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41 year old only child taking care of her mother with cancer. Mother in SNF and my father, while sick, is still able to live at home. After seeing the drama of their own healthcare events, I would like to try and plan my own future better.


Any advice?


My parents say they are sorry they did not do any advance planning for their futures like they should have.


When should I look into LTC insurance or try to protect whatever assets I may have in the future? I am not being greedy but do not want to give everything I own to a nursing home for myself that may be quite stinky.

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First thing to get into your head is to plan on downsizing when the time comes, if that is applicable for you. In other words, don't plan on living in a large multi-story home by yourself. I'm amazed how elderly think they can 'age in place' in a residence that is actually a hazard to their health and well-being, not to mention eats up funds just to maintain a property that they really can't keep maintained or repaired if needed, or refuse to spend the money to do so.

Setting up a Trust is also something to look into in order to protect your assets. LTC insurance is probably something to look into - you're rather young and you might decide to hold off for a few more years unless your health is not great.

I plan on hiring a housekeeper (not live-in) soon that can stay with us for years . My MIL had one and helped immensely with her day to day life before moving into AL. Son(husband) and I were traveling quite a bit and we would send emails and pics of our adventures. She enjoyed that so much, she saved every single email story, that I now have a stack of memories on paper because of her. :) She planned everything for her old age and bad health - and did a great job doing it. She was happy, and so were we! I took care of all her book-keeping when in town, and my husband would help with other issues regarding trust assets. We did not do ANY caregiving. NADA. Thank goodness! She didn't want that burden placed on the rest of the family. She knew it was HER responsibility to take care of her own personal self. I was blessed to have the greatest MIL in the world!

Just my perspective on the 'future of aging'.
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Good for you for asking this question!

However, planning for elderhood involves more than just finances, bookkeeping, paperwork and bad physical health.

Someone trustworthy, responsible, local and younger than you (by at least 15 yrs preferably) needs to have your Durable Power of Attorney so they can manage your care when you can no longer help yourself (or you become uncooperative). Right now you can have someone about your own age but as you reach 60 it should really be someone younger than you.

Most planners make the mistake of planning for best-case scenarios. If you think bad physical health is a worst case scenario, you need to understand cognitive decline. Just read the thousands of posts on this site. This is what I consider a worst-case scenario. For example: dementia sneaks up on people. There is no visible line that gets crossed. You may be humming along in your retirement when you gradually slide into some cognitive issues and become a hoarder and your home is no longer safe but you refuse to leave it. Or become unpleasant, paranoid and uncooperative. Or you become a dangerous driver and won't see it or give it up. Or, as was the case with my MIL, you have short-term memory loss that you don't recognize and don't even realize you haven't remembered to eat for days and pass out in public. You will need to execute your move to a full-spectrum of care facility BEFORE you think you "need" to. When you "need" it may be too late. At that point you may not be able to make your own decisions anymore.

I realize this sounds awful. Obviously not every senior develops dementia or AZ but seniors often are averse to change and get irrationally stubborn and less able to judge situations correctly. You are too young right now, but in about 15-20 years start looking at senior communities that provide the entire spectrum of care (from independent living to hospice) AND accepts Medicaid (if that's still a thing in the future).

I'm part of the boomers generation (60). Right now senior communities and facilities are being built fast and furious because there is a shortage. However, after the boomers will be a population bust. I'm hoping for your generation that this will mean a glut of housing options and lower prices. It will also mean aging facilities.

I'm no expert on LTC insurance but you need to buy it before you reach age 59. I chose not to get it. I've heard today's policies hardly cover anything, so make sure you really study what you will get before buying insurance. Not enough people are buying it and the costs just keep rising so policies offer less and less.

I realize that healthcare laws may be very different in the future but loading up an HSA (if you have one) is often better than a 401k. An HSA is tax-free going in and coming out. Not so with a 401k. This is what I'm doing.

If digital passwords are still a thing 30 years from now you need to have a way for your DPoA to know how to access them. My sons are our PoAs and I gave them the master password. I'm not recommending this for you, but we don't have any other good options. I use 1Password and can't image life without it.

Make sure your PoA knows where you keep any important things like keys to a fireproof safe (for physical valuables like jewelry, coins, etc).

Then just review your DPoA every few years to make sure you still want the designated person(s). You should also have a Medical Directive and give a HIPAA release to anyone who has your medical PoA. Surround yourself with wise people who you love and trust and are local to you. Everyone needs a friend and helping hand and its better if they are near you. Every once and a while review your financial plan with a specialized elder estate planner / attorney. The Medicaid "loopback" is 5 years, so if you want to leave your home or other assets to a LO, you will need to know if it is protectable.

Other than all that, planning for your elderhood is a piece of cake (wink wink)!
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Really? Because my brother is in assisted living and has close to enough money to never have to worry about the life span he has even if he has to go into memory care. He was a waiter. He saved all his life to earn this (Real estate going up and up over his 85 years helped a whole lot). He is thrilled he has it. I am thrilled he has it. I do not want his money. I want it to go to his care.
So my advice is save like mad. And be only too happy to give it in exchange for your good care.
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Who do you expect to pay for your care if you don’t use your own assets?
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Great advice from CapnREY about downsizing and a living trust.

I'm going through this myself. I'm childfree, divorced, went no-contact with my twisted sisters, and moved in three months ago to my first sole home ownership after I sold my joint business/home with my ex-husband. (Life is good!) My ex is my health care POC, and POA and HIPAA access. Recently it became painfully clear I cannot depend on him in an emergency.

I've been extremely concerned about asking my trusted neighbors if I got hurt, or dementia hit, or if I died if they would act as my agent. That's a huge request. Two weeks ago I asked my bank's trust department (it's already my Successor Trustee) if they also performed as health care agent, estate management if I became mentally or physically incompetent, and executorship. YES! (The cost to me is 1.2% a year of my estate for taking care of my business because of mental/physical incompetence, and a flat 2% to settle my estate after I die).

The weight off me is enormous. All I need to do is ask a neighbor to be a go-between and report to the bank rep if she/he heard I was in the hospital in real bad shape or if I'm getting mentally incompetent, then the bank will step in.

For me, I'm going to skip long-term care insurance. I have snooped--only a bit to be honest--and there seems to be a lot of "exceptions" in what the insurance will cover. There's no guarantee that what I may eventually require (AL, skilled nursing home, et al) the insurance will cover.

Dixie, it's great you're thinking of this now. Ensure you have:
- An advanced medical directive (living will) and that it states everything you want or don't want, and make sure your doc and hospital has a copy
- A HIPAA release form with people you want to be able to speak with medical personnel about you, and make sure your doc and hospital has a copy
- A Durable Power of Attorney for Health Care so someone can act for you with the docs and hospitals in case you can't
- A Durable Power of Attorney so someone can act on your behalf about non-medical items
- Your Will and Personal Property Memo are current

If you have a job, make sure Social Security payments are included to build up retirement benefits.

Good luck, Dixie!
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Great comments above, especially from MountainMoose.

All that I have to add is the following: take care of your own health to the extent possible. Tell your health care providers about the family history of cancer. Start to exercise and develop good eating habits, if you're not doing so already. Make and keep friends. Be kind to yourself.
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Look into Long Term Care insurance . Yes it is expensive but so is getting old and having to get caregivers in to help out.
Have a plan..at what point will you (if you have no other option) move into Independent Living facility then to Assisted Living then Memory Care if that is necessary.
And as a prelude to that get rid of STUFF! That dresser that has been in the family..no one really wants it, sell it. The china set, silver, sell it. Use the money to 1. pay for that long term care insurance or..
2. Take a trip do something you have wanted to do.
Make sure everyone knows what your wishes are. There is a helpful pamphlet, more like a booklet called % Wishes and it goes into detail about many things that you can and should do to plan for the future.
Do you have advance directives? POLST? POA for Health, for Finances?
Do you have a Will? Do you need to set up trusts for anyone?
Might add seeing an Elder Law Attorney to your list of "to do's"
The answer to your question as to when you should do all this.
The answer is NOW.
The longer you wait the more expensive Long Term Care insurance becomes. Make sure it is a plan that will convert to something like a Life insurance that will pay beneficiaries just in case you never need Long Term Care. (as I put it to the person that I talked to..if I am mailing my check for the premium and a car hits me while I am at the mail box I don't want all the money I have paid in to vanish.)
As for now..Take care of your health. Have a good outlook on life. Volunteer if you can. Make friends, keep friends. If there are people that drag you down they are not friends and have no place taking up space in your life.
I just won a frame with this saying on it, and I agree completely...
Begin each day with a grateful heart. (that and it came with a $25.00 Panera gift card so win-win!)
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Amen to the above advice to take care of your health. Health is wealth. Keep your weight down. Obese people cannot easily move around and it just takes one injury or illness to make it impossible to function at a higher weight. Frankly, from what I'm seeing all around me, stay as slim as you can.
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Riverdale Dec 2019
My mother is overweight which saddens me greatly. She is 89 and has so many health issues. She had been her worst enemy for years. She was a Christian Scientist so she avoided medical care. Now medicine is keeping her alive. Her weight obviously creates mobility issues. She is in AL. I dread the thought of her ever being in a NH because I can't imagine how she would manage with her weight. Before entering AL she was hospitalized and lost a decent amount of weight only to put it all back on. It caused me to go through a period of serious depression. I lost weight as I literally could not eat. That time has passed and now I basically have given up seriously caring. Whenever she gets sick as she is now with a UTI she says she cannot eat and I secretly rejoice. What makes this all so much harder to understand is that for many years she was a very serious dancer in beautiful shape. Oh well. Your comment on weight made me relay all this.
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I would definitely get LTC insurance. My mom had it and she was able to stay at home longer. It paid almost $2K/mo. of her care, and with her $4K/mo. retirement, and $800/mo. annuities, she was able to get 12 hr./day care from a licensed agency and stay at home. Now she is in memory care and the LTC insurance still pays about $2K/mo., and it will for the rest of her life.
Dave Ramsey recommends getting LTC insurance at 60 yrs. of age.
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Geaton777 Aug 2019
I think the age cut-off age is actually 59? Also one needs to make sure they know exactly what the insurance will cover, as I've read where some were shocked to find their policies covered almost nothing. If a person purchased insurance more than a decade or more ago, their coverage was probably more robust. I think ins. companies are losing their shorts nowadays because the cost of care variable keeps going up. Hope you find a good policy!
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Lots of folks on this thread seem to be recommending LTC insurance. That is pretty dated advice — very few reputable insurers even offer it any more, and those that do, charge absolutely astronomical premiums for very limited policies. Remember that insurance is a for-profit business.
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Save, save and save as much as you can! Live under your means. Eat well, get enough rest, enjoy relationships, experiences, not material things. Be happy with what you have instead of what you don’t have. Don’t stress. Stress kills. Contribute time to causes that are meaningful. The rewards are priceless. Exercise for your body and mind. Nourish your soul. Take care of yourself.
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Work on your career, pay yourself first, take advantage of any company benefits such as 401K, learn how to invest your money...stay away from saving accounts and other options that pay next to nothing...finally live within your means.
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