Get the documents signed
The right time is while your parents are healthy, because the papers that make everything else possible can be signed only by someone with the mental capacity to sign them. Frame the talk as logistics: you need to know where things are and what they want, not what they are worth.
Four documents matter. A durable power of attorney lets a named person handle money and property. A health care proxy names who makes medical decisions, a living will states which treatments they would want, and a privacy release lets doctors talk to you. Without these, a family facing dementia or a stroke must petition a court for guardianship, which takes months and costs thousands of dollars. An elder law attorney can prepare the full set, commonly for a flat fee. Ask also for one sheet listing doctors, medications, accounts and the location of the will.
What care costs and who pays
Most families assume Medicare pays for long-term care, and it does not. Medicare covers up to 100 days of skilled nursing after a qualifying hospital stay, but not ongoing help with bathing, dressing and meals. Assisted living commonly runs $5,000 to $6,000 a month and a nursing home considerably more, with wide regional variation. Medicaid pays for nursing home care only after a parent's assets are nearly exhausted, and it examines gifts made in the previous five years, so moving a house into a child's name at the last minute backfires. State rules differ.
Warning signs on a visit
- Unopened mail and unpaid bills suggest trouble managing money.
- New dents on the car suggest unsafe driving.
- Weight loss and expired food suggest skipped meals.
- Missed medications, repeated stories and new acquaintances asking for money suggest cognitive decline or fraud.
Help that exists
Every county is served by an Area Agency on Aging, found through the federal Eldercare Locator, which connects families to meal delivery, transport and respite care. The Family and Medical Leave Act gives eligible employees twelve unpaid weeks a year to care for a parent, though not a parent-in-law.
The expensive mistakes are quitting your job or draining your retirement accounts. A caregiver who leaves work loses wages, retirement contributions and future Social Security credit at once. Divide tasks among siblings in writing, and pay for help before you break.
Tip Ask your parent to name you as a trusted contact at the bank and brokerage. The institution can then call you if it suspects fraud or confusion, and you get no access to the money.
