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More how-to guides for life
Sunday, July 14, 2002 - 12:00 a.m. Pacific

How to's for life
A monthly guide

ArtHOW TO
GET STARTED
WITH ELDER CARE

By Catherine Tarpley,
Seattle Times staff reporter

Do we ever get over the realization that, contrary to what we believed when we were 3, our moms and dads are mortal? Here's what the experts advise: Recognize that your parents will likely need care some day. Get involved in elder-care planning while they're still able to make their own decisions: What do they need you to know? What do they need from you in a crisis? Do you know how to find the deed to their home or what pressing bills to pay if they are suddenly hospitalized? What follows could help start what is one of the most difficult but important conversations parents and adult children can have. And remember that you will be there someday, too. The following advice can help you plan for your own aging.

INDISPENSABLE DOCUMENTS:
Only about 30 percent of American adults have wills. If your parent is a Washington state resident, and he or she dies without a will, the estate automatically becomes the next-of-kin's inheritance.

START
TALKING
John Schenk
John Schenk, retiree:
Talking to parents
"It's best to talk about it when things are normal. I can even joke about it now, but on my deathbed I don't think it will be so funny."

Talking to kids
"Leave clear instructions in letter form. Make sure (your kids) know it's been done."
"I'm going to tell them that the one who doesn't want to talk about it gets stuck with the piano or something none of them want. It's probably easier if you can kid around about it."
LONG-TERM CARE OPTIONS:
Sadly, 85 percent of long-term care decisions are made after an older person has already reached a medical crisis. Discuss elder-care options with your parents now, so that you'll know later that you're doing the right thing by them. Your options include:

• Retirement communities.
• In-home care.
• Assisted living facilities.
• Adult family homes.
• Nursing homes.

CHOOSING A LONG-TERM CARE APPROACH:
As you and your parents make elder-care plans, be sure you take into account the following factors:

• The level of care your parents might need.

• The money that will be available to pay for such care.

• Special considerations, such as whether your parents smoke, use wheelchairs, or can no longer drive a car.

• Your own ability to monitor the care your parents are getting.

FUNDING CARE:
Nursing homes cost between $40,000 and $80,000 a year. Don't count on Medicare to cover these costs. Eligibility is short-lived (usually no longer than three to four weeks) and limited to people needing rehabilitation services. More commonly, your parents will have to use one of the following means to pay for care:

• His or her own money and assets.
• Medicaid.
• Long-term care insurance.

START
TALKING
Liz Taylor
Liz Taylor, founder, Aging Deliberately:
Talking to parents
"Sit down and talk from the point of view that it's a family issue. Don't use a lot of 'you shoulds.' Start by asking questions."
GETTING STARTED:
A 2001 AARP study found that while 75 percent of adult children worry about their parents' elder-care plans, a third never discuss it with their parents. What kind of care is available for your parents if they can no longer live on their own safely? How will you know when they've reached that point? Numerous agencies in the Seattle area can help you and your parents discuss these issues now.

• Senior Information & Assistance, a division of King County Senior Services: 206-448-3110; 800-972-9990; www.seniorservices.org.

• King County Long Term Care Ombudsman Program: 206-623-0816; www.ltcop.org.

• AARP: 206-517-9348; www.aarp.org.

MAKE SURE YOU TALK TO YOUR PARENTS ABOUT:
• Durable Powers of Attorney for health and finances.
These permit your parents to designate someone to make legally binding decisions should they become incapable of doing so, ranging from their medical care to housing to signing checks.

• Living will (or "Directive to Physician").
What medical care do your parents want as they are dying? Do they want aggressive medical intervention? Living wills offer good guidelines to families and can prevent squabbles among relatives in crisis.

• Contact information for doctors, dentists, banks, accountants, lawyers, insurance agents, etc.

• Medicaid, Medicare and Social Security ID cards.

• Deed to house and other properties.

• All insurance policies, including health, life, car, disability, mortgage and homeowner insurance.

• Living trust documents.

• A list of assets, including checking, savings and money-market accounts, securities including stocks and bonds, titles to all vehicles, retirement accounts, etc.

• A list of debts, including loans, credits cards, etc.

• A list of monthly household bills that should be paid if they are ill.

• Copies of tax returns.

• Funeral plan.

AGING AND DRIVING:
The normal retina receives only a third as much light at age 60 as at age 20. So as people age, it gets riskier to drive at night or turn off the lights in the house.

Evaluation: If you or your parent is worried that he or she can't perform some tasks safely, you might want to seek a professional evaluation from an occupational therapist or, if the parent's driving is a concern, a driving test which the Department of Transportation will perform on request.
SIGNS THAT SOMEONE MAY BE READY FOR ELDER CARE:
One percent of Americans between ages 60 and 64 suffer from some degenerative brain disorder, but the incidence jumps to almost half for Americans over 85. Experts say that many families ignore early signs that a parent needs care. Even if your parent seems to be fine, you may want to seek a professional evaluation if he or she:

• Has repeated falls.

• Lacks energy to take care of himself or herself.

• Is depressed.

• Neglects hygiene.

• Constantly forgets words or doesn't understand numbers.

• Stumbles but doesn't break the fall.

• Loses interest in old passions and hobbies.

• Doesn't seem to comprehend what's going on in his or her immediate surroundings.

• Seems to be eating or sleeping less, or sleeping more than normal.

• Insists he or she is taking care of basic needs, such as housekeeping, when clearly that isn't the case.

Illustration by Paul Schmid, Seattle Times news artist


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