Photo by Flickr user Beth Kanter
Photo by Flickr user Beth Kanter
Aging issues don’t come with instructional manuals. Only when life forces us to shoulder the role of elder advocate do we begin to face the complexities of transitioning aging loved ones into eldercare.

There are different stages of aging. A comprehensive action plan will enable you to become an effective advocate for your aging loved ones. First, you need to assess your loved one’s situation, overcome objections and then create and implement a blueprint for care.

One family’s story: At a crisis point

A middle-aged man shared with me that his aging parents (both in their 80s) were still in their own home. He was concerned for their safety and well-being. His stepmother has multiple sclerosis and is legally blind. His dad is her primary caregiver, but he is starting to have cognitive issues. Because she needs a watchful companion whenever she leaves the house, his stepmother isn’t getting out much. Their home is two stories, and that presents some “aging-in-place” concerns.

Dad does the shopping but won’t make grocery lists, forgets the few things Mom requests and then gets angry if she points out his forgetfulness. Dad is unwilling to accept help and will not logically discuss the issues at hand.

The man’s stepmother is difficult and often triggers arguments with his dad.

The son has found scorched pans. The once-well-stocked pantry is looking sketchy; there’s an odd mix of staples, making healthy meal preparations difficult.

Dad is not transferring funds correctly because he has been complaining about bank-overdraft fees.

The son is concerned and wants to know what to do.

Often, families wait until there is a crisis to take action and seek help. There are important conversations and preparations that should take place while your parents are fully competent.

First, determine their wishes. The topics for discussion: their physical risks, nutrition, safety, transportation, home maintenance, medical care, socialization, financial stability and potential temporary and long-term care and living solutions.

Second, review their daily activities. In a family meeting, discuss the types of assistance available. Are their personal needs being met? What financial resources are available for care and assistance? Do they have long-term-care insurance? What are their wishes concerning life-sustaining measures? Would they qualify for government assistance? 

Step-by-step solutions

For the concerned son, I suggested he make a list of their doctors and medications and set up a series of medical, financial and legal appointments. With memory issues, a medical assessment is the place to start.

On the legal and financial front, it’s desirable to have a signed medical directive, a durable power-of-attorney for health care and another for financial matters, and a properly written last will and testimony, which will avert disagreements over the estate.

Another key decision for the son: Where can his parents safely and comfortably live? Should they stay in their home?

Seattle has a bounty of credible senior-living facilities. In this case, we told the son to consider caregivers in the home and to investigate assisted-living providers and adult family homes. Assessing the best senior-living options requires time and diligent research.

Through the son’s efforts, medical evaluations were completed and the medical staff arranged for an additional evaluation by a social worker.

To buy time and to complete his research on senior-living options, the son hired temporary in-home caregivers. The caregivers did the grocery shopping, prepared meals and provided safe transportation for outings and doctors’ appointments.

After completing his research, the son made two decisions. He decided that, after using in-home care providers, his dad and stepmother could afford to stay in their home for the foreseeable future and have the help they need.

If maneuvering about in their two-story house becomes problematic, he found a senior-living facility with an excellent reputation. His parents can afford to live there, and the facility guarantees a continuation of care: If and when they transition from private-pay to state-provided financial aid, they can continue to reside there.

These decisions are better made when one is not in crisis mode. While your parents are able, have the all-important conversations about care and living transitions. 

MARLA BECK is the founder and president of Andelcare Inc., which provides in-home eldercare. Beck was recognized by the U.S. Small Business Administration as Washington’s 2012 Small Business Person of the Year. Submit questions by calling (206) 838-1844 or via e-mail to