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Oregon Senior Referral Agency Association Raising Industry Standards since 2004

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Be Smart About the Costs of Moving Mom In With You

Be Smart About the Costs of Moving Mom In With You

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As our parents age and become frail, we start looking at different care options. If you or your sibling is thinking of moving mom in with you, carefully consider the costs. Know what you’re getting yourself into.  

Most adult children are usually motivated by a deep love for their parent. They’re committed to providing the best. They feel no one can do a better job of caring than family.

While you may agree with that sentiment, be sure to examine your motives. Before making any commitment, start by answering your ‘why’.

Is it a philosophical belief that ‘family takes care of their own’? Or do you hate seeing all mom’s assets spent on a facility? Or do you feel obligated because of promises made long ago? Or do you feel guilty and want to live up to your parent’s expectations?

Whatever your reasons, clearly define them. They’ll help you create healthy boundaries and expectations of your own.

After you’re clear about your ‘why’, consider the impact of multi-generational living on your finances, relationships, and personal space.

Financial Costs

People often under-estimate the financial costs of caring for a parent. And expenses go up as they age. These costs include possible income loss, remodeling, and hired care.

Potential income loss

People often under-estimate the financial costs of caring for a parent. And expenses go up as they age. These costs include possible income loss, remodeling, and hired care.

Studies show that:

  • 33% of working women decreased work hours
  • 29% passed up a job promotion, training or assignment
  • 22% took a leave of absence
  • 20% switched from full-time to part-time employment
  • 16% quit their jobs
  • 13% retired early

Considering that, think about whether someone will have to quit work when mom or dad moves in. Can your family afford the reduced income plus the increased costs of food and utilities? Will you parent contribute to the household expenses?

Potential remodeling costs

First assess your home for safety, accessibility, and logistics. You may decide to expand your home, remodel a bathroom, build ramps, or build a separate “granny pod”.

Do your research on estimated costs. Can you afford it? Will it increase the value of the property?

Will your parent contribute financially to the remodel? If so, what reimbursement will they get if you sell the home? And if something unexpectedly happens to your parent, will you reimburse their estate?

Potential care costs

Your mom might move in with you while she’s still cognizant, ambulatory, and continent. But as she ages, her abilities will likely change. If you’ve never been a caregiver, you’ll be surprised by how hard it is.

Family caregivers often don’t realize how stressful care giving is. It’s a 24 x 7 job. You’re constantly taking on new care tasks – ones you’re not trained for. They often report feeling exhausted and depressed. Caregivers report finding it difficult to maintain a healthy balance in their lives.

Family caregivers underestimate how much support they’ll need. And for many, it’s hard to ask for help. They often put unrealistic expectations on themselves. They try meeting every need and be the ‘perfect’ child.

Respite breaks are essential for a caregiver’s well-being. So ask yourself, ‘Who else can help with increasing care demands’? Family, siblings, relatives?

Can you or your parent afford hired in-home caregivers? If not, are there other family members who can chip in?

Get a realistic picture of what it means to be a caregiver.

  • Read personal stories from caregivers.
  • Watch how-to videos on YouTube. Things like how to safely transfer someone, give showers, and help with incontinence.

Relationship Costs

Moving a parent in with you is a family decision. Even if you’ll do most of the work, everyone must be on-board. Many marriages have split over the change in duties, roles, and relationship dynamics.

Siblings and extended family

This includes having a conversation with siblings and other extended family. It’s an emotional time. You’re acknowledging your parent is aging and needs help. And you won’t be able to do it alone. Find out who’s willing to help and how.

Additionally, prepare for sibling disagreement. Past roles and relationships can come into conflict. Your motives will be questioned. Make sure everyone’s viewpoint is heard.

Try to keep the discussion focused on the well-being of your parent. And expect everyone to have different ideas about how to best meet those needs.

A word of advice: consider hiring an elder mediator, social worker, or elder advisor to act as a guide.

Your relationship with your parent

Similarly, consider the relationship you’ve historically had with your parent. Has it been easy going or fraught with tension? Has your dad been controlling? Or your mom been a complainer? Have you felt they’re impossible to please?

If that’s the case, it probably won’t change. In fact, living with your parent as an adult will likely bring up a lot of emotional baggage from the past.

When 3 generations or more live under one roof

What’s more, if children still live at home, they may need extra attention. Especially if they’re asked to give up their room for grandma. And what about if you have a blended family? Will your stepchildren cope?

Living under one roof won’t be like in the TV series, The Waltons. Consider your parent’s attitude about kids. There’s a big generation gap between acceptable lifestyles. Your dad or mom might voice strong opinions; which likely won’t go over well. Are you ready to act as peacekeeper?

Factor in illness or dementia

And your kids will need help understanding what’s happening if your parent has an illness or dementia. Irregular behavior by a grandparent may scare or embarrass your children.

Let your kids know that they are not the cause of their grandparent’s possible anger, weeping, or fear.

Seek out books and videos from the library. Read them together and discuss the questions that come up. Talk about ways they can deal with the situation.

Your parent's social needs with peers

While we’re discussing relationships, think about how living with you will affect your parent’s friendships. Will their friends feel comfortable visiting? Will you take your parent to the senior center or church groups for socialization?

Finally, think about if your parent will get lonely and isolated if you’re still working outside the home. Plan ways they can keep up the activities they enjoy.

Costs on Your Space, Time, & Routine

For most of us, our home is our refuge. It’s where we relax and turn off the world. When your parent moves in, you may feel your space invaded. Your home is no longer your home.

Most likely you’ll find your schedule and time now revolves around someone else’s needs. You’ll cook differently. You’ll find a corner of your mind is always listening in case mom needs something.

Interruptions

For instance, if you work from home, anticipate interruptions. A knock on the door. The intercom beeping. Dad has a question or needs help in the bathroom.

Similarly, if you and your spouse are watching a movie how will you feel about your parent joining you or interrupting you?

Privacy and personal space

Your parent doesn’t need to know everything that’s going on in your personal life. Set boundaries and expectations. This is a role reversal and you may feel uneasy doing it. But this is the time to work it out or readjust your thinking.

While you are your mother’s daughter (or son) you’ve both evolved over time. You may not share the same opinions, standards, politics, values, or belief systems now. Agree to disagree. Steer clear of criticism and judgement.

In Summary

Without a doubt, moving your parent in with you (or your moving in with them) can bring about a closeness you never had before. It’s an opportunity to put love into action.

On the other hand, it’s not for everyone.

Carefully think about why you want to be their primary caregiver. There’s no guilt if you don’t choose this path in order to love and care for them.

Then factor the financial, relationship, and personal space costs.

Leave a comment below to let us know how this article helped you.

We have a library full of great information to help you navigate the aging process. Be sure to check out these other articles too.

Need a Senior Advisor to help guide your decisions?








Having “The Conversation” About Moving to Assisted Living

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Kate called me last month asking about assisted living options for her mother. Mom had been living at home by herself and was doing fine (her words when family checked in on her by phone).  It wasn’t until there was a family gathering at Mom’s house that they realized things weren’t as “fine” as they thought. The milk was expired and the bread was moldy. Piles of bills and other paperwork covered all the tables, unread newspapers were piling up by the front door and the yard which she took pride in was obviously untended.  Everybody could tell Mom had lost weight, her clothes and her house were very dirty and she seemed confused.  The family got together and decided she wasn’t safe to be at home any longer and needed to move somewhere where she would get some assistance.  We toured several assisted living buildings and found one the family thought was perfect. Next came the question I dreaded “How do we tell Mom she needs to move?”

According to recent Marist research, 80 million Americans are reportedly conversation avoiders, meaning they haven’t talked about any important end-of-life issues with their parents or children.  In addition, research by Home Instead Senior Care revealed 70% of family conversations about aging are prompted by an event such as health crisis or other emergency.

Why aren’t families talking? It’s difficult! Research by Home Instead Senior Care indicates a majority of adult children (54%) described their critical conversations with parents as uncomfortable at times, difficult but necessary, emotional with yelling and tears, or difficult and unsuccessful.  How do we get the conversations started earlier so it’s not prompted by a crisis?

Home Instead Senior Care has very comprehensive materials on getting the ‘talk’ started and focuses on areas such as driving, health care, relationships and dating, end of life.  In an effort to guide Kate, in the example above talking about the future far in advance of the crisis would have helped a lot.

Starting the conversation is the hardest part. Caring phrases can get the conversation going. “I know we want the best for one another. Let’s talk about options that will work for both of us” or “I know you want to remain home for as long as possible. But I want you to be safe. I’d be less worried if we had a plan now in case something happens in the future.” “I know you want to be independent as long as possible, let’s make short, medium and long term plans and define what may trigger implementing each of the plans when necessary.”

During the conversation ask questions such as “What if you could no longer drive, what would you want to do?” “If you’re unable to navigate the stairs in your house what would you do?” “Where would you live if you have to make a change someday?” “Who (or what) do you want to live near?” “What can you afford?” “Do you have long term care insurance that would help pay for care at assisted living?” “What activities are important to you that you want to continue doing if you move in to assisted living?” “What possessions are important to you that you must have if you move to assisted living?” You may want to tour some assisted living communities to see what’s available and choose where to go when the time comes. Document the plan and keep in a safe but accessible place so it’s readily available when needed.

Making decisions, identifying choices and conveying wishes are an important part of the road ahead. Working together to develop the plan helps Mom feel like a part of the decision rather than having the decision made for her. By having the conversation early you’ll both feel more comfortable with the aging process and you’ll avoid having to make decisions during a crisis.

There Comes a Time in Every Family

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Judy, age 80, had been her husband John’s caregiver for the past 10 years; ever since his diagnosis of dementia. Now she was starting to see her own health fail as a he began getting agitated in the evenings and would frequently be up at all hours of the night, convinced he needed to go “home”. As much as Judy would try to soothe and reassure him, John’s agitation continued to increase.

The couple have 2 very supportive adult children who were becoming increasingly concerned about how all the stress was affecting their mother’s health. They were worried she might collapse from all the pressure and lack of sleep. They realized something needed to be done so they called a family meeting.

During the course of the meeting Judy made it very clear that the most important thing to her was that she and John stay together, no matter what. They had been married for 55 years and she wasn’t about to leave his side now. Sarah, the eldest daughter, had spoken with a friend before the meeting who suggested they call a placement and referral specialist who could help sort out available options. Sarah was pleased to learn that the agency would not charge them for services, that instead, the agency contracts with communities themselves for payment. Sarah made arrangements for the Placement Specialist to meet with them.

At the consultation the family learned there were basically 3 choices available; hire care to come into the home, John and Judy could move to a community together that offered Independent Living for her and Memory Care for him, or Judy could stay at home and find placement for John. Everyone knew what Judy’s choice was.

As the situation unfolded, the family learned that it could cost upwards of $6000-$8000 per month for Judy and John to live in a community that met both their needs and a whopping $10,000 per month to have a caregiver from an agency in their home to help 24 x 7. At this point Judy agreed they would have to rethink their strategy.

The couple owned their home free and clear, they had downsized to one car and had about $150,000 in investments. As they continued to explore more affordable options, the referral agency was able to guide the family toward looking into having John move into Memory Care somewhere relatively close to Judy. That way she could visit as often as she liked without having to be the one responsible for care, and could just enjoy being with her husband without all the headaches and stress.

The Agency, looking longer term, suggested they explore Assisted Living/Memory Care communities with a Medicaid contract. That way, if Judy decided at some point she would like to join John, she could, having the security of knowing if they ever spent down their assets, they could both stay.

The placement specialist also recommended the family see an Elder Law Attorney to make sure they have everything in order and are knowledgeable about their rights. The State of Oregon has laws that protect “the community based spouse,” that is, the partner who stays in the home, making sure they do not become impoverished by spending all the couple’s assets for their spouse’s care. Medicaid planning is one of the many services in which Elder Law Attorney’s specialize in.

If you are in need of guidance or just have questions regarding a friend or family member who is having trouble managing independently, call a member of OSRAA for professional guidance.

 

[author] [author_image timthumb=’on’]http://osraa.com/wp-content/uploads/2014/04/highres_11658246.jpeg[/author_image] [author_info]Michele, a native Oregonian, was inspired to begin Lets Share Housing out of a passion for making a difference in the lives of our boomers and seniors. She was introduced to the senior housing industry by having owned and operated an Adult Care Home of her own from 1997-2000. In 1997 she also founded Adult Placement Network, an agency that assists families find the most appropriate care setting for their aging loved ones. Having spoken with thousands of people, each with their own unique situation, Michele began seeing a huge population that was not being served by the system; those that had a limited income but no care needs. Lets Share Housing was then born to offer a vibrant, sustainable and affordable alternative to what is presently available.[/author_info] [/author]

 

 

Stroke? Too Close to Home!

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A very close friend and her family have recently experienced a tragedy that so many other families experience every day.  I asked to her to write about it to share the many valuable lessons she and her family learned…. here is what she wrote.

The medical stories about people experiencing a heart attack or stroke are in the news every day, I heard them but I really didn’t pay much attention. For me those stories took place far away and to other people.  Then in an instant my 72 year old thriving father collapsed from a stroke. It hit without warning in a restaurant during a busy lunch rush. From the moment I heard the news I was on crash course of learning about the intense world of stroke recovery. I hope the dreaded moment never touches someone you love. However, I wanted to share a few initial experiences I had with my dad.

I could come up with well over a 100 lessons to share, but I’ll keep my list to ten…

  1. If you are the first family member to arrive at the hospital and the doctor reviews the facts with you, you’re now the family messenger. It’s up to you to get the word out and with details.

  1. Do not leave your loved one alone. I thought, “Dad’s fine, he’s in a hospital with 24 hour care.” I couldn’t have been more wrong. With the damage from the stroke and heavy medications there was NO way he could find the “call button” for help. My mom, brother, sister and I broke up the 24 hour day into shifts. I took the 9:00pm to 7:00am shift to be at my dad’s bedside. There were countless moments when he reached out for a hand to hold, needed more pain medication, a pillow to be adjusted, a warm blanket for his partially paralyzed body, his eyes covered at 4:30am when hospital staff would blast into the room and turn on the overhead lights to take a blood sample and so many more tasks in the role of patient advocate.

  1. Hold off assuming a nurse’s denial of a request is just plain mean. When dad arrived at the hospital he was so thirsty. I didn’t understand why they wouldn’t let him have an ice chip or a sip of water. Later I found out they hadn’t tested his ability to swallow yet, they were looking out for his safety.

  1. Don’t take children to visit too soon. Let some healing occur. I waited for nearly a month before I took the kids to see him. It was a heartwarming reunion. Dad was in a wheelchair with a smile, and not hooked up to IV’s, writhing in pain or fading in and out of a sedated sleep.

  1. Communicate the good and the not so good with family and friends. Honesty can be difficult when you feel you must be stoic for everyone. Accept help. One of the greatest gifts of support was from a dear friend who gave three hours of housekeeping.  Use your support system.

  1. Celebrate the most simple of achievements. We wanted to bring out the pompoms and marching band when dad brought an ice chip to his mouth with a spoon for the first time.

  1. Record voices and moments. Four days after his stroke I asked my dad to record a message to his grandchildren. His words were slurred, his thoughts were slow, but he told them how much he loved them. A few days later I recorded him again. He found such motivation from hearing how far his speech had improved in less than a week. His grandchildren also heard his improvement.

  1. Caring for a stroke patient is exhausting. Dad was with 24/7 hospital care for five weeks. The very hard work started when he came home. I had no idea!!

  1. There will be many tears. There will be many heart wrenching moments. There will be many heartwarming moments. There will be smiles and laughter along the way.

  1. Family life won’t be the same, but be realistic, learn and grow from the personal challenges of being exposed to the cruel and anguishing experience of stroke.

Our family is now in the early process of selling my parent’s two level home on the Oregon coast and building a one level ADA home near the family in Portland, Oregon. We feel such peace knowing if their house sells before the new one is ready, the placement and referral service I have selected to work with is right there to find mom and dad a temporary senior living environment with all the amenities they could possibly need.

[author] [author_image timthumb=’on’]http://osraa.com/wp-content/uploads/2014/03/Cherie-Henry-Pic.jpg[/author_image] [author_info]A member of the “golden girls” team at Golden Placement Services, Cherie is a senior housing and transition specialist. She has extensive experience as a licensed administrator in assisted living communities. Cherie has a passion for making sure seniors are secure, comfortable, and happy, so she works diligently to ensure they find that right place. Cherie has been happily married to her best friend for over 30 years and loves travel and golf, preferably together.[/author_info] [/author]

Plan Ahead for Long Term Care Decisions

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As referral and placement professionals, we are accustomed to receiving frantic calls from families, social workers, and care managers who are working with someone in crisis who needs placement.  These situations may arise when insurance no longer covers a hospital or skilled nursing room, or a loved one has reached the limits of being able to stay at home.  No one wants to face the idea of moving into a care setting, however, planning ahead can save considerable stress and anxiety when it comes to finding a home for a loved one.

Do the research early- there’s a lot to see.

Even if you have no intentions of moving a loved one anytime soon, it can’t hurt to put feet on the street and see what’s out there.  In the greater Portland metro area, the options range from large retirement communities and assisted living complexes, to micro-communities, residential care, and adult care homes.  Each of these options has pros and cons and offers a variety of amenities depending on the level of care.  What’s important here is to know what these levels offer should your loved one need them.

Do the research when your loved one can participate in the decision making process.

If your loved one has had a chance to participate in this process, your job becomes much easier once the time comes for a change.  Not only will your loved one have their own opinions and preferences, they will give you insight on things to look for that you may not have thought about that may be important to them.  In fact, they might like what they see and kick-start the transition without a crisis event.

Do work with a placement and referral professional.

We highly recommend working with a reputable agency to guide you through the process of finding care options.  The search for the right fit can be overwhelming and very time consuming.    This is not a one-time phone call.  When you decide to work with a placement and referral agency, you have enlisted an educated, in-the-know-advocate for you and your loved one that will work with you from start to finish.  They will take the time to understand your situation and present options to fit you and your loved one’s needs, desires, and budget.  In addition, these agencies have done their homework and have checked the Public Disclosure Files on long term care settings to research complaints and violations.  To find agencies who are members of OSRAA, click here.

Do place a deposit if you find something you like.

Most settings will accept a small refundable deposit that puts your name in the queue when a vacancy matching your preferences becomes available.  If you are not ready when they call, they simply move to the next name on the list.  At this point, you are in their system and have a better chance of getting what you want.

Do expect the unexpected- but now you are an informed consumer.

Life Happens.  Your loved one might have a crisis that forces you to make placement decisions.  Your first choice may not be available, or no longer appropriate.  However, you have done your homework and have a plan B, and C.  You will also have a placement professional by your side every step of the way.