Medical & Legal Advice for Elderly Parent

Parent Cafe
1

Am looking for info or a checklist/website that summarizes what steps one should take before an elderly parent becomes incapacitated. My widowed mother’s health is slowly failing, and a recent diagnosis has prompted her to realize she finally needs help. So I will find someone to drive her to medical appointments, grocery shopping, and perhaps help with the laundry, but I want to be sure I cover all my bases legally.

Here is a list of things I am thinking of, and welcome suggestions of anything I may be overlooking. She lives alone in a house that can actually be adapted fairly easily to age in place. She is comfortable financially, although she hates the thought of paying someone to drive her around.

–Have her fill out paperwork authorizing doctors and insurance companies to discuss her medical records with me. All physicians, drug store, LTC carrier, medicare and her medical coverage provided by my father’s retiree plan.

–Have her add me as a signer on her checking account. Someone at the bank suggested this to her to avoid problems with probate, but I think it will be useful if she becomes more incapacitated.

–Migrate her bills to automatic online payment, or at least have some recurring charges placed on her credit cards (cable and cell phone are two obvious ones).

–Place a freeze on her credit files. I have been wanting her to do this for years but now that she will have helpers around, probably a prudent move.

I have Power of Attorney and am named on Health Care Proxy.

Anything else obvious? I want to be able to act on her behalf to ensure that she receives appropriate care and can remain in her home as long as possible.

Thanks!

2

My mom is 87 and perfectly capable of taking care of everything now and she and my dad were proactive a number of years ago by having revocable trust, medical proxy, POA etc., but last winter suffered a fall (not age related) and while she was hospitalized I found out a few things - like not even the cable company would let me schedule a tech call if I wasn’t an authorized user. I wasn’t an authorized user on any of her credit card accounts so we needed get that done too. Plus, her one checking account not in the trust we needed to make joint.

If she has a safe deposit box make sure you are authorized to get into it.

I also had to sign separate forms allowing me to handle her investment accounts even with a POA.

You might want to look into revocable trusts as that avoids needing to go through probate.

Consult an elder attorney.

One other thing I found out was that I could not read my mom’s passwords as she wrote them in a code only she can decipher. We had to go through all of them so I couid take care of her online things ( like check her bank balance, pay her bills, etc.

3

When looking for caregivers you may want to look into multiple people to cover when one is sick, on vacation, etc. Be very specific with what there responsibilities are. For example, some “sitters” believe that there only job is to provide supervision and companionship , no physical assist or housekeeping . It can be difficult finding trustworthy, reliable CGs so make sure to ask for references. You may want to consider an agency because they usually do background checks, are bonded and take care of all taxes etc.

4

You are smart to think about this in advance. My H is a t & e attorney and advance planning saves time, money and tears.

Don’t just be a co-signer on her accounts. The way to avoid probate is to be on a joint account so that when she passes the money goes straight to you. That’s how I did it with my aunt.

Does she have a will? If she does, review it and make that it’s up to date. If not, have her do one and videotape the execution ceremony if there’s any chance that someone might challenge her competency later on. If you think there might be a challenge, don’t use an attorney who’s a friend of yours but, if you have a lawyer friend, ask who they would have do their will. If she has sufficient resources, think about using an elder law attorney. Think about a trust if there’s enough money. Think about spending down if she may require in home care. Nursing home is a 5 year look back but in home is less (3 months in NY and you can own your home, as my MIL does).

Who will inherit her house? Does it make sense to transfer the house to you and give her a life estate in it?

Does she have retirement funds that will need to be distributed? Who are the beneficiaries?

In addition to migrating her bills to on line pay, set it up so that you are notified when they are due, etc. H and I are listed on MIL’s utility bills as third parties to be notified if a bill is not paid. This came in handy when my psycho sister in law decided to divert funds to herself. Make sure that you cover all of the bills, including property taxes, water bills, home owner’s insurance and the like.

When my aunt started having aides around the house, I removed all of the checkbooks and credit cards and had mail related to her finances sent to my home instead of hers. Why court trouble? You should also consider removing jewelry and the like if it has any value. I also took her birth certificate, SS card, passport and since she was a WWII veteran, her DD 214 and other military papers as any of these can be used in identity fraud. My aunt didn’t have a computer so that wasn’t an issue, but if your mom does, put a tracker on it so you can make sure that nobody is using it to order things etc.

I moved my aunt to an assisted living center, but before I did that, I used to do her food shopping. If you aren’t close enough to do that, consider setting up food delivery with Amazon, Fresh Direct or the like so that you don’t have to leave a lot of cash around the house or credit cards. The key is to reduce temptation to the aides.

Discuss with her whether she wants a DNR or not. You can record her decision with the will or separately.

Good luck.

5

Thank you @emilybee. The confusion is starting to set in, so better to get this now.

I actually think it would be too overwhelming for her to try to get the cable company to add me. She is distracted by her current medical issue, so will be grateful to me to just do whatever is needed and explain it to her. For instance, she has finally agreed to allow me to freeze her credit, so I can just do that from my house using her CC #.

She does not have online banking set up so I will have to take her into the bank to have me added and then see about setting that up.

I had not considered that POA would not help on the investment account. One more to add to the list.

Many thanks!

6

One more thing - make sure all the medications she is taking are on a list and in a place where it’s easily seen ( like on the refrigerator) in case emergency warrants 911 being called. That list would go with her in ambulance if needing hospitization.

7

@carolinamom2boys --thank you, yes, will do all you suggested. We had live-in 24 hour help when my father was dying several years back, but my mother was of more sound mind then so the helper was really just for physical care, not shopping & driving.

The required duties will change as her illness progresses. For the very short run, we may employ a nanny of friend of friend type of thing/word-of-mouth, but that will only be for driving.

8

@CT1417 -

I called the cable company, utilities, etc. and said I was MIL. I have all of her info and she wanted me to do it. If you don’t want to call, just set up an online account for her cable and use your email address for the communications. Once that is done, you can then add yourself.

9

@techmom99 --WOW. Lots to process.

I wil make sure to set up her bank account as joint.

We set up a new will five years ago after my father died. I am named as POA and my brother is named as successor. The four siblings are all on the same page and no one will protest anything.

She has an LTC policy that pays benefits for five years, either in the home or in a facility. I learned from some mistakes we made when my father was dying, so will avoid those and work diligently to satisfy the 100 day elimination period. She can still perform the five activities of daily living, so any care hired now will not satisfy the elimination period.

The four children are slated to inherit the house & the investment account. I should confirm that she updated the beneficiary designation on the IRA, that is housed at same investment firm. I think the lawyer would have had her do that when the will was written up, but I will confirm.

“Does it make sense to transfer the house to you and give her a life estate in it?” I don’t know what this means…and would it even apply if four children are to share jointly?

I don’t believe she has a trust, perhaps because the estate value is not high enough? (NY State) Her account balances are almost exactly where they were when the will was written five years ago. She lives on my father’s pension, SS, and IRA distributions without touching principal.

Good advice on checkbooks, etc. My boys have some log-in software on her computer so that they can repair it remotely, but I think she has stopped using the computer in favor of the iPad.

THANK YOU again. You gave me much to think about.

10

I would be careful about pretending to be another person. I understand the reasons for doing so but it could be a red flag if another family member or a financial institution were to challenge the estate plan or another financial matter.

11

@CT1417 you can also post in the parents caring for parents thread near the top of the cafe page. Many adults in that thread have had the same questions you are asking.

12

@rosered55 -

The advice I gave was premised on the mom being fully aware and wanting her to call on her behalf. My MIL is past 90 and just doesn’t want to be on the phone too much anymore. I also assumed that she was an only child prior to the last post mentioning siblings. It also applied only to having the OP added to the cable and utility accounts, not for anything else.

The life estate works like this - the house is transferred into another name/s and the now former owner has the legal right to live in the house until they die. Since there are 4 siblings, it might not make sense in your case. I assume that will leaves the house to the 4 of you in equal shares. If the house is sold now, your mom would get a $250K capital gains exclusion over the basis of her house. If your mom holds on to the house until her death, please make sure you get a reputable realtor to do an appraisal immediately after so that you have the date of death valuation on the house. If you have any work done to the house, keep good records as many things put into the house can raise the basis and reduce any potential capital gains. Speaking of the house, is your mom eligible for enhanced STAR?

If you think that she might need in home care, NY Medicaid is pretty decent. There’s a three month look back (at least there was 3 years ago when we did my now deceased aunt and my still living MIL) at income. You are allowed to have a small amount of assets and the house doesn’t count against that. That helped my MIL, whose main asset is the house, and screwed over my aunt, who always lived in apartments and whose assets consisted of savings bonds; they both had the same value, but I had to spend down my aunt at a crazy rate and she died anyway before I could finish. You can divest your mom of savings by gifting her assets to the children/grandchildren. I think it’s $14K/year/beneficiary that can be given free of gift tax and, in NYS, a single filer can exclude $5K/ year placed into a 529 plan. That’s total, not per beneficiary but it’s better than nothing. While her estate might be under the estate tax amount now, the laws may change any time so keep that in mind. There are income limitations which you can check into.

Also, if your mom or dad was a veteran, the VA offers a benefit called Aid and Attendance. I was in the process of filing for it for my aunt when she died. It’s income based but the amount is higher than NY Medicaid. A spouse gets less than a vet but it’s worth looking into. Check out the VA’s website.

13

@techmom99 --thanks again!

We had the house appraised after my father died for the step-up basis evaluation (that may be the wrong term…but to get a value at the time of death so that his half of the house had a current value instead of the purchase price from decades ago). She will still have to pay some capital gains, but not a ton.

Yes, I do believe she has enhanced STAR, or did at one point?

My father was a veteran (I think…). The Army sent someone to his grave site…honorably discharged but never saw fighting.

I think she knows about gifting money but is no conservative that she will not do that. She feels that her LTC policy will cover everything. I know otherwise, but it is not worth upsetting her and too late now to have much spending down effect.

14

I gave the advice I did because my ex-h almost got in trouble with his parents’ bank because of various financial thingis he attempted to do, with his father’s permission (his mom has Alzheimer’s disease). The bank people were quite prickly. Again, I understand why people call on family members’ behalf (I’ve made a few doctors’ appointments for my daughters), but it’s good to be aware of the potential stickiness. I think you’re giving great specific information, @techmom99!

15

Everything I am thinking of has been said. Firstly, we closed his account and made a new one, with me added. I had all bills forwarded to me. I put his checking account online, and shared password with my sibling, so she could check on the spending. I used my money for first few months, then got smart and called his accounts, like Vanguard and Janus. My dad would confirm me as authorized to withdraw money, and so I set up a monthly plan with one of them.

Dad didn’t have a LTC plan, and resisted an ALF or a caregiver. He did know and like our mutual cleaning woman, so I had her come to him a few times a week. She was a great cook, so on her days on, I didn’t have to drive over with dinner.

After his second stroke, he agreed to move into an ALF because he needed dialysis. At that point, he officially turned over his car to my then 16 y o son. Less than a month before he died, his neighbor, a realtor, and I had him sign forms to sell his condo. I don’t believe he knew what he was doing by then. I learned from this, and had my house re titled to be in my Trust.

Hope this helps. May I add, I consolidated all his accounts into fidelity. I never used nor needed a lawyer, which was quite the change after my mom’s death. I needed far fewer death certificates. I could contact SS and the VA online.

16

Getting a joint checking account is important for more than just avoiding probate. You need to know what checks are being written now. Watching out for phony charities and repair scams is one thing but there are also other expenses that may not be needed (my mom had a ‘pants of the month club’ subscription and a closet full of unopened, identical knit slacks that were arriving in the mail every month).

Also, if there are savings and investment accounts try to get them set up so that money cannot be moved from them without your OK. My mother signed away her life’s savings to a crooked “investment agent” and we only got it back through some very lucky breaks.

17

A negative of a payable-on-death joint account is that its creation might be considered a divestment for Medicaid purposes.

18

RE adding yourself to the utilities: With your mother in the room, call each company and explain what you want to do. Then tell them your mother is right there to authorize them to speak to you and make the change/addition. All Mom has to say is that yes she is Jane Doe and gives you the authorization to speak to them. Worked with everyone and no suggestion of fraud.

19

Since my father passed away, my brother and I have been handling my mom’s finances, upkeep of the house and various services for the house. We have never added ourselves to my mom’s acct. I opened up online services for my mom on everything - bank, brokerage, cable, etc. I have all of her acct information, so if she needed someone to transfer money I could do it for her. My brother regularly calls up cable and electric companies for various issues.

20

I think you are getting a lot of really bad advice on this thread. SEE A LAWYER.

1.are you an only child? If you are, then I kind of withdraw my “bad advice” remark. If you are NOT, see a lawyer. At the very least, tell your siblings exactly what you’ve done.

  1. Nobody likes to think of the possibility, but you may die before your mom. If you do, following some of the advice on this thread will cause an absolute nightmare.
  2. Many estate & trust attorneys oppose having the execution of a will videotaped. It's not my usual area of law but I just did some CLE. Advice of the expert? NEVER videotape the execution of the will.