Taking Care of Parents

A wonderful couple recently met with me about taking care of the wife’s parents. They have been dedicating all their spare time and more to help the parents at home and were frank that giving care full time is not an easy job. Another comment they made is that it is a big learning curve, which is true. It not only involves the physical, but the financial and legal aspects as well.

The physical part is what kind of care is needed and how much. Is it simply helping with household and personal tasks due to mobility, or cognitive issues? Or is it help with bathing, dressing, feeding, and more? If the parent is fully on board with getting help, that is a big plus. But if the parent is resistant to accepting help, that can be a big strain. And that often happens, because it is not easy for anyone to admit to themselves that they cannot do certain things safely or properly. It is a sign they are losing their independence and no one likes that. So the child caregiver has to learn how to suggest, encourage and motivate that parent who raised the child decades ago, to limit certain activities, such as using a stove, or going up and down stairs, or
bathing without supervision due to risk of a fall.

During the course of assisting with modified physical routines of living, financial issues arise in most families. Will parents have enough money to stay in their home, and if needed, pay for care? Another pertinent comment the couple made is that they are “up against the wall” in figuring out how they are ever going to solve the care issues, including the legal part for handling finances and qualifying for Medicaid, or VA benefits, or state programs to help pay for care. They are caring, well meaning people, but after their experience and talking to friends, they realized that most people are not well prepared to deal with the physical, financial, and legal issues that occur when long term care is needed to keep that loved parent at home.

That is where what we call a “life care plan” can be a tremendous help to such a family. An experienced elder care coordinator who knows the physical problems of aging, and the solutions, can guide the family in making the home safe and livable for a parent, and getting outside aid to give the family much needed relief so the children do not burn out with all the physical and psychological strain.

Then a Medicaid or VA specialist can assist in getting care paid for by a government program if the parent is eligible, while the family uses money to pay normal living expenses. In most husband and wife situations, all assets can be saved for the healthy spouse. Even for a single person, there are often options to save assets while getting care paid for by a government program. And in some cases the child can get paid by Medicaid for giving personal care.

The third aspect of a life care plan is to have all the legal ducks in a row, so that the family has the ability to handle the assets, apply for programs, and preserve as much of the life’s savings as possible. That involves a power of attorney with special powers that allow the family to take full advantage of all the laws that protect assets. An example is if a power of attorney has language that could permit a 401k to be transferred to the healthy spouse, without paying income taxes, and then qualifying for Medicaid to pay for care. That means significant savings that the couple
needs to live on. And in cases where the spouse needs care, and the family’s savings are put in the healthy spouse’s name, that healthy spouse needs a special will with a trust inside it that will protect the assets if the “healthy” spouse dies first. A dramatic example is a case where a spouse needing long term care was in a nursing home and the family had several hundred thousand dollars. The other spouse was also in the nursing home, but with terminal cancer. All the money was put in the name of the terminally ill spouse with cancer and when that spouse died a few months later, all of the money was saved by the special will with a trust inside it. It also saved 2/3 of the income that money earned, and the surviving spouse went on Medicaid for several years before dying.

The wonderful couple who recently came to talk about taking care of the wife’s parents were being proactive so that they could help mom and dad stay at home, and preserve as many of their life’s earnings as allowed. A life care plan is a huge help in doing that.