Caring for Aging Parents: Plan Early, Talk Often


It's called the Sandwich Generationâ€"that group of middle-aged Americans who, in increasing numbers, are finding themselves caring for both their children and their parents simultaneously. And as the multitude of baby boomers storm into their 60s and beyond, more and more individualsâ€"including physiciansâ€"are expected to join that unenviable clique.

“From caring comes courage.”—Lao Tzu

It’s called the Sandwich Generation—that group of middle-aged Americans who, in increasing numbers, are finding themselves caring for both their children and their parents simultaneously. And as the multitude of baby boomers storm into their 60s and beyond, more and more individuals—including physicians—are expected to join that unenviable clique.

With membership comes the demand for time and money to help care for their aging parents. And in most cases, explains Jeannie Keenan, a health care manager with My Health Care Manager, the cost of that care is often underestimated.

“They have no idea,” says Keenan, referring to the lack of education in this area. “To have a basic caregiver in the home, 24/7, we’re talking more than six figures a year. It’s at least $10,000 a month.” And cost is only one part of the challenge.

Get Affairs in OrderShelle Womble, with ResCare HomeCare, has been working in the field of geriatric care for more than 17 years. What she has seen, over and over, is the sense of denial when it comes to planning for the time when parents are no longer able to function with the level of independence to which they’ve grown accustomed.

“There are a lot of good long-term care insurance policies out there right now,” Womble says. “But I always hear people say, ‘I’m too young for that.’ But when the house is on fire, it’s too late.”

Brian Carpenter, PhD., assistant professor of psychology in Arts & Sciences, Washington University in St. Louis, specializes in psychological issues influencing family relations later in life. He says it’s extremely important that conversations with aging parents take place as early as possible, before cognitive abilities begin to decline.

“I’ve heard many people start the conversation by talking about wills, or living wills, that take into account their healthcare preferences,” Dr. Carpenter explains. “Some families may have a friend or another family member who has experienced a medical decision, and the children could say to their parents, ‘You wouldn’t want to get into the same situation as your friend down the block, would you?’”

A Delicate Conversation

Talking about care and living preferences is one thing; talking about money with aging parents is another. It’s a topic that many middle-aged children find difficult to broach with their parents. That’s because people, says Dr. Carpenter, have a lot of psychological feelings about money. “It’s hard for children to imagine bringing up a conversation about money and not seeming as if they are interested in their parents’ inheritance,” he explains. “But these are important conversations for families to have.”

Part of the problem is that today’s middle-aged children often are unaware of not only their parents’ finances, but also their preference for medical care and living arrangements. A study Dr. Carpenter conducted in conjunction with the Visiting Nurse Service in New York City found a considerable disconnect when it comes to children predicting their parents’ preference. According to the study, children were only moderately accurate in the area of Caregiving, and only fair in predicting their parents’ preferences in the area of Autonomy.

“Different families are going to feel differently about privacy and what they want to share about their financial arrangements,” Dr. Carpenter explains. “But a good rule of thumb is the more open and honest you can be with each other about available financial resources and how those resources should be spent, the better.”

Keeping a Watchful EyeWhether across the street or across the country, innovative companies have developed tools to help middle-aged children care for, and watch over, their aging parents. Keenan explains that sensors can be installed in a home to detect if someone falls. Telephone systems phone in several times a day, and if the individual doesn’t answer, an alert system will contact a neighbor.

“The same sensors can tell you how many times somebody got up during the night, if they went into the bathroom, did they exit the bathroom, and provide an electronic report every day,” says Keenan.

In addition, cameras can be installed in a home for visual check-in. This option, says Womble offers family caregivers the ability to see if their parents have changed their clothes, or even if they have taken their medications as instructed.

“Families can log in from different places, check in on mom and dad, and talk to them,” Womble explains. “Eventually, these systems will have two-way visual. That can help prevent depression that can set in when you feel isolated as a senior.”

But nothing, says Carpenter, is better than planning early. “People have an idea of a certain kind of lifestyle they want to maintain in their old age. So, they need to think way ahead about how they’re going to start saving money to maintain that lifestyle.”

Ed Rabinowitz is a veteran healthcare reporter and writer. He welcomes comments at

$70,000Average cost of a year’s stay in a private nursing home.(USAA Journal, 2008)

Read More:

10 Long-Term-Care Insurance Facts

The Sandwich Generation

Families Ill-Prepared for Toll of Caring for Aging Parents

AARP: Cargiving

Ten Tips for Talking to Your Aging Parents

Don't Overlook Long-Term-Care Insurance

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