Elder care, finances, housing...what kind of professional can help me?
May 5, 2022 6:09 PM Subscribe
A family member (90s) is struggling in her assisted living facility, primary caretaker is in her 70s and is overwhelmed, everyone is upset. I can't tell what's going on, who do we hire? (We're in NJ)
At a minimum, the 90 year old is deeply unhappy with where she's been for a few years, but refuses to/is unable to cooperate with plans for moving. The caregiver is newly much more upset about the situation, including an insurance policy that may not have been paying out properly since mid 2021(!!) how much the facility is charging, and whether it is providing the right services and type of living arrangement and care. Also bedbugs.
The stories we are hearing are not totally adding up yet (we are getting a LOT of info but not much context or linear narrative.) They seem to involve errors, miscommunication, or malfeasance among multiple institutions, and we (just finding out about all this) are underinformed both about elder care in general, and the history/current state of this specific case as well.
We would like to advise the caregiver to hire someone to help her with all of this, who is in a better position than us to evaluate things, ask the right questions, and make sure that everyone knows what they need to do. They have previously worked with an estate planning lawyer - should they start there, or with a specific kind of financial planner, or something else?
At a minimum, the 90 year old is deeply unhappy with where she's been for a few years, but refuses to/is unable to cooperate with plans for moving. The caregiver is newly much more upset about the situation, including an insurance policy that may not have been paying out properly since mid 2021(!!) how much the facility is charging, and whether it is providing the right services and type of living arrangement and care. Also bedbugs.
The stories we are hearing are not totally adding up yet (we are getting a LOT of info but not much context or linear narrative.) They seem to involve errors, miscommunication, or malfeasance among multiple institutions, and we (just finding out about all this) are underinformed both about elder care in general, and the history/current state of this specific case as well.
We would like to advise the caregiver to hire someone to help her with all of this, who is in a better position than us to evaluate things, ask the right questions, and make sure that everyone knows what they need to do. They have previously worked with an estate planning lawyer - should they start there, or with a specific kind of financial planner, or something else?
Caregiver should also contact the county senior living ombudsman if they haven’t already! That would always be my first call for any conflict with an assisted living that can’t be resolved between the two parties.
posted by assenav at 6:31 PM on May 5, 2022 [2 favorites]
posted by assenav at 6:31 PM on May 5, 2022 [2 favorites]
I haven't used them yet, but there's a whole field of eldercare consulting, which is like a private social worker+, which may be what assenav links to with the geriactric care manager and advisors. I'm in this market too, so I'll be watching the thread, but good luck! This industry is overcomplicated and stupid a lot of the time.
posted by rhizome at 7:41 PM on May 5, 2022
posted by rhizome at 7:41 PM on May 5, 2022
If the money is available to do so, and the structure of the law in your state allows (including if those family member consents, or if a conservatorship is issued) hiring a private fiduciary may very likely be one of the steps an elderly law attorney (and you should definitely consult one!) is going to advise be taken. Family members were draining my grandfather’s finances, one of the kids managed to get conservatorship. He immediately turned everything over to a private fiduciary and oh man did everything change. His finances were well cared for, his bills got paid, and he was able to live out his days in a nice assisted living place instead of one of the Medicaid funded warehouse type living facilities.
posted by azpenguin at 8:19 PM on May 5, 2022 [3 favorites]
posted by azpenguin at 8:19 PM on May 5, 2022 [3 favorites]
I'm sorry to hear you're going through this. I am too, with different circumstances. Sometimes the actual problems reveal unexpected issues that need to be resolved. There may be multiple issues that need to be solved in different ways.
Finding the overwhelming points for the primary caretaker and addressing them is important. In my case, my mother (late '80's) has been shouldering a heavier burden since my father (mid '90's) has faded in the last two years. Last year, I had to do their taxes for the very first time. This year, doing taxes revealed other lapses, and ironically enough I've got an appointment later today involving setting up financial power of attorney. It turns out that handling the paperwork is a stress generator, and since my father had been the one doing this up until recently, things took a turn for the worse. Thankfully, Dad had set up lots of stuff on automatic payments for years and nothing important went awry.
Setting up a private fiduciary or finding a trusted family member who is willing to keep books and track finances can be an important stress reducer. Using family members may not work in cases where family is draining the finances, but be aware that malfeasance (especially minor varieties) isn't entirely unheard-of in the "professional" category. Be prepared to maintain some supervisory access.
The pile of paperwork that had been building up, often arriving as postal mail, some unopened, was a large part of what had been overwhelming, especially as it became unclear what was meaningful, what was routine, and what was junk. My dad had kept this stuff in files my entire life, but his organizational system was his own, his chickenscratching unreadable, and he couldn't produce things I was asking for. So we got a porta-file for taxes/income/banking, another for bills, and a third for medical stuff. I brought over a bunch of old hanging file folders and a labelmaker, and we've been filing stuff a little every visit. All important paperwork is now findable. Mom has clear instructions to make a pile out of all incoming paperwork, whether or not she has "handled" it, and seems much less stressed knowing that she doesn't have to keep track of it.
Making other plans is helpful as well. My folks set up healthcare PoA decades ago, leaving clear and simple directives. Their wills are prepared, funeral arrangements and directives have been made and prepaid, services such as weekly cleaning are arranged, and we generally hope that they can maintain residence at their senior apartment, which has worked out well for the last decade.
There are lots of things where you might not want to take personal responsibility. Moving can cause a lot of unhappiness, and having an outside service that can be blamed for having messed it up is a blessing, especially if there is already reluctance there. Contractors can be fired or forgotten, but family is forever. Farm out the stuff that could be contentious.
posted by jgreco at 5:06 AM on May 6, 2022 [1 favorite]
Finding the overwhelming points for the primary caretaker and addressing them is important. In my case, my mother (late '80's) has been shouldering a heavier burden since my father (mid '90's) has faded in the last two years. Last year, I had to do their taxes for the very first time. This year, doing taxes revealed other lapses, and ironically enough I've got an appointment later today involving setting up financial power of attorney. It turns out that handling the paperwork is a stress generator, and since my father had been the one doing this up until recently, things took a turn for the worse. Thankfully, Dad had set up lots of stuff on automatic payments for years and nothing important went awry.
Setting up a private fiduciary or finding a trusted family member who is willing to keep books and track finances can be an important stress reducer. Using family members may not work in cases where family is draining the finances, but be aware that malfeasance (especially minor varieties) isn't entirely unheard-of in the "professional" category. Be prepared to maintain some supervisory access.
The pile of paperwork that had been building up, often arriving as postal mail, some unopened, was a large part of what had been overwhelming, especially as it became unclear what was meaningful, what was routine, and what was junk. My dad had kept this stuff in files my entire life, but his organizational system was his own, his chickenscratching unreadable, and he couldn't produce things I was asking for. So we got a porta-file for taxes/income/banking, another for bills, and a third for medical stuff. I brought over a bunch of old hanging file folders and a labelmaker, and we've been filing stuff a little every visit. All important paperwork is now findable. Mom has clear instructions to make a pile out of all incoming paperwork, whether or not she has "handled" it, and seems much less stressed knowing that she doesn't have to keep track of it.
Making other plans is helpful as well. My folks set up healthcare PoA decades ago, leaving clear and simple directives. Their wills are prepared, funeral arrangements and directives have been made and prepaid, services such as weekly cleaning are arranged, and we generally hope that they can maintain residence at their senior apartment, which has worked out well for the last decade.
There are lots of things where you might not want to take personal responsibility. Moving can cause a lot of unhappiness, and having an outside service that can be blamed for having messed it up is a blessing, especially if there is already reluctance there. Contractors can be fired or forgotten, but family is forever. Farm out the stuff that could be contentious.
posted by jgreco at 5:06 AM on May 6, 2022 [1 favorite]
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Outside the legal issues, a geriatric care manager or placement advisor can help with the logistics of finding a better living situation and facilitating the actual move.
posted by assenav at 6:29 PM on May 5, 2022 [6 favorites]