Growing Risk to America’s Seniors: Themselves

[blueskyk]

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Originally Posted by ExFlyBoy5 I am not sure if you referencing the same person as the article (Brooke? The young lady in the article was named Pia) but she died at 44 years old...they mentioned that at the time she was found, she would have been 49. This article follows up on it a little bit and shows that she had quite a large family. https://www.freep.com/story/news/loc...ater/24188637/

Ah, thanks for the correction - I must have misheard the name and I missed the detail re: age of death and age of body discovery. I've corrected the related post.

[LRDave]

It's ironic that this thread (especially the way it has turned) is in the "Life after FIRE" topic....

[blueskyk]

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Originally Posted by Boose Professional fiduciaries are licensed in CA; DH and I recently signed one on as part of our estate plan (we don't have kids and our siblings are not up to the task). For anyone who thinks pulling the plug/voluntary euthanasia will be a clear-cut decision, I just finished this episode of NPR's Hidden Brain podcast: https://www.npr.org/2019/11/13/77893...ake-at-the-end . There are a lot of discussions to be had beforehand, and even then, the afflicted person may change their mind. Lots of interesting thoughts and plans here, good thread.

+1 I recently heard this on NPR and thought is was excellent. And it reminds me a bit of Mike Tyson's, "Everyone has a plan until they get punched in the face."

I did make arrangements for a profoundly disabled family member that included a professional fiduciary should I not survive him. By the time he passed, the fiduciary had gone out of business. So, I'm wondering - do people in this line of work offer some sort of "continuity" if that should be the case? I'm thinking I also need someone to select another professional fiduciary if this should happen. ETA: Looking back over my records this was actually a company that continued to provide a variety of other financial-related services but shuttered the professional fiduciary department.

[LRDave]

^^^^^ As Josey Wales famously said.... ^^^^^

[NW-Bound]

Maybe the government should take over financial affairs of the elderly, and in return look after their well-being.

You say you do not trust the gummint? Do you trust some Nigerian princes more?

[razztazz]

Quote:

Originally Posted by blueskyk +1 I recently heard this on NPR and thought is was excellent. And it reminds me a bit of Mike Tyson's, "Everyone has a plan until they get punched in the face." I did make arrangements for a profoundly disabled family member that included a professional fiduciary should I not survive him. By the time he passed, the fiduciary had gone out of business. So, I'm wondering - do people in this line of work offer some sort of "continuity" if that should be the case? I'm thinking I also need someone to select another professional fiduciary if this should happen. ETA: Looking back over my records this was actually a company that continued to provide a variety of other financial-related services but shuttered the professional fiduciary department.

Estate Administration department at a bank. Make it a large bank. They likely ain't goin' nowhere. That's what I did. My "solutions to life's loose ends" problem was discussed with the lawyer making up the will. I told him the will is one thing but I really have nobody to actuate it if I end up dead. At home. Nursing home. Assisted living. Anywhere. He mentioned "Banks have a department that handles that kind of thing." There's usually a minimum estate value needed for them to take the case. The fee is "not more than 2% of estate value" in my state but he said that's pretty much the limit almost everywhere. My bank's min estate value is 250k but smaller banks do it for less.

Final fall-back solution: There is an office in every state that basically handles these loose ends for people who have no one else. Somewhere on this forum from yrs ago there's a news story about the office in New York City clearing some old guy's stuff. He died in his apartment. He left no notes. No will. No nothin'.

If you have a will and anciliary instructions readily available they will proceed in-accordance-with and appreciate your forethought.

[athena53]

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Originally Posted by misshathaway I am far more worried about ending up with a state appointed guardian and getting financially wiped out, than I am about being found long dead. You're not going to care about the latter. I think Nevada has implemented some guardian reforms but a few of the stories from that state really chilled me. I have one distant family member and, through Facebook of all places, we'ver rekindled contact. Glad about that, except he is older than I am.

I agree. There are worse ways to go than quietly, unnoticed in your own home (provided it's something quick- not starvation/dehydration). I'm 67 and in good shape but my only son lives 3 hours away. I'm in almost-daily e-mail contact with a couple of friends so they MIGHT be alarmed if I didn't respond for a few days. If I didn't show up in church on Sunday without advance notice (usually I'm in charge of something for the service) they might get alarmed if it happens 2 Sundays in a row. Most people know I have a son in Des Moines but might have a problem tracking him down because we have different last names. I might be a little "ripe" when found.

OTOH- a friend was telling me about her 97-year old mother who's now in full-blown dementia after a fall and subsequent surgery. Mom will lovingly stroke her arm and then grab her daughter's little finger and bend it back, trying to break it. My nightmare is ending up with dementia and a complete change of personality.

[Scratchy]

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Originally Posted by blueskyk I’ve been thinking along the same lines - professional successor trustee backup, professional fiduciary, and backup medical POA. I think what distresses me the most is that I have served in these roles for others and, quite honestly, they were weighty and difficult responsibilities. I was glad to be there for them and I know it brought them peace of mind. I managed things as I hoped someone would manage for me - but there were also times I wished someone else was doing it because some aspects were very difficult and it was an extended timeline. That being said, I would absolutely do it again because it’s such a noble undertaking. The root of the word “care” means to “cry out” - when we care for others, we cry out for them. Advocacy for an incapacitated person requires much - especially when they are not family. This is, for sure, a trending topic as the population ages and doesn’t just impact those of us without children - I know several who do not believe their children are capable (for whatever reason) of serving in this capacity.

What you say above rings so true. I also know from experience how difficult in terms of time and effort it is to be a guardian for someone. That's why I'm hoping to be able to set things up so my family member or friend has some control over who is doing those things for me, but has plenty of assistance from the professional trustee (managing the trust) and professional fiduciary (handling our living arrangements and medical care). I don't want to ask the family member/friend to be responsible for my trust or retirement accounts, I want them to control those who are (by power of appointment/replacing them) and have the power to tell them what to arrange for me.

One of the things I'm trying to figure out with how to deal with is my retirement accounts, which are not in my trust, but the funds in them would be needed for my care. I'd need someone to have POA over those and coordinate with the professional trustee, but again I don't want to impose too much on the family member or friends. Still working on a solution to this.

[Scratchy]

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Originally Posted by ShokWaveRider "Squirrel!" or "Jibe O!" Simple. As I implied in my posting, When ONE of us cannot look after the other or we were both unable to care for ourselves. More than likely one will go first, so the decision for the remaining partner is easy. The problem I have is finding a painless method that can be self administered. Drugs are the clear winner, but getting and finding which would be the best one is a the challenge.

California has an a "End of Life Option Act" whereby a physician can prescribe a lethal dose of medication under certain conditions. I can imagine many scenarios where I would want to avail myself of this but it's not something that can be relied on. One of the conditions is that the medications must be administered by the patient to him/herself. One has to find a physician willing to do this. Then of course, imagining the moment where the deed is done is overwhelming. Although the law is in effect, I do not believe it has been frequently utilized.

[Spock]

I was going to start a separate thread on this when things calm down on my end, but a key item for anybody... both those with and without family... is the wording of the incapacitation clause in your estate planning documents.

Dad's documents state (paraphrased) "X takes over when a letter from my Dr says I am no longer able". Except. The medical health professionals in this area absolutely refuse to state a person is no longer capable. 2 different Drs and 2 social workers have all used the exact same phrase "He's still making decisions, they are just bad decisions". Mean while he is trying to give his house to his home health aid.

[Scuba]

This is a good thread and DH & I are also concerned. We have friends who’ve agreed to serve as financial and healthcare POA’s, but who knows if we will outlast them or vice-versa.

My biggest concern with the idea of a professional fiduciary is whether they’ll really care that much. Incapacitated people who have family members paying close attention to their care and actively advocating for them get better care and treatment than those who don’t. I can’t imagine that a professional would have the same passion and commitment to their clients. But for those of us without other viable options, perhaps that is the best path.

[Dtail]

We haven't quite worked out the details yet. Not sure any of our combined children can be entrusted with the financial aspects.

[oldphd]

A friend's father was in an assisted living facility (I guess you'd call it that). Small room with meals provided, activities in a common room, etc. He was in his 90s, still mentally alert but declining physically. Also had a sense of humor, and a strong sense of reality, nothing was left unsaid.

The last couple of years, he would send out an e-mail every morning to his 4 kids that said "I'm not dead yet". Went on for quite awhile, and the kids would joke about it, when I'd ask my friend how his dad was doing, he'd just say "He's not dead yet, at least as of this morning".

Then one day, no e-mail. In hindsight, there was some sort of technical glitch with the ISP and his mail didn't get through. All 4 waited, saying he was sleeping late, then called each other wondering if they should follow up, finally selecting one of them to contact him or the facility, I forget. He was fine, and the delayed e-mail came out late that day.

Alas, the end finally came, so no more e-mails. RIP Charlie...

[gerntz]

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Originally Posted by ExFlyBoy5 Interesting article from the WSJ about the growing number of seniors that are unable to take care of themselves, yet aren't getting the care they need. It's a fear I have since DW and I have no kids and our extended family is pretty small. https://www.wsj.com/articles/growing...d=hp_lead_pos9

"Rising numbers of older adults are unable to care for themselves, often leading to serious health problems and even death, according to state and local government agencies."

Wouldn't these higher numbers be expected with rising numbers of seniors?

[daylatedollarshort]

The Blue Zones studies show many of the people in these areas not only live much longer than most Americans do but they remain sharp up until the end.

[blueskyk]

Quote:

Originally Posted by razztazz Estate Administration department at a bank. Make it a large bank. They likely ain't goin' nowhere. That's what I did. My "solutions to life's loose ends" problem was discussed with the lawyer making up the will. I told him the will is one thing but I really have nobody to actuate it if I end up dead. At home. Nursing home. Assisted living. Anywhere. He mentioned "Banks have a department that handles that kind of thing." There's usually a minimum estate value needed for them to take the case. The fee is "not more than 2% of estate value" in my state but he said that's pretty much the limit almost everywhere. My bank's min estate value is 250k but smaller banks do it for less. Final fall-back solution: There is an office in every state that basically handles these loose ends for people who have no one else. Somewhere on this forum from yrs ago there's a news story about the office in New York City clearing some old guy's stuff. He died in his apartment. He left no notes. No will. No nothin'. If you have a will and anciliary instructions readily available they will proceed in-accordance-with and appreciate your forethought.

Great information razztazz - thanks. As part of my due diligence, I think I'll set up a meeting with an estate attorney and understand the current "state of the art" on this topic. Also, I'll make an appointment with the state Loose Ends Department and find out what happens there and under what circumstances.

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Originally Posted by Scratchy I don't want to ask the family member/friend to be responsible for my trust or retirement accounts, I want them to control those who are (by power of appointment/replacing them) and have the power to tell them what to arrange for me.

Exactly! If I can arrange things (to the best of my ability anyway...) so that a Master Representative is overlooking things and has tools to engage others, that seems a more manageable scenario to me.

Quote:

Originally Posted by Spock I was going to start a separate thread on this when things calm down on my end, but a key item for anybody... both those with and without family... is the wording of the incapacitation clause in your estate planning documents. Dad's documents state (paraphrased) "X takes over when a letter from my Dr says I am no longer able". Except. The medical health professionals in this area absolutely refuse to state a person is no longer capable. 2 different Drs and 2 social workers have all used the exact same phrase "He's still making decisions, they are just bad decisions". Mean while he is trying to give his house to his home health aid.

Thanks Spock - checking on this scenario is now on my list.

Quote:

Originally Posted by Scuba This is a good thread and DH & I are also concerned. We have friends who’ve agreed to serve as financial and healthcare POA’s, but who knows if we will outlast them or vice-versa. My biggest concern with the idea of a professional fiduciary is whether they’ll really care that much. Incapacitated people who have family members paying close attention to their care and actively advocating for them get better care and treatment than those who don’t. I can’t imagine that a professional would have the same passion and commitment to their clients. But for those of us without other viable options, perhaps that is the best path.

It seems problems can arise with or without family. Our local newspaper just featured a front page story about a local woman bilked out of $250K by her family members. One would hope that entities laboring under fiduciary constraints/laws/oversight(?) would behave honorably. But, if they don't, I'd like to have my Master Representative be able to step in and rectify!

Overall, it feels like maybe having someone look after you (however you've chosen in your plan) as they would a loved one (or themselves) is a high bar. But I've also known some people who served as guardians and find they, like me, had to do so for someone they loved and believe in the value of offering this service. They say it's a lot easier emotionally when it isn't your family. I spent decades in nursing homes with my family member and now I actually volunteer in them. I too, find it much easier than it was with a family member. So, I try to keep this in mind.

I think I'll feel better once I do the best I can. And then, well, that's that!

[Teacher Terry]

When my friend was dying he made me both medical and financial POA. Since his 2 kids were trustworthy I asked him to add them to the financial in case something happened to me. After he died his son said he would take over paying the bills for his step mom which I was glad because keeping on top of her medical care was enough.

[Scratchy]

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Originally Posted by Scuba My biggest concern with the idea of a professional fiduciary is whether they’ll really care that much. Incapacitated people who have family members paying close attention to their care and actively advocating for them get better care and treatment than those who don’t. I can’t imagine that a professional would have the same passion and commitment to their clients. But for those of us without other viable options, perhaps that is the best path.

Agree, it may be worth trying to identify fiduciaries who are conscientious and keep a current list with estate documents.

Another issue is cost. I spoke to one that I selected from research on the internet. He seemed to be a very competent and pleasant fellow. His fees: $200/hour for any activities such as wellness checks, arranging appointments, researching and coordinating care, bookkeeping for his activities. Based on my doing this for family members, 15-20 hours/week is probably a reasonable estimate for what he would bill. Let's say average 15 hours/week-that is $156,000 a year. Add to that professional trustee fees maybe 0.5-1% of portfolio/year. We haven't even gotten to the actual costs of care which would vary very widely.

So this solution seems to be extremely expensive, not sustainable for the vast majority of folks.

[Scuba]

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Originally Posted by Scratchy Agree, it may be worth trying to identify fiduciaries who are conscientious and keep a current list with estate documents. Another issue is cost. I spoke to one that I selected from research on the internet. He seemed to be a very competent and pleasant fellow. His fees: $200/hour for any activities such as wellness checks, arranging appointments, researching and coordinating care, bookkeeping for his activities. Based on my doing this for family members, 15-20 hours/week is probably a reasonable estimate for what he would bill. Let's say average 15 hours/week-that is $156,000 a year. Add to that professional trustee fees maybe 0.5-1% of portfolio/year. We haven't even gotten to the actual costs of care which would vary very widely. So this solution seems to be extremely expensive, not sustainable for the vast majority of folks.

Wow, that’s expensive. Again my biggest concern is how much they care. Supervision/oversight is important!

[audreyh1]

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Originally Posted by braumeister I could have written that post, except I hope it will be after 80. We have several active octogenarians on our block, and one nonagenarian, and they are all doing well in their own homes so far. One other neighbor moved to a CCRC a couple of years ago at 94. I'm hoping to be in that crowd.

My understanding is that 85 is the average age to move into a CCRC.

And being in one doesn’t keep you from being active, or traveling, or driving, or living independently.

But you do have to move in before one of you develops an illness that requires care. You have to have mobility, not have dementia, be able to take care of your daily needs.