Elderly Care in Times of Pandemic
Caring for your aging parents can be emotionally stressful under any circumstances, and with COVID-19, extra planning is needed. But there are actions you can take now that will help make your life easier when you need to care for elderly parents. Becoming involved in their lives to understand what support they need from you, having a conversation about their estate plan and desires, being informed about their finances, and being empowered to help them, will help to ease the transition.
Role reversal: parenting your parents
At some point in our lives, our relationship with our parents changes and our roles reverse – we begin helping our parents with tasks such as tax returns or bill paying, or a quick drive to the store or a doctor’s appointment. As we become more involved with helping our parents with tasks they used to do on their own, their finances take on additional significance, particularly if we have not been involved previously.
Our journey began with a request for a simple gift. My mother-in-law asked for a CD from an artist we didn’t know. We dutifully researched and picked a “Best of” CD from this artist. When her birthday arrived, she opened the gift, looked at us blankly, and asked, “This is nice. I have never heard of him. What does he play?”
My husband and I looked at each other, slightly in shock, and at that moment, we knew we were at a turning point. You see, my mother-in-law had been independent her whole life; married, divorced, raised two children, married and divorced again. She had worked in many roles and in many fields; she had survived and thrived. She was forever quick-witted, opinionated, curious about science and nature, and loved to travel and cook. In a word, she was sharp.
Looking back, we realized there were other clues that something was amiss, such as when we saw the sheer number of address labels, note cards, calendars, and writing tablets with her name on them. She was donating to charities—a lot—and they kept sending her gifts, so she sent more money. Within that year, she had a fall, a concussion, and we noticed unpaid bills. We visited her to find tables full of junk mail, bills, and scams.
Have the conversation with your parents and other family members
Before all this happened, we mentioned that we were getting our estate planning documents in order and asked if she had thought about her estate plans. Of her own volition, she had already hired an attorney to draft a complete set of estate planning documents so her children (my husband and his sister) could manage her affairs when the time came. Having taken care of her own aging mother, she had seen the decline of her mother’s memory and wanted to ensure that her children would be in the best position to care for her.
With the aid of my mother-in-law’s foresight in setting up her estate plan, we began to unravel the mail piles and put things in order. My husband and his sister split up duties: He took charge of her finances and bills, while his sister sorted out the medical issues, charitable donations, and magazine subscriptions. 10 years of a magazine subscription paid in advance with more offers coming. Bogus travel offers paid with her credit card with crazy restrictions so that you could never use the “tickets” you paid for. Donation requests and demands from every conceivable charity. Our fears were confirmed: My mother-in-law was out thousands of dollars, and yet her phone, cable, and electric bills were past due. A year’s worth of condo fees already paid because she had a coupon book and thought she needed to send the check. She was not taking her medication regularly, and her records of her medical needs and prescriptions were a mess. It took more than a year to clear it all up—bill by bill, scam by scam, bogus and legitimate charities, and endless magazines.
Understand the financial situation
We also spent some quality time at her bank. We opened a credit card that allowed us to block online or phone purchases but unlock these permissions if we needed to. We gave the bank a copy of the power of attorney (POA) form so that my husband could access and maintain her accounts. (POA gives someone you choose the power to act on your behalf when you are unable to do so). We were involved. We learned people’s names, called, and sent them thank-you notes. These early connections paid dividends, time and again. We were not strangers on the phone, but real people with a back story and updates on their customer, who they knew by name and cared for.
Despite the “table-pile” craziness, my mother-in-law’s finances were in decent shape. Her house and car were paid off and she had several credit cards but with zero balances. She had a modest retirement income stream, made up of a few IRAs, some laddered CDs, and checking and savings accounts. We were fortunate to have something to work with.
But we learned that while her allocations and account choices were fine for her accumulation years, she hadn’t transitioned her investments into preservation or withdrawal mode, making it difficult to access these funds. Long-term CDs in her savings and an IRA account made cash flow difficult and came with withdrawal penalties, tax implications, or both if withdrawn unexpectedly. Furthermore, her investment choices in another IRA account were growth- and value-oriented and would not weather a market downturn well—right when she needed her capital most.
Life progresses, so should your care
We became involved and, for a while, were able to help her stay at home and live independently. My husband, his sister, and I introduced ourselves to her doctors, condo manager, maintenance guy, retirement staff, the local taxi service, car dealership, postal carrier, hairdresser, and her friends. When she got lost one day driving (that was a very long 14-hour day), we had to take that lifeline away. But because we had established a relationship with the local taxi service, she was able to get to her appointments, go shopping, and take care of other errands.
Eventually we had to move her out of her condo and into a retirement community that offered independent living and tiers of increasing long-term care. And we were empowered to help her – here is where all the legal, financial, and medical documents clearly came together. Also, we had talked with her previously about what-if scenarios when it came to where she would want to live.
She is in a beautiful part of town, right on the water, surrounded by other people her age and an attentive staff. They believe in aging-in-place and have tons of trips and on-site activities for all interests and abilities. We frequently ask ourselves, when is it our turn!? But for now, it is her turn and she is safe and happy.
Having plans in place eased later transitions
During the new “normal” healthcare environment brought on by COVID-19, we had to move my mother-in-law from the assisted care living accommodations to a memory care unit for seniors with memory issues such as Alzheimer’s. We were not allowed to be there, so you can imagine how stressful this move was—not only for us but for my mother-in-law. But after a stressful 2-week quarantine in the special care unit, she is now settled into her new studio, making friends, and (ahem) has even been spotted holding hands with someone. Who would have known?
But we were able to make this happen remotely because we had all the right documents in place and built relationships with her caregivers. We were involved, informed, and empowered to help her. We were also lucky because we had had that conversation with her seven years ago to discuss her estate plan and doubly lucky because she followed through!
Caring for your loved ones and managing these life transitions can go smoothly with some conversations and planning. Here are some steps you can take so that you and your loved ones can also have a smooth transition to aging.
Be Involved. You know your parents and their habits. When you stop by for a visit, try to pause and take a fresh look at what might be going on. Have you seen any changes in behavior? Is the house still well maintained? How are their personal grooming habits? Have any of their friends raised concerns? Are there piles of mail and other items that look neglected?
Organize all important papers and keep them in a safe place. These may include the deed to the house, tax returns, bank account statements, insurance policies, passcodes to digital accounts, and contact information for your parents’ doctors, financial advisors, and other service providers.
Be Informed. Talking about money with your parents is not easy. Perhaps you have a little knowledge of what their finances are like, and it’s easy to assume that all is well. Start the conversation with your parents now; don’t wait. Are they filing their taxes? Are they managing their day-to-day finances or need help setting up automatic payments? Have they activated their accounts online and would they authorize you to help keep an eye on them? Talk with them about scammers and telemarketers and how they target the elderly. It may be helpful to ask about their giving plan and keep an eye on the outflow of funds from their financial accounts.
Be Empowered. Did you know that you need a POA to close an account, shut off a telephone line, or stop the newspaper delivery for your parents? Do your parents have their estate plan documents in place? Are they up to date (drafted within the last 3-5 years)? Do you have a copy of important medical documents so you can help when needed?
For example, you need a HIPAA authorization to speak to your parents’ doctors about their care. You also need a POA with your parents’ financial institutions so that you can access their accounts. Everyone is happy to start up services for you but if you need to turn off something or change something, especially for someone else, you need these important documents. Along with a POA, we also recommend that you consider a living will, trust, healthcare directives (this is a legal document that specifies what action should be taken when you are unable to make decisions for yourself due to illness or incapacity), property distribution, and a medical POA. Be sure to keep these documents current (they should be no more than 3-5 years old). And if you move to a new state, these documents should also be updated accordingly.
Having the conversation now with your parents and getting those important documents in place as part of your parents’ estate planning can pay dividends down the line. We are here to help you have those conversations and to get started on your and your parents’ estate planning needs.