The sandwich generation

If you are still taking care of your children – whether they are young children or in college – and either currently or soon to be taking care of at least one of your parents, then you are considered part of the “sandwich generation”. The age range for this generation is wide, spanning from 30s-60s, because of the trend of having children later in life, which means even Millennials (27-42), Gen X (43-58), and Baby Boomers (59-77), can be a part of the sandwich generation. According to the Pew Research Center, “nearly half of adults in their 40s and 50s have a parent age 65 or older, and are either raising a young child or financially supporting a grown child.” Trying to take care of your children and your parents at the same time is hard work, and with this responsibility comes the guilt of not doing enough. Deciding the best way to care for your aging parents is a huge decision. In this article we address the common feelings of guilt, setting boundaries, a caregiving checklist, a list of all the documents you will need to have access to (from financial to health care), and different care and insurance options for you to consider.

Do you feel guilty when it comes to taking care of your parents?

It is very common for children of aging parents to feel like they are not doing enough, and they typically feel guilty about moving their parents into a retirement community, assisted living facility, or independent living, because they feel they should be taking care of their parents themselves. Remember not to “Should” on yourself! You might feel you could provide more happiness or a better quality of life if you had them live with you. You might feel that you are not a good enough caregiver with everything on your plate, or you just might feel that you are failing to be a good child or not doing your duty to take care of them. Remember to give yourself grace as you navigate what is best for yourself, your family, and your loved ones, and to have an open conversation and dialogue about your ability and their wants and needs. And try not to be so hard on yourself.

Consider setting healthy boundaries early on and decide what you can and cannot do. The Pew Research center also determined, “not only do many provide care and financial support to their parents and their children, but nearly 40% say both their grown children and their parents rely on them for emotional support.” This means that you need to be careful not to try to be everything to all people. Ask for help and don’t feel guilty when you need to rely on others to help with the financial, daily care, or emotional burden.

When is it time to move your parent(s)? What are the signs or guideposts you can look for?

It can be hard emotionally as well as financially as you try to make the best decision for your parents. Determining when to move them into an alternative housing community such as an assisted living or long-term care community is tricky. Here are some signs can you look for to help guide your decision:

Your parent(s) can no longer care for themselves.
Your parent(s) can no longer take care of their home or yard.
Your parents no longer wish to live in their current home or living environment.
You do not have the time, space, or ability to take care of your parent(s) yourself.
Your parent has been diagnosed with an illness that is outside your realm of knowledge or care ability.
Caregiver burnout – Maybe you have been your parent’s full-time caregiver and you are now feeling overwhelmed by the continuous care.

Living options

Independent living is for seniors or those who are still enjoying an active lifestyle and want to age in place, but no longer wish to deal with the hassle of homeownership or tasks like yard work, cleaning, and cooking for themselves.

An assisted living facility is for aging adults who are active but may need more help with daily living and healthcare needs.
There is a great benefit to finding an aging-in-place community that offers both options so that your parent(s) can change their level of care as needed. They can maintain the same community and relationships they have built while having the option to get more assistance and care when they need it. Another thing to note is whether the community has a memory care option for those who could need help with Alzheimer’s and dementia.

Living with you

If you are your parents’ full-time caregiver this likely means you will be in charge of managing their medicine, transportation to appointments, making sure they get daily exercise, grocery shopping, meal preparation according to their health restrictions or dietary needs, hygiene such as bathing, laundry, and cleaning up after them. Don’t forget to recognize your limitations and don’t try to take on too much. Ask for help when you need to and set healthy boundaries with your time, making sure to make time for yourself to recharge and do things you enjoy as well. Set boundaries around finances and make sure to communicate your boundaries clearly to your loved ones.

Things to consider if your loved one is going to move in with you:

Remove tripping hazards like area rugs, extension cords, thresholds between rooms, dog food and water bowls, toys, and any clutter.
Consider installing non-slip mats inside of bathtubs, a zero-barrier entry shower, grab bars in the toilet area and shower, and a shower seat.
Store vitamins and medications in a safe, secure, and out-of-reach place.
Provide things that are nostalgic such as games they like to play, or music they enjoy listening to.
Install wheelchair entry ramp if needed.
Lower pile carpet creates a better surface for walkers.
Will your parent be able to manage stairs?
Add extra lighting and nightlights throughout the home. This is very important between the bed and the bathroom. You can even install motion sensor lights.
Check to make sure the water temperature settings are not set too high. 120 degrees is a good guideline.
Check all smoke alarms and install carbon monoxide detectors if they are not already throughout the home, as even tiny amounts of carbon monoxide can be hazardous to your elderly guest. Don’t forget to change the batteries every six months.
Do your parents have easy access to the common areas such as the kitchen, and living room, or do they have their own living space?
Install outdoor lighting along the sidewalk, front porch, and backyard.
Keep flashlights handy or next to your loved one’s nightstand.
Install a medical alert system.

Medicare, Medicaid, PACE, and Long Term Care Insurance

Medicare Coverage

Medicare Part A covers most hospital visits.
Medicare Part B is health insurance. It covers doctor visits and most diagnostic testing.
Medicare Part D is drug coverage for prescription meds.

Medicaid

Medicaid is not the same as Medicare. This is a Federal and State funded program that is designed to provide assisted living and medical insurance for those who could not otherwise afford it, or low-income individuals.

PACE

What is PACE? PACE (Programs of All-inclusive Care for the Elderly) is funded by Federal and State governments through a person’s Medicare and Medicaid benefits. This is an alternative to nursing care for those who want to maintain their independence and remain in their homes while receiving care. It offers both medical care and wellness support, including social engagement but it is only available to those who qualify. To qualify you must be over 55 and live in a PACE service area and need nursing home-level care.

Long-term care insurance

This is self-funded in advance to pay for long-term care needs such as an assisted living facility, memory care, or a nursing home. It is important to check if your parents have purchased this type of insurance, and is something to consider for yourself as well. Check with your Financial Advisor or CFP® for a referral, or check the internet for professionals with good reviews in your local area. You can also ask your friends who they would recommend.

Checklists of some of the documents you will need:

Tax returns
Retirement accounts such as traditional IRA, Roth IRA, and 401(k) information
List of all bank accounts
Pension documents
Annuity contracts
Savings bonds
Stock certificates
Brokerage accounts
Business partnership and corporate operating agreements. (*If your parent owns a business)
Property deeds
Vehicle titles
Documentation of loans (mortgage, vehicles, etc.)
Documentation of debts including all credit accounts
Access to all online logins including usernames and passwords – consider sharing through LastPass or another password management tool
Contact information for their Financial Advisor* if they have one. It might even be helpful to join their annual meeting.
Copies of life insurance policies, including beneficiary information
Power of Attorney. A power of attorney (POA) is essentially a legal document where your aging parent can name a person or persons to act on their behalf in all legal and financial matters. Should your aging parent become incapacitated, a general POA will terminate while a durable power of attorney (DPOA) will remain in effect and be able to outline your loved one’s financial expectations. This is something you can do online or with an Estate Attorney. They can also help you create a Will and Trust if you do not already have one.

*If your loved one does not have a financial advisor or financial planner it might be advantageous to hire one who can help manage their assets as well as your own. Goodwin Investment Advisory loves to work with multigenerational families as our vision is to, “empower families with confidence that their money will last for generations.” To schedule a free intro call with our consultant click here. Tara will get to know your story, what you’re looking for and help set up a meeting with one of our CFP® professionals. If you are a client and have questions about your aging parents please reach out to your advisor as they are always available to help guide you.

Health care

Make sure you know your loved one’s health care preferences and that they are stated clearly in writing in a health care directive. A healthcare directive is a document you can make with your loved one so that you can make medical decisions on their behalf. You want to have a conversation with your parents and ensure that your loved one’s general wishes and care instructions are written down, especially regarding life support in an advance directive.

Health care documents

Authorization to release health care information (HIPAA release)
A health care directive
POLST or Physician Order for Life-Sustaining Treatment is written by a physician or nurse practitioner to help those dealing with a more serious illness so that they can have more control over their care and treatment. This can then be used to tell all healthcare providers what your aging parent wants to allow or not allow during a medical emergency.
Personal medical history
Insurance card
Long-term care insurance policy
Emergency information sheet including all doctors
List of prescribed medicines and vitamins including quantities and when and how to take them
List of allergies
List of dietary restrictions
Nutrition plan

End-of-life and estate planning documents

You will want to make sure your loved one has estate planning and end-of-life documents that are up-to-date. Having these documents helps to save everyone involved the burden of added stress when you are already grieving. These documents help families to avoid unnecessary legal and financial frustration.
When it comes to end-of-life and estate planning, you and your aging parent can consult an Estate Attorney who specializes in these documents to make sure everything is thoroughly taken care of.