Every day, when I look in the mirror, I am reminded that I am getting older. Time spent with family and friends, and especially around my children, highlights this fact. Not always in a kind way. Our parents are getting older, aging is a fact of life. As adult children who are slowly being transitioned out of the role as caregivers of our children, and sometimes not so slowly, being transitioned into caregivers to our parents, the transition comes with challenges.
As an Elder Law attorney who has dealt with this scenario on a regular basis (both personally and professionally), there are some consistent approaches to these situations that we use at the fim to evaluate and to help our clients be the caregiver that they need to be, and to do so in a way that allows them and us to care for loved ones, and not go crazy or ruin all of our family relationships in the process.
So, I would like to share with you the three things that I wanted to know when caring for my parents, and what I want all of my clients to know, when a parents health starts to fail, to help make this challenging time easier and more manageable.
1. Estate Plan: You want to know if they have one, and what it looks like. This is not so you can see what everyone is getting if mom and dad were to pass. This is not about inheritance. What you are really looking for here is to make sure that you have the tools to manage their finances and their healthcare if their health fails. Not all estate plans are created equal, and good quality plans are like those Craftsman tools dad had in his toolbox, ready for anything and useful in all situations. But if they have no plan in place, GET ONE ASAP!!!! Without a plan, be prepared to spend some time and a fair amount of money in probate court getting appointed as someone’s guardian and/or conservator. It’s time consuming and expensive on the front end, and the ongoing reporting requirements back to the probate court are no picnic.
2. Finances: You needs to have a clear and accurate picture of their finances, so you know exactly what resources are available to take care of mom and dad if something happens. To be clear, this is not you being nosy about how much money mom and dad have so you can see how their estate might be split up. This is about having a clear understanding about what resources are available to cover the cost of care. In home care can be expensive, assisted living facilities and memory care can cost almost as much as a nursing home, and knowing whether a nursing home is going to be paid for with private funds or the possibility of filing for Medicaid, understanding their finances will help define the urgency with which we have to act when it comes to setting up a care plan for mom and dad. Cash is king in this situation, and you need to have a real understand of how much is on hand.
3. Care Plan: You also need to know what mom and dad’s wishes are as it relates to their care, and how realistic those wishes really are. Many people say “no matter what, I want to stay in my home”. So, ask the question: is that feasible physically and financially? Is the bathroom on the second floor? Are there lots of stairs that need to be managed? Is there a substantial amount of maintenance needed to keep the house in good condition? You also want to know if the house is up for grabs as an asset to pay for long term care costs. Are they open to a reverse mortgage? Some people want to keep the house at all costs to leave as a legacy to the kids. Does that impact the amount of money available for care? Is there a child/sibling living in the house who promises to care for mom or dad but is not living up to the promise? Will they be forced out of the home if its sold to pay for care?
What you’re trying to do is plan for what we call the “Care Continuum”. Is the plan to stay at home with private aides, move to an Assisted Living Facility, or go to a nursing home when and if the time comes? Is the plan avoid the Assisted Living Facility and nursing home at all costs-what is the plan and is it feasible and acceptable? Do you have a long-term care insurance policy, and is it any good?
In many cases it’s best to have and A, B and maybe a C plan. Mom and dad may want to stay home for as long as possible, but their health may take a turn and that just may not be possible. Be open and be honest about who can do what. Busy families with young kids may not have the time for heavy-duty, hands-on care, and a sibling with no kids, or older kids may have the time, but not the inclination to be a primary caretaker. You need to get a sense of what everyone’s expectations are when it come to care. One sibling might think of an assisted living facility as great idea, while someone else sees it as a prison, and wants to try and keep them home.
The overall goal is to make sure that everyone understands what the plan looks like given a few different situations, who is in charge (heath care proxy, power of attorney), and who will be doing what by when. The best way to achieve this is to have this conversation before you need to have this conversation, when there is no urgency pre-emergency so everyone can approach it from a comfortable, clear-headed, mindset. And if the conversation seems daunting or overwhelming, remember, you don’t have to have it all at once. Start with “have you done some planning?” so we know what to do if something happens to you. What would you want if someone had to make decisions for you? And make sure everyone knows the plan, so they can all be on the same page. The more you talk about it, the less awkward it becomes, when and if the time comes. A care plan is hard to execute, especially if it doesn’t exist.
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