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f your parents are mobile but show mild signs of dementia or forgetfulness, you may want to investigate out-of-home adult day services or day health-service programs. Supervised adult day services let the elderly socialize with other seniors, and day health services may have nurses who can give out shots and medications. These services often have their own facilities or may be part of a local community center. In addition to asking the Area Agency on Aging for names of reputable, convenient programs, you can consult the staffs of nearby senior centers, churches, and synagogues.
If your parents are less independent — say, if your mom is having a hard time getting in and out of bed or sometimes forgets she turned on the stove or bath — she’ll need in-home care. “It took three different people and about three months to find a perfect match for my mother,” says Helen Nazar Bishop, whose mom has Alzheimer’s. “And we are always communicating with the home-care worker.” As a first step in finding a reliable caregiver, start at the Website of the Family Caregiver Alliance (caregiver.org), which has put together the first comprehensive, 50-state online directory of caregiver support programs.
For a personalized, overall-care plan, hire a geriatric-care manager, usually a nurse or social worker trained in helping the elderly. You’ll typically pay $300 to $800, depending on where your parents live, to have this person visit them in their home, assess how they’re doing, and recommend cost-efficient things they might need to stay independent. “Geriatric-care managers have their fingers on the pulse of services available locally,” says Elinor Ginzler, senior vice president of livable communities for AARP. For an additional fee, the geriatric-care manager can also make all the arrangements. Expect to pay roughly $80 to $200 an hour for this service, depending on how much attention your parents need and where they live; the cost isn’t covered by health insurance, Medicare, or Medicaid. You can find Professional Geriatric Care Managers (PGCMs), who are trained, experienced professionals, by visiting caremanager.org.
HOW TO SAVE MONEY
Hiring help doesn’t have to mean draining your parents’ bank account — or yours. Adult day services, which average $64 a day, are far less expensive than in-home daytime help. And in-home, nonmedical daytime assistance (about $18 an hour) will probably be a bit less costly than an in-home health aide (about $20 an hour), if your parents won’t need medical supervision. The federal government might shoulder some expenses, too. Medicare usually pays for some short-term, in-home medical help prescribed by a doctor for people 65 and older. But it won’t pay for long-term custodial care. If your parent does qualify for that, check medicare.gov to find local Medicare-certified in-home health-care agencies.Medicaid rules vary by state. The program may cover home care or day services if your 65-plus parent is nursing-home — eligible and meets low-income requirements. So you’ll likely have to exhaust your parents’ resources before turning to this type of help. If your dad needs constant surveillance, Medicaid would likely require him to go to a nursing home or similar facility (check govbenefits.gov for details).
Since this is difficult terrain, consider consulting an elder-care attorney to help navigate regulations and discuss asset-management planning, which will be important if your parents’ health declines. Find a specialist at the National Academy of Elder Law Attorneys’ site: naela.com.
Look into lowering expenses through local senior programs. For example, utility companies may offer a break on energy bills — just give them a call and ask. Church or synagogue volunteer programs might provide a companion to keep your mom company periodically. Some areas have transportation services that can save the cost of using taxis or part-time drivers. In the Boston area, disabled or impaired seniors can use The Ride, which provides a door-to-door wheelchair-access van or sedan for $2. “I had a 90-something client who took it to work every day,” says Suzanne Modigliani, a geriatric-care manager in Brookline, MA.
With some delicate conversations and aid from the right places, you can help your parents stay in their homes for as long as possible. “It’s hard, make no mistake,” Ginzler says. “But respect the fact that Mom and Dad want to control their lives as much as they can. Being compassionate will lead you to the right decisions.”