What to Cover When You Talk with Your Aging Parents About the Future

by Maria

in Long Term Care Planning

I know, I know.  NO ONE wants to have the conversation with their aging parent or parents…the one where you actually talk about the worst case scenarios and ask them what they’d want.

But it’s so important to talk about these things.  In fact, it’s hard to underestimate how important it is to talk about these things…

A few months ago a visitor contacted me to let me know that she, her spouse and her sons were planning to have one of these difficult conversations. She wanted my advice about the areas they should absolutely discuss and perhaps some lead off questions too.  She signed it, “Any input would be helpful. Aurora, CO”.

So, I went at it… 

Below is my response.

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Thanks for your question!  It is EXCELLENT that the family is getting together to discuss the future.  My hat is off to you all for jumping into some of the most difficult (but so, so important!) conversations you can have.  In fact, my first piece of advice is to meet on a regular basis.  Once a year should suffice so long as there have been no major changes in yours or your husband’s health, then more frequently as needed.

For the first meeting I think there are 5 important areas to touch upon. They are:

1) Where you/your husband would like to live through the end of your life (including what would be your choice for Plan B and Plan C if necessary)
2) What kind of assistance you/your husband would be willing to accept if needed and from whom (here again, it would be good to talk about Plans B&C)
3) Your finances
4) What quality of life means to you
5) Plans for the next meeting

In my experience, #1 an #2 above are almost always dictated by finances. The reason for this is that most people are unaware that the government (i.e. Medicare) doesn’t pay for long term care. This is something I talk a lot about on my site, but the most important thing to know is that virtually any kind of help at home that you or your husband would need on a regular basis (e.g. help with shopping, laundry, or even bathing & dressing, etc.) would need to be paid for by you.  AND, this kind of help can cost anywhere from $12-$25 per hour.

Similarly, you and your husband would be on the hook for the cost of an assisted living facility — which for the two of you could be anywhere from $2500-$5000 per person — and/or a nursing home ($8,000 – $12000 per month per person).  In some states Medicaid pays for home care and in every state Medicaid pays for a nursing home.  Barring that, we are all on our own. So plan an honest discussion with your sons about your finances. It may also make sense to meet with a financial advisor to better align your finances with your long term care goals if needed.

#4 takes you into the world of the health care proxy and financial power of attorney.  You and your husband should have both and I would strongly recommend executing these as soon as possible if you haven’t already.  A health care proxy (also known as an advance directive) will serve as a guide to your sons in making difficult decisions about your health care should the need arise; the financial power of attorney will enable them to act in your stead with regard to your financial obligations.  A will is also a great idea.  If you haven’t created a will, now would be an excellent time.

Health care proxy forms can be revoked at any time and you do not need a lawyer to create one. Also, I did a quick check and it looks like The Five Wishes meets the legal requirement for an advance directive in Colorado.  If you’re not familiar with the Five Wishes, you may want to review it here.

A financial power of attorney, on the other hand, is something you should see an elder law attorney about.  The easiest way to find an elder law attorney in your area is to visit the National Academy of Elder Law Attorney, Inc.  You may also want to inquire about forms for providing financial power of attorney at your local banks as some banks require that their own forms be complete in addition to other legal documents in order to grant your sons the power.

This brings me to #5 – plans for the next meeting.  Set the date, sketch out the agenda and most of all, KEEP TALKING!  As you and your husband age, your wishes may change and you’ll want to update your forms and make sure your sons are aware of what you’re thinking.

If I could also make a few preventative suggestions to you and your husband to maintain the great health you’re both enjoying today they would be these:

1) Find a good primary MD, preferably a geriatrician, whom you will trust to guide you and your sons in the years ahead
2) Live your life with the goal of preventing chronic illness by eating well and exercising regularly
3) Remain social with people your own age and look for opportunities to meet new people/ have new experiences
4) Develop a new sense of purpose as you and your husband transition into retirement (this may be the most important of all)

I hope this helps and should you have any additional questions, please don’t hesitate to ask.

All the best,
Maria

{ 1 comment… read it below or add one }

Jeff July 19, 2011 at 3:17 PM

I think you’re right that it’s important to meet on a regular basis. In fact, after the first discussion it makes it easier to discuss again later. Things change as we age and sometimes plans change too. Living with the goal of preventing illness is so important. It’s the unforeseen things in life that catch us by surprise so it’s good to be prepared. And don’t wait until it’s too late. You can discuss these things at any time.

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