Caring for an Aging Family Member

Sep 3, 2019 | 9 minutes 47 seconds

Transcript

Whitney:

Hi, and welcome to an HMC HealthWorks podcast. Today, Vicki Putnam, a business analyst with HMC, will be joining us to discuss caring for an aging or sick family member. Vicki has been an advocate and caregiver for over 20 years for her father and mother. Her father passed away in 2005 and her mother is 86. Her parents resided with her for 20 years, but recently her mother moved to a small apartment a few minutes from her house.

Vicki:

Hi, Whitney, and thanks for having me.

Whitney:

When taking on caregiver responsibilities and aging or sick family members, there are many big decisions you’ll have to make from medical and financial issues to housing and legal concerns. Being able to maximize the quality time you have together means you may want to spend a bit more time in the beginning working to reduce stress and minimize expenses.

Vicki:

Yeah, that’s definitely right, Whitney. Becoming a caregiver is really rarely an easy decision to make. I mean, the job can be overwhelming and very stressful at times, but it’s also an opportunity to spend more time with those that you care about and be with them when they need you most. And if you’re wondering how to take that first step in your journey as a primary caregiver, what I did and I recommend for others to do is to use a five step checklist that may make things a little easier for you and your loved one.

Whitney:

So, what is the first step?

Vicki:

So, I feel like the most important thing is start with an open and honest discussion. At first it can be tough to know what to do as a caregiver for a family member, but start by taking the time to really listen and understand the person’s wishes and needs, most importantly, their concerns and fears for both today and the future. Start the discussion by asking these questions, “Do you want to stay in your own home or will you need assistance? And if you’re not able to make medical or financial decisions for yourself, is there someone that you trust to make them on your behalf? And what time… Well, actually for now, what kind of daily care and help do you need? And how are you feeling about ongoing medical treatment or end of life care?” And this is a tough one, but it’s definitely something that you want to do in the beginning, “How would you like funeral arrangements or financial obligations handled when the time comes?”

Whitney:

I imagine one of the big challenges would be dealing with your loved one’s medical issues. When caring for a family member, you’ll be an advocate for ensuring he or she gets proper medical treatment.

Vicki:

That’s exactly right, Whitney. Talk to them about any medical condition or conditions and ongoing needs for care, be sure to involve the attending physicians, therapist, or counselors if necessary. And this leads us to the very important step two, which I think is one of the most complicated things, stay on top of medical issues. Start off by creating and maintaining a current and complete list of all their medications, be sure to include dosages, also keep notes on who all of their doctors or providers are, also get notes on their medical history.

Vicki:

Next, this was difficult for me, but with the help of our local senior services, I was able to undertake it, get a solid understanding of your loved one’s health insurance, any social security benefits, and then also if they have supplemental Medicaid, Medicare, or any private Medigap insurance. The next thing is to be sure to research short and long-term care options so that you’re prepared no matter what happens, and there are many programs for both offsite and in home care. And finally, ensure all medications are accessible and clearly marked for your loved one to be able to access or a caregiver might need to access if your loved one is unable to keep track with the dosages and frequency.

Whitney:

Wow, that is really a lot of information. Was this type of medical management the same for each of your parents or did it differ?

Vicki:

Well, actually, Whitney, that’s a good question because it will ultimately lead us into step three. My father was ill with cancer from 1997 to 2005, and that’s when he passed away. It was his second bout with cancer and they were definitely in a strained financial situation, and that’s why we had them move in with us for emotional, physical and the financial support. We made an apartment for them, and so that way they did not have housing costs. So, like my parents, all planning and care is really tied to and contingent upon figuring out your loved one’s finances.

Whitney:

A frank discussion about money is not fun, no matter the age, but understand that it’s critical for ensuring the means that are available to pay for necessary housing, medications, and other living expenses your loved one can incur. Vicki, what are the steps that will help put a financial strategy in place?

Vicki:

Well, the way that I started and what I recommend is make a list of all bank account numbers, any interactions with financial institutions, retirement accounts, if they have any, and also if there’s a current mortgage that is still due, any car loans or credit card debt. And after you make that list, assess all incoming income and match them against these monthly expenses to make sure that necessary payments can be made. Also, know how they are paying bills currently, if they’re doing it online by recurring payment or by mail, I know in my mom’s instance, she likes to do it by telephone. There’s also many templates and apps or resources where you can create what I call the personal information organizer, which is where you can keep all this information. All these vital details would be in one document so your loved one can locate it as well as you.

Whitney:

Do you need to consult with an attorney need to do this?

Vicki:

So, to organize and familiarize yourself and your loved one with this initial financial landscape, you don’t necessarily need an attorney for that particular step, but you will definitely need an attorney for step four. And that is make sure the appropriate legal documents are in place.

Whitney:

Having the appropriate and current legal documents will help you understand your loved one’s wishes ahead of time and guide you through difficult decisions if something were to happen. What are the essential legal documents to have in place?

Vicki:

So, the first two documents I recommend are getting a health care power of attorney and also a HIPAA representative document. The healthcare power of attorney allows you to make medical decisions on behalf of your loved one when they’re unable to make the decisions on their own. Also the HIPAA representative allows doctors, hospitals, and insurance companies to share medical information with you along with your family member. Next, I would address having a living will, and this is also known as an advanced directive, and what it does is it details your loved one’s wishes regarding end of life care. And this document goes into effect in a terminal situation, only when the patient is in the end of life situation or they’re permanently unconscious or incapable of making their own decisions.

Vicki:

I know that was something that was important to my mom and that she wanted to make sure that she had the power to make her own decisions until she was unable to, and that’s what that allows you to do. The document names someone to manage the patient’s affairs beyond medical care, that’s a durable power of attorney, it also allows access to the financial accounts and also gives whoever’s holding the durable power of attorney decision-making authority.

Vicki:

And finally, last will and testament, this outlines final directions for the distribution of any assets if there are any, and that would include real estate and any personal property when they pass away. And this document also identifies a person who is referred to as the executor and they carry out those particular wishes and orders.

Whitney:

It’s my understanding that there are elder and family law attorneys who are especially helpful for these things?

Vicki:

Yes, and I would definitely recommend seeing an attorney that specializes in elder law, but before that I would recommend to essentially meet with your town’s local senior services division, because they can give you so much valuable assistance that is free of charge. And our local senior service department was very helpful to me and I wish I had known to contact them years ago before, I did this recently in the past several years, because my parents could have received some public health and other senior benefits that we were not aware of. And they also gave me guidance on senior websites and resources.

Whitney:

Wow, that’s really a great suggestion. Any extra help is always nice. So, Vicki, what is our final step five?

Vicki:

Step five is to talk about options for living arrangements. And when choosing the best living arrangement for your loved one, whether it’s remaining in their own home, or moving in with you, downsizing, choosing assisted living in a residential care facility, you really need to first figure out what your loved one’s personal comfort and preferences are. And then of course, you must tie into that their financial resources and limitations. Also, given their health concerns and those needs that come along with that, they may require ongoing medical services and insurance payments, and that will also determine where they will eventually reside. Also, find out when you decide what that place is going to be, what the availability of community and support services are.

Vicki:

And finally, as a caregiver, know that the responsibilities and duties that they really vary by situation, and one thing I had to learn is that there’s no right or wrong answer to the question, “What do caregivers do?” I also recommend something that I did, which is to seek out caregiver resources and support for yourself when you need it. Caregiving on your own is a tough task, but enlisting a team of people will help lighten the burden over the long haul.

Whitney:

Well, Vicki, I want to thank you for joining us today and sharing this brilliant, important information.

Vicki:

Whitney, you’re very welcome.

Whitney:

Thank you to our listeners and be sure to visit our newsroom at hmchealthworks.com where you can read our blog and listen to additional podcasts.