Top Experts Give Advice to the Sandwich Generation

As you notice your parents beginning to age and decline in health, you are most likely faced with making important decisions about their well-being that affect not only them, but your family as well. We spoke with some senior care planning experts about what steps the sandwich generation—children with aging parents and their own families—should be taking to help keep their parents safe at home while juggling their own responsibilities.

Here's what they had to say:

“I feel that the most important thing the sandwich generation should be doing is having conversations with their parents about how they want to be cared for. Conversations about Advance Directives are important for them to understand their end of life wishes and who they want making decisions for them. I also think they need to be discussing how they want their care to look as they age and what is financially feasible. These are hard conversations to have, but I think they are the first step in understanding what is required to care for them.”

Melissa Wombwell-Twersky, Geriatric Care Consulting 
Geriatric Care Manager and 18 years of experience as a social worker

“Becoming a part of the sandwich generation can have an effect on personal time, health, and finances. According to the Pew Research Center, 25% of those in the sandwich generation are financially supporting their parents. In order to lessen the stress, both emotionally and financially, children of aging parents should consider having a discussion regarding proper estate planning, asset protection, and tax planning.

There needs to be a plan in place, not just for finances but for health care emergencies, as well. At a minimum, we recommend that our clients have a Last Will and Testament, Financial Power of Attorney, Health Care Power of Attorney, Living Will, and HIPAA Authorization in place. Additionally, it is highly recommended that they consider the possibility of protecting assets from the high costs of health care and unexpected events that may occur that may leave one of the aging spouses struggling to protect assets at the last moment. Lastly, we counsel our clients to consider tax issues. This may include tax bracket management, death tax issues, income tax issues, and ways to reduce both, not only for the aging parent but the child of the aging parent, as well.”

Charles Bratton, Esq., Rothamel Bratton, LLC
Founding Attorney and Chairman of Elder Law Division

“The most important thing the sandwich generation can do for their aging parents is to get educated about how to carry out their parents' wishes concerning remaining in the family home for as long as possible. They also need to be aware of the elder law issues concerning aging parents such as medical and financial decision making as well as the rules regarding asset protection prior to any transfer of assets.”

Daniel Del Collo III, Esq., The Law Office of Daniel Del Collo, III LLC
Experienced Elder Law Attorney

“The sandwich generation needs to be aware of the things that might cause a crisis situation, and plan to avoid them. Their time is at a premium, and they would be well-advised to sidestep situations where they need to devote a lot of time and resources in a compressed window. Legal documents such as a Power of Attorney and a health care proxy are essential, as are regular evaluations of their parents' health care needs. Caregivers can make sure the appropriate resources and modifications remain in place and adapt as their parents age.”

Carl Archer, Esq., Archer Law Office, LLC
Experienced Elder Law Attorney

“Plan! The most important thing a child can do for their parents is to encourage them to develop a plan for their care as they age. Having important legal documents in place such as a Financial Power of Attorney and Health Care Power of Attorney are key, and provide an easier transition when a parent can no longer handle their finances on their own or make health care decisions. Additionally, the plan begins the conversation between the child and parent so expectations, wishes, and goals can be clearly communicated and understood.”

Rebecca Hobbs, Esq., CELA., O'Donnell, Weiss & Mattei, P.C.
Certified Elder Law Attorney

“First, make sure the home is safe and make any required adaptations. Second, develop a plan to keep them in the home as long as possible including bringing in outside people to maintain the home and to provide care services–eg, doing repairs, cleaning the home, providing home health care. It’s important to determine a funding source to pay for these services. Encourage the parents to be involved in community and family activities.”

Thomas D. Begley Jr, Esq., Begley Law Group, P.C.
Certified Elder Law Attorney

“Children of aging parents along with the caregivers should first make sure that the parents have valid Wills, Durable Powers of Attorney and Living Wills that have been prepared by an elder law attorney. I cannot stress the importance of these documents enough. They should also be making sure the house is safe so as to prevent falls or other dangerous situations. Rehabilitation of their home is a great idea to make it "age in place"-ready (eg, install grab bars, widen doorways, etc.) and consider a live-in assistant in the future. Safeguarding valuables, especially those with sentimental value, is always wise.”

Laura Ergood, Esq., Law Office of Laura L. Ergood, LLC 
Experienced Elder Law Attorney

“Start having discussions in advance of the need so you’re as prepared as possible if a crisis arises.  There are many questions to ask of your parents; write important information in a notebook or folder that you can easily grab prior to doctors' appointments or emergency room visits. Start with basic health information like health diagnoses and medications. Move on to who might have the Power of Attorney for health and legal issues. Get an Advanced Directive completed and be sure a Will is in place. Additionally, it is much easier on family members if funeral arrangements are planned in advance. 

This can be a stressful time, so spread the weight; access all possible sources of assistance and direction, like the United Way, illness-related organizations (eg, MS, ALS, arthritis, heart, etc.), clergy, hospital social worker, family, and friends. Amidst the whirlwind of activity, remember to enjoy your loved ones and make the most of everything they can do. Have them participate in everything they can, including practical decision making and festive activities. Much may be thrown at you during this time, but remember that if your actions are focused on the best interests of your loved ones, then whatever decisions you make will be the right decisions. Take a deep breath and make the most of this experience. You are creating memories that you might find you really savor over time. Helping loved ones through this transition can be very enriching for them and for you.”

Marti Trudeau, BAYADA Home Health Care
Director of BAYADA Home Health Care, University City, PA

“Children of elderly parents need to begin to identify resources early on before they are needed. Install cameras and motion detection devices. Find independent care managers or patient advocates who can go with the parent to doctor appointments and assist with medications and medical bill paying. These steps will go a long way in decreasing risk and keeping parents safe in their homes, and connected with their community.”

Sheryl Riley, Clarion LLC
Founder of Clarion LLC and a nurse for over 25 years

If you have any other questions about a Home Health Care Agency, please leave a comment below and we will respond.