Your mom is forgetting to turn off the stove burners or maybe dad just can't keep up with the maintenance of the family home.
The realization that your parents are getting older and might need assistance with day-to-day activities is a hard one.
People across the country are having one of the most difficult conversations of their lives: the talk with an aging parent about possibly moving into a nursing home or an assisted-living facility.
"It's one of those things that you will face, but no one wants to talk about," said Larry Minnix, president and CEO of LeadingAge, an advocacy organization of more than 6,000 not-for-profit members that provides elder care and housing for the aging. "It's hard to discuss those issues."
Minnix said that 70 percent of Americans will need long-term care during some point in their lives. According to the federal Administration on Aging, those 65 and older numbered 40.4 million in 2010, an increase of 5.4 million or 15.3 percent since 2000.
Minnix said that while the conversation may be awkward and filled with emotional angst, it's an important one to have.
"I recommend that you should sit down with Mom, Dad, brother or sister and ask them, 'In the event you break a hip, or have a stroke or develop dementia, what are your wishes?'" said Minnix. "Once the ice is broken, the conversation might be easier to have than you think."
Minnix said it's important to document what the parents want in order to avoid conflict among other relatives in the event that Mom or Dad may need to be put in a nursing home, assisted-living community or is so ill that he or she may not be able to state what they want in terms of long-term health care.
He recommends that parents draw up a legal document such as a living will, or assign someone durable power of attorney for health care.
Minnix said once the conversation has taken place, another thing families need to do is to visit the places where the older person might live one day.
He said people should consider whether the facility has been accredited and what public records say about the facility; ask others about the facility's reputation. He said there are numerous websites that provide information on a facility. (See page 25)
"You also want to trust the five senses," said Minnix. "Does the place smell? Does it look busy? Are residents being wheeled around? What's the interaction of the staff with each resident?"
Some older people might not need the level of care of a nursing home and may be better suited to an assisted-living facility. Such places offer housing alternatives for older adults who might need help dressing or bathing but not the intensive medical care that a nursing home provides.
Minnix said many of the considerations in searching for a nursing home also apply to searching for an assisted-living facility.
Those looking for senior housing for their parent or for themselves should also consider the cost.
Medicare does not pay for these facilities. At most, Medicare covers 100 days of rehabilitation after being admitted into a hospital. Help with daily life activities such as bathing and eating are not covered.
Most people who enter nursing homes don't qualify for Medicaid at first. They must pay for care either through long-term care insurance or out-of-pocket and will only qualify for Medicaid when most of their savings and assets are depleted.
According to AssistedLivingFacilities.org, which lists information on more than 36,300 state-licensed assisted-living facilities, the average cost of assisted living in Connecticut is $3,600 per month, and there are extra fees for additional services.
The National Clearinghouse for Long Term Care Information found that in 2010, it would cost on average $19,000 a year for a home health aide to assist a person three times a week.
The federal agency found that Connecticut's average daily rate for a private room in a nursing home was $376, and $345 for a semi-private room.
Affording the cost for long-term health insurance may also be burdensome. According to the American Association for Long-Term Care Insurance, a 55-year-old couple purchasing this insurance can expect to pay around $3,000 per year for about $340,000 of benefits, which will grow to over $700,000 in combined coverage when the couple turns 80.
The average cost for a single 55-year-old is about $2,000 for between $165,000 to $200,000 of current coverage.
Minnix said whatever decision is made among family members, preparation is key to making the transition into the next phase of life as smooth as possible.
"The latter years of life have some indignities that are inevitable," said Minnix. "The hope is to find purpose and meaning in life."