Why and How Caregivers Should Create a Personal Care Agreement

January 24, 2017

As my friends and I enter our late 40s and 50s,  I find we talk more about caring for our parents than any other topic. For some, the care involves an occasional check-in and phone call. For others, it involves full-time care. A few were even thinking of quitting their jobs so they can take care of their parents full-time.

If you find yourself facing the same decision, consider creating a formal agreement, known as a personal care agreement, that can help manage the expectations of the person receiving care and their family members and clarify the compensation the caregiver will receive. (You can see a sample here.) Before creating it, consider discussing your desires with family members to avoid conflicts and resolve concerns. Generally, there are three basic components of a personal care agreement:

  • It should be in writing.
  • Money received is for future not past care.
  • Compensation must be reasonable, similar to what a caregiver in your area would charge for the same service. Consider looking at online job agencies like Monster to find out the average pay for the services you will be providing.

The other parts of the agreement to consider are to:

  • Note when the care will begin as well as the expected length of the agreement.
  • Include where the services are expected to be given, such as the care recipient’s home.
  • Detail the services the caregiver will provide such as food preparation, transportation, etc. In addition to talking to the care recipient about the services he or she wants, consider consulting with the care recipient’s medical providers to determine the level of service needed. Assess the level of care the caregiver is capable of giving.
  • Estimate the expected number of hours or days of the week for the services to be rendered. Consider writing a plan to account for the caregiver’s time off such as illness or vacations.
  • Cite the amount of compensation and dates of payments. If the caregiver plans to live with the person they are caring for, consider including whether there is an expectation of payment for room and board.
  • Consider adding in an “escape clause” so each party can terminate the contract. This will go a long way in preserving the relationship.
  • Have the completed document signed by all parties (if the care recipient cannot sign, then the durable power of attorney agent should sign) and notarized.

As you can see, drawing up a personal care agreement can quickly get complicated. Consider consulting with an attorney. See if you have a workplace benefit for free or reduced cost legal services to help you write the agreement. Doing your due diligence can help alleviate stress and prevent a lot of conflict.

 

 

 

 

Does Your Aging Parent Need Help?

December 06, 2016

My father had a presence about him that made him seem larger than life. As my father started aging, we still saw him as invincible and initially ignored the signs that he could no longer take care of himself. As we celebrate this holiday season, take the time to observe your parents as well as any other elderly relatives to see if they may need help. My sister-in-law was the first to notice the changes in my dad so be sure to involve your spouse in the observation too. Look for the following warning signs:

1. Home in Disrepair – As you pull up to your elderly relative’s driveway, look for signs of disrepair. Does the exterior of the home need painting, is the driveway cracked, are newspapers piling up. (It may be a sign that she cannot move around as much).

As you enter the home, look to see if the home is more cluttered or disorganized than normal. Is there an odor? Is there a lack of food (he could have problems paying for food or he may not be able to travel to buy food) or does he have a lot of expired food? If you find there is a problem, consider talking to your relative. It may be as simple as helping them once a week or month or hiring a caregiver or it may be time to look for an assisted living facility.

2. Deteriorating Physical Health – Has the personal hygiene of your relative changed? Has she experienced unusual weight loss? Does he have unexplained bruising? (My father had bruises due to falling, but did not want to tell us.) Is she more tired than normal?

Does he have more bottles of medication than you remember? Is she actually taking her medication. (You can look at the date the medication was given and check the bottle. If it’s full after several weeks, she may not be taking her medication. If it’s empty after a month, she may not be able to travel to get  her prescription filled.)

Is he struggling to move around his home? First step would be to talk to your relative about his health. If possible, go to a doctor to understand any health challenges and if there is a need for a caregiver.

3. Cognitive Impairment. If you can, check his mail for late notices, bounced checks and collection notices. (This could be due to a lack funds as well.) These could be signs of forgetfulness. Does she seem to be confused or uncertain about doing tasks that were once familiar – cooking a favorite meal, playing a familiar musical instrument, recounting a favorite story she has told for years and/or forgetting a favorite song? Do you notice a change in his mood – more closed, angry, depressed or unusual mood swings?

If you have concerns about cognitive impairment, talk to your parent and if possible, talk to his physicians about getting your parent or elderly relative evaluated.

As I write this, I know firsthand that not all parents are cooperative. If your parent is resistant to talking about your concerns, be patient. Websites like AARP offer a wealth of resources on care giving. An aging life care professional  (sometimes known as a geriatric care manager) is a specialist trained to help with the care of the elderly. Ask questions to get to the root of why they are resistant.

Ultimately, it was a team effort that convinced my father to go to an assisted living facility where he is doing great. We got a lot of people involved, including clergy and a social worker, to talk to our father. The key is to respect how your parents feel, lovingly but persistently keep talking, involve as many people as you need, and take it slow. Consider using the holiday season not only as a time to spend with your loved ones but also to uncover a need for help. This could be the greatest gift you give your family member.

 

 

Helping Aging Parents Decide Where to Live

September 13, 2016

As a Generation Xer, it’s amazing how the conversations I have with my friends have changed over the years. At first, the conversations were about who was dating who and the latest episode of The X-Files (the original one). Then it was all about the baby pictures, which quickly turned into prayer vigils as to how we are going to survive the teen years.

Over the last few years, the conversations have been about our aging parents and how we can help them make life decisions, such as where they will live once they retire. If your parents are healthy and can perform activities of daily living, then an independent living facility like a senior apartment/condo may work. These types of homes can be subsidized for those with low income or private pay only.

If your parents have health issues that requires monitoring and struggle with some of the activities of daily living but do not need 24 hour nursing care, then an assisted living facility may be an option. Since there is no uniform standard for assisted living facilities, call and ask about what services are offered and the living arrangements. Another option is for your parents to stay at their home and hire a caregiver for basic non-medical care. If your parents have a condition that is progressive such as Alzheimer’s or that requires extensive nursing care, then a nursing home may be a consideration. Consider using checklists like the one from the Alzheimer’s Association to go over questions to ask.

As you start to evaluate which one is the best option for your parents consider the following:

1. How much can they afford? Assess all their income resources. Some senior facilities are private pay only, and some are income based. If your parent’s finances are limited, consider contacting your local Department of Aging Ombudsman Program for guidance. Review your parent’s benefits and insurance documents to see if they have long term care insurance, and contact the insurance company regarding the requirements to activate the policy.

2. What level of care will your parents need now and possibly in the future? Some active adult community facilities only provide limited heath care while others are connected to an assisted living facility that offers more comprehensive care so if needed, your parents can seamlessly transition. Organizations like A Place for Mom,  Adult Living Solutions, Seniors Resource Guide and possibly your local senior center can provide information on helping you make the most informed decision.

3. What level of independence do your parents want? This may require a reality check. Talk to your parents to make sure that the facility they want and the expected level of care matches. Once you have agreed, use the resources above to find the best option that matches your parents needs and wants.

Elder care can be stressful. There’s a lot you can do though. Taking the time to help your parents make the best decision will go a long way into making the transition as smooth as possible.

 

The Value of Your EAP Program

June 09, 2015

Years ago when I was pregnant, I was a nervous wreck. I did what every pregnant woman should not do. I found every article I could on every worse-case scenario imaginable about daycare. Continue reading “The Value of Your EAP Program”

Managing Mom’s (or Dad’s) Money

September 09, 2014

I recently spoke to a caller on the Financial Helpline, where we provide over the phone financial coaching as an employee benefit through her employer.  She had just learned that her parents had deeded over the family home to her nephew, who was in his early 20s and barely getting by. Her mom had just recently settled into an assisted living facility at $5,500 a month due to an onset of dementia. Her dad, age 93, still lived at home with her sister and nephew and was getting worried he might go broke trying to pay for her care and he didn’t want to lose the family home.  Continue reading “Managing Mom’s (or Dad’s) Money”