1. The Sandwich Generation

2. 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

3. 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

4. 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

5. 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

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

7. 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

8. 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

9. 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

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

11. 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

12. 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

13. 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

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

15. 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

16. 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

17. 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”.

18. 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?

19. 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?

20. 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

21. 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

22. 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

23. 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