My father-in-law just took a serious fall. So far, he has spent 45 days in the hospital in Missouri. Modern medicine is bound to find something wrong at age 90. This should have been a wake-up call for his kids to start asking questions about his final wishes if they never did before.
It seems the generation raised by the Depression-era parents have a difficult time talking about money or health or death.
They don’t want to worry their kids or have never shared finances with them before and don’t know where to start. Add to this equation any possible dementia or fear of loss of independence and you are not likely to come by information easily.
The time to open these conversations is before there is an emergency. Many adult children don’t want to seem nosy, or don’t know how to broach the subject. Perhaps a good place to start is to share your own estate plan with Mom or Dad. Approach the situation with concern that their wishes will be granted, and therefore need to be known.
In a perfect world every adult should have an estate plan that includes a will or trust, a living will, a financial Power of Attorney and a health care agent. Settling estates in this country is a very robust industry. It takes time, money and legal assistance on average taking about 18 months and costing about $12,000.*
Large or complex estates of course are more expensive and can be tied up for years. These are definitely things worth planning for.
Money aside, health and comfort for your loved one should be the first focus. Part of the estate plan should include a living will and Advanced Medical Directive that instructs the health care agent how to handle care and prolonged efforts to stay alive.
No one thinks in these terms if you are just going in the hospital with the flu. It seems there is never a good opportunity to discuss feeding tubes or ventilators. Perhaps when you are all together at the family barbecue? Probably not, and thus many families are unprepared.
First be aware of the HIPAA laws designed to protect your parent’s privacy. What this means is you can’t really have a meaningful conversation with the doctor without the proper documentation.
Next, make sure there are proper care directives. This could be a matter of opinion of different family members. Having written instructions will help keep the sibling rivalry to a minimum. Also, it is easy to get scared and want to change your mind at the last minute, which you can do, but stop and think of what the purpose of the living will is in the first place. Most likely it is to ensure quality of life and that probably has not changed.
These guidelines are also important when placing Mom or Dad in an extended care center. You will need to know what kind of care is available and what is realistic in the ratio of patients to medical staff before you move in.
Patients without elder care insurance may be tempted to cut corners on the level of care they sign up for. Make certain you leave the hospital with a Plan of Care.
This helps keep everyone on the same page and makes the providers aware of their responsibilities. The family will be busy enough with personal care, visiting, paying bills etc. It would be difficult to also be the person providing care as well.
Final wishes are never easy to discuss but it is very necessary to have a clear understanding of how you can help be an advocate at this difficult time.
Patricia Kummer has been a certified financial planner and a fiduciary for over 30 years and is managing director for Mariner, LLC d/b/a Mariner Wealth Advisors, an SEC Registered Investment Adviser. Please visit www.marinerwealthadvisors.com for more information or refer to the Investment Adviser Public Disclosure website (www.adviserinfo.sec.gov). Securities offered through MSEC, LLC, Member FINRA & SIPC, 5700 W. 112th Suite 500, Overland Park, Kansas 66211.
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