In 1988, my widowed mother-in-law had been living with us for nine years. Within one week, the flu swiftly rendered this healthy woman comatose and precipitated a family crisis.
My husband and I, who were only in our 30s, scrambled for information about Medicare insurance and home-care assistance for the frail elderly. The fear that Grandma would require expensive long-term care consumed our lives. We could not find affordable home help and for weeks, we alternated staying home from our jobs. We were overwhelmed by our struggle with sickroom equipment, fear, resentment and guilt.
Fortunately, she recovered. But the problem was not resolved, just postponed.
According to Shirley Radding, program director of the Long Term Care Ombudsman Program of Ventura County, "if you have a parent alive today, you are likely to have a crisis awaiting you. It may be financial, medical or emotional. Or it may be all three at once." But, she added, "inevitably, you will be part of the solution and part of the problem."
Radding said 7 million to 8 million American adults provide personal care to their parents, elderly relatives or friends. She said nearly 25% of these care-givers spend between six and 35 hours a week on some kind of care-taking. These duties have an enormous impact on the work force. Eventually, care-taking demands require over half of these adults to reduce their workload, and 12% are forced to quit their jobs.
Studies have revealed that women, especially daughters and daughters-in-law, make up 85% of people who are taking care of an elderly relative. American women average 17 years caring for children and can expect to devote 18 years to taking care of an elderly parent. Furthermore, nearly 40% of such women do so while maintaining a full-time job.
The "sandwich generation" of middle-aged family members who have responsibility for children and aging parents is changing. Due to increased longevity, middle-aged children today are the first to be living in an age where a four- or five-generation family is becoming commonplace. More frequently, adult children in their 50s and 60s who are hoping to retire and enjoy long-anticipated freedom find themselves caught in what Radding describes as a "club sandwich generation," with responsibility for very old parents of their own.
Aging parents and adult children should be preparing now instead of reacting to a crisis. While parents are healthy, children should initiate a dialogue about resources and preferences for health care and housing. Parents should be asked about their hopes, how they would like to live and what they fear about aging. Children should ask about their parents' income and nest egg and about Social Security and Medicare entitlements.
There are insurance policies that supplement Medicare coverage, but they are less expensive and much easier to obtain before age 65 and while in good health.
Parents can fill out a document called a "durable power of attorney" for health care and one for financial affairs. Such documents go into effect only if the person is incapacitated. Children should find out the locations of the following items: keys, important documents, safe-deposit boxes, insurance policies, bank accounts, stocks, real estate and tax returns for the last three years.
Radding said it is common to experience fear, anxiety, guilt, despair, depression and anger over the situation. Counseling may be needed, but many people have found support groups for children with aging parents to be very useful.
Whether your parents still live in their own home, with you or in a nursing home, your biggest allies are advance planning and the network of social services in Ventura County that includes Meals on Wheels, case management, transportation, adult social day groups, support groups and volunteer respite for care-givers.
Above all, Radding advises care-givers: "Be healthy-selfish. Set limits and have realistic expectations for yourself and how much you can handle."
* WHERE TO GET HELP
* The Ventura County Area Agency on Aging can answer most questions and provide referral information: 652-7560.
* The Long Term Care Ombudsman Program of Ventura County provides preadmission counseling about entering a nursing home and referral information: 656-1986.
* A support group called Children With Aging Parents meets at Los Robles Regional Medical Center in Thousand Oaks at 7:30 p.m. the third Tuesday of the month: 497-0189.