Tough talks with parents

For your parents’ end of life wishes to be honored they need to have certain legal and financial documents in place before they die or become ill, and their family should understand what their funeral and burial wishes are.  I’m not talking about role reversal, or parenting our parents. Nothing will upset a conversation about these topics faster than if they feel they are being overpowered and bossed around. It’s about becoming partners with them in the process of their aging.  I haven’t been perfect at this but I am usually put in my place by my mother’s fierce independence.

Seven important questions to ask your parents:

Where do you envision living as you get older and need care assistance?  A senior residential community?  Home? Your current home? There are costs associated with each plan, as well as quality of life issues.  There are many plusses and minuses to each option that should be explored.  For example, do they want to be around people?  Living at home can become increasingly isolated, but on the other hand they are in familiar surroundings with their own possessions.

Do you have a will?  55% of older adults do not have wills, which means that their state of residence will decide the disposition of their assets.  This process is lengthy, costly and might not be the way your parents wanted their assets allocated.

Have you appointed a power of attorney? This is very important and is often included as part of a will.  It designates a person to take over your parents’ financial and legal affairs if they become unable to do so themselves.  If there is no designated power of attorney, a judge will decide which may make life very complicated for a surviving spouse if there is one.

What do you think about long-term health insurance?  This is a very complicated and difficult issue because this type of insurance is expensive and rates keep climbing.  This insurance partially covers the costs of long-term assisted living, at-home or nursing home expenses, which are not usually covered by Medicare. These costs can run into the hundreds of thousands of dollars.

Do you have advanced healthcare directives?  These include a living will (gives written instructions on their desires regarding life-sustaining measures), a health proxy (which designates someone to make health related decisions on their behalf if they are not able to) and a HIPPA release (allows another person to access their medical records, which insurance claims will need).  These directives vary from state to state and they can download the specific forms they need in their state from the National Hospice and Palliative Care Organization’s website (www.caringinfo.org).

Do you have an authorized user on your bank and investment accounts?  This usually is the same person who has the power of attorney.  It is important because it’s very helpful for someone to have access to the older person’s bank accounts in the event that they can no longer manage their finances or they die.  The family often needs funds to continue caring for the parent, or for burials and other death-related costs.

Do you have any wishes for your funeral and burial? This one is SO helpful for family.  My unsentimental mother just guffaws and tells me to put her into recycling.  My stepfather has an entire folder of where he wants to be buried, the church in which he wants the service and the hymns.  Which approach do you think gives more guidance?

Starting the conversation is delicate and awkward at best.  No one wants to talk about their own demise, especially an older person, and the topic can be upsetting for their family.  I try to keep it light with my mother. I start with ‘If you got hit by a bus tomorrow…” which diffuses the tension around her being elderly and could happen to anyone. I can then launch into whatever issue I need to discuss with her. My other tactic is to say something along the lines of  “I am drawing up a will for myself and I feel it is important for everyone to have one.  Do you have a will?  Should I know where it is in the event that I need it?” Everyone is different and you’ll need to give some thought to what will work best with your parents.

Ask your parents to create a file or document box which will hold their financial, insurance and health documents along with other information. There is a list at the bottom of this article of what should go into the master file.

A final thought, my mother is 94 and going strong.  I am mindful, however, that while she might be around for many more years, it won’t be the forever I assumed when I was young.  I am taking the time now to ask her about her life, her thoughts and feelings on the events in her life, and to also bury any hatchets.  She is an amazing person and while her lack of sentimentality might have seemed cold to me growing up, it served her well for coping with several unfortunate events in her life, and again now as she faces being 94 with most of her friends gone.

From Lifehacker, here is a list of what should be included in the master file:

  • Will
  • Letter of instruction
  • Birth certificates
  • Marriage certificates
  • Citizenship papers
  • Divorce/separation papers
  • Adoption papers
  • Social security numbers/cards
  • Passports (numbers and expiration dates)
  • Driver’s licenses (number, expiration dates)
  • Military records
  • Names/address/telephone numbers of healthcare professionals
  • Healthcare proxies/living wills
  • Medications (dosages, name of prescribing physicians, pharmacy, address/telephone
  • Address and phone numbers of hospitals of choice
  • Medicare numbers
  • Medicaid numbers (caseworker numbers, address/telephone)
  • Social worker or caseworker names and contact information
  • Passwords, web sites, and other digital information
  • Income sources (retirement and/or disability benefits, Social Security, etc.)
  • Financial assets (institution names, account numbers, address/telephone, form of ownership, current value) of cash, bank accounts, stocks, bonds, mutual funds, money market funds, retirement and pension plans, IRAs, annuities, life insurance
  • Real Estate (property addresses, location of deeds, form of ownership, current value)
  • Other assets (location of items/titles/documents/form of ownership, current value) including automobiles, boats, inheritances, precious gems, collectibles, household items, hidden valuables/items in storage, loans to family members/friends
  • Liabilities (Creditor institutions, address/telephone, approximate debt) of mortgages, personal loans, credit cards, notes, IOUs, other).
  • Trust documents

I would add:

  • All insurance information – car, long term, health and agents
  • Location of safe deposit box, contents and keys
  • Accountant’s name and contact information
  • Funeral arrangements and last wishes
  • Items in storage, storage facility name and location