Phil Moeller: Intergenerational caregiving: 10 topics to guide an important conversation
Written by Phil Moeller, UnitedHealthcare contributor, Medicare and Retirement expert
If you’re getting together with family and friends over the holidays, I’d like to gently encourage you to include some time for a cross-generational caregiving discussion. This probably does not make your normal holiday to-do list, I know. But there are important things that adult children and their aging parents and other loved ones need to say to each other, which might be best said face-to-face.
Before doing so, it’s essential for older parents to realize that their kids and other younger relatives are, well, not kids anymore, but grownups who have learned a lot. And kids need to confront the fact that their parents are not ageless and likely will need more help from them with each passing year.
As the insightful people at the Conversation Project1 have documented repeatedly, there are crucial caregiving and, especially, end-of-life issues that everyone needs to address. The message boils down to: “You’ve got to talk to each other, people!” Yet sadly, many of these conversations never happen. And as those involved will testify, no regrets are as hard to bear as the ones that can’t be corrected.
Waiting to have these more serious discussions may have other costs, too. As people hit their later years, their cognitive skills may often be impaired due to a number of factors. So, as I say in my Medicare book,2 it’s essential to use your marbles while you still have some.
10 things older adults may want to discuss with their adult children (and other family members) on caregiving and end-of-life planning
1. End of Life documents
Adult children and other caregivers should have access to:
- Their parents’ wills
- Living wills
- Physician orders for life-sustaining treatment (POLSTs)
- Any related end-of-life documents
What should you do if you don’t know what these documents are and, especially, how they are governed by state laws where your parents live? The National Academy of Elder Law Attorneys is a good place to start.3
2. Health care proxy
One or more caregivers should be designated as a medical decision-maker by their parents or other older relatives, and this should ideally happen before a parent requires help.
When that happens, a child should be prepared to step up and provide informed support for the care their parent needs from doctors, hospitals and other medical personnel. If the parent’s spouse or partner is still alive, they will need decision-making support from a child so that they can focus their energy on providing the kind of loving support their partner needs.
3. Age-friendly living needs
As parents age, their homes may change from being castles to prisons, and dangerous ones at that — full of steps, dark hallways plus uneven and slippery surfaces that can cause devastating falls.
Ask yourself these questions when it comes to assessing an older adult’s living situation:
- How age-friendly is your parents’ home? Their surrounding neighborhood and community?
- Are their driving skills suspect? Do they know how to use ride-sharing services?
- What about downsizing into an apartment or senior living facility or continuing care community?
- Who’s going to scout out these places, figure out what they cost and decide if they are affordable? The help of adult children is crucial here.
4. Relief for caregivers
Who is going to help the caregivers? Often, one daughter (overwhelmingly, primary caregivers are women)4 takes on the heaviest load for looking after one or both aging parents. This can lead to sibling bitterness, especially if the other children don’t step up and periodically provide help – both physical and financial.
5. Financial planning and budgeting
Two-thirds of older Americans fear outliving their money more than they fear death itself.5 One of the best gifts to give an older parent can be helping to build a life-long financial plan and accompanying household budget that will provide peace of mind and a pathway to having enough money in their later years. This is easier said than done, as many parents are reluctant to share this information, and many adult children don’t know where to start. Bringing in a financial professional can help on both fronts.
6. Access to bank and investment accounts
This may be a very sensitive topic, but if parents trust their kids, they should consider providing them online access to their bank and investment accounts.
7. How to crack the nest egg
A cardinal financial planning rule is that retirees should not threaten their own financial futures by providing too much money to their children. While that is a fine and dandy thought, for many of us it flies in the face of human nature.
Half of all parents provide financial support to their adult children, to the tune of nearly $18,000 a year, on average.6 And an even higher percentage of grandparents provide an estimated $238 billion a year to their grandchildren.7 There is no right answer here but there is a right way to get to the answer that makes sense for your family: Talk about it!
8. Social Security and Medicare needs
I decided to write books about both topics because they are cornerstones for successful aging. For Social Security, informed decisions are crucial for deciding when to take your own benefits, how spousal benefits work, and the best strategies for maximizing survivor benefits when one spouse dies.
Medicare decisions are getting more complicated every year. The opportunity to make the right (or wrong) coverage decisions presents itself during Medicare annual enrollment period, which begins every year on Oct. 15 and extends through Dec. 7.
9. Digital communications
Smartphones, digital assistants, and other wireless devices are everywhere. It’s important that family members and friends know how to reach you reliably and quickly, and vice versa.
10. Build a buddy system
Many older adults have no children or none in a position to help. Friends can step up to help, but only if they know help is needed. As with other conversation topics, you need to tell them.
By way of full disclosure, my own efforts to bring these things up with my children, ages 41 and 44, have been met with limited success to date. But I will keep trying, aided by the passage of time that is bringing me inexorably toward old age and beyond.
Visit UnitedHealthcare’s Caregiver Resources library for more information.
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Author bio
Philip Moeller is the principal author of the Get What’s Yours series of books about Social Security, Medicare, and health care. Read his Substack newsletter and connect with him on LinkedIn.