When elderly parents physical condition declines to the point where they cannot stay at home without some kind of help, there are many ways to provide that help, either at their long time home or elsewhere. In some cases the adult children may be very willing to have the parent live with them, as it may be easier than constantly running back and forth to the parents home, and keeping up the parents home. There is no single answer for everyone, but if the decision is to have a parent live with an adult child, there are federal and state programs that can help pay for assistance, that can include paying the child giving the care.

We are just past the holiday season, and the New Year gives us the emotional permission needed to just relax. After the travel, the baking, the wrapping, the cleanup, and all the many thoughtful things we do for one another during this special time, it’s time for you.

A typical situation an older couple may face is that one of them has a serious medical event that puts them into the medical system for treatment, rehabilitation therapy, and then discharge to home. In a large number of those cases, the spouse going home needs help with the activities of daily living (ADLs) such as bathing, dressing, eating, toileting, and safely transferring from bed to chair. They may also need support with meal preparation, medication management and mobility around their home. From long experience a huge majority of those folks want to do it on their own, with help from their spouse, and believe they can do it. For many, that is not reality and increases the chances that both will end up needing help for long term care. Here are some thoughts.

Almost all families work hard through much of their lives to pay off their home mortgage, and have raised their families in that home. Most have a desire to leave that home to the children or at least have the children receive the value of it. They fear losing it to pay for long term care. Often that human desire is stated as “I don’t want my home to go to the nursing home.” There are several rules that are designed to protect the home, and in many cases, it is possible to save that value for the family.

Everyone should have a healthcare directive, also called a living will. It is a legal document that states your wishes if you should be in a life ending situation, with no hope of recovery, and don’t want extraordinary measures taken that can never return you to any meaningful form of life. Whether you are age 20, or 80, and have a normal quality of life, and are in a car accident and are bleeding to death, its common sense that you want the EMT’s to do all in their power to keep you alive. The saying “I don’t want anything” really means you don’t want extraordinary means taken to prolong life when there is no likelihood of returning to a decent quality of life. Here is a more complete explanation.

When a single person or a married couple decide to do estate planning, or asset protection planning, a key question is who to name as an Executor, Trustee, Power of Attorney, and Healthcare decision maker, called the Healthcare Representative. Let’s look at a typical married couple with children. Assume both are healthy and middle aged and their kids have no medical problems. They need standard powers of attorney so that each of them can sign for the other. But any older couple must consider that if one of them becomes incapable, or dies, a backup power of attorney is needed. That backup must have good judgment, be fair minded, and have the ability to handle financial matters. Let’s face it, some adult children simply do not have good financial skills or judgment. And in rare cases, they would not be fair to their siblings. That child should not be given a power of attorney, because finances could be mismanaged or siblings shortchanged. So the parents should choose as backup, children who are capable of handling the parents financial affairs, who have the parents’ welfare at heart, and who will treat their siblings fairly. If two or more children are to act, it should only be done if they would be cooperative.