Recently I heard from Sarah, an old friend, about a hard situation she's in that I'm sure many Caring.com readers can relate to. Sarah's mother-in-law moved in with her and her family more than a year ago, and since then Sarah's had a really hard time dealing with her husband's siblings, who aren't helping out as much as they promised.
But what Sarah's finding even more stressful is that the expense -- both in direct costs and in time lost from work -- of having an elderly person join the household is much greater than she expected. And what really galls her? No one else in the family seems motivated to chip in. "This summer it really got to me," Sarah told me. "We were stuck here in the Midwest heat, working ourselves to the bone keeping up with our jobs and caring for mom, while my husband's sister's family went to the Bahamas, and his brother and his wife spent weeks at their lake cabin. They didn't invite their mom to join them, and it never occurred to them that we could use a vacation too."
The problem is, it's much harder to get situations like this straightened out after the fact, after expectations have gelled and things have settled into a routine. So here are some suggestions culled from elder planning experts for how to set up a working financial arrangement with siblings before your parent or other family member makes the move.
1. Create a “caregiving budget.” Make a list of estimated expenses and determine how much the parent, the caregiver, and/or siblings will contribute. This budget should take into account the full cost of living for the family; not just food and transportation, but mortgage or rent, homeowners' insurance, utilities, etc. Many people make the mistake of thinking, well, I'm already paying this mortgage amount, so I shouldn't charge my parent for a share -- no. Even if your home is big enough that you don't have to make any changes to accommodate your family member, he or she should still share those basic expenses, unless there's really no money available. If not, resentments will arise down the line. Again, this may need to be made clear to siblings.
2. Figure out how much your parent can contribute. Sometimes, aging parents will have sufficient resources (possibly following the sale of their home) to pay the full cost of their care in your home. For example, if Sarah's mother-in-law sold a home before moving in with Sarah and her husband, that money could be used to contribute to Sarah's household. Sibling alert: This is an issue that must be discussed openly ahead of time. In many families, there's an unstated expectation from adult children that they will inherit the funds from the family home. I've heard more stories than you can believe of families where the family home is sold, and the proceeds set aside for future inheritance, while one sibling struggles to support and care for the now non-independent parent. That's not how it should work, experts say. All the siblings need to discuss and agree that the proceeds from the home are to be used for the parent's care during his or her lifetime. And if that care is in one sibling's home, the funds will last much longer than they would if they were used to pay for assisted living.
3. Calculate a fair contribution for the parent to make to household expenses. This is tricky, of course, and has to take into account both what resources the parent has, and what the cost of living is for that particular household. But here's a ballpark way to look at it: If an aging family member becomes part of what's now a five-person household, and the total monthly expenses for that household are $2,500, the new resident might contribute one-fifth, or $500.
4. Call on siblings to contribute. If an aging family member doesn't have resources to pay for his or her care, the siblings together should come up with a payment plan. Really -- it's only fair. If you figure it costs you $1000 a month to have your parent in your home, and there are three additional siblings, you could ask each for $250. Alternatively, your siblings might very reasonably decide that your time in caring for the parent is your contribution, and divide the $1000 three ways.
5. Keep track of additional costs and share those too. Food, housing, and utilities are only the start, and not realizing this ahead of time is one of the biggest stressors for family caregivers, as the costs begin to mount. If you're the one taking Dad to the doctor and picking up his medications, you'll be writing checks for co-pays and prescriptions. There will be special purchases to make and supplies, such as adult diapers. You may have to make changes to your home, such as putting bars in the bathroom or widening a door for a wheelchair. There may be transportation costs, or fees for services. Since you're Johnny-on-the-spot, these expenses will end up coming out of your pocket. Keep a running tab of caregiving expenses and send a regular tally to other family members, with their share indicated. One way to simplify the record keeping? Have a separate credit card and use the monthly bill as your record. If other siblings can’t or won’t pay their fair share on a monthly basis, you'll want to keep even more careful records, as you may be able to recoup your expenses from your parent’s estate before it's divided up.
6. Don't be afraid to hire outside caregiving help and share that expense. Whether you work full or part time, or stay home, you may need to find adult day services, or a senior center that provides meals, or hire a caregiver a few hours a week, so that you have the freedom to take care of your other responsibilities. This is perfectly understandable; don't get stuck in the guilt trap feeling like you signed on to do it all. You may also need transportation for your parent to and from the senior center or day care center, and may need to pay for that, too. Discuss these arrangements with other family members ahead of time, so they don't feel blindsided, and see if there are other options. Another family member might, for example, choose to step in and have Mom come for a visit every Thursday rather than pay for adult day services, and that's fine. But if no one else can provide regular, continuous care you can count on, then you'll need outside help, and that's a shared expense.
7. What about being paid for your time? This one is pretty individual, and every family situation is different. But here's the bottom line: If you or someone in your immediate family has to quit work or cut back hours in order to care for your aging family member, then that lost income is a family-wide issue. Likewise, your time. If your parent needs a lot of day-to-day care that would otherwise be provided in an assisted living facility or by a caregiver, and it's you doing that work, your family needs to acknowledge that time spent, and its impact on the rest of your life. Maybe they'll want to spring for a caregiver, maybe another family member can step in for a few shifts, or maybe they'd prefer to pay you for your time. But no matter what, the contribution of the one doing the caregiving needs to be acknowledged. You can also look into being paid as a caregiver through Medicare.
Of course, if an older family member is already living with you, and some of this advice is hitting a nerve, it's never to late to revisit arrangements. Call a family meeting and be direct and honest. Explain that you're happy having your family member in your home, but there were certain details about how it would all work financially that you didn't know enough to consider at the time. Lay it all out for the rest of the family, and explain that things need to change. It helps if you've made a budget, kept track of expenses, and can demonstrate what is and isn't working. Remember, your siblings are getting off easy, here. All the work and responsibility for your family member's care is falling on your shoulders, not to mention the inconvenience, lack of privacy, and at least occasional frustration and irritation of having an elderly person in your space. So let them step up to the plate in other ways, so you feel supported. It's the only way to protect other family relationships from the stress and strain of resentment.