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Parental Care

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  • Parental Care

    So my parents are in their advancing years, as are my in-laws, and I wanted to get some advice regarding parental care in this stage.  My wife and I are completely on board with having any of them move in with us.  Our motivations are not the least bit financial yet there are financial implications and strategies to potentially employ.  We haven't bought our "forever home" yet, and I suspect each will handle their own living situations until the other spouse passes away.  So the questions/issues I see here:

    1.  Living arrangements.  I see a separate living area (guest house, apartment above garage, etc.) as the most ideal because it allows for other uses (rental, AirBnB) until one of them moves in (or on a continued basis if they don't) and privacy.  Issues I see.  Who gets to live there - which side of the family?  How much space to have?  Do you make it handicapped accessible or wait to do this?  Do you engage in a rental situation with them?

    2.  Long term care insurance.  I don't know a lot about this topic and the options available.  I imagine the ideal in a live-in situation with us would be to pay for a policy that covers the extremes of medical expenses beyond what they could reasonably afford with retirement draw-down.  Do those policies exist?  Issues I see.  Who does the care if any is needed?  Planning on possible part time work for spouse, theoretically having the situation becoming a financial and time burden, etc.

    Has anyone tackled this and have advice?  Appreciate the help.

  • #2
    my parents didn't want to live with us.  are you sure yours do?

    we have a full mother in law suite for just in case.   separate entrance in garage, bathroom, kitchen, bedroom in basement.  it is conceivable that we might have my mother some day, as dad passed a little while back, but she prefers to live where they did as long as she can.  if my mother in law passes first, father in law is definitely coming to live with us as other daughter doesn't get along with him.

    re:long term care insurance.   we had it for dad, and he passed without ever using it.  mom decided not to have it consequently.  she has enough income, that she can cash flow it.  currently about 10k per month while we were researching.  people typically don't live that long so the name long term is a misnomer.  care can be provided by visiting nurses or spent on nursing home.  every few years, the companies scale back the coverage.  getting to that point is a terrible thing.  good for you guys to be willing to invite your parents.

    will be watching for other responses.



    • #3
      Thanks for the response.  I considered your question and should have included it in the original post.  I think they would strongly consider it, especially as the burdens on taking care of a big house take their toll and their desire to be with kids/grandkids dominates.  Can't ever know how they'll react, but it's a nice thing to have available and can be used for other things to help offset the mortgage in the meantime.


      • #4
        Having both set of parents in the same house as you and your wife may not work quite as well as you expect, unless they get along quite well and have separate living quarters in the house. My wife's parents don't go and stay with their other daughter when they come here, since her in-law resides with them. They visit her only if the in-law is out of town on vacation.

        As they age parents become set in their ways and sometimes small things they do might irritate you or your wife. Resist the temptation to make a comment. Also they will be unable to climb stairs at some point so separate entrances to basement living area ( if it exists) or an elevator would be needed, usually sooner than you expect.


        • #5
          The inability to climb stairs is a big deal.  If you build a house the living quarters need no stairs for your parents.

          My father died at 92.  My mother had died at 64.  He continued to live in the family home for many years.  He developed macular degeneration in both eyes but he wanted to stay in his familiar place.  When his type 2 diabetes started requiring insulin he decided on assisted living.  It was his decision.  I helped him by finding the place and arranging for it.  He lived there for 6 months before deciding to sell his house.  I think it is important to let your parents make their own decisions and you help them if they ask.

          LTC insurance is best to self insure in my opinion.  I have looked at this and the market is very unstable.  This another reason to build up a nest egg yourself. You really do not want an insurance company dictating the type of care you have in your senior years.


          • #6
            This article, The Sobering Realities of Paying for Long-Term Care, makes some excellent points. We rarely recommend LTC policies, although we used to. @hatton1 is correct, the market is very unstable and shifting demographics don't bode well for the future. I have heard too many stories of people who have paid for LTCI for many years, only to find that it didn't cover their needs as they had planned. If possible, self-insure. Of course, as all of you know, one of the fastest-growing reasons to have to turn to nursing home facilities is for Alzheimer's care. I don't think you can self-insure for that (will be happy if someone can correct me on that), but you can make financial preparations if it runs in your gene pool (or just plan to go the Medicaid route).

            We have found that a very popular topic for physician clients is not just caring for children but caring for parents. It has been eye-opening. If you and/or your spouse have siblings, I'd suggest that you call a planning meeting with them and get the topic out in the open. Otherwise, the burden seems to typically fall on the oldest, the nearest, or the person who raises their hand first. Even siblings who don't earn "doctor pay" can volunteer to help by taking in parents for a week or so a year or come to stay and allow the caregiver a break, even if they are in nursing homes.

            I also realize that this is a cultural issue in many physician households and there may be no choice as to who cares for the parents. In those situations, it's very important to have sibling support for emotional needs of the caregivers and/or to have an outside caregiver who your parents are comfortable with and who can relieve you periodically.
            Our passion is protecting clients and others from predatory and ignorant advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087


            • #7
              Good advice all around.  Regarding the living arrangements, we may not have the ability (given the home we buy) to have a no-stairs situation.  In that case, it might be reasonable to wait to install some kind of stair lift for some above-garage situation, similar to what Mrs. Deagle had in Gremlins (without the accelerated modifications of course).  I like the idea of having a group meeting about this and simply putting it on the table for our parents to decide.  They're stubborn, but sometimes it just gets hard to function with advancing age, not to mention lonely when the partner passes away.  Interesting niche topic worth reading about some more.  Thanks all!


              • #8
                One thing to consider is that your parents may be able to live with you in their declining years if all they (and you) are dealing with is general physical frailty and inability to drive a car.  But if they develop dementia, that's an entirely different scenario.  Eventually a patient with dementia cannot be kept safe in an ordinary residential house, and needs a memory care unit.  You can't really "baby-proof" a house when the "baby" in question is 6' tall and weighs 150 lbs!


                • #9
                  This is a hard problem.  I agree with some of the others that it is a good idea to figure out what the parents really want.  My parents moved into an excellent assisted living facility.  It has a loose association with my father's college, and he is able to audit courses there.  Many of the other residents are also connected with the school (alums, teachers, used to work at the hospital, etc) which facilitates social interactions among the residents.  It was a great move and they have made a lot of friends there.  There is an on-site memory unit, a nursing home, and an on-staff geriatrician.  For us and for the parents this is so much better than having them live with us.  There are a lot of these facilities around - I imagine some are less appealing than others!  My parents looked at a number of options once driving became difficult, and I am so glad that they chose this route.


                  • #10
                    My in-laws would not want to move in with us and, quite frankly neither my wife nor I would want them to. My parents live with us and are very happy. They are poor and we help support them. We bought a big home (7000 sq ft) so they have their own apartment with full kitchen and entertaining area in a walk-out basement. We just updated their space and put in a master bathroom fully wheelchair accessible. If they lose mobility we will install a lift for the stairs to get to their apartment. If they need help, we will hire in-home help. Culturally I was raised to have your parents live with you and end their life in the house. The relationship developed with the grandchildren this way is priceless and I hope our children will treat me and their mother the same way. A nice side benefit is free unlimited 24/7 child and pet care, help with cleaning and cooking, free landscaping and errand runs. My wife gets along with them but wants her privacy and space. I would not have it any other way but it is certainly a process for my wife who was not raised this way. I was very upfront with her when we first met about the fact I wanted my parents to live with me and she accepted it. It would be very hard to impose it later on.