- DR. MARION'S METHOD
- CAREGIVER TRAINING
Moving a Parent Into Your Home
Before you do, consider Mom’s or Dad’s legal, financial, and health-care needs.
You have fond memories of how your parents always kept you safe and protected when you were a child. But after Mom died, Dad seemed to become increasingly forgetful. Lately he’s been complaining of one ailment after another, and he’s fallen a few times. Now it’s your turn to be the caregiver.
Welcome to the sandwich generation. Some 34 million Americans care for an older parent or relative, according to 2004 data from the National Alliance for Caregiving and AARP.
Like many people in this situation, it might make sense to have your parent move in with you and your family rather than keep up two homes and shuttle between them. But this is not the kind of move to make on a whim. “You may want to go in there like gangbusters and take over care of your parent. However, this is a major decision that needs to be though out,” says Marion Somers, Ph.D., a geriatric-care manager and the author of “Elder Care Made Easier: Doctor Marion’s 10 Steps to Help You Care for an Aging Loved One” (Addicus Books, 2006).
Here are some issues to address before you bring your parent under your roof and into your daily life.
Get Your Legal Ducks In A Row
You’ll want to protect your parent’s legal rights. Debra Speyer, an elder-care lawyer who practices in Pennsylvania and Florida, recommends that your parent have four basic legal provisions in place: a will, which provides instructions for how assets and other belongings will be passed on when he or she dies; an advance health-care directive or living will, which states his or her final medical wishes at the end of life; the financial power of attorney, which allows a person of your parent’s choosing to make monetary decisions if he or she can’t; and the health-care power of attorney, which allows a designated person to make medical decisions and obtain medical records.
Handling those matters and drawing up the documents will require your parent to make some important decisions, and your entire family should be involved. “Decide with your parent and siblings who will receive the power-of-attorney rights,” Speyer says. “You ideally want to do this while your parent is lucid and can help in these important decisions.”
Decide before the move how much you and any siblings will each pay toward the cost of extra food, utilities, home retrofitting, and nursing or other care, if needed. An attorney should draw up an agreement that spells out all the details, recommends Mark Shalloway, president of the National Academy of Elder Law Attorneys and president of the Shalloway & Shalloway law firm in West Palm Beach, Fla. You can alter the document if your parent’s medical or care expenses change.
“People may forget down the road what they agreed to three or four years ago, so having something in writing is very important,” Speyer says. You can find a list of attorneys who specialize in elder-law issues by going to www.naela.org.
Understand The Finances
If you pay for at least 50 percent of your parent’s expenses, you can claim him or her as a dependent on your tax return. Then you’ll be able to deduct Mom’s or Dad’s medical expenses – including doctor visits, dental care, insurance premiums, medical equipment, and home care – that exceed 7.5 percent of your adjusted gross income, notes Carolyn McClanahan, a board member of the National Association of Personal Financial Advisors (www.napfa.org), which represents fee-only planners, and president of Life Planning Partners in Jacksonville, Fla. For example, if your AGI is $100,000 and your dependent parent has medical expenses of $10,000, you will be able to deduct $2,500 – just the amount over the 7.5 percent of your AGI. For more information, see IRS Publication 502, “Medical and Dental Expenses,” available at www.irs.gov.
Modifications you make to your house to accommodate your parent’s health-care needs are considered medical expenses, McClanahan says. These include installing handrails on a stairway; putting in a ramp; widening doorways or hallways; installing porch lifts; modifying smoke detectors or other types of alarm systems; moving or modifying electrical outlets and fixtures; bathroom alterations; and lowering kitchen cabinets. But the amount you can deduct is reduced by the increased value that the improvements bring to your property. If a specific modification does not increase the value of your home, the entire cost can be deducted as a medical expense.
Work with a financial planner to create a conservative, low-risk investment portfolio for your parent’s assets. “The financial goal for your parent now is to preserve wealth for as long as possible to pay for expenses that will come up,” says George Wells, president of Legacy of America, an Auburn Hills, Mich., retirement and asset-protection company.
Retrofit Your Home
You will want your parent to feel as comfortable as possible in your home. Ideally that means providing a bedroom and bathroom of his or her own. If you don’t have a spare room, consider closing off a dining or living room with a wall, if that’s possible, or even just a curtain for privacy. Your parent’s quarters should be on the main level of your house so that he or she won’t have to climb stairs.
If you will be remodeling a bathroom for your parent’s use, consider following universal design guidelines to create one that is functional for all members of the household, advises Mary Jo Peterson, a design consultant in Brookfield, Conn. For example, install grab bars in the toilet and bath areas. Taller, comfort-height toilets are easier for those with bad backs or weak leg muscles. Allot enough space for wheelchairs in the doorway and in front of the toilet. Avoid rounded, smooth faucet controls that can be difficult to grip, and install antiscald fixtures. (For additional information about universal design guidelines, go to blogs.ConsumerReports.org/home/2007/12/universaldesign.html.)
Make sure that the rest of your home is safe and accessible as well. Install bright lighting in hallways and at the top and bottom of stairs, and make use of nightlights. Keep entranceways and floors clear of clutter, and tuck electrical cords away from walkways, recommends Angela Mickalide, Ph.D., director of education and outreach for the Home Safety Council.
In addition, replace doorknobs with easier-to-open levers, and install light switched that are within reach when you first enter a room, says Patricia Nunan, president of Lifestyles Design in Perkiomenville, Pa., who specializes in home remodeling for seniors and people with disabilities. She also recommends that you lay down commercial grade, rather than plush, carpeting, which makes it easier to maneuver wheelchairs and walkers.
Arrange For Services
If you are not sure what health-care services your parent will need, talk to his or her doctor. You can also consult a geriatric-care manager, who can assess your parent’s needs and advise you on the best ways to meet them. You can find one in your area through the National Association of Professional Geriatric Care Managers (www.caremamanger.org). Costs for a consultation range from $60 to $200 an hour, says Steven Barlam, the chief professional officer of LivHome, a Los Angeles at-home services and geriatric-care-management firm. Find out if your company has an employee-assistance program that offers free or reduced fees for the services of geriatric-care professionals.
At some point, you may decide that you need to hire a home-care aide to assist your parent with bathing, dressing, eating, or other activities. Your parent might resist the idea of “outside” help, but stress that it will allow him or her to remain more independent in the long run.
Set ground rules for the aide, especially if he or she will be spending many hours in your home. “You want to maintain some privacy for you own family,” Barlam says. “A paid caregiver needs to know that there may be some areas in your home that are just for you, your husband, and kids unless there is an emergency.”
Expect to pay $15 to $22 an hour in most areas of the country for health-aide services, says Roger Baumgart, president of Home Instead Senior Care, an Omaha, Neb., nonmedical home-care agency with 572 offices around the country.
Having the right services in place for your parent can give you more time to take care of yourself and the rest of the family. Christine Rimkus, 49, a project manager for a technology company, found that telecommuting from her Schaumburg, Ill., home and 24/7 home care made it possible for her father, John Butkevich, to live with her family until his recent death at age 83. Butkevich had advanced pulmonary fibrosis and needed round-the-clock care.
Rimkus’s employer offers a benefit called LifeWorks that helped her find home-care professionals who assisted her father with bathing, dressing, and getting his oxygen and breathing treatments. Her father paid for the $250-a-day care.
Another option is elder day care, which generally charges on a sliding-scale basis. This service has worked well for William Fuller, 62, an aviation engineer in Austin, Texas, who moved his mother, Phyllis, 82, into his home in March 2007. Fuller felt that it would be safer for his mother, who has dementia, to live with him and his wife, Beth, 60, rather than by herself in her Battler Creek, Mich., home.
While the couple is at work, Phyllis is at adult day care. She participates in such activities as playing cards, exercising, and doing arts and crafts at a cost of $50 a day, which she pays. “My mother is safe and occupied with fun activities,” says Fuller. “And we have peace of mind.”
Don’t’ Overlook Your Family’s Needs
“Bringing a parent to live with you will affect your family’s lifestyle and emotions in a profound way,” says Suzanne Mintz, president and co-founder of the National Family Caregivers Association (www.thefamilycaregiver.org) and author of “A Family Caregiver Speaks Up” (Capital Books, 2007).
Here are some tips to help your family adjust to the changes your parent will bring to your household:
- Take time for yourself. Exercise, eat healthfully, keep up your social contacts as best you can, and consider joining a support group. “Even just giving yourself a couple of hours to read a book or take a nice long bath will give you a breather,” advises Marion Somers, a geriatric-care manager in Brooklyn, N.Y.
- Prepare your children. Explain to them ahead of time that they may not be able to have friends over as much, or will need to be quiet after a certain time of the evening so that they don’t wake Grandma. “Your kids may be resentful at first,” Somers notes. “But tell them that this could also be a time to bond with Grandma in a special way.”
- Spend time just with your spouse and kids. Ask a sibling or other relative to stay with your parent while you and your family have a special outing for the day or weekend.
- Include your parent in special family events. “Even if your parent is frail, try to make him feel like an important part of the family and a part of special family events or celebrations,” Somers recommends.
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