Caring for Aging Parent

The questions you should be asking now to prepare for the future.

If you are caring for an aging parent, or expect the need to do so in the future, there are several questions you need to ask yourself: Do my parents have an estate plan that includes a will, trust, advance health care directives, and powers of attorney? Do I know where these documents are, who prepared them, and what my responsibility will be when my parents die? When my parents can no longer safely live on their own, what will we do?

Furthermore, if you’re a parent yourself, have you made these plans for yourself so that, in the event something should happen to you, your children will be taken care of, and your final wishes will be met?

“The need to step in and assist was prompted by a call in 2015 from my dad,” says Barbara Buffaloe, 39, sustainability manager for the City of Columbia. “He was calling to tell me that my mom’s memory issues were not just her normal forgetfulness, but rather a diagnosis of advanced memory loss that will lead to Alzheimer’s. Neither of my parents have ever been good with making long-term plans and, with the latest diagnosis for mom and my dad’s own health concerns, it was important that we sit down and talk over what they wanted for their end-of-life care.”

Barbara’s mom, 74, and dad, 79, still live in Barbara’s childhood home in Springfield, Illinois. Barbara’s two siblings live abroad, so looking after them from Missouri fell to Barbara.

Barbara says that when it became clear that her parents needed help answering the questions about end-of-life care, she went to visit them to help them tackle a no-doubt difficult task; after all, who wants to dwell on their own mortality and examine every aspect of their potential legacy?

“I brought a legal pad and just asked them question after question about their health, finances, wishes, etcetera,” Barbara says. “We also did a power of attorney for health and property [and] updated their will. On that trip, we also added my name to all of their bank accounts, so that I could help arrange things from afar.” 

Seeking Legal Counsel

Virna Camacho, 54, a litigation paralegal for Shelter Insurance, has had a similar experience in caring for her aging mother, who is 90. Her father, 89, was in the Air Force, so Virna lived all over growing up, but moved to Columbia from Seattle in 1999. 

After Virna settled here, her parents came to visit, and they enjoyed the town. As they grew older, they wanted to be closer to her, so they moved to Columbia. Twenty years ago, Virna’s father had to move back to his homeland, Puerto Rico, and her mother chose to stay in Columbia, leaving Virna to be her mother’s main caregiver. 

“Because of my mother’s circumstances, I became responsible for helping her with health care, personal needs, finances, and being the main source of her transportation,” she says. 

As a paralegal, Virna felt comfortable finding the appropriate estate-planning documents online, but still consulted with an attorney.

“These are very important documents to have prepared, especially if you are caring for your parents,” Virna says. “Many of these documents are forms that can be found online. For my situation, I was able to use the online forms, but I still consulted with an attorney to make sure they were done correctly . . . I would recommend a visit with an attorney who specializes in estate planning or elder law to help prepare the documents . . . it’s worth the peace of mind to have this done and be certain it is done correctly.” 

One such attorney is Connie Haden, of the Law Firm of Haden and Colbert.

“Elder law attorneys handle a broad range of legal issues that affect the elderly or disabled, including issues related to estate planning, health care, long-term care, retirement, public benefits, and guardianship,” Connie says. “We are really specialists in the area of dealing with issues that affect our senior population, and we act as counselors to elderly individuals and their families in guiding them through a challenging time.”

Breaking Down The Legal Process

Nathan Jones, of Nathan Jones Law Firm, specializes in estate planning, trust, and probate law, which he describes as “putting a plan in place for whatever assets you have, whether they are simple or complex, to go to the people and organizations that you care about as efficiently and cost-effectively as possible.”

What is probate law? Probate court deals with the property and debts of a person who has died. The basic role of the probate court judge is to assure that the deceased person’s creditors are paid and that any remaining assets are distributed to the proper beneficiaries.

If you have assets when you die that you did not name a beneficiary for, your heirs will be headed to probate court to suss out who gets what. Nathan warns that this process can cost tens of thousands of dollars in legal fees and can last 10 to 15 months. “It’s not the most efficient process,” he says. “By the time you liquidate and sell off things and get beneficiaries on the same page, a year in probate is not uncommon at all. That’s why people who have experienced [the process] are motivated to take action to keep their families out of probate.”

If you die with only a will in place, that document must be filed with the probate court (within a year after death in Missouri).

And what about a power of attorney?

“Any good estate plan should also include both financial and health care powers of attorney,” Nathan advises. “In the event you are incapacitated and unable to make decisions for yourself, a POA is a document that appoints somebody to do that for you. With a financial POA, you’d be saying who can call a bank or pay a bill on your behalf. With a health care POA, you’d be saying who can communicate with doctors and nurses if you cannot. They are important documents for people of any age, but extra important for elderly clients who may experience memory troubles someday.”

A legal document that goes hand-in-hand with a health POA is the advance health care directive, which outlines in what circumstances you would wish to be resuscitated, receive life-saving or extending interventions, be placed on (or removed from) life support, and more. Your physician should have a copy of this document, as well as whomever you appoint to make decisions for you.

Here’s what you should bring to an estate planning appointment: “General categories of the information we need to know are your health condition, what assets you own, what income you are receiving, who should make decisions on your behalf if you are unable to do so, and who should receive your assets when you are gone,” Connie says.

Finding a Place for Mom and Dad

Virna’s mother, living alone without her husband, downsized to a condo, then a small apartment, and now a retirement community as her health has worsened. Virna’s father has since returned to Columbia to help care for her.

According to the Missouri Department of Insurance, the average cost of an assisted or independent living facility in Missouri is about $2,700 a month, which is more than $32,000 annually, while a nursing home costs around $58,000 a year for a semi-private room.

Virna says, in her mother’s case, paying for her living arrangements is mostly out-of-pocket, with supplements from Social Security and her father’s military pension. Most Americans pay for this care with Medicaid, known here as Missouri HealthNet, but to qualify requires that you have few assets. Some people find they have to spend down or sell off assets to qualify for Medicaid, and the paperwork process is daunting.

“We help people navigate this process,” Connie says. “It is certainly true that MO HealthNet should be considered a ‘safety net.’ However, we can help clients assess their options and determine the best path for them. There are often ways to protect assets for a spouse or other loved ones.”

Retirement accounts, pensions, Medicare, and private insurance are also options for paying for long-term care, but if you or a loved one need 10 years of long-term care or more, paying for it can get tricky. That’s why saving for retirement, and starting early, is important. And tackling your estate plan early is important, too. Nathan adds that the process need not be scary, and the peace of mind is worth the effort.

“The most common comment I get from clients when we finish is, ‘That was so easy, I don’t know why I was putting it off for so long,’” he says. “I think people build up estate planning in their heads as something daunting, plus it’s scary — we’re talking about mortality. And the best time to talk about it is when your death is a long way off.”

For Barbara, dealing with her parent’s affairs has motivated her to take action for herself.

“Since dealing with my parent’s affairs, [my husband] and I have talked about what we want our end-of-life plans to look like, developed our wills and estate plan, and had the conversation with our parents, siblings, and close friends about our final wishes,” she says. “It is a comfort to know that we’re working to prepare our affairs to be in a better state than my parents, because I would not want my daughter to have to go through what I have been through.”