For those with aging parents, November takes on special significance as National Family Caregivers month. It reminds us that millions of family caregivers do the vast majority of care for our older and disabled loved ones. And family caregiving is on the rise. As the U.S. population ages, increasingly the next generation will be faced with the task of exploring their parents’ care preferences. “Role reversal” or the idea of taking care of someone who used to take care of you, can be uncomfortable, sensitive, threatening, emotional — but necessary. The sooner you have that conversation, the better because having to guess or scramble when there is a health emergency isn’t good for anyone.
In just a short decade, the vast majority of the massive baby boomer population will be over 70 years of age while their children will still be in the peak of their careers and busy raising families. Families may be more dispersed geographically, adding even more complexity. All of this, combined with a healthcare provider shortage, puts significantly more pressure on families to step-in and actively plan for their parent’s care. The first step is to have “the talk” to better understand your parent’s care preferences. Typically these sorts of family relationship conversations fall into two camps, welcome or unwelcome. Some aging parents may appreciate a direct conversation, while others may procrastinate and prefer greater privacy. That was the case with my father who is now age 93. He always believed he would die in bed, on the family farm, and planning for anything different was nonsense and totally unnecessary. Perspective and context Research tells us that as we age, seniors tend to be concerned about issues of control and legacy. Understanding how these two forces play in your parents’ lives will be helpful context when having these conversations. These matters are often at the root of a parent’s resistance to help or transition. Control increasingly becomes a concern as parents begin experiencing a decline in physical and mental capacity, likely the first threat to their independence. Loss of control is understandably a difficult topic. Mortality magnified by the loss of loved ones brings legacy to the forefront for older adults. According to David Solie, author ofHow to Say It to Seniors, “coming to terms with one’s legacy is a tremendous job, and has a powerful effect on a person’s actions, whether they are aware of it or not.” Helping your parents piece together their legacy can help make those final years more rewarding. Care considerations There are many considerations when helping your parents plan for their care and stay independent as long as possible. Some of the common topics include housing, finances, healthcare, transportation, home modifications, home care, personal care, shopping, meals and even companion care. The really good news is that there are a lot of resources now available to help with most of these needs and we saw these services become more mainstream during the pandemic. Most seniors have a preference for “aging in place” for as long as possible. In fact, according to a recent survey by AARP, 3 out of 4 adults age 50 plus want to live in their home as they age. While this is understandable, very few achieve this goal without some housing transition. According to the National Council on Aging, seniors tend to move more times after age 65 than they did in the prior years combined. We saw this with my 92-year-old mother-in-law who has moved five times in the past 15 years. These transitions are difficult and typically involve some degree of incremental downsizing and loss of control. Read: 90% of adults say they want to age in place — what that really means Aging in place successfully is likely the most cost-effective housing solution, but it does not just happen, it requires a plan that evolves over time. For some, that will involve downsizing to the ideal retirement home, ideally with progressive care alternatives. Cognitive decline also becomes an increased risk with age and will likely lead to expensive care and more limited housing options. For others, safety, including home accessibility modifications, will be priorities. Helping parents see the value in having help with home maintenance and care such as lawn service and housecleaning is helpful. As parents age, they will likely need more assistance. Helping with shopping, doctors’ appointments, meals, driving, and finances are often next in line. For many, there comes a time where there are greater care needs that require a heavier lift. According to the Benjamin Rose Institute on Aging, 75% of people age 85 and older report some degree of permanent limitation in performing activities of daily living such as eating, bathing or dressing. Many couples don’t factor in a period where one of them lives solo after losing their spouse. This can be a trigger for a housing change and additional care needs. For some, it is an opportunity to boomerang back to their home, live with a sibling, move closer to family or move to a new community. Legacy considerations As part of the overall care plan, it is important to ensure that basic estate planning has been done and is current. This should include key documents such as having a healthcare directive, power of attorney and a will in place, along with ensuring assets are properly titled and beneficiary designations are current. A deeper dive into a healthcare directive and having a designated healthcare proxy is important as well. Gifting is often an important part of having a meaningful legacy. Understanding their bequests beyond the wealth transfer will help your parents feel more connected to their legacy. It may feel overwhelming to discuss this with your parents, thinking that you and other family members are looking at a period where you will be stepping in and doing a lot of the care. I like to think about a care plan and family members playing the role of care coordinators. Most parents don’t want to be a burden to their children so helping them understand they have a plan, a range of care options, and the financial wherewithal is really important — you might even say a valued gift. Angie O’Leary, is head of wealth planning at RBC Wealth Management-U.S. RBC Wealth Management, a division of RBC Capital Markets, LLC, Member NYSE/FINRA/SIPC.