Chapter l:

Preparing a Plan

Chapter I:    Preparing a Plan

To care for those who once cared for us is one of the highest honors.

—Peggi Speers and Tia Walker, The Inspired Caregiver:

Finding Joy While Caring for Those You Love

THE FAMILY CONVERSATION #1

PLANNING ACROSS THE GENERATIONS

Providing good care not only requires advanced planning, but thoughtful, ongoing conversations between adult children and their loved ones.

These are tough conversations.  They cover complex subjects, ranging from financial and health issues to estate planning issues—sensitive topics that loved ones may be reluctant to discuss with other family members.  And they’re emotional issues, often resulting in an uncomfortable reversal of adult-child relationships. We’re forced to acknowledge that while we’d all like to see our family members or friends as robust and independent persons forever, the odds are they will need our care at some point. Even if they don’t want it.

Too often, families and couples avoid such conversations until a crisis arises—a fall, an accident, or a serious health diagnosis.  We allow ourselves to succumb to a condition I call (somewhat tongue-in-cheek) PDD—“Planning Deficit Disorder.”

Making big decisions in the midst of emotionally trying circumstances, however, is never a good strategy.  No matter the challenges or reluctance, it’s better to talk when your loved ones are healthy, sharing information and weighing options and preferences before a crisis happens.

So how do you start?  As I discovered, you start with yourself.

As you read this guide, reflect on your own life’s plans and expectations.  Discuss them with your spouse or significant other.  While reviewing plans for your loved ones, make sure you have your own critical documents, such as a will, health care proxy, and power of attorney.  Take notes about your own needs and fill out the checklists in this guide for yourself, as well as your loved ones, and you will discover the true continuum of caregiving across generations.

Setting the Scene—In Person or Online

Everyone’s situation is different.

You and your family members could decide to bring up these topics informally or in a formal, planned meeting, whichever seems appropriate. While these sensitive conversations certainly benefit from face-to-face interaction, many families may continue to worry about health and safety issues, even as the pandemic has subsided. At the same time, we now have opportunities for virtual meetings that most of us rarely experienced before. The explosion in popular online platforms like Zoom, Skype, Free Teleconferencing, Facebook Live, WhatsApp, Microsoft Teams, and Google Hangouts has made it easier to bring together family members who live far from each other.

  • Set aside time during holiday visits or other traditional family occasions.  When your family gets together for the holidays remember that your first priority is to celebrate these special times together. Holiday gatherings can be stressful, so don’t bring up emotional topics like long-term planning at the traditional family meal or other events. After these occasions, look for opportunities to have relaxed, unrushed conversations, say at breakfast after the big family dinner. But don’t take this discussion lightly; plan in advance to have more than one conversation over the course of several hours. Perhaps start by mentioning someone else’s situation—someone the family knows who may be having health problems or even some aging celebrity in the news.  You might tell your loved ones that you’re thinking about your own retirement and ask them, “How have you planned ahead, and do you feel prepared?”
  • If circumstances don’t offer a natural opening, tactfully raise the topic. Suggest that while no one likes to think about getting older and needing help, that’s not realistic, so perhaps the family could begin exploring potential plans as a way of ensuring that your loved ones get help when they need it—in ways they want to be helped.  Ask them, “Can we look at this together?” Reassure them that having the conversation does not mean that changes are imminent or inevitable.
  • Frame the conversation in a supportive way, reminding your loved ones that this is about their wishes.  Like many older people, your loved ones may be reluctant to have “the conversation” until a catastrophe occurs. No one wants to give up their independence and many will fight tooth and nail to protect it, even if it means personal discomfort.  You can’t force parents to discuss these things.  As life’s roles shift, they’re still our parents.  No matter how “adult” we are, we’ll always be “the kids” to them.
  • Show them this Caregiving Navigator. Tell them you’re learning a lot from it and you would like to share your thoughts with them.
  • Consider enlisting the help of a trusted outsider, like a financial advisor, doctor or clergyperson. Your loved ones may feel more comfortable broaching these topics with them, rather than younger adult family members.  That’s OK— you just want to begin the conversation with someone your loved ones will listen to, creating a bridge to the next generation.
  • Keep in mind your loved ones’ ethnic and cultural traditions.  Your family may have long-held (or unspoken) expectations about how elders should live during their later years—and how adult children, spouses or other relatives should be involved in their caregiving.

Despite the challenges, families that work together usually find that it relieves anxiety and enhances their relationships. It’s hard to create a good caregiving plan for your parents without building a team, especially with the people closest to them.

If family members take the time to explore things early, they’ll likely avoid facing serious conflicts later.  It can’t be too soon, but it can be too late if a health crisis occurs.  The longer you wait, the fewer options you have, and you may find yourselves forced to make decisions without any idea what your loved ones may have wanted.

Tips for Having the First Conversation

How you conduct potential caregiving conversations depends on your family dynamics, of course, but here is a list of suggested tips from geriatric care experts:

  • Let your loved ones start the conversation—and let them talk with each other.
  • Don’t interrupt. Respect their time and thought process.
  • Don’t have this discussion when family members are tired or emotional.
  • Avoid drifting into old hurts; stick to specific issues at hand.
  • Ask questions and listen. Be open to your loved ones’ response—you might not know them as well as you think.
  • Don’t make decisions ahead of time. Allow the conversation to go where it will.

Once your loved ones have had a chance to express their thoughts, you and other family members share your views.  Be honest about your own concerns. Are you worried that your loved ones aren’t safe? That they don’t have enough access to friends and social activities?  If your loved one is caring for a spouse or partner, are the duties too much?  And if your loved ones assume that their adult children will be the “default plan” when it comes to caregiving duties, what impact will that responsibility have on the caregivers’ jobs, children, and other responsibilities?

Be methodical in your approach, but don’t worry about covering everything at once.  Again, stay respectful.  Never give the impression that you want to “take over” your loved ones’ lives.

Think of this process as the beginning of a series of conversations, integrating legal, financial, and caregiving needs as they unfold over time. I like the approach offered by one of my professional colleagues, Brian Tully, an experienced elder care law attorney: He calls it Life Care Planning.  Putting together “documents and dollars” are not enough, Brian points out. Caregivers and their loved ones “want peace of mind, stability, dignity, quality of life, and the tools to manage change and the coming transitions.”

All in the Family: The Sibling Syndrome


If you and your siblings are taking care of a parent or another elderly loved one, you’re lucky if you agree on a caregiving plan. But that’s often not the case. When siblings don’t share the same priorities, it can flare up into a war, and in some cases, sadly, they end up never speaking to each other again once your loved ones are gone.

To help families avoid such situations, caregivers and care recipients need to talk openly about family history and dynamics, and how they might affect caregiving plans. Old roles and patterns from childhood may re-surface, creating contentious meetings and awkward choices. You and your siblings are affected by how each of you related as family members growing up, yet those past roles should not continue to define you today—especially in the context of current caregiving needs. To help navigate emotional disagreements, therapists often recommend that siblings try a simple semantic technique: Use “I feel” sentences, speaking from your own experience and perspective, rather than “You” sentences that may make your brothers or sisters defensive or angry.

While a care plan should be a shared responsibility among siblings, realistically, one family member frequently ends up as the primary caregiver. This role should not necessarily default to the person who lives closest but delegated to the one who is most skilled, willing, and emotionally prepared. In some cases, the primary caregiver may end up moving in with an elderly loved one, which could provide additional support and financial savings for both generations. In other instances, the care recipient may move into one of his or her caregivers’ homes. Whatever the plan, the primary caregiver should make a list of tasks that need to be done. Share them with their siblings and talk about where the primary caregiver needs help and what each of them could reasonably do to share the overall burden.  Be specific about how each person can contribute—perhaps with respite care, assistance in navigating entitlement benefits, or managing financial assets and estate planning.

In my family, for example, three of us lived close to Mom, but our fourth brother lived far away, so he could not practically participate in our mother’s daily care. But he was a skilled physician, and we regularly teleconferenced him into family meetings, where his broad medical knowledge was especially valuable in assessing Mom’s changing health conditions.

Good communication is critical. The primary caregiver needs to:

  • Respect the opinions of all those involved in the plan.
  • Share all information, keeping everyone up to date on their parents’ condition.
  • Keep everyone abreast of care issues through regular communications, such as email, texts, conference calls, and in-person meetings.

Conversely, family members also should consider what must be done to support the primary caregiver as they carry out these often-demanding, emotional and time-consuming responsibilities. As I noted in Chapter VI of the Navigator, “Caring for Yourself, the Caregiver”, if caregivers themselves are not cared for, they can’t take good care of their loved ones. What can families do to make sure that caregivers stay healthy and avoid burnout?  

And finally, there is the sensitive topic of money: If the care recipients are parents who decided to provide some financial compensation or transfer assets such as their house to the primary caregiver in return for their substantial support, it’s critical that these agreements be spelled out in writing—and explained to other members of the family to avoid any surprises.

These conversations may not always be pleasant, but if you take the time to address issues early, you’ll likely avoid more serious conflicts later—and hopefully keep your family intact!

Making Your Plan: Don’t Worry, it’s Just a Draft

There is no one “right” caregiving plan, but there are common issues.

  • First, the plan should center on your loved ones’ wishes.  Don’t take decisions out of their hands.  As long as they are able to do so, let them steer their own ship, choosing how they’d like to live their lives and who they want to handle their finances, health and personal affairs.
  • Put the care plan in writing, especially if any siblings are missing from these conversations. It may be helpful to chart out your loved ones’ goals, the steps required to provide them, and the people assigned to each task.  While family members are likely sources of support, don’t overlook friends, neighbors, and community resources. Remember, effective caregiving often requires “care-partnering,” sharing responsibilities with financial and legal professionals, government and social service agencies, and health care providers.
  • Set up a communications system that keeps everyone in the loop. AAnd remember, the plan is just a draft. As your loved one’s circumstances change, plans will evolve to meet their immediate as well as long-term needs. You may not decide on a number of key issues, but at least you’ll know what your loved ones’ priorities are and will have reached some common ground.
  • Consider bringing in a third-party expert to help smooth communication if these conversations prove difficult. Mediators, family therapists, social workers, elder law attorneys, geriatric care managers and financial advisers—all these professionals can help family members get on the same page. Some experts, such as social workers, usually provide support at no cost; others may charge for their services, but it is usually money well spent, an investment in the well-being of the entire family.
  • Consider this the first of many conversations.  There may be many complex, evolving issues you’ll have to balance, such as weighing the best health care options along with the best overall support system for your loved ones. Discuss what matters to both care recipients and their caregivers; be open to compromise.

Even if the conversation does not go smoothly, you will have accomplished something: The seed has been planted. Your loved ones may not respond much initially, insisting, “We’re fine, thanks, we don’t need help.” But you’ve probably gotten them thinking and they may even restart the conversation themselves as they face new experiences.

The whole point of talking early in the game is to create a plan, so you don’t have to face an emergency without the information you need.

Here are some helpful resources to jump-start these early family conversations:

Helpful resources to jump-start the conversations:

The Family Meeting Checklist

My brothers and I didn’t really start employing the family meeting process in earnest until after our father died suddenly of a heart attack, at age 76. Our Mom was close to ten years younger, seemingly in good health and capable of driving, writing, reading, cooking, and caring for herself.  So our initial family meeting focus was on regularly talking with her to make sure she was in good shape financially—such as helping decipher her husband’s life insurance policies—and encouraging her network of family, neighbors and friends to stay in touch while she lived alone.

One of our first decisions in evaluating Mom’s health care was to switch her primary medical care to a “concierge practice,” a private medical network that we believed would provide more personalized, in-depth care and availability for a set annual retainer.  We wanted to make sure Mom was guaranteed at least quarterly exams with physicians who were nearby and weren’t overwhelmed with a plethora of patients. These were generally in-office appointments but could have involved home visitation as well, if necessary.

We soon realized, however, that as Mom’s situation changed with age, so would our family meetings. Yours will, too.

Here is a short list of suggested topics to help keep your early meetings focused. Whether you’re a planning to care for a spouse, a parent, another relative or friend, here is a list of things to consider. Yes, the list is short, but the topics can be formidable.

Here is a short list of topics to help you focus on the plan:

Caregiving Resources

There are dozens of national nonprofit organizations, caregiving advocates, and government agencies that offer websites with useful caregiving resources, information, and advice. Researching them can be overwhelming, but if you have siblings or partners willing to help, you might divvy up portions of the following lists and then share your findings. 

Here is a listing of some general caregiving resources:

Note: clicking this symbol

in the menu above will give you quick access to all resources from any page in the website

ELDER CARE SPECIALISTS

As the U.S. population has gotten older, the field of specialized experts and advisers who serve the needs of older people has also grown.  Before you meet with one of these professionals, do some homework. Find out what kinds of services they provide and be clear about what specific needs and tasks you’re looking to address.

Certified Senior Advisors

Professionals who are Certified Senior Advisors offer multidisciplinary services to older adults. The CSA credential is given by the Society of Certified Senior Advisors, which requires individuals to pass a comprehensive exam covering areas such as health and mental health, financial literacy, family and social issues, Medicare, Medicaid, and Social Security. CSAs also must pass criminal background checks and agree to uphold the organization’s code of professional responsibility. The CSA website includes a locator to find advisors in your geographical area.
 

Here is a sampling of other types of senior specialists and experts:

There are also a number of professional organizations with local chapters on Long Island whose members can be valuable resources for caregivers and their loved ones.

Here is a listing of some elder care specialists:

Here is a listing of some local government agencies:

Consulting an Elder Law Attorney


Assuring the future care of an aging family member usually involves making important decisions about legal, financial, health care and estate planning options. Not everyone may need an elder care lawyer, but these professionals can help multiple generations of families plan how their health care and financial wishes will be carried out, including the execution of key legal documents such as health care proxies, living wills, and powers of attorney. An attorney also can assist in planning for possible long-term care needs, including Medicaid options, as well as reviewing wills creating trusts, and designing estate plans to preserve assets.

If family caregivers are adult children, they should be aware that when parents hire an elder law attorney, the attorney represents the interests of the parents —not their adult children. The attorney’s goal is to make sure that good care is provided and see that the senior’s assets are preserved as much as possible, and not necessarily for the sake of the children’s inheritance.

So how do you find a local elder law attorney

As with the hiring of other professionals, I started with referrals from people I trusted, including some close friends whose situation was similar to mine, as well as business colleagues, my financial advisers, and health care professionals. Then I widened my search by comparing my referrals with listings and information services in local and national legal organizations.

Of course, the internet has become a standard starting point for finding basic information about elder law attorneys and their practices. Many attorneys are offering free webinars and email newsletters covering eldercare issues that have taken on growing currency as many more people are living longer and need an array of services as they age. Topics range from long-term care planning to changes in Medicaid regulations for home care; the creation of advance directives like health care proxies and powers of attorney; trusts and estate planning, and how to conduct difficult family conversations, like funeral arrangements.

Many elder law attorneys also are partnering with financial advisors, social workers, patient advocates, and assisted living communities in presenting joint events. Regularly check the events calendar at your local public library or senior center for these presentations.

Consider elder attorneys who are members of national organizations that specialize in providing legal services to older individuals and their families, such as:

Here is a listing of several websites that offer help in finding an elder law attorney:

What to Ask When You’re Hiring an Attorney

Once you’ve assembled a short list of attorneys, check each candidate’s background (most likely individual credentials will be listed on the firm’s website) and request a brief interview, which should be free. Confirm their background, experience and credentials:

  • How long has the attorney been in practice?
  • Is the attorney a member of the National Elder Law Foundation or the National Academy of Elder Law Attorneys?
  • Is the attorney a member of the elder law committee of the state or local bar associations
  • Is the attorney a member of non-profit groups such as a local Alzheimer’s organization or the American Parkinson Disease Association?

Then, ask a series of additional questions:

  • What percentage of the attorney’s practice is involved with elder law?
  • Does the attorney speak or write frequently on the topic of elder law?
  • What is the fee for the first consultation, and what information or documentation should you bring to that meeting?
  • How are the attorney’s fees assessed for additional consultations, as well as the execution of wills, trusts and other legal documents?
  • Can the attorney refer you to a handful of his or her clients?

An experienced elder law attorney can be an asset for seniors and their caregivers, helping to explain complex regulations, and identify unforeseen alternatives as well as potential family conflicts—before they become crises.

There are four important legal documents for caregivers and their elderly loved ones: two relating to medical decisions (the health care proxy and living will), known as advance directives, and two relating to financial issues (power of attorney and will).

Your loved ones should have a conversation with their family caregivers about these documents so that it’s clear what their wishes are, who in the family has been designated to assume various roles—and that they’re willing to serve in these capacities.

Make sure you know where these documents are stored and that your loved ones provide copies to their doctor, elder law attorney, and other family members, as needed. Your loved ones also should consider keeping a copy of their health care proxy in their wallet, in case of a medical emergency.

Both family caregivers and their loved ones should review these directives every few years, since changes in state law, as well as changes in personal situations can affect how the provisions of legal documents are carried out.

Health Care Proxy


This document allows your loved ones to appoint an “agent,” typically a trusted family member or close friend, to make important health care decisions for them if they become incapacitated and unable to make such decisions for themselves.  In New York, a health care proxy does not have to be notarized, but the form must be signed in the presence of two adult witnesses, not including the agent.

In fact, everyone over age 18—including young adults who are college students—should appoint an agent who can make health care decisions on their behalf, in case something unexpected happens. A health care agent can be your voice, someone who makes decisions according to your best interests.

In a health care proxy, the agent may be given limited or broad authority, including instructions about the types of medical treatments a person wants to receive if they are either temporarily or permanently unable to make their own health care decisions.  Hospitals, doctors and other health care providers must follow an agent’s decisions as if they were the care recipient’s own.  If someone does not have a health care agent, all appropriate medical treatments will be provided to that person.

You don’t need to hire an attorney to complete a health care proxy. To obtain a sample form go to the New York State Department of Health website (www.health.ny.gov) and search for Health Care Proxy. Or write and enclose a stamped, self-addressed envelope to:
New York State Department of Health—Health Care Proxy, PO Box 2000, Albany, NY  12220.

Living Will


A Living Will is a document that specifies what types of medical treatments your loved ones desire should they become incapable of expressing those desires. It must be signed in the presence of two competent witnesses over the age of 18.

People may wish to receive or refuse specific treatments under certain circumstances, most commonly a progressive or terminal illness or permanent disability.  A living will should be clear and follow verbal instructions that have been given to family and friends.  It can include instructions concerning the termination of life support.

My Mom, for example, openly dictated her end-of-life-care wishes to all four sons.  After observing the fates of many of her older friends and neighbors, she repeatedly asked us to promise that we would never put her in a nursing home—she wanted to die in her own home.

Yet Mom also believed there should be limits to efforts to keep her alive, even at home. She visited a neighbor who lived for more than 10 years with a feeding tube pegged to her stomach.  So, she stipulated that if she lost mental capacity AND she could not be fed or was able to swallow, she did not want any heroic, life-saving measures performed.

If a person does not have a health care agent, a living will is better than having no advance directive at all.  Still, no statute in New York governs living wills. The highest state court has ruled that a living will is valid as long as it constitutes “clear and convincing evidence” of your wishes.

But there is no standard living will form, so even a well-drafted document is ultimately subject to interpretation, and it’s hard to provide specific instructions to cover all possible future events.  It’s especially important, then, for you and your parents to consult with an attorney to make sure that their wishes are stated in the most effective manner possible. And both

A sample living will form is available on the New York State Bar Association website (https://nysba.org/WorkArea/DownloadAsset.aspx?id=21705)

 In addition, if your loved one already has serious health conditions, they should consider completing another critical document, known as a MOLST, which stands for Medical Orders for Life-Sustaining Treatment.  These medical orders, including instructions regarding “Do Not Resuscitate Orders” or “Do Not Intubate Orders,” are intended to document to health care providers a person’s wishes and preferences in providing medical care at the end of life. (See more information in Part V of the Navigator)  The MOLST form (which should be printed out on bright pink heavy stock paper) is available on the New York State Department of Health website (www.health.ny.gov; search for “MOLST”).

FINANCIAL AND ESTATE PLANNING

Powers of Attorney (Modified)


The  Power of Attorney gives an “agent” broad powers to take care of certain business or financial matters on behalf of another person, known as the “principal.” While such documents are often created in case older loved ones are no longer able to make decisions on their own, a principal does not need to become incapacitated for the power of attorney to be triggered. Agents must act according to the instructions of the principals, or where there are no instructions, in their best interest.

In New York State the principal must sign a power of attorney in the presence of a notary and two witnesses (the notary can be one witness); it does not become effective until it is signed by the agent. That authority ceases upon the death of the principal or revocation of the power.

If a POA was completed several years ago it’s especially important that families review changes to POA provisions that went into effect in 2021. Under the new POA law, a separate document known as the  “Statutory Gift Rider” (SGR), has been eliminated. Previously, if a principal wished to authorize their agent to make gifts of the principal’s money or any other property, they were required to separately execute an SGR. Under the new law, principals may now modify a standard POA to authorize themselves to make gifts up to $5,000 (increased from the previous limit of $500) in any one year, or to make other changes to interests in their property without the need for an SGR. Plus, any gift in excess of the $5,000 limit can be made by stipulating that authority in an optional modifications section in the POA form itself.

The new statute also greatly expands an agent’s permissible authority over the principal’s health care matters, although that authority extends only to financial issues. It does not permit the agent to make health care decisions for the principal; such decisions still require a health care proxy.

There are four basic types of powers of attorney:

A general power of attorney enables an agent to perform almost any act as the principal, such as opening financial accounts and managing personal finances. A general power of attorney arrangement is terminated when the principal becomes incapacitated, revokes the power of attorney, or dies.

A durable power of attorney may be used immediately and remains in effect until the principal revokes it or dies.  It includes a durable clause that maintains the power of attorney after the principal becomes incapacitated–mentally incompetent or physically unable to make decisions.

A nondurable or limited power of attorney takes effect immediately and remains in effect until the principal revokes it, becomes mentally incompetent, or dies.  It is often used for a specific business transaction, such as the sale of a property, or the handling of financial affairs while the principal is traveling and unavailable to take care of them.

A springing power of attorney becomes effective at some future time and remains in effect until the principal’s death, or until it is revoked by a court.  This POA is often triggered by a specific event identified by the principal, such as an illness or incapacity, and initiated when the principal’s physician declares the principal not competent to manage their own affairs.

Many online resources like the New York Bar Association offer to consider when drafting a power of attorney (https://www.nyc.gov/assets/hra/downloads/pdf/services/homelessness-prevention/poa.pdf).  But a POA should be executed with the guidance of an elder law attorney to ensure that areas of authority are clearly defined and understood by both loved ones and their family members.

Last Will & Testament


A last will and testament is a legal document that helps individuals ensure that their assets and estate will be distributed according to their wishes when they die. In New York, a will must be signed in the presence of two competent witnesses over age 18. This document enables someone to choose an executor to manage and distribute their property. Without a valid will, a person’s property will pass to those relatives specified by law through the court system.

While not related to the immediate financial aspects of caregiving, serving as the executor of a parent’s will is often an important part of a family caregiver’s long-range responsibilities.

ASSEMBLING VITAL DOCUMENTS

In addition to making sure that your loved ones have their key legal documents in place, families need to assemble key information relating to various aspects of their personal lives. It can be a big job, so try breaking this process into manageable steps:

1. Identify where your loved ones keep their important papers. Make sure they’re in a safe place, whether at home, in a fireproof file cabinet or safe, in a safety deposit box, or with their attorney—or all those places. It doesn’t do any good to have your parents’ records in order if no one knows where to find them, or they’re in a safety deposit box where no one else in the family has the keys.

2. Sit down as a family to review all relevant documents and accounts. Identify missing links—information gaps you need to fill in to help your loved ones plan for retirement, as well as data or contacts you might need in a medical emergency.  Make sure designees and beneficiaries are up to date for all policies and accounts.

3. Come up with a checklist of all the documents. Note which ones you need to keep together in a safe place, such as a secure file cabinet, so you can locate them quickly when needed. Keep original documents, such as passports and birth certificates, in a fireproof safe.

4.  Make sure you know who is authorized to speak to company or government agency representatives if your loved ones can’t speak for themselves. Make copies of key documents for the person(s) designated as Power of Attorney and Health Care Proxy.

 5. Consider electronically scanning files onto a memory stick that can be stored at another location.  Remind your parents to update their documents every three years, or whenever there is a major life change.

6. Don’t forget to keep a record of your parents’ “virtual estate.”

These records may include digital photos, social media, online records, financial and other accounts, including user names and passwords. (More than a few years after my Mom died, we still have not digitized many photos from family albums. But we did convert dozens of 8 mm films several years ago, and that gave us many hours of joyful reminiscing with her.)

7. Make a “contacts” file with the names of all key people in your parents’ lives. Make it easy for your family members to locate these important people—close relatives and friends, primary physician, minister/priest/rabbi, attorney, accountant, tax preparer and banker. And in case of an emergency, identify who needs to know about your loved ones, and what they need to know.

Here is a suggested list of vital documents and information

ESTATE PLANNING

The primary aim of estate planning is to protect your loved ones’ financial resources, minimizing inheritance taxes while enabling them to control how their estate will pass to heirs or charitable causes.

Estate planning also is an important way to avoid the additional stress of a court proceeding known as probate, which is required when a person passes away with assets solely owned by them. Probate proceedings often result in significant delays in settling an estate, court costs, legal fees, and public exposure of a loved one’s estate. At a time of growing identity theft and fraud, especially among seniors, it’s advisable to maintain the privacy of your family members and the assets being inherited.

There are three basic ways to avoid probate. First, if a loved one’s assets are owned jointly with another person, they will automatically pass to that person upon the death of the first owner. Second, if assets are placed in accounts such as IRAs, annuities, or life insurance policies that have beneficiaries, the assets will transfer directly to those beneficiaries, once a claim form is completed. Third, if a person’s assets are placed in a revocable or irrevocable trust, probate can be avoided for the assets held within those trusts.

In addition, asset protection through a trust may become a key component for caregiving purposes, providing legal structures for long-term care when your parents need assistance beyond family caregivers.

Unless your family has sufficient private income to pay the cost of your parents’ care when they need substantial daily assistance, you may eventually have to consider a Medicaid program to assist with or cover the cost of long-term care. While getting Medicaid coverage can result in huge financial savings, the rules to qualify for such benefits are complex, and elder law attorneys can be instrumental in helping families implement legal tools to plan for long-term care, such as irrevocable trusts or pooled income trusts. 

As was the case in my family, the adult children often end up being the trustees or legal representatives appointed to oversee these trusts. (See more information in the “Long-Term Care Planning” section)

THE ‘LONGEVITY RISK’:

ASSESSING YOUR FAMILY’S FINANCIAL SITUATION

Older couples usually have some kind of financial plan for their later years, whether or not they decide to “retire.” Too often, however, it’s not in writing, or limited to a monthly budget of expenses and retirement income and other assets. The bigger issue—the one that keeps many seniors up at night—is what financial experts call the “longevity risk.” That is, as advances in health and medicine enable us to lead longer and healthier lives, the risk that we may end up outliving our retirement savings.

It’s important that you are informed about your loved ones’ financial resources,  because eventually, you may end up being in charge of their money as part of your overall caregiving responsibilities. That’s what happened to me—with no preparation. Our father died unexpectedly of a heart attack and had not shared much information about the family’s assets with Mom, who was a shrewd manager of their monthly budget but not privy to most of Dad’s financial dealings. At the time, Dad was not actively working with a financial adviser or attorney. So, Mom asked me, along with my brothers, to ferret out the insurance, annuities, three stock portfolios and various other assets. It took almost two years to assemble all the records and resources, create a financial/legal team and set a new course for Mom.

Older couples usually have some kind of financial plan for their later years, whether or not they decide to “retire.” Too often, however, it’s not in writing, or limited to a monthly budget of expenses and retirement income and other assets. The bigger issue—the one that keeps many seniors up at night—is what financial experts call the “longevity risk.” That is, as advances in health and medicine enable us to lead longer and healthier lives, the risk that we may end up outliving our retirement savings.

It’s important that you are informed about your loved ones’ financial resources,  because eventually, you may end up being in charge of their money as part of your overall caregiving responsibilities. That’s what happened to me—with no preparation. Our father died unexpectedly of a heart attack and had not shared much information about the family’s assets with Mom, who was a shrewd manager of their monthly budget but not privy to most of Dad’s financial dealings. At the time, Dad was not actively working with a financial adviser or attorney. So, Mom asked me, along with my brothers, to ferret out the insurance, annuities, three stock portfolios and various other assets. It took almost two years to assemble all the records and resources, create a financial/legal team and set a new course for Mom.

Conducting an Annual Financial Checkup

Before a crisis hits, caregivers can help their loved ones conduct a “financial checkup,” especially when it comes to two major areas of concern: housing and health care/long-term care costs.

Housing costs will depend greatly, of course, on your parents’ living preferences in their later years: Do they want to age in place, and for how long? Do they want to move to an independent living complex or a 55-plus retirement community? And eventually, will they prefer to—or need to—move into some type of assisted living community? When my Mom became a widow, she made it abundantly clear to us that she wanted to remain in her home for as long as possible, so that established some financial parameters right away. (For more, see “What’s Your Loved Ones’ ‘Retirementality’?” )

Calculating future health care and long-term care costs can be much trickier. Who knows how long any of us will live, what illnesses or ailments may arise—and how fast health care costs will rise in our later years? According to the recent Fidelity Investments’ Retiree Healthcare Cost Estimate, by the time a person reaches age 65 the average health care costs are $11,300 per year. And the average 65-year-old couple retiring now can expect to spend $315,000 on health care and medical expenses throughout retirement. (The average American couple estimated the total cost of health care in retirement to be only $41,000!) Many people still assume that Medicare will cover all their health care costs in retirement, but it doesn’t. So families need to carefully plan ahead and weigh their options to lower costs, wherever possible. 

Here is a Financial Resources Checklist that could apply to multiple generations:

Finally, visualizing these later years is not unlike planning a vacation—a long one. Your parents (and ultimately you, too) need to pick a destination (how they want to spend their time and where) then meet with the financial adviser and map out how to get there. Granted, there are many unknowns, but caregivers can encourage their loved ones to create a written plan, so the family can assess their resources for caregiving.

In many families, a financial checkup should incorporate two checkups: One for your elderly loved ones, and a second for the adult children, who may end up assuming some of the costs of caregiving, on top of other responsibilities. A recent AARP study found that family caregivers can expect to pay an average of more than $7,400 a year for caregiving expenses. The biggest out-of-pocket expenses for caregivers often include contributing to household costs of their loved ones, medical needs, legal fees, caregiving assistance, and travel. One in five caregivers experiences short-and long-term financial strain, so before you undertake the job, it’s important to review your own financial strength.

The first step in assessing your loved ones’ situation is to make sure your loved ones have a financial adviser who is a “fiduciary,” an investment adviser who is required to act in the best interest of the client at all times, not just offer products that are “suitable” for them. Advisers who are designated as Certified Financial Planners are professionals who meet the educational and ethical requirements set by the Certified Financial Planner Board of Standards.

These advisers can act like a quarterback, working with your parents’ accountant, banker, estate attorney, and other professionals to help them plan their future. The Financial Planning Association (www.plannersearch.org) has a registry service that can be used to search for names of Certified Financial Planners in your area. And you can learn more about the financial planning guidelines and resources at the Certified Financial Planner Board of Standards website (www.letsmakeaplan.org).

Protecting Your Loved Ones Against Financial Fraud

Be prepared to protect your loved ones against fraud and predatory marketing—a growing epidemic, especially targeting seniors who live alone. These scams have taken on a troubling variety of sophisticated tactics: identity theft schemes; lottery and sweepstake scams; and imposter phone scams, such as callers claiming they’re with the IRS, Social Security, or a company’s customer service department; or callers pretending to represent a family member in distress who needs money.

And sadly, people who have been victimized by fraud (I’m one of them!) may be too embarrassed or upset to tell other family members or law enforcement officials. 

Be on the lookout for mailers or emails to your loved ones with disguised sales pitches, frequent phone mail-order purchases, or large bank withdrawals. Also, here are some signs that you or one of your loved ones may have been a victim of identity theft (someone has stolen your “Personally Identifiable Information” or PII):

  • Household bills stop showing up in the mail.
  • A credit or loan application is denied.
  • You get statements for purchases you didn’t make.
  • Fraudulent transactions appear on your financial accounts.
  • A tax return is denied.
  • Small charges appear on your credit card statement.

It's often difficult to recover losses from a scammer, so the best strategy is to prevent fraud in the first place.  Here are a few tips from experts at AARP’s Fraud Watch Network to protect your loved ones.

  • When dealing with phone solicitations:
  • Don’t answer calls you don’t recognize; let them to voicemail. If they’re legitimate, they’ll usually leave a message.
  • Hang up on robocalls (no need to be polite).
  • Never feel pressured to give financial information over the phone.
  • Be wary of false urgency to provide information or make decisions.
  • Do not click links from emails or texts; type the web address you know to be valid into your browser.
  • Review your credit bureau reports regularly.
  • Use a credit card, rather than debit card, to limit financial exposure.
  • Opt for electronic statements (thieves can steal statements from your mailbox).
  • Protect personal information by shredding bank documents, credit card receipts and financial records before throwing them in the trash.
  • If you’re hiring in-home care, properly screen the person with a background check.

Reviewing Social Security Benefits

When your family sits down to discuss future caregiving needs, your elderly loved ones may already be collecting Social Security benefits. But it’s still impor