Care Giving For End of Life


By Hilary Thompson

Caregiving for a parent can be challenging, especially as you’re aging yourself. You may be managing your own health and financial concerns, trying to help children and grandchildren, or establishing a new life in retirement. The challenges can compound if you’re caregiving from a distance , or if your parent is approaching the end of life. Rest assured, there are plenty of ways to help your elderly parents, whether you’re living near or far.

The truth of a parent aging and become ill or frail undoubtedly causes concern and stress. Regular visits to ensure your parent is meeting his or her basic needs can be important during this time. If you’re not in a position to check on your parents yourself, building a network of friends or family in their area can be an incredibly helpful tool. These helpers may be able to do quick check-ins with your aging loved one, take them on an occasional errand, or stop by to play cards, or bring a meal.

If your parent resists the extra attention, you can frame the visits in terms of offering peace of mind to you or the visiting friend, or as a way to make a helpful relative feel that they’re contributing something. For tech-savvy friends and family, an online scheduler like Lotsa Helping Hands can ensure the visits and check-ins are coordinated. If your parent’s declining health begins to accelerate, you may consider looking into assisted living options, or paid caregiving services, which may be available through Medicare or other insurance.

Understanding where your parent is in their aging or end-of-life process can help you to assess what kinds of care your parent may need. Standard assessments such as Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) can help determine what kinds of living situation is best for your parent. The National Institutes of Health defines ADLs as those activities necessary for basic functional living, such as bathing, dressing, feeding, and walking. If any of these activities are difficult or impossible for your parent, they may need some paid home healthcare services, or possibly placement in assisted living or a nursing facility.

IADLs are those activities that are important but not strictly necessary, ensuring a person can live independently in a community. It might include cooking, laundry, transportation, and managing finances. Knowing what your parent is capable of doing or wishes to do on his or her own can help you both decide if there are any gaps, and if your parent needs to seek help with one or more of these activities.

It may be a difficult conversation, but knowing what your parent’s assets are in terms of final expenses is important. As your parent nears the end of life, you might be concerned about the financial burden a funeral and burial might have upon you, especially if your parent has little or no savings. A saving grace is funeral insurance for those over eighty. There are plans in place that can pay benefits when you need the money for burial and funeral services.

Essentially, these are whole life insurance policies, and can be purchased at different benefit levels, usually a minimum of $2,000. Premiums will increase in cost the higher the benefit payout, which can be used for any expense, not limited to funerals. If your parent is healthy, know that the policies build cash value from which they can borrow. Premiums are fixed so they will not increase, and the policies will not expire due to age. These policies are a good option to ensure the burden of paying for a funeral does not fall upon you or your siblings.

An equally difficult conversation but imperative in avoiding heartache and misunderstandings is what your parent’s end-of-life wishes are. Do they want every effort made to prolong life? Have they asked their doctor to include a do-not-resuscitate order written in their medical records? What efforts do they want or not want implemented, such as feeding tubes or breathing machines? Legal documents called advanced directives can ensure your parent’s wishes are met. These include a living will, which outlines the type of care they wish at the end of life, and the health care power of attorney, which designates a person who will make decisions on their behalf.

Checking the laws in your parent’s home state (and part-time home state, if they winter elsewhere) will help you to have the right documents in place. Without these documents, you may be called upon to make difficult decisions. Thinking about what you might want if you were in the same situation may help you to make the best decision possible for your loved one.

When you know the end is approaching, your parent may be able to consider whether to spend the final days at home or in inpatient care. The Mayo Clinic suggests that caregivers may not feel prepared even when the end of life is expected, but knowing what you can do to make your parent feel more comfortable can help. If your parent prefers to be at home, you may want to be the caregiver, or enlist the services of hospice care, usually available through insurance coverage. Hospice services are also available through inpatient care and are often located at separate facilities that specialize in palliative care, which focuses on easing pain, relieving symptoms and helping to address the spiritual and psychological aspects of dying.

Talk to your parents about their wishes at the end of life. Choosing to stop treatments may allow your parent to avoid prolonging painful care or troublesome side effects while getting the most out of his or her final days, allowing for a peaceful passing. Talking to their health care provider, social worker, or nurse navigator can help you to know that you and your parent are making the right decisions. Bring in spiritual advisors if your parent wishes it.

If your parent’s health allows, the end of life can be a time to share a legacy with family members and friends. They may wish to make recordings, write letters to share final thoughts, or talk about things that have been left unsaid or have created a burden. The important thing is opening doors to communication at every stage in your loved one’s end-of-life process, allowing them to speak their wishes and feel confident that you want to help them receive the best care they can.



Category: Blog