Gambit's 2017 family care guide

FAMILY CARE

Helping an elderly parent downsize LOC AL PROFE SSIONAL S C AN M AKE THE PROCESS E A SIER

2017 GUIDE

The legal needs of aging parents PRE-PL ANNING FOR RE TIREMENT AND BE YOND S AVE S MONE Y A ND PROVIDES PEACE OF MIND

BY K ATHERINE M . JOHNSON

BY SUZ ANNE PFEFFERLE TAFUR

“She was no longer driving her car, but she was getting out fairly often,” he adds, explaining how she relied on taxicabs to run errands. “She wasn’t into Uber.”

But Dorothy’s bustling lifestyle came to an end when she fell while preparing for a trip to a hair salon. The incident landed her in the hospital and left her with broken ribs, a broken finger and some bumps and bruises.

Dorothy was in severe pain.

She couldn’t get in and out of bed on her own, and she had to rely on a walker, which made it difficult to cook and do chores around her home. Dorothy and Gary realized new living arrangements were necessary.

“I had a bedroom for her with a bathroom attached to it, so

it was very convenient for her,” Gary says, noting that it was still disheartening for Dorothy to leave her own home.

Gary also had to confront the legal issues associated with becoming his mother’s caretaker.

He didn’t hire a lawyer since his mother “didn’t have a lot of assets left where she would have had to pay estate or inheritance taxes,” he says. But he did obtain power of attorney (POA) documents that made him the primary decision maker for his mother’s medical and financial matters. His brother became the secondary decision maker.

“I could see that at her age, those things needed to be taken care of, and she was very agreeable to that,” Gary says. “She PAGE 02

AS PARENTS AND THEIR CHILDREN AGE, A FAMILY’S NEEDS CHANGE. Parents’ focuses evolve from immediate concerns, such as school dropoffs and getting kids to basketball practice on time, to long-term issues like preparing for retirement and moving into smaller quarters after the children are grown. Once these discussions begin, it’s important to cover all the legal bases that will make these transitions go smoothly. Stephanie Quinlan, wills, trusts and successions attorney with the law offices of Jules J. Mumme III, works with clients of all ages to prepare them for the unexpected and the inevitable.

“It’s always a good time to think about planning, certainPAGE 04

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IN TRADITIONAL FAMILY HIERARCHIES, THE PARENTS NURTURE THEIR CHILDREN. But at some point, those roles often reverse.

Adult children one day will provide care and comfort for their aging parents, which may include helping them downsize their living space and navigate complex legal matters. It can be an overwhelming and emotional process, wrought with tough decisions.

For New Orleanian Gary English, that process began when he and his mother Dorothy determined that she needed to move in with him and his family.

Dorothy, who was 89 years old at the time, had been living independently in a Metairie apartment for nearly 10 years. She still was “pretty active,” Gary says.

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We are looking for Bereavement Volunteers at Canon Hospice to talk with bereaved family members and help with computer entry tasks.

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Call Jared at 504-818-2723

Sorting through a parents’ belongings and deciding what to sell and what to keep is a difficult task. Professionals can help.

knew it needed to be done. She knew that I needed to start paying her bills and making decisions for her.”

However, people in situations similar to Gary’s would benefit from calling a lawyer.

The ‘triumvirate’ of legal documents

Vincent B. “Chip” LoCoco is an estate planning attorney and partner at Many & LoCoco. “[Estate planning] deals with handling people’s estates after they pass away,” he says. He works with executors (or administrators) in handling the affairs of the deceased and distributing assets to heirs (without a will) or legatees (under a will).

“I get their affairs in order so that when they pass away, their property goes to who they want it to go to, how they want it to get there,” LoCoco says.

It also entails the three documents LoCoco calls “the triumvirate of estate planning”: a will, a POA and a living will.

A POA dictates who will act on the person’s behalf when he or she is incapacitated or simply needs assistance in handling certain affairs. The power of attorney can apply to financial or medical matters, or both.

The third document, the Louisiana living will, “tells your family, the doctors and everyone what your desires are regarding end-of-

PHOTO BY CHERYL GERBER

life medical issues,” LoCoco says.

LoCoco urges prospective clients to agree on a fee arrangement with an attorney before beginning the planning process.

The attorney also can collaborate with the client’s financial adviser and certified public accountant (CPA), he says.

“That team of people can get together and come up with the best avenue to get the client where they want to be and give them a feeling that at least they have a road to travel,” LoCoco says. “At the end, everything will be handled properly and taken care of.”

Estate sales

In addition to the legal details, adults helping elderly parents downsize also must help decide what to do with the all of their possessions, furniture and stuff.

Sorting through a person’s lifetime of belongings is a major undertaking. Beth Cathey, business manager of The Occasional Wife, works with clients planning estate sales and urges them to be patient.

“It’s a very emotional (process), which is often why they hire us, because we don’t have the emotional contact with the items,” Cathey says. “Both the family and the parents can get caught up in the emotion by sitting there and

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then you can probably let it go,” she says. “But we have to be able to do that and be sensitive when we’re working with them.”

Big Easy Estate Sales collaborates with clients who prefer to stage the estate sale in the home.

“They are coming to me directly, or their children are coming to me, and asking me to work with them on liquidating the contents of their home,” says owner Jonathan Wells.

The process begins with a phone call between Wells and his client to determine the time frame of the sale. He says listening with compassion is critical at this stage.

“Are they trying to get the house on the market? Are they calling me in the beginning part of the transition? Or, are they calling me at the last minute?”

Wells says. “We then find the best formula that fits their needs.”

Wells schedules two walkthroughs of the client’s home to help them decide what to keep and what to sell, then sets a date for the sale, which typically spans two days. After the sale, Wells helps the family clean up and make donation arrangements.

“People find satisfaction in knowing that their personal things that they’ve worked so hard to get through the years are going to good homes,” Wells says. He and his team try to make a difficult time easier to get through. “Let us handle the house, the contents and everything that’s involved with that. We’re professionals, and we know what we’re doing.”

Beyond downsizing

After a year of living with Gary and his family, Dorothy began having anxiety attacks and experiencing health issues.

“We realized that my mom needed more supervision,” Gary says. He hired sitters to stay with her, but round-the-clock home care became too expensive, and they moved her into St. Margaret’s at Belleville assisted living facility, where she lived for 18 months until her death.

Although he had witnessed friends endure similar experiences with their parents, Gary says it felt “different” when it was his turn.

“You learn your way through it,” he says. “You’re never really sure if what you’re doing is the right thing. But if you’re doing what you think is in your loved one’s best interest, then you have a clear conscience.”

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going back through time, and they don’t make progress.”

Some items carry sentimental value, some are family heirlooms and some may be useful down the road. There may not be enough room in the new space for those treasures, and placing them in storage is pricey.

Dorothy English distributed her furniture and many of her other belongings among her sons and grandchildren. For those who don’t have this option, an estate sale ensures a second life for those objects — and can bring in some money.

These sale events can take place in the home, with the items displayed in their usual spot, or you can host the sale elsewhere, such as The Occasional Wife’s estate sale store.

The store attracts a wide range of clients, from interior designers to college students, and is crammed with everything imaginable — caneback chairs, framed artwork, Japanese-style room dividers, vintage fur stoles, dinnerware, doe-eyed Precious Moments figurines and Christmas decorations. All items are sold on consignment.

“When you used to think of an estate sale, you thought of higher-end antique items,” Cathey says. “Now, because people are downsizing, that definition is much broader. We get everything.

Unless it’s broken, we try to find a way that someone can reuse that item.”

The Occasional Wife helps clients organize the home for an on-site estate sale, pack up possessions that are going to the new home or to relatives, decide which items should be donated to charity and which can be sold and stage the home to go on the market. Staging the estate sale in the home and then arranging to transport unsold items to the store also is an option.

“Many times, we’re called in from stage one, meaning we may have a client who is either going to sell a home or going into an assisted living facility,” Cathey says. “The family brings us in from the beginning because they don’t know what to do. We tell the family, leave everything as it is — even the cleaning supplies — because you never know what somebody may buy.”

Cathey and her colleagues help clients decide which items to keep and which to sell.

“If you’re going to tuck it away and look at it 10 years from now,

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504.486.5044

ly when someone is young and healthy and wants to have these things in place,” Quinlan says.

“You can tuck them away in a drawer when you’re done and if they’re needed, they’re already there. But certainly, there are trigger events, regardless of age, especially in terms of health, that necessitate estate planning.

And with the elderly, it is always a good time, especially in the case of an elderly person without a spouse. It’s also important in blended families.”

Quinlan advocates a team approach to lifetime and succession planning. When making these decisions, involve your lawyer, CPA, financial advisor and your kids. She recommends her clients complete three specific tasks: create a will and appoint agents for business power of attorney and a separate medical power of attorney, agents who can make decisions on a client’s behalf in those contexts.

Speaking legal-ese

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Splitting powers of attorney (POA) into business and medical allows you to choose a person most suitable for each job. One trusted person may have a background in health care and another may have financial acumen, so it makes sense to let each draw on what they know to help you make informed judgments. In case a POA becomes unable or unwilling to serve, name successor agents.

Consider the age and health of each one, and make sure it’s documented in the legal paperwork.

As parents transition into later stages of life, parents and children may consider adding the adult kids’ names to parents’ bank accounts for greater financial flexibility. However, depending on the way accounts are structured, this may not have the intended result.

Signatory authority (the ability to sign checks or initiate money transfers) on an account does not equate to co-ownership of that account, and Quinlan has seen cases in which children spend money from co-titled accounts only to find that they have to replace those funds when the account enters succession after the parent’s death. Signatory authority is extremely limited; if parents want co-signers to be able to perform any other business in their names, a POA is necessary.

Quinlan says a will is a must for everyone. Anyone that has any

assets at all should write a will and appoint an executor.

“It avoids a tremendous amount of confusion and it’s more often than not less expensive to do a little bit of pre-planning,” Quinlan says. “Court costs and attorneys’ fees — those things can be minimized just by creating a will, and it makes things easier on the kids.”

People also should consider establishing an advance health care directive, or living will, that dictates what medical procedures and treatments are allowed and prohibited in case a traumatic injury or illness leaves them incapable of making a decision about their care.

Quinlan says online legal service sites offer temptingly cheap legal documents for things such as wills and POAs, but she urges caution.

“Louisiana law is different — we have civilian jurisdiction here [while the rest of the U.S. follows mostly common law],” she says. “Don’t act on legal advice from LegalZoom or the AARP website. It is always worth consulting a local professional.”

Nightmare scenarios include creating a will or POA through one of these sites, only to find out the documents aren’t binding or the language doesn’t achieve what you want — situations Quinlan has witnessed and had to litigate.

The cost of a consultation with an estate planning attorney and notary fees for these documents begin around a couple hundred dollars; the costs that rack up to annul one document or agent and instate another easily will eclipse what you’d spend on a lawyer in the first place. Quinlan recalls court battles over invalid wills that have cost families tens of thousands of dollars.

She also recommends updating a will at least annually, and especially in the event of major life changes.

“Wills are living documents,” she says. “Important life events like having a child, receiving a medical diagnosis, inheriting money, kids graduating from high school or getting married — report all these things to your financial team. It may change the scope of some of the provisions you’ve set down.”

Speaking from the heart

With all the legal necessities of planning for life and end-of-life,

parents and kids shouldn’t overlook the emotional snarls that can occur. Parents may begin to feel like they’re ceding authority to their kids as they begin appointing POAs. They may feel anxiety, depression or even fear as they come to terms with their own mortality when drafting a will — a document that only takes effect after the holder’s passing.

“What’s important for clients to understand when they sign a power of attorney is that they’re not surrendering their ability to make their decisions,” Quinlan says. “They’re merely extending some of it to another party. It can be difficult emotionally to surrender control, especially in the case of an elderly person facing end-of-life issues.”

Children also are dealing with the eventuality of their parents’ passing while trying to balance their parents’ autonomy with making sure they’re stable and healthy and protecting their legacy. Quinlan has advice for these kids.

“Keep a gentle but close eye on your parents so you’re aware of any kind of change in their physical or mental status,” she says.

“It’s a tightrope that you walk, between not infringing on your parents’ autonomy … and being so hands-off that things happen that are unfixable. The direct approach is best — good, open discussion, and an agreement that no big decisions will be made without first talking to family members, especially the POA (agent).”

Quinlan has observed clients that resent kids’ involvement in their business affairs, finances and health as they age, especially if the interest arose late in their relationship. They ultimately see it as “looking over their shoulders” or interfering, but she says that’s the time to enlist the help of a trusted friend or relative to help convince parents to accept kids’ support. The only way to avoid this scenario is by showing earnest, consistent attention to parents’ affairs. If mom has a doctor’s appointment, offer to go with her and make a day of it, Quinlan says. Take her for a late lunch or early dinner afterward; she gets your undivided attention and you are up on any potential health issues.

“Maintaining good relationships with your loved ones is super important,” she says. “That way it never looks like you’re swooping in from out of the blue.”

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Caring for the Caregivers N AV I G AT I N G T H E S T R E S S O F L O O K I N G A F T E R L O V E D O N E S

BY J O E K EL LY

attorneys specializing in issues that the elderly face.

According to statistics from the Caregiver Action Network (CAN), roughly 66 percent of caregivers are women. The average caregiver is a 49-year-old woman caring for her 69-year-old widowed mother, who does not live with her, and 37 percent of these caregivers have children or grandchildren living with them at the same time. Most unpaid caregivers also work full time.

Muller is familiar with this trend and has a term for them.

“We call them the ‘sandwich’ generation because these people typically also have children of their own that they care for in addition to having to be the parents for their parents,” she says. These people are “sandwiched” between dual responsibilities, and Muller says the elder parents often are resistant, which can enhance the stress.

The pressure that comes with the responsibilities of caregiving can have profound mental, emotional and even physical effects. The CDC report cites high levels of depression and anxiety, as well as a resultant increase in the use of psychoactive medications, as risks for caregivers. The stresses of their duties also are associated with self-reported poor physical health and compromised immune systems. Overall, CDC data shows more than half of caregivers say their ability to provide adequate care is compromised by a decline in their own health.

The medical community has given the symptoms a name: caregiver burnout syndrome. It’s roughly defined as a state of physical, mental and emotional fatigue brought on by caregiving. Defined symptoms are similar to depression: withdrawal from family and friends, loss of interest in previously pleasurable activities, loss of appetite, disruption of sleep patterns, irritability, getting sick more often and others.

The condition can be brought on by a number of issues, including the stress of being upended by

sudden caregiving, unreasonable expectations and a lack of sleep and exercise.

Muller is familiar with this syndrome. “Caring for family members often causes one to neglect caring for themselves,” she says.

“Knowing when and where to ask for help can cause some guilt in the asking and some anger that can lead to burnout.”

She says caregiving for someone with Alzheimer’s or dementia can be especially stressful. The CDC report confirms providing care for dementia-related ailments can have “profound consequences” for caregivers, who can become responsible for everything from managing behavioral disturbances to attending to physical needs.

Caregivers — professional or not — could benefit from assistance from a community that recognizes their challenges and sacrifices. There are a wide variety of online communities with resources, Q&A forums and social media groups, including Comfort Finders and The Caregiver Space. The Comfort Finders website (www.comfortfinders.com) has a long list of support groups for caregivers, including local chapters

of the American Cancer Society and the Alzheimer’s Association with offices on River Road in New Orleans and Causeway Boulevard in Metairie, respectively.

The New Orleans Council on Aging (NOCOA) on Canal Street also offers support. It provides access to an array of resources and services related to the elderly, including social services, as does the National Family Caregiver Support Program (NFSCP).

This program provides everything from counseling and outreach to in-home respite (which allows a caregiver a four-hour break from his or her obligations), to material aid for caregivers. The group also has a support group that meets on the second Thursday of every month.

Many organizations, including the AARP, CDC and CAN, recognize caregiver burnout syndrome and offer tips for proactively managing it. The AARP recommends alerting your doctor and other medical professionals of your caregiver status, getting regular exercise (no matter how brief), mapping out priorities and to-do lists, and establishing a network of friends or relatives with whom you can communicate.

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MANY PEOPLE DON’T IMAGINE TAKING ON THE ROLE OF PRIMARY, OR EVEN PARTIAL, CAREGIVER TO A LOVED ONE. The responsibilities of providing that kind of medical assistance and interactive social care are simply not part of their reality — until they are.

The term “caregiver” is fairly broad, but caregivers are either unpaid or professional care providers for people in need of medical assistance or help with everyday tasks. They can be live-in help or operate out of formal institutions.

According to a 2009 survey by the Centers for Disease Control and Prevention (CDC), approximately a quarter of U.S. adults provided care or assistance to a person with either a chronic illness or disability over the previous 30 days. All of these people fall into the category of “informal or unpaid care” since the caregivers are family or friends rather than paid professionals. Another CDC report, in tandem with the Kimberly-Clark Corporation, found caregivers in one of every five U.S. households, and that 83 percent of those caregivers are unpaid.

Professional help is available through organizations like Home Care Solutions in Metairie. Megan Muller, human resources manager, says they are, first and foremost, here to help.

“We offer a range of companion care, transportation and whatever else is needed in the home of someone in need of a caregiver,” she says.

Home Care Solutions has a team of social workers who can accompany family members to doctor appointments and follow-up visits, as well as a team of trained caregivers.

“It can really save the families a lot of time,” Muller says. “Caregiving, especially when the responsibility is unexpected — as it often is — is a time-consuming task.”

Home Care Solutions also connects clients with related resources in the area, including assisted living and nursing homes. It also provides financial planning and resources like

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