How To Balance Family and Work While Caring For Your Aging Parents

SOLUTIONS FOR THE SANDWICH

GENERATION

Balancing your family with the

care of your aging parents.

Overview

• Impact of informal caregiving

• When is it time to make a change

• Approaching the subject

• Understanding the various options

• Beginning the search

• Finding the best fit

• Meeting with service providers

• Making a successful transition

Impact of Informal Caregiving

• $306 billion in lost productivity annually to U.S. businesses.

• 25% of all workers provide care to a family member 65 or older.

• Caregivers of people aged 65+ spend an average of 20 hours per week providing care.

• One-third of respondents said dependent health concerns were a top reason employees were not able to focus on their job while at work.

Sources: AARP Press Center, American Productivity Audit, Family Caregiver Alliance Fact Sheet, and The Seattle Times

Impact of Informal Caregiving (cont.)

• Two-thirds report having to rearrange their work schedule, decrease their hours or take an unpaid leave in order to meet their caregiving responsibilities.

• One in five caregivers quits working or looks for a less demanding job.

• The cost of medical care among caregivers is approximately 8% higher than that of non-caregivers.

Sources: AARP Press Center, American Productivity Audit, Family Caregiver Alliance Fact Sheet, The

Seattle Times, and The MetLife Study of Working Caregivers and Employer Health Care Costs

When Is It Time To Make a

Change? • Traumatic Event

- Death of spouse

- Loss of driver’s license

- Recent fall or medical diagnosis

- Family moves

• Social Interaction

- Withdrawn/depression

- Spends less time with friends

• Physical Appearance

- Weight loss

- Clothing unwashed

- Poor hygiene/grooming

When Is It Time To Make a Change? (cont.)

• Home Environment

- Yard is not maintained

- House is un-kempt

- Minimal groceries in kitchen

- Concerns regarding safety

- Neighbors concerned

• Mobility

- Difficulty with walking and climbing stairs

• Medical

- Sleeping pattern changes

- Overtaking/forgetting medication

Approaching the Subject

• Build a support system for yourself.

• Don’t wait for an emergency – plan ahead!

• Involve the family doctor.

• Approach gently with concern.

• Involve your family member in the decision-making process.

• Be prepared for resistance.

• Be persistent, but understanding.

• Return to the topic another time, if necessary.

Understanding the

Various Options • Senior Lifestyle Communities

• Independent Living Communities

• Continuing Care Retirement Communities (CCRC)

• Assisted Living Communities

• Adult Family Homes

• Alzheimer’s, Dementia, and Memory Care

• Skilled Nursing Facilities

• Home Health Care

Senior Lifestyle Communities

Senior lifestyle communities are age restricted

communities that offer resort-style amenities and

social activities. • 55+ or 62+

• Generally no meals are included

• Many offer community rooms and social activities

• Purchase, rental, or lease

• Private funding only

Independent Living

Communities Independent living communities cater to seniors who

are very independent and have few medical problems. Residents live in fully-equipped private apartments and have access to a wide range of programs and services.

• Month-to-month rent

• Transportation

• Meals

• Weekly housekeeping

• Concierge

• Transportation

• Social and recreational activities

Assisted Living Communities

Assisted living is an alternative for seniors who need

more assistance but do not require the heavy medical

care provided in a nursing facility. • Trained caregivers assist residents needing help with one or more activities

of daily living

- Help with dressing, grooming, bathing, medication reminders, etc.

- Usually includes three meals per day, transportation, weekly

housekeeping, laundry services, and social activities

• A licensed nurse typically oversees services

• Private Pay, Long-Term Care Insurance, VA Benefits

Continuing Care

Retirement Communities CCRCs (continuing care retirement communities) are

designed to meet all levels of care, from independent

living to skilled nursing, in one building or on a

single campus.

• Generally require a “buy-in” ($50,000 – $1 million+)

along with a monthly fee

- Typically guarantee lifetime shelter and care

• Private Pay, Long-Term Care Insurance, VA Benefits,

Medicare (skilled nursing) and Medicaid (only if

resident can no longer afford monthly fees)

Adult Family Homes

Private homes that typically have a small number of

residents who live together and receive care from

live-in caregivers. • May not be age-restricted

• Private or shared rooms

• Offer a more “home-like” living experience

• Services range from assisted living to end of life care, including hospice

and dementia care

• Programs and services may be less robust

• Private Pay, Long-Term Care Insurance, VA Benefits, Medicaid

Alzheimer’s, Dementia and

Memory Care Specialized care and housing tailored to the needs of

individuals with Alzheimer’s, dementia, and memory

care needs. • Specialized assisted living or skilled nursing

communities that also offer:

- Memory care programming

- Modified building features

- Secure environment

• Private Pay, Long-Term Insurance, VA Benefits, and Medicaid (only if services are provided in a skilled nursing facility)

Skilled Nursing Facilities

Provide 24-hour nursing care for those who require a

high level of medical care and assistance. • Shared or private rooms

• Care provided by nursing staff

• Services may include:

- Physical therapy

- Occupational therapy

- Medical services

- Speech therapy

- Rehabilitation service

• Private Pay, Long-Term Care Insurance, VA Benefits, Medicare/Medicaid

Home Health Care

Organizations with licensed and bonded caregivers

that will provide services in one’s home.

• Medical services

• Nursing care

• Socialization

• Therapeutic treatment

• Nutritional services

• Light housekeeping, errands, transportation

Once Deciding That Senior

Housing is the Next Logical

Step…

What are your requirements and who is

going to meet/fulfill these needs?

Beginning the Search

• Placement Agencies

• Referrals

- Physician

- Family or friends

- Human resources department

- Pastor

• Internet

• Yellow Pages

Narrowing the Search

• Call communities or service providers and have

information sent, or contact a placement agency.

• From that list, visit the communities and/or arrange

meetings with service providers that meet your

needs.

• Make arrangements for all key decision makers

and influencers to tour/meet.

Choosing the Best Fit

• Location

- Is the community close

to:

Shopping

Banking

Family/friends

Church

Medical facilities

Recreation (park, library,

etc.)

• Reputation

- Who is the owner?

- Length of time in

business?

- Are they well known in

the community?

Choosing the Best Fit (cont.)

• Cost

- Rental (month-to-

month?)

- Lease (length of time?)

- “Buy-in” with monthly

fee?

- Rental increases?

• Residency criteria

- When does a resident

have to move out?

• Entrance fee/deposit

- Refundable/non-

refundable

- Conditions

- Guarantee

- Amount

• Community features

- Common areas

- Building design

- Parking

Choosing the Best Fit (cont.)

• Services - What is included in the rent?

- What is not included?

- Are choices available?

- Is the staff trained?

• Social interactions - Review activity program

- Transportation schedule

• Apartment styles -what is important? - View

- Easy access to common areas

- Square footage

- Kitchen/bath features

- Emergency communication system

- Storage space

- Private or shared

Visiting the Communities

• Use your eyes to get a feel for the environment:

- What does the community look like?

- How does the staff interact with residents?

- Do residents appear happy?

- How active are the residents?

- Is the community clean?

- Are the grounds maintained?

Visiting the Communities (cont.)

• What did you hear?

- Is the community noisy?

- Is the community too

quiet?

- Are the residents

socializing?

- Are the apartments

quiet?

• What does it feel like?

- Warm and friendly?

- Sterile and uninviting?

Involve Yourself on the Visit

• Visit the dining room - Does the food taste good?

- How is it served?

- Are there choices (meals/times)?

- Are specific needs addressed?

- Is the staff friendly?

• Try it out - Does the community offer an

overnight stay?

- Does the community welcome guests to activity events both in and out of the building?

• Talk with residents - Does the community provide a

supportive environment for retaining maximum independence?

- Do current residents appear to have their needs met?

- What do residents or their families say about their care and/or the community?

Making a Successful Transition

How do I reduce the stress and strain

of the transition?

Prepare for Emotions

Leaving a long-time home often creates significant

feelings of loss, dependency, and frustration.

• Recognize, validate, discuss feelings.

• Celebrate belongings and memories together.

• Reinforce independence to be gained.

• Distribute belongings creatively.

• Pace the process and create rewards.

Begin the Process

• Create a Master Plan (see handout).

• Discuss goals, concerns, and personal preferences.

• Work backwards from “target date”.

• Break relocation process into smaller pieces.

• Identify all possible service needs, including legal and financial.

Tips for Rightsizing

Downsizing a lifetime’s worth of belongings takes

time and is both emotionally and physically

demanding.

• Start early – allows for good decisions.

• Begin with items and areas not part of daily life.

• Take time to experience memories.

Tips for Rightsizing (cont.)

• Sometimes it is helpful to use mechanical

approaches to assist the downsizing process:

- Use removable adhesive colored stickers to mark belongings: Keep (green), Give (blue), Sell (yellow), Donate (Orange), Discard (red).

- Complete a floor plan of the new residence as early in the process as possible, enabling the determination of which furnishings and decorations will physically fit.

Tips for Rightsizing (cont.)

• Use boxes that are the same size as drawers in the new residence – limit based on what fits in the box.

• Use masking tape to create approximate sizes of shelves – limit what to bring accordingly.

Tips for Rightsizing (cont.)

• Give away

- Involve family and friends in sharing family heirlooms and cherished items – take pleasure in watching them received.

• Sell

- Identify priorities – highest $, shortest time, easiest

method.

- Consider options – online, estate sale, auction.

Tips for Rightsizing (cont.)

• Donate

- Consider tax advantages

- Not everything will be accepted

- Be creative

• Discard

- Plan for hazardous materials

- Shred all personal documents

- Consider trash removal service

Transitioning the New Living

Space Into “Home” The key to ensuring a smooth transition into community living involves

starting with a residence that is safe, sound, and secure. With this in mind, the following steps are recommended:

• Unpack all boxes and remove all packing materials as soon as possible.

• Reset cupboards, drawers, and cabinets in a familiar way.

• Place furnishings and rugs with safety in mind.

• Reestablish décor that feels like “home”.

• Move items to be stored out of residence as soon as possible.

SOLUTIONS FOR THE SANDWICH

GENERATION

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