Five Things to Do Before Your Parent Goes to a Nursing Home

Michael Kort, whose 96-year-old mother has Alzheimer's disease and is in a nursing home, has sage advice about what to ask before nursing home care becomes inevitable. The bottom line is not to miss the chance to ask these questions and make arrangements while your parent is still lucid.

1. Ask Your Parent Questions About Your Family History

Michael has many questions he wishes he had asked his mother -- particularly about her childhood, relationship with his father, and family history. The moment to ask never seemed right, but now it's no longer possible.

2. Discuss End-of-Life Options

It's a painful and awkward discussion, but knowing your parent's preferences as to end-of-life options -- such as wishes regarding resuscitation efforts or feeding tube usage -- will help you tremendously. Have this discussion and get your parent's preferences in writing, in the form of a living will.

3. Choose a Facility For Your Parent that Offers Options for Future Changes in Need

If you need to have your parent move to assisted living, make sure there is an affiliated section where she can move if her condition worsens. Facilities that offer both assisted living and options for increased nursing care help make the transition easier if and when assisted living no longer meets her needs. Many facilities have long waiting lists, but if your parent is in that facility's assisted living section, then she will have priority over people coming from a different setting.

4. Do Not Let Your Parent Bring Jewelry or Other Valuable Items to an Institutional Residence

At the time she entered an assisted living facility, Michael's mother still derived pleasure from wearing her fine jewelry. It never occurred to him to take it for safe keeping. In fact, he thought having the jewelry would help his mother maintain her identity at this unfamiliar new home. But when Michael's sister went to visit their mother a few months after she moved in, she noticed that some of the jewelry had disappeared. The family will never know what happened. Did their mother give it away? Discard it? Was it stolen? They regret that the jewelry is no longer available as a keepsake, for sentimental reasons, and to pass on to their children and grandchildren as part of the family heritage.

5. Obtain Legal Powers to Handle Your Parent's Affairs if She Should Become Incompetent

• Durable power of attorney

In order to make decisions on your parent's behalf, you will need what is called a power of attorney -- a document that allows your parent to appoint a person or organization to handle her affairs while she is unavailable or unable to do so. A "durable" power of attorney appoints someone to make decisions if an individual becomes mentally incompetent. The document can "remain in effect or take effect only if the person becomes mentally incompetent," thereby protecting the individual's rights while giving someone the ability to handle her affairs if necessary.

Without the power of attorney, a family will likely need to go through the messy and expensive process of going to court to have the parent declared incompetent and then have the court appoint someone to manage the parent's financial affairs.

• Social Security Administration account

Having authorization to deal with the Social Security Administration on your parent's behalf enables you to inform them of moves your parent makes, such as to an assisted living facility, nursing home or hospice. It also enables you to obtain information about your parent's account and to deposit her social security checks -- though arranging for direct deposit into your parent's bank account can eliminate this latter task.

Authorization can be obtained by going with your still-lucid parent to a social security office, with photo identification of both you and your parent, and filling out a representative payee form application. If this isn't done beforehand, if and when your parent does become incapacitated, you can still go to a social security office yourself, along with photo identification and your parent's name, address, social security number and the name, address, and phone number of a doctor who can verify that your parent is mentally disabled. For more information about this, call 1-800-772-1213.

• Bank and investment accounts

Power to handle bank accounts can be obtained by going to the bank with your still-lucid parent and adding your name to his/her account(s). Or, if your parent calls the bank or investment service from his/her home phone, she/he can request a form that adds your name to the account, enabling you to access it on your parent's behalf. You and your parent will both need to sign the form, which may need to be notarized.

Ronnie Friedland is an editor at Care.com. She has co-edited three books on parenting and interfaith family life.

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