Coping with the Caregiving Dilemma

Nearly 10 million baby boomers are raising kids while giving a financial hand to an aging parent, the Pew Research Center reports. BusinessWeek's Lauren Young asked Keith Klovee-Smith (right), head of elder services at Wells Fargo Private Bank (WFC), for tips on coping with the caregiving tug-of-war.What advice do you have for people who are stuck in the middle?

Step back and look at what you are doing for yourself as well as for your parents. If you are helping them and worrying about your children at the same time, there's a good chance all you will really be is angry. We want to honor our parents, but we have to be comfortable with the choices they've made. If they didn't save for retirement, they shouldn't expect you to bail them out. Don't get into the victim-rescuer mode.How do you know whether it is better to keep parents in their home or move them into a facility?

Right now our society thinks everybody should be aging in place. There's a feeling that nobody should ever go to an assisted-living facility. That's considered the last resort. But sometimes that level of care is far better than staying at home. Move away from your stereotypes and look at the specific situation. What can be done at home? What is available at an assisted-living facility? As children, we often project our wants or needs onto our parents. The assisted-living facility is for our parents. It is not for a 50-year-old son or daughter.

I helped my mother stay in her home as she aged. But when she started losing her memory, she went out less and less. I kept throwing services at her. I had someone come in to clean and prepare meals. What I did was socially isolate her. It was the worst thing that could have happened to her.What caregiving mistakes do people make?

Acting too quickly. Before you make any major changes to the caregiving structure, it's important to look at what is actually working. Members of the sandwich generation, particularly if they are professionals, often come into a situation and lay waste to all the systems in place. Perhaps a neighbor is helping out on Mondays. That arrangement is not just about bringing over a meal. It also provides important socialization.

There is a cultural stigma attached to Medicaid. Even though we want Medicaid to be there, we don't want a handout. It's true that some Medicaid facilities do not have the same services as other private facilities, but they offer a level of care you cannot get at home.What's the best way to keep the peace among family members?

When you are talking about caregiving, it is a good idea to use language about what works and doesn't work rather than what's good and what's bad.

Don't make the mistake of shielding your parents from the decision-making process. Parents can and should make choices. Remember, we are assisting them to meet their needs and preferences.

There is always one sibling who has bailed out Mom and Dad more than others, especially when family members are spread out. At the same time, parents do not treat children the same. They tend to lean on one child more than another one.

It's very helpful for the child who lives the furthest away and comes to visit once or twice a year to pay careful attention to caregiving and finances. They pick up information no one else sees. An expert opinion from an outsider such as a geriatric case manager also helps diffuse some of the tension.What alternatives do you suggest to people who may need to dip into retirement savings to pay for tuition and elder care?

Think of "resources" in a broad sense. Look at what other services are available for the individuals you seek to help. For some of us, financial help may seem like an appropriate step; for others not. The challenge is to make the decision consistent with our own values, not someone else's. I have always been pleasantly surprised how supportive parents and children can be if they understand how limited resources are.

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