The holidays are fast approaching. You look forward to spending time with family who live away from you. Then when you arrive, you are surprised at the changes you see in your parents, who have always been your rock, your protectors, and your safe harbor.

Your long-distance phone calls have not prepared you for what you are seeing now. The realization that your loved ones are aging and might have difficulty with memory or function comes unexpectedly.

Often you want to deny the changes you are seeing. Now the roles are reversing, and you find yourself in the role of providing support. You’re the “sandwich” generation taking care of both children or grandchildren and now your parents.

You realize that the coming years are going to be challenging. How will those changes affect your life, your siblings, if any, and your children? What options do you have?

What’s the cost of caring for your parents if they move in with you or you with them? What about independent living or retirement communities? Non-medical or medical home care? Assisted living or skilled nursing communities?

Do you know which care community or agency they would prefer? How will you pay for it?

What do you really know about your parents? Who are their doctors? What is their medical history? What medications are they taking and from which pharmacy or pharmacies?

Who is their attorney? Financial advisor? Do they have a will? Investments? Insurance policies? Where do they bank? Do they have financial and healthcare powers of attorney in place?

What are their end-of-life wishes? Where are these documents located?

So many questions!

The best advice is to initiate discussions about these issues with your parents (or with your children) before a crisis occurs. It will be the greatest gift you could give each other.

Then when a situation arises you will know their wishes and can honor them if possible. If you don’t know how to approach your parents (or your children) or your siblings, you can visit and read the 40/70 Rule for help.

As recently as 22 years ago, there were only two options for care: family or a nursing home. Thankfully, there are now many options available.

The earlier you plan, the less stressful it will be when you must make a decision regarding their care. Knowing all the options available and discussing them beforehand provides peace of mind.

As you consider all the options and the financial implications, there is an excellent resource available. The book “Stages of Senior Care: Your Step-by-Step Guide to Making the Best Decisions” was written by Paul and Lori Hogan, co-founders of Home Instead Senior Care. All proceeds from the book are donated to the Home Instead Foundation, a source of grant monies for projects benefiting seniors. Another wonderful resource is

Rachel Carson, Certified Senior Advisor, is the owner of the Home Instead franchise serving Beaufort and Jasper counties since 1997.