Understand How Much Care is Needed
When preparing to facilitate care for an aging parent, you must first determine what their needs are. Every caregiving situation is different. You will need to understand the cognitive, emotional, and physical abilities of your parent to determine what support they need. It’s also necessary to consider what your own limitations might be (emotional, cognitive, physical) in providing care for your elderly parent.
Some aging parents require minimal assistance, such as transportation, coordination of appointments, and helpful reminders. Others may require hands on help to perform their activities of daily living or ADLs. Think about your parents’ mobility requirements; this may help determine what level of care they need. Some general necessities to consider are:
Transportation
Your parent may no longer be driving, so may require transport to and from medical appointments. Also consider social outings and to get groceries. If they do require transportation, do they also require that you stay with them to keep them safe? Think about their physical limitations. How will that affect them once they have arrived at their destination?
Activities of Daily Living (ADLs)
Your parent may need assistance performing their ADLs to remain healthy and safe. This may mean managing incontinence.
Some common ADLs in include:
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Dressing
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Bathing
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Walking
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Transferring in and out of bed/chair
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Toiletry/continence and personal hygiene
Instrumental Activities of Daily Living (IADLs)
Instrumental activities of daily living are more complex tasks that promote independent living. Some Instrumental ADLs (IADLs) that your loved one may need assistance with are:
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Managing money (paying bills, managing incoming and outgoing money)
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Preparing meals (from grocery shopping to cooking)
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Preparing medications (requesting refills, obtaining prescriptions, filling pillboxes)
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Performing housework (cleaning their home, home maintenance)
Your parent’s healthcare provider may be able to provide some guidance on the level of assistance required.
Consider Finances for Your Parents
The expenses of older adults' care can be daunting, and for some, out of home care is not financially possible. There are various types of supportive environments for aging adults with differing price points.
Below, you will find the average cost of care in a facility setting:
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Nursing home semi-private room- around $78,110 each year or $214 per day
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Nursing home private room- around $87,235 each year or $239 per day
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Home care (homemaker)- around $19,760 each year or $19 per hour
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Home care (home health aide)- $21,840 each year or $21 per hour
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Adult daycare- around $18,200 each year or $70 per day
Do a review of your and your parents’ finances; would you and they be able to afford out of home care? Consider what will be the best option based on the level of care your parent requires, what is affordable for you, and what is an acceptable solution for your parent, yourself, and anyone else this decision may affect (your children, grandchildren, or other family).
Your parent may have been receiving social security, but for most elders, the benefit is relatively low and will not cover the cost of nursing home level of care or assisted living. However, your parent may have additional sources of income that may include assets, private retirement plans, or even long-term care insurance. These should all be considered in the planning process.
Determining your parents’ financial status can be confusing and challenging as there may be many things to review (social security, reverse mortgages, investments). It may be helpful to use a professional senior living planner and/or a financial planner to sort it all out.
Think About Health Insurance Options
Elders 65 years or older qualify for Medicare. Medicare recipients are responsible for sharing the costs of benefits and may also have co-payments, deductibles, premiums, and co-insurance. However, Medicare cost is dependent on the individual’s financial resources.
Medicare coverage is divided into Part A and B. Part A, or hospital insurance, covers some or all of inpatient hospital care. It includes skilled nursing, hospice care, and nursing facilities. Part B includes standard healthcare and covers medical equipment, doctor's visits, outpatient care, home health care, and certain preventive services.
In addition to Medicare basic coverage, people can also opt for Medicare Advantage, also known as Medicare Part C. Sometimes Medicare C is coupled with part D. Medicare Part C is an alternative way to receive your Medicare benefits through private insurance companies, often offering extra benefits like vision, dental, and hearing care. Part D helps you pay for some prescription drugs.
Discuss your coverage options with a Medicare representative.
Determine the Best Living Arrangements
After determining your parents’ needs and financial status, you will need to determine the best living arrangement. Home environment – including the community, available resources and living structure – greatly impact mental and physical health.
Below is a breakdown of the possible living arrangements, who they are appropriate for, and what they offer:
Type of arrangement |
For Who |
Caregiving Location |
Who are the caregivers |
Services Needed |
Living at home |
Parents who are independent or parents who need full ADL assistance |
Personal residence |
In-home caregivers or family members |
Full ADL assistance, skilled healthcare, personal companionship |
Independent living communities |
Independent parents |
Trailer homes, residential spaces, and rentals in communities with other seniors |
Professional caregiver |
Basic living services like transport and laundry, but no medical assistance |
Assisted living communities |
Parents who are independent but need ADL |
Rentals or rooms\ in a community house |
Other caregivers and seniors |
Group meals, ADL assistance, medication, social activities, exercise, laundry, medication, transport, and housekeeping |
Nursing home |
The parent with severe conditions or parent who require rehabilitative care |
Institute of nursing care |
On-site nursing staff |
Meals, full ADL, medical care and surveillance |
Living with family and relatives |
Parents who need non-skilled healthcare, ADL assistance, and personal companionship |
Family or relative house |
Family or relatives |
ADL assistance, instrumental or basic |
Make Yourself Power of Attorney and choose a Health Care Proxy
Decisions regarding health care proxy (HCP) and power of attorney (POA) should be addressed early with your loved one. Prior to a decline in cognitive functioning (should it occur), it is essential that your parents' wishes are determined. Should your parent become ill or unable to make decisions for themselves, they will need a proxy decision maker. The power of attorney makes financial decisions and can manage affairs. The health care proxy makes determinations about health care interventions and advance care directives (based on the parents' wishes, spelled out in the living will).
If you don’t have a durable POA or an HCP and your parent becomes ill, you will not have the authority to make medical decisions or pay for any medical bill on their behalf.
In the case that more than one child or individual would like to be part of the decision-making process, they can each obtain power of attorney. Multiple people can be named healthcare proxy agents as well. Make sure that you have the proper paperwork filled out for each determination.
Remember Living Wills and Estate Planning
The Living Will is the legal document that specifies which medical interventions would be desired at the end of life. Often a sensitive topic, end of life decisions are extremely important to determine before your loved one is ill or close to the end of life. The Living Will is a tool utilized by health care professionals if your loved one is no longer able to voice their desires. It may include resuscitation orders like: Do not resuscitate, do not intubate, or Do not Hospitalize.
Things You Need to Do for Yourself
Make sure to take care of yourself while you are providing care to your parent. While keeping your parents happy, take some time for your own hobbies and interest.
Consider the following in trying to strike a balance of caregiver with your regular life:
Set Boundaries
It’s true that setting boundaries between you and your parents can be challenging and may seem impossible. However, you need to learn how to implement boundaries early. Without these, you are at great risk for caregiver burnout, a very real side effect of caregiving.
Emotional boundaries are vital in maintaining a healthy caregiver relationship. Setting expectations for your parent maintains mutual respect and fosters a successful closeness.
It can be difficult to maintain a career and family life as a caregiver, but setting clear limits with your parents can help.
Sit down and take your time to write some non-negotiable boundaries that you need to set no matter what happens. Do remember, you have the ability to set new boundaries whenever you need. When you feel that your priorities are being ignored, address the issue to avoid future infringements.
Consider Shared Responsibility
Sharing the responsibility of caring for a parent is a great idea if it is possible. To avoid caregiver burnout, and to share comradery, having a second or third caregiver to distribute tasks can be extremely helpful. When determining who will be part of the caregiving team, consider who is willing, accessible, skilled, and emotionally prepared to participate in this role. Then determine how the tasks can be delegated.
Understand and Respect Family Opinions
The role reversal of becoming a caregiver to your parent can feel awkward and uncomfortable for some.
It is important to allow family members to have opinions, give them space to feel their emotions, and process the situation in their own way. Determine who the decision makers are, listen to their opinions, and make decisions together if possible.
Bottom Line
Providing care for your aging parent may include everything from providing incontinence care to determining the best living environment. It can feel overwhelming. Use resources to make the best decision possible, include siblings or other family members with your parent’s best interest in mind, and don’t neglect your own self-care.
Taking care of an aging parent involves numerous decisions. Let Parentgiving alleviate some of that stress. We offer resources ranging from adaptive equipment to educational articles and aim to provide the tools and information to help you provide the best possible care. Explore our selection of products by clicking here.
Reviewed By: Katie Pescatello
Katie Pescatello, RN, MSN, FNP-C Katie Pescatello earned a Master of Science in Nursing from Simmons University, where she also taught pharmacology in the Master's program for several years. She has worked as a nurse practitioner in skilled nursing facilities, outpatient clinics, and hospitals. She is passionate about providing individuals with the tools to make informed decisions. While working as a Hospitalist in several Boston area hospitals, she enjoys writing health content for several online publications, focusing on aging in place and preserving dignity at the end of life. She also acts as a content reviewer for Parentgiving.com.
Sarah Johnson
Aging in Place ExpertSarah Johnson is an Aging in Place Expert with extensive experience helping seniors remain independent and comfortable in their homes. She has specialized knowledge of how to help elderly individuals stay healthy, safe, and happy as they age. Sarah is passionate about providing quality care for aging adults, allowing them to remain in their homes and enjoy the highest quality of life.