Run (don’t walk) your fingers over to click on this link to a great article by Jane Gross of the New York Times. In it, she spells out four major steps she wishes she’d done differently when her mother was failing at home. Today more and more Americans are the sandwich generation, and, like Ms. Gross, often managing life-or-death decisions on behalf of frail parents from a distance of not streets, but two or three states away. Her advice is accurate, hard-won, and still pertinent nowadays. Most importantly, she has no financial motivation, no conflict of interest, and no camp to support. Her take-home points: 1) find a local geriatrician (if you can) – it can mean the difference between living (frail but) independently versus a fast-slide downhill due to avoidable age-related complications; 2) resist the siren call of assisted-living (especially for-profit ones) compared to nursing homes; 3) reconsider selling the house (and why); and 4) understand the limits of long-term care insurance (which Ms. Gross spells out).
What would I add to that? One huge bit of insider advice – hire a licensed social worker. A good social worker, familiar with your parents’ states resources and benefits, is invaluable and can help you avoid all these mistakes (and more). How do you find one? Call a local hospital in your parents’ area, ask for a nursing station and then ask the nurses who’s a great social worker. Call that person and ask if he/she does freelance, hourly work – if not, is there someone good who does? No matter what you’re charged ($30/hr, $60/hr, $100/hr), a great social worker is worth every penny and more. These are the people who can tell you how to maximize benefits, where to find a geriatrician, how to plan for long-term placement, and how to transition from hospital to lower-level care without having byzantine claims rules rejected. They know the waitlists, the forms, and the person to cajole on the phone. They recognize when the time comes to move to a different level of care. They understand and talk money – you can say what you can pay them for their time ($600 total? – in other words, the price of one airplane ticket) and then ask how to maximize the result for your parent. Even if you end up spending a whopping $5,000 out-of-pocket, you’ll undoubtedly end up saving vastly more (just ask Ms. Gross), and, more importantly, never live with regrets about what you wish you’d known.