Good afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
My last podcast dealt with money matters and legal issues. I’ll talk more about that today.
According to a survey by The Conversation Project, 90% of people say that talking with their loved one about end-of-life care is important. Only 27% have done so. Another 60% say making sure their family isn’t burdened by tough decisions is extremely important. Fifty-six percent haven’t communicated their end-of-life wishes.
Families caring for someone with Alzheimer’s face special challenges when it comes to managing their end-of-life care. Caregivers often are left to make critical decisions on their own because their loved one can no longer think or speak for themselves. As a result, caregivers can feel isolated, guilty and uncertain about the decisions they’re making on their loved one’s behalf.
Initiating conversations about legal, financial and end-of-life issues might be difficult for everyone involved. Having those conversations, however, ensures that a plan is created that accurately reflects your loved one’s wishes.
What to talk about
There may be a variety of topics you want to address during these conversations. While not all-inclusive, this list is a good place to start.
- List all your loved one’s doctors and pharmacy contact information
- Medical records
- Medicare and/or Medicaid number and identification card
- Insurance policies
- Living will
- Durable power of attorney for health care
- List of their medications, including dosage and cost
Preparing for the conversation
It’s important to gather your thoughts before talking with your loved one. Thinking about the basic aspects of your conversation may be helpful. Here are some things to think about.
- Pick a time to talk. Holidays, family get-togethers and other special occasions are the perfect opportunities to include friends and family members in the conversation.
- Choose a location.
- Decide who should be included in the conversation.
Start the conversation
Money is often a forbidden topic in many families. It doesn’t have to be. Consider these questions.
- What are your loved one’s assets and their ability to pay for care?
- What are their sources of income?
- Who owns their assets?
- Have they done any planning to pay for the cost of elder care?
- Do they have long-term care insurance?
Find out what’s important to your loved one
Talk to your loved one about their preferences should they need care.
- Are they adamant about staying in their home?
- Is it important to them that they’re not a burden to their children?
- Are they comfortable with the idea of moving to an assisted living facility or a nursing home?
Seek financial advice
It’s important to seek advice from a financial planner who specializes in elder care. A “fee for service” planner is recommended instead of one who provides advice for “free” as long as they are managing your loved one’s assets. A “fee for service” financial planner is licensed to provide advice or recommendations in exchange for a predetermined fee. They are legally bound to provide unbiased advice that’s in their client’s best interest instead of being paid a commission to manage assets.
Financial planners help you understand which of your loved one’s assets may have to be liquidated to pay for their care, the order in which that should happen and how long the assets are calculated to last in different situations. If it’s calculated that your loved one may eventually need Medicaid assistance to pay for their care, your planner will be invaluable in helping to implement strategies for preserving assets and/or income. They also can identify tax management strategies during Medicaid’s asset “spend down” or liquidation process and help make sure that beneficiary designations on all accounts are correct and up-to-date.
Seek legal advice
It’s also important to work with a lawyer who’s well versed in the elder care laws specific to the state in which your loved one lives. They can ensure that your family member has to up-to-date legal documents, such as a will, power of attorney, health care proxy and living will.
Know where financial documents are located
Find out where your loved one keeps their insurance policies, investment statements and/or banking accounts and legal documents.
Consider how your role as caregiver will impact your finances
- Will you miss work to attend doctor’s appointments?
- Will you have out-of-pocket expenses associated with caring for your loved one?
Keep the conversation going
Every conversation will empower you and your loved one to truly understand each other’s wishes. After that first conversation, it’s important to document what was discussed and continue talking with your family and friends when it’s necessary. One way to be sure their wishes reflect any changes in thinking following a life change is to review plans when any of the “5 Ds” occur.
- Every new Decade of life
- After the Death of a loved one
- After a Divorce
- After any significant Diagnosis
- After any significant Decline in functioning
That’s all for today. Thanks for listening. I hope this information was helpful.
Join me next time when I’ll talk more about money matters and legal issues.