Providing care for an ageing parent or loved one can be a rewarding experience. However, it is also considered one of the most physically, mentally and emotionally stressful times an adult child will face. This isn’t only because of the intense demands placed on the caregiver, but also due to potential conflict amongst family members. The conflict isn’t just contained to who does what for mom or dad.
Among other things, financial matters are one of the main sources of conflict among family caregivers. This is especially so when siblings or other family members disagree on how funds are spent or if one or more caregivers are helping to support mom or dad. Who is in charge of the money decisions? Should mom/dad stop handling the investments? Is the ageing parent showing signs of cognitive impairment? How bad is the condition and how do you know? Is one family member doing all the hard work?
Pertinent questions such as these can sneak up on adult children and the ageing parent, wreaking havoc on family relationships if distinct instructions aren’t discussed and answers are left vague. Combined with the fact that the caregiver may have to reduce working hours or leave their job entirely to care for a parent, resentment and animosity may surface.
If the situation isn’t handled delicately, the result can be explosive. Ugly accusations fly back and forth, someone brings in a lawyer and the conflict escalates.
Hence, before things get to this stage, you should have conversations with all parties in the family about how the ageing parent wants their needs met during their later years – especially if you’re getting along in years and still able to make decisions. Doing so would make the caregiving experience easier in later years and bring the family closer.
While you probably won’t cover all the important topics in one conversation, it’s a good idea to have a plan. At the very least, make sure you cover these two areas: understand your parents’ financial situation and lay the groundwork for advance care planning.
Talking With Parents About Finances
Money is often a sensitive issue. Many people don’t talk about their finances, even with family members. As such, communicating with your parents about the subject may feel awkward or like you’re overstepping a boundary in their personal lives. Some are concern that they might upset their parents by talking about issues related to their possible incapacity or death.
On the other hand, many adult children aren’t aware about their parents’ financial situation. They don’t know if their parents have sufficient money to live on, what type of care or medical treatment they want, whether they can financially afford the care they want, or even what they would want in the event they became incapacitated and unable to make decisions for themselves.
However, it is never too early to have such discussions with them. Most families don’t talk about these important matters until a major crisis occurs. Then more often than not, important health and financial decisions are made under great emotional distress and without the time to find and consider all the alternatives.
Consider these questions to start off your discussion:
- Are your parents living on a pension or fixed income that requires a strict budget?
- Do your parents have enough money to cover their future medical expenses?
- If there is a medical emergency, do you know who are your parents’ doctor and how to contact them?
- Have your parents designated someone to make financial decisions for them if they’re incapacitated?
- Do your parents have preferences on medical treatment or long-term care options that you should know?
- What is your parents’ opinion on assisted living?
- Have they designated a power of attorney? If so, where are the documents kept?
- Where do they keep important personal documents, such as their identification cards, birth and marriage certificates?
- Where do your parents keep their life, medical, and property insurance policies?
- Have they made a list of their savings and investment accounts? What are the names, addresses, and phone numbers of the financial institutions that hold these accounts?
- Who are their financial advisors and what are their contact information?
- Do each of your parents have a will? If so, where are they located?
* Source: “The changing needs of your aging parents: Have you talked to mom and dad lately?”, Timmermann, S. 2001.
The list is non-exhaustive, but it will help you narrow down the relevant topics you need to cover and guide you in the right direction.
The Benefits Of Advance Care Planning
You may have heard of Advance Care Planning (also known as ACP) and pays to have one. Planning how you receive care ahead of time is important for not only your peace of mind – for yourself, as well as your parents – it also helps to save money and lead you to more options and better choices in healthcare, housing and legal matters. It also helps to reduce family conflicts and ease the emotional distress.
The sooner your family begin planning for care, the more options they have available. For example, while many Malaysians would choose to stay in their homes for as long as possible – aided by home care services when needed – when given enough time to plan and compare different senior living arrangements, your parents might choose to move into a retirement community as they develop more definitively in Malaysia.
Some may prefer it over other options because they can stay in the neighbourhood near like-minded peers and be assured of the availability of continuum care. The facilities may also offer amenities -such as a fitness centre or transportation to planned social activities and shopping sites – that are important to your parents.
However, if your parents’ condition requires a high level of care, it could eliminate this alternative altogether. In such circumstances, such as limited mobility, they might have to choose another, less desirable living arrangement. Planning for these situations is especially pertinent as decisions are more difficult if your parents haven’t considered the options.
While talking about these issues – while they’re still healthy with time to plan and make choices – is discomforting, bear in mind that its much less so than the distress caused by failure to plan and decision-making during a crisis. You may not be successful in getting your parents to do some advance care planning, but the risks of not even having that conversation can be devastating.
Conclusion – The Pros and Cons
Unlike writing a will, penning down an Advance Care Plan document is not legally binding in Malaysia. The parties involved – such as doctors, healthcare professionals, and family members – are under no obligation to follow the directives listed and can ignore them in favour of options or treatments that healthcare professionals may deem more suitable.
However, having an ACP document that clarifies your preferences in a confusing and emotionally charged situation would give you or your parents a higher probability of receiving the care you wish for.
It also helps reduce ‘silence or violence’ responses – where family members either clam up when they get angry and shut off communication, or they get aggressive, accusatory and begin shouting and name calling, which also shuts off communication – and restore peace within the family.
If you need help with making an Advance Care Plan, do your research to find a trained and experienced Care Administrator. You can seek their services from Managedcare’s one stop care platform or visit www.managedcare.com.my for more information.
In the aftermath of medical emergencies, the matters is that a family pulls through the experience together for the better.
First Published: Smart Investor, November 2017
Written By: Aged Care Group