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After my mother-in-law died suddenly, my wife and I found ourselves caring for my father-in-law. There was so much we didn't know. One area where we were flying blind: We had no idea what financial resources he had, what banks and mutual funds he used, or how to access the funds he needed to pay for his home health aides and, later, assisted living and nursing home care.  

It turns out we were hardly alone. Less than half of adult children say they have ever had a conversation about money with their aging parents. And only 4 in 10 know how much their parents make. Yet, more than 60 percent of these parents think their kids are aware of their financial situation. 

This troubling gap is reported in the Employee Benefit Research Institute's 2010 health confidence study. And it is more evidence that adult children and their elderly parents do a terrible job talking to each other about money. 

There is no doubt that it is awkward. How do you sit down with a parent and say, "So dad, how much money do you have, anyway?" And how often, when adult children try, do parents shut them off with a response that says, in effect, "It's none of your business."

When folks who come to my community programs ask about it, I usually suggest they have this talk when their parents are relatively young and healthy. It is always easier to discuss money--to say nothing of advance directives and other end-of-life issues--before someone is very sick.

It is also easier to make it a two-way street. For instance, adult children can sit down with their parents and first talk about their own planning.

Imgaine starting off a conversation with mom and dad something like this: "We met with our lawyer last week to talk about our own estate plan. We thought it would be a good idea to let you know about our assets and give you a list of our insurance policies and bank accounts. Just in case something happens...."

In that context, it is much less uncomfortable to ask them the same questions. Even if they are unwilling to tell you how much they have, it is critical to know where they keep their funds and, if possible, get a power of attorney that gives you access to their accounts should they be incapable of managing their money. Without those documents, even paying bills on their behalf can turn into a nightmare.

Those of us who are caring for our parents have a huge job. Knowing a bit about their finances can make it a little it easier. But to do that, we need to talk.      

 

 

 

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The other day, I had a long talk with a friend about her mom. My friend lives on the East Coast. Her mother lives in the Midwest. Mom is in an independent living apartment and recently has been falling and suffering memory lapses. The other day, mom got lost trying to drive home from her regular bridge game.  

My friend realizes it is time for her mother to get more help and they have discussed the possibility of her moving closer to her daughter. But, my friend asked, which care facility would be best?

I suggested she was putting the proverbial cart before the horse. Before we could know what care setting was appropriate, we needed to know a lot more about this memory loss. Was it early Alzheimer's? Was it stroke-related? Was it a polypharmacy issue? After all, mom is taking lots of drugs, including meds for depression, a thyroid problem, and a range of other complaints. It is not uncommon for combinations of medications to create symptoms that look very much like dementia.

Mom has a psychiatrist who treats her depression, but this doctor has little experience with elderly patients and does not seem very knowledgable about her other drugs. I suggested she see a geriatric psychiatrist--if she can find one. Once my friend learns more about the cause of her mom's confusion, she should be much better prepared to help find an appropriate care setting.

This story was on my mind as I read an article about economic importance of early diagnosis of dementia. A new study by the Department of Veterans Affairs reports that early dementia screening can reduce first year health costs by 13 percent. More importantly, recognizing Alzheimer's or other dementias can signal health providers to watch for related problems before they reach a crisis stage. For instance, checking to be sure a dementia patient is taking her meds properly could prevent a trip to the emergency room.  

The VA screening was remarkably easy. The study merely added a simple three-item memory test to its regular check-ups for patients over 70. Patients who failed the test were then given a more thorough diagnostic screening.            

 

 

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John Mills, who cared for his dad for six years, has started a nice new website filled with practical tools and information for caregivers. You can find it at http://www.ecarediary.com/

For those caring for parents, this is one worth checking out.    

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The wonderful families I met while writing Caring for Our Parents had many things in common: The made tremendous sacrifices to help frail parents or spouses, they brought deep love and great patience to this responsibility. And under great physical, emotional, and financial stress, they often ignored their own health. 

It may sound selfish, but if you are assisting a loved one, you first need to take care of yourself. After all, if you get sick, who will help mom or dad? It is like the announcement flight attendants make: In an emergency, first put on your own oxygen mask before helping your child.

Often, people must move into a nursing home, not because their own health changes, but because their caregiver suffers a medical crisis. It happened to my own mother-in-law, Ida, who suffered a massive stroke while caring for her husband Al.

What can you do to keep yourself healthy while assisting a loved one who is frail or disabled? Here are a few tips:

Take a break. I know it is hard, but at least one day each week take some time off. Ask a neighbor or friend to sit with your dad or your spouse for a couple of hours. If you can afford it, hire an aide. While she is there, she can help with cooking or housework.

Use adult day care. Many offer meals, activities, and even transportation. Not only do they provide caregivers with important time off, but they can also be a great change of pace for mom or dad.

Get some exercise. If nothing else, at least walk a little bit each day. It will not only make you more physically fit, but it will help relieve stress.

Watch your own health. If you start feeling unusually tired or weak, or get headaches or lose your appetite, see your doctor.

Join a support group. They are a great way to share ideas or find a shoulder to cry on.

Caring for a loved one is never easy. But you can make it a lot more manageable if you first remember to care for yourself. 

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