As you travel home to visit family around the holidays, you may notice a change in your aging parents. They may be exhibiting physical issues associated with getting older or showing signs of dementia. It might be time to talk about what to do for them as they enter these later years of their life. What steps should you take given the likely need for long-term care in the future?

Here are some topics to consider as you try to plan for long-term care:

1. First, the family must decide what environment is most appropriate for the parents as they age. Most people would like to age in place if possible. This will require a discussion about whether aging parents can receive the appropriate attention and care in their home. Are there relatives close by to check in on them? Is the house safe for them to age in place? For example, are there stairs in the house that pose a risk of falling or are the bathrooms accessible if a walker or wheelchair is needed?

2. If the home is not the most appropriate environment, would an independent living or assisted living setting be more suitable? Independent living can include senior apartments and retirement communities. Assisted living offers a range of care services, including memory care for those suffering from dementia. The cost of these arrangements varies depending on the type of care needed, with memory care being the most expensive. These facilities will often want to see the finances of the applicant to ensure that they can pay for two to three years’ worth of residency. Unless your loved one is a Veteran, there are no government benefits to pay for assisted living.

3. Perhaps your loved one has been suffering from dementia and now the family is thinking of nursing facility care. This is a much more expensive environment for care, and the family needs to consider whether they can pay privately for the care or if they will need to apply for government assistance, known as Medicaid or Medical Assistance. A visit to an elder law attorney is highly recommended to determine if your loved one is eligible for benefits or if some planning is needed to qualify them. There is a five (5) year look back for transfers of assets if you intend to qualify for benefits in the future. For those who need to qualify now, there are various techniques for accelerating eligibility for benefits.

4. Even if planning to qualify for benefits is not going to be done at this time, it is recommended that the family review and update legal documents such as Powers of Attorney. Powers of Attorney name an individual to make decisions for an older adult if they become incapacitated and need assistance with financial matters or making health care decisions. It is important to ensure that the financial power of attorney allows the family to engage in Medicaid planning to help their loved one become eligible for benefits.

5. In many cases the family needs to discuss who is going to take on the various roles associated with caring for an older adult. Some family members are good at healthcare decisions and even want to become caregivers. It is not unusual for an older adult to move into a child’s home or an in-law suite or similar arrangement. Other children are better at financial management and try to ensure that there are enough funds available to pay for care whether at home or in a facility.

These are just a handful of the topics you need to eventually discuss when you realize that your parent or loved one can no longer live independently and needs some assistance as they age. The conversations tend to be very difficult and there is rarely an easy solution in these cases.