In my 30 years as an elder law attorney I have had the opportunity to counsel many families in the journey through the elder care maze. Families struggle with the want to help their elders, the high cost of care outside and even inside the home, the time commitment for care, jobs outside the house, layoffs because of the current economic condition, and caring for the family and children. I have seen some creative solutions and some disasters.

Let me share with you one family’s solution to their elder care dilemma. Mother – age 73 and father – age 84. Mother is healthy and has been caring for her husband who was diagnosed with Alzheimer’s disease 4 years ago. Mother admits she is tired and feels isolated. There are 4 children in the family. All children have children. Three of the 4 children live in Minneapolis, the 4th lives in San Francisco. Two of the children have been laid off from their jobs and have been looking for work for the past 8 months. One child, a daughter, is a registered nurse and is working. She is single with 3 small children.

elder care dilemma

All children get along. After much discussion with Mom and Dad alone in my office and later with the children, with the consent of the parents, a plan was devised to help mom care for dad, help single daughter with daycare issues, find employment for the 2 laid off children and keep the child in San Francisco involved.

In a nutshell this is what the plan looks like. The parents will pay to build an addition to RN daughter’s house to add a mother-in-law suite. (This daughter has the space on her property to do so.) The value of this addition to the house will be noted and used for further discussion about the division of the parents’ estate upon both parents’ death. A contract will be developed to determine who is responsible for what costs in the maintenance of the family compound.

RN daughter will continue to work but will monitor and oversee medications and be involved with medical issues for Dad. Mother will continue to provide care. The two children who are currently unemployed will be hired by Mother and Dad to augment care for Dad and for Mother, if Mother begins to need help. Social security will be withheld, along with FICA, FUTA and workers compensation insurance. The three children will allocate hours for care, develop cleaning schedule and meal preparation schedules, and be on sight to assist Mother with care for father and to care for father when Mother needs time away.

The children of RN daughter are school age, but need oversight after school. They will now be able to return home after school. RN daughter will discontinue the after school programs that the family used to provide daycare for her children while she is working.

AND the child in San Francisco? This child agreed to handle the investments, income taxes, set up the accounts, pay the parents bills and pay the salaries of siblings. This child will also make periodic trips to Minnesota to visit the parents and spell the other three children. (The parents don’t see this child enough and would like to pay for the child’s return to Minneapolis more often.)

We have a lot of things to determine here. How long can the parents stay independent? What happens if any of the children want out of the arrangement or if the parents want out? How do we determine salaries for the children? What other work is to be done around the house while the children are caring for the parents? Is any of this work going to benefit the RN daughter and if so should she pay the other children? Should RN daughter be paying siblings and parents for the child care? Who is responsible for meal preparation? Who will pay for groceries? Do the siblings have to bring their own lunches? And how will the parents allocate the funds that remain, if any, after their deaths?

Interesting, isn’t it. When care was being provided to parents during the depression often times there was no money to pay for expenses. Everyone just pitched in. The benefit now is that in this family they are choosing to provide care at home and pulling the entire family together to do it. Thankfully there are sufficient funds to carry this program on for some time.