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Things you need to know about talking to your ageing parents

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Having the Talk? Here’s a few tips.

If you have not had “the talk” with your ageing parent/s, don’t put it off any longer. While mom and dad are cognitively intact the process is pretty straight forward… albeit, it can be somewhat uncomfortable for both parties. It needs to be approached from the same angle as if the conversation was to be had with you by your own grown children.

IOC The talk1Talking about the future can be hard. Such discussion will invoke anxiety in even the most calm of us when we start to think about all the unknowns in our futures and those of our loved ones. These discussions can get even harder when it’s not our future we’re talking about, but rather someone else’s. However, as difficult as it may be, there are some questions that we need to have answers to when it comes to our ageing parents and it is wise to have these conversations sooner rather than later. On that note, here are 7 basic questions that you should include in the “talk” with your ageing parent/s… as soon as you can.

1. How do they feel about getting older or having to get help to sustain their independence?

A parent/s can have all the legal stuff taken care of, but that doesn’t tell you how they feel. To really understand your ageing parents, it’s important to talk about how they feel about the situations that might happen.  Allow them to talk about their fears, their wishes, how they envision things unfolding in the event of a medical situation, and so on.  This is the type of conversation that will tell you if they have made decisions based on what they think will be easiest for others or what they really want.  This is the type of conversation that will allow you to make sure that the legal documents accurately represent your loved one’s wishes.  Most importantly, it is the type of conversation that will allow your ageing parent/s to know how much you support and love them and want what is best for them.

2. Do they have a will? Is the Will is safe keeping and up-to-date?

Bringing up a will can seem like you only care about what you’re getting, but a will contains so much more than just ‘who gets what’ and is essential to the process of handling matters when a loved one passes. This is your parent’s opportunity to dictate how they would like their affairs to be handled and who they want to handle things.  It is equally important for our parent/s to ensure their will is up-to-date so that loved ones don’t end up in bureaucratic chaos trying to simply execute the wishes of a loved one while simultaneously trying to mourn. Importantly, the same questions pertain to life insurance, which is separate from a will and requires the beneficiaries to be named to the life insurance company directly.

3. Do they have a living will?

Although many people plan for their deaths, many forget to also plan for any situation that might render them incapable of making their own decisions while still living.  Your parent/s may assume that the “right” decision will be made for them, by those in charge. This is not always how it plays out. Taking the time to decide what they want and making sure those wishes are legally noted is the only way to ensure your parents will be cared for in that way.

4. Do they have a Power of Attorney?

This can be one of the trickier topics to discuss if there are multiple children or individuals who might expect to be “chosen”.  Parents sometimes put this off because they simply don’t want to be seen as picking favourites, but it’s an essential document to have.  For this reason it is important that children (and any other interested individual) are respectful of whatever decision the elder makes.  No offense should be noted to the parent/s and if there are concerns about a selection, it would be wise to make sure all parties are involved in discussing this instead of trying to quietly bring it up to the parent. By involving everyone, the right decision for your aging parent can be made.

5. Do you have long-term care insurance?

Not all people have invested in long-term care insurance and with the costs of long-term care. This is something your parents may want to consider if it’s not too late to invest. If they have invested, being aware of what is covered, who to contact to initiate the insurance claim, and what services your parent will want to take advantage of is important to know ahead of time and can save money and hassles if/when the time comes.

6. What kind of care situation do you want?

Does your parent have a retirement or assisted living home in mind?  Do they want to stay at home as long as possible, focusing on ageing in-place (Home Care)? What nursing homes are they comfortable with if the situation were to become necessary? Having these discussions before a decision needs to be made ensures that people can look for the right care, make any needed arrangements, and not scramble at the last minute and have to take whatever is available.

7. What are your wishes for a funeral/memorial?

IOC-The talk2Sometimes there’s a lot of pressure to do things in a “traditional” way when it comes to how we remember our loved ones, but that’s not always what they want.  Although funerals/memorials need to reflect both the person that is gone and those who are left behind, having a discussion ahead of time can mean that all sides get their voices heard.  When a decision is reached beforehand, our loved ones know their wishes will be respected and those of us left behind can know we’re memorializing our parents in a way that they accept as well. This means no guilt for anyone and that’s a much-needed relief at a time of sorrow.

However hard it may be, please take the time to talk to your loved ones about these issues.  It’s also not too late to start thinking about them for yourself as well. The more prepared you are, the easier it is for those around us and the more open we are, the more likely we are to respect everyone’s wishes and know that ours will be respected too.

Alzheimer’s & Dementia Care… The road ahead

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Alzheimer's & Dementia Article1Alzheimer’s and Dementia Care… The road ahead

Caring for a loved one with Alzheimer’s disease and other types of dementia can be a challenge, not only for the person diagnosed but also for their spouses and family members. Although caring for someone with Alzheimer’s or dementia can seem overwhelming at times, the more information & support you have, the better you will handle the demands and determine the long-term care options that are best suited to you and your loved one.

 

 

THIS ARTICLE WILL DEAL WITH:

  • Preparing yourself for the care
  • Developing routines
  • Engaging your loved one in activities
  • Planning activities with your loved one
  • Handling challenges as they present themselves
  • Considering long term care
  • Assessing assisted living or nursing homes

Preparing yourself for Alzheimer’s & dementia care

You may be dealing with a whole range of emotions and concerns, as you come to grips with an Alzheimer’s or other dementia diagnosis. There’s no doubt you will be worried about how your loved one will change, how you will keep him or her safe & comfortable, and how much your life will change in order to sustain it. Emotions such as anger, grief, and shock will be likely to be experienced. Adjusting to this new reality is neither, easy or immediate. It is critically important to give yourself some time, process the road ahead and reach out for help and support from a number of resources available. The more support you have, the better you will be able to help and manage your loved one, care.

While some of these tips are aimed specifically for people with Alzheimer’s, they can equally apply to persons suffering with other types of dementia.

Early-stage Alzheimer’s care preparations

Some Alzheimer’s & Dementia care preparations that are best done sooner rather than later. It’s hard to consider these questions at first, as it means thinking about a time when you or your loved one is already well down the road of his or her Alzheimer’s journey. However, putting such preparations in place early helps a smoother transition for everyone later on. Depending on the stage of diagnosis, include the person with Alzheimer’s & Dementia in the decision-making process as much as possible. If the person is at a more advanced stage of dementia, at least try to act on what their wishes would be.

Questions to consider in preparing for Alzheimer’s and dementia care:

▪   Who will make healthcare and financial decisions when the person is no longer able to do so?

While this is difficult topic to raise, if your loved one is still lucid enough, getting their wishes down on paper means they’ll be preserved and respected by all members of the family. Consider having a family meeting involving the person and those who may be impacted with the decisions being made (all children, and or grandchildren who may have to ultimately step up and take on a role in their care). In most cases such family meetings can go smoothly as it pertains to respecting the affected person’s wish. However, do not hesitate to involve an elder law attorney to best understand your options. You’ll need to consider power of attorney, both for finances and for healthcare. If the person has already lost capacity, you may need to apply for guardianship/conservatorship. Last but not least, their Personal Will if one is not in place already.

▪   How will care needs be met?

It is not uncommon that some family members assume that a spouse or nearest family member can take on the role of caregiver, but this assumption is not always the case or even possible. Caregiving is a rather a large commitment, and one that becomes greater over time. The person with Alzheimer’s and or advanced Dementia will eventually need round-the-clock personal care. Although family members are more than willing to take this challenge on, many family members may have their own health issues, jobs, and other roles & responsibilities. Communication is essential to ensure that the needs of the affected person are known & met, and that the caregiver has all the support in place to meet those needs.

▪   Where will the person live?

Knowing their wishes ahead of time will certainly ease the process in making this decision. Their own home will more than likely be their first wish. However, before concluding that home care is the final decision, consider a home assessment to determine the appropriateness of the home to meet their care needs. An assessment can be performed free of cost and determine the care needs and client’s challenges for today and moving forward. This way you will know if perhaps the home is fine for now, but difficult to access or make safe for later. On the other hand, the home could be fully suitable for their care… now and to meet future challenges. This is the type of information that will be invaluable to make informed decisions. If the person is currently living alone, for example, or far from any family, it may be necessary to relocate or consider care options that best suits their need, care, wishes… or a facility with more support.

Find out what assistance your medical team can provide in these areas. In some countries, you can also hire a care manager privately. Geriatric care managers can provide an initial assessment as well as assistance with managing your case, including crisis management, interviewing in-home help, or assisting with placement in an assisted living facility or nursing home.

Developing day-to-day routines

Having a daily routine in Alzheimer’s & Dementia care helps caregiving run smoothly. These routines won’t be set in stone, but they give a sense of consistency, which is beneficial to the Alzheimer’s patient even if they can’t communicate it.

While every family will have their own unique routine, you can get some great ideas from your medical team or Alzheimer’s support group, especially regarding establishing routines to handle the most challenging times of day, such as evenings.

  • Keep a sense of structure and familiarity. Try to keep consistent daily times for activities such as waking up, mealtimes, bathing, dressing, receiving visitors, and bedtime. Keeping these things at the same time and place can help orientate the person.
  • Let the person know what to expect even if you are not sure that he or she completely understands. You can use cues to establish the different times of day. For example, in the morning you can open the curtains to let sunlight in. In the evening, you can put on quiet music to indicate it’s bedtime.
  • Involve the person in daily activities as much as they are able. For example, a person may not be able to tie their shoes, but may be able to put clothes in the hamper. Clipping plants outside may not be safe, but the person may be able to weed, plant, or water. Use your best judgment as to what is safe and what the person can handle.

Communication tips

As your loved one’s Alzheimer’s progresses, you will notice changes in communication. Trouble finding words, increased hand gestures, easy confusion, even inappropriate outbursts are all normal. Here are some tips, do’s and don’ts on communicating:

Communication Do’s and Don’ts?
Do
Avoid becoming frustrated by empathizing and remembering the person can’t help their condition. Making the person feel safe rather than stressed will make communication easier. Take a short break if you feel your fuse getting short.
Keep communication short, simple and clear. Give one direction or ask one question at a time.
Tell the person who you are if there appears to be any doubt.
Call the person by name.    
Speak slowly. The person may take longer to process what’s being said.
Use closed-ended questions, which can be answered as “yes” or “no.” For example, ask, “Did you enjoy the beef at dinner?” instead of “What did you have for dinner?”
Find a different way to say the same thing if it wasn’t understood.Try a simpler statement with fewer words.
Use distraction or fibs if telling the whole truth will upset the person with dementia. For example, to answer the question, “Where is my mother?” it may be better to say, “She’s not here right now” instead of “She died 20 years ago.”
Use repetition as much as necessary. We prepared to say the same things over and over as the person can’t recall them for more than a few minutes at a time.
Use techniques to attract and maintain the person’s attention. Smile, and make eye contact, use gestures, touch, and other body language.
Don’t
Ever say things like: “Do you remember?” “Try to remember!” “Did you forget?” “How could you not know that?!”
Ask questions that challenge short-term memory, such as “Do you remember what we did last night?” The answer will likely be “no,” which may be humiliating for the person with dementia.
Talk in paragraphs. Instead, offer one idea at a time.
Point out the person’s memory difficulty. Avoid remarks such as “I just told you that.” Instead, just repeat it over and over.
Talk in front of the person as if he or she were not present. Always include the person in any conversation when they are physically present.
Use lots of pronouns such as “there, that, those, him, her, it.” Use nouns instead. For example, instead of “sit there” say “sit in the blue chair.”
Use slang or unfamiliar words. The person may not understand the latest terms or phrases.
Use patronizing language or “baby talk”. A person with dementia will feel angry or hurt at being talked down to.
Use sarcasm or irony, even if meant humorously. Again, it can cause hurt or confusion.

Planning activities and visitors

As you develop daily routines, it’s important to include activities and visitors into their life. You want to make sure that the Alzheimer’s patient is getting sensory experiences and socialization, but not to the point of getting over-stimulated and stressed. Here are some suggestions for activities:

  • Start with the person’s interests.
  • Ask family and friends for memories of interests the person used to have. You’ll want to tailor the interests to the current level of ability so the person doesn’t get frustrated.
  • Vary activities to stimulate different senses of sight, smell, hearing, and touch. For example, you can try singing songs, telling stories, movement such as dance, walking, or swimming, tactile activities such as painting, working with clay, gardening, or interacting with pets.
  • Planning time outdoors can be very therapeutic. You can go for a drive, visit a park, or take a short walk. Even sitting on a balcony or in the backyard can be relaxing.
  • Consider outside group activities designed for those with Alzheimer’s. Senior centers or community centers may host these types of activities. You can also look into adult day care programs, which are partial or full days at a facility catering to older adults and/or dementia patients.

Visitors and social events

Visitors can be a rich part of the day for a person with Alzheimer’s disease. It can also provide an opportunity for you as the caregiver to socialize or take a break. Plan visitors at a time of day when your loved one can best handle them. Brief visitors on communication tips if they are uncertain and suggest they bring memorabilia your loved one may like, such as a favorite old song or book. Family and social events may also be appropriate, as long as the Alzheimer’s patient is comfortable. Focus on events that won’t overwhelm the person; excessive activity or stimulation at the wrong time of day might be too much to handle.

Handling challenges in Alzheimer’s and dementia care

One of the painful parts of Alzheimer’s disease is watching your loved one, display behaviours you never would have thought possible. Alzheimer’s can cause substantial changes in how a person acts. This can range from the embarrassing, such as inappropriate outbursts, to wandering, hallucinations, and even violent behaviour. Everyday tasks like eating, bathing, and dressing can become major challenges.

As painful as some behaviours are, it’s critical not to blame yourself or try to handle all the changes in behaviour alone. As the challenging behaviour progresses, you may find yourself too embarrassed to go out, for example, or to seek respite care. Unfortunately, difficult behaviour is part and parcel of Alzheimer’s disease. Don’t isolate yourself. Ask for help from the medical team and reach out to caregiver groups for support. There are ways to modify or better accommodate problem behaviours. Both the environment you create at home and the way you communicate with your loved one can make a substantial difference.

Considering long-term Alzheimer’s and dementia care

It’s the nature of Alzheimer’s disease to progressively get worse as memory deteriorates. In the advanced stages of Alzheimer’s, your loved one will likely need round-the-clock care. Thinking ahead to these possibilities can help make decisions easier.

Care at home

There are several options for extending care at home:

  • In-home help refers to caregivers that you can hire to provide assistance for your loved one. In-home help ranges from a few hours a week of assistance to live-in help, depending on your needs. You’ll want to evaluate what sort of tasks you’d like help with, how much you can afford to spend, and what hours you need. Getting help with basic tasks like housekeeping, shopping, or other errands can also help you provide more focused care for your loved one. Be sure to look for a service provider who has extensive Geriatric Care experience.
  • Day programs, also called adult day care, are programs that typically operate weekdays and offer a variety of activities and socialization opportunities. They also provide the chance for you as the caregiver to continue working or attend to other needs. There are some programs that specialize in dementia care. Alternatively, you can hire a caregiver for the days you need it for without any time commitment. This may alleviate some stress on the part of the patient, as they do not have to leave their familiar surroundings.
  • Respite care. Respite care is short-term care where your loved one stays in a facility temporarily. This gives you a block of time to rest, travel, or attend to other things. Of course, you can hire a caregiver for the block of time desired. This may alleviate some stress on the part of the patient, as they do not have to leave their familiar surroundings.

Is it time to move?

As Alzheimer’s progresses, the physical and mental demands on you as caregiver can gradually become overwhelming. Each day can bring new additional challenges. The patient may require total assistance with physical tasks like bathing, dressing, and toileting, as well as greater overall supervision. At some point, you won’t be able to leave your loved one alone. Nighttime behaviours may not allow you to sleep, and with some patients, belligerent or aggressive behaviours may exceed your ability to cope or feel safe. Every situation is different. Sometimes, you can bridge the gap by bringing in additional assistance, such as in-home help or other family members to share the caregiving burden. However, it is not a sign of weakness if moving to your loved one to a facility seems like the best plan of care. It’s never an easy decision to make, but when you’re overwhelmed by stress and fatigue, it’s difficult to maintain your caregiving standards. If the person with Alzheimer’s is living alone, or you as the primary caregiver have health problems, this option may need to be considered sooner rather than later.

When considering your caregiving options, it’s important to consider whether you are able to balance your other obligations, either financial or to other family members. Will you be able to afford appropriate in-home coverage if you can’t continue caregiving? Talk to your loved one’s medical care team for their perspective as well.

Evaluating an assisted living facility or nursing home

If the best choice is to move the Alzheimer’s patient to a facility, it doesn’t mean you will no longer be involved in their care. You can still visit regularly and ensure your loved one gets the care he or she needs. Even if you are not yet ready to make that step, doing some initial legwork might save a lot of heartache in the case of a crisis where you have to move quickly. The first step is finding the right place for your loved one.

Choosing a facility

There are two main types of facilities that you will most likely have to evaluate for a loved one with Alzheimer’s: an assisted living facility or a nursing home.

Assisted Living

Assisted living is an option for those who need help with some activities of daily living. Some facilities provide minor help with medications as well. Staff are available twenty-four hours a day, but you will want to make sure they have experience handling residents with Alzheimer’s disease. Also be clear about what stage your loved one is at, as he / she may need to move to a higher level of care.

Nursing Home

Nursing homes provide assistance in both activities of daily living and a high level of medical care. A licensed physician supervises each resident’s care and a nurse or other medical professional is almost always on the premises. Skilled nursing care providers and medical professionals such as occupational or physical therapists are also available.

How do I choose a facility?

Once you’ve determined the appropriate level of care, you’ll want to visit the facility announced and unannounced—to meet with the staff and otherwise evaluate the home. You will also want to evaluate the facility based on their experience with Alzheimer’s residents. Facilities that cater specifically for Alzheimer’s patients should have a designated area, for residents with dementia.

Questions to ask such a facility include:

  • Policy and procedures – Does the unit mix Alzheimer’s patients with those with mental illness, which can be dangerous? Does the program require the family to supply a detailed social history of the resident (a good sign)?
  • Environment – Is the unit clean? Is the dining area large enough for all residents to use it comfortably? Are the doors alarmed or on a delayed opening system to prevent wandering? Is the unit too noisy?
  • Staffing – What is the ratio of residents to staff? (5 to 1 during the day, 9 to 1 at night is normal). What is staff turnover like? How do they handle meals and ensure adequate hydration, since the person can often forget to eat or drink? How do they assess unexpressed pain—if the Alzheimer’s resident has pain but cannot communicate it?
  • Staff training – What training for Alzheimer’s care do they have? Does the facility provide staff with monthly in-service training on Alzheimer’s care?
  • Activities – Is there an activity plan for each resident based on the person’s interests and remaining cognitive strengths? Are residents escorted outside on a daily basis? Are regular outings planned for residents?
  • Services – Does the unit provide hospice services? What were the findings in the most recent Ministry conducted inspection? What are the rates of infectious outbreaks? What is the resident rate of injury incidences?

What to expect during a transition

Moving is a big adjustment both for the person with Alzheimer’s and you as their caregiver. Your loved one is moving to a new home environment with new faces and places. You are adjusting from being the person providing hands-on care to being an advocate. Remember to give yourself and the Alzheimer’s patient time to adjust. If you’re expecting to move, try to have essentials packed and ready to go, and as many administrative details taken care of as possible, as sometimes beds can come up quickly. Work closely with staff regarding your loved one’s needs and preferences. An extra familiar face during moving day, such as another relative or close friend, can also help.

Each person adjusts differently to this transition. Depending on your loved one’s needs, you may either need to visit more frequently or give your loved one their own space to adjust. As the adjustment period eases, you can settle into the visiting pattern that is best for both of you.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at 

 

Dollars & Sense

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Personal FinancesPersonal Finances – An Overview:

This is never an easy topic, but one that has to be embraced at some time in our lives… sometimes twice or three times.

  • Planning for our own retirement
  • Engaging our ageing parents financial plan into action
  • Engaging our own retirement financial plan

The article is powerful in part because it deals with an issue that — if we’re lucky — most of us will face. Despite the fact that the experience is almost universally shared, too few of us are prepared to deal with the financial challenges that tend to arise as our parents reach old age, it is now more important than ever to prepare for this stage of life.

Dealing with aging parents can clearly be trying — emotionally and financially — but you can make the process much easier if you begin to prepare before your parents face serious health problems. To get you started, here’s a look at six basic steps you’ll need to take.

Have a financial plan of your own

The first thing an adult child needs to do is protect his own financial security, to avoid serious financial difficulties while caring for their parents. Of course children want to be there for mom and dad, but it’s important to know your own financial capacity to help. If you have your own plan in place  — one that takes into account the likelihood that you’ll live longer than your parents — you’ll better know those boundaries.

Unfortunately, most seniors today haven’t purchased long-term care insurance, and by the time they know they’ll need it, such policies are prohibitively expensive. But if you have aging parents, buying long-term care insurance for yourself may provide you with the certainty needed to be able to spend income and assets on your parents’ care.

Open up the conversation… gently

Getting your parents to be forthright with you about their financial situation can be very difficult. For decades, they have been the ones caring for you, and the ones dispensing advice. Reversing those roles can be trying for both you and your parents. That’s why framing the conversation effectively is important, broaching the subject in such a way that comes across as asking for help rather than offering it. Like, ‘Hey, Dad/Mom, I’ve been thinking about my long-term financial stability and it looks like you’re doing well. How did you plan for this?’” This way you can gauge if you’re parents are struggling, and if they’re not. It can also be great way to learn some planning strategies for yourself as well.

Get help

Dealing with ageing parents can be a source of acrimony between siblings. If you’re the adult child taking the lead, it’s important to involve your siblings early in the process – both to avoid resentment, and to avoid having the burden placed entirely on your shoulders. It is also a good idea to bring professionals into the conversation – a doctor, lawyer and financial adviser that your parents already trust. This will add outside authority to your discussions and help mitigate any qualms your parents have with being told what to do by their children.

Make it legal

In case your parent’s health deteriorates quickly, you or a trusted ally will need to be given the legal authority to make financial and health decisions for them. Documents like a durable power of attorney will allow a proxy to make financial decisions for your parents in case they become incapacitated. A living trust will allow a proxy to manage your parent’s estate under similar circumstances, and a will is necessary to dictate how your parents’ estate will be disposed of after they pass.

Simplify their financial life

Many seniors are resistant to online banking, but showing your folks the ropes will allow them to set up automatic bill pay, which will help them stay up on their financial responsibilities. It will also allow you to monitor their finances and make sure everything’s okay. Many individuals have their financial assets spread among a range of financial institutions; you’ll want to consolidate those assets to some extent.

Take over gradually

As you begin to take a larger role in your parents’ medical care and finances, it’s important to make the transition slowly if possible. Give them autonomy where they can handle it, as this will reduce tension between you and your parents. For health reasons, it’s also important for your parents to maintain a sense of autonomy and self-reliance.

As you move forward in the process of taking responsibility from your parents, the most important thing you can do for yourself is learn from your pa
rents’ experiences. Today, people are living a third longer than they thought they would, and that trend is likely to continue. Doing things like buying long-term care insurance and setting up your own legal directives while you’re still young will make the process that much smoother when you and your children face it.

Planning for the discussion:

If you are working with your elderly parents, choose a quiet moment to introduce a conversation about the five wishes concept. It is a good idea to document the answers. These points can formalize the five wishes as part of their legal documents, including their Power of Attorney and will documents. Five Wishes allows a person to spell out exactly how he or she wants to be treated should he or she become seriously ill. Note that specific funeral instructions, memorial services, and burial requests may be included in this document. Give your parent time to think about the following questions.

Wish 1: Whom do you wish to make health-care decisions for you, when you can’t make them for yourself?

Choose someone who knows you very well, cares about you, and who is able to make difficult decisions. Family members or your spouse may not be the best choice as they are too emotionally involved. Choose someone who is able to stand up for your wishes and lives close enough to help whenever needed. Be sure to discuss your wishes with this person; first ask if he or she is willing and able to take on this responsibility. You will need to fully discuss your wishes with this person. Ask if he or she is prepared to act on your wishes.

Wish 2: What is your wish for the type of medical treatment you want?

Traditionally this wish begins with the following statement: I believe that my life is precious and I deserve to be treated with dignity. When the time comes that I am very sick and I am not able to speak for myself, I want the following wishes and any other directions I have given to my health-care agent, to be respected and followed.

Describe your wishes for pain management, comfort issues, life support or extraordinary measures and what to do in specific situations (e.g., close to death, in a coma, or having permanent and severe brain injury with no expectation of recovery).

Wish 3: How comfortable do you wish to be?

This wish may contain specific requests; for example, music to be played, poems or favourite passages read out loud, or photos to be kept nearby. This may also include information about your grooming needs and cleanliness of bed and towel linens.

Wish 4: How do you wish people to treat you?

This wish may include requests for who you will want to be by your side in your dying days such as whom you would like to see (e.g., family, friends, clergy) and whether or not you want someone by your side to comfort you. You can also specify that you want to die in your own home (if possible) or to be in a facility with professional caregivers while family and friends visit as guests (as opposed to being caregivers).

Wish 5: What do you wish your loved ones to know?

This wish may contain statements that you want the family to know; for example, that you love them, or you may ask for forgiveness for times you have hurt family, friends, or others. It may also show forgiveness for hurts you have experienced from others. It is a wish that can evoke a need to make peace with yourself, your family, and your community; or to remind loved ones to celebrate your life with memories of joy, not sorrow. When you die, your debts must be paid first – before any money or property you leave behind is passed on to your loved ones. There may also be funeral costs, legal fees and other administrative expenses in settling your estate. There may be other estate costs, such as probate fees and taxes on investments that you may not have considered.

Common Estate Costs

Probate fees
When you die, your executor often needs proof (requested by financial institutions, government agencies and others) that they are the person authorized to represent your estate. Probate is the process that provides court certification of this fact. There can be a cost to this – and probate fees to settle your estate can be high depending on the province you live in. In Ontario, the fees (officially called an estate administration tax) equal almost 1.5% of your estate’s value.

Tax on capital gains
You’re deemed to dispose of all capital property at death.  Your estate must cover the tax on any capital gains.

Tax on tax-sheltered savings plans
Registered plans such as RRSPs and RRIFs can be transferred tax-free to your spouse’s plan. If you don’t have a spouse, these savings are fully taxable at your death.

Ways to manage estate costs

Personal Finances2Leave a valid will
If you die without a valid will, your estate gets settled according to the laws of your province, rather than according to your personal wishes. This can be a more complic
ated process, with higher legal fees and the potential for costly disputes. 

Name beneficiaries for insurance and registered plans
When you buy life insurance or open an RRSP or other registered plan account, you can name a beneficiary to receive the money when you die. This means the money bypasses the estate process and is paid directly to that person. Because it does not form part of your estate, the money is not subject to probate fees and there is no delay in your beneficiaries receiving the money.

Jointly own property
Holding assets – such as a home or cottage – with another person is another strategy for reducing probate fees. Joint assets pass automatically to the surviving joint owner – and are generally not considered part of your estate and subject to probate fees. However, there can be complications to joint ownership, especially if you co-own an asset with someone other than your spouse.

For example:

  • If you transfer half-ownership of an asset to an adult child – and they have a spouse who they later separate from – the spouse could have a claim on your child’s half of the asset.
  • If your child has financial problems or declares bankruptcy, their ownership in the asset could be subject to claims by creditors.
  • If the asset has increased in value, you may have to pay tax on any capital gains when you transfer your half ownership. This is because a transfer is considered a sale for tax purposes.
  • You can no longer deal freely with the asset and must make joint decisions in managing or selling it.

Professional advice is essential: Joint ownership arrangements can be complicated. Get expert legal and tax advice before entering into one of these arrangements.

Preplan and prepay your funeral
Preplanning and prepaying your funeral doesn’t necessarily save you money, but it does remove a key expense that your family or estate must cover upon your death. When you prepay, the money goes into a trust account or insurance fund until your funeral. You gain certainty over costs because you choose the type of funeral you want in advance. And your family is saved the difficult job of making decisions during a time of grief.

Buy permanent life insurance
Life insurance proceeds can be paid to your estate to cover estate costs or left directly to a beneficiary to provide additional amounts to a particular person. The proceeds are always paid tax-free. Consider a permanent insurance policy for estate planning purposes. Permanent insurance covers you for life, no matter how long you might live. Term insurance does not.

Probate fees and life insurance
When you name a beneficiary for your insurance proceeds, the money is paid directly to your beneficiary. It does not form part of your estate and is not subject to probate fees.

You can also use insurance to cover estate costs. To do this, name your estate as the beneficiary. Your estate will pay probate fees on the insurance proceeds, but it gives your estate the cash to pay debts, taxes or other obligations. This can avoid the sale of estate assets – such as a home or cottage – that beneficiaries may want to keep in the family.

Life insurance can help cover estate costs: Taking out a life insurance policy can help cover the cost of capital gains taxes.

I know this a lot to cover in one sitting, but should really be broken down and discussed over a course of time… that allows for both parties to really have time to form questions and seek answers.

So what’s next?

Your mom and dad paid taxes all their life. Let the government take care of him/her? He/she should get rid of their assets so they’ll qualify. While some financial planners considered this to be good advice others consider it to be terrible advice.

What the financial advisor is tellingyou or your aging parent with this suggestion is that it is a good idea for your aging parent to give away his assets or otherwise impoverish himself so he can qualify for Medical Aide. Medical Aide is a state, county and federally funded health insurance program for the indigent. The benefits are quite limited

An impoverished elder may have only one option for care when care is needed for the basics, such as bathing, dressing, and walking. That option is a nursing home.

Some counties have programs, such as In Home Supportive Services, which will provide limited home care services through paid caregivers or sometimes through a relative. The care provided can enable a low income elder to remain at home rather than go into a nursing home.  However, with the severe budget cuts going on in most states and provinces, these kinds of programs are either being cut back severely, or eliminated entirely.

If mom/dad needs help only with bathing, dressing, eating or meal preparation, walking, getting out of the chair or bed, or using the bathroom, Medical Aide will not cover care in a nursing home.  Help with this so called “custodial care” is not a covered service under Medical Aide, or other health insurance. (Long term care insurance is the only exception).

Ask your parent what he or she wants for the long run.

“I want to stay at home as long as possible” may be in direct conflict with “I want to leave my assets to you kids and grandkids”.  Some people simply do not have sufficient assets to do both, should they live long enough to need care.

Figure out the cost of caregiving at home.

There are many services that enable an older person to remain at home with additional care and services such as meals-on-wheels, adult day services, and home modifications. You will want to understand all the options in your community and calculate the costs.

Compare the cost of home care services with your parent’s income and assets.  If there is no way their assets can match what they will need at home, and no other resources are available from you, or anyone else, by all means get legal advice about qualification for Medical aide.  However, if they can take care of themselves with what they own, put their needs first and “your inheritance” second.  Sorry, it’s their money.  They deserve to stay at home with services if they want to.

Be realistic about expectations concerning inheritance.

Any competent estate attorney will advise adult children that no one is “entitled” to an inheritance.  An aging parent can do whatever he or she wishes with assets.  When parents lose competence and need daily supervision or have physical decline and need paid caregiving, they can burn through their assets rapidly.  If your parents don’t have long term care insurance, they are likely to be paying out of pocket for the care they may need with advanced age. If that care lasts long enough, there may be nothing left when they pass.

As a person who makes a living giving advice and caring for seniors, I learn a lot from my clients.  One thing I have learned based on not only my own experience but also on research is that our parents are likely to want to stay in their own homes.  Most are happier if care can be brought to them, rather than expecting them to go to where the care is delivered in a facility. With that in mind, I hope you’ll carefully rethink any advice about relying on government benefits for your aging parent.  Considering how to provide the best quality of life for them as they age needs to be the priority.  Caring can take many forms.  Helping parents plan ahead is one way to show you care.

Look down the road. Learn from what your parents did or didn’t do to plan for this phase of life.  One day, it will be you and I.

Please contact us today, to discuss any challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at