|It can be difficult when the parent-child relationship shifts and the child must take on increasing responsibility in the care of his or her parent. “As a person’s health begins to decline with age, many aging parents are concerned that they will become reliant on their children or caregiver,” states Dr. Barbara Paris, Director of Geriatric Medicine. She emphasizes the importance of respecting the wishes of one’s parent, while balancing a safe environment in order to maintain a high quality of life. “Sometimes aging parents won't admit they need help, while others don’t realize that they need it,” states Dr. Paris. That’s where you come in. In order to do what’s best to maintain your parents’ health and well-being, it’s important to think about several considerations when planning the future of their care.
1. Understand your parent’s health insurance and entitlements
“People are often overwhelmed and surprised at the costs incurred in caring for chronically ill patients,” states Dr. Paris. While Medicare and HMOs cover a significant portion of doctor’s visits and hospitalizations, many don’t pay for medications, home health care aides and long-term care. “Unfortunately, this puts a tremendous burden on the family,” explains Dr. Paris. Understand if your parents qualify for additional entitlements, such as Community Medicaid, and identify how this may support their care.
2. If your parents wish to remain in their own home, determine what safety measures should be implemented
“Many parents wish to remain in their home and maintain a certain level of independence,” notes Dr. Paris. “However, conflict can often occur when a child no longer feels that the parent should live alone.” If you are concerned about your parent’s safety, identify potential issues and make a plan to address the problems. For example, certain assistive devices such as handrails in the bathroom can be installed to create a safer environment. Additionally, emergency response buttons can be useful for many older parents who choose to live alone. In the case of a fall, medication error, or other emergency, they can press their personal emergency response button to be connected to a 24-hour call center.
If your parents are having difficulty with certain tasks that limit their at-home independence, a part-time aide can be hired to take care of errands or assist with daily activities such as bathing and dressing. “One of the advantages of aging in New York City is the accessibility to certain basic needs,” states Dr. Paris. “In fact, surveys have shown that many adults choose to move back to cities as they age because they find it more convenient. Groceries can be delivered, clothes can be inexpensively laundered, and there are many senior and community care programs.”
3. Have ‘the conversation’
Your parents’ goals and values for their care may be very different from what you wish for them. “Children can often become overprotective and may make decisions based on their personal desires, and not the wishes of the parent,” explains Dr. Paris. For example, it’s very difficult if a parent chooses not to be resuscitated, which may conflict with your values. However, it is vital that you understand what your parents want in the event that you have to make decisions on their behalf. “This conversation is often very uncomfortable, but it’s necessary,” emphasizes Dr. Paris. “Make sure you understand what it means to have power of attorney, a living will, or a health care proxy. If you don’t, an eldercare expert or geriatrician can help.”
4. Seek help from local Brooklyn agencies
Brooklyn has many specialized community services available to assist senior citizens in maintaining their independence. Find a local agency using the Eldercare Locator. This can help put you in touch with special services in your parents’ area that may assist you with finding home care workers, meal delivery services and transportation. “The Maimonides Division of Geriatric Medicine works with several community organizations to coordinate care and facilitate social interaction,” notes Dr. Paris. “This allows senior citizens to maintain independence, despite the functional decline that can come with age.” Dr. Paris also emphasizes that aging parents should continue to socialize by joining church or synagogue groups, senior centers or other clubs.
5. Contact the doctor for guidance
If you feel overwhelmed, or your parents dismiss your concerns, consider contacting the doctor directly. Make sure you understand the role your parents’ doctor will play in their care. Will they coordinate all medications, tests, procedures and treatments? Can they be reached after hours or on the weekend? If not, what should you do during an emergency?
“Elderly patients often transition from one medical setting to another,” states Dr. Paris. “This requires detailed coordination of care among specialists in order to prevent duplication of diagnostic tests and medication errors.” Your parents’ care can be complex, and it’s important to ensure that one physician is helping to coordinate all care to reduce potential complications.
Taking care of an aging parent is no easy job, but planning ahead can give you a clear path and limit any surprises. This preparedness will help you to maintain your parents’ wishes and preserve their independence as appropriate. By making sure you have an understanding of the financial needs of your parents’ care, as well as a clear idea of their health care goals, you will have the proper tools to help them as they age.