As we age, the decrease in independence and concurrent increasing need for care which often occur can be a source of stress and conflict in many families. Adult children who must provide care to aging parents or who must make health care or financial decisions for dependent family members face tremendous challenges. Care-giving and decision-making for others requires work, effort and love. At the same time, the potential for family conflict increases greatly when family members must make life care decisions for aging and dependent seniors. Few decisions can lead to heated disagreements and family fractures quicker than those concerning the care to be provided to incapacitated family members.

A key way to head-off future uncertainty and decrease or eliminate family discord is by creating a comprehensive “elder life plan,” and sharing the plan with family and loved ones. An “elder life plan” involves creating a plan for our lives as we age and become increasingly dependent, a plan that reflects our wishes for future health care and financial decision-making. None of us wants to depend upon strangers or government officials to make decisions for us in the event of incapacity. Planning for life as an elder gives us more control and leads to fewer family conflicts. Family members, who often help the senior create the elder life plan, or have been informed of the elder’s wishes and decisions for future care, are prepared for the challenges they will face as their loved ones age. They know the senior’s wishes and plans and can assist in implementing the plan when necessary.

Readers can plan for the future by preparing a comprehensive elder life plan themselves, or they can hire an independent third party such as a geriatric care manager or certified elder law attorney to work with them and their adult children and other family members to create the plan.

The top 11 steps in creating an elder life plan follow:

  1. Make a will and review it annually, revising as needed.
  2. Plan for potential future incapacity by hiring an expert in long-term care planning who can advise you and draft durable powers of attorney, advance medical directives, trusts and other necessary estate documents. Copies of the documents should be given to appropriate people including your doctor, attorney, health care proxy, agent under the durable power of attorney, clergy and family.
  3. Be certain your personal physician knows you and your history. Discuss your future health care choices with him/her prior to any incapacity.
  4. Label and organize all of your important documents including a list of prescription medications and make sure your family knows where to find them in case you become incapacitated and  unable to tell them where they are located.
  5. Be careful when you are asked to sign any documents. Have someone you trust and who is knowledgeable review the documents before you sign anything.
  6. Be thoroughly familiar with your financial status and know how to handle your assets. Delegate financial authority with discretion. Be wary of deeding your home or giving away assets to anyone promising to “keep you out of a nursing home.”
  7. In times of change, utilize a geriatric care manager for a comprehensive health assessment. Review your estate plan with a certified elder law attorney.
  8. Become knowledgeable about the cost of long-term care and resources available to pay the cost of nursing home and other institutionalized care, including Medicaid and veterans benefits.
  9. Seek the advice of an expert in needs-based government benefits such as a certified elder law attorney before transferring assets to qualify for any needs-based government benefit program.
  10. Cultivate friends of all ages so there are always people around you who are concerned about your welfare. Don’t rely solely on your family for your social life or for care.
  11. Become knowledgeable about the many long-term care options available. Discuss with your family where you want to live and how you want to be taken care of should you become incapacitated.

(Adapted from an article by Judith S. Parness, L.C.S.W., C.M.C., entitled “Let’s Talk Turkey: Elder Life Planning,”  published in the Nov/Dec 2012 edition of the New Jersey Foundation for Aging’s Renaissance Magazine)

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