Dr. Mor's Column - Febuary
When to step in and help your parents
By Dr. Eva Mor - Author of "Making the Golden Years Golden"

Today, some 15 million children already care for elderly parents, but this care is provided mostly in a fragmented manner and as a response to an emergency occurrence, such as a fall or an acute medical event.

We, as children, are reluctant to step in and take over the handling of our parentsí affairs, and are happy to push the time as far into the future as possible, until we have no choice but to act. It is difficult to decide when itís the right time to sit down with your parents and go over financial issues, safety issues, and planning for their senior years, without your parents thinking that you are interfering with their lives. You need to make it clear to them that you are not after their money and possessions. Such a conversation needs to take place, should be brought up early, and even happen a few times so as to become less threatening. The conversation should be respectful to the elder, and on their terms.

So, the most difficult question is, when do you step in?
Early planning gives both you and your parentsí control of their situation. As our parents grow old, our roles slowly reverse; we become the care givers and they become dependent and needy. The initial stages creep up almost unnoticed, as our parent starts slipping in behavior or physical In general they seem to be doing okay, functioning in his or her daily routines. As I mentioned in the beginning of this article, if we are unprepared, the first sign of trouble will be some emergency that will force us to step in and react to that event. Unplanned reactions tend to be costly. For example, if your parent falls and sustains a fracture, that will require time spent in rehabilitation. If you are not familiar with such facilities in the area that your parent lives in, it may be difficult to start research on such facilities and compare cost. Planning ahead and being knowledgeable on such issues will help you and your parent if the need presents itself.
The decline happens in stages:
Here are the signs when you need to begin to consider stepping in:

Deterioration of personal hygiene
Unpaid bills, unopened mail
Carpets stained with food
Trouble remembering recent events
Change of eating habits
Misplacing objects
Inability to remember if medication was taken or not
Unexplained bruises
Frequent calls to you or others

During the next stage, the severity of the symptoms escalates, and your parent needs immediate involvement of a caregiver:

Odors in the house
Urine stained carpet
Noticeable weight gain or loss
Skin tears or bruises
Repetitive phone calls at odd times
Inability to recall how the day was spent
Offensive mouth odor
Medication bottle either too full or too empty
Final notices on bills
Unexplained dents on the car

If you notice the symptoms above you have to step in before it is too late. You will need to find the right time to sit down and talk to your parent.

The following points should be considered:

Have your parent evaluated professionally, medically, and mentally to make sure a proper diagnosis is made, and appropriate treatment is in place. Home care should be set up if needed, either by the family or paid help.

Write down all of your parentsí financial assets, all their insurance policies, real estate holdings, bank accounts, and safe combinations. Familiarize yourself with the content of all documents. Make copies of all relevant documents and place them in a different location, perhaps in your siblingsí house, for safekeeping.

Make sure that all original documents are kept in one place, and the place is known to you, or to someone else your parent trusts.

Make sure that all documents that are time-sensitive are periodically updated. Make sure that the Living Will reflects your parentís wishes, and includes what should be done for them if they are unable to make decisions for themselves.

Review all life, health, car or property insurance and make sure that they are all in effect, and that they cover whatever they are covering to the max. You may be surprised how many elderly people are paying for policies they no longer need.

Make sure you are aware of your parentís monthly expenses, and that they are paid on time. Elderly people commonly misplace bills, do not open them, or pay the same bill twice.

Encourage your parents to speak about, or to write down if it is easier, what their wishes are regarding the topic of funeral and burial. It may help to bring a third party into the equation; a friend, priest, rabbi, a financial advisor, or other person. At times it is easier to express oneself to a stranger than to your child, regarding oneís own death.

Even as the roles of parent and child reverse themselves in later years, we can carry out the task while continuing to recognize the fact that they are our parents. We should not make them feel childish, or that they are unable to care for themselves. We should promote a sense of dignity and self-respect in our parents and help them to know that their life is of value even though they may need help from others to maintain their everyday routines.