By: Marc Kriessmann | Posted: November 4, 2013 | Updated: April 5, 2023
Going beyond money management, part of our daily work includes having conversations about the complexities of providing care for aging family members, the range of costs for providing this care and the difficulty families have in planning around these issues. Yet, most people don’t think about such things until there is a crisis.
Why We Don’t Plan
Caregivers provide a wide range of services, from simple help such as grocery shopping, to complex medical procedures. Most of the healthcare in this country is unpaid and undocumented, performed by friends, neighbors, and family members. For some, caregiving occurs gradually over time. For others, it can happen overnight.
Unfortunately, many people postpone talking to their closest family about aging, finances and health and are then put in a position of making decisions under stress, without accurate information and with little time at hand.
Humans inherently put these conversations off because they are difficult and uncomfortable. From the perspective of the adult child, we would clearly rather not have to contemplate the passing of a parent. From the perspective of the parent, the last thing we want to think about is needing assistance as we age. Independence is vital for most of us and we don’t want to lose control over it.
In fact, both aging parents and their adult children will lose independence and control if dialogue is not initiated. It doesn’t matter which side initiates, or even if a third party acts as a catalyst. And the simple fact remains that this conversation will only get harder as those involved get older and circumstances change. These conversations are not done in one day, it often takes months and sometimes longer to come to conclusions a family can be comfortable with.
Here are the three questions that typically come up around the topic of caregiving: (1) what long term care options are most preferred, (2) what are the potential roles and responsibilities of different family members for managing care, and (3) how long term care needs would be paid for if they are needed.
Despite the importance of the issue, the vast majority of families have not had a comprehensive discussion regarding long term care. 91% of all Americans have not discussed all three topics with their spouses; 92% have not discussed all three topics with their adult children; and 94% have not discussed all three topics with their parents (Age Wave/Genworth Study, 2010).
Starting the Conversation
Kick-starting these conversations is clearly not an easy exercise. Sometimes, it will require some professional guidance, but it can be an empowering and liberating process. In assessing personal desires and sharing the planning with those you love, the impetus to get important documents and policies in place helps everyone get back to the business of enjoying their lives right now.
Again, the sooner the conversation begins the better. A good place to start is by simply discussing the daily routine if that is unfamiliar territory. What is good? What is bad? What changes could be made?
Another child-parent conversation starter might begin with questions along the lines of who is involved in their daily lives, i.e. other relatives, neighbors, friends and professional relationships. Have any of these people been involved in their planning?
The foundation of these discussions often revolves around legal documents. The most important are: an up-to-date will, a living trust, a durable power of attorney (which assigns someone the authority to make financial and legal decisions on their behalf), an advance directive or living will (which expresses wishes for end-of-life care) and a power of attorney for health care (similar to the durable power of attorney, but aimed specifically toward medical decisions).
Focusing first on these tangible items and where they are located, paves the way for what these documents may or may not contain. The absence of one or several of these documents can even help move the conversation toward more specific topics such as inheritance, paying for care, housing options and final wishes. As the conversation unfolds it is important to remember not to rush things, keep and open mind and to truly listen.
Is there a Role for Technology?
Communication between the generations is vital to the success of positive aging. Can technology play a role in this type of planning? In a world of multi-layered families, fast-paced lives and geographical separation, there might not be a choice.
Are the apps designed to help families keep tabs on their elders effective? Can a PC or mobile device take the place of face-to-face meetings in facilitating the ongoing exchange of information around caregiving?
Are remote monitoring systems in the home doing their job and keeping elders safe and independent? Do senior citizens tolerate these products/services? Do they really bring peace of mind to adult children and the extended family and professional networks?
A recent report by Laurie Orlov (1) sheds some light on one of the most visible segments of the “Aging in Place” market, that of Personal Emergency Response Systems (PERS).
She writes that the success of widespread adoption of these technologies depends on business models that include go-to-market strategies. Despite the fact that some of these caregiving solutions have been around for some time, there is still a long way to go. Some device makers have been invested in this space for a long time (Philips, GE, Honeywell) but not anywhere near adoption tipping points of their various markets. Will some larger players on the service side (insurers? healthcare providers?) drive the adoption of this type of solution on a large scale?
Earl Powell brings up the need for “right” business models for delivering this type of Aging in Place technology to as many people as possible. He posits that the entertainment industry, in particular, the cable, satellite, and streaming video companies could be the answer to mass market adoption.
Comcast/Xfinity has rolled out home security and control. Could bundled “home healthcare” be included in the mix?
References
(1) Aging and Health Technology Watch
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