Aging—for aging parents and their adult children—sneaks up on all of us. Planning should begin early. And that includes not only the senior individual or couple, it includes the family, professional caregivers, and friends. The old African proverb tells us that it takes a village to raise a child. It is also sometimes advantageous to have a “village” helping at the end of our lives. We spoke with various professionals in the Triangle. Their work covers everything from home services, senior living spaces, legal services, and financial planning. It is easy to become intimidated by all the bases to cover. All of the people we spoke to agree that it is best start early, take it one step at a time, and respect the dignity of all involved.
Briant Sikorski, a wealth advisor with Stratos Wealth Partners* based in Cary, North Carolina, recommends a “Family Meeting.” “It can be done completely in-person with all interested parties in attendance, or it can be done via telephone conference call or video conference. The objective of the meeting is to get everyone involved ‘on the same page’ and to identify any areas of conflict or disagreement. It is preferable to select a location away from the senior’s home at a neutral location such as a hotel, conference center, or private restaurant. Family Meetings will evolve over time from a discussion of plans, intentions, and roles and responsibilities to more specific discussions around aging and future housing decisions.”
Melanie Mattingly, managing partner with Preferred Living Solutions agrees. She said that sometimes you have to get out of the house to have a productive meeting, such as going to “a local restaurant, a coffee shop or ice cream parlor. You may be surprised by how much easier it is to tackle tough topics in a neutral setting.” Even the term “meeting” might be intimidating, especially during a crisis. That’s why professionals advise to plan well before a crisis erupts or, if the crisis has already occurred, “those crucial conversations may need to be put on hold until the crisis has passed or the situation has stabilized,” said Vivian McLaurin, a geriatric care manager with Preferred Living Solutions. Depending on the personalities of the family members, and with added factors such as cognitive issues, passing on the generational baton can be a rocky road. McLaurin urges adult children who may visit their parents to look for signs that the parents need help.
“If the refrigerator is empty or you find spoiled food; if mail is stacked up unopened, if bills have not been paid, if voicemail has not been checked, if the car has numerous dings or new dents, your mom or dad likely needs some assistance.”
Sikorski added: “When family members live nearby, they will often take on the role of helping the family member in need. However, if the family members, as caregivers, live a long distance away then they may need to consider engaging more local resources to provide assistance.” Sikorski assists seniors and families “by following a prescribed discovery process, adhering to an investment policy and offering a range of defined service levels to my clients. My services typically include financial, insurance, retirement, retirement income, education savings and estate planning. I am licensed and registered to provide access to investment assets such as stocks, bonds, mutual funds and exchange-traded-funds; insurance such as life, disability and long-term care; and annuities including fixed, fixed index and variable.”
“While most Financial Advisors focus the majority of their financial planning on retirement and helping their clients plan for their ‘Bucket List’ years,” said Sikorski, “I recognize that aging and frailty know no economic boundaries, so I focus not only on the achievement of a financially secure retirement, but also one with the best quality of life possible.”
Jeffrey G. Marsocci, an attorney and Certified Medicaid Planner™, sees the planning as basically covering three large areas: (1) estate planning, (2) long term care planning, and (3) financial planning. “In the area of estate planning,” he said, “seniors and their families should be reviewing who they want in charge of making financial decisions for them should they become incapacitated or pass on, who would be in charge of making health care decisions for them if they become incapacitated, and if they pass on who gets their assets.
Lyndah Tello is manager of Smart Moves Financial. She stresses that seniors should investigate a number of methods to manage the money they will need. A retirement solution to consider is permanent life insurance, where part of the premium goes to life insurance and the other part to an investment building cash value. Withdrawals can be taken at any age without penalty. Some seniors prefer to divide responsibilities among different family members; some designate one person to coordinate everything; and some avail themselves of professional assistance. Everyone we spoke to agreed that it’s best to have a plan and a team. “Consulting a professional care manager is a great place to start,” said McLaurin. “Most care management companies offer a free initial consultation. Preferred Living Solutions offers a free 1-hour meeting to discuss your needs.” They start with an assessment of the senior’s unique needs and wishes; they help identify goals; and they help find resources to achieve those goals.”
“Not everybody’s journey is going to be the same,” said Ahana Muth, admissions director with The Oaks at Whitaker Glen, which is a part of Pruitt Health. Pruitt began as a pharmacy service, and has now grown into a “one-stop shop for geriatric health care, from independent living services to hospice.” Home health care is a big part of the picture. A senior at home would receive visits from the staff.
Another approach is day care, which is one of the things provided by Senior CommUnity Care of North Carolina a P.A.C.E. program (Program of All-Inclusive Care for the Elderly). Senior CommUnity Care of North Carolina (SCCNC) is sponsored by Volunteers of America, which was founded in 1896 and focuses on “the homeless, seniors, veterans, the disabled, formerly incarcerated and youth and families,” said Kimberly Ladue, marketing manager for Senior Community Care of North Carolina, which is a PACE program. There are 115 PACE programs nationwide and 11 in North Carolina. “We have a day center which houses a medical clinic and at the heart of our center is a team of professionals that oversee everyone’s health care. That team includes a doctor, nurses, occupational and physical therapy, recreation therapy, a registered dietician, social work and transportation,” said Ladue. “Ninety-two percent of PACE participants live at home,” she added. “That is our goal!” “Parents often think things are just fine while the children are near exhaustion trying to be parent/child/coworker/soccer coach. The best time to talk about needs, wants, wishes? Years before the fall or diagnosis,” said Ladue, although that is seldom the case. And what if family members disagree? It’s not necessarily going to happen, but in some cases, it can. Planning can alleviate or prevent that kind of stress. “When there is no clear and concise plan,” said Ashley Bejte, regional admissions director for Pruitt, “that’s usually when we see quarrels.”
“Siblings should remind themselves that this is a time to put aside past issues and conflict and focus on their aging parents’ safety and well-being,” said McLaurin. “Asking everyone what they can do to contribute and then assigning tasks is one way to bring together the family.”
“We always strive to promote family harmony,” said Marsocci. He added that attorneys have it a little easier than some other professions because there are strict professional rules about who the client is. Sometimes the client may be the mother or father; sometimes it is the child who has power of attorney; sometimes it is a court-appointed guardian.
Ladue’s strategy is to present all of the information about PACE services and hope there is an eventual consensus. She sees the dynamic as a three-way partnership between the caregivers, the participant, and the program. Another challenge can be caregiving by long distance. Ladue says that technology has been a great way “to integrate far away family into the care process…Our enrollment specialists will even refer folks to PACE programs near where they live so that they can check out the program hands on. We are not only about our center, we are about ALL PACES and how we can keep folks living independently for as long as possible. If there isn’t a PACE nearby, they also look up their local council on aging to refer folks to services in their area. We try to meet with everyone involved, near and far. Once we learn more about their needs and concerns, then we can better tailor our program and what we can offer to their specific needs. In that way, we are covering all the bases.”
“Our firm focuses on preventing problems and chaos,” said Marsocci, “keeping things simple and easy to understand, and providing peace-of-mind planning and resources in plain English. While we accomplish this for our clients in the areas of estate and Medicaid planning using legal tools such as trusts, powers of attorney, and sometimes even utilizing financial instruments, it is the planning ahead to help our clients avoid problems that drives our firm first and foremost.”
If there’s one lesson here, it all comes down to planning and teamwork.
*Securities offered through LPL Financial, member FINRA/SIPC. Investment advice offered through Stratos Wealth Partners, Ltd., a registered investment advisor and a separate entity from LPL Financial.