though temporary, medical care at a less intense level than in the hospital. In many cases, this care is provided at a skilled nursing facility (SNF).

Formerly known as "nursing homes," these facilities commonly accept two types of patients. The patients most often associated with skilled nursing facilitiess suffer from long-term, acute conditions that require permanent, around-the-clock care. The other population served by skilled nursing facilities consists of patients recovering from illness or injury who need care until they are well enough to return home. In this role, SNFs are classified as post-acute rehabilitation facilities.

Moving out of a family home after many decades seems akin to moving a mountain. If the move is to Assisted Living, the mountain can feel even bigger.

First, consider the situation. Often, such a move does not have a long planning runway. A sudden trigger event can start the process. Incidents like an accident (e.g., a fall in the home) or illness can put an abrupt stop to independent living and kickstart a frantic effort to move a loved one into an Assisted Living or Skilled Nursing setting. 

Aging in place at home remains the most popular option for senior living. According to AARP, over 75% of age 50+ respondents to a 2018 survey said they would prefer to stay in their own homes. However, as we age, the risks of living at home increase, with the most common being the risk of falling. CDC data shows that 36 million older adults fall annually, resulting in 3 million emergency department visits and over 32,000 deaths.

To reduce falls and other accidents, a home needs to be modified to accommodate older adults' needs. These modifications range from low-cost and straightforward to expensive and complicated. However, any change that makes a home safer may enable the older resident to remain independent longer.

Dig back into your childhood memory, and you'll recall your mother telling you to stop fidgeting and sit still. (Or maybe you said that to your own kids!) Youth and its boundless energy make young people into seemingly perpetual motion machines. Yet as we age, the inevitable slowdown takes place. We need to consciously make an effort to be active.

The Problem of Limited Mobility

This becomes particularly difficult when mobility becomes limited due to illness or injury. With the onset of disabilities, physical and non-physical such as memory issues, even routine activities become challenging. The temptation to become inactive can be overwhelming.

This leads to numerous health risks. The Centers for Disease Control and Prevention (CDC) states that disabled adults have a threefold chance of experiencing major diseases like cancer, stroke, cardiac issues, or diabetes. On the flip side, the CDC says disabled people who engage in aerobic exercise can cut disease risk in half compared to those who are inactive. 

Ted had always looked up to his father as a tower of strength and inspiration. Often laboring seven days a week for decades to build a successful small business, he still found time to coach sports teams for Ted and his three other children.

Ted's dad and mom were able to retire comfortably at an age when they could still enjoy an active lifestyle. They caught up on all the travel and other leisure activities they put off during their working years. After enjoying this wonderful life for 17 years, Ted's mom was diagnosed with ovarian cancer. She was gone in a matter of months.

His dad held up well despite feeling devastated. After a couple of years, he almost seemed to be his old self. However, Ted noticed some changes. A fastidious dresser all his life, his dad began to neglect his appearance. It wasn't surprising to find him in the middle of the day wearing the clothes he slept in the night before. Also, as a business owner, he had expertly managed his finances over the years. Now Ted was finding past due bills.

Ted came to the realization his dad was having memory and cognition issues. After a series of doctor visits, it was clear his dad needed a memory care living arrangement.

Ted's story is one example of a scenario faced by many families of older adults. However, it may be difficult for adult children to admit a parent is suffering from memory and cognition problems. One reason is some older adults with memory deficits can be otherwise healthy. This seems to make it easier for families to deny there are problems.

Another reason is denial due to a feeling of shame about dementia and memory loss. Due to common misunderstandings about these afflictions, they have acquired a vicious stigma that leads to needless suffering due to delays in seeking treatment and support.

Families who educate themselves about memory and cognition issues are better prepared to seek assistance sooner. Here are ten signs that a loved one may benefit from memory care:

When I was five, my parents made a fateful decision. They invited my widowed great-aunt to live with us.

My mother's parents had both died by the time she was twelve. She was adopted by her Aunt Lillian and Uncle George, who lived in a large Newark, New Jersey brownstone with Lillian's parents. A three-generation household came into being.

By the time my mom and dad were married, her grandparents and Uncle George had passed away. When my father was transferred to Dallas, mom and dad felt anxious that Aunt Lil would be alone in Newark. So began our 17-year stint as our own three-generation family.

The situation had its ups and downs. Lil had a bedroom of her own, but that was her only private space, which was probably difficult for her. Childless herself, she seemed to compete with my mom for the title of family matriarch. Reminiscing years later, my mom said that was the most challenging aspect of the arrangement.

From a child's perspective, three generations living under one roof seemed normal. It drilled into me the value of "we take care of our own." While the whole family pitched in, my mother was the primary caregiver all the way to the point where Aunt Lil was bed-ridden. It wasn't until Lil acquired bedsores that my parents arranged for a skilled nursing home. Ironically, the day before she was to move in, she died.

This experience drove home for me the sometimes complicated nature of a multigenerational household. While we gained much as a family, it was also stressful. Therefore, families must carefully consider the implications of older parents moving in with their adult children.