Planning For Eldercare

Money isn’t the only concern when making care arrangements for an aging parent or loved one.

The implementation of the Affordable Care Act, or Obamacare, is creating uncertainty in many areas of health care. Decisions about appropriate coverage and care choices will likely become more complex as the new health care system takes effect, with health care costs for seniors receiving most of the attention.

Despite that fact, many people fail to consider other important aspects related to eldercare. The good news is that advances in medicine and nutrition mean that more people are living longer. According to the Centers for Disease Control and Prevention, Americans who make it to the age of 65 have about 20 years of life ahead of them, including nearly 14 years in relatively good health.

But greater longevity may require a thoughtful approach to eldercare. Planning should not only include financial savings, but also legal and medical considerations. Consider a 2012 cost of care survey, which revealed that almost 70 percent of people aged 65 would require some degree of long-term care over the rest of their life.

According to a 2011 MetLife study of Caregiving Costs to Working Caregivers, one out of four adult children provide personal care and/or financial assistance to a parent, and more than 65 million people spend an average of 20 hours a week caring for chronically ill or aged family members.

The circumstances that trigger a higher level of care are not always predictable, although advance planning can help you make better decisions and remove certain roadblocks. The preparation includes having certain key documents in place, knowing which advisers to consult, and having sensitive discussions before making decisions becomes critical.

A family meeting is the first step to creating a plan to address the issues. Ask each family member to express his or her opinion on what should be done and what responsibilities they will assume in the process.


If you cannot reach an agreement, consider contacting an elder mediator who specializes in resolving such disputes.

Bruce Spector, founder and chairman of Pinnacle-Care, a full-service health care advisory firm, said throughout his career he had “trusted advisers — accountants, attorneys, financial advisers — for both my personal and business needs. But I had no trusted adviser when it came to the most important decisions I had to make, namely those that affected my own health and the health of my family.”

Consider forming a “planning team” that can help you navigate daunting issues such as medical care; government health benefit plans; private health insurance; the types, location, and cost of health care; and estate and agency plans. A private health advisory specialist can provide an assessment of your specific situation by reviewing medical records, living arrangements, caregiving needs, and access to benefits.

An experienced lawyer can help prepare important documents related to eldercare, such as a durable power of attorney and a health care proxy. An accountant can advise you about tax deductions related to claiming your parent as a dependent, or claiming a tax credit for the cost of in-home care.

“It’s important to evaluate different types of long-term care facilities to determine if they will provide the type and quality of care required,” says Andy Broder, an attorney at Payne, Broder & Fossee in Bingham Farms who specializes in eldercare. “Nursing and assisted-living facilities offer varying fee structures and services compared to continuing care retirement communities.” As famed actress Bette Davis put it, “Getting old is not for sissies.” That’s why many people put off thinking about the aging process until they are called upon to serve as a caregiver or forced by a life event to face it for themselves — which can make hard choices all the more difficult. With a clear understanding of the key issues, you can get a head start on this life stage and make informed decisions for yourself and your family. db

Mark J. Rogers is an executive director and family wealth director with Jbara and Rogers Financial Management at Morgan Stanley in Farmington Hills.