Charting an eldercare path requires family teamwork

With the holidays past, it's a good time to take stock in an older parents' needs. Because many families are spread far apart these days, we often don't see each other until it's turkey time. Keeping in touch by telephone, letter or e-mail just isn't enough to spot the important signs that someone is beginning to need some help.

When holiday get-togethers reveal what every family doesn't want to know, there's no point in ducking the issues. It's time to have that "little chat" with your parents about something important and difficult: helping them plan for their aging. Since eldercare affects the whole family, that's where the conversations should begin. People without family need to do this with their friends.

But where to start? The topics aren't exactly a normal part of what you hear around most dinner tables "Hey, Dad, have you thought about visiting a couple of retirement communities to see what they're like?" or "Do you have long-term care insurance?" Yet exploring them — and helping your parent explore them — is critical to figuring out what his options are and what he will want.

What's needed here is common sense — what does it take for a person with failing health to retain as much independence and a good quality of life as possible? There's no "one size fits all" in eldercare, so each person requires a tailor-made response. Here's an example.

Pete, age 76, had a devastating stroke over a year ago. His two daughters live on the East Coast, and he divorced many years ago, so he's pretty much on his own. He gets around by wheelchair, since his left side is frozen. He loves his old house, but it has 20 steep stairs to navigate before he can go anywhere.

A caregiver comes four hours a day to help him fix meals, take a shower, get groceries, clean house and dress. His daughter visited at Christmas and asked me to be Pete's geriatric care manager — to monitor and advocate for him, to make sure he's getting what he needs.

He had the basics: an emergency-response system that lets him call for help if he gets into trouble while he's alone, and his durable powers of attorney are set up to carry out his wishes for care and finances if he can't communicate.

But his daughters were concerned about other issues. Pete has in-home physical therapy to help him get stronger, paid for by Medicare. But the agency makes no appointments, saying a therapist will be there three times a week. The therapist spends about 20 minutes showing him what to do to get stronger — then leaves, telling the paid caregiver to handle it from there.

We're now exploring different services to find one that will be reliable, consistent — and hopefully get him up and walking again.

Pete has a hefty pension, thanks to his career, but many people (including me) don't. So we have to think ahead to how we'll pay for our care someday — for many, long-term care insurance is a must. In addition, we need to know our options. Pete loves his home, but the stairs and need for daily caregivers have their disadvantages. We're now visiting retirement communities to see what his options are. He's in no hurry, so we can take our time. Good meals, good care and a pleasant environment are high on the list.

The point is, wherever you're starting from, it's time to plot a course of positive action. Pete and his daughters and I are talking about his choices, exploring what they mean, looking at his finances, weighing the trade-offs — the things that must happen, versus what he might like.

The Eldercare Locator can advise you on how to find the services you or a parent might need. For the nearest office, call 800-677-1116 or go online to www.eldercare.gov. Input your parent's city, then contact the Senior Information & Assistance office in that area. It's free, paid with your tax dollars, and can provide unbiased lists and more.

Most of us age accidentally, without planning or forethought. Aging Deliberately tells us how to age on purpose, with more control. You can reach Liz Taylor at lizt@agingdeliberately.com or write to P.O. Box 11601, Bainbridge Island, WA 98110.