Caregiver Tip of the Month

Situation. "I've become a long distance caregiver for my parents, in addition to handling their finances. I've been paying their mortgage for quite some time, and just recently took over their other day-to-day finances. Do you have any insights on how to do it more effectively long distance?"

Response. Assuming that you have your parents' power of attorney, and your parents' checkbook, notify every company that sends them a bill that your parents' billing address has changed so that all of their bills are sent to you. The bills should still be sent in their name, but also addressed "c/o [your name]" at your address. You may have to send a copy of their POA to each billing company to accomplish this.

The next time you visit, call each of their credit card companies with your parents in the same room and ask them to change the billing address to your address. The credit card companies will ask to speak with one of your parents to make sure they agree.

This will also keep your parents from receiving the "convenience" checks that credit card companies send out, and which the elderly often cash thinking that someone has sent them money. They don't understand that they are really taking out a cash advance loan against their credit card.

If you are concerned with your parents' ability to manage their money, or perhaps about their being conned by someone else (in person or via an infomercial) to spend their money foolishly, you might take the approach I did with my mother. I had her apply for a new credit card with a limit of only $1,000 (again with my address so that I could monitor her spending). As a result, she could buy some things with her credit card when I wasn't there (she liked to shop for clothes from catalogs).

I also left her with anywhere from $50 to $100 in small bills so that she could give her hairdresser tips and purchase a few other incidentals that were available in her assisted living facility. Then, when I visited once a month, I replenished whatever cash she had spent. Both the credit card and cash in her purse allowed her to maintain her dignity; she could pay for things on her own without having to ask someone else's permission.

If they still have their Social Security and pension checks mailed to them each month, have your parents change over to direct deposit into their checking account. Because a power of attorney means nothing to Social Security, this assures that their monthly checks won't sit around uncashed when a crisis hits, and you need to have money available to pay their bills. (More details are in our September 2006 issue.)

You'll find several more helpful suggestions in the FDIC's article, Financial Caregiving: A Survival Guide.

Our advice for everyone whose parents are still capable of handling their own affairs: Plan ahead and get all powers of attorney and advance directives in place BEFORE a crisis hits, and BEFORE your parents lose the ability to handle their own financial affairs. If you (and they) don't, you will have even more frustrations to deal with at a time when you are already stressed-out because of all the other issues you will have to worry about.

The requirements for advance directives to be legally valid vary from state to state. If your parents cannot afford to hire an elder care attorney to prepare documents tailored to their specific needs, visit the Caring Connections website. Caring Connections is highly respected and provides free advance directive documents and instructions for each state. To go directly to the appropriate page on their website, click on Advance Directives.

A final word of advice: While you and other members of your family may be able to help your loved one financially, be very careful about accidentally becoming a co-signer for any of your loved one's debts, or signing any other type of document (including a hospital's forms) where you agree to become financially responsible for him or her. If you were to become a co-signer or become financially responsible, you would be legally obligated to use your own money to pay your loved one's bills.

If you do have to sign something for your loved one as his or her Power of Attorney, make sure that you include POA after your name AND that you also sign your loved one's name after yours. That isn't forgery as long as you have a valid Power of Attorney. Acting as his or her Power of Attorney does not obligate you to use your personal funds to pay your loved one's expenses.

Our visitors ask ...

Q. My mother-in-law has Alzheimer's. If my sister-in-law quits her job to care for her, can she be paid for doing this and where would she apply for it? They live in Tennessee.

A. Some states have very limited programs through which family caregivers receive some payments for providing care. To find out if Tennessee has such a program, visit the Eldercare Locator's website or call them. Developed by the U.S. Administration on Aging, the Eldercare Locator is a free public service. It helps older people and their caregivers find local support services to help them live independently and safely in their homes and communities for as long as possible. Look for the resources you need by following the easy directions on their website. Or, call their toll-free telephone number 1-800-677-1116, between 9 am and 8 pm weekdays, Eastern Time.

If it isn't possible for your sister-in-law to be directly compensated, she may be entitled to some tax write-offs and perhaps other benefits for providing care for her mother. You'll find more details about a variety of resources in our article 12 tips to help you find money (and free resources) for care at home.

If her mother has sufficient funds, your sister-in-law (through a Power of Attorney granted to your sister-in-law) could be reimbursed in reasonable amounts for the time and expenses she incurs on her mother's behalf for providing her care. She can also be reimbursed in full for anything she pays out of her own pocket that's directly related to her mother's care. If her mother is legally competent and can afford it, she could also "hire" your sister-in-law to provide her "private duty" care.

Daily Living Solutions

— products for seniors —

As we grow older, it often becomes difficult to use many everyday products because of arthritis and other conditions. If you or a loved one needs a little help – or a lot – we've selected a group of practical and affordable solutions from our affiliated merchants to help overcome those limitations.

Whether you are looking for yourself, or to help an elderly senior continue living in their own home, you'll find a wide variety of supplies and accessories – raised toilet seats, safety rails, incontinence supplies, large-handle eating utensils, pain relief, diabetic supplies, pill splitters and crushers, big-button telephones, canes, walkers, rollators, wheelchairs – and much more.

Everything is sorted into convenient categories in our Solutions for Seniors section.

Caregiver Reminder

What you need to know when your loved one
is a Medicare hospital patient

If you are looking for assisted living, home health care, skilled nursing or a nursing home, it's usually because of a medical crisis involving a loved one. You're probably in a time crunch – decisions have to be made quickly. The hospital may have said that your loved one will be discharged tomorrow. They've given you a list of rehab facilities, and it's up to you to pick one. But, how do you know which one is best? Are some better than others?

If you're in this situation – take a deep breath – relax a little – and read the next paragraph. You might make a better decision as a result.

Medicare has special rules to keep patients from being discharged from the hospital too soon. In spite of what the hospital may have said, your loved one cannot be discharged until 3 days after the hospital gives you a form called a Notice of Noncoverage. If they have not given you the Notice, insist that they do. (You won't get into trouble by insisting, and neither will your loved one.) This will give you additional time to find the rehab facility that's best for your loved one.

Hospitals discharge their Medicare patients quicker and sicker that ever before. In 1968, patients age 65 and older stayed in the hospital an average of 14.2 days. By 1982, that was down to 10.1 days. Now it only 6.4 days.

Why? Medicare is under constant pressure from Congress to cut expenses. Now, Medicare benefits pay a hospital the same fixed fee for each patient with a particular medical condition – even if one patient's condition is more severe than another's. If a patient stays too long, the hospital has to pay the extra costs out of its own pocket. But, the shorter a patient stays, the more money the hospital gets to keep.

How bad has the situation become? According to The Wall Street Journal, "Nearly one in five people admitted to hospitals with broken hips are discharged before all of their vital signs are stable ... . Those patients are far more likely to die or be readmitted to the hospital within two months."

To protect you, Medicare guarantees you certain rights if you think you are being asked to leave the hospital too soon. Unfortunately, these rights are given to you along with all the other papers a hospital makes you sign when you are admitted. So, they are usually lost in the shuffle, with most people never realizing how important they are. Hospitals sometimes take advantage of that fact. ...

Our visitors ask ...

Q. What do I need to know about my father's Medicare to find answers about obtaining a hospital bed for him? He has congestive heart failure and can't breath well to sleep; they have installed oxygen in his home to help. But I think a hospital bed would be good for him since his heart is only pumping at 8% and he is so weak that he has a hard time getting up and down.

A. Medicare will cover a hospital bed IF (1) your father is enrolled in Medicare Part B (check his Medicare card), AND (2) your father's doctor will give him (or you) a written order (prescription) for it. When you have the doctor's written order, take it to a nearby medical supply store that offers hospital beds, and they'll help you with the details.

Recommended Reading and Videos

Many excellent books and videos can help guide you through the caregiving process. For our recommendations, including a brief description of each one, click here.

The material on this site is for informational purposes only, and is intended as a supplement, not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. More