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Face the Facts

Financial, legal, health care, and long-term care issues affect families, not just individuals. Aging parents may not understand how estate planning can affect their own financial status as well as that of their children.

The Eldercare Locator produced this guide to help families “face the facts” about important topics to discuss with aging parents. It addresses key areas of concern, suggested questions to ask, and ways in which families might initiate conversations.

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Key Considerations

  1. Determine what benefits are provided by Social Security and any pensions. Then, determine whether your parents are eligible for other financial programs.
  2. Ensure that each family member has a living will. Make sure you know the location of all insurance policies, wills, trust documents, investment and banking records, and tax returns.
  3. Investigate what type of long-term care insurance coverage might be best for your parents. Note that premiums are usually lower when policies are purchased at younger ages.
  4. Identify community services that can help your parents maintain independence for as long as possible. Learn what housing options are available to meet their changing needs.

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Financial Organization

Your parent may already be receiving or eligible for a variety of financial resources. Social Security is the federal program that provides retirees a regular income based on work history as well as benefits to workers with disabilities. Long-time workers usually have pensions that are retirement compensation plans either fully managed by the employer, or involve employee contributions, such as a Tax-Deferred Annuity (TDA) or Individual Retirement Account (IRA). Some people have “lost” a pension they earned, while others forget about a retirement account set up many years prior. Low-income individuals with disabilities or age 65 and older may also be eligible for monthly cash benefits through Supplemental Security Income (SSI).

Ask...
What type of retirement income do they receive?
Are pension savings from all jobs being collected?
Is there a need to apply for SSI benefits?
Who can access important financial information in case of emergency?
Where do your parents keep these important documents?

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Legal Preparation

Wills and power of attorney may not be topics your relatives want to discuss; however, these issues need to be addressed to make sure that assets are properly taken care of and that medical treatment preferences are known. A will directs how a person wants property to be distributed after death and appoints a trusted person to be the executor. A durable power of attorney provides written authorization for a person you name to act on your behalf for whatever financial or health care purpose you spell out. An advance directive is a legal document that provides directions for your health care if you are unable to speak for yourself.

Ask...
Do your parents have a will?
Are their important legal documents up to date?
What other legal matters are you concerned about?
Have your parents executed a durable power of attorney or considered whom they want to make financial or health decisions if they are unable to do so?

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Health Insurance

Health care is a high-cost necessity, so it is crucial to know what is available and what your parents are eligible to receive. Most adults over age 65 are covered by Medicare, the federal health insurance program that helps pay medical expenses for older Americans and younger people with disabilities. However, Medicare does not cover all needs, such as long-term care, including nursing homes. Medicare Supplement Insurance (also called Medigap) might be necessary to cover additional health costs.

Medicaid, on the other hand, is the federal and state insurance program that helps pay the health care costs of low-income individuals of any age. Long-term care insurance is available through the private market to assist individuals to cover the cost of long-term care services such as home health and nursing home care.

Ask...
As health statuses change, are your parents prepared to meet their long-term care needs?
Do they have proper health insurance coverage (not too much or too little)?
Are they comfortably able to pay for prescription drugs and other out-of pocket health costs?
Who are their doctors and how can they be contacted, if necessary?
Where are their insurance cards, Medicare information, and other important health documents?

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Community Services

One of the most useful things that adult children can do for their parents is to provide information about resources that help maintain and enhance independence. Services like home modification are available to help reduce the risk of accidents and make daily activities more comfortable to perform.

There are many community resources that provide related information or services. Find out about support available through Area Agencies on Aging (AAAs) and local providers by contacting the Eldercare Locator at 1-800-677-1116 or https://eldercare.acl.gov.

Ask...
Are there home repairs or modifications, such as bathtub railings or an emergency response system, that could help your parents?
Do they need assistance with housekeeping, shopping, or personal care?
If they become homebound, would they need home-delivered meals?
Do they need transportation? If so, what services are available?

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Conversation Approaches

Prepare to be open, honest, and non-argumentative when discussing these topics with your loved ones. Consider preparing by doing research about the topics you want to review. Below are some approaches you can take, depending on the personality of the care recipient.

  • Direct: If the care recipient is a ‘no-nonsense’ personality, openly express your concerns and ask for information you need to address specific situations that might arise.
  • Educational: For the relative who needs a delicate push, you might begin by sharing the experience of another caregiver and how it made you realize the need to discuss issues that could help your whole family in the future.
  • Expert: For the relative who refuses to talk about personal issues or tends to accuse others of taking control, seek to make them the expert by asking for their advice about a particular issue. “What type of long-term care plan should I look into?” “Can you recommend someone to help me prepare my will?” This strategy is non-threatening and could lead them to share personal details or let you know where they stand on a subject.

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Resources

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