Questions for Aging Parents

A Real Simple magazine article discusses how adult children and their parents can have an open discussion about their concerns, and together face the challenges of aging.  This discussion is often not an easy one to have; a 2001 AARP study revealed that three-quarters of adult children think about their parents' ability to live independently, but one-third of the children surveyed have avoided discussing the topic with their parents.  The results for parents are similar; 70% said they think about their ability to live independently, but more than one-third said they do not discuss the subject with their children.  The article provided several conversation-starting questions that adult children can ask their parents.

Do you have enough health insurance?  Your parents should have coverage through Medicare (both Part A and Part B, and a Part D prescription drug plan).  You should discuss adding a Medigap insurance policy, which can cover co-payments, deductibles, costs, and services not included or only partially included under Medicare. Your parents may also want to consider purchasing long-term care insurance to help defray the cost of long-term care in their home or in a facility.  You should work with an expert who is familiar with all of the options for these insurance plans.

Do you think your physician is well-informed about the issues common to older patients?  Geriatric physicians are invaluable resources, but they can be hard to find.  You should look for physicians who emphasize care for seniors.  If your parents require services from multiple specialties, then hiring a geriatric care manager to help coordinate healthcare services can be a big help, especially if you do not live near your parents.  Think of the geriatric care manager as a general contractor who will investigate your parents' needs, scope out the project, and link the family with health and support resources.

Can we help you make your home more comfortable?  Your family may want to discuss moving the master bedroom to the first floor of a multi-level home, or installing a stair climber.  Simple changes such as removing throw rugs may help prevent falls, and if your parents get up during the night to use the restroom, then you can install motion-triggered nightlights to light the path.  You might want to discuss other housing options, such as ranch houses, condos, and assisted living facilities, so you can be prepared financially if and when the need arises.

Are you feeling secure about driving?  This can often be the most contentious issue between parents and children.  The parents want to maintain their independence, and the children are concerned about safety.  Seniors who are still capable of driving can enroll in the two-day 55 Alive driver safety program sponsored by AARP.  If it appears that your parents will have to stop driving in the foreseeable future, then you can help ease the transition by talking with the local Chamber of Commerce, community centers, churches, synagogues, and the local agency on aging, to see if any of them offers shuttle services.  Taxi or car services will often set up standing appointments to drive so people can shop, go to dinner or to the movies. 

Do you have an estate plan in place?  The key pieces of the plan are a general durable power of attorney to manage finances if a parent becomes ill, an advance medical directive to make medical decisions if needed, and a will or trust for the disposition of assets at death.  The plan also includes a thorough financial review to ensure that asset allocations are appropriate, and that any necessary insurance is in place.  Your parents should have lists of their important information (including funeral and burial preferences) in one place, and they should let you know where to find this information in case you need it.  You should consult with an elder law attorney to ensure that your parents' plans are comprehensive and integrated.

If possible, parents and children should discuss these issues face-to-face.  The atmosphere should be one of comfort and collaboration, not confrontation.  Children should emphasize that their top priority is ensuring that the parents' wishes are honored and carried out.  There is no need for children to parent their parents; rather they should become partners in helping their parents manage their lives.  If possible, all family members should be on board; sometimes it may be necessary to involve a third-party facilitator, such as a therapist, trusted family lawyer, or a financial planner who is already working with the parents or children.  Above all, be patient; many issues may not be resolved with the first conversation.  The key is to start the ongoing dialogue.

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Sandra L. Smith joined Oast & Hook in 2003.  Oast and Hook has served Southeastern Virginia and North Carolina for more than 80 years. Visit their website at www.oasthook.com for more information. Ms. Smith practices primarily in the areas of elder law, estate planning, estate and trust administration, special needs planning, asset protection planning, long-term care planning and Veterans' benefits. She is certified as an Elder Law Attorney (CELA) by The National Elder Law Foundation (NELF). In 2008, Ms. Smith was named as a Rising Star by Virginia Super Lawyers magazine. Rising Stars names the state's top up-and-coming attorneys.