The Sandwich Generation Part II: Long-Term Care Facilities
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The Sandwich Generation Part II: Long-Term Care Facilities

Recently, on Father’s day, I was reflecting on the last ten years of my relationship with my dad since my mother passed away in 2006. Like many of us, I am part of the “sandwich generation”, which is when we are at an age where we have to care for our children, and at the same time have to care for our parents.

As our parents age, they often require us to oversee their financial affairs, their physical and emotional health, and their safety. My mother died ten years ago from lung cancer. Since then, my father, who had been dependent on my mother for most domestic responsibilities, was not able to function normally without help from me and my sister. Luckily, my father and sister both live in Central Florida. My sister and I decided that I would assist him with his financial affairs, and she would handle his health, safety, and day-to-day needs. I am in the fortunate situation of having a sister with a certain skill set that is extremely valuable and practical, when matched with my ability to handle his financial well-being. I am proud to say we make a good team.

However, several years ago, we realized that his health needs were beyond my sister’s ability, so we decided to look for a long term care facility that could provide my dad with his required level of care.

The first level of care is called “Independent Living” (AKA an “ILF”, or Independent Living Facility). This level of care is basically an apartment, with safety features such as a pull cord in the bathroom or bedroom, and some basic provision of minor healthcare services.

The next level of care is called “Assisted Living” (AKA an “ALF”). In this level of care, the facility is allowed to manage the administration of medications, and provides basic assistance with hygiene, supervision, and other health needs.

The highest level of care is called “skilled nursing care” (often referred to as a “nursing home”). In this level of care, full nursing care is provided, with the oversight of a physician, who is often employed by the facility as the Medical Director. As you can imagine, the higher the level of care, the more expensive it is. Medicare, unfortunately, covers only a very short time period for this highest level of care (skilled nursing care), leaving us sandwich generation members in a bit of a pickle.

For my family, the answer was to turn to the professionals. My sister and I found that in order to financially plan for moving our dad to any level of long term care, an Elder Law attorney, a financial planner, and an insurance specialist (to consider purchasing long term care insurance) all turned out to be valuable resources we were able to utilize.

My sister located a few facilities near my dad. The facility we chose was one that provides all three levels of care, so that as my father gets older, and his health may deteriorate, he can feel comfortable in knowing that he will be staying in the same “home” (just moving to a different section of the same facility).

The process of learning all of this was quite educational (and a bit scary). However, advance planning in reaching out to the right advisors and professionals is the best way to figure out how your parents can live their later years comfortably and safely. Regardless of who looks into these issues for your aging parents, I strongly suggest starting the process sooner than later.

Best of luck to those of you in this stage of your life. I love you, Dad.

-Craig Goldenfarb