The Sandwich Generation

Overview:

Ways to handle the many competing demands of caring for both children and aging parents.

Feeling pulled in many directionsBalancing work and familyHandling financesSharing the loadTime for yourselfRespite care

Feeling pulled in so many directions

Sandwich generationBetween ages of 35 and 60Balance the needs of your own childrenTrying to attend to the care needs of your parentsPlanning your own financial future and helping your parents meet their financial needs

Balancing work and family

WorkingRaising your own childrenCaring for an older adultCan cause you to feel:

ExhaustedOverloadedGuiltyWorking 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 parentOther relatives who can assistExplore FMLA as an optionExplore community resources that can be helpful

Community Resources:

Adult Protective Services (APS)IHSSSenior CentersMeals on WheelsVisiting Nurses AssociationEAP

Important Issues for Seniors

MedicareCovers medical expenses for individuals over age 65Part A: hospital insurance and skilled nursingPart B: basic medical services-md office visits

Medicare

Part A covers 90 days IP per episodeLife time reserve of 60 daysAnnual co-pay of $840Up to 100 days of skilled nursing care per illness

Medicare

Part BBasic medical servicesMonthly premium of $58.70 and this increases by 10% if you do not sign up when initially eligible$100 annual deductible80/20 benefit

Medicare

Many care needs not coveredPrescription drugsRoutine physicalsEye glassesHearing aidsMost dental servicesRoutine foot care

Medigap

To fill the difference left by MedicarePurchase 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 consFuture 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 coverageUse mail order for chronic medicationsTalk with MD about alternative medications or genericsShop around to different pharmaciesExplore low income programs through the pharmaceutical companies

Senior living environments

Independent LivingContinuing Care Retirement CommunitiesAssisted Living CentersBoard and Care HomesSkilled Nursing HomesDementia/Alzheimer Units

Senior living environments

Identify the options available in your areaReview these optionsSelect a few facilities for a site visitDo you homeworkMaking a decisionConsult 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 careFinancial affairsHousing plansAnd other arrangements

How to help Your Aging Parents

Important to start planning before a crisis occursNever an easy conversationNeed to overcome your natural fear about “meddling in their affairs”.

Helping your Aging Parents

Number of issues need to be clarifiedDo 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 interestBe supportive and not judgmentalAsk open ended questionsBe prepared to accept your parents’ decisions and points of viewDo 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 DirectivesIn 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 coverageCheaper when purchased at a younger age

How to avoid care giver burnoutCare most often provided by women in the familyEmotional burden of care giving

Lack of privacyLack of time for selfFeeling burdened by the need to provide all care needs and guilt about making decisions on placement

Importance of taking care of selfRespite