Holistic Care for Aging Loved Ones

Navigating the financial, legal, healthcare, and personal aspects of wellbeing

Many of us may find ourselves in the role of caregiver as our loved ones age, as they face a diagnosis, or enter a new phase of life. In fact, for someone turning age 65 today, they have almost a 70% chance of needing some type of long-term care in the future. At Bartlett, our experience with clients would echo this statistic. In a recent client survey, the top concern our clients shared was how to handle the rising healthcare costs of long-term care.

This was followed closely by caring for a spouse as they age. Our clients have spoken, we’ve listened, and we recently brought together a great group of experts to share more about a topic that we know many people very interested in.

We recently hosted a webinar on the topic of holistic care for aging loved ones, with expert guests who provided unique perspectives, ranging from the financial and the legal to the wellbeing of the caregiver.

Their experiences, best practices and action steps are sure to help you build a roadmap for customizing your own aging well plan, so read on to gain more insight into these complex issues we are all likely to face.  Our panelists included Melissa Mabley, CFP®, Wealth Advisor at Bartlett Wealth Management; Mark Reckman, Attorney at Wood + Lamping; Jennifer Wessel, Executive Director of Confident Living-Life Enriching Communities; Teresa Youngstrom, Memory Care Specialist and Founder of A Better Approach to Memory Care; and Emily Kendall, CEO of Industrious Marketing and current caregiver.

Melissa Mabley

My top advice for clients who come with questions about planning for this next stage of life is to create a plan in concert with your trusted advisors, your spouse or partner, and family.

When we are working with clients, regardless of age, we generally start with the financial plan. It’s the foundational document we use for decision making, and we revisit that document annually. Then, as retirement approaches, and we start to think about how they’d like to spend their later years, we’re able to run various scenarios and their associated costs. We really find that clients get a lot of peace of mind from that planning document.

We also create a list of action items. Oftentimes in a relationship, one spouse will be the money person and they know where everything is, and they know how it’s all being managed. And if the other spouse were to be put in charge of that or left behind, they need all that same information. And so, we make sure that they both have access those details. And then we revisit those action items annually, too.

We work to make sure that everything is in place in advance, because it’s helpful for the people who will be caring for you or working on your behalf to be very clear about your wishes. We also annually look at things like beneficiaries on your IRAs and your accounts to make sure that those are up to date with any changes in circumstance. It’s critical a piece of your financial plan to make sure that the way that things read is actually how you would intend for things to happen.

It’s also important to communicate your wishes with family members. Sometimes those conversations can be the most difficult ones to have. In our role as wealth advisors, we act as kind of a quarterback. We try to coordinate the accountant and the attorney and get to know that next generation so we’re sure everybody’s on the same page, so that if something were to happen, we can be helpful. We maintain a list of trusted contacts that we provide to clients that they can provide to family members to let them know how to reach them if something were to happen.

Mark Reckman

It’s critical to give someone that you trust the written authority to step in and manage your affairs and your health. It’s an easy step. It will save you a lot of time and money.

At the top of my list of important documents is the durable power of attorney for financial affairs. This is a revocable document through which you appoint someone you trust to act on your behalf on all legal and financial affairs. People often appoint their spouse, an adult child, or a responsible sibling. This document must be filed before you get sick or incapacitated, so I recommend filing your power of attorney with a bank, money manager, or insurance company so it’s already in place.

Next is the living will and the power of attorney for healthcare. These documents do the same thing, but with respect to medical decisions. It’s important to communicate how you wish to be treated in writing and appoint someone to oversee your care if you are not able to care for yourself.

Another important item is the last will and testament. This is also a revocable document that does two important things – three if you are a young parent. Number one: it says who gets your money. Number two: it says who’s in charge of settling your final affairs. And number three: if you’re a young parent, it also says who you want to raise your children after you’re gone.

Finally, is the trust agreement. This is really a fancy will that is common for larger estates or more complicated situations such as children with disabilities or blended families. It works faster and cheaper than a will because it avoids probate and minimizes the time and expense it’ll take to settle your affairs.

These documents should be refreshed every four or five years. And everybody in the family needs to know where these documents are. In most families, there is an allocation of duties. What I’ve learned is that there are people who are good at the legal and financial stuff, that suits their nature. There are other people who are good at the handholding or the personal management, it suits their nature. And those are not necessarily interchangeable. I tell people all the time is to try to align the skills with the person who’s appropriate to have them. These documents are your opportunity to make those kinds of distinctions, because if you don’t, your survivors will be confused about who’s supposed to step in.

Jennifer Wessel

Take the time to put the plan in place and be realistic, and really think about being honest with yourself and your family. And start today while you feel good, while time is on your side.

As a society we’re really good at planning for things by buying insurance for our cars, and our boats, and our houses. We plan for our weddings. We plan for college tuition. But we leave a lot of planning to age successfully up to chance.

I think Ben Franklin said it best, that if you fail to plan you plan to fail. So, take the time and answer questions for yourself as to how you’d like to live your life and empower yourself to stay in charge of your own future. That’s where programs like ours come in… we are their advocate to help them make good decisions as they age. There are a lot of great families out there that are very supportive of each other. But there’s also some family dynamics that get tricky. And so, as an older adult, the more you put in place, the more decisions you make while you feel good, healthy, and well, the better off you’re going to be down the road should something happen.

The rate of aging is 100%. None of us are getting out of this. So, setting up your own plans and then sharing that information with your family and friends is crucial so that they know how they can help you.

If you find you begin to need a bit more care, it’s all about working with your medical professionals and the advocates that you have asked to help you make those decisions and the services that you’ll need. For some folks, the best thing is to stay in their own home, but sometimes it’s more advantageous to move somewhere where you’ll have more access to care, engagement, and socialization. As you look at that continuum, the best thing I can recommend is to have those tough conversations today and make as many decisions and plans as you can before you need to activate them.

Teresa Youngstrom

With memory care, sometimes our loved ones are aware they’re having challenges, and sometimes they are not… so the situation can really be sensitive. It’s so important that we remember to meet together and talk about what’s going on, try and get everybody going in the same direction.

If you’re not sure, journaling behaviors can be a great place to start. That can help caregivers and medical professionals determine whether a person might be experiencing age-related memory loss or a more serious memory diagnosis. Oftentimes that person that’s closest to patient is not the best person to raise the issue of memory challenges. And so, it’s so good to build a team. Whether that’s family members, community resources, neighbors, friends, or a religious community, build that team. This team is not necessarily as technical as what Mark’s saying in regards to outlining designees with legal documents, but more of an schedule and an understanding as to who comes when and who’s responsible for what.

in these situations, eventually you’ll be in a position where you’re going to need to bring in help or go somewhere to get help, so it’s useful to start thinking about what your Plan B might be sooner than later. Some of the statistics around the impact on caregivers are daunting. Caregivers almost need permission to lessen that burden and recognize that it’s good for everyone. So, think about the people around who might come to help. Make a list and plan for caregiver breaks. For those who are hesitant because they’re not used to working with someone with dementia, education is key. Dementia is a long-term journey, so you definitely need a plan and a team.

The good news is that there are more and more resources all the time. The Council on Aging and the Alzheimer’s Association are great resources. Communities often have support groups that you can plug in to. There are now have geriatric care managers in the community where you might be able to pay a professional to come by and help you. You need to get some help to do this successfully. And always try to remember to take care of your relationship with your loved one first. 

Emily Kendall

Having all the essential items taken care of as early as possible is critical, because this gets emotional really fast. That way you don’t have to worry about the tactical while you are navigating the emotional.

My mom was diagnosed with Parkinson’s at 62, and she has started to decline pretty rapidly in the last two years. In our family, I have three children of my own, a sister who lives locally, and my dad, and my mom.

A year after my mom’s diagnosis, my dad made the executive decision to move to a single-story home in the same neighborhood so it’s easier but still familiar for my mom. That made a big difference because part of our care plan that we didn’t necessarily think through as well was whether we could care for my mom at home. In the height of COVID, she had two falls, resulting in two surgeries within 48 hours. That really changed the landscape of the type of care that we needed to provide for her. So we reached out to hospice, which provides palliative and respite care. We have a team of caregivers that comes from 8:00 in the morning until 8:00 at night because we decided that the best thing as a family was to have her be at home.

Something that really helped us along the way is having all the financials, power of attorney, estate, all that tactical stuff that needs to be taken care of, done well ahead of time. And not having to worry about dealing with money or finances or who’s going to do what while you’re in the thick of navigating surgeries and appointments and things that come up is really helpful.

What’s been a challenge to navigate recently as my mom has declined more quickly, because my sister does not have children and I have three – including one with special needs and a medical complexity, and now a newborn baby – my ability to help out is a lot more limited. And that can be a source of resentment on my sister’s part, because I think she looks to me to help more and I really just can’t. And that’s something that we’ve all talked about and navigated as a family.

We also try and find ways to have my mom engaged and involved with her grandchildren because that’s something that’s been hard. I was expecting to be able to have my mom help me and now I’m in quite the reversed role, where I’m having to help my mom.

Make sure you have the financial plan in place and that you understand the potential costs of care. Make sure that all of those legal documents are in place. And don’t go it alone… there are plenty of resources to support you, local organizations, wherever you are on this journey.

Want to learn more? Click here to gain access to our Holistic Care for Aging Loved Ones Resource Sheet, as well as Managing Finances for Your Aging Parents: A Checklist. Or, contact us to continue the conversation. We’d be honored to help your family.

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