Posted by Sheri Samotin on Thu, May 06, 2010
One of the more stressful parts of caregiving is the worry about how to pay for it. Planning ahead can help, as can creating a caregiving budget. Of course, once you create your budget you need to stick to it! As a rule of thumb, if you're thinking ahead you're making a plan while if the situation is unfolding right now, you're creating a budget. Yet, even when you are building a budget it is important to think through the "what ifs" and create a few scenarios for how your caregiving journey might unfold. It's helpful to construct a best case, worst case, and most likely case because this view of the future might help you make decisions about what to do now. I advise caregivers to assume that the resources available at any moment will be lower than what you expect and the needs of your care recipient will be higher. If you think about things this way, you are more likely to be "surprised" that you have more than enough rather than the opposite.
A budget is made up of inflows, outflows and the assets and other resources available. Inflows include your care recipient's income, social security payments, pension benefits, IRA, 401K, or annuity distributions, Veteran's benefits, long term care insurance proceeds, support from family, etc. Outflows include all of your care recipient's expenses, not just those associated with the care itself. For example, if Mom lives in her own apartment, you have to include her rent and utilities, not just the cost of the home health aide. Always include a contingency or cushion line when you are fashioning a caregiving expense budget. Be sure to consider all of the assets or other resources that are available or could become available. These include savings, value of the home or car, gifts from others, loans, credit card limits, and life insurance policies to name a few. It is important to know about the availability of these resources along with how to access or monetize them.
Once you have crafted the budget, you will immediately see whether the inflows are sufficient to cover the outflows. If they are, you have a surplus, and that's a good thing! When you have a caregiving surplus, put it away for immediate access later. If the outflow exceeds the inflow, a budget deficit occurs and must be funded. That's where assets and other resources come in. If the deficit is short term, as when extra help is required for respite, it might be feasible to fund it from savings or using a credit card. Alternatively, if the deficit is ongoing, it's time to determine if the available resources are sufficient to cover it and for how long. It may be time to consider making changes to the caregiving budget so things are more in balance.
A budget is like a roadmap - it gives you an idea of where you're headed. When you're on vacation it's sometimes fun to toss the map and take the scenic route that might lead to an adventure or a great little restaurant. However, a budget detour is less likely to be fun. Therefore, as caregivers, it is important to periodically take a look at our directions and make sure we're heading where we planned to go. Whether you do this weekly, monthly, quarterly or less often will depend on how tight your caregiving budget is and the stability of the caregiving needs. For example, if yours is a deficit budget and the caregiving needs suddenly and permanently go up, it is critical to keep a very close eye on the budget. On the other hand, if you have a surplus budget and things are stable, it is likely to be fine to check in with your budget less frequently.
When you review your caregiving budget you are looking for variances. A variance occurs when the actual amount spent differs from what you planned when you created your budget. A variance can be positive or negative. For example, if inflows are greater than planned, that is a positive variance. Similarly, if expenses are lower than planned, that's also a positive variance. On the other hand, if inflows are lagging or expenses are higher than plan, you have a negative variance. The idea is to explain the variance and determine whether it is likely to recur, not to blame yourself or anyone else for the fact that the variance happened. For example, if the electricity bill is high in August relative to your budget for August, you're unlikely to be alarmed if you assumed that the bill for the year is divided evenly by month. One way to help interpret a variance is to look at both this period (e.g., this month or quarter) and to also look at year-to-date. In this way, you can see if a variance seems to be a one-time matter or a trend. If you see trends, you're likely to be facing a new reality, and it's probably time to revise the budget!
Posted by Sheri Samotin on Tue, Apr 13, 2010
A just published book for adult children and their aging parents is "The Daughter Trap: Taking Care of Mom and Dad ... and You" by Laurel Kennedy. This is a valuable resource for all adult children, daughters and sons alike. Ms. Kennedy bases her work on hundreds of interviews with baby boomers in the thick of caring for their parents and the anecdotes help to illustrate her key points and make the work come alive.
The first half or so of the book frames the problem. While this section doesn't introduce much in the way of new insights, it does effectively capture the issues faced by so many who care for aging parents and summarizes many of the important studies and resources that have been published on this important topic over the past few years. At the end of each chapter, Kennedy has a section of "what we've learned" where she tries to guide the reader on actions they might take or things to think about. Some of this tidbits are more helpful than others. For example, at the end of Chapter 4, Kennedy writes, "When you need outside help -- ask for it." This sort of feels like motherhood and apple pie. On the other hand, in the wrap up of Chapter 6, Kennedy wisely opines, "Acknowledge your limitations and those of your family. Develop a plan B if caregiving becomes overwhelming to the detriment of your life..."
The second portion of The Daughter Trap focuses on solutions and here is where Kennedy forges new ground. For example, in Chapter 9 entitled "It Takes A Village", Kennedy does an excellent job of bringing her readers up to date on the various initiatives underway to explore alternatvie senior living models and later chapters focus on ways that corporate America can make a difference and technology solutions that are needed.
Kudos to Kennedy for this well researched work. For those who are well versed in the issues of baby boomers and their aging parents the second half of the book provides some "aha" moments. For those who are just getting involved with this critical demographic reality the first half provides a thoughtful overview.
Posted by Sheri Samotin on Tue, Oct 20, 2009
I am often asked to describe the benefits derived by adult children of aging parents when they elect to work with a family transition coach. Perhaps the best way to answer this question is through an example. I've changed some of the personal details to preserve the privacy of those involved, but the situation itself is based on a real situation from my practice.
Jennifer found me by reading an article I had written and published about family transition coaching in a local senior resource publication. I was in a meeting when she initially called, so she left a voice mail message that began, "I really need help, and I need it fast!" When I called Jennifer back, she told me that she is one of four siblings and the long distance caregiver for her mother Nancy. Nancy lives in southwest Florida and Jennifer lives in Michigan. Jennifer's siblings are scattered across several states, but none live near their mother.
Nancy is 84 and suffers from memory loss and some confusion. She is otherwise in good health and remains fairly active. Ever since Dad died six years ago, Nancy has been managing herself. She continues to live in the condo that she and Dad moved to in 1995 when they first relocated to Florida and until recently has maintained an active social life with her friends from church. Jennifer usually visits Nancy a few times each year; her siblings visit less frequently. Several months ago, when Jennifer came to visit, she noticed that Nancy seemed confused and somewhat withdrawn. Jennifer accompanied Nancy to her doctor's appointment and learned that Nancy's condition is considered to be "age related memory impairment." It was explained that this is a "normal part of aging" and that "there is nothing to worry about." Nancy assured Jennifer that she was fine and still able to manage on her own.
Several weeks after returning home from that visit, Jennifer called Nancy for her regular check-in and found her agitated and confused. She became extremely concerned, and called Nancy's neighbor and asked her to check on Nancy. When the neighbor called back, she told Jennifer that Nancy seemed okay. The next morning, Nancy didn't answer the phone when Jennifer called, and didn't respond to a knock on the door by the same neighbor whom Jennifer had called again. Fearing the worst, Jennifer called 911 who responded and took Nancy to the hospital. It turns out that Nancy suffered a stroke. Jennifer jumped on a plane to come to be with Nancy. She has taken on the role of primary long distance caregiver by default. The family has never discussed Nancy's situation as a group.
That's when Jennifer called me. She knew that she had to return home to her job and her family within a few days and was in a panic about what would happen to Nancy. At the same time, she was getting frustrated trying to convey information to her siblings, each of whom offered lots of input but none of whom offered to come and take over so that she could get home. Jennifer was under extreme stress.
The first thing I helped Jennifer to do was to get organized and get her siblings involved. We started by making a list of all of the things that had to be done, the documents that had to be found, the bills that had to be paid, and the decisions that had to be made. We then scheduled a conference call among the siblings which I facilitated. The stated objective of the conference call was to identify Nancy's needs and the resources that could be provided by the family working as a team. These resources included knowledge, time, and money. Once we had an exhaustive list of what needed to be accomplished, we matched the available resources. By the end of that first call, each of the siblings had their assignments and was committed to working as a team. Within a few hours of Jennifer's initial call to me, she was feeling as though she was back in control of the situation and didn't need to carry the burden on her own shoulders.
Over the next several days, I worked with each of the siblings on their piece of the puzzle, making sure that everyone stayed on track. The family had one very important decision to make, and that was where Nancy was going to go upon her discharge from the hospital. We worked with a geriatric care manager to identify the options and concluded that she could return to her condo safely as long as she had appropriate in-home care. Nancy's family now needs to address whether this is a sustainable solution given the financial realities, and the siblings have arranged to all come to visit Nancy at the same time within the next month. During that visit, they plan to go and look at several assisted living facilities and determine if that might be a better solution for Nancy. In preparation for their visit, Jennifer has asked me to help her identify several alternative facilities and to gather all of the necessary information so that she can share that with her siblings in advance of their visit so that they can make the most of their time together.
Family transition coaching can be helpful during a crisis, as in the case study presented above. While it is always better to plan ahead, the reality is that most people avoid thinking about the inevitable issues that will arise as their parents age. If you find yourself in the midst of a caregiving crisis, don't hesitate to reach out to a family transition coach.
Posted by Sheri Samotin on Tue, Sep 15, 2009
If we're honest with ourselves, we can remember back to a time when we and our siblings were all living at home and we settled into certain patterns within our families. For example, in a family of three brothers, there was the elder who had his act together, the middle one who was the clown, and the youngest who was Mom's favorite. Does it surprise you when forty years later, these three brothers are dealing with their aging mother and the same patterns play out? The oldest brother, the "responsible" one, takes charge of the nuts and bolts, and at some point he probably feels put upon because his siblings aren't helping enough. The middle brother is always there for the fun and happy times, but he seems to disappear when the going gets tough. He might feel that he's not in the loop. And the baby, Mom's favorite, announces that he is coming to visit and Mom talks about nothing else for weeks before and after. It's likely that he's oblivious that both of his brothers are annoyed with him. This is an example of siblings who, despite the adults they have become, revert to their childhood roles when confronting the aging of their parent.
In addition to historical family patterns, gender roles often come to the forefront in family caregiving situations. Why is it that women so often take on the caregiver role? Is it because they expect it of themselves, or because their families expect it of them? Is there truth to the old saying that, "a daughter is a daughter for life, but a son's a son until he takes a wife?" Is it because caregiving is often still considered to be "women's work"? While there are certainly many families where men play leading and significant roles in the care of their parents, many surveys show that sons most often write checks while daughters (and daughters-in-law) provide more of the hands on caregiving. Whatever might be the situation in your family, it helps to be aware of gender roles, and think about whether you are falling into default positions or really are sharing the load.
Proximity and distance also become factors in the family caregiving dynamic. In many families, one sibling lives near their parents, while others don't. The one who is close by will tend to see the parents more often and may not notice subtle changes in a parent's ability or behavior. Then, one of the out-of-towners comes for a visit and begins pointing these things out. If not handled with care, the in-town sibling might take this personally, thinking that the sibling is saying that he or she isn't doing a good enough job of looking after Mom and Dad. At the same time, the distant siblings might take it for granted that their in-town brother or sister is both expecting and willing to take on the caregiver role, leaving that caregiver by default to feel taken advantage of.
Complicating the family dynamic, each of us has different needs. We all know someone who needs to be needed. This person will often have great difficulty when their caregiver role naturally comes to an end. What about the person who needs to fight fires, and who might even set a few in order to be able to save the day? Without even realizing it, this person might make the caregiving more complicated than it needs to be. Do you know someone who needs to be seen as the big spender? This person is likely to feel that money is the answer to every caregiving challenge, and will look for opportunities to show how generous she is. When that generosity isn't acknowledged, she's likely to get angry. Finally, do you know anyone who has a need to be the "good" son? This person will take actions based on how they appear to others, and will look down on his siblings who aren't as "good" as he is.
Money, competing responsibilities, and disparate skills rear their heads as well. It is all too easy for families to fall into roles when they don't take the time to discuss these things out loud. The best family caregiving situations arise when everyone is working together. There can be a role for everyone, even those who live far away. All it takes is some good ongoing communication and a plan. If you're not sure how to get started, you might consider hiring a family transition coach to help. As an objective third party, your coach can help provide focus and will have experience with others who have going through similar transitions so that you don't have to start from scratch. In addition, a family transition coach will be knowledgeable about the many resources that are available to you and can facilitate necessary but difficult conversations and decisions. If you can anticipate the challenges you may face with your siblings in these circumstances it is likely that you can avoid some of the pitfalls.
Posted by Sheri Samotin on Thu, Jul 30, 2009
One of the toughest parts of being a family caregiver, especially a long-distance caregiver, is keeping all of the balls you are juggling aloft. The truth is, the more organized you are, the less stressed you will be. Checklists and calendars are a big help for keeping yourself organized. But family caregivers are often expected to keep others informed too and taking the time to make all of those phone calls can sometimes just be too much. There are many wonderful tools available that will help you facilitate communication between yourself and your care recipient, your caregiving resources, and friends and family.
Conference calls can be a terrific way to get far-flung family members involved with important decisions. For example, if you are the primary caregiver, but have several siblings who each live in a different city, you can use one of the many free conference call services to set up a number that each of you can dial into at the appointed time. In this way, all of those who should be part of the decision-making process can participate in real time. Similarly, if you are a long-distance caregiver, you might find it helpful to convene a monthly conference call with all of your caregiving resources so that everyone is aware of the others' insights and concerns.
Care pages are a great way to keep your care recipient's friends, family, and support network up to date on his or her condition and activities. Also free of charge, care pages are essentially personal websites or blogs. They allow you as the caregiver to post entries and photos, and allow visitors to post words of encouragement to you and your care recipient. You can set up the care page with various levels of security so you can control who sees what. This can be a really convenient way to communicate when you don't have much time; you determine when you post, and when you read what others have posted. Many people who have used care pages find that they develop a wonderful network of others in similar situations, a virtual support group!
Social networking sites like Facebook can serve a similar function to care pages, in that you can post updates which interested parties can follow. You can create various levels of security on Facebook, so make sure that you don't expose personal or medical information to the world. Similarly, there are many sites where you can set up a blog. You can then post your thoughts or updates and viewers can post comments in return. Blogs are generally very public, so you might find that a care page is a better tool for this purpose.
Finally, webcams allow you to get a visual on your care recipient if you are a long-distance caregiver. Unlike a phone call where you can only hear their voice, the webcam allows you to both see and hear the person on the other end. Many computers today have built-in webcams, and freestanding ones are available inexpensively. Once the webcam is set up, many care recipients are able to follow simple instructions to use them.
By putting updates in one place and allowing those who wish to do so to access them, you eliminate the need to make multiple phone calls. You are freed from worrying about whether it is too late at night to call your sister who lives three time zones away since she can read your update when it's convenient for her. Likewise, if all of those involved with the hands on caregiving report their activities and observations in one place, the information is available to all of the caregivers without the need for long conversations. As you can see, using technology can be a big help in your caregiving journey.
Posted by Sheri Samotin on Mon, Jul 27, 2009
Whether you are teaching your young daughter how to knit, or helping your aging mother balance her checkbook, how do you take charge without taking over? How many times have you found yourself "showing" someone how to do something by doing it for them? It's human nature. But while it might make sense to show by doing when you are "teaching" someone younger or less familiar with a particular topic than you are, it usually leads to anger when you do this when you are "assisting" someone with a task that he previously has been perfectly capable of handling himself.
It was probably hard enough for your mom to agree to let you help her pay her bills and balance her checkbook. And even once she agreed, it wouldn't be surprising if she told you that she didn't know why you were insisting on helping her since she is perfectly capable of doing it herself. The truth is that acknowledging that you need help with the business of life is really, really hard for most seniors. If they come to the point where they need your help, they are confronted with their own limitations. And those limitations won't "get better" in most cases. Deep down, your mom knows that this is the beginning of the end of her independence as she has come to know it.
So, how do you take charge without taking over?
1. If possible, do the tasks alongside your mom rather than doing it for her. While this approach might take longer than doing it yourself, you allow mom to retain some self esteem by letting her take the lead.
2. Let your dad tell you what aspects of a particular activity he needs your help with, and if possible, try to limit your assistance to just those things, at least for now. Of course, if your dad doesn't have a realistic picture of what he can do for himself, you will need to gently find a way to help him see your perspective.
3. Be respectful, and ask permission before you just jump in. For example, when you take your parents to a doctor's appointment, don't just assume that they want you to come into the examining room with them. Instead, ask them if they'd like you to be there the whole time, or if perhaps you can just be called in toward the end of the visit to make sure that YOUR questions are answered.
4. Set up invisible safety nets. For example, if you come every Sunday and set up your mom's medications in a weekly medication management system, you can have some expectation that she will take the correct medications at the right time. But it wouldn't hurt to also have a way of checking that once or twice during the week. This might take the form of a medication management visit by a home care company or trusted friend or relative or perhaps daily medication reminder phone calls from you.
5. Make a distinction between safety and everything else. When your dad's safety is on the line, you might just have to take charge by taking over. On the other hand, if you'd just prefer that something be done a certain way or at a certain time, there might be an opportunity to loosen the grip a bit.
Your job as your parent's caregiver is to keep them safe, comfortable, and happy. As long as you keep that in perspective you should have no trouble taking charge without taking over.
Posted by Sheri Samotin on Tue, Jul 21, 2009
If you are like most baby boomers, you're busy, busy, busy! Whether you do it with a PDA, a scratch pad and pencil, or all in your head, you're a list-making creature. With so many balls in the air, you don't want one to crash back down. You feel immense pleasure when you accomplish something and can cross it off that list. Your orientation is to "fix it", isn't it? Unfortunately, if you're the caregiver for an aging parent, you can't "fix it". Your parent's death is inevitable, and no checklist, no matter how well you accomplish all the tasks on it, will prevent that day from coming. Indeed, your aging parent is going through a natural process, and you can't make everything okay. All you can do is smooth that natural process through paying attention to your parent's needs. You don't have to have all the answers, and you'll probably never feel like you have all of the information you'd like, but you can still make good decisions.
The day you stop looking at your caregiver role as Ms. (or Mr.) Fixit is the first day of the rest of YOUR life. The next time you have a caregiving challenge, stop for a moment and think about the situation. What does your parent need? Are you sure this is what she needs, or are you making an assumption or projecting your own needs onto the situation? If you're sure about the need, then what are the possible ways to fill it? Is there really only the one way, the way that seems impossible right now and has you (and your Dad) so frustrated?
Let's take the situation of Lisa and her Dad, John. Lisa is in her mid-50s, is married, and has one teenager still at home and two in college. Lisa works full time outside the home. John lives about an hour away from Lisa and her family in a condo he owns. John is in his mid-80s and was widowed two years ago. Lisa's younger brother lives across the country. John's in pretty good health, but he's become increasingly frail over the past six months and seems to have lost a lot of weight. Lisa is worried about her Dad, but with her other responsibilities, it's hard for her to get to John's home more than once per week.
Over the past week or two, Lisa has concluded that John is not eating well and that's the cause of his weight loss. Every time she visits, she brings a load of groceries and meals she's cooked at home. Ms. Fixit to the rescue! Yet, on subsequent visits, the food is pretty much right where Lisa left it. She's frustrated because, "no matter what I do, Dad won't eat." When she begs him to eat, John gets angry and tells Lisa that he's just not hungry. The situation escalates, and ends with Lisa storming out of John's home in tears.
What if Lisa had stopped for a moment before her Ms. Fixit instincts kicked in? Instead of jumping right in to fix what she saw as a "problem", Lisa might have talked with John about how he was doing. Had she done so, she would have learned that John was very worried about his finances. He was afraid that he was going to outlive his money, and as a result, John had decided that he could get by on less. The last thing that John wanted was to be a burden on Lisa and her brother. So when Lisa starting bringing food to John, he felt guilty because exactly what he feared seemed to be coming true. He felt that if he didn't eat much of the food that Lisa brought, maybe she'd stop brining it, and he would find his way out of this cycle.
Had Lisa just asked the right questions and really listened to John's answers, she might have come up with another way to solve the problem. In any event, by allowing John to participate in the solution, she would have allowed him to preserve some of his independence and feel more in control of his situation. And Lisa herself likely would have felt less stressed and less frustrated. Of course, it's possible that John wouldn't have shared his fear with Lisa directly, but Lisa might have included John in identifying the problem and trying to solve it. Even if that approach failed, maybe Lisa could have arranged for some of John's friends to invite him over for dinner so that he would have the social interaction and not feel like a burden.
As the caregiver for your aging parent, you have many choices and decisions to make, and the sheer volume of what needs to be done can be overwhelming. To the extent that you can remember that it is not your job to fix everything, you and your care recipient will both be better off. Your job is to make the natural progression of aging easier for your parent, but as hard as you try, you won't be able to stop it. Once you can acknowledge and accept this reality, it will be easier to keep things in perspective. Your job is to do your best, and to do it with positive intentions.
Posted by Sheri Samotin on Thu, Jul 09, 2009
A recent NYTimes New Old Age blog post regarding funeral expenses offers lots of important information for caregivers performing their "final act" on behalf of their care recipient. While it is always best for the care recipient to make their final wishes known to their caregiver and other loved ones, we all know that this doesn't always happen.
The big debate in the comments to the post is about whether or not prepaid arrangements are a good idea. The post states that AARP and the Funeral Consumer's Alliance both advise against such plans. However, a number of the comments relate stories about why it WAS a good idea for their situations. In fact, the executive director of the FCA actually posted a comment giving their rationale, which is basically that each state has different laws and protections for consumers, and in some cases, when funeral homes or cemetaries are sold, the prepaid plans are not honored. However, he does acknowledge that a prepaid funeral might make sense in the case of a Medicaid spend-down for nursing home care.
One thing that is not covered by either the blog post or the comments is the notion of "pre-planning" vs. "pre-paying". While it might or might not make sense for your care recipient to pre-pay for his funeral arrangements, I can't think of a reason why pre-planning would ever be a bad idea. With pre-planning, the individual gets to decide exactly what he or she wants and that is documented by the funeral home of choice for later reference.
Posted by Sheri Samotin on Mon, Jun 29, 2009
If you are the adult child of an aging parent, you have probably asked yourself, "How do I know what type of help my aging parent needs?" Unless you are a senior resource professional, sorting this out can often seem overwhelming. So, here are six questions to ask to help sort it all out.
- What is my parent's physical condition?
- What is my parent's emotional condition?
- What is my parent's cognitive level?
- What financial resources are available to pay for help?
- What human resources are available to provide help?
- What input has my parent given on the entire topic?
Your parent's physical condition will help you determine such things as whether your parent needs help with activities of daily living (e.g., toileting, dressing, feeding, mobility), with medication management, or with managing medical conditions such as diabetes or using supplemental oxygen. Your answers will help you decide whether your parent's physical condition allows them to be safe in their current living environment without extra help, or whether you need to arrange for in-home help or possible transfer to an independent or assisted living setting. If your parent's physical condition is likely to be short-term, as when she is recovering from surgery, you have other options to consider, such as having physical or occupational therapists come to the home, or perhaps a short stay in a rehab setting.
Sometimes, your parent is physically capable of taking care of himself, but he has become isolated and is not engaging in social interaction with others. This might be simply because he can no longer see well enough to drive or because many of his friends have passed away and he lacks someone to "hang out" with. Whatever the reason, social isolation can often lead to depression or other emotional difficulties. If this is your situation, you might decide to look into available senior centers, adult day care, or companion services for your Dad. Depending upon your answers to the other questions, you might also consider an independent or assisted living arrangement since these environments generally offer a great deal of social interaction and stimulating activities.
Some of the toughest decisions come when your parent is memory impaired. If your parent wanders outside of the house and gets lost, or leaves the stove on overnight, she needs closer supervision. If she becomes agitated due to the cognitive impairment, she may require someone around all of the time to keep her calm. If your parent suffers from Alzheimer's disease, there are often physical considerations as well, especially in the later stages of the disease. As is always the case, safety should be your first concern.
When it's time to figure out what help to put in place, there is no way to escape thinking about the financial side of the decision. While some home care is covered by health insurance such as Medicare, most care related to activities of daily living is not. If your parent has long term care insurance, it will generally begin paying for services once your parent meets the policy guidelines, which typically state that a physician must certify that they have difficulty with two or more ADLs and that this state will continue for at least three months. Some long term care policies provide for "first day" coverage for in-home assistance or services within an assisted living facility. You need to know whether the care you seek will be covered by Medicare, and if so, you must use a Medicare certified home health agency. If you are paying privately, then you have the flexibility to use any agency or to use a private caregiver who is not associated with an agency. Be sure to take the time to decipher your parent's insurance policies in advance so that you have some idea about what will be covered.
Many families are able to take care of their aging parents themselves. This is especially true when there are many adult children who live nearby and who can take turns or divide up the duties. If this is the case with your family, it is helpful to sit down before a crisis strikes to figure out who has the capabilities and the time to do what. In that way, the entire family will function as a team, and if supplemental resources need to be hired, everyone on that team will understand why that needs to happen. Some families set up care contracts so that the family caregiver is paid by the parent for whom they are providing the care.
Last but not least, if your parent is able to provide input to this discussion, it is a good idea for them to do so. It is helpful to understand what your parent's desires are, and if practical, to honor at least some of them. This is not always possible, but when it is, it is an important step in the process of a smooth transition.
Posted by Sheri Samotin on Fri, Jun 26, 2009
This is the title for a very interesting blog post on the New York Times' "New Old Age Blog". Take a look at the posting. While the post itself is interesting, and covers the concept of care contracts for family caregivers, I find the discussion prompted by this post to be incredibly interesting. The points-of-view expressed make clear what an emotional and difficult issue we face as individuals and as a society. As with so many things, there is no "one right answer" for every family and every situation.
It is true that we place value as a society on the commandment to "honor your parents", but there are many ways to fufill this goal. Are we honoring our parents if we quit our jobs to care for them and by doing so, make it impossible to properly care for ourselves and our own children? You'll likely answer this question differently than I will, since we come from various faith traditions and family circumstances.
So, instead of pretending that there is "one way", why don't we acknowledge that therer are many ways, all equally valid, and work to support the way chosen by an individual family? If we can agree to that, we can focus our attention on putting the resources in place to support every one of the "ways".
As a family transition coach who works with baby boomers and their aging parents, I can assure you that some situations absolutely call for care contracts for family caregivers, while other situations do not. Let's not create a stigma or guilt for the caregiver who feels they need to implement such a contract. Instead, let's applaud him or her for rising to the challenge, and do everything in our power to make that journey meaningflul and as stress-free as practical.