Resources for adults to care for parents
May 5, 2017 9:52 AM   Subscribe

My mother is 75, and is clearly a little "lost"--while active and independent, it's becoming apparent that things like Medicare, estate planning, how to pay her cell phone, are eluding her. Some of these are tough, to be sure, but when she was younger, she would have figured them out. She needs (and asks for) my help--but much of this is new to me. What resources are available for adult children as they become caregivers to older parents?

Case in point, with the cell phone--She recently switched carriers, and just ignored all the emails and billing reminders she was sent until she got a text warning her that her service would be cut off the next day if her arrears were not brought to date.

And immediately precipitating this question, she's having some health issues that have led her to discover that her Medicare supplement is not accepted in the state where we live (she moved here 18 months ago).

She needs and wants some help, and I can provide it, but I don't have expertise in most of the areas in which she needs support. I know nothing about Medicare, though I have an estate planner to set her up with. Cell phone billing I can handle, but only to the extent I know about it, and I'm not reading her emails.

There are lot of dimensions to this transition, some emotional, some pragmatic. I'm sure I could figure much of this out, but it would be so much easier to learn from others who had been through this.

Massachusetts specific resources would be great, but anything would help.
posted by Admiral Haddock to Human Relations (8 answers total) 52 users marked this as a favorite
Some things can be done that are the least invasive but can provide both you and your mother with the assurance that her needs are being looked after as a follow-up until you need to be the complete overseer of finances. Set up a billing email account through a gmail account: have the major bills funneled to that account. Your mother will have the login and password so she can access it if needed and you will also have access to the account. Check it as you would your own financials (per morning, preferably) and also auto-pay most of what you can through a draw on her checking or credit account. This will simplify the process for making sure things with monthly dues are taken care of and receipts can be saved in a folder on the gmail account to have a running tab of what's been paid.

The best thing during this time is to make things routine for her. Familiar places she always puts things, a list of important people and numbers in a small notebook she keeps in her purse or in a pocket, set a daily alarm on her cellphone to remind her of her meds, if need be.

There are several guides available on AARP's website about the conversations to have and the plans to start making now as the needs are manifesting. I used something similar to this about 15 years ago when I cared for my grandmother and I am using similar resources to plan for my mother's transition currently.
posted by missh at 10:17 AM on May 5, 2017 [2 favorites]

I had to deal with this and still dealing with it for my dad when my mom passed away a couple of years ago. She was his primary caretaker and it is a lot of work to handle.

First thing is to get yourself added as an authorized representative for her for: Medicare, MassHealth (is she's on it), Social Security, any other government agencies, doctors and utility companies if you can, so that you can call on her behalf and speak to them if you need to. They will ask you to mail or fax it in. Make a copy because they will lose this form, they will not find it in the system or they will just be too lazy to look for it. So keep a copy to send in a again when needed.

It would be good for her to give you power of attorney. That would make it easier for you to deal with bank, utilities, etc...

Create online accounts for her now on the websites for medicare, masshealth, social security, etc... I know for a fact the SSA will not let you create one for another person even you have their permission. How will they know? They won't but if you have a technical issue and call in like I did you will not get far.

Is she on MassHealth? She should be able to get home care, personal care, and possibly other services covered. My parents were getting services directly from an agency but after my mom passed away I contacted Springwell and they basically act as the liason between my dad (really it's me) and the agency so that there is accountability, that they are providing the services and doing the things that they are required to.

Medication management? Dad had a visiting nurse come once a week and organize his medication. That got taken away because they couldn't get it paid for anymore. Originally she came after he had had a stroke but it wasn't necessary after a while. We had an isse with him taking his medications correctly. The eventual solution was to have the pharmacy organize the pills into pouches so that all his morning meds would be together pre-arranged and all his evening meds would be the same way so all he would have to do is to rip the morning pouch and take the meds etc...

I created an email address for him and set as many of his bills as possible to be sent electronically. I get an email for a bill that is due and then I can pay it online from his bank account. My brother was added to my dad's checking account so that we don't need to drag him to the bank every time some physical banking needs to happen. I set up bill pay through the bank account and pay bills, even his rent, that way.

Next steps for me is to get him internet service and set up a camera or computer/tablet so that I can have visual contact with him on a regular basis. Sometimes he doesn't tell us he's having an issue until we see him in person. And if it's serious like an eye infection and we don't know about it for a week, away to urgent care or the ER we go because it's usually on a weekend.

I am also in Massachusetts so if you have any questions please send me a message or ask here. If I think of anything else I will post back.
posted by eatcake at 10:18 AM on May 5, 2017 [6 favorites]

1) If your mother has saved any significant money, it's a good time to find her a good family/elder law attorney. This attorney can likely provide direction regarding the medicare question and many many other issues you will be facing. WORTH THE MONEY if you can find a good one.
2) Either with that attorney's help or (if a lawyer is out of the question) using internet research, draw up a durable power of attorney so you can act on your mother's behalf
3) Find out what the living will/health care power of attorney laws are in your state and get those documents drawn up. This is one place where that attorney would be helpful.
4) With your mother's assent, get yourself added to her accounts so you can easily keep an eye on things and detect any problems.
5) Put as many of her bills as possible on autopay, to a single credit card, which you can review regularly and detect any problems there.
These are some of the steps I followed in the past few years as my father travelled the same path as your mother.
It's also a good idea to track down and consolidate her assets sooner than later. Over a lifetime, people of our parents' generations might have amassed a bewildering array of savings/investment instruments and it's better to get a handle on it before her memory/cognition degrades further.
posted by BigLankyBastard at 10:19 AM on May 5, 2017 [5 favorites]

Does she have a primary care physician? Usually, a PCP can refer you to a caseworker or hospital social worker who might be able to guide you.

Massachusetts Area Agency on Aging might also be a help.

It sounds like you could benefit from a joint session with a caseworker and/or therapist to brainstorm and guide you.

One thing I can tell you as someone who had elderly parents: If possible, put all bills on autopay. This ensures everything gets paid on time and without fuss. Even my Luddite parents were fine with the autopay once I showed them how it worked and set it up for them.

You might also consider a convenience account to make sure any necessary payments can get made if she's in the hospital or otherwise incapacitated.
posted by Rosie M. Banks at 10:21 AM on May 5, 2017 [4 favorites]

At the risk of tiresomely providing the same answer: get powers of attorney, general and medical. Don't put it off because you don't really need them yet. When things go south, they do not always go south gradually; and if they happen to do so suddenly, you will want to have all that stuff already done.
posted by Sing Or Swim at 11:13 AM on May 5, 2017 [1 favorite]

One thing to check is whether your employee benefits include anything like eldercare consulting. We're in MA and found recently that work benefits could link us to a social worker who had knowledge of resources. Your local Council on Aging (or whatever your Town calls it) isn't a bad place to start, either, just for finding out what resources are out there.
posted by ldthomps at 11:29 AM on May 5, 2017

In my area there is Mystic Valley Elder Services. They cover Chelsea, Everett, Malden, Medford, Melrose, North Reading, Reading, Revere, Stoneham, Wakefield and Winthrop, and while I've only just started talking to them about my mother, so far they've been very helpful.
posted by clone boulevard at 11:52 AM on May 5, 2017

I did this with my dad. Like your mom, he was willing to accept help, which is HUGE and will make everyone's lives so much easier. All of this turns into "let's get our ducks in a row to be on the safe side" (which is what it is!) instead of "you're taking away my independence".

All of this is going to be way too much to do all at once; get the lawyer-stuff done first, then other things pick maybe one or two related things per month to do.

My advice:

First and as soon as possible: Go to a lawyer with your mom and get a Durable Power of Attorney and a health proxy written up and signed. Make many copies of both documents. Once you have those in hand, everything else is just making things easier on everyone, not actually vital. (Make sure you have a conversation first about what her wishes are, obviously.)

Go with her to her bank(s) and put your POA on file, and also have her add you to her account(s) as joint owner with individual signing privileges, and have your name added to the checks along with hers. She's still in control of the accounts, but if anything happens, you won't actually need to invoke your POA to send someone a check, you can just write it on your shared account. While you're at the bank, have her add you as a second owner on her safe deposit box, with individual access to the box if she has one. Safe deposit boxes are completely separate from bank accounts, and if she dies (god forbid) your POA is instantly worthless; you want to have legal access to all of these accounts/boxes already set up in addition to the POA.

Go with her to her next doctor's appt and put your health proxy on file, and if there's a particular hospital she goes to, put it on file there, as well. Get a rundown of her physical status from the doctor so you're all on the same page with what's going on.

Sit down with her on a separate day and go over finances: what income she has coming in and how & when she receives it; what bills she has going out and how & when she pays them; how her taxes get done and where her copies are; etc. Don't forget about annual-type expenses. Also make a list of all of her credit and debit cards, and take a look at the credit card balances. (One of my dad's unexpected things was the sudden appearance of store cards, which he'd avoided for years - but as he got older, the "get 20% off your first purchase" deals sounded too good to pass up, and then suddenly he was buying things on store cards. Who knew!)

Once you've got an overview of everything, work with her to set as many bills to auto-pay as you possibly can, and put income on direct deposit if it isn't already. Set up online accounts for her at the different companies if she doesn't have them set up already. If she's willing, change the contact email address everywhere to your addy; you can talk to her before you take any action on anything to make sure it's what she wants to do, but if all the communication comes to you her inbox will be cleaner and less confusing, and she won't have to sort out which is spammy "buy more of our services" and which is vital "um, you haven't paid for our services" stuff.

(When I took over my dad's checkbook and banking, I would bring the check register with me every time I saw him, so he could see what was going on in his finances. It's hard, losing that control, even if you know it's too much for you anymore! This was a PITA because I hadn't used a check register in ages, but it was how he understood money, so. He no longer understands money at all, so I just have a separate YNAB account for him that makes my life easier.)

Somewhere in here, also sit down with her one day and go over all her logins. When I did this with my dad I had to reset a bunch of them, because he'd been forgetting them and locking himself out of things. Don't introduce anything new like a password manager, just make sure all the passwords are working and write her a nice clear list.

One other thing I did that saved both of us huge amounts of time and frustration was installing Team Viewer on his computer, setting it up with a specific password so anyone who knew that password could remote in through their own Team Viewer without him having to do anything. It was so much easier just to log in and do whatever tech support was needed, rather than him having to write everything down and wait for me to show up. He knew to call with any popup message; I would rather take a few minutes to be sure that it was harmless than deal with him installing malware because it looked like a normal "click ok" message.

Basically you're building a safety net to help her out, and preparing the ground to eventually take over responsibility for things without it being a shock to either of you.
posted by current resident at 12:56 PM on May 5, 2017 [5 favorites]

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