How to care for your elderly parents

As the pandemic hit, many adult children looked at their parents through a new lens. They realised how susceptible even the most active, independent, not-quite-elderly parents could be if faced with this fearsome virus. For some, it pushed them to consider the need to get organised ahead of time.

So, where do you start with planning for a time when your parents might not be able to look after themselves like they once did? It’s not that long since I had to say goodbye to my parents. I know how hard some of these decisions can be.

It’s important to think ahead:

1. Talk to your parents, siblings and spouse (if you have them) about what everyone would like to happen if they were not able to care for themselves alone in their house anymore.
2. Could they continue to live in their own home with a carer?
3. Could they live with you in your home?
4. Could they live in a retirement home, and if so, what would the cost considerations look like?

Plan ahead

In addition to the points above these questions are vital and should be answered as soon as possible:

• Do you have medical and financial Lasting Powers of Attorney (Opens in new window) for them?
• Are their wills (Opens in new window) up to date?
• Do they want a living will (Opens in new window)?

They may well have wills, but suggest they check and update these. They may also want to put living wills in place, which will set out their wishes about refusing medical treatment if they're unable to make or communicate those decisions themselves. With or without these, it’s important that they discuss their wishes with you, in case you have to talk to medical staff on their behalf.

Even if your parents are currently in perfect health, you may want to suggest they consult a family lawyer and help them to put Lasting Powers of Attorney in place. If they are unlucky enough to suffer one day from any sudden illness, accident, cognitive decline or dementia, it will be a lot easier for you to look after them effectively

Powers of Attorney explained

The key to this puzzle lies in Lasting Powers of Attorney. Without these, you cannot assume that you will be the one making decisions for your parents; that authority might be left to a judge. There are two types: health and welfare, and property and financial affairs. It’s sensible for your parents to have both, especially for times when they may be unable to make their own decisions.

The health and welfare LPA is for making decisions about daily routines, medical care, transitions to a care home or life-sustaining treatments. This can only be used when the person is unable to make their own decisions. The property and financial affairs LPA is for making decisions about their money and property for them, including managing a bank account, paying bills, collecting benefits or a pension, or selling their home. This can be used as soon as it’s registered, with your parent's consent.

They will need to choose one or more attorneys, which can be you, other family members or trusted friends, who will make decisions on their behalf (the word ‘attorney’ in this context does not refer to a lawyer, as it does in the US). Once the LPA forms have been filled in, these will need to be signed by your parents and the attorneys, and then registered with the Office of the Public Guardian, a process that can take up to 20 weeks. You don’t need legal help with filling in the LPA forms, but using a lawyer can ensure you get it right the first time and avoid delays.

Currently, the registration fee is typically £82 per LPA, which could be a small price to pay for peace of mind – and it could save you the cost of going to a judge later on.

Where will they live?

Of course, at the beginning of this time with your parents, they will be the same people you’ve known all your life, and you will be making decisions with rather than for them. One of those will be when and whether they move into a care home. It’s a big step, and in the initial stages of caring for your parents you may prefer to help them stay in their own home or move them into yours, engaging some regular help if they need it. Local authorities may be able to help with funding depending on your parent's state of health and their assets.

If they do live with you, you are likely to have a caring role yourself. It will be important to manage your mental health as well as theirs, particularly if the burden falls more on you than other family members.

How much do care homes cost?

The average weekly cost of a residential care home is £760, while the average nursing home cost is £960 per week across the UK. Care homes providing specialist care, such as dementia care, will generally charge more.

How much a parent will contribute depends on what they have in savings and assets. This differs by country, as follows: England £23,250, Scotland £32,750, Wales £50,000 and Northern Ireland £23,250.

If your parent's assets and savings fall below these thresholds, local authorities will cover some or all of their costs after a financial assessment. If they have a partner or relative over the age of 60 living in their house, the value of the house will be excluded from the assessment.

Talk it through

If you have siblings, make sure to talk to each other before things start to unfold. What might seem like a minor injury for most people could have unexpected consequences for someone older. A GP friend of mine talks of the cascade effect that can begin with just one injury, such as a fall, and how it can bring on other problems, often quite swiftly.

One daughter I know added an extension to her house after her active mother experienced a stroke while she was away on holiday. The daughter quickly engaged a carer to look after her. The mother recovered partially from the stroke and lived happily in the extension for many years until her her passing. Fortunately, this arrangement worked well for both of them.

Of course, not everyone has a great relationship with their parents. You may need to set some boundaries and decide for yourself how much help you want to offer them. You may not want them to live with you, but you may be willing to assist them in figuring out what help they may be eligible for from the local authority, for example, or help them in choosing a care home.

And try to be aware of what it might be like for them to be facing physical decline. The loss of mobility, eyesight, hearing, memories and more might be slow and subtle, but it doesn't make it any less frustrating. As my mother said to me more than once, referencing the famous quotation often attributed to Bette Davis: "If one more person says to me, getting old is not for sissies, I’ll scream!"

Recommended reading

• How to fund your dream retirement lifestyle
• How you could retire with friends
• How to deal with an unexpected life event: illness

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