Your Comprehensive Guide to Elder Care for Promoting Work-Life Balance

Elder care is a major consideration when achieving work-life balance. Caregiving can feel like another job, especially for the “sandwich generation” – adults who are caring for their aging parents while raising kids. Now that people are living longer and couples are starting families later in life, there are millions of adults in this middle ground feeling squeezed for time and money as they balance caring for themselves, their children and their parents.

Elder care can involve taking loved ones to appointments, paying bills, grocery shopping, dressing, feeding and bathing. This dynamic can be stressful for the elders involved because they’re coping with losing their abilities and independence. It’s taxing for caregivers because they’re watching their parents decline and may be grieving the parent-child relationship as they once knew it. While this can be demanding at times, the experience as a whole can be very rewarding. Adult children have a special opportunity to return the favor for everything their parents have done for them.

Most people don’t have the training to provide full-time care, and many are thrown into the challenge of maintaining someone else’s life without any preparation. Even if you’ve assumed this role before by having children, this is an adult and there are different considerations.

A study by the U.S. Department of Health and Human Services found that family caregivers spend an average of 21 hours providing care for aging loved ones. If you’re already working full-time, you can easily get burnt out. Signs of caregiver stress can include social isolation, anger, anxiety, depression, exhaustion, irritability, sleep issues and health problems.

People often don’t think about elder care issues until an unexpected illness or injury occurs. The sooner you begin exploring care options and planning ahead, the better.

Here are tips to help you thrive in your caregiving role:

Plan ahead.

Create a long-term plan for every aspect of your parent’s care. Find out what your parents’ preferences are for the care they wish to receive for the rest of their life and who they want to make their medical and legal decisions once they’re no longer able. Some people may want to stay at home as long as possible while others may welcome the opportunity to be part of an assisted living community that provides activities and other social outlets. There are many care options available including home care, assisted living, group homes, nursing homes and retirement communities. If you’re the primary caregiver, it’s important to have a plan in case something happens to you as well.

Support independence.

Whether parents are living at home or in a nursing home, you can find ways to support their independence. Parents should be part of decisions regarding their care when possible. They’re more likely to be positive about the direction you’re taking if they were involved in formulating the plan. If your parents are still living at home, make sure it’s safe and accessible to prevent injuries. Find products that can help your loved ones maintain their independence and make day-to-day tasks more manageable; this can help you out as well. Honor the independence and control your parents still have. For example, if you’re buying gifts on their behalf, let them make the selection online if they’re homebound rather than taking that on yourself and going shopping. As a general rule, treat your parent how you’d like to be treated as you age.

Get your whole family involved.

Elder care requires a lot of time and money. If your parents are financially well-situated and only need physical assistance, your family will have to designate a primary caregiver or determine how everyone will divide responsibilities. The primary caregiver can be an adult child or professional; sometimes children don’t live nearby, or the level of care needed is beyond what laypeople can handle. If one person is designated as the primary caregiver, that doesn’t mean the rest of the family is off the hook. There are ways everyone can be involved. Perhaps the person who is the caregiver contributes time while other siblings pitch in financially. Your family can figure out the arrangement that suits your unique situation. Create a plan that outlines the time and financial arrangements that have been agreed upon.

• If your parent can’t afford the care needed, you and your siblings will need to discuss how you will approach the financial aspect of elder care.
• If you are designated as the caregiver and your parent will be living with you, involve your children since they will be living with their grandparent. This can be a valuable teaching experience for children to learn about compassion and caring for others.
• If you’re not the primary caregiver, think of ways you (and your siblings) can support that person, whether it’s helping with house upkeep (e.g., paying for housekeeping or helping with yardwork) or giving the caregiver days off to recoup.
• Communication is essential to keep family members informed, especially if they’re financially contributing to the care. The primary caregiver should keep everyone in the loop and schedule regular calls or send email updates. Shared drives such as Google Docs can be used to record finances and health updates for everyone to access.

Create a financial plan.

Whether your parents want to stay in their home as long as possible, or as a family you’ve decided it’s time for long-term care, elder care is expensive. Be open and honest with your parents and family about the cost of care that’s needed. As you prepare for this expense, you’ll need a thorough understanding of your parents’ financial situation – assets, income, expenses, debts, insurance policies, wills, power-of-attorney assignments and anything else that pertains to their finances. Make sure you know where those accounts are held and important documents are stored. Assess their financial situation to see if there are things they’re paying for that are no longer needed (e.g., car insurance if they’re not driving anymore).

Other considerations:

• If your parents have a financial advisor, set up a meeting to review their assets and ensure the adviser has your parents’ best interests in mind.
• If your parents don’t have long-term care insurance, consider it.
• Make sure their bills are being paid on time. If insurance payments lapse, important policies can be canceled, which can be a costly oversight.
• If your parent’s funds aren’t sufficient, figure out how you’ll pay for care. If you’re going to pitch in, this may require examining your own finances and cutting back on spending or investments. You may want to consult a financial professional yourself.
• Get familiar with Medicare and Medicaid.
• Explore what free and low-cost services are available.
• If possible, use a separate account to pay for expenses related to your parent’s care.
• Keep in mind that elderly people are often targets for financial scams.

Be clear about the care you can provide.

When creating a care plan, be honest about the care you can and cannot provide. For example, if your parent needs to be lifted to be bathed, and that’s beyond your physical capability, make it known. You and your loved one (and family) should figure out the best way to fill in those gaps in care. If you’re busy driving your kids to lessons and sports practice throughout the week, find a senior transportation service that can help your parent stay mobile. If your parent is relying on you for their social life, locate social outlets for them. Be realistic, not only about the type of care you can provide but the amount. If you’re working full-time and a loved one needs full-time care, you can’t realistically provide it. Family members, adult day programs, in-home care and senior companion programs are all resources at your disposal. You can automate errands for your loved one; mail-order prescriptions, grocery and toiletry deliveries and other conveniences can save you time (and in some cases, money).

Take time for yourself.

You need to take care of yourself so you can be the best caregiver possible. It benefits your loved one and helps prevent burnout. Caregiving can be emotionally, mentally and physically draining. Take time to recharge. It’s important to care for your own health by fitting in physical activity, eating a balanced diet, getting enough sleep and practicing stress management techniques. This will be more challenging if you need to make arrangements to get away, but that can be incorporated into your parent’s care plan. If you’re not healthy, how can you care for your parent’s health?

Seek professional help.

If you’re feeling stressed, take a step back and think about the support you need. It’s easy to experience anxiety without knowing exactly what you’re anxious about. Reflect on your current situation and identify what problems need a solution.

• If your parent was your main source of emotional support and you’re having trouble coping with your new role as a caregiver, consult a counselor.
• If you’re struggling to figure out how to handle the high cost of care, consult a certified financial professional.
• If it seems like your family doctor isn’t quite addressing the unique issues of your aging loved one, find a gerontologist.
• If you’re finding yourself overwhelmed by the logistics of managing your parent’s care, there are geriatric care managers who can oversee their care.
• If you’re noticing that your responsibilities are taking a toll on your relationship, hire in-home care so you can enjoy a night out.

There are many experts who can help; tap into the network of professionals in your area. If you don’t think you can afford professional help, check if your company has an Employee Assistance Program (EAP). EAPs provide access to many services that are paid for by your employer including counseling, legal resources, financial consulting, information and referrals for elder care, and more.

Get help from your community.

You may not want to share the burden of caregiving or trust others to provide the same level of care, but you simply cannot do it all yourself. The sooner you accept this truth, the sooner you can get the support you need to avoid burnout. You’re living your life and sustaining another, and there are only 24 hours in the day; something has to give.

If you’re the primary caretaker, get help with other tasks such as paying bills. Accept help when it’s offered. And when it’s not, ask for it. Outsiders often don’t know how to help but would like to. They may assume you have it under control until a request is made. Start delegating. And if financially possible, hire help if needed.

Write down your loved one’s schedule, along with detailed instructions and important information regarding their care. Having everything written out makes it easier for people to jump in and help. This is especially important so you can get breaks to recharge. Document:

• Your parent’s daily routine
• Medical appointments and events
• Treatment instructions
• List of medications and supplements, along with dosages
• Important tasks people can help with – picking up prescriptions, grocery shopping, meal preparation, laundry, household chores and arranging social events (e.g., outings or visits)

Know your stuff.

Learn about your loved one’s illness so you have a better understanding of the condition and can provide the appropriate care. This may also prime you for what’s to come. Take advantage of doctor’s appointments as an opportunity to ask questions. If others help out by taking your loved one to appointments, send along your written questions. Be prepared to navigate all the logistics of providing care. There often are illness-specific support groups at local hospitals that discuss the condition and proper care, as well as supporting the loved one. The internet is a great resource, as are friends and family who have been through it.

Be a health care advocate.

Managing another person’s health care is no small feat. The medical system is complex, making it easy for the details of a patient’s care to fall through the cracks. If your parent is receiving care from multiple doctors, someone needs to oversee the treatment plan as a whole. As you help your parent navigate health care, keep in mind that you understand the full scope of your parent’s health more than a doctor who spends only minutes with your loved one. At times, you will need to stand up for your parent to ensure quality treatment.

Here are tips for being a health care advocate:

• Accompany your loved one to appointments (or recruit someone else to do so); ask questions and write detailed notes (with the date). The details of your parent’s condition or instructions for care may seem clear in the office, but may start to get fuzzy once you get home.
• Make sure you understand all treatments and medications prescribed, and help your parents follow through.
• Review all medications and supplements with your parent’s doctor and/or pharmacist on a regular basis to make sure they all safely interact.
• Maintain your parent’s personal medical history.
• Create a binder with folders to house information pertaining to each doctor from which your parent receives care. You can store physicians’ business cards, copies of medical cards and other relevant information here as well. If this system doesn’t work for you, create one that does. You’ll benefit from having all this information in one convenient spot.

Get support.

There are lots of organizations that provide information and assistance for caregivers (many are listed at the end of this post). Doctors are also great resources and can help you navigate the medical system. Support groups are available both online and in person if you need a community who can relate to what you’re going through. Make sure you have someone you can turn to – an advisor, clergy, friend or counselor. There will be times you’ll simply need someone who can listen.

Know that caregiving may take a toll on your career.

Caregiving can stall your career advancement. This isn’t necessarily a bad thing – there’s more to life than work, and relationships are invaluable. But it’s important to come to terms with this during this phase of your life. If you’re unable to travel for business or need to work non-traditional hours to accommodate your caregiving schedule, it may lower your chance of a promotion. Think twice before quitting your job to care for a parent full-time. While it may be challenging to achieve work-life balance, carefully consider the consequences of resigning:

• Can you survive financially despite your loss of income and benefits (e.g., health insurance)?
• Would it jeopardize your retirement savings?
• What are your chances of picking up where you left off when re-entering the workforce if you take a few years off?

The first step if you’re having trouble striking a balance is exploring what resources are available to support you and your aging parent. If you’re still having difficulty, talk to your supervisor about flex-time options or review your company’s policy on family leave. Openly communicate your situation and see what conditions can be made. For example, if you’re having trouble getting to work on time due to morning caregiving duties, see if it’s an option to shift your day so you come into work later and leave later. If you find that caregiving tasks, such as phone calls, are affecting your productivity, address these items during your lunch hour.

Be realistic.

Your aging loved one’s condition probably will not reverse. Having unrealistic expectations can lead to heartbreak. As your parent advances in age, the reward doesn’t come from them getting better but from the integral role you play in their quality of life. It’s easy to feel angry or anxious at times; that’s natural and perfectly normal. Just try not to stay in that place.

Throughout the process of caregiving, never lose sight of the gravity of what you’re doing – for your parent and your family as a whole. The role you’ve taken on is what community is all about – people looking out for each other. It’s a noble undertaking. Always remember you’re not an expert; you’re doing what you can and giving an incredible gift to your loved one.

Here are some valuable resources to assist you in your caregiving role:

• • AARP
  • Adult Day Programs
  • Aging in Place Workbook
  • Aging Life Care Association
  • Caregiver.com
  • Caregiver Action Network
  • Caregiver Resources
  • Elder Care and Long-Term Care Resources and Reference Materials
  • Family Caregiver Alliance
  • Government’s Eldercare Locator
  • In-home Caregiving
  • Long-term Care Calculator
  • Medicaid
  • Medicaid Planning
  • Medicare Caregiver Resources
  • National Association of Area Agencies on Aging
  • National Caregivers Library
  • National Council on Aging’s Benefits Checklist Service
  • Senior Care Aides
  • Senior Companions
  • VA Benefits