In many ways, I was blessed with parents who aged well. My father passed away recently, but they both celebrated their 90th birthdays last year and lived active and independent lives. But the time of real cognitive and physical decline did finally befall them. My father had been in a bad accident and spent over six weeks in the hospital, and his physical and mental health had taken a sharp downturn. He struggled to walk any distance, and incontinence had hit him hard. Conversations with him, once easy and full of wit and humor, became labored. Details and words escaped him, and he struggled with day-to-day financial and personal affairs. My mother is still sharp and healthy, but she has never paid the bills or tracked finances, so she has not been able to fill the void.
Supported Independence
So, our family rallied around them and put into place guard rails and checks and balances to assist them and to help them maintain a degree of independence and financial security. My father still paid the bills — it was a task he enjoyed and gave him some purpose — but it can easily go wrong with online banking user names forgotten or bills paid twice or not at all. I have online access to their bank and bill pay service, and I monitor the flow of funds to make sure my mother is paying key services. (I have a list I check against.) I also make sure she has enough funds to cover payments and that no strange amounts are suddenly flowing out. My sister, who lives close to my mother, has taken the lead in making sure she has a relationship with her doctors and has taken part in meetings where care and next steps are discussed. She can then follow up to make sure care is being delivered and followed through on.
Document Organization
We have made sure all of their estate-planning documents are up to date: this includes not only the will and trust but also health care powers of attorney, financial powers of attorney, and advanced medical directives; and it is a good idea to keep them all in a secure but accessible place such as Dropbox or Everplans.
Long-Term Care
We have, as a family, talked about plans for the next steps in care, assisted living, and the limitations of my mother's finances and some of the compromises she will have to make. We have even talked about funeral arrangements and end-of-life matters. The more you plan now for these things, the easier they are to handle when the end-of-life arrives.
Checks and Balances Among Family Members
Lastly, I urge family members to have checks and balances in place. Do not give only one family member access to checking accounts without oversight. For example, I make sure my sister and I go over my mother's checking and investment accounts from time to time, so she knows what is going on (and that I am not helping myself to her money). I do not want my sister to be surprised or shocked at how things are being managed and for her to have a clear sense of where their financial resources stand. I stay in touch with my parents’ close personal friends to get their take on how they see things progressing (my mother tends to just tell me everything is fine). As a complement to this, you can also build a strong network of trusted advisors such as estate planning attorneys, CPAs, and financial advisors. Make sure they are willing to talk with adult children and are fully transparent with their guidance and advice. Every family is different, and there are always dynamics in play that have likely lasted for decades. Parents can have challenging personalities, siblings can fight (or just not care), and tensions can flare on any number of fronts. The key is to build a network of support where trusted advice and oversight can be given as needed. Key documents need to be updated and kept in an easily accessible place. The more thought and care that is given when things are manageable, the more likely this transition to dependence and personal decline is made manageable.
