For years, Madeleine Smithberg has been at the forefront of American comedy as co-creator of "The Daily Show" and a talent coordinator for "Late Show with David Letterman."
That sense of humor was especially handy during the last few years. That is because Smithberg had to cope with not one, but two elderly parents in rapid decline.
"It's heartbreaking," says Smithberg, 56, who heads a production company in Los Angeles. "And yet it's invisible, because nobody talks about it."
Dealing with one aging parent is challenging enough, whether you are helping navigate the complex healthcare system, paying for an assisted living facility or struggling with cognitive decline as the parent slips away. But the emotional and financial stress can be more than double if you are caring for both parents at the same time.
"It's like having toddlers," says Smithberg, whose father passed away in 2014 after she moved her parents to Los Angeles. "They're hot, they're cold, they're hungry, they ask repetitive questions, and their needs become the most important thing in the world at that second... The biggest challenge of all is holding onto your patience."
According to a new study by Northwestern Mutual, the childrearing comparison is apt: 59 percent of Americans feel that taking care of two parents between ages 85 and 90 would be even harder than handling two kids between ages 3 and 5.
Caregivers may also have kids of their own. In that case, it's not just the "Sandwich Generation" - it's a Triple-Decker.
The Northwestern Mutual report found that 38 percent of those surveyed have not planned at all for handling the financial burdens of caring for elderly parents.
The costs can be gigantic: National median costs for an assisted-living facility are now $43,200 annually, according to insurer Genworth Financial in its annual Cost of Care study. A private room in a nursing home? $91,250.
That is more than enough to blow up any financial plan. The following is advice on how to care for your parents without going bankrupt yourself.
"Long-term care, long-term care, long-term care." That's the simple advice from Smithberg. Her father had taken out coverage for himself and his wife, which she calls "the best thing he ever did."
Long-term care insurance covers expenses for nursing home or home care if you become incapacitated - most of which is not covered by Medicare. The coverage, like the care, can be extremely expensive, and to be sure, it did not cover all of Smithberg's parents' assisted-living costs. But, combined with their own life savings, the policy has meant that she has not yet had to dip into her own savings to pay for their care.
HAVE THE TALK
With the holidays right around the corner, it is one of the few times of year when far-flung families tend to gather in one place. Don't let the opportunity slip by to discuss your parents' expectations, should illness arrive. Find out if they have advance directives - documents that spell out what treatment they would and would not want during a life-threatening health crisis. Make sure you establish who has power of attorney, should they need someone to make important decisions.
"It's the perfect time to have this kind of conversation," says Kamilah Williams-Kemp, Northwestern Mutual's vice president of long-term care. Her spouse's grandmother lived to 102, and her mother-in-law has been diagnosed with Parkinson's.
CONSIDER A REVERSE MORTGAGE
Reverse mortgages allow homeowners aged 62 and above to borrow against their home equity and to receive either a lump sum, a series of monthly checks or a line of credit that can be tapped as needed. The upside of a reverse mortgage? With the bank paying you every month, instead of the other way around, that check can help cover costs for in-home caregivers.
Tom Davison, a financial planner in Columbus, Ohio, is working with a 90-year-old woman whose daughter moved in with her as a caregiver. "A reverse mortgage could help (the daughter) pay her the wages she has given up," Davison said.
The downside, of course: The family home will eventually become property of the bank.
Your first instinct as a child may be to drop everything and handle all your parents' needs yourself. But if it comes at the cost of your own career, think about the ripple effects - on your retirement savings, on the needs of your own kids, even on your own sanity.
With Americans extending their lifespan - 76.4 years for men, 81.2 years for women, according to the National Center for Health Statistics - this is a family challenge that won't be going away anytime soon.
Denver financial planner Kristi Sullivan recommends hiring a case manager to do the heavy lifting.
"For an hourly fee, these people can handle tasks quickly that it might take you hours to do - scheduling doctor's appointments, handling medical payments and dealing with insurance, helping find a good nursing home or in-home care," Sullivan says. "Spending this money may seem expensive, but it's less than putting someone's career on hold to become a full-time caregiver."