As your parents age, there’s a good chance they will need long-term care. According to the Department of Health and Human Services, more than half of Americans turning 65 today will develop a disability serious enough that they will need daily help with the basic activities of living. Most will need care for less than two years, but 1 in 7 will need assistance for more than five years.
As tough as it might be to imagine your parents being unable to care for themselves, the thought of discussing this possibility with them probably seems even harder. But it’s important to talk to your parents sooner rather than later to develop a plan for long-term care if they ever need it. If you wait for an emergency to strike, emotions will be running high and you’ll likely have fewer options to deal with your parents’ need for care.
Why you need to have the conversation
If your parents need long-term care (and, remember, the odds are high that they will), the cost of care can be expensive. Professional care can range from about $4,000 a month for a home health aide or assisted living facility to more than $8,500 a month for a private room in a skilled nursing facility, according to the 2019 Genworth Cost of Care Survey.
Unfortunately, most people aren’t prepared to pay for this cost. Medicare typically does not cover long-term care, and neither does health insurance. Long-term care insurance can help cover the cost of care, but only 11% of adults have it, according to the Bipartisan Policy Center. As a result, most people who need long-term care end up relying on family or friends to help.
That means your parents might be counting on you to help them – and that could impact your finances. Being a caregiver can be a full-time job. Not only might you have to give up a steady paycheck to help a parent, but also you might have to open your wallet to cover costs for mom or dad. Eight in 10 caregivers pay for caregiving costs out of their own pocket, according to an Associated Press-NORC Center for Public Affairs Research study, and 43% have raided their savings as a result of caregiving.
How to start the conversation
There are several ways to start discussing long-term care with your parents. Keep in mind as you have the conversation, though, to be respectful and understanding if your parents are reluctant to talk about this uncomfortable topic. Acknowledge that it’s a tough topic for you to talk about too, but that it’s important to discuss so that everyone can be prepared if they ever do need care.
One way to start talking is to discuss an article you’ve read (such as this one) about the cost of care and the need for planning. Focusing on the financial side might make the conversation easier. For example, you could say something like, “I recently read an article that Medicare doesn’t cover long-term care, and this sort of care can cost several thousand dollars a month. Have you ever thought about getting long-term care insurance to pay for this sort of care if you needed it?”
Of course, if your parent has already been diagnosed with a long-term illness, the conversation will be different. You could let your parent know that you want to be able to do what is best for him or her. Then say that that will require some discussions about what your parent wants and needs.
What to discuss
There can be a lot of ground to cover when it comes to talking about long-term care. You don’t have to cover everything in one conversation, but you should try to find out the following information over time.
Where your parents prefer to receive care. Most likely, your parents will say they want to remain in their own home. If they do, ask them to consider whether their home is set up to meet their needs. Do they have a shower that’s easily accessible? Would they be able to make it up and down the stairs? If they’re determined to receive care at home, encourage them to make any improvements to the house sooner rather than later or to consider downsizing to a house that will better suit their needs.
You also should ask under what circumstances they would consider receiving care in a facility that can cater to their specific needs – such as a memory care facility if one of them should develop dementia. You might even want to encourage them to look into options available in their community to determine which ones are acceptable to them. Let them know you’re asking them to do this because you want it to be their choice, not yours, where they get care.
Who will provide care? If your parents are counting on each other to provide their care, gently point out that that might not be possible if they need care much later in life. They might not have the physical strength to provide that care, or they both might end up needing care.
Encourage them to have a backup plan – a way to pay for a home health aide or assisted living. If you are your parents’ backup plan, discuss whether you would be able to provide the care they might need. If you have children of your own who count on you for financial or caregiving support, helping your parents might be a challenge for you.
Ways to pay for care. Find out if your parents have savings that are earmarked for long-term care or if they have a long-term care insurance policy. If they don’t and they’re in good health and in their 50s or early 60s, they could qualify for a long-term care insurance policy or a life insurance policy with a long-term care benefit at a relatively affordable rate. They can find an independent insurance broker through the American Association for Long-Term Care.
If your parents served in the military, they might qualify for long-term care benefits from the Department of Veterans Affairs. They might be able to use the equity in their home to pay for care with a reverse mortgage. If they have a permanent life insurance policy, they might have built up enough cash value in the policy that can be withdrawn to pay for care. Or they might be eligible for Medicaid to pay for care at home or in a skilled nursing facility if they have limited income and assets.
Although these conversations can be difficult, having them will make it much easier if and when your parents do need care. You’ll know your parents’ wishes for the care they want, and, hopefully, you’ll have a plan to provide them with that care.