Your Not So Elderly Parents Moved to Florida or Arizona or North Carolina or Wherever

But now your very elderly parents live in Florida or Arizona or North Carolina or Wherever.

I was with a client, Anne, that had moved to Florida from New York a number of years ago. She and her husband were 'young' retirees, quickly made new friends and began a new phase of life. Their children stayed in the Northeast and established their own lives and families.

Fast forward 20 years --Anne's lifestyle has dramatically changed. Her husband has Alzheimer's and is now in a nursing home. Anne goes to the nursing home each day, does his laundry, supervises his care, brings him food, and tries to provide him with some socialization. She's taking great care of him. What's going to happen when Anne needs some similar type of care?

There isn't a boilerplate answer to this situation. Every family situation is different and everyone needs to address their own particular set of circumstances. Here are some questions that may help define the issues specific to your family.

• Can you and your siblings work together to come up with a plan?
• Is one of you willing to take the lead, be the point person and be comfortable that they have the support of the other family members?
• Do you know the state of your parent's finances?
• Is there Long Term Care Insurance?
• Can your surviving parent afford to pay out-of-pocket to have help in the house in the event that they can't stay home alone?
• What is your surviving parent's feeling about applying for Medicaid if they don't feel that they can afford nursing home care?
• Is there a significant difference in the finances of you and your siblings? Can one of you help out financially more than the other(s) and how do all of you feel about that?
• Is the surviving parent willing to relocate to where one of the children live?
• Was a goal of your parents to leave a financial legacy to their children? Or, is the surviving parent willing and comfortable using up most or all of their money on their own care during their final years? How do each of the siblings feel about their parent using up all of their money if that situation arises?
• No matter what the quality of home health care or nursing home care, there needs to be someone paying attention, someone to be the elderly person's advocate. If there isn't a family member able to do that due to geography, family relations, or other reason, are there funds to hire someone?

Speaking in generalities, it is typically the woman that is the surviving elderly parent. The woman has been the mom, the caregiver, the nurturer. Now someone has to step up to the plate and make sure she's taken care of.

As a lead in to my planned next post....it's called Family Dynamics - We've all got them. I have a feeling you can predict where this is going!!

Paying for Home Health Care Part One

Or better known as:

MY SISTER-IN-LAW'S CLEANING WOMAN'S DAUGHTER'S BEST FRIEND

As most everyone knows, needing an aide, CNA, or some other type of professional to come to the house to help an aging parent is expensive. It doesn't matter if the need is for someone to cook and drive or someone to provide medical care. Most people don't have insurance coverage for this type of service. So, once they gasp at the amounts quoted by agencies, registries, community organizations, etc., the typical response is to get names from friends and relatives to hire them privately.

There are definitely pros and cons, as well as some legalities and practicalities, to this approach.

The obvious first perceived advantage is cost. An agency will charge an amount per hour or per day. Some of this money is paid to the aide, the rest is retained by the agency for their services. What many people want to do is to hire the aide directly and save the amount that the agency retains for their services. The service that an agency provides is very valuable and the amount saved by hiring someone directly may turn out to be very costly. Not only does the agency screen all employees, make sure they are properly trained and supervised, they also take care of all payroll issues.

Everyone knows that when hiring household help--aides, nannies, cleaning help, etc --that payroll taxes such as Social Security and Unemployment are to be paid. The reality is that most don't do it. The help wants to be paid in cash, the person doing the hiring doesn't want to do the paperwork or incur these extra costs. Even those people trying to do the right thing end up at their wits end actually doing it.

Doreen's husband's medical issues began to get worse. It got to the point that he couldn't be left alone any longer. Doreen got the names of several aides and set-up a schedule to have coverage for 4 hour shifts each day. She called her CPA to find out how to handle paying each of the aides. He explained that she needed to pay Social Security and Unemployment for each of them, file reports on a regular basis, and calculated the amounts for her. Doreen wanted to do this the right way so she followed his instructions. Her husband's condition worsened and she needed progressively more help in the house. The paperwork associated with having multiple aides each week, different pay scales depending on day/night, weekday/weekend became a nightmare. She basically was running her own home health care agency. When just balancing her checkbook became a daunting task because of all these transactions, she threw up her hands and gave up. She had to decide whether to use an agency so they would handle the paperwork, just pay the aides in cash and forget all the paperwork, or hire someone else to do the paperwork for her.

This is the trade-off. Hiring someone directly whose name you get from a friend or relative may be less expensive if you're not paying their Social Security and Unemployment and if you're not paying an agency fee. But, you also aren't getting the screening, training, and supervision that home health care agency provides.

Computers, Social Media, and Aging Parents

Twitter and Facebook, online banking and ATM's, blogs and ipads -- they've all become part of many of our daily norms. Some seniors won't touch a computer beyond getting pictures of their grandchildren, some are computer savvy.

The use of technology has many implications when figuring out how to handle the financial affairs of an aging parent. The decision has to be separated into multiple layers.

When an aging parent begins to need help to take care of their financial affairs, the obvious first answer is to have one of their children start to take over. Today, even if the child doesn't live locally, a plan can be implemented due to the technology available. Bills can be sent via email, access can be set-up to bank online, consent can be given to have duplicate brokerage statement sent.

But, even the elderly that are comfortable with technology may balk at this plan. Why? Yes it is partially due to the issue of security of their personal information. But, it's more than that. It's the lack of human involvement that is equally as much the issue. This becomes more pronounced the more home bound the person has become. Sometimes I think we forget how much there is to be gained by the 'old school' way of interacting.

Molly was well into her 80's when we first began to work together. She had had a career in the garment industry in New York and continued to lead a very active life when she retired to Florida. After some medical issues, she needed some help taking care of her household finances. Nothing was terribly complicated and her son that lived out-of-state could have easily set everything up so he could handle things online. Molly was home alone more and more. After having lead a very active, social life she was now very lonely. It was better for someone to come to her home each week to not just pay the bills, but to sit and visit for awhile. I was fortunate to be that person and learned far more from her than I could have ever learned from sitting at the computer.

So, text and tweet, watch movies on your ipad, get your information from google searches, take advantage of whatever the next generation of technology brings. The technology may be very good at getting the mechanics done. But, don't forget to sit at the kitchen table and talk to your grandmother, a friend or a neighbor!

Donations to Charities

There are thousands of wonderful charities doing amazing things. This post isn't to pass any comment about charities and how deserving they are of contributions. The purpose is to highlight some issues facing the elderly and offer some solutions.

Problem #1

The frequency of repeat requests for donations from the same organization is one problem people encounter. Before you realize it, you've given donations to the same charity multiple times in the same year. Obviously you wanted to give money to this organization in the first place, but you may not have wanted to give four times in one year.

Solution

Track your contributions. Not only will it come in handy when it comes to tax time, it will keep you from making unintended multiple contributions. For those that use one of the personal finance software programs such as Quicken, it's easy. If you aren't a computer user, keep a file with the acknowledgements, receipts or just a note from yourself. Then, check that file before sending in additional money.

Problem #2

It seems that once a contribution to an organization is made, the amount of requests from different organizations increases exponentially. Mailing lists are shared and/or sold resulting in getting swamped with mail. It can become especially overwhelming to the elderly. One elderly client of mine read each one of these requests, took them all to heart, and made donations to each. Not only did it start to have an impact on his finances, he began to have to take a tote bag to his mailbox in order to get his mail back to his apartment.

Solution

Each person needs to decide where their charitable dollars will be allocated. One idea is to pick one medical, one religious and one social organization. As difficult as it may be to do, any solicitations from other organizations are ignored.

Problem #3

An organization sends you something - a calendar, an address, book, some note cards-and then a week or so later you get a bill in the mail. You didn't order it and had thought it was a gift because you made a contribution. Now, either you have to pay for it, or figure out how to mail it back.

Solution

This is a way for an organization to make additional money. They get the items in bulk so the whole thing costs them almost nothing over and above the postage. You have a choice to make. Do you want to keep the item? If you do, you have to pay for it even though you didn't order it. If you don't and still have the box or envelope, return it by writing 'Return to Sender Did Not Order' on the outside and give it back to the mailman. If you don't have the mailing paraphernalia, you'll need to pack it up yourself. The next time one of these items comes in the mail, you'll recognize it, not open it, and give it right back to the mailman.

The Death of a Parent

Whether you’re talking with me in person or through this blog, I will always try to share my personal as well as professional experiences with you. The reason I haven’t posted to my blog since the end of June is that my elderly mother developed some serious health issues which ultimately resulted in her passing away earlier this month. I want to share some of what I’m going through with you–maybe to help you in the future, maybe to help me in the present.

Relief wasn’t an emotion I was expecting to feel when I got back to Florida from the funeral in Boston. But, I realized that I’d had so many different scenarios, possible problems, and potential solutions continually circling in my head for so long that it was a huge relief to not have to keep thinking about all the unknowns. You can relate I’m sure: will your mom outlive her money; what to do if a hurricane (or other weather issue) is forecast; can she continue living on her own. The list is endless.

Part of me wants to hole up in my house to process all that’s happened. Part of me wants to dive into all the tasks associated with sorting out the condominium and its contents, settling the estate, and figuring out how to sell the car. For me, the way to cope is action –cleaning out the kitchen cabinets and getting the paperwork started is cathartic. Each one of us has to figure out what works best, there is no right or wrong way to cope.

And finally, in case you think that because of my job, I have all the i’s dotted and t’s crossed and the administration of the estate will go easily, well……I spent the morning today on the phone finding out how to get a duplicate title to the car. I’ve been through every file, the safe deposit box, and the glove compartment (thank goodness, it wasn’t in there) and I can’t find the title. No matter how carefully you plan, something is going to fall through the cracks and be a hassle.

Planning For When You May Need a Caregiver

Who's Got Your Back

We’ve talked about planning for someone to pay your bills and handle your mail if you need help. This back-up plan is about the stuff of daily life. If you are elderly or are facing some major health issues, who will be there to pick up some groceries, take you to a doctor’s appointment, or just sit with you for an afternoon when you’ve come home from the hospital? These can be stressful, upsetting questions to face.

Your friend may have a gazillion children, grandchildren, and great-grandchildren all living within a ten mile radius of her home. And, your sister may live in one of those fantasy neighborhoods with a slew of neighbors ready to pitch in at a moment’s notice. Yes, you’re allowed to have a five minute pity party for yourself if you don’t. Then, start to come up with a plan.

Talk to friends, people in your church/synagogue, and the help in the doctor’s office - anyone you can think of. Many times they know someone looking to make some extra money. Getting some names and talking to them well in advance means you can implement a plan quickly.

Learn about the different types of agencies and the services they offer. Know which supply nurses and aides vs. those that drive to appointments and put a meal on the table. Do the research now.

Give some thought to the concept of ‘pay it forward’. Think about volunteering or getting involved in a community organization now. Hopefully by helping others now, others will help you if and when you need it.

The reality is most people don’t like to ask for help. Or, when people ask ‘what can I do’, it may be hard to have an answer for such a broad question. Or, a lot of people offer to help at the beginning of an illness or problem and then slowly (or maybe not so slowly) the offers of help stop.

Before you need it, really think about how you’ll cope with a variety of situations, be they of a temporary or permanent nature.

Sweepstakes Scams and the Elderly

Most junk mail is no more than just a pain in the neck and environmentally unfriendly. But, for people that are trusting and vulnerable, it can become more than that. Fraudulent sweepstakes and contests via the mail as well as over the phone rob the elderly of huge amounts of money every year.

There are many legitimate sweepstakes and contests (Publisher’s Clearinghouse and Reader’s Digest are two) and the laws that they must abide by have been strengthened over the past several years. Unfortunately, there are many other types of sweepstakes that use strong tactics to entice money out of people. The elderly are a prime target because not only are they vulnerable, when they realize what’s happened, they’re too embarrassed to report the crime.

Here are some rules of the road:

It’s illegal for a company to require you to pay a fee or buy something to enter a contest or sweepstakes.

If you really do win something, taxes will be deducted from your winnings or you pay them directly to the government. If they tell you to mail the taxes to them and then they will send your check, it’s a fake and they will just keep your money.

No legitimate sweepstakes company will ask you for your credit card number. Do not give this information to a caller telling you that you’ve won a contest.

Some of these fraudulent companies purposely have names that are misleadingly similar to the legitimate ones.

Be careful of those very official looking envelopes. Con artists know that using words like ‘urgent’ or putting official types of seals on the envelope make the recipient more likely to believe the contents.

If the postage on the envelope is bulk postage, a lot of people got the same mailing telling them they are winners. Don’t believe it.

If you are at an elderly person’s home and you see an extraordinary number of sweepstakes mailings, start to ask questions. Once someone responds to one of these fraudulent contests, their names go out on the mailing lists and they receive more and more mailings.

Again, if you’re at an elderly person’s home and you see a large number of magazines, ask questions why. They may be subscribing to magazines thinking it will increase the chances of their winning.

You will never be asked to wire money to a legitimate sweepstakes company.

Keep telling yourself – if it sounds too good to be true, it probably is.