8 Steps to Help Elderly Relatives Make Long-Term Care Decisions
Posted September 30, 2011
8 Steps to Help Elderly Relatives Make Long-Term Care Decisions
The best time to begin helping an elderly parent or relative plan for long-term care and other end-of-life issues is when they're healthy and there is time to consider the options. Unfortunately, events can intervene and make an elder's need for assistance an emergency.
It's important for adult children and younger relatives to gather up the courage to begin a series of conversations when elders are healthy. These talks should go far beyond money, and include discussions about independence and basic preferences for how the person wants to live or die.
Here are eight tips on how to start the process and get to the most favorable results.
1. Start with the Most Important Priorities
Jumping right into money issues is usually a mistake. Deal with immediate health and lifestyle issues first. Instead of asking about a will or health care power of attorney, make the first conversation about noticing that the parent or loved one is moving slower, is more forgetful or is clearly looking like their health has taken a turn for the worse.
2. Prepare Your Questions in Advance
Make a list of questions for the elderly relative to answer in detail while they have the capacity to address them. In creating this list, ask yourself: "What do I need to know if my family member suddenly becomes sick or dies?" The basics include:
- The location of legal documents, deeds, insurance policies and other important papers
- How household expenses are paid
- The names of doctors and specialists
- Medicines that are being taken
- If there's a will, an advanced directive and a funeral plan (and money or insurance proceeds to pay for it)
3. Turn the Conversation to Affording Long-Term Care
This conversation needs to be about preferences and finances. One of the greatest fallacies about long-term care is that Medicare pays for it. In fact, Medicare pays for a significant amount of medical care associated with it, but not for the actual cost of home-based or nursing home-based care. In 2009, private room nursing home care averaged more than $60,000 a year. Long-term care insurance should be purchased before age 60 for the best chance at affordability, but if an elder cannot afford top-quality care, family members need to plan alternatives, especially if it means pitching in financially.
4. Be Patient
Having a successful financial discussion may take several attempts. Don't become angry or frustrated if this happens. Just keep starting the conversation until it catches on. It might make sense to say something like, "You've always been so independent, Mom. I just want you to give us the right instructions so we do exactly what you want."
5. Offer to Get Some Qualified Advice
If you don't fully understand your relative's financial affairs, it might make sense for you both to talk to an attorney, a tax professional and a financial advisor such as a CERTIFIED FINANCIAL PLANNER™. A qualified advisor can help you straighten out any confusion that exists, help you put specific legal documents in place and set up ways to pay medical and household bills. Whenever possible, involve your elder in that conversation. Above all, an elder should have a current will and health care power of attorney documents in place.
6. Plan a Care-Giving Strategy Together
Discuss the relative's preferences and trigger points for various stages of health care. An individual always wants to stay in his or her home, but you should have an honest discussion about how much you can do at home as a caregiver and whether various services (home health aide, geriatric care manager, assisted living) should be introduced at various stages. Talking through what a parent will be able to live with at various health stages, and putting it in writing, will save doubt and bitterness later.
7. Discuss What Should Happen With the Home
If an elderly relative becomes irreversibly incapacitated, the equity in his or her home may come under consideration as a resource to pay uncovered medical or household maintenance. Since the home is both a major asset and an emotional focal point, it's best to get good advice and spell out specifically what the elderly relative wants done with his or her property and under what conditions.
8. Make Sure Everyone Knows the Plan
Once you settle on a strategy, make sure all family and friends understand the plan and their part in it.
Contact us to learn more about financial planning for elderly relatives.
