Facing the Facts on Elder Care

By: Ellen Hoffman
Business Week, November 30, 2000

When you think about retiring, it's tempting to focus on such enjoyable prospects as traveling more or moving into your dream home. Yet as we -- and our parents -- age, it's crucial that we think about the potential downsides, including becoming responsible for the care of another person. By taking action now, you may be able to minimize the financial and emotional stress. 

The need to help out older parents often becomes apparent at holidays. Sometimes when children visit their folks, they're "shocked," says Bonnie Lawrence, spokesperson for the Family Caregivers Alliance, a nonprofit group that helps locate resources for dealing with an ailing relative. "They see piles of mail and unpaid bills lying around, their parents making mistakes while they're driving, or getting lost when going to a familiar destination such as the grocery store." 

Although some signs of mental or physical decline may appear gradually, others surface in an acute fashion, such as with a stroke or heart attack. But either way, the implication is the same: Someone needs to make sure that the affected person gets the necessary care or assistance, whether it be help with day-to-day tasks like paying bills or round-the-clock medical treatment. 

PREPARING FOR PROBLEMS. While caring for a frail or incapacitated elderly person is a topic you'd probably rather not think about when you're planning for your own retirement, you need to face that it could very well be part of your future. In 1997, an estimated 23% of U.S. households contained at least one person who was helping someone older than 50 with such tasks as feeding and dressing themselves or household chores, according to a study by the AARP and the National Alliance for Caregiving. Consider also the federal government's publication, Older Americans 2000, which says that the percentage of people with "moderate" or "severe" memory impairment increases from 4.4% in those 65 to 69 years old to nearly 36% of people 85 or older. 

The federal government has acknowledged caregiving as a growing issue by enacting a new, $125 million Family Caregiver Program to provide information, training, counseling, and respite assistance (a chance to get out of the house) to people who provide care in their home. Funding is still pending before the lame-duck Congress. 

Several experts I interviewed say both baby boomers and folks who are already retired are often unprepared to deal with caregiving problems because, as Lawrence puts it, "We all look forward to a nice retirement" and don't want to think about issues that could diminish the fantasy. So I asked these experts for some tips on how to prepare for possible problems and where to find help if you suspect that someone needs some type of medical, psychological, financial, or legal assistance. 

LEGAL AID. Buying long-term-care insurance that pays part of the cost of nursing home or home health care is one answer. The pros and cons of this decision are addressed in a recent Business Week story (see BW, 11/20/00, "Long-Term-Care Policies That Will Last"). The federal government will give you a tax deduction for a portion of the cost of the premium. According to the National Conference of State Legislatures, you can also take a tax credit or deduction if you live in one of 23 states that have enacted such laws. Check with your state tax or revenue department to see if your state is among them. 

Several legal documents are essential for you -- and your relatives. In addition to a will for distributing the estate, you should have the following: a living will, which will provide medical guidance in a life-threatening situation; a durable power of attorney that gives another person legal authority to manage financial affairs if necessary; and a durable power of attorney for health care, which offers guidance in case you or a relative become disabled or incapacitated. To find an attorney who specializes in these matters, contact your state bar association or the National Association of Elder Law Attorneys. 

But up-to-date insurance policies and legal documents won't help if you need to search for services. For a parent who's living alone -- especially in another town or city -- and is frail but not seriously ill, for example, you may need to arrange for food delivery through such organizations as Meals on Wheels, transportation to the doctor, help with household chores, or adult day care. The latter provides opportunities to socialize as well as such services as counseling, recreation, and exercise. For an elderly person with serious physical or mental problems, you'll need to identify sources for medical care and rehabilitation, and perhaps a nursing home or hospice. 

And there's good news: Lawrence says at least "in most urban areas, there's quite a bit of help" if you know where to look. And if you educate yourself now, finding help later will be less difficult. To look for services or to learn about how you can help an elderly person with mild or severe problems, you can use the following sources: 

Eldercare Locator This national, federally funded telephone system provides information and referral to all types of elder-care services -- including information and ratings on nursing homes -- all over the country. You can reach them at 800 677-1116 between 9 a.m. and 11 p.m. Eastern Time. 

Family Caregivers Assn. ( This site features useful fact sheets on different health problems, such as Alzheimer's disease or heart disease, including different options for care. 

The National Alliance for Caregiving ( Has a handy list of numerous books, videos, and other resources you can tap. 

The AARP ( For long-distance caregivers, the site offers a checklist of ways that you personally can help your parent or spouse find various community services.