The possibility of parents losing independence and control of their lives is a very real fear, and watching parents get older is a wake-up call for those in their 50s and 60s, too.
If your parents have reached the age of 70, it’s time to have a conversation with them about what to do should their mental or physical condition begin to decline.
Often, families delay this conversation until a triggering health event occurs. Adult children are left making difficult decisions about medical care, living arrangements and ongoing care with little or no information about what their parents want — or if their financial situation can support them.
Having the conversation with your parents
Money talk with family members can be difficult, particularly in families where the topic has never been discussed or was intentionally kept private. Parents might feel ill at ease talking about their finances, especially if they think they are not prepared financially. In cases of significant wealth, we find some aging parents have not revealed the extent of their wealth to their children for fear of them being less diligent about creating their own independent wealth.
Regardless of the reasons, if you find your parents are completely unwilling to share information, at a minimum, you should inquire whether anyone has reviewed their financial situation and potential care needs. You may even ask if there is anyone they have confided in whom you should contact if a crisis arises.
When Kim Natovitz, an associate of Tri-Bridge Partners and leading authority on aging and long-term care, works with her clients and their aging parents, she coaches them to consider some of the dynamics of aging. These often influence parents when they consider and discuss their plans with their adult children. Some of these common challenges of aging include:
- Loss of control, which parents try to overcome through secrecy
- Loss of physical strength and stamina
- Loss of their peers
- Loss of authority and respect gained from employment
- Fear of outliving their resources
- Resistance to change
“Recognizing that your parents may be grappling with how to handle these aspects of aging can help you structure a conversation that recognizes their concerns,” said Kim. “Stating your intentions in a gentle way, such as, ‘Let’s talk about a backup plan in case we ever need one,’ or ‘I want to make sure I understand your financial situation so I can make decisions correctly,’ may make the conversation more comfortable for them.”
If you’re still meeting resistance, try asking whether they have a long-term care policy. If they do, have them provide the details of the policy and where you can find a copy in case you need to access the information.
If you want a more directed conversation or some help in structuring the topics to cover, a great book to give reluctant parents is “The Other Talk” by Tim Prosch. This is a fantastic resource, because it describes why early planning is so important. The book suggests that parents can maintain control of their lives even in old age, as long as they articulate their wishes in advance of a crisis.
Deciding what type of help they need
Another reason that early planning is important is that disability can occur at any age, and diminished mental capacity can occur much sooner than age 70, especially in the case of early onset dementia or Alzheimer’s. Like any medical condition, these diagnoses have a wide range of implications, and each patient’s experience will differ. The planning for care in the case of diminished capacity differs from planning for someone with physical limitations. If patients are substantially younger than the average age of patients in a nursing home, care options may be more limited.
Online resources, such as the Alzheimer’s Association’s, offer information about providing care for a loved one with dementia or Alzheimer’s. They have local chapters that can help you find care in your area. You may also want to consider hiring an aging life professional for more personalized assistance. These specialists understand the specific nature of the disease and what your loved one is experiencing. Like the Alzheimer’s Association, you can find local resources and care options specializing in these cases.
Sometimes, these diseases progress quickly, making the need for care come sooner than expected. In other cases, the need for assistance and care may extend for a prolonged period of time and have significant financial implications for families. Once diminished capacity sets in, you may have difficulty knowing your loved one’s true desires. Having conversations with them early on will give them comfort that their wishes will be heard, and those who may be making decisions on their behalf will have their plan to guide them.
Another thing to consider is who will be responsible for managing the daily financial affairs of a parent if they become incapacitated either mentally or physically. A family member who is good with finances may take on this role. Families often utilize online bill paying or establish a specific process to ensure their parents’ financial needs are met in a timely fashion. Someone will also need to coordinate medical bills between providers and insurance companies. Since elder abuse is on the rise, we encourage you to establish some form of checks and balances regarding the handling of your parents’ money and to call in the help of an elder law attorney if you believe misappropriation has occurred.
When family members disagree
It is all too common for adult children to disagree about the medical and financial care of their aging parents. For example, if your parents do not have powers of attorney, who in the family will make financial and medical decisions for an incapacitated parent? If there is disagreement, who will be responsible for making those decisions, and how will they be made? What should happen if financial resources are not sufficient to meet the needs of your parents?
Two options for deciding these difficult family matters include hiring a mediator, or a care manager. These professionals are experienced at helping families work through care decisions and the emotional struggles and individual agendas that can surface. Elder care attorneys may also be needed depending on the situation.
Often, a family member will step in to provide care. This leads to a host of different questions to be answered. For example, will the family member be compensated for their time and any expenses that come up as they care for their mom or dad? How do you balance the needs of the parent with the needs of the adult child to work or care for other family members, such as their own children?
Kim Natovitz recommends that in these cases, families consider creating a care agreement that spells out the exact nature of what care will be provided and what, if any, compensation will be provided. It should also address how to provide relief for the family caregiver when they need to take some time off.
‘Gray divorce’ and aging
One trend to keep in mind when considering family caregiving is the rise in “gray divorce.” When parents divorce later in life, they won’t have their spouse to take care of them as they get older. In many of these cases, their children are needed to provide care or make decisions on behalf of their single parent.
Aging in place
Most parents will say their plan is to live at home. While many consider aging in place the ideal solution, it comes with tradeoffs in safety and costs to refit their home. Adding services to do yard work, clean and maintain their home and provide transportation are additional expenses to consider.
If physical limitations progress, you’ll probably be considering care options that include home care, assisted living or nursing homes. If transitioning out of the family home is necessary, remember that someone will need to decide what, if any, personal items will accompany the parent as they move to a new residence. Companies that offer downsizing and home-clearing services can come in handy when families are helping parents move into assisted-living facilities.
We cannot overemphasize the importance of having conversations with your parents about their care plans as they age. Consider both their financial situation and their range of desirable care options if assistance becomes necessary. There are many professionals well-suited to support you in working out plans in advance or in times of crisis. Elder attorneys, insurance professionals, financial advisors, care managers and specific non-profit organizations such as the Alzheimer’s Association have information and resources to assist aging parents in planning ahead and lending a hand when adult children are called in to execute those plans.
In the next article, our focus shifts to what you can do to better prepare yourself and your children for the years ahead. It’s never too early to plan for a life that is lived as you want at every stage.
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