The following content is complex, and you should consult an expert about this topic.
If a parent or spouse needs temporary help, say, recovering from surgery, many of us will likely find some way to muddle through. Instead, the big decisions—and the hefty expenses—often occur when a family member suffers a permanent deterioration in physical or mental health. Elder care planning can make all the difference—and that means taking steps to address it before a crisis hits.
Whether you are thinking about care for yourself, your spouse, or your parents, this may be a good time to find out what everybody's wishes are—and where things stand financially, including:
- Looking into long–term care insurance. The premiums will generally be more affordable if you buy insurance well before you need it and if you choose a policy with a fairly long "elimination period." The elimination period is the time between being deemed eligible for benefits and the benefits actually beginning. Keep in mind a longer elimination period means you'll have to cover the initial months of long-term care out of your own pocket.
- Asking your parents about their finances. If they have long–term care coverage, find out what it covers and the length of the elimination period. Ask about their investment accounts and the value of their home or any other real estate they own. Find out how much income they receive from Social Security, pension plans, annuities, and income–generating investments. If your parents would struggle to pay long–term care costs, you might look into Medicaid planning. Consider meeting with an attorney who specializes in elder law to advise you on qualifying for Medicaid.
- Thinking through logistics. Now is a good point to determine how much time, energy and financial support each family member can contribute. Also talk to others who have gone through this before to get recommendations for assisted–living facilities, nursing homes and local in–home health agencies. Find out what meal delivery and transportation options are available in your area. Check out local care facilities: talk to the administrator, staff and, if possible, some of the residents. See whether the kitchen, bedrooms and hallways are clean. Make sure the facility has a current license.
Once a family member needs ongoing, long–term assistance, whether at home or in a facility, here is a checklist of steps to consider taking:
- Talk to your parents or spouse about their wishes. Remember, the goal is to help elderly family members maintain as much control over their lives as feasible, not take it away.
- Consider hiring a professional care manager. You can get a list of any local care managers from the Aging Life Care Association, an association of health–care professionals who oversee long–term care arrangements.
- Gather key information. Start with the family member's date of birth and Social Security number, which you'll need when applying for many services. Get the names, addresses and phone numbers of all medical providers, including the family member's doctors, dentists and pharmacies. Check on eligibility for Medicare and Medicaid, and make sure the person is enrolled properly. You will also need copies of health–insurance policies and insurance cards, including Medicare cards.
- Make a list of all medications, including prescription drugs, over–the–counter products and daily vitamins. Make sure their doctors and pharmacists have copies of the list, including dosages, to help avoid dangerous prescription drug interactions. It is also helpful to have dates and results of recent medical tests and exams.
- Organize phone numbers, documents and keys. Distribute a list of important phone numbers, including those for family members and doctors, to everyone on the caregiving team. Family members should know how to locate legal, financial, and medical documents like durable powers of attorney, living wills, and health insurance policies. Find out who, if anybody, has been named to take care of financial matters and make healthcare decisions in case of temporary or permanent disability. If the family member lives at home, at least a few family members or friends should have keys to the house in case of an emergency.
To get a quick initial projection on costs for home care, assisted living and nursing care, try out the Citi Personal Wealth Management long–term care planning tool.