The Big Balance Part 2

[Editor’s note: Betty Booker, a regular BOOMER contributor, is also one of the area’s foremost experts on caregiving, through both reporting and personal experience. Her evaluation: “I am convinced that informed plans, organization and awareness of personal limits lessen the stress of managing someone else’s life.” In this issue, she explains not only why but how. ]

Scott McGregor cares for the clients at his Museum District family salon, aptly named Serenity. They settle into his hairstylist’s chair and sometimes unload their struggles to balance demands on their time and energy. He listens.

And he understands, more than they may realize. As a teen, he took care of his grandmother, then as an adult, his mother. That was so consuming that he stopped working for two years to tend her.

Despite the financial toll, he says he doesn’t regret it for a minute. “Now I make sure my caregivers (clients) pamper themselves. It’s okay (for them) to recharge their batteries mentally and physically,” McGregor, a boomer, continued.

THE SUDDEN CHANGE THAT OVERWHELMS

“People are often thrown into the role of caregiver in a crisis situation, suddenly and without knowing what the impact will be on their lives,” said gerontologist Adrienne Johnson, executive director of SeniorNavigator.org. a website resource for aging in Virginia.

For boomers, whether planned or taken on in crisis, caregiving involves a not-one-size-fits-all attempt to keep their own financial, physical and emotional health in good shape. BOOMER got advice from many experts on how to do so for those on the caregiving learning curve.

10 TIPS FROM THE EXPERTS

1. SELF-ASSESS. Marian Dolliver, a Central Virginia pioneer in caregiver support and support manager at Senior Connections, advises caregivers to look at these types of questions and answer them in writing as honestly as possible:

a. What is your own physical health status?

b. What is your own emotional health status?

c. What are your work and family responsibilities (including pets)?

d. How well do you get along with the person you will help?

e. After reviewing those answers, what services such as shopping, cooking, bathing, doctors appointments, errands or bookkeeping can you reasonably provide?

2. LIST YOUR SELF-CARE ESSENTIALS. Beyond sleep, working and other essentials, what should be included in your life to maintain the YOU that you want and need to be? Different for everybody, that might mean time with grandkids for one person or time to exercise for another. What must be preserved and what can be dropped from the list?

3. KNOW WHAT YOU CAN AND CANNOT DO BY YOURSELF. Not asking for or accepting help can cause serious, even life-shortening, health problems for the caregiver, noted Dr. Richard Lindsay, University of Virginia emeritus professor of internal medicine and family practice. One person cannot handle round-the-clock nursing care. Have a list of task-specific requests. What tasks can be delegated to professionals, siblings and volunteers such as church visitors, friends, neighbors and senior community organizations?

If you’re the main caregiver and have siblings, ask them for periodic respite such as: “Can you visit on Sundays so I can have a free day?” Then get a firm commitment. If relatives prove unreliable or disinterested, find volunteers or other resources.

4. LOOK FOR HOUSING AND CARE OPTIONS THAT BEST PROVIDE WHAT IS NEEDED. One of the best things caregivers can do for themselves is to orchestrate the right housing and care environment, even though there might be resistance. Downsizing and moving to a life-care community can help prevent boomer financial losses and lighten the caregiving load significantly, according to Peter Robinson, a vice president of the nonprofit Virginia Baptist Homes.

Elders might be resistant to change, but chances are the colonial with four upstairs bedrooms that worked when you were a child isn’t needed – and is far from ideally suited – for this stage of life. “So many seniors’ needs can be met by finding the right housing and care environment. There are more options than most people know about or understand. … Richmond has more than 100 seniors communities that offer a variety of solutions from low-income to high-end homes, or from those who need no personal care to high levels of medical care,” said Katharine Ross, vice president of Seniors Guide, a local free magazine and website identifying and explaining these options. [Editor’s note: Seniors Guide is published by Ross Media Solutions, BOOMER’s parent company.]

Sometimes people balk at moving because it simply seems too daunting to handle. There are moving companies that specialize in the unique needs of the elderly. Senior move specialist and owner of Door-to-Door Solutions Katie Hamann advises: “Hiring help to delegate the tasks of the move, or the organizing of the home, will save hours of time that can then be spent enjoying the person you are caring for, or just give you time for yourself.”

Here’s a housing checklist to consider:

a. What are the financial and time costs of the current housing, such as lawn and yard maintenance, interior maintenance and repairs, taxes and utilities, regular housekeeping services and mortgage?

b. What will those costs likely be in two years? Five years?

c. What difficulties are likely in the future in this environment? Isolation? Lack of transportation? Maintenance issues? Mobility problems?

d. Is a family member or caregiving friend living nearby? If not, lack of proximity may be a serious problem waiting to happen.

e. How will aging in the current home be addressed if more assistance is needed with bathing, grooming, transportation, cooking or medical care?

f. Which expenses will be eliminated by moving from the current home? What assets are freed up? How much money will be available for a new home?

g. What social needs are desired? Taking a pet? Companionship? Bridge games or golf?

5. SEEK FINANCIAL GUIDANCE – AND EVEN A SECOND OPINION. “What happens when parents’ assets are done?” asked financial counselor Pete Wrampelmeier. “Are you willing to use yours? Is that the smartest thing to do?”

Before shelling out your personal savings, discuss your investments with a reputable certified financial planner. Make an appointment at Senior Connections (804-343-3000) or an area agency on aging where your parent lives to get a free, confidential overview of available resources for your parent. The resources for your parent help you, too, and conserve your savings for your own retirement.

Stories about poor advice abound, as when spouses, faced with their mates’ nursing home bills, are wrongly advised to divest all marital assets to qualify for Medicaid, the health insurance for low-income people. Don’t do that. Retaining some marital assets for the at-home spouse is allowed by Medicaid. Plus, Virginians can buy special long-term-care insurance, called “Partnership qualified policies,” that protect some assets if Medicaid is required. Visit partnershipforlongtermcare.com.

Consult an elder law attorney specializing in Medicaid qualification, the earlier the better, especially if you suspect you won’t be able to afford expensive long-term care. Contact the Virginia State Bar (vsb.org) for Medicaid legal specialists and for the Senior Citizens Handbook, a comprehensive guide to major issues faced by seniors and their caregivers of all ages. Visit Genworth Financial Inc.’s Genworth 2014 Cost of Care Survey (genworth.com) for long-term-care costs at home, adult day services, assisted living and nursing homes.

6. CONTROL THE PAPERWORK DELUGE: Especially if bookkeeping isn’t your talent, keep filing simple.

The idea is to be able to find papers when you need them. If that’s too complicated, put everything in one file for each month. If you aren’t good at filing and bill paying, let another trusted relative or bonded and insured reputable professional handle it while you focus on daily tasks. A free service is Senior Connections’ bill payer service. The agency also hosts a periodic free senior pro-bono legal “law day” program to draw up simple wills, powers of attorney and advance directives for people 55 and older. AARP’s Tax-Aide Program helps file seniors’ simple returns without charge.

7. SO YOUR FAMILY HAS “ISSUES.” Yes, real families have issues. “Sometimes when I have worked with adult sons and daughters with aging parents, I have heard their stories of how demanding an aging person can be if there are tendencies in that direction,” said the Rev. David H. Knight, interim priest at the Church of the Epiphany (Episcopal). “Being gentle but firm helps the caregiver keep some sense of sanity. Keeping some space is essential,” he said.

Set limits with imprudent siblings as soon as possible. Write a letter (so you’ll have evidence that you’ve given notice) that you will not be able to send them money for their retirement.

8. CHIP AWAY AT WASTE. Financial counselor Wrampelmeier said: “Ask yourself, when there are limited resources, what is important to me? You don’t want to be so self-deprived that you don’t enjoy life, but don’t forget that a $5 latte five days a week adds up to $1,300 a year. If you don’t have enough money for your real estate taxes, don’t go on a beach vacation. Consider a ‘staycation’ at home with day trips. Check the library before you buy a book. Curb impulse food buys. Exercise? You have a whole outdoors that is a gym. It costs nothing to take a walk.”

9. YOU NEED A CONFIDANT. You need someone who won’t flinch or blab when you speak your truth. Whether you need to cry or laugh sometimes, share this part of your life with at least one person. Just as important, avoid confessions to folks who judge or trivialize the hard realities of living someone else’s life.

10. LOVE YOURSELF. Caregiving is an act of love and compassion. You deserve to give the same to yourself.

WHAT THE EXPERTS ARE SAYING

“Part of the battle is understanding that you need to accept help and not go it alone.”

Adrienne Johnson, executive director, SeniorNavigator.org 

“It’s very hard to strike a balance between taking care of someone else and taking care of yourself. But we need to and ought to.”

Scott McGregor, owner, McGregor’s Serenity Salon 

“Support groups can be helpful. People say they don’t want to share their dirty laundry, but somebody else there may have solutions to your problems. The reality is that most of the people in a support group have the same feelings. They don’t think anything of somebody blowing off steam.”

Sherry Peterson, CEO, Alzheimer’s Association, Greater Richmond Chapter 

“Caregiving is exhausting work. I often meet caregivers who are so consumed by the doing of all the tasks that they lose track of the person for whom they are doing all the work, and this can lose the meaning and purpose of their gift.”

Katie Hamann, owner, Door-to-Door Solutions