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How to Keep Your Parents Safe and Sound and Out of a Nursing Home” is one of those rare books that delivers what the title promises—and more. I only wish it would have been written ten years ago as my husband and I struggled to make decisions with and for his aging parents—one of whom was physically healthy but was deteriorating mentally and one of whom was mentally alert but failing physically.
Had Raymond Reiss’ book been available then, we would have had a much clearer picture of what to expect; the full range of choices; and all of the quality-of-life, financial, medical, and legal ramifications of those choices. Our stress level would have been reduced significantly.
I begin this review of “How to Keep your Parents Safe and Sound...” by telling you that it is a treasure trove of relevant information written by a man who’s “been there, done that.” His professional background and his personal experiences make this book extremely credible as both a practical, how-to guide as well as a reassuring philosophical companion. The author, who has spent his entire thirty year career in the senior healthcare field, is also a son and a sibling in a family who has benefited from his professional knowledge and from his caring attitude. By sharing personal anecdotes about his own family’s challenges as he collaborated with his brothers and sisters about their parents, he contributes to the book’s authority and assures us that he shares the same core values we do: to care for our parents and to help them make decisions to ensure their well-being for as long as possible. There is no question that Raymond Reiss makes this huge responsibility easier for us by having shared his expertise and experience.
Before I even opened the book, I noted that the cover’s art work inspired a feeling of calm and peace---an eagerness to learn and to grow. The sketch is a delightful watercolor of a cottage with a woman sitting on the stoop; it evokes the pleasure our parents might feel as they sit within the comfort and beauty of their own familiar spot in the world.
A complete Table of Contents allows the book to be used as a quick reference tool. Or, it offers a helpful overview for page-by-page reading. It’s obvious that Reiss’s professional and personal background is reflected in the comprehensive content. Every relevant topic is included. While reading, I was constantly reminded of the questions, problems, and solutions we had muddled through ten years ago. This how-to guide is definitely steeped in reality.
In the Author’s Preface, Reiss makes his bias known: nursing home living should be an option of last resort. While he acknowledges that nursing homes fill a valuable void in our society, he believes that despite caring administrators and caregivers, nursing homes are not a good choice unless there is no other alternative. The reasons for his thinking are contained within the covers of the book and serve as a testament to why this is a sad reality.
The book’s thirteen chapters begin with “Getting Started,” where he introduces us to his professional and personal background—as well as why he believes that nursing homes are not the best choice we can make for our parents, or even for ourselves as we begin to consider choices for our own futures.
At first, I thought this chapter was a little too personal and chatty. I was eager to move on to the nuts and bolts of facts and decision-making. But I soon realized that the philosophies and perspectives he shares with us are valuable insights into his openness and his integrity---both as a seasoned professional in the senior car industry and as a caring son to his parents.
One of the facts I learned from this chapter that I did not realize is that nursing homes only make money from private paying residents. They lose money on Medicare and Medicaid residents. So, it’s obvious who subsidizes the care for these residents. Combine this fact with the reality that, despite the nursing home administrator’s and the staff’s best intentions, there are simply not enough hours in the day to accomplish the reams of paper work required by the government and still care for residents in a consistent, caring manner.
The next twelve chapters deliver on the author’s promise to give us the information we need to keep our parents (or ourselves) out of a nursing home. With the goal of not making this review too long or cumbersome, I will briefly summarize one point from each chapter; however, I would like to emphasize that the point I, personally, select may not be the one most relevant for you in your unique situation. So, please understand that every word of these thirteen chapters, plus the appendices, contain helpful information. They are must reading if you want to be in the know regarding how to plan for your parents—or for yourself.
• Chapter 2: “Bio-Ethical Issues: When is enough, enough?” Reiss stresses that these issues are easier dealt with after you and your siblings have talked with your parents. If your parents don’t bring up the subjects of life support, living wills, advanced directives and other end-of-life concerns, they can be awkward and emotional topics for adult children to raise. Nonetheless, if a family wants to make informed decisions, it’s necessary.
• Chapter 3: “Caring From a Distance.” The author tells us that whether we live across the country or across town, our parents’ safety and security needs must be our top concern. He lists scary statistics proving that caregiver’s backgrounds are not always what they seem to be. “Keep in mind,” he says, “that scam artists smile too!” He’s believes a “Granny Cam” or some device should be used to assure our parents’ safety, especially if we are providing oversight from a distance.
• Chapter 4: “Getting Organized.” The checklists in this chapter are invaluable. At a glance, the reader is able to check off what medical, legal, and financial documentation they have easy access to on behalf of their parents and what
information they are going to have to request from various sources.. As the author points out, if you’re going to provide protective oversight for your parents, it’s best to have these documents before you need them and to have them well
organized.
• Chapter 5: “Getting Your Legal Ducks in a Row.” “Your ability to help your parents will be greatly hampered in an emergency if you do not have legal authority to represent them,” Reiss writes. He lists about fifteen or more creative and practical ways we can get our parents to assist us with getting the information we need.
• Chapter 6: “Needs Assessment.” Reiss describes trends toward holistic healthcare which treats the whole person and how medical care has evolved into a multi-disciplinary team of specialists working together for the common good of the individual patient. He provides excellent checklists and charts so we can objectively get a sense of how dependent (or independent) our parents are. This information, in turn, can point us in the direction of choices that might work for them.
• Chapter 7: “Financial Matters.” This topic more or less speaks for itself. The author writes, “If you think getting information about your parent’s health is hard, wait until you try to get information about their financial health.” He offers readers gentle and patient ways to get this information from them.
• Chapter 8: “Medicare and Related Federal Programs.” “To give you a little forewarning,” the author writes, “this section is very dry, but I assure you when you are finished you will be glad to have this information so you can refer back to it when questions come up.” Specifically, I was surprised to read about veterans’ potential benefits as well as other kinds of financial aid that might be accessible.
• Chapter 9: “Long Term Care Insurance, Home Care Insurance, and Reverse Mortgages.” A piece of information, potentially worth its weight in thousands upon thousands of dollars, begins this chapter. Reiss writes, “You buy homeowners insurance to protect your home against disaster. You buy long-term care insurance to protect your net worth against disaster. This is your best bet to staying out of a nursing home. Buy long-term care insurance with great in-home care benefits.” Every word in this chapter should be devoured by all of us who are caring for parents or who will soon be making these decisions for ourselves.
• Chapter 10: “Housing Options.” The many options (more than certainly I ever dreamed of) and the accompanying pros and cons that go with them is especially valuable in assuring us that we are thinking of every conceivable option. As the author says, “Do not rule out any option...circumstances change....” He suggests a “creative brainstorming session” where any and all options are voiced and written down, regardless how bizarre they may seem. “Work and feed off each other’s creative juices, and start mixing and matching different scenarios,” he suggests.
• Chapter 11: “Home Care.” Reiss states that if we are serious about keeping our parents at home, that this is the area in which we need to expend most of our energy. With easy-to-read lists, he outlines the concerns we need to address.
• Chapter 12: “Safety Issues.” The author states that the coping skills of seniors are very low when accidents, disasters, and trouble looms. He provides a checklist of the many items that any household should have available, depending upon where our parents live and what type of disaster is more likely in that region of the country. A fully charged cell phone, a “grab and go” disaster kit, and a weather disaster radio should be on everyone’s ‘must have’ list. The types of disasters he refers to could be an all-out regional disaster or a house fire or be as simple as leaking pipes, ice storms that result in power outages, or even, perhaps, a flu epidemic.
• Chapter 13: “Pulling it All Together.” The author summarizes the cogent points from the previous twelve chapters. He emphasizes that the best way to keep your parents (or yourself) out of a nursing home is to get a long-term care insurance policy with great in-home benefits. In today’s economic climate, I know we can all identify with this caution, “Long-term care insurance is great, but why pay premiums for benefits that will go to bail out the federal and state programs? Stick with in-home care for as long as possible.”
The three Appendices which follow are jam-packed with information about state-by-state resources; a glossary of terms used in the senior care industry; and a variety of forms similar to those we may have to complete or which we may find useful. Even with all of this in-depth state-by-state information, the author cautions us throughout the book that all legal requirements, financial aid, and other matters can vary state-by-state, so we must consider the information he provides a launching spot from which to confirm what is available in our parents’ state of residence and in our unique financial situations.
If this lengthy review gives you the sense you’ve been on a long journey, you’re right. And, if we believe in the maxim, “Knowledge is power,” we have Raymond Reiss, author of “How to Keep Your Parents Safe and Sound and Out of a Nursing Home” to thank for arming us with all we need to know to make a positive difference in our parents’ lives as they grow older
and need us to care for them, as they cared for us and our safety.
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Diane Wiltjer’s background is in education, business, and conflict resolution. She reviews books for individuals and organizations, including “Resolutions,” a publication of the Office of Dispute Resolution, Supreme Court of Virginia. She may be reached at DianeWiltjer@aol.com.
