Aging With A Plan

Marvin and Ethel, 71, have two adult children Sally, 38 and Larry, 42 who are married with children but live in different states and rarely see each other. They would try to visit their parents once a year, but they both have very hectic careers and family lives. Their parents, each time they visited or spoke to them, seemed relatively fine. Their father, however never felt the need to discuss with them the fact their mother, Ethel, was diagnosed with early onset of dementia.

Early one morning, Sally received a call that her father, Marvin suffered a major stroke. When she arrived at the hospital with Larry, the nurses requested copies of the healthcare power of attorney/medical directives and his living will. Sally, nor her brother, ever had any conversations with their parents about the “what if” of aging or what their parents had in place, such as estate documents, finances, long term care insurance, funeral arrangements, accounts and passwords, or who their professional team was. The kids spent hours going through the mail and their parents’ den trying to find any information that would be helpful to them.

Since Marvin’s stroke left him mentally incapacitated, with the doctors not optimistic that he would even survive, they were quickly thrust into making all the decisions regarding both Marvin and Ethel’s healthcare. In addition to the finances and paperwork, Sally and Larry now had to play the role of caregivers for their mom. Sally and Larry alternated taking time off work and away from their families to be with Marvin while he was in the hospital and since Ethel was not safe to be home alone, one of the kids had to stay with her around the clock. Within 48 hours of staying with Ethel, the kids were totally overwhelmed and exhausted. Her attention span was just a few moments long and she needed constant attention or she would try to get out of the house unattended. Sally and Larry started researching home care options while they figured out what to do long term.

It was decided to move Ethel closer to Sally. Sally began researching what facilities were in her area. Sally’s husband, Rob agreed to do the tours of the places Sally thought might be good for Ethel, however neither of them really knew what type of questions they should be asking during this process. Rob started viewing all the assisted living, secured memory care units, and nursing homes in the area and decided that the memory care unit was best, however they were told that their mother would have to financially, physically, cognitively, and behaviorally qualify to get into the memory care unit, which unfortunately, had at least a six-month waiting list. Sally found another memory care facility which had immediate openings, however her husband said the staff was rude, the residents didn’t look well cared for, and they looked bored just lined up watching television. As part of Ethel’s onboarding to this facility, Sally learned that a doctor must write an order for memory care and fill out paperwork. Sally didn’t know who her mother’s doctor was and Ethel was too confused to provide any information. She eventually found her dad’s calendar which contained all of Ethel’s doctors’ names. Even though Sally’s heart was breaking that she’d have to pursue this undesirable facility, she didn’t have much choice. Sally received the facility’s financial application but couldn’t fill it out; she had no idea what her mother’s monthly income was, the balances in the checking and savings accounts, the balances in the retirement accounts, or if there was a trust in place. In addition to all of this, Sally was also tasked in finding furniture for the unit, since the units were unfinished and her mom’s furniture from home did not fit.

A few weeks later, Marvin passed away. Not only were Sally and Larry grieving the loss of their father, but reflecting back during this time, they began to acknowledge how completely blindsided they were with all that was going on with their parents. Sally kept saying, “Mom sounded fine over the phone. We’d talk once or twice a month for a few minutes. Dad did most of the talking, now I understand why. Mom can’t really carry on a conversation for long”.

Like most families who find themselves in crisis mode, they learn “expensive” lessons. Not only their own out-of-pocket expenses of flights, meals, and missed work, but the angst of realizing how ill-prepared they all were. They couldn’t find any pre-paid burial arrangements, they had to plan and pay for their father’s funeral, they had to figure out what bank accounts their parents had, what bills were due (and past due), they couldn’t find the will or any indication their parents had an attorney. They had to pay for legal feels to obtain guardianship and conservatorship for the estate and Ethel’s care. In addition, when they were ready to place her in the memory care facility, the cost for just the room was going to be $8,000 with additional expenses for the coverage of medication and assisted personal care throughout the day and evening. It quickly became apparent to both Sally and Larry that they would need to sell their parent’s home to keep up with all the bills coming in. And since her parents did not plan accordingly with the right documentation, they were going to end up in probate court to settle the estate.

Completely overwhelmed, Sally suggested to Larry that they speak to her Financial Advisor, John, with hope that he would be able to guide them accordingly. John mentioned to them that Oppenheimer has a Wealth Management Alliance, CareRight, Inc. that works with clients on proactively establishing an Aging Plan. This value added resource engages clients in planning for the “what if’s” to help families avoid what Sally and Larry were dealing with. He also suggested to them, that after Annalee, the founder of CareRight, helps them with their current situation, they should consider a secondary meeting to discuss how to prepare themselves for any future occurrence within their own immediate families.

Sally and Larry arranged a meeting with Annalee. During that meeting, Annalee discussed with them common mistakes most families make, and why. She explained to them that most often families never discuss the “what if’s” of aging and never develop a proactive Aging Plan. She went on to explain the importance of why a Grab and Go binder should be established, which would outline all of the important documents, accounts, passwords, funeral arrangements and their parents’ professional team (attorney, accountant, financial advisor, physicians). Understanding how to ask the right questions of the caregiver and remain involved with their parents as their parents aged is essential. Children often assume their parents are doing better at home than they actually are. In fact, not engaging in discussions early on, they never proactively toured any care communities or had their parents on waiting lists. Typically quality care options are limited when you wait until a medical crisis occurs. Parents will end up in whichever facility has an open bed, and often parents end up separated if the facility does not have an opening for the levels of care needed for both parents.

Annaleee comforted them with the fact that although, their parents may have made mistakes by protecting them from what was occurring with their mom, no one ever feels confident when emotions are high and time is limited to make big decisions and that crisis scenarios are always overwhelming. Let alone when there is no Aging Plan.

Aging and caregiving can be a positive experience when there is a proactive Aging Plan in place – family meetings to discuss what is working well, what may not be working so well, what documents/plans are in place, who is the professional team, what care or home supports are needed now and in the future (and the funds available to pay for care) and being prepared by being on the waiting list of multiple care in case aging at home is no longer safe, feasible or affordable.

Sally and Larry were grateful for the introduction to CareRight. Although it was too late to change everything that had occurred with their parent’s situation, Annalee and her team were instrumental in helping them achieve the right home for their mom. She also gave them the motivation to actively establish an Aging Plan for themselves now, since although they are young, anything can happen. They now have the confidence that no matter what the future holds for either one of them, their own children or loved ones will have the direction and documents readily accessible if ever faced with a crisis situation of their own.