Managing Elderly Family Care: Finding Comfort in Discomfort and Peace in Preparedness

Lynne Born and Wealth Architect Iris Nguyen, J.D., draw from personal and professional experiences as they discuss the nuances of caring for aging loved ones and share best practices for managing logistics, financials, and emotions.

Recognizing A Loved One’s Decline

Lynne: 

I was much younger when my parents’ health started to decline. Looking back on the experience now, I realize it’s impossible to anticipate the complexity of what is to come, when caring for aging parents. Even though my siblings and I researched best practices and were ultimately successful in managing our parents’ care, there were so many nuances to the journey that we couldn’t have possibly understood, having never been through it before. This is where an outside advisor–one who’s gone through the process many times over with their clients–could have been monumentally helpful to us.

When you begin to notice decline in a parent, it can be awkward and difficult. It was tough, for example, to ask if I could help them review their financials. My father had been a business executive and finance was his arena. I didn’t want him to feel like I was undermining him.

Iris:

These are common concerns I hear from clients with an aging parent or other family member. But I’ve found there are usually workarounds.

If you have concerns about your parents’ financial management, then it’s responsible to ask to review financial information and planning; but there are ways to approach this conversation delicately and respectfully. You might consider asking if you can help to review their estate plan to ensure the document reflects their current wishes or review their accounts to ensure each is accurately titled to avoid unnecessary probate. Alternatively, you can offer to have a trusted advisor of yours review their information on a complimentary basis and provide input and feedback. We have assisted clients in reviewing such documents which helped to bridge the conversation between family members.

Part of my job is to work with our clients, as well as the children of elderly clients, to help navigate difficult conversations like this effectively.

Finding the Right Retirement Living Arrangements

Lynne:

I found talking to my parents about moving them into a “home” could be a sensitive topic. However, there are natural ways to acclimate aging family members to the idea even before it’s time for them to move.

We learned that when a person is ready to move into assisted living, there are typically three phases:

• Phase 1: largely-independent assisted living, such as an ADA-compliant condo building with easily accessible resources and safety features, such as railings in the bathrooms. 
• Phase 2: traditional assisted living with services such as vans to take residents shopping and employees to drop off food if a resident is sick.
• Phase 3: nursing care with medical professionals who might oversee residents’ medical plans, administer prescription medications and shots, and more.

I recommend finding an all-encompassing facility that offers all phases. At one point, my parents had to move to a different community because the original facility we picked didn’t have the full continuity of care they needed for each phase of living.

Iris:

When we think about how best to manage parents’ needs, we don’t just focus on physical needs. We also think about things like emotional and psychological support, socialization, and sometimes religion comes into play, too. If living in a Lutheran or Jewish community is important to a client, we’ll help them find that.

One consideration when researching options is that some facilities offer “Benevolent Care,” which means, if a resident eventually exhausts their financial resources, the facility will still allow them to remain a resident. Often in such communities, every resident pays a small monthly fee that is directed to the community’s “Benevolent Fund.” This fund grows over time to assist those who may encounter financial difficulties during their stay in the community. It provides peace of mind to all residents that they will be able to remain in their home regardless of their financial circumstances.

Lynne:

Finding the right assisted living program goes a long way. In the case of my parents, after a week or two of adjustment in their new Continued Care Retirement Community, they actually had a great resurgence in their health that lasted quite a long time. They were eating better and could participate in events and activities, received physical therapy, were surrounded by more assistance, and they liked being around people and socializing. Many people don’t realize how much good it can do.

Sibling Roles & “No Harm, No Foul” Policy

Lynne:

The family dynamic is key throughout this process. It’s a time when you really have to work together as a team. In my family, designating specific roles among the siblings was crucial and worked really well.

My brother and his wife lived in the same town as our parents, so they visited multiple times a week and did an incredible amount to care for our parents. My sister lived a few hours away from them and took frequent trips to help and also managed many financial details, like handling their checkbook or arranging veteran’s care or understanding insurance coverage to get our father a motorized wheelchair. My role–being across the country in California–was to handle the complicated paperwork or projects, and whenever I had vacation time, I flew out to help in person and I would take our parents to a full schedule of doctor visits or other necessary appointments where I could help. 

Iris:

That’s so important. It’s critical that every family member is at the table, if possible. Assigning duties and responsibilities based on each person’s strengths ensures that (1) not all of the burden falls onto one person, and (2) everybody feels like they’re significant and contributing.

Not all families work well together and unfortunately dysfunction may exist within family units. Our advisors have experience mediating such complicated family dynamics and helping them work together effectively.

Lynne:

My siblings and I followed what we called a “no harm, no foul” policy, where we decided that nobody would be blamed for decisions made during this process. It was our agreement that we were doing the best we could and would work together as a team to solve problems as best we could, during these challenging years. 

Assembling A Strong Care Team

Lynne:

An area that really matters, and where Wealth Architects can be helpful, is building an amazing team around your parents. This group generally consists of social workers, physical therapists, doctors, nurses and other advisors and caretakers. Also, developing a solid relationship with someone in the accounting or finance department at their facility will go a long way to helping with complicated paperwork or resolving insurance issues with the guidance and expertise of the accounting department.

Every team looks a bit different based on the needs of your parents. In the case of my father–a veteran–it was really valuable to have a connection at the Veterans Affairs office. The VA provided generous benefits for both him and my mother, but it was unbelievably complicated to resolve the paperwork and then manage it on an ongoing basis.

Iris:

Our advisors are deeply entrenched in this process and familiar with the key players and network of care providers in our area. We know reputations, we know retirement communities and we know caregivers. It matters because some are better than others. We have the resources to take an enormous weight off clients who are trying to juggle this themselves. The more logistics and planning you leave to us, the more time you have to focus on the more meaningful interactions with your parents.

Well-being, Legacy & Moments of Beauty

Iris:

As advisors, we are well versed with analyzing the financials and handling logistics. But we are also adept at addressing more nuanced areas, too. If a client is going through a very traumatic and emotional situation, we will recognize it and respond with compassion, care and a clear plan to assist. One of the key things I believe Wealth Architects does really well is that we’re there every step of the way for our clients and their family members. I believe this type of care makes us stand out.

Lynne: Agreed. I think that’s what drew me to Wealth Architects. Our values are aligned.

When your parents’ health is declining, it can be very painful and upsetting. Yet there are many incredible moments of beauty and love that continue to resonate with me, when I look back on this precious time.  

I found beauty in the fact that my father, though physically struggling, was totally lucid until his passing; still reading his Wall Street Journal at 92 years old. When my mother had Alzheimers and didn’t know who we were anymore, she looked at my sister and I one day and said sweetly, “We like each other, don’t we?”

At her funeral, three women approached me. They had grown up disadvantaged and my mother had connected with them through her church. She helped them get their GEDs, get jobs, helped one of them get into college – basically, helped them transform their lives. These three women called her their “adopted mother” and I didn’t know anything about this. My father had helped people his whole life too, and even more stories surfaced at his funeral service. 

From this difficult journey, I came to learn a core life lesson–that the legacy and community you create is the purpose of life. These moments of beauty, and learning more of my parents’ contributions to their community of friends and the circle of people they helped, resonate with me still. The privilege of looking back on the many years of caring for my parents is part of the deeper meaning of life for me now, and is an important part of my feeling of well-being.