Making preparations for my parents' future
July 5, 2010 11:01 AM   Subscribe

My parents are currently in their late 50s, and in good health. But given the many threads recently on caring for elderly and sick parents, I want to start making some plans for their future care. What sorts of things should we be talking about NOW?

There have been a lot of threads here on AskMe and Metafilter on the topic of caring for elderly parents. Although my parents are still relatively young, and in relatively good health, this is a topic I think about all the time.

My parents live in the U.S. I live about 5000 miles away, with no plans to return to the States anytime soon. I am thinking it is not too soon to have a frank discussion with them about their plans and wishes for future care, but I'm not sure what sorts of things I should discuss with / ask them / ensure they've taken care of on the legal side.

I mean, the extent of my knowledge at this point is that I *think* they both would prefer DNR status and want to be cremated.

So again: what sorts of questions should I be asking them, what kinds of legal provisions do we need to discuss having in place, and what issues should I be considering, especially as someone living very far away from my parents?

And another, tl;dr way of looking at this question would be: if you currently are caring for ill/elderly parents, what things do you wish you had discussed in advance?
posted by ladybird to Human Relations (13 answers total) 21 users marked this as a favorite
Long term care insurance! After spending a fortune on my grandfather's nursing home, my folks immediately went out and got long term care insurance to help protect them financially should either or both of them end up in a facility for an extended period of time.
posted by Blue Jello Elf at 11:20 AM on July 5, 2010 [2 favorites]

Are you the only child? If so, is there a relative closer by who is their health proxy, if something should happen to both of them? If not, is one of your siblings designated the health proxy, and do they know exactly what your parents' wishes are if they are incapacitated for any reason?
posted by roomthreeseventeen at 11:24 AM on July 5, 2010

Get them to fill out living wills (also called advance health care directives). There are some stock ones online. Make sure they have copies, you have copies, maybe a neighbor or a good friend in the area has a copy, and their doctor. This will force them to explicitly answer a lot of these questions, which can make things a lot easier.
posted by brainmouse at 11:27 AM on July 5, 2010

Seconding long-term care insurance. I begged my parents in their 50s to buy it after watching what my grandparents all went through at the end of their lives. They ignored me, so here we are, with both of them in their late 60s with mounting health problems, and my sister and I silently terrified of the costs we know are coming down the road.

Also: do they have a will? Do they have a trust? Do they have life insurance? Do they have advance directives?

Fingers crossed that your parents are willing to have these conversations with you in a thoughtful, engaged manner. Mine weren't (and still aren't).
posted by scody at 11:28 AM on July 5, 2010

Response by poster: roomthreeseventeen: I am the eldest of two children. I have a younger sibling, early 20s, who does live in the same town as my parents, but I feel pretty strongly that neither my sibling nor my parents would really want Sibling to have to make any snap decisions regarding my parents' healthcare - that would probably fall to me.

Thank you for pointing this out, I'm not sure why I neglected to mention it in the original post.
posted by ladybird at 11:29 AM on July 5, 2010

My mother died about 7 years ago after months of debilitating illness. The one thing I really wished she'd had in place is Long Term Care Insurance. I've heard similar concerns from many of my friends. Unfortunately, it's the sort of coverage that's really hard to get if you have any hint of actually needing it any time soon. Other than that, it's smart for everyone to have a regular will, living will (with the DNR instructions if that's the way you want to go), and medical and financial power of attorney in place.

Considering that your parents are still young, I'd tread pretty carefully in bringing all this up. (I'm 53 and I'd be a little freaked out if my niece wanted to talk about all of this with me!) I think a small white lie is in order here. Say you know someone (or read about someone) whose parents died unexpectedly and the person was left with an absolute NIGHTMARE of financial and "last wishes" stuff to deal with -- and that since learning about this terrible situation the person was in, you've been worried (to the point of losing sleep!) that you could face something similar. So, mom and dad, could you help a poor worrying far-away kid out and talk about all of this with me? Just to sort of bring me down and ease my mind?

I think that's the approach I'd be most receptive to -- if a child or niece (I've got no kids of my own) were approaching me to discuss this stuff.
posted by rhartong at 11:32 AM on July 5, 2010

I think a small white lie is in order here
This is not a terrible way to look at it. My husband and I are in our late twenties and we're planning for things like living wills and "health care power of attorney". It's never too early to think about these things, you never know what might happen. So I would consider these things for yourself, which will necessitate conversations with your close family members about your wishes. Which will, in turn, open the conversation up to what their wishes might be in such-and-such a situation...
posted by purpletangerine at 11:56 AM on July 5, 2010

make sure that they have the wills and such as others have mentioned above, and make sure that you have a copy of it. you don't need to read it, you just need to have a copy of it, so that if you have to go to the hospital and prove that they have a dnr, you have a copy of it in your hand. you don't want to have to go rummaging around their house, wondering if it's in their lockbox or at their bank in a safety deposit box or in your mom's sock drawer. better to just have a copy.

find out who their executor is. make sure you know who their lawyer is if they have one.

my parents have a binder of this stuff. when they were going through a phase, every once in a while they'd ask "remember where the binder is?". when they were selling the house they called and told me where they'd moved the binder to. when i finally got to see their new house, part of the tour was seeing the file cabinet where the binder is now.

we did up our wills 'n' shit when we were in our early 20s and my parents have a copy of them. it's more important in our case because we're a same sex couple and our wishes will be less likely to be respected. but it's never to early to talk about this stuff and have wishes spelled out, especially if they're anything less than "traditional".
posted by misanthropicsarah at 12:58 PM on July 5, 2010

This is by no means a subject that is in any way creepy, premature or anything else. Look at it this way (and point this out to your parents): They could be riding together to the store tomorrow and be hit by a bus. We don't control our futures even as we try to plan them. If they were taken to the hospital, both in comas, what would they want done and by whom? You need to have a serious discussion with both of them and your sibling. Some things to discuss is exactly what treatment they do or do not want. Respirator for two years before pulling the plug? O.K. to wake up totally paralyzed? Food and water withheld after brain activity reaches a certain level? You may be surprised by how much they may or may not have considered these issues. This is not a fifteen minute discussion.

Next, get a professionally prepared Living Will and a separate Durable Power of Attorney. I suggest (but it is really up to the four of you) that the Durable PoA name sibling as first attorney-in-fact with you as the second and with you having the final say if there is a disagreement between the two of you. This will give you time to get home knowing that their wishes are being carried out by your sibling in the interim.
posted by Old Geezer at 1:27 PM on July 5, 2010

I have no first hand experience with any of this, but my Mom recently told me that it was extremely stressful for her to deal with my grandfather's estate after he passed away. He had all his accounts, etc. very will organized, but he never had an accountant or a lawyer, so there were all kinds of little snags along the way to add stress to an already stressful situation. He wasn't rich either: he worked for the government and my grandmother (who passed away before him) was a teacher.

Since then, my parents (who are also in their 50s) have gotten powers of attorney & heath care detectives set up, and did something (I'm not quite sure what) so a lawyer and the trust department of a local bank are ready to handle all the details for the estate when they pass away.
posted by cosmic.osmo at 1:43 PM on July 5, 2010

As your folks age so are their friends. And when they mention the problems their friends face it's an opportunity for you to address the topic. Also there is no reason to assume that they will die at the same time, so you can ask them what they want for their spouse. That can lead to the discussion about wills, insurance, ect..
Older people have been through a lot and seen a lot. I bet they have given this more thought than you have...just watch for the chances to ask them about it.
posted by what-i-found at 6:45 PM on July 5, 2010

I don't know how you would bring this up, but if you can - how much stuff do they have? If something were to happen to them, and their house is stuffed with collectibles or just plain detritus, someone is going to have to shovel it all out. I say this as someone with a mom in her late 70's who may need assistance sometime soon, and who has a four-bedroom house stuffed with stuff - she's a total packrat, it's everything from valuable antiques to old rusty nails. If something were to happen to her, guess who will be spending WEEKS sorting through it all?

Power of attorney: If Sibling isn't suitable (not all adult children are) do your parents have a trusted family member, neighbor, pastor/rabbi, anyone who can serve as POA if you are not there? It should be someone close by.

If they want to age in place - and most people do - they can start thinking about retrofitting their house. Simple changes to improve accessibility and safety don't look institutional, will pay for themselves, and it will be easier to look for contractors and equipment now rather than wait till the last minute when something does happen. Here is an article on aging in place design.
posted by Rosie M. Banks at 7:07 PM on July 5, 2010

Response by poster: Thanks to everyone for your thoughtful responses and for sharing your experiences. Difficult to mark a best answer on this one, as all the answers were useful to me.
posted by ladybird at 5:18 AM on July 6, 2010

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