Interview with Author Carroll Golden on: How Not to Pull Your Life Apart: Caregiving

By Emma Peters

Today, we interviewed Carroll Golden about her most recent book: How Not to Pull Your Life Apart: Caregiving. budget. You’ve dotted every I and crossed every T… or have you?

Carroll S. Golden’s three simple steps kickstart critical conversations. They offer a path of discovery. In the following interview, we ask the author about the best ways to uncover a financially stable plan for you, your family, the people you love, and clients that are more likely than not going to deal with these issues at some point in their lives.

CBM: What was your motivation to write this book and your selection of this title: How Not to Pull Your Family Apart?

Carroll: “Growing up, I witnessed firsthand the importance of financial planning—my mother handled all aspects of long-term care with grace and efficiency. However, when I married into a different family, I experienced the opposite. Disputes over financial matters led to deep divisions, and the conflict between my husband and his brother persists to this day. This painful experience opened my eyes to the need for a better approach. It inspired me to write my first book, How Not to Tear Your Family Apart, with a focus on equipping financial planners to prevent these situations by guiding families toward more collaborative, informed decisions.”

CBM: Many people will have personal experiences with family and the need for LTCi to address the cost of care. Tell us about the current numbers of people who will need LTC.

Carroll: “In the industry, we refer to this as ‘Peak 65,’ marking the time when a staggering 11,200 people turn 65 every day. This raises an important question: is our government or personal financial systems prepared for this wave of aging baby boomers? Many of them may not have the funds to cover the costs. According to Genworth, the national average for nursing home care in 2023 is $100,000 per year. Between 2021 and 2023, the cost of assisted living increased by nearly 18%, with the average cost of a one-bedroom apartment in assisted living now reaching $64,200 annually.

Many people, however, prefer to age at home, where they feel more in control. Yet, this option also comes with significant costs. Hiring help for daily tasks like cooking and cleaning can run around $30 per hour, with a minimum commitment of 4 to 6 hours a day. Ultimately, regardless of the route one chooses— whether nursing home, assisted living, or aging in place—the reality is that extended or long-term care is expensive."

CBM: In general, what are the options to cover expenses?

Carroll: Many people mistakenly believe that Medicare will cover long-term care, but in reality, generally, it only covers hospice care, which is not considered long-term care. The primary payer for longterm care is Medicaid, but it requires individuals to spend down their assets to qualify, which many people are hesitant to do.

For those who can plan ahead, Health Savings Accounts (HSAs) can be a great tool to pay for long-term care insurance premiums. This allows individuals to set aside money they can rely on to pay premiums during retirement when their income may be lower. While reverse mortgages were once a popular option, rising interest rates have made them less attractive.

I’ve worked with a life settlement company that repositions buy/sell agreements, especially in the context of mergers and acquisitions. Rather than using the entire buy/sell life insurance for one purpose, they divide it up into hybrid care solutions—such as life insurance with long-term care, annuities with long-term care, or a combination of both.

There’s also the option to purchase traditional long-term care insurance while you’re still young, since the cost of purchase becomes more expensive with age. Another approach involves using multi-purpose financial vehicles that combine benefits, which are becoming increasingly popular. There are additional options for multigenerational advanced planning that is best reviewed in the context of health and budget constraints.

The economic effects of family caregiving can result in financial strain with substantial financial consequences. A 2021 AARP study found that 38 million unpaid caregivers provide 36 billion hours of care annually, valued at around $600 billion. This highlights a critical point: caregiving can interfere with your own financial planning for retirement.

CBM: Since care in the home is often a preference over a facility, what advice do you have to work through the in-home process?

Carroll: If you don’t plan ahead, you’ll eventually find yourself in crisis mode, which is much harder to manage. The real challenge is starting the conversation. Approaching a parent or grandparent to discuss how they want to handle aging can feel uncomfortable, and many people may resist or shut down the conversation.

But aging in place isn’t just about finances; it's also about using the right tools to support independence. Today, there’s a wide range of technology available, from wearable healthcare devices to advanced home safety systems, like floors that can detect falls and alert help immediately. These innovations offer valuable solutions for making aging in place more feasible.

The key is to find a way to open the dialogue, emphasizing that it’s a personal and important topic.

CBM: What are your ideas on how to find care givers to help families cover their loved one's daily needs?

Carroll: When it comes to finding caregivers, you have two main options: you can either hire someone directly or go through an agency. In my book, How Not to Tear Your Family Apart, I dedicate pages 72-76 to help families navigate this process.

If you're hiring someone on your own, it’s important to gather the necessary documentation and clearly outline your expectations. For example, what happens if the caregiver gets injured while working in your home? You need to consider liability, insurance, and legal requirements. Be clear about what tasks you want the caregiver to perform.

If you’re using an agency, there are specific questions you need to ask them. For instance, how do they conduct background checks? What are their procedures if a caregiver doesn’t work out? It's crucial to be upfront about your situation. For example, when we hired in-home care for my own mother, she had strong preferences, like not wanting anyone to move her picture frames. These personal details are important for the caregiver to know.

Also, consider who will conduct the interviews—will you, or will the agency? And what happens if the caregiver isn’t a good fit? Does the agency charge for every interview or replacement? These are critical questions to ask before making a decision to ensure the care fits your family’s specific needs.

Caught in the sandwich generation, slowly morphs from the casual helper to the ‘on-call’ caregiver heading towards ‘full-time’ caregiver.

CBM: You mention planning is the best way to prepare and your three steps offer a guide to organize. Talk about the key points of each---The Care Guide; Care Squad; and Care Planning Team.

Carroll: Care Guide: Most care guides focus heavily on either medical or financial questions, but there’s so much more to consider when planning for care. For instance, even if you’ve set everything up perfectly, your parents might be using an app to store important medical information, but without access to their passwords, you could be left in the dark. It's crucial to include not just medical information but also practical details like passwords and financial access. A comprehensive care guide goes beyond just medical details—it’s a blueprint for managing all aspects of care.

Care Squad: As an advisor, you often hear clients say, "Don’t worry, my son or daughter will take care of me." But it’s important to dig deeper: How far away do they live? How will they respond in an emergency? Who’s going to contact them? It’s vital to assemble a care squad—a designated group of people responsible for specific tasks during a crisis. For example, one family member may oversee calling 911, another might handle transportation to the hospital, and someone else may take care of notifying the rest of the family. In my book, I’ve included a simple chart to help families organize their care squad, making sure the right people are in place to provide immediate support.

Care Planning Team: The care planning team (CPT) is focused on exploring all available options for extended or long-term care, whether for themselves or their loved ones. This involves researching whether life insurance with long-term care benefits or an annuity might be suitable. The book provides numerous resources and links to help families investigate different solutions. The team’s role is to look at what’s feasible for someone who is insurable, uninsurable, or has budget constraints.

CBM: For a health insurance professional, any last thoughts you want to share?

Carroll: As a health insurance professional, it's important that you can at least guide your clients in the right direction, even if long-term care (LTC) isn’t your specialty. Some advisors may feel uneasy about discussing these issues with clients, but it’s crucial to address them. You can say, 'While this isn't my area of expertise, I care about the work we do together, and I want to ensure you're informed.' You might offer them resources, like a book on the topic, and ask, 'Do you see yourself or a loved one in these scenarios?' This approach helps spark a conversation and distinguishes you from other healthcare brokers who might avoid the subject.

Additionally, there are LTC specialists you can refer your clients to, but first, reflect on your own situation. Are you comfortable discussing these topics with your own family? It's important to be able to handle these conversations before advising clients. Ultimately, as professionals in the healthcare industry, it’s our responsibility to ensure clients understand that while solutions exist, they require proactive planning.

CBM: The book has many resources you explain for covering the LTCi topics. This is a must have resource for both caregiving and how financial stability is connected to this topic. Our subscribers can find the book how?

Carroll: You can find my book, along with the others in the series, at The Caring Conversation. My books are also available for purchase through Amazon via the links on the website. The first book, How Not to Tear Your Family Apart, is a comprehensive resource for financial advisors. The second, How Not to Pull Your Family Apart, is a story-based consumer guide with planning options to discuss with an advisor. The third book, How Not to Pull Your Life Apart Caregiving: Overcome Challenges and Objections to Planning Conversations, focuses on handling difficult client conversations through real-life stories. Each of these books is designed to help advisors and agents provide guidance and planning support for their clients."

CBM: Carroll, thank you so much for your time. We at California Broker Magazine sincerely appreciate your commitment to providing the best advice for caregiving and financial planning.

My Story

I first learned the power of care as a financial professional. I worked with men and women who approached their finances with fear. Business owners wanted to do right by their employees, but feared the financial impact. Wives were scared of what would become of them if something happened to their husbands. Daughters, aunts, grandparents, stepchildren, adopted children...I’ve seen it all in planning, but it truly hit home when my own family was ripped apart fighting over financial caregiving of a loved one. My passion to help people unleash the power of care was born.