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August “Senior Sense”: Where to Begin When You Know Your Parents Need Care

Liz O'Donnell on July 20, 2021 02:29 PM

If you only knew part of my caregiving story, the part about both of my parents getting diagnosed with terminal illnesses on the same day – you might think I was a decisive, action-oriented and confident caregiver, because when I got the news that my mother had Stage 4 cancer and my father had Alzheimer’s, I sprung into high gear organizing their care. And while I do think I am those things some of the times, at the beginning of my caregiving journey I was more often indecisive, overwhelmed, and sometimes paralyzed. It took a crisis to get me going.

Barring a crisis – a fall, or bad diagnosis for example, many adult children, myself included, see our parents growing older and more dependent but we just don’t know what to do about it. We know our parents need, or will need, more support, but we’re not quite sure what kind of support, or how to provide it. Where do I start? It’s a question I hear from other caregivers almost weekly.

Well, now that I am on the other side of caregiving (for the time being), I can answer that question. Not only do I know what I needed at the time, I have also researched and studied best family caregiving practices. So where do you begin? Well, like I tell my teenage daughter when she finds cleaning her room daunting, start where you can make the biggest impact (usually the unfolded laundry pile) and then keep going.

Your proverbial laundry pile could be your parents’ finances, if they are running low on money, or maybe contemplating a move to a senior living facility or facing big medical bills. It may be health, if they just received a significant diagnosis or chronic ailments are wearing them down. Maybe the home they are living in has become too much to manage. If so, start there. My favorite quote, since becoming a caregiver is credited to folk singer/songwriter Joan Baez, “Action is the antidote to despair.” So, what actions can you take?

If the most pressing need is financial, hiring an elder law attorney is one of the smartest things you can do. Elder law attorneys can assist with a number of things including health directives, creating guardianships, writing wills, and guiding families through any disagreements related to assets and inheritance. To find an attorney, your Senior Care Planning benefit through can find you vetted attorneys with specialty in multiple areas of elder care. Your parents should designate you or someone else they trust to be their power of attorney (POA). This designation allows you to handle financial and legal affairs on their behalf. POAs can help pay bills, talk to insurance agents, and sign legal documents.

If the most pressing need is medical, the most important thing you can do is have your parents designate one person to be their health care proxy. This person, often the primary caregiver, has the authority to make medical decisions for a patient in the event they are unable to. Some people have a proxy statement prepared by an attorney while others complete a form at their doctor’s office or at the hospital. Most proxies require at least two witnesses to sign them, but requirements vary state by state. Also, proxies can be changed, so if, for example, your parent names someone who can no longer fulfill the role, they can assign someone else. When you are a proxy doctors will share information with you. If you are not the proxy, doctors are not allowed to discuss a patient’s medical issues with you due to the Health Insurance Portability and Accountability Act of 1996, commonly known as HIPAA. It is also good to have your parent fill out an advanced directive, sometimes referred to as a living will or physician orders for life-sustaining treatment (POLST). This document clearly spells out what, if any, medical intervention your parent wants to receive in certain medical situations, in the event they cannot communicate their preference.

If the most pressing need is your parents’ living situation, know that here is no one right decision when it comes to living arrangements for your aging parents. Some parents thrive at home, others do better in a senior living facility. If your parents want to remain in their home, talk to them about what kind of assistance they might need now or later. Think about driving, household chores, paying bills, and dressing, and medical needs including transportation to doctor’s appointments, assistance with medication, medical tasks, physical therapy, etc. You may want to retrofit their home by lowering shelves, removing any trip and fall hazards such as area rugs, lowering toilet seats and widening doors to accommodate walkers and wheelchairs. If moving to a senior living facility is an option, your Senior Care Advisor through can help with this too. You don’t need to overcomplicate the process – you just need to start and contacting an Advisor or visiting facilities are simple ways to do that. You’ll get a feel for what’s available, what you and your parents like, and the business or marketing manager can walk you through payment options.

Regardless of the issue - if you want to talk to your parents about their living situation, or surrendering their driver’s license, or giving you access to their finances, for example - start slow, and as early as possible. Try talking to them about the impact their decisions are having on you - framing the conversation around what you need. Your Senior Care Advisor can also share strategies for your specific situation. After all, many parents remain wired to care for their children, no matter their age, until the day they die. I have seen this approach work for many, but I’ll be honest, it didn’t work for me. And so sometimes, you may start, with the best plan in place to help your parents as they age, and you will not be able to get through to them. If that’s the case, your next action should be about you. You then need to decide, how you will accept your parents’ choices and make peace with them – until, they have a crisis or ask for help. When and if that happens, see above.

 For caregiving support, information and resources contact a Senior Care Advisor at We are master’s-level social workers specializing in adult and senior care. Call us today at (855) 781-1303 x3 or email questions to

Liz O'Donnell

Liz is the founder of Working Daughter, a thriving community for women balancing eldercare, career, and more. A former family caregiver, she is a recognized expert on working while caregiving and has written on the topic for The Atlantic, Forbes, TIME, WBUR and PBS’ Next Avenue. Her book, Working Daughter: A Guide to Caring for Your Aging Parents While Earning A Living, will be published in August 2019.