Ask someone who has been there, and they’ll tell you that caring for an aging parent in decline is one of the hardest things they’ll ever have to do. In this eye-opening article in US News, a son describes the incredible challenges he faced as he assumed control over his mother’s affairs during her severe mental decline. What makes this story especially compelling is that this man had actually done his homework and was also extremely tech-savvy. Yet even with good pre-planning, he wasn’t prepared for the obstacles he would face along the way.
“There’s No Playbook” for Assuming a Parent’s Affairs
The US News article was written by reporter Lisa Esposito. She writes, “When his mother could no longer fend for herself, William Pabst learned there’s no playbook for assuming a parent’s medical, financial and legal affairs if their mental capacity quickly deteriorates. And when his mother passed away in the fall of 2020, difficulties and frustrations continued.”
Pabst, who lives in Virginia, has extensive online experience, and he and his mother already had some key documents in place, but it wasn’t enough. “Having power of attorney makes it possible to assume a parent’s financial responsibilities – but not necessarily easy,” Esposito recounts. Instead, Pabst encountered an array of institutional barriers, company procedures, and online security measures that complicated the process repeatedly. “The effort to sort it all out drains more time and effort than adult children could ever expect,” says the article.
Good Institutional Care and a Supportive Partner
According to US News, Pabst’s mother struggled with a progressive, degenerative neurological condition that affected her body and mind. This left Pabst, an only child, as point man to assist his mother and meet her needs, something he “jumped in” and did willingly. As the article recounts, he “was there each step of the way as his mother’s situation followed a continually changing trajectory.”
Fortunately, the mother was getting good care as her condition worsened. “She went from living independently in her home, to repeated hospitalizations related to her degenerative condition, and then a stay at a skilled inpatient rehabilitation facility,” Esposito writes. In the rehab facility she received physical and occupational therapy, and staff also managed Pabst’s mother’s medications. For a brief time, she stayed with Pabst and his girlfriend, who was supportive of providing care for the mother and who had experienced something similar in her own family. In spite of their willing attitude, however, Pabst and his partner called his mom’s brief stay in their home “an eye-opener.”
“It was incredibly disruptive,” Pabst told US News, “and we could tell we were out of our depths.” Unable to provide adequate care and fearing for his mom’s safety, he was able to move her to an assisted living facility which afforded a period of adjustment and stability. Things seemed to be going better. But then came COVID-19 and the facility went into a complete isolating lockdown. The effects were devastating.
“Staying confined to her apartment for months with nowhere to go, with nothing to do, not allowed to see anybody, friends, family or otherwise – it just crushed her,” Pabst told Esposito. “The change in lifestyle forced on people was very deleterious.” That was the situation at the time his mother died.
Power of Attorney Doesn’t Solve All Problems
According to the article, during the entire time of his mother’s decline, “Pabst was doing his best to oversee his mother’s care, get a handle on her accounts, [and] pay her bills.” He was also engaged in selling her home to help finance her care. Fortunately, his boss was supportive of the situation and understood how distracting it was for Pabst to have to wrestle with his mother’s affairs. During this period, Pabst called his job “the only stable thing in my life.”
As US News reports, Pabst had a power-of-attorney document in place. His tech career also gave him solid insight into the security requirements built into online accounts. “Even so,” the article reports, “he found tremendous challenges in accessing his mother’s accounts to manage her affairs as needed, and he certainly wasn’t prepared for the scope of paperwork required.”
The power of attorney alone wasn’t enough. “Just because you have this piece of paper in hand doesn’t change anything in reality,” Pabst told US News. He explained that each financial institution has its own additional processes in place to make him prove to their satisfaction that he had the legal standing to control his mother’s assets and make decisions on her behalf.
Professional Help is Essential
One key piece of advice from the US News report is that adult kids assuming control over a parent’s affairs should never try to go it alone. “Professional help was a godsend,” says the article. “Working with an attorney and financial planner made a big difference for Pabst. Had he known that ahead of time, he says, ‘I would already have had them on board.’”
Pabst’s advice to others sounds exactly like something Rajiv Nagaich of AgingOptions would say – and, in fact, he often does. “The time for building any of these structures – the will, power of attorney, the financial planning – is before you need it,” Pabst says. “Because once that ball starts rolling, it can accelerate faster than you think it will.”
The Time to Talk with Aging Parents is Now
Elder law attorneys frequently encounter clients trying to pick up the pieces of their parent’s affairs after dementia has progressed, only to find that by then it’s too late. “The best time to talk to your parent about sharing information on health decisions, financial affairs and even logistics like account passwords is well before urgent situations arise,” says US News. As Sara Czaja, New York expert on aging and behavioral research, told Esposito, “In an optimal, ideal world, it’s when the parent is approaching their later years, is still healthy and able to communicate about these issues and there can be a meaningful discussion.”
So, why do so many families put off these essential conversations until things become critical? “The reason people don’t speak about these issues before an urgent situation occurs is that it’s not a pleasant topic to talk about,” Czaja states. “You don’t want to think about someone being ill, or injured or out of your life.” Because these are highly sensitive topics for both parties, avoidance becomes the easy way out.
Czaja offers suggestions on how to approach these delicate topics of dependence and incapacity without making parents or adult kids defensive. Be transparent and honest, she says, and use terms that are positive and nonthreatening. For example, an adult child might say to a parent, “You’ve accomplished a lot in your life. You have these things that are a part of you. Do you have preferences as to what you would want to happen to those things should you no longer be here, or not be able to state those preferences?”
Legal Documents Also Require Advance Planning
Elder care and estate planning attorneys can help families manage all these issues, says Esposito, but you need to involve parents while they’re still well, before they lose the capacity. At AgingOptions, we often advise families to schedule a family conference so all the adult children and surviving parents know what the family has planned for the future. Attorneys can prepare a financial durable power of attorney so everyone understands who will manage an ailing parent’s financial affairs. Other important documents such as wills, living trusts, and advanced medical directives also need to be created or updated.
“Having estate documents prepared is infinitely preferable to waiting until a parent develops dementia (or comes down with a severe medical condition like advanced COVID-19 or suffers a life-altering accident),” writes US News. “When parents develop dementia, family members can face an unfortunate surprise in terms of their legal rights.”
For her article, Esposito spoke to Maryland elder law attorney Lena Clark, who has had potential clients some in after a parent has developed dementia and ask for “a power of attorney or a medical directive, just really something quick, very simple.” But that’s not how the system works. “If the person has dementia, it’s too late,” Clark warns. “People don’t understand – they’re kind of in denial about how expensive it is and how complicated it’s going to be to get [themselves] appointed as guardian. Because it goes through the court at that point.”
Not One and Done: Review Docs to Keep Them Current
The US News article suggests that outdated legal documents are often inadequate, and it’s important to keep documents updated. Attorney Clark says, “we typically recommend once you have the documents in place, review them annually on your own.” She suggests seeing an estate planning attorney every three to five years to make sure documents – like powers of attorney – are still current with any new laws.
Online access to accounts is also a potential minefield of problems, says US News. There’s a federal law called the Fiduciary Access to Digital Assets Act which governs “access for executors and family members to email and website accounts, and other electronically stored assets upon a person’s incapacity or death in most U.S. states.” (Here’s a link to the related law in Washington State.) Once again, family communication – before a crisis arises – is absolutely vital.
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(originally reported at https://health.usnews.com)