Evelyn began spending her weekends researching and visiting assisted living facilities in her area. When she found two she thought her mother might like, she brought Jean down for a weekend and they visited them both. Jean didn’t like either one. She thought they were too institutional feeling and she didn’t want to eat in a dining room with “a bunch of old codgers and biddies.”
Evelyn kept looking, this time with the help of a senior care manager (SCM) who was more familiar with all the options for senior living in her area. The SCM introduced Evelyn to an alternative she had not been aware of: a spacious, one-level, suburban residence that had been converted into a board and care home. The man and woman who owned and ran it were both licensed practical nurses and they seemed dedicated to their calling. They also had several part-time aides who came in to assist in the cooking, cleaning, and care of the three residents they could accommodate. The house had a homey and comfortable feel. Evelyn met the two current residents, who seemed happy and well cared for. She also contacted their families, who told her they were very impressed with the kindness and attention their older loved ones were receiving. Like Jean, the other residents needed supervision, but otherwise were relatively independent, still mobile, and required no intense care. They were happy to be living in a comfortable home with no responsibilities for cooking, cleaning, or household upkeep of any kind. Everyone had their own bedroom and bath, and could have privacy or companionship, as they chose.
To Evelyn’s delight, Jean agreed to “give it a try.” Together they spent the next six months getting Jean packed and moved. She was reluctant to get rid of anything, but in the end agreed to give most of her prized possessions to her grandchildren and give the rest to charity. She moved into the board and care home with her own bedroom furniture, sheets, towels, and her many family pictures, which were re-installed on the walls of her new bedroom.
There were a few setbacks in her adjustment to the new life, but after two years, Jean finally agreed to let her daughter and son-in-law sell the old family home—a major milestone. Jean, now in her mid-nineties, is happy and well cared for. She gets frequent visits from Evelyn and her two nearby grandkids, one with a new baby—her first great-grandchild.
Where there are no adult children to push the issue, most older people simply stay where they are and cope as best they can. In fact, even when there are adult children in the picture, many, like Mary in our earlier story, are not able to convince the parent to move to a safer location. For many elders, the challenge of learning to navigate a new home (even a much smaller space), meet new people, give up familiar surroundings, and relinquish their treasured independence seems loathsome, insurmountable, or both.
Investments and Other Financial Decisions
As time goes on, some older adults begin to feel they are gradually losing touch with the ever-changing realities of the outside world. Adult children in the prime of life may have a better grasp of the current economic challenges or financial realities of the day. At eighty-five or ninety, a person’s mental faculties are often not all they once were. When an older person is aware of this, they might decide to let a capable and trustworthy adult child take over some or all of the financial decisions—maybe handling the investments and doing the income tax calculations—sometimes in conjunction with a fiduciary or financial advisor.
As with a residential move, some older parents see financial help as “interference.” There may be strong denial their behavior has changed, even with clear evidence such as an unfiled tax return or the purchase of a peculiar item. The parent’s denial makes monitoring the situation more difficult for the adult child who must find a way to check up on the parent without causing too much conflict.
Legal Representation
Children are most often named first on durable power-of-attorney documents (DPOA) for financial matters and health care decisions. A DPOA allows them to have legal proxy for all decisions in one or both of these domains, meaning their signature is treated as the parent’s own. Barring a lack of trust among family members, the child named on the document may be the one considered by the parent as the most competent in that area, the one living the closest, or the one considered the most astute or fair.
Bill Paying and Handling Money
An adult child often takes over money management when a parent requests help or starts displaying diminished cognitive abilities. This kind of decline shows up when a person discovers the parent has not been paying bills on time or has been writing checks to unknown recipients. The adult child then takes over the checking account and begins to shift credit information, redirecting bills and financial statements to himself or another of the adult children. Adam’s mother, in her late eighties, was aware of her diminishing capacity to handle her own day-to-day financial affairs and asked him for help:
Adam took over his eighty-nine-year-old mother’s finances after she had a debilitating stroke. Even before the stroke she had started to talk about giving up her driver’s license and was asking Adam to help her with household tasks on a more frequent basis. When the stroke occurred, she became unable to speak or write for four months. Adam recalls having her legal power of attorney a “Godsend.” The POA allowed him to get his name added to all her accounts, manage her income, pay her bills, file her taxes, and wade through the mountain of medical bills and statements that arrived daily. He was also able to arrange for her in-home long-term care and to pay himself and his other siblings for out-of-pocket expenses that occurred in the first few days of her hospitalization. After his mother recovered most of her mobility and some of her speech, Adam continued to manage her finances, and his mother expressed relief and gratitude that she had someone to take over for her.
To a great extent, involvement like Adam’s in the life of his mother will also protect her (and the estate) from financial scams by those who prey on older citizens.
Medication Management and Help With the Activities of Daily Living
Managing and monitoring medications, ensuring there is food available, and help with personal hygiene are all areas where assistance is often needed as aging parents progress into their final years. In elder care residential communities, staff provide many of these services, yet the adult children continue to take their parents shopping (or shop for them), accompany them to medical appointments, pick up prescriptions, help them put on a nice outfit for a family visit, etc.
Who will be there to help us with these things as we age? The many responsibilities and activities adult children undertake on behalf of their aging parents provide clues to how we should prepare for a later time—a time when we may not be quite as mentally sharp or as physically able as we are today.
The Social Network
As we age, our social network plays a very big role in our well-being. Parents, no matter their age, may include in their social network their children, their children’s friends, the parents of their children’s friends, their children’s in-laws, their grandchildren, and so on. One can imagine how easily and organically this network grows, even with just one or two kids. Those without children, on the other hand, create their social network by design, often including friends, colleagues, neighbors, church members, and other like-minded people as well as any siblings and those offspring interested in staying close.
During the years when parents are changing diapers, helping with homework, and playing chauffeur, those of us who are child-free are developing outside interests, deepening friendships, building their careers, and sometimes playing a role in developing their communities.
The following diagram illustrates the make-up of a typical older parent’s social network. The stronger the tie, the darker and wider the connector:
Where does this leave the rest of us? Ties with friends, siblings, nieces and nephews and even community