The Sandwich Generation

Overview: Ways to handle the many competing demands of caring for both children and aging parents. Feeling pulled in many directions Balancing work and family Handling finances Sharing the load Time for yourself Respite care

Feeling pulled in so many directions Sandwich generation Between ages of 35 and 60 Balance the needs of your own children Trying to attend to the care needs of your parents Planning your own financial future and helping your parents meet their financial needs

Balancing work and family Working Raising your own children Caring for an older adult Can cause you to feel: Exhausted Overloaded Guilty Working that you have neglected someone

Balancing work and family Try to find ways to share care giving tasks Spouse assists with children or the aging parent Other relatives who can assist Explore FMLA as an option Explore community resources that can be helpful

Community Resources: Adult Protective Services (APS) IHSS Senior Centers Meals on Wheels Visiting Nurses Association EAP

Important Issues for Seniors Medicare Covers medical expenses for individuals over age 65 Part A: hospital insurance and skilled nursing Part B: basic medical services-md office visits

Medicare Part A covers 90 days IP per episode Life time reserve of 60 days Annual co-pay of $840 Up to 100 days of skilled nursing care per illness

Medicare Part B Basic medical services Monthly premium of $58.70 and this increases by 10% if you do not sign up when initially eligible $100 annual deductible 80/20 benefit

Medicare Many care needs not covered Prescription drugs Routine physicals Eye glasses Hearing aids Most dental services Routine foot care

Medigap To fill the difference left by Medicare Purchase Medigap policies Private insurance Two forms One fills the gaps in Medicare benefits One assigns coverage for medical care through an HMO or other managed care plans

Medigap Policies Pros and cons Future premium increases Plan needs to be affordable today and in the future Pre-existing conditions Insurance company screens potential high users of the benefit Check your parent’s current medications against the plan’s prescription formulary

Prescriptions: Explore medigap plans for prescription coverage Use mail order for chronic medications Talk with MD about alternative medications or generics Shop around to different pharmacies Explore low income programs through the pharmaceutical companies

Senior living environments Independent Living Continuing Care Retirement Communities Assisted Living Centers Board and Care Homes Skilled Nursing Homes Dementia/Alzheimer Units

Senior living environments Identify the options available in your area Review these options Select a few facilities for a site visit Do you homework Making a decision Consult with the EAP for assistance in this process

How to help your Aging Parents Importance of having a conversation with your parents about the following topics: Medical care Financial affairs Housing plans And other arrangements

How to help Your Aging Parents Important to start planning before a crisis occurs Never an easy conversation Need to overcome your natural fear about “meddling in their affairs”.

Helping your Aging Parents Number of issues need to be clarified Do your parents want to remain in their home as long as possible? Do they have long-term care insurance? In the event of a crisis, is there a family member available who can provide care for several months? How do you and your parents feel about their moving into your home?

Helping your Aging Parents Do your parents live in a remote area or are there services available in the area? Do your parents have an update will? How do they want to have health decisions made? Have they signed a health care directive?

How to Talk to Your Parents about the Future Try to be sensitive and show genuine concern and interest Be supportive and not judgmental Ask open ended questions Be prepared to accept your parents’ decisions and points of view Do not overwhelm them with lots of probing questions

Health Care Directives Durable power of attorney for healthcare Allows you to appoint someone to see that doctors give you the type of gave you want Advanced Directives In event that you are unable to direct your own medical care, this document allows the person you appoint to direct your medical care

Long-Term Care Insurance Insurance that provides for long-term care in a skilled nursing facilities, assisted living or home care. Purchase three years of coverage Cheaper when purchased at a younger age

How to avoid care giver burnout Care most often provided by women in the family Emotional burden of care giving Lack of privacy Lack of time for self Feeling burdened by the need to provide all care needs and guilt about making decisions on placement Importance of taking care of self Respite