Caring for an Elderly Relative: Where to Begin

As Americans live increasingly longer lives, many require ongoing, long-term care. This care often falls to grown children -- men and women who are in their forties, fifties, and sixties and busy with careers or perhaps children of their own. Getting caught in this care-giving "sandwich" -- growing children on one side, aging parents on the other -- can be an emotional and financial burden, especially if you don't know where to begin or how to get help.

If you are, or soon will be, caring for an elderly relative, you'll need to consider some legal and financial matters. It may be necessary to deal with care facilities, insurance, powers of attorney, and more. Here's where to start.

Figuring Out What Needs to Be Done

Following is a checklist to help you determine what your relative may need. Don't let it overwhelm you. Simply use it to make your own list of things to do or to learn more about, if necessary. Then you'll be in a better position to ask others to help with both discrete and long-term tasks.

Type of Care Needed

To determine the types of care your relative may require, ask yourself these questions:

• What kind of care does my relative need now, and is that likely to change in the future?

• Could my relative be taken care of at home with some help from a skilled nurse and/or a health aide? (For more information, see Is Home Health Care an Option?)

• Would assisted living be appropriate for my relative? (For more information, see Assisted Living For Seniors.)

• Will he or she require a skilled nursing facility, now or in the future? (For more information, see Choosing and Paying for a Long-Term Care Facility.)

• Does my relative's mental condition require him or her to have special care and housing? (For more information, see Residential Care Facilities for Elders With Alzheimer's Disease.)

Health Insurance and Medicare

The following questions will help you understand what kind of health care coverage your loved one has or may need:

• What are the likely costs of the care my relative will need?

• What do Medicare and Medicaid cover? (For information, see Medicare FAQ and Medicare and Medicaid: What's the Difference?)

• What kind of health insurance does my relative have, and what does it cover? (For information on policies meant to cover what Medicare does not, see Medigap: Covering the Gaps in Medicare and Medicare Managed Care Plans: An Alternative to Medigap Insurance.)

• Does my relative need long-term care insurance? (To find out, read Long-Term Care Insurance: The Risks and Benefits.)

Taking Over Finances and Decisions

The time may come when you or other loved ones need to make basic financial and health care decisions for your relative. Be sure to get answers to these questions:

• Does my relative have a living will (advance health care directive) or power of attorney for finances? If not, how can I help my relative create the necessary documents? (For more information, see Helping an Elder Make a Power of Attorney.)

• Is my loved one no longer capable of making his or her own decisions or consenting to a power of attorney? (For help, see Conservatorships and Adult Guardianships.)

End-of-Life Issues

Finally, here are some important issues to consider about wills and other arrangements at the end of life:

• Does my relative have a will? If not, how can I help my relative create a legally binding will? (For information on making a will, see The Simple Will: No Frills, No Fuss, No Anxiety.)

• Has my loved one communicated any wishes for final ceremonies and the disposition of his or her body? (For help, see Planning Your Funeral or Memorial Service.)

• Has my relative shared information on where to find important documents and passwords regarding bank accounts, retirement accounts, safe deposit boxes, stocks, life insurance policies, and wills and trusts? (For help, see Nolo's article Practical Estate Planning: Organize Your Documents.)

Getting Help

After you've reviewed the list above and have an idea of the tasks and issues involved, take a deep breath and remember that you can ask for help. To begin, you can encourage your relative to be as involved as possible in his or her own care. Avoid taking control of tasks that your loved one can still perform. The more your relative is allowed to do, the longer he or she will be able to maintain a sense of ownership over the course of his or her own life.

Next, you can turn to others for assistance, such as your immediate family and friends, brothers and sisters, aunts and uncles -- anyone who might be able to lend a hand. (In many families, siblings divide the responsibilities of parent care.) Often, delegating even a small task can mean a great deal, especially if it relieves you from something on your to-do list. You can also turn to professional resources, such as in-home health aides and elder companions. Of course, most of these services cost money, though some are covered under some health insurance plans or Medicaid.

Caring for an elder relative is not easy, and you deserve all of the support you can get. During the hard times, it might help to remember that what you are doing is noble and generous. Whether or not your loved one is able to express it, he or she is fortunate to have someone who is willing and able to do the job you've taken on.

For More Information

For help managing the care of your elder relative, you may find it helpful to consult the following Nolo resources: Long-Term Care, by attorney Joseph L. Matthews (Nolo), and Social Security, Medicare, and Government Pensions, by Joseph L. Matthews and Dorothy Matthews Berman (Nolo).