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Prepare now for a future that might include caring for your elderly family

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By Michelle Singletary
Washington Post Staff Writer
Sunday, May 16, 2010

The time has come.

As the nation ages, millions of adults will find they are thrust into caring for an aging parent or other relative. My husband and I have just joined this group of caregivers.

We recently began taking care of my father-in-law, a fiercely independent, 81-year-old ex-military man. He's mentally competent, but his basic living needs -- walking, cooking, bathing and cleaning his house -- have become too hard for him.

So for now, he's living with our family of five.

My father-in-law would rather be living on his own. We are trying to make that happen, but he can't move back into his home without a lot of daily help and supervision.

I recently participated on a panel on elder care hosted by Volunteers of America, a nonprofit that provides human service programs nationwide to seniors, veterans and families. I had no idea when I accepted the invitation that the conversation would hit so close to my home.

It was a sobering discussion when you consider that by 2020, 12 million older Americans will need long-term care. And when they need that care, they will realize that they and the caregivers they will have to lean on are woefully unprepared for the cost.

"As a baby boomer myself with parents in their 80s, I find it hard to face the reality of preparing," said Vicki Bendure, a spokeswoman for Volunteers of America. "They're in relatively good health at the moment, but we have yet to discuss the grueling particulars, and my sister and I and our families just continue to pretend the inevitable isn't going to happen. I feel like there's a tsunami on the horizon."

The storm is coming, and it's likely to bring emotional and financial turmoil.

I thought I knew a lot about caring for the elderly -- and I do -- but I still was unprepared for how quickly the workload and concerns would take a toll on my family life. As I trek up and down stairs to the basement guest room checking on my father-in-law and taking him meals, I'm annoyed that when we built our home several years ago, we didn't include a bedroom on the first floor. We talked about it but believed we had years before it would be an issue.

We didn't have as long as we thought.

The burden has largely fallen on my husband and me to figure out the best care and living situation for my father-in-law. But the most distressing thing about this situation is that he is caught in the middle of a conundrum so many seniors face.

He is too rich for most government-funded social programs and not rich enough to pay for full-time, long-term care services. He was a good steward of his resources, but still it's going to be tough for him to afford the care he needs.

He has health insurance. He has Medicare. But contrary to what many people assume, Medicare generally does not pay for long-term care, which assists people with daily living activities such as dressing, bathing and using the bathroom. Medicare helps pay for medically necessary skilled nursing or home health care, but only if you meet certain conditions.

Medicaid, the state and federal government program, will pay for some long-term care services, but it's limited to people with low incomes and limited assets.

As we go through the process, I'll be writing about our experience and what resources we find. One place I've explored is http://www.medicare.gov. On the Web site you will find a "Long-Term Care Planning Tool." You will be asked 12 to 20 questions that will help you start the process of finding long-term care.

For now, I have a little advice to offer. If you have even an inkling that you may become the caregiver for an aging parent or relative, start planning for it now. Ask questions about the person's finances. Collect information from community and nonprofit organizations.

Get your own finances in order because you'll probably have to pitch in financially.

Most importantly, if you are the one in your family whom people rely on or who steps up to take on the challenge when a family crisis occurs, accept now that you will be the one taking care of your elderly parents or relatives. Don't waste time or expend the emotional energy arguing with siblings that it's not fair you're left with this heavy responsibility. Ask them to help, but if they're unmovable, suck it up, get professional counseling or find a caregiver support group.

Prepare now. The time will come before you know it.

Readers can write to Michelle Singletary at The Washington Post, 1150 15th St. NW, Washington, D.C. 20071.

Comments and questions are welcome, but because of the volume of mail, personal responses are not always possible. Please note that comments or questions may be used in a future column, with the writer's name, unless a specific request to do otherwise is indicated.


© 2010 The Washington Post Company

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