March 30, 2021
Sometimes becoming a caregiver is planned and you have time to prepare, other times you’re thrust into it (like we were). Whether you’ve discussed this or not, whether you have a plan in place or not, taking on this life role can be extremely taxing, confusing and expensive. There are many good guides for elder care and how to pay for elder care available online from reputable sources, but nothing can prepare you for the labyrinth you’ll need to navigate when that time comes when a parent needs your support.
If you’re like half of middle-aged Americans, you’re part of what’s known as the sandwich generation: You have a living parent of 65 as well as at least one child whom you likely support financially. And according to Pew Research, one-in-seven middle-aged Americans is providing support to both a parent and a child. Even if you’re only supporting a parent, the emotional and financial stress can be a burden on your career, your emotional health, and your relationships.
Caring for a loved one comes in all shapes and sizes, from providing technical support on a new iPad to arranging end-of-life affairs. The most stressful form of caregiving comes when you don’t feel supported, and gets amplified if you don’t have a plan.
We’ve gone out and done the heavy lifting for you in an effort to reduce stress in this extremely stressful life role. We interviewed a number of elder law attorneys, some who specialize in estate planning others in Medicare and Medicaid. We also spoke with dozens of Geriatric Care Managers and other service providers.
The most critical designation you will need (for now) is Durable Power of Attorney (POA), or Attorney in Fact. This designation allows you to act as if you were your parents. For instance, you cannot legally sign, or sign-up for anything on their behalf without being their power of attorney. Many parents nominate their kids without ever telling them. Others haven’t nominated anyone. I cannot stress this enough - the POA designation is critical.
This is a document that probably lives with your parents other sensitive documents - it may be alongside their will or insurance policies. If you cannot find it, you will have to enact it. That means you’ll need to find an attorney you trust to draft the document, then sit with your parents in person, gather joint signatures and even have this notarized.
Important note: Many institutions do not accept scans or photo-copies. Create multiple originals. You should always hold on to one as you are going to likely mail copies out as well.
As with most things in life, money can buy high quality goods and services. The world of aging is no different. Deciding how you’ll pay for the basic expenses like food or activities is one thing, but paying for major expenses like housing or specialized care are a different calculation altogether.
Get a copy of your parents health insurance, whether it's private or public (like Medicare) - it's important for you to understand what’s covered and what must be paid out of pocket. Ask for a copy of their life insurance or long term care insurance as well. The more you know, the better position you’ll be in to act.
Consider creating a plan with your partner/spouse or significant other. Do you have savings you can tap? How much are you willing to spend? Are there accounts your parents have that are set up for this purpose? Think about how this might affect your overall family’s future.
Regardless of where you are in the planning or caring process, here are four powerful tactics that you won’t get from the typical social worker, care manager or family lawyer
Begin spending money for things that will reduce your stress level and preserve your quality of life. Your parents “estate” (ie: any money they have saved) can reimburse you for expenses related to their care. Hiring an attorney, find a geriatric care manager, book a babysitter so you can decompress.
Most money you spend can be reimbursed without impacting any medicaid eligibility. If you aren’t sure whether an expense qualifies, use your judgement and keep it under $700. Most medicaid case workers focus on larger transactions when doing their audits.
Caring for any loved one is emotional, but when doing so for a parent - you have to remain objective. You will need to make decisions that require objectivity and focus. You are the best advocate your parents have, regardless of how old you or they are.Be prepared to ask for things and be told no. Keep asking.
Be relentless. Your job is to get the things for your parents that they cannot get on their own.
Most services that cater to older folks have a high level of empathy and appear to be focused on altruism. But when push comes to shove, it's about the money. This can feel defeating, even infuriating - but when you understand this you can use it to your advantage.
Everyone you’re interacting with - service providers to nursing homes, they’re all running a business. Understand that most parties you interact with - especially housing-related businesses, will treat you and your parents better if you have money to pay out of pocket, rather than forcing them to rely on federal insurance.
Start a spreadsheet, keep it simple. Some families stash money in books, others in curtains; mine happened to use Dutchmaster Cigar Boxes.
However, most families are more sophisticated than they lead on. Figure out if your parents have a life insurance policy. While there’s a chance this would have gone to you, it's actually a huge asset that can be appraised and used to pay for any service you need to pay for and the proceeds can be used at your, or your parents discretion.
You can start by asking them, then asking any financial advisor they may have had. Often insurance is bought from a family friend - don’t be afraid to ask around. I wound up getting into my mother’s laptop and then Gmail to track this down.
Most financial or insurance advisors aren’t familiar with this appraisal as an option, so don’t be discouraged - just focus on learning if your parents have one, and possibly for how much.
4 out of 5 employed adults are caring for an aging loved one. It’s hard, complex and often expensive; however you’re not alone. Worthright was founded to help families find the financial opportunities they don’t know they have. Let us help you find the money to reduce the burden on your family’s future.