tl;dr: If you have elderly parents, and expect to become responsible for them later, then you should start talking to an elder-law attorney right now about obtaining Power of Attorney over their affairs.
For the last couple of months, my full-time job has consisted of dealing with the fallout generated when my father died at age 82 and left my mother, also 82, behind. Losing dad was as difficult as you can imagine, and perhaps you’ve experienced something like it in your own life; coping with the “natural” death of an older family member represents a species-old universal experience, of course, and those who have lost at least find themselves buoyed by institutional support in any human culture you can name. The much more profound difficulty, the one that we the surviving family had no preparation at all for, lay in the situation that remained for our mother.
We’d for years felt comfortable thinking of mom as “senile”, a funny old lady. Maybe she’d gotten a bit funnier in recent years, with an ever-shakier grasp of reality, but she and dad remained inseparable and clearly loved each other more than ever as time passed. So we let it lie. And so all that time, while she suffered from undiagnosed, untreated and worsening dementia, our dad covered for her — a very common state of affairs between old, lifelong spouses, when only one of them begins to lose their faculties. He would artfully deflect any concern we’d voice about her mental health, and, frankly, we would play along, I suppose because it was easier that way. And suddenly he was gone, and we began to discover both mom’s utter inability to care for herself, and our own total ignorance of what to do next.
The ongoing crisis has forced me to put my career on hold (to say nothing of my hobbies), build up a rather significant financial debt, and take on quite a bit of personal stress and relationship strain. I liken my situation to steering a brakeless car zooming downhill: exerting what control I can as we all plunge onward, knowing it has to stop eventually but unable to say when, doing my best to minimize harm to me and mine in the meantime.
It didn’t have to be this way, had I started preparing even a few months beforehand. But I didn’t know what I didn’t know. I’m one of the first people in my local peer group to deal directly with aging parents — most of my friends being my age or younger, while my parents were rather older than average when they had me. Unlike other major life-changing events such as child-rearing, caring for elders in decline carries a stigma in our culture such that I was not already awash in passively acquired knowledge and advice by the time I found myself faced with it. Like many others in my situation, I mainly just didn’t think about it, right up until it was too late.
So, I wish to write down here what I wish I’d known two years ago, when my mother first started showing signs of “going senile”. What follows are my recommendations for anyone expecting to take on a role of primary responsibility for one or both parents (or sufficiently parent-like entities) as senescence sets in.
Obviously, your family probably doesn’t resemble mine, so please adjust this advice as needed. I also expect that the relevance of my advice may vary a great deal if you and your family don’t live in the United States; it could be that, unlike me, you enjoy a non-hostile national health-care system, or perhaps your local culture isn’t quietly ashamed of its elders in need, and has some clearly established, non-obscure paths about how to prepare for this sort of thing in place. In which case, I can only doff my hat in your direction, I suppose.
That said, the first step of lawyering up is one that I do expect applies to nearly every situation; you can never go wrong by seeking an expert advisor. The rest is mainly about securing Power of Attorney, which in my case I’ve had to accomplish amidst all the chaos of cleaning up my father’s affairs, keeping my mother safe, and arranging long-term care for her, all while finding a way to pay for it all. Much of my current struggle would have been eased rather a bit had I settled this matter sooner.
Hire an elder-law attorney
Through the channels of your choice, locate and hire an attorney who is expert in elder law. If possible, do this with your parents, in their name and on their dollar. In my experience, the lawyer will consider your parents their client, but will consider you a sort of co-client.
Yes, the lawyer will cost you money. I can guarantee you that the money you spend on the lawyer will pay for itself many many times over in the money, time, and overall grief that they will save you later.
Were I feeling more efficient, I’d just stop writing here. The lawyer’s advice to you, based on your family’s own situation, quite obviously trumps anything further I have to say. But I do strongly advise asking the lawyer about Power of Attorney, and so I may as well explain why.
Set up Power of Attorney for yourself
Power of Attorney, in short, involves an individual granting someone else the full power to speak or act for them in some regard. Depending upon the scope of the agreement, person granted PoA can directly access bank accounts and make decisions about property owned by the person granting the power. They can also sign agreements in this person’s name, see medical records, and make medical decisions for this person.
In my case, I’ve been using PoA to let my brothers borrow her late husband’s car to run errands for her benefit, and I’m selling her house to help pay for her ongoing care. I can cut checks from her bank account in her name, and also arranged for all the adjustments to her social security and pension income that came after dad’s death. I’m gradually re-pointing all her creditors’ databases to point at my address and phone number, so that she won’t be harassed and confused by scary financial phone calls she lacks the wherewithal to do anything about. I invoke PoA when we take her to the hospital, so that they can freely speak with me about her medical condition and needs. And on and on: it’s invaluable.
PoA agreements come in a variety of flavors. In my case, I found Durable PoA (involving finances and property) and Medical PoA, two distinct agreements, to cover every situation involving all my parents’ financial and medical affairs.
Have the lawyer draft Durable and Medical Power of Attorney paperwork for both of your parents, and then have your parents sign this paperwork with a notary public as witness. (The lawyer might themselves be a notary public, in which case they can witness the signing themselves.)
The output will be paperwork. Make sure you get a copy, of course, and then you should scan that copy in full as soon as you can. Allow the scanned copy to begin a new folder on your computer for storing all the digital documents you’ll gradually start to accrue about your parents’ health and financial affairs. When the time comes, you’ll find yourself returning to this folder an awful lot.
Have the agreements appoint you as PoA immediately, if possible
A PoA agreement can be configured to confer its powers only once various circumstances have been met. Do not do this, if you can help it. It is far simpler to simply have the PoA powers take effect as soon as the document is signed and notarized. The idea, in this case, is that the signer trusts that the PoA recipient will not abuse these powers, and will make use of them only how and when they are needed, and expressly for the signer’s own direct benefit.
If your parents do not trust you not to abuse this power, then you may have problems that lie outside the scope of this document. Consider, however, privately telling the lawyer how you wish the document to work, and subsequently allowing the lawyer to sell your parents on the idea. Lawyers worth their pay are very good at changing peoples’ minds through skilled argument, and this includes their own clients, if they feel it’s for their own good.
In my parents’ case, they drafted their agreements to set each other up as their PoAs, respectively, failing over to me only in the case the other’s incapacitation or death, or if they voluntarily ceded PoA to me. This was a mistake, but they arranged this years ago, long before I thought to get involved with any of this stuff.
Because of this setup, I had to go through the pain and trouble of having them legally (and literally) sign both PoAs over to me in the very short period of time between my father’s prognosis and his passing — and even then, I needed to call in their lawyer’s help to convince them that this was a good idea. While even those few extra days proved invaluable for tying up his affairs, it would have proved much less painful had I just been able to immediately activate PoA upon its obvious necessity.
If you’ve gotten this far, you’re doing great! You have now secured the ability to speak for your parents about medical decisions should they ever lose the ability to voice or make good decisions for themselves, and that’s huge. Doctors and hospitals recognize PoA quickly and without fuss, in my experience, when the need arises. Your next step involves sending your PoA documentation to financial institutions, who tend to be a bit more cautious and slow-moving than medical professionals when it comes to other people trying to reach into their customers’ accounts, but whose cooperation is no less important in setting up early.
Start applying PoA to your parents’ stuff
First, collect all the information you can about your parents’ financial institutions, including banks and credit card companies. Obtain bills and statements and account numbers of every entity with whom they regularly send or receive money. This includes insurance agencies, car or home financiers, and utility companies, and any income from employment or retirement pensions. Naturally, you’ll want their social security numbers as well.
Save all this documentation into a folder, and copy all the most pertinent information into a notebook or textfile or something for your own benefit.
Now, starting with the banks, call up each of these entities to introduce yourself as their customer’s power of attorney. You will probably find that the phrase “power of attorney” works like a magic charm in every instance; even if you’ve never said it before, every single one of these institutions should know exactly what it means and what they ought to do about it. (Good businesses know to pay attention here — the presence of a PoA claimant implies that the customer in question might be unable to keep conducting business themselves, and they should welcome your offer to step in and continue things yourself.)
You’ll specifically need to ask what to do in order to gain full access to your parents’ account, and you’ll most likely be asked to send a copy of the PoA paperwork to the institution in question. You can use snail mail, but most companies will have a fax number for this purpose. Some will allow you to email scanned documents as well, but don’t count on it.
In my case, where time was of the essence, I learned to accept and even prefer sending these documents by fax. Yes, yes, we’re far enough into the 21st century that the idea of sending a fax induces much groaning and eye-rolling and so on from everyone born after 1972, but on the other hand there today exists many fine desktop computer applications that make it easy to send faxes over the internet. I use a Mac program called iFax, which charges a dollar or two for every document you send, and I’m sure you can find a good solution for whatever system you prefer.
However you send it, write and attach a short letter identifying yourself as the child of their customer, and provide your parent’s account number and any other identifying information the person receiving the fax might need to figure out who you are and what exactly you want. This is especially important when contacting larger companies, where the employee manning the fax machine might work in an entirely separate country from whomever you just spoke with on the phone.
Learn from each institution how long they expect to take to process the PoA documentation. In my experience, this time period may range from an hour (for a bill collector) to six weeks (for a life-insurance payout account). Whatever they say, mark it down somewhere, along with the name of the person you spoke with, and when you spoke with them. Then, hold them to it. Set an alarm on your calendar to call them back at the right time, and confirm that the PoA has been received and approved, and that you have full access to the account in question.
And then, do nothing further, at least for now. Feel good that you’re saving your future self a lot of trouble, and that at this point you’ve made a great start towards fulfilling the responsibility you feel towards your aging parents.
What if it’s too late?
If you found this post because you’re dealing with a crisis situation right now, then you basically have to do what I did: fumble your way forward as best you can, day by day. Figure out what your goal is and then start slogging towards it.
Your first step will still involve finding an elder-law attorney you trust and explaining the situation to them. (In my case, I was lucky in that my parents already had one, and had shared his contact information with me years ago — my mistake lay in never doing anything with this until everything was quite on fire.)
From there, you might want to make use of a service like A Place for Mom to help you locate a home for your parent; I’ve found them invaluable. Or you could become their primary caregiver yourself, moving in with them and permanently sacrificing a significant slice of your time and attention for their benefit, but this is not a tactic I can speak to.
If all else fails, you can fall back on contacting your state’s Adult Protective Services bureau, which has the advantage of costing you no money (you already pay for it with your taxes) but the disadvantage of it being a blunt, government-wielded instrument. I can’t advise that unless you feel truly out of options.
And when the time comes…
I intend to write a follow-up post about what I learned from my months of searching for long-term care for my severely demented mother, but I won’t do that until my current ordeal reaches a stable state. I will link to that post at the end of this one, once it exists.
Update: Here is that followup.