Eldercare: Engaging the softer side

This article was originally published in 2006.

Patty Randall understands that caring for an elder loved one is no small task. For 10 years she was the primary care guide for her aging parents who, after being separated involuntarily by health issues, were living out their long-term care years – her father in a nursing home and her mother in her own home. After her father passed away, Randall set up what she describes as a virtual mini nursing home in her mother’s Okanagan home, and cared lovingly for her mother until the latter’s death last summer at the age of 94.

Randall’s is a scenario that many children of Canadian elders can relate to — the issues surrounding the transference of care to aging parents, including determining who is the appropriate person to provide the care, where that care should take place, i.e. in an assisted care facility, long-term care residence, or simply staying put at home — or with offspring — and importantly, how that care will be funded.

Her experiences with caregiving compelled Randall to spread the word to Canadian boomers and young seniors about the intrinsic need to become proactive in their own care planning — and to do it well ahead of the game — in order to ease the burden of those “less-than-glamorous” care years. She penned her adventures in her popular book entitled, Let’s Talk – The Care-Years… Taking Care Of Our Parents/Planning For Ourselves. An extensive guidebook for all families to follow.

Although her book targets the Canadian consumer, her multifaceted role as a consultant, speaker and author of long-term care issues, allowed her to come face to face with Canada’s financial advice sector. Aside from the more complicated tax and estate planning issues, Randall recognized the benefit in simultaneously informing this group on some of the necessary softer strategies to help guide their boomer and senior clients through their respective caregiving experiences.

In an interview, Randall talked about some of these more tender tactics.

AE: How do advisors get their aging clients — and their families — talking about the important issues surrounding care?

PR: First and foremost is communicating that “care” is an acceptable four-letter word. Each family should have what I call “DRIP” conversations. Once you hear about a particular concept you may not absorb it the next time you see it, but pretty soon you’ll [realize], “You know, I should start thinking about that.” So you have to drip the information on this issue to people — you can’t spring it on them. Advisors can also offer “drip information” to clients. For example, every month or two they may see an interesting article related to their aging client. [They might] clip their card to it and send it off to them. Then, if they want to start talking to clients about this issue, they have to do some drip communication. And families do too.

AE: What types of things should advisors ask in these conversations?

PR: The first thing they have to ask is who is going to be [the elder’s] care guide? It’s very important that families have the discussion about the care guide. We’re not talking about moving [that person] into a nursing home yet, but ask, “When the time comes, if something were to happen to you tomorrow, who’s going to be your guide?” We all have executors for when we die, we have powers of attorney — and it may or may not be the same person — but a care guide is very much required in our lives, given the century we’re living in. We can’t go without that now because length of life is expanded. So an adult child would ask, “Mom and Dad, if you were to fall tomorrow and needed hip surgery, who’s going to be your care guide? Who’s going to help you in the hospital etc.?” It would likely be two people: It’s going to be a spouse — up to the age of 70. Statistics Canada says that after 70, if the client is of comparable age, he or she had better put a child down as a second care guide.

AE: Many parents of boomers tend to communicate differently than a younger generation. They are often more inclined to keep things to themselves and rest on vested pride. How can advisors get these people to open up more about their wants and needs?

PR: There are several things an advisor has to touch on. The first one is that the discussion on care has to be a gentle one. You’ll begin to understand the dignity and the need for independence, which is highest. Independence is a trigger word for seniors in Canada, and it’s the trigger word to use in all of your discussions and articles with seniors. They want to remain independent. And the boomers have to respect what that independence might mean. How a senior sees independence is related to things such as personal appointments and errands. Those are the things that are important for their independence. If there’s a lot of [talk] about independence, they will start talking to you about other things — one of them being their everyday health.

AE: What do advisors need to know about care trends when a caregiver is a part of the “Sandwich Generation?”

PR: It’s no longer the Sandwich Generation. Now you’ve got children, work, your own family and parent- or in-law care. So now it’s called the Clubhouse Sandwich.

Think about it — this could be four-way — four persons in the marriage. Let’s say you were married. You’ve got your own mom and dad and your in-laws, and they’re all going to go into care. You could have what’s called a forced separation taking place — forced by health basically. In my case, for the first two years I had Mom and Dad living in the same house. So you’ve got your care situation set up there for both. Then dad’s health changed and we couldn’t cope at home because of his dementia. He had to go into a nursing home. So that’s one cost. And then my mom was still being cared for at home. So now you’ve got two care scenarios and the combined costs. Let’s say you’ve got a care scenario in your house that’s costing you an extra $5,000 in fees and equipment etc., and you’ve got another care-home scenario that’s costing you $4,000. Your costs now are not one or the other — they’re combined for two parents. Now, for a couple that is caring for both [sets of] parents — you’ve got that happening four times over.

AE: So how should advisors guide clients through these potentially staggering care costs?

PR: Advisors need to inform clients that everyone needs their own care insurance. The care they buy isn’t necessarily going to be something that [both parents] will use at the very same time, in the very same place, because it could alter differently. You can walk hand-in-hand with your husband till you’re 84-and-a-half, and you’re both staying at home, and you’re fine, but at 85, one may end up in “A” [care situation], and one may end up in “B,” and the [resources] have got to cover both. It’s like having double the amount of those resources available in case things go off track.

AE: What can advisors tell these boomers to help them prepare ahead of the game?

PR: Well, like Dr. Ken Dytchwald says, “We want to retire the word retirement.” Now we want to use the word “empowerment years.” If that’s the case, then I want that empowerment to decide on my care. If you’re an advisor, you’re talking to me first as a woman, second, you’re talking about my parents’ care; and then you’re talking about my own care. You just have to know a lot. I want part of my lifestyle plan now to include my care plan, which includes long-term care insurance for me. When I buy long-term care is critical to me, especially what it covers and the benefits triggered. I don’t think we can be subtle about care. We’re not getting the message. I never got it. I didn’t know what planet I was on when care hit. I thought, “How did I miss this for 50 years?” Some women are saying, “Caregiving is a career we never planned for ourselves.”

To learn more about Patty Randall please visit her web site at www.longtermcareCanada.com.