Paying for long-term care -- Can I count on my family?

Friday, March 15, 2002

Part 2 of a 3-part series

As we live longer and are increasingly successful in fighting acute disease and injury, the likelihood that we'll need some form of long-term care is high. Unfortunately, the cost of long-term care is also high and likely to climb. Given these uncomfortable realities, it's not surprising that a common first reaction is "my family will pitch in."

But how much help can you really count on from family members? What is reasonable to expect?

There was a time when extended families living close together provided care for aging family members. An elderly parent was, at a minimum, assured of a place to live and regular meals. This was easy when everyone worked on the same farm, shared living quarters, and ate dinner at the same table.

Beyond this, aging relatives received emotional support through their continued involvement in child rearing and family decision-making, even after they were unable to contribute to the family's economic viability.

Times have changed

For better or worse, the extended families of yesterday have been replaced by today's nuclear families, and geographic proximity has given way to geographic dispersion. Chances are, without adequate planning, the financial and emotional burden of your long-term care may be visited on a spouse and/or the one or two children to still live nearby. The time when care of the elderly was spread over a large group of siblings, children, nephews and nieces, and grandchildren is probably gone forever.

Your adult children may face the possibility of a financial squeeze. They may already be challenged just maintaining their own lifestyles while saving for college tuition costs, funding retirement benefits, and planning for their own long-term care. Paying for, or providing for, your care, may place their own financial security at risk.

The changing face of the workforce is another reason why it's unreasonable to look to "the kids" as the sole source of your long-term care. Traditionally, women were the primary caregivers. But, today, approximately 60 percent of women work outside of the home. Statistics show that about one third of those providing care to elderly family members end up suffering physical and metal disabilities themselves.

What is reasonable?

Although times have changed, there remains much that your children can do to help without possibly ruining themselves financially or making themselves ill.

First, involve them in preparing for your long-term care, by sharing basic information such as Social Security numbers, tax records, insurance coverage, health records, financial statements, and legal documents such as wills, trusts, and powers of attorney. They'll need that information if you become incapacitated and they are called on to act on your behalf.

Second, involve your children in gathering information about community resources for the elderly. Nora Jean Lewin in her book, "How to Care for your Parents: A Practical Guide to Eldercare," suggests that a starting point is to call the National Eldercare Locator Number (1-800-677-1116). This number provides a link to the local Agency on Aging. Available community resources range from adult day care centers and nursing homes to organizations that provide caregiver training, offer homemaker services, and grant expert legal and financial advice.

Finally, ask your children to help you make your home safe. Make sure they know about your medications and the dosages your take. Get their help in adding lighting, reducing the maximum temperature on water heaters to 120 degrees from the usual 150, mounting grab bars on securely around bathtubs and toilets, installing non-skid flooring, storing necessities in easy-to-reach places, and replacing loose rugs with low pile wall-to-wall carpeting.

When these straight forward steps are combined with other approaches such as spending personal assets, qualification for government-sponsored programs, accessing employer-sponsored programs, and reliance on personal long-term care insurance, younger family members are involved without being weighed down.

Sharon Stanley is a representative of The Prudential Insurance Co. of America in Cape Girardeau. (334-2603)

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