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Just a couple of years ago Annie helped her parents get the washer & dryer moved from the basement to a bedroom on the first floor after her mom missed the last step & broke her toe. Annie reassured them that she would make sure they would stay in their own home no matter what. Before she knew it she was fixing every supper for them at their home, taking care of the yard and cleaning the house on the weekend.

Then, Annie started to receive calls during the day at work. Mom had an accident with the car or Dad couldn't get out of the bathtub. She hired a home care aide during weekdays after she talked them into selling the car & accepting help for cleaning and cooking. Annie continued to promise her parents that they would live in their home forever. Her life was consumed with their care.

She hid a house key outside their home after the second time the EMTs called in the middle of the night because they couldn't get into the house for her dad who had fallen while going to the bathroom in the night & her mom couldn't get out of bed to unlock the door. Annie hired a nighttime aide. They now had help 24 hours a day.

After their phone was disconnected for non-payment, Annie finally realized that their mental capacities had degenerated, and convinced her parents she should take over their finances. It wasn't long before she discovered that her parents could not afford to pay for the current arrangements for long. She was surprised how little money they had put away and how small their monthly income was.

When she finally tried to discuss long term care needs with her parents, they were convinced that they were doing just fine on their own. They announced that they would stay right where they were even if they had to let the night time help go, which was of course unthinkable. It was at this point that Annie came to see that they had slipped into an unrealistic state, believing that they were independent and she had never spoken with them about the realities of aging and their possible needs for care.

Annie's kids claimed they felt like orphans, her husband threatened divorce and though her boss told her to take the time she needed, she was unclear what that meant before her job was in jeopardy.

Then, so suddenly it seemed Dad was in the hospital with pneumonia and the doctor said that a nursing home was probably imminent. Annie was exhausted, on the verge of a breakdown and faced with calling her brother who had had little contact or time for his parents for the past few years and lived a thousand miles away.

Like a snowball rolling down a hill, Annie's involvement, her parents needs and the resultant problems grew bigger and bigger over time. We never know the exact course of aging, so it is impossible to be sufficiently prepared for all unforeseen events, but some targeted pre-planning can avoid dealing with one crisis after another. Don't wait for a crisis to talk to your parents about their future. It may become too late before you know it.

As soon as Annie's parents needed the laundry room moved upstairs it was time to talk, as the situation usually doesn't get better. Aging is a process of loss & degeneration. It may be difficult to bring up such private matters, but the situation won't go away. Often it gets worse if we wait and our loved one's cognition deteriorates as it did with Annie's parents, who really thought that they were independent as she continued to reassure them that they would stay in their home.

We plan more for our young/old lives than we do for our old/old years. We may look forward to retirement and we specify an age at which that will begin, so we are clearer about the target and our desires. Old/old age is difficult to imagine and the specific age for which to prepare is slippery as it is more health than age related. Most people announce their desires for this age by simply saying, 1. they don't want to go to a nursing home, 2. they don't want to be a burden, and 3. they don't want to be in pain. But that's too vague and not enough direction for future caregivers. Have that talk with your loved ones the first chance you get. Create a chance to talk about old/old age.