I’m a loyal Grace & Frankie fan. Partly for the house porn (that beach house!!), but mostly for the hilarious family drama. The show creators have a firm grasp on real struggles confronting each generation, and Season 4 hit a nerve about a particularly sensitive topic for an aging population: When is it time to move to assisted living? And what happens when adult children are involved making that decision?
Cognitive and physical ability play a huge role, but so do family dynamics and money. National surveys showed it can cost $8,121 per month to live in a nursing home. With an average stay nearly two and a half years, that’s over $240,000.
If you’re a Boomer or Gen X-er, you may be wondering how to navigate this conversation with your parents. You aren’t alone. You want to make sure they’re protected financially, while also receiving the best care in the most comfortable environment. Here are five ways boost your confidence and prepare for a productive talk.
1. Be Empathetic and Take the Conversation Slowly
For the Grace & Frankie crowd (potential spoiler alert), you know that underhanded tactics and a series of events misinterpreted by their children landed them in an assisted living community prematurely. Then it’s revealed a dear friend of theirs moved to assisted living for a very good reason – early stage dementia. But Grace and Frankie had a business to run (which wasn’t allowed), hobbies to keep them active (also not allowed), and love lives to cultivate (difficult in a tracksuit).
Jokes aside, lifestyle preservation is a main concern for retirees. Take stock if a move into assisted living would truly enhance their lives, or if it’s a move that would only put you at ease. As the adult child, lay the groundwork over many conversations to understand their desires if they need help with daily living tasks.
Luckily, it’s increasingly possible to remain in their home if they wish. New services such as Instacart, Uber, and Task Rabbit accomplish chores they might not be able to complete, and at a much lower monthly price than moving into assisted living. Honor is like the Uber of home health aides and promises to provide flexible skilled nursing care that you can trust. These are all options not available a decade ago.
Hopefully the decision to move into assisted living is made by your parent or parents. But you might feel pressure to make decisions quickly if they’ve had a recent accident or diagnosis. Assisted living and nursing home communities can have waitlists to move in, so having time on your side is a huge asset if they want to make the move.
2. Learn About Long-Term Care Insurance Policies
Long-term care insurance will cover a specified amount of care should your parent lose the ability to complete two or more of six ‘daily living activities.’ These six activities remain constant among insurance providers, but the point at which a person becomes unable to perform them is subject to a nurse’s evaluation.
- Going to the bathroom (hygienically)
- Continence (physical ability to control functions)
- Transferring in and out of bed or a chair
The first generation of long-term care policies weren’t great, but there are different types of policies now. Traditional policies were expensive and the premium was lost if you never made a claim. Companies have since created hybrid policies, such as those offered through Lincoln Financial or Pacific Life. They offer the same protection, but with this new breed of policy, you don’t have to turn on the long-term care rider if you don’t need it. Also, because it’s life insurance, you can leave a benefit to your heirs when you pass away. Many of these insurers offer assistance finding a home health aide or caregiving facility once it’s needed.
If long-term care insurance is something they’re interested in, take note: the underwriting process can be lengthy. It’s best to apply early, which can mean somewhere in your 50s, although it’s still possible to get good rates if you are healthy in your 60s. Seemingly routine medical procedures, like a cortisone shot, can potentially delay an insurance application for six months or a year. Each year you wait can decrease the chance of being accepted, and may significantly increase the premium costs.
3. Read Up About Government Programs
The United States Government doesn’t have their back. Medicare, a publicly funded health insurance program, isn’t designed to cover the cost of assisted care due to natural aging, like a home health aide or assisted living facility. Medicare is for hospital stays and acute care immediately after a hospital stay, such as after a stroke or car accident.
Medicaid is the government program that would cover long-term care expenses, but you have to be impoverished to qualify. Not only that, if one spouse uses Medicaid assistance while the other is still living at home, the home could be subject to a clawback once the Medicaid recipient dies.
Medicaid is complicated, so it’s best to consult an attorney about a plan for protecting their home, bank accounts, and investments. Check out a few trusted law offices nearby to see if they offer any seminars to get started.
4. Understand There May Be Another Option
So what happens to folks who don’t qualify for long-term care insurance? People of any age can ‘self-insure,’ for financial emergencies. This means they have dedicated money set aside for that specific scenario. For your parents, it would be money only to be used for assisted living or nursing home care.
The question remains, how much is that? There’s no way to predict the future, but medical expenses aren’t getting cheaper. Bear in mind, self-insuring is usually done by wealthy individuals. Setting aside a few hundred thousand dollars would probably cover nursing home bills for a year or two. That doesn’t include medical equipment, drugs, or treatments.
5. Think About Your Involvement Level if Their Health Takes a Quick Turn for the Worst
Who is responsible for taking time off work to provide care or locate professional help? Do you or a sibling live nearby and have the ability to drop by multiple times per day in the meantime? A family member who provides dedicated care will probably need to take a medical leave from work. Are you able to do that without creating a financial burden on your own family?
There’s a chance your parents think you or a sibling will be their caretakers when they’re older. Or they haven’t thought about it at all. Avoidance is a very common approach to uncomfortable conversations. You need to be clear about your ability to help if the need arises.
These can be difficult conversations to have. You know your parents best, and chances are they know they’ll need help at some point. Leading with compassion, and being vulnerable about your own concerns for their health and wealth, will go a long way to show you have their best interest at heart.