How Family Generations Can Confidently Respond to an Elder Care Crisis
How can younger generations–Boomers, GenX, Millennials, and even GenZ—take a step back to learn about health care, legal, and money issues around caregiving to avoid experiencing one elder care crisis after another?
Learn steps to walk with grace and work through unexpected situations. For young or inexperienced family caregivers, there can be a lot to learn about avoiding an elder care crisis.
Elder Care Crisis: A Broken Hip
Mom or Dad falls and breaks a hip. An ambulance takes them to the hospital emergency room, where they are evaluated and admitted into the hospital for surgery. Suddenly, an elder care crisis is set in motion for a family response.
Estate or Legal Plans
The hospital admissions person asks Mom or Dad if they have a legally responsible party. This means whether your parent met with an attorney or downloaded forms off the internet to appoint a legal medical and a legal financial power of attorney agent.
Your parents are also asked if they have a living will and a DNR or MOST form if the surgery doesn’t go well, and they can’t make decisions about their health or financial matters. Having this type of documentation is extremely important to respond confidently to an elder care crisis.
Only your parents know if they have created their estate plan. When parents create their legal documents, they may not discuss this topic with adult children – even though they should.
Parents can do this because it’s likely that your parents are the first power of attorney agent for each other. Documents created in this manner do not require adult children to know their parents’ plans.
What might require involvement by an adult child is when a parent is divorced or widowed, and the spouse who was appointed as the healthcare or financial agent is deceased. The question then is: did a parent appoint a successor or a second power of attorney agent, perhaps one of their children, to handle an unexpected elder-care crisis?
Sometimes parents have made these plans. However, they may not discuss the plan with the child they appointed because they never think that they’re going to need help, get injured, or become sick. They may also hesitate to discuss this information if the parent believes naming one child as agent over another will result in family conflict.
So a parent’s broken hip can be a wake-up call for aging parents and adult children to start conversations around health care, money, legal matters, and dealing with an elder care crisis. Let’s look at why.
Healthcare Forms and Paperwork
Upon admission to a hospital for care, there is a lot of hospital paperwork to sign. Hopefully, a parent can read the forms, understand the intentions, and sign them with confidence.
To be honest, most people don’t read the forms before they sign. And if English isn’t a primary language, the person may be too embarrassed to say, I can’t read or understand these forms. More on this in a minute.
Let’s follow along. Mom or Dad breaks a hip, goes to the hospital, and has surgery. The surgery for a full hip replacement goes well, and the hospital wants Mom and Dad up and walking immediately. It’s important to know that not everyone is approved for a full hip replacement.
Some caregivers wonder
how serious a hip fracture is for an elderly parent. Others have questions around
how nursing homes and rehab work. Other children may be
pressured to sign a nursing home contract when their parent should be signing the document. These are good questions to ask and issues to learn about.
Discharge Planning and Nursing Home Admission
In most cases, the discharge planner or the social worker at the hospital may ask your parent if they have a choice of a nursing home, and your parent probably said, “I have no idea, pick one.” So the discharge planner chooses a nursing home they like working with that will accept the patient referral.
This is an opportunity for adult children and parents to learn about good and not-so-good nursing homes.
The next step is that your parent has been transferred by the hospital to the nursing home. Upon arrival, your parent is quickly taken through a stack of paperwork, probably 30 to 50 pages, by the social worker or admissions staff.
Your parents don’t read it; they sign it. Information in nursing home admission documents is essential to read and understand so that patients know which rights they retain and which they give up.
Nursing Homes Behind the Scenes
So what happens behind the scenes while your Mom or Dad is in a nursing home? The staff have care conferences that you may not be aware of or invited to attend.
Your healthy Mom or Dad may not be invited to these care meetings. However, your parent who is in the nursing home should be invited, although they can refuse to attend.
Mom or Dad, in the nursing home, may be a little confused or a little drugged from the pain medications they might be receiving. They may be stressed out over this elder care crisis that resulted in their having to go to a nursing home.
The nursing home staff provides your parent with a potential discharge date and has them sign a form called “three-day notice,” which specifies the date your parent will leave the nursing home and return home.
But this conversation goes over your parents’ heads. Neither Mom nor Dad nor the nursing home staff mentions the discharge date to anyone else in the family.
Until, your healthy parent or you get the call. This is usually late on a Friday afternoon. The nursing home staff asks you when you are coming to pick up your Mom or Dad because they’re ready to go home.
Your first thought is, go home? Mom or Dad is nowhere ready to go home. You know that your healthy Mom or Dad can’t take care of your other parent’s injury and that you will have to step in to help.
How Can Adult Children Help Aging Parents Navigate Health Care?
So, let’s back track a bit and start over at the beginning. This is a scenario of what might happen when families have intergenerational discussions to talk about a potential elder care crisis and how to respond with grace, compassion, and confidence.
Why Educating Aging Parents About Care and Costs of Care is the Best Thing Adult Children Can Do for Themselves
Educating aging and elderly parents about care and care costs is the best thing adult children can do for themselves. Not only do children benefit from this learning, but their aging parents also benefit from gaining information that helps them be more proactive about their care.
Click the red button in the photo below to watch this video.
Watch More Videos About Caregiving, Aging, and Health on
Pamela’s YouTube ChannelInvestigate Healthcare Plans and Costs
Your parent has a hip fracture and goes to the hospital.
You know about your parents’ health insurance, Medicare, or a Medicare Advantage Plan. You and your parent call the health plan to ask about the coverage for a hip fracture, repair, and rehab in a nursing home plus the out-of-pocket costs to your parent. .
Through this process, you receive a list of nursing homes that are approved by the insurance company. You visit the nursing homes to see firsthand which are better than the others, and as a result, give the discharge planner two preferred care centers.
Before giving the two care homes to the nursing home discharge planner, you called and spoke with the Ombudsman to learn about whether families are generally happy or not about the experiences of their loved one in these particular nursing homes.
Understand Nursing Home Contracts and Discharge Plans
You meet your parent at the nursing home when the transport from the hospital arrives. You called earlier to ask for a copy of the nursing home contract so you can read and review it with your parent before your parent signs the document.
By making time to read the nursing home agreement, you learn that Mom or Dad might be in the nursing home for only 20 days. This is a hint that you need to plan for them to return home.
You learn that there are weekly care conferences that you can attend to discuss your parents’ progress. For example, how is your parent walking today compared to how they walked before they fell and broke their hip? What other physical actions do they need to be able to perform to return home and be successful?
You might learn more about the actual date of your parents’ discharge from the nursing home by calling the case manager every week to ask about the timing of the three-day discharge notice. This allows you, your healthy parent, and any other siblings you have to get the house ready for a homecoming.
Maybe you need to have stair railings installed or buy a handheld shower attachment and a seat so your parent can bathe safely.
Learn About Medications and Coordinating Health Care
Through this experience, you might have learned to compare your parents’ medication list before they went into the nursing home to what the nursing home plans to discharge them with to see if there are any differences.
Sometimes, nursing homes don’t receive an accurate medication list from the hospital because your parent forgot to tell the hospital about everything they were taking.
And in the exercise of talking to the nursing home staff, you asked for your parent’s health conditions and learn that there are a couple of new diagnoses since you were last aware.
This leads you to wonder why your parent isn’t being more active in managing their conditions. Because instead of getting better and remaining active, they seem to be getting worse and becoming less active. Afterall, a fall was the cause of the current elder care crisis.
Nursing Home Discharge
Since this is the first time your parent is in a nursing home, you learn about what happens when your parent leaves the nursing home. Thirty days of medications are sent to your parents’ pharmacy. Someone has to pick up the medications and take them to your parents’ home.
Maybe Mom or Dad is confused about what to take and when to take it. So, you buy medication boxes and set them up for the next two weeks.
What happens when these medications prescribed by a hospital doctor run out? Your parent needs to see their primary care physician to get these orders continued. Someone has to call and make that appointment and physically help your parent get there. Is this you or your healthy parent?
At the nursing home on discharge day, you might have learned about physical and occupational therapy orders for a home health care company to come to your parent’s home, and your parent arguing, saying I don’t need that when they really do.
You convince your parent to at least try working with the physical and occupational therapist.
Home Health Care: Physical and Occupational Therapy
Your parent returns home. The home health staff show up, but you’re not at that appointment. More paperwork is signed by your parent, who doesn’t read the details about participating and making progress, so that the insurance continues to approve at-home therapy.
Your parent doesn’t take the physical therapist or the exercises they are given seriously. After all, who wants to exercise? So the physical therapist discharges your parent from the program.
Yet your parent doesn’t realize that the more they sit and are inactive, the less they will be able to walk and do all the things they could do before.
Maybe your parent received a walker. They don’t want to use the walker because only old people use walkers. And guess what, your parent falls again, breaks the other hip, and another elder care crisis begins.
It’s one elder care crisis after another that you’re not prepared to deal with, even though you gracefully and compassionately made it through the first crisis.
It’s back in the hospital, back to the nursing home, but then, because your parent isn’t doing well physically from the first fracture and the second fracture, they can’t return home.
Costs of Caregiving Around Navigating an Elder Care Crisis
Now you’re trying to figure out the cost of 24-hour care in their home. The cost is between $20,000 to $25,000 a month. You are shocked to learn that Medicare doesn’t cover 24-hour home care.
This is one area you weren’t prepared to deal with because Mom and Dad didn’t want to share their financial information when previously asked. Their response was, “Why do you kids need to know?”
You have no idea whether mom or dad can pay for their care because you don’t have access to your parents’ bank account. Your healthy parent doesn’t know either because the parent who broke the hip controlled and managed all of the money.
All you know is Mom or Dad doesn’t have $25,000 a month to pay for in-home care. So maybe assisted living is the next best option.
The Pros and Cons of Referral Services
So you start looking and go to a website for a senior referral service to assisted living communities. The company starts calling you and wants to help you find a care community, saying there’s no charge.
Well, there is a charge. The company is paid 1-2 months of the assisted living community’s monthly rate, so the more your parents pay for a community, the more money the company makes. But they don’t tell you this.
The details are in the small print on the website you visited, as well as in the statements saying that by visiting the website, you agree to hire the referral service, and they will be paid at the time your parent moves into any of their recommended communities.
Managing Elderly Care
So now you may be trying to find and temporarily manage a care agency until you can figure out a better plan and learn how much money your parents have. Or maybe you are moving a parent to assisted living.
Either way, navigating an elder care crisis is stressful.
You have a full-time job, a promising career, a spouse, and kids. And because your parents agreed to share some information but not everything, like money, you can’t believe the time all of this is taking to manage and sort out. Your healthy parent is too stressed to be helpful.
How All Generations Can Deal with an Elder Care Crisis with Grace
The simple lesson of this story is for families to collaborate across generations. To share intergenerational knowledge and learning with an open mind so that when an elder care crisis arises, everyone responds with grace.
To summarize, here are a few steps to make this happen.
- Start by learning about your health insurance, then how Medicare or Medicare Advantage plans work.
- Learn how primary care works. If you don’t have a primary care doctor, get one and schedule an annual physical so you know what your parent might go through.
- Attend a doctor’s appointment with your parent to learn about their health problems and their medications. Learn how parents can be healthy, physically strong, and active instead of getting physically weak, falling, and breaking a hip, which can start a very long cycle of more health problems and a need for more care.
- Talk about money with your parents.
- Learn the costs of caregiving: home care, assisted living, memory care, nursing home care, and what happens if your parents didn’t save money to pay for this.
- If your parents didn’t save, learn about Medicaid.
Responding With Grace
Responding to an elder care crisis can be overwhelming and unexpected for many adult children living their own lives who might never thought about having a conversation with mom or dad about caregiving.
Caregiving is often not discussed in families until a crisis occurs. Experiencing an elder care crisis can be overwhelming for an elderly parent, especially one who has not planned for health problems and the related costs of care.
By initiating these discussions early in life, younger generations can have a greater impact on family health and well-being, and on how parents age and receive care as they move into their retirement years and beyond. Aging parents may welcome conversations and be willing to collaborate so that plans are in place to age gracefully.
By taking these steps, younger and older generations can navigate an elder care crisis with grace and learn
how to reduce the costs of caregiving and related stress for the entire family.
©2025 Pamela D. Wilson All Rights Reserved.