Caring for aging parents: what to put in place now

Maybe it was a fall, or a confusing phone call, or just a holiday visit where Dad seemed slower. Suddenly you are wondering what would happen if he couldn't speak for himself, and whether anything is written down.

This post is for the adult child. It walks through the legal things worth putting in place for an aging parent, with Washington's rules as the worked example. It is part of our guide to paying for care and protecting what you leave, which covers the money side.

The one rule that shapes everything

Your parent signs these documents, not you. You can't sign a power of attorney on a parent's behalf, and it only works if they understood it when they signed.

That is why timing matters so much. The easiest time to put things in place is now, while it's a calm conversation rather than a hospital decision. Our post on power of attorney for an elderly parent covers how to raise it gently.

What to put in place

Here is the short list, with what each document does and Washington's rule.

The financial power of attorney

This is often the most urgent one. Without it, a family may need a court before anyone can touch a parent's accounts. Our post on the financial power of attorney explains what it covers.

In Washington, a power of attorney must be signed before a notary, or by two witnesses who aren't relatives or care providers (RCW 11.125.050). It also needs wording that keeps it working after incapacity. Our post on the durable power of attorney explains that wording.

The medical power of attorney and directive

A medical power of attorney names who speaks for your parent with doctors. A health care directive records what they would want. Our post on advance directives explains how the two work together.

If neither exists, Washington law sets an order of who may consent to care (RCW 7.70.065). After a guardian and a health care agent come a spouse, then adult children, and everyone in the same group must agree.

For siblings who don't always agree, that last part matters. Naming one person, with a backup, avoids it.

A will, and maybe a trust

A will names an executor to settle the estate. A revocable living trust can let a trustee manage things during incapacity and after death, often without probate.

Whether your parent needs a trust depends on their property and wishes. A local estate planning attorney can say.

The permission slips people forget

Legal documents aren't the only thing. A few simple permissions save hours on the phone.

• Medicare. Medicare can share your parent's information with you only if they give permission on the call, or add you as an authorized representative (Medicare.gov fact sheet). The form is called "Authorization to Disclose Personal Health Information" (Medicare.gov forms).
• The doctor. Medicare's fact sheet says the doctor needs your parent's permission to talk with you about their care. Ask the office how your parent can give it.
• The bank. Your parent can name a trusted contact, someone the bank may reach if it suspects fraud (CFPB). A trusted contact can't see accounts without separate consent.

Medicare says that if the form is completed online, you can call on your parent's behalf right away. A mailed form generally takes a few weeks.

The list only your parent can make

Much of what you'll need isn't a legal document at all. It's knowledge that lives in your parent's head.

1. Bank, retirement and investment accounts, and where statements arrive.
2. Regular bills and how they're paid.
3. Doctors, medications and pharmacy.
4. Insurance, Social Security and pension contacts.
5. Where the original documents are kept.
6. Passwords, or at least where they're stored.
7. Who to call: the neighbor with the key, the dog walker, the friend from church.

Write it down together and keep a copy where you can find it. Update it once a year.

Talking about it

Many parents want to have this talk; they just don't want to start it. Try opening with your own plans: "I just did my power of attorney, and it made me think of you."

Ask about wishes, not just paperwork: where they would want to live if they needed help, and who they would want making decisions. Their answers become the plan.

Here is a typical case, a composite

Maria, 49, lives three hours from her mother. Over a long weekend they met with a lawyer, and her mother signed both powers of attorney and a directive.

Maria is the agent and her brother is backup. Her mother added Maria on Medicare's form and as a trusted contact at the credit union. When her mother had surgery last spring, nobody had to guess.

If the load is already on you

If you are already doing the bills, the rides and the doctor calls, our post on caregiver burnout is about sharing it. Keep an eye out for scams too; our post on elder financial exploitation lists the signs.

When the time does come, our post on what to do when a parent dies walks through the first days and weeks.

Planning for how care gets paid is its own topic. Our posts on long-term care insurance cost and the Medicaid spend-down explain the options.

Some families also name a professional, first or as backup, so one child isn't carrying everything. Kinly does this with a trust company named in the roles your parent chooses, and a team that answers any hour. How it works has the details.

Common questions

What legal things should I set up for my aging parents?

The core list is a durable financial power of attorney, a medical power of attorney, a health care directive and a will. A trust may fit too. Add Medicare's authorization form, a trusted contact at the bank, and a list of accounts, doctors and medications.

Can I sign a power of attorney for my parent?

No. Your parent signs it, naming you, while they can understand what they are signing. In Washington, it must be notarized or signed before two qualified witnesses, and include wording that keeps it working after incapacity.

What happens if my parent has no power of attorney and can't decide?

For health care, Washington's RCW 7.70.065 sets an order of who may consent: a spouse, then adult children, and all children available must agree. For money, a family may need to ask a court to appoint a guardian or conservator.

How do I get permission to talk to Medicare about my parent?

Your parent can give permission on a call with Medicare. Or they can add you as an authorized representative with the "Authorization to Disclose Personal Health Information" form. Completed online, it takes effect right away.

When should we start?

Now, while your parent is well and the conversation can be calm. Documents signed early are ready when needed, and your parent gets to choose for themselves.

Sources

• RCW 11.125.040: Power of attorney, termination
• RCW 11.125.050: Power of attorney, requirements
• RCW 11.125.240: Agent's authority, including health care decisions
• RCW 70.122.030: Health care directive
• RCW 7.70.065: Who may consent to health care for an adult who lacks capacity
• RCW 11.12.020: Requirements for a will
• RCW 11.103.030: Revocable trusts
• Medicare.gov: Talking with a friend's or family member's doctor (fact sheet, PDF)
• Medicare.gov: Other forms, including Authorization to Disclose Personal Health Information
• CFPB: Choosing a trusted contact person (PDF)