Four things every family caregiver should discuss with an aging parent

August 30th, 2019

By: Sharon Roth Maguire, MS, RN, GNP-BC Chief Clinical Quality Officer, BrightStar Care

Woman discussing care options with aging motherConversations about long-term care and end-of-life decisions are very important but often overlooked topics of discussion as our loved ones age. Whether it's documenting an aging parent's wishes in writing or providing him or her with the most comfortable and caring environment possible, having open conversations now can ensure the end-of-life care your loved one wants and deserves. Here are the four things every family caregiver should discuss with their aging parent.

Starting the Conversation

An advance directive is a legal document that goes into effect when individuals are unable to speak for themselves or are incapacitated, according to the National Institute on Aging. It allows an individual to express if they’d like emergency measures used to keep them alive, such as:

  • Artificial nutrition or hydration to feed an individual through a feeding tube.
  • Cardiopulmonary resuscitation or CPR to restore an individual’s heartbeat if their heart stops or has an abnormal rhythm.
  • Comfort care to soothe an individual and relieve suffering while still following their wishes.
  • A ventilator to help individuals breathe.

A power of attorney (POA) for healthcare allows an individual to entrust someone else to make decisions about their medical care. Individuals might need two separate POA documents – one for healthcare and another for finances. The power of attorney can be the same person for both or different people.
 
An estate planning attorney can help your loved one establish a power of attorney or a living will to communicate end-of-life healthcare wishes. Your loved one may also consider creating additional documents regarding their wishes about a single medical issue such as:

  • Do Not Resuscitate (DNR) Order: A medical order written by a doctor that tells healthcare providers not to do CPR if an individual's breathing stops or if the individual’s heart stops beating.
  • Physician Orders for Life-Sustaining Treatment (POLST) or Medical Orders for Life-Sustaining Treatment (MOLST): These forms clarify your medical care preferences in the form of a doctor's orders. Not all states acknowledge this form; check with your medical team for additional information.

Once your loved one has established power of attorney or a living will, it is important to make sure this paperwork is available and easy to locate. Some individuals may consider wearing a medical identification bracelet or choose to carry paperwork with them, expressing their desire for advanced directives. It is also very important to review your healthcare preferences and wishes with your POA regularly.
 
There are also communities with programs that encourage people to put advanced directive instructions in a baggie in their freezer because emergency personnel are trained to look for it there. It is important to understand your state laws and if there are any community programs related to advanced directives.
 
It’s also crucial to update these advanced care documents periodically to make sure your loved one’s wishes are current. Legal paperwork should be reviewed every five years, or more often if needed, to make sure it is accurate.

Collect Key Documents

As you start caring for your elderly parent, you’ll also need access to their health and financial information. Compile information connected to your parent’s insurance policies, Social Security benefits, housing contracts, retirement, and bank accounts. Make a list of their doctors’ names and preferred health facilities as well as their current medications and health conditions. Check to see if an individual has Medicare and/or any Medicare Supplement Insurance. It’s a good idea to make copies of these key documents. And don’t forget to keep copies and know where originals are of the POA, living will, and property deeds.

Do Your Parents Have a Long-Term Care Plan?

Long-term care is not always easy to discuss with a parent or loved one, but it’s best to address it before an unexpected accident, illness, or injury changes their needs. Here are some questions you should ask:

  • How much are you or your loved one willing to spend on care? Long-term care can be expensive. According to the AARP, the average cost for a home health aide was $20 per hour in 2016 with the average aide providing in-home care for approximately 30 hours a week. The annual cost was $31,000. Some older adults use private financing options, such as long-term care insurance.
  • What kind of help do you need now? Or, in the future? At first, your loved one may only need a ride to appointments or help with meals. Establish a schedule for them and discuss how the schedule could be adjusted as their needs change.
  • Can you get used to having a stranger in your home to help you? Some individuals might have a hard time having a stranger care for them. It’s also important to ask if they have a preference whether if an aide is male or female.
  • How do you feel about care outside of the home? Many individuals want to stay in their homes, but you should be careful what you promise. A long-term care facility may be the best choice for some illnesses or stages of the end-of-life journey. 

Listen and Follow Your Parent’s Cues

Clarity is essential for the family. Everyone should be on the same page about care for their elderly loved one. The following topics should be discussed and answered among family members:

  • Who is the main spokesperson for the elderly loved one? It’s important to have a point person and keep things moving ahead. Often that person is the ultimate decision maker. Ask other family members what tasks they can take on to support your loved one.
  • Establish general rules. Understand your loved one may not want to share everything about their health or personal life. Be respectful of their choices and be supportive even if you don’t personally agree with their decisions.  

Helpful Resources

Organizations, such as AARP, provide helpful information such as Prepare to Care: A Resource Guide for Families that can help you plan and prepare for being a first-time caregiver. Contact your area agency on aging (AAA) or use the Eldercare Locator to receive information about services in your area. The AAA can help you determine the services you or a loved one may need. If you are interested in exploring home care as an option for additional help, our Home Care Planning Guide may answer some questions and help you make the best decision for your unique family situation.
 
Long-term care is a sensitive topic, but it doesn’t have to end in an argument or hurt feelings. By starting the conversation early, listening to and respecting your parents’ wishes, and exploring options together, you can help your parents live safely and happily.
 
To learn how BrightStar Care may be able to help your parent live safely at home, call 866.618.7827, or contact a BrightStar Care® home care agency near you.