The Sandwich Generation

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The Sandwich Generation
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Overview

• Ways to handle the many competing demands of
  caring for both children and aging parents.
• Feeling pulled in many directions
• Balancing work and family
• Handling finances
• Sharing the load
• Time for yourself
• Respite care

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Feeling pulled in so many directions

• Sandwich generation
• Between ages of 35 and 60
• Balance the needs of your own children
• Trying to attend to the care needs of your
  parents
• Planning your own financial future and helping
  your parents meet their financial needs

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Balancing work and family

• Working
• Raising your own children
• Caring for an older adult
• Can cause you to feel
• Exhausted
• Overloaded
• Guilty
• Working that you have neglected someone

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Balancing work and family

• Try to find ways to share care giving tasks
• Spouse assists with children or the aging parent
• Other relatives who can assist
• Explore FMLA as an option
• Explore community resources that can be helpful

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Community Resources

• Adult Protective Services (APS)
• IHSS
• Senior Centers
• Meals on Wheels
• Visiting Nurses Association
• EAP

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Important Issues for Seniors

• Medicare
• Covers medical expenses for individuals over age
  65
• Part A hospital insurance and skilled nursing
• Part B basic medical services-md office visits

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Medicare

• Part A covers 90 days IP per episode
• Life time reserve of 60 days
• Annual co-pay of 840
• Up to 100 days of skilled nursing care per illness

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Medicare

• Part B
• Basic medical services
• Monthly premium of 58.70 and this increases by
  10 if you do not sign up when initially eligible
• 100 annual deductible
• 80/20 benefit

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Medicare

• Many care needs not covered
• Prescription drugs
• Routine physicals
• Eye glasses
• Hearing aids
• Most dental services
• Routine foot care

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Medigap

• To fill the difference left by Medicare
• Purchase 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

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Medigap Policies

• Pros and cons
• Future 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 parents current medications against
  the plans prescription formulary

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Prescriptions

• Explore medigap plans for prescription coverage
• Use mail order for chronic medications
• Talk with MD about alternative medications or
  generics
• Shop around to different pharmacies
• Explore low income programs through the
  pharmaceutical companies

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Senior living environments

• Independent Living
• Continuing Care Retirement Communities
• Assisted Living Centers
• Board and Care Homes
• Skilled Nursing Homes
• Dementia/Alzheimer Units

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Senior living environments

• Identify the options available in your area
• Review these options
• Select a few facilities for a site visit
• Do you homework
• Making a decision
• Consult with the EAP for assistance in this
  process

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How to help your Aging Parents

• Importance of having a conversation with your
  parents about the following topics
• Medical care
• Financial affairs
• Housing plans
• And other arrangements

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How to help Your Aging Parents

• Important to start planning before a crisis
  occurs
• Never an easy conversation
• Need to overcome your natural fear about
  meddling in their affairs.

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Helping your Aging Parents

• Number of issues need to be clarified
• Do 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?

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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?

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How to Talk to Your Parents about the Future

• Try to be sensitive and show genuine concern and
  interest
• Be supportive and not judgmental
• Ask open ended questions
• Be prepared to accept your parents decisions and
  points of view
• Do not overwhelm them with lots of probing
  questions

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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 Directives
• In event that you are unable to direct your own
  medical care, this document allows the person you
  appoint to direct your medical care

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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 coverage
• Cheaper when purchased at a younger age

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How to avoid care giver burnout

• Care most often provided by women in the family
• Emotional burden of care giving
• Lack of privacy
• Lack of time for self
• Feeling burdened by the need to provide all care
  needs and guilt about making decisions on
  placement
• Importance of taking care of self
• Respite