If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
visualguy
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by visualguy » Wed Jul 10, 2019 1:39 pm

dm200 wrote:
Wed Jul 10, 2019 1:11 pm
Maybe "Blissful Ignorance" is the answer! ;)
It truly is... If I can't do anything much about something, I find that it's best to distract myself with other things, and not think about it or study it much. This is one of the reasons I'm afraid of retirement - too much time to obsess about these things. By the way, the thing that woke me up from blissful ignorance was dealing with what's happening with my parents right now where the entire family (4 children) is helping to manage their situation, and this help is absolutely critical. Once you're more aware, it's hard to go back to blissful ignorance. You need to switch to thought suppression :wink:

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1210sda
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by 1210sda » Wed Jul 10, 2019 1:41 pm

dm200 wrote:
Wed Jul 10, 2019 1:11 pm
visualguy wrote:
Wed Jul 10, 2019 1:09 pm
dm200 wrote:
Wed Jul 10, 2019 12:58 pm
I am getting depressed just reading all this! :oops: :?
Yeah, that's the problem with digging into these things... Blissful ignorance or being in denial truly is a better way with some things unless there's something you can actually do to put your future on a different path. The younger you are, the easier it is to influence how things develop, but it's also easy to be oblivious of anything related to needs related to aging when young.
Maybe "Blissful Ignorance" is the answer! ;)
I can't say you're wrong. Everyone's case is individual.

However, my intent in starting this thread was to learn from the experience of others. For me, I prefer not to be blissfully ignorant. I'd rather prepare for the worst, hoping of course, that the worst case doesn't happen.

A couple of philosophies that I use to keep me grounded are: 1. I cried because I had no shoes until I met a man with no feet. 2. I have to play the hand that I was dealt. 3. I cannot control (much of) what happens in the future, I can only control how I react to it.

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Cuzz35
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Cuzz35 » Wed Jul 10, 2019 2:39 pm

I still need to go through and read this thread but I have a similar problem.

I currently have a grandmother who lives in rural Wyoming and has her entire life. Her only child, my mother, passed away 20 years go and I am her only living grandchild (I'm 33 with 3 young children). I live in Atlanta and have my own family and job that takes up my time. Grandmother is starting to suffer from dementia and Alzheimer's. She currently gets help from two of her sister's that are a little younger but their age makes it difficult to visit as much as they used too. It really didn't dawn on me that I would be responsible for her at some point until a year or so ago. My grandmother has very little assets as far as I know and I myself don't do well enough to pay the expense of visiting frequently to take care of her. She has no interest in moving. The women in her family have typically lived to 100 (my great grandmother lived to 99) and at some point she is going to need continuous care but more importantly, someone to make difficult decisions for her.
Last edited by Cuzz35 on Wed Jul 10, 2019 2:44 pm, edited 1 time in total.

afan
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by afan » Wed Jul 10, 2019 2:43 pm

I did this for an eldey friend. When I realized I had to step in I investigated bank trustees. They were dllighted to talk about their marvelous active management but not interested in talking about beneficiary service. Managing money is cheap, as Vanguard has shown. Handling an individual with medical problems takes a lot of time.

One advertised that they specialized in managing these cases. When I contacted them the trust rep had no idea they did this. After sending her the link she agreed to look into it. Turns out they would hire a separate company to do this, at extra cost of course.

Depending on the situation one might use a bank trustee to handle the finances and arrange for a separate company to handle other things. You could save a lot of money if your bank trustee does the accounting and pays bills but does not manage the investing. If you have someone who is not local or does not have the time to do everything but who can run a 3-fund portfolio then you may not need a paid portfolio manager. Or you could put everything in a balanced or lifecycle fund. Then there would be no managing to do.

In my case, I decided I could do the investing and bill payment, which would have been the main thing a bank would have done. I also had to do the health care proxy work. That was challenging talking to caregivers by phone, particularly as the person declined and could not make any contribution to evaluating how things were going.

I did not find any bank that I thought would be useful for guardian-type decisions.

I would be more comfortable with a bank trust department than all but the closest family in terms of honesty. A bank also has more than one person involved, so you don't have to worry about the one family member being out of reach.
Last edited by afan on Wed Jul 10, 2019 3:47 pm, edited 1 time in total.
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dm200
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by dm200 » Wed Jul 10, 2019 2:49 pm

Cuzz35 wrote:
Wed Jul 10, 2019 2:39 pm
I still need to go through and read this thread but I have a similar problem.

I currently have a grandmother who lives in rural Wyoming and has her entire life. Her only child, my mother, passed away 20 years go and I am her only living grandchild (I'm 33 with 3 young children). I live in Atlanta and have my own family and job that takes up my time. Grandmother is starting to suffer from dementia and Alzheimer's. She currently gets help from two of her sister's that are a little younger but their age makes it difficult to visit as much as they used too. It really didn't dawn on me that I would be responsible for her at some point until a year or so ago. My grandmother has very little assets as far as I know and I myself don't do well enough to pay the expense of visiting frequently to take care of her. She has no interest in moving. The women in her family have typically lived to 100 (my great grandmother lived to 99) and at some point she is going to need continuous care but more importantly, someone to make difficult decisions for her.
I certainly wish you well.

To start, I suggest you contact a local jurisdiction Social Worker (or similar) to get some ideas about that "environment" in Wyoming.

clip651
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by clip651 » Wed Jul 10, 2019 2:53 pm

Cuzz35 wrote:
Wed Jul 10, 2019 2:39 pm
I still need to go through and read this thread but I have a similar problem.

I currently have a grandmother who lives in rural Wyoming and has her entire life. Her only child, my mother, passed away 20 years go and I am her only living grandchild (I'm 33 with 3 young children). I live in Atlanta and have my own family and job that takes up my time. Grandmother is starting to suffer from dementia and Alzheimer's. She currently gets help from two of her sister's that are a little younger but their age makes it difficult to visit as much as they used too. It really didn't dawn on me that I would be responsible for her at some point until a year or so ago. My grandmother has very little assets as far as I know and I myself don't do well enough to pay the expense of visiting frequently to take care of her. She has no interest in moving. The women in her family have typically lived to 100 (my great grandmother lived to 99) and at some point she is going to need continuous care but more importantly, someone to make difficult decisions for her.
Sorry to hear this. First step is to find out who she has listed as power of attorney (financial and health care). If she doesn't already have them in place, see if it's possible to get them done ASAP.

Arlington2019
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Arlington2019 » Wed Jul 10, 2019 4:19 pm

As a healthcare risk manager, I am often called to the bedside for a consult when a patient is brought in and there are no living or available relatives, guardians or even friends involved in their care or their life, or the family members do not agree on what should be done.

If I could wave a magic wand, every person in the US by the age of 45 would have the following documents (completed while you are competent) printed in hard copy and readily accessible at home and a copy would be filed in your primary provider's medical chart or state registry:

1. Living will or advance directive
2. POLST form if you don't want to have the aid unit/medic one resuscitate you at home
3. Durable power of attorney for health care
4. Durable power of attorney for financial matters
5. Your wishes in terms of funeral, body disposition, etc.

It makes it really difficult for us in the hospital when Grandma is dying, the family members don't agree on treatment, and some people think that Grandma would have wanted to just die, but of course Grandma never got around to writing this down or completing a form. Many state laws set an order of priority for who makes the decision, but if there is more than one person in that class, they usually have to all agree, and that is where the trouble comes in.

My other pet peeve is the people who download a power of attorney form from the Internet, fill it out, and then present it when Grandma is unconscious and incompetent in the hospital. I have to tell them that they downloaded the wrong form, and the power of attorney they have is for financial matters only, and it gives them no authority over healthcare.

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GerryL
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by GerryL » Wed Jul 10, 2019 4:58 pm

dm200 wrote:
Mon Jul 08, 2019 4:28 pm
I have not gone deeply into such groups, but our locality has a "group" (annual fee required) called "Neighborhood Village" for seniors needing and wanting help. I gather there are similar organizations elsewhere.

The "caring for you" can be provided by commercial agencies. The bill paying and money parts are more complicated, in my opinion.
The Village Movement started over 20 years ago in Boston and is spreading around the country. Virtual Villages are volunteer organizations that aim to help people age in place. The list of services that each village offers (as well as the annual fee) varies from group to group, but are essentially the kinds of things you might ask a neighbor to do for you: rides to the doctor, help with occasional tasks around the house or garden. There may also be a significant social component available. Although village volunteers will likely have undergone a basic background check, they are unlikely to be bonded or qualified to perform financial or legal tasks or personal care. You can find more information at v2vnetwork.org (but note that the map function on that site is not up-to-date).

I've been involved for 5 years as a volunteer and now as a member of the village that launched in my town about 3 years ago. The issue of solo aging is serious for me. I've been trying to learn about how to prepare for it and promised myself that I would start pulling together information this year. I am off to a weak start. But as today is the 10th, I have to go pull a report on the number of hours people volunteered for our village last month and send it off to the central office.

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1210sda
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by 1210sda » Wed Jul 10, 2019 5:01 pm

Arlington 2019

What is a POLST form ?

1210

Broken Man 1999
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Broken Man 1999 » Wed Jul 10, 2019 5:09 pm

1210sda wrote:
Wed Jul 10, 2019 5:01 pm
Arlington 2019

What is a POLST form ?

1210
Physician Orders for Life-Sustaining Treatment (POLST) is a form that gives seriously-ill patients more control over their end-of-life care, including medical treatment, extraordinary measures (such as a ventilator or feeding tube) and CPR. Printed on bright pink paper, and signed by both a patient and physician, nurse practitioner or physician assistant, POLST can prevent unwanted or ineffective treatments, reduce patient and family suffering, and ensure that a patient's wishes are honored.

Broken Man 1999
“If I cannot drink Bourbon and smoke cigars in Heaven than I shall not go. " -Mark Twain

Electrum
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Electrum » Wed Jul 10, 2019 7:46 pm

The name can differ by State. In Massachusetts it is MOLST (Medical Orders for Life Sustaining Treatment.

Arlington2019
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Arlington2019 » Wed Jul 10, 2019 7:53 pm


Rosa
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Rosa » Sat Jul 13, 2019 9:31 pm

1210sda wrote:
Mon Jul 08, 2019 2:30 pm
Recently I posted about using a bank trust dept to administer our (spouse and me)affairs.

Rosa, thank you for your thoughtful advice. As I am alone (or will be soon), have no family or close friends, I may do as you suggest and hire a lawyer to draft a good will and LRT (when I figure out the beneficiary details). But the issue that keeps nagging me is who do I designate as a Trustee to administrate? In your case, if I may ask, who did you designate? The lawyer who drafted the LRT? Does he charge a annual administrative fee or a final fee upon execution of the LRT/Will?
Hi 1210sda, you are the trustee, then you choose anyone you want as a successor trustee who'll become the trustee when you die. I designated this lawyer who drafted my LRT as well as ALL the complementary documents necessary. Also a good thing is she designated another successor trustee in case the present successor trustee dies, retires or something. I made it so that the successor trustee (my lawyer) is silent until I become incompetent or die, in which case she takes over to the end.

My situation is simple and she charged $1500 for everything and I never yet paid anything more and it has been almost 2 years plus she's very accommodating. Of course she'll have to get paid for her work so after death (or incompetence) by law she'll charge a certain percentage from my assets and will withdraw all necessary money for expenses on my behalf. Also needed, which she said she'll take care of, is an executor, but I'm sure, according to what I read extensively in the internet, she'll hire whoever is needed to complete the job. If you happen to live in or near NYC, she doesn't charge for consultation. But I'll be glad to give you more info on this if you want it. Perhaps through the PM here? Meantime, good luck to us! :wink:

P.S. To insure that the estate won't go through probation even with a LRT, one must be sure to re-title each and every bank or other financial accounts or properties of any kind into the trust. IRAs and annuities are not re-titled but you can use a POD (paid on death which won't be probated).

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1210sda
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by 1210sda » Sat Jul 13, 2019 10:43 pm

Rosa wrote:
Sat Jul 13, 2019 9:31 pm
1210sda wrote:
Mon Jul 08, 2019 2:30 pm
Recently I posted about using a bank trust dept to administer our (spouse and me)affairs.

Rosa, thank you for your thoughtful advice. As I am alone (or will be soon), have no family or close friends, I may do as you suggest and hire a lawyer to draft a good will and LRT (when I figure out the beneficiary details). But the issue that keeps nagging me is who do I designate as a Trustee to administrate? In your case, if I may ask, who did you designate? The lawyer who drafted the LRT? Does he charge a annual administrative fee or a final fee upon execution of the LRT/Will?
Hi 1210sda, you are the trustee, then you choose anyone you want as a successor trustee who'll become the trustee when you die. I designated this lawyer who drafted my LRT as well as ALL the complementary documents necessary. Also a good thing is she designated another successor trustee in case the present successor trustee dies, retires or something. I made it so that the successor trustee (my lawyer) is silent until I become incompetent or die, in which case she takes over to the end.

My situation is simple and she charged $1500 for everything and I never yet paid anything more and it has been almost 2 years plus she's very accommodating. Of course she'll have to get paid for her work so after death (or incompetence) by law she'll charge a certain percentage from my assets and will withdraw all necessary money for expenses on my behalf. Also needed, which she said she'll take care of, is an executor, but I'm sure, according to what I read extensively in the internet, she'll hire whoever is needed to complete the job. If you happen to live in or near NYC, she doesn't charge for consultation. But I'll be glad to give you more info on this if you want it. Perhaps through the PM here? Meantime, good luck to us! :wink:

P.S. To insure that the estate won't go through probation even with a LRT, one must be sure to re-title each and every bank or other financial accounts or properties of any kind into the trust. IRAs and annuities are not re-titled but you can use a POD (paid on death which won't be probated).
Rosa, thank you for the comments, but it was Zonian59 not 1210sda who was asking the question. Perhaps he/she will see your post and respond accordingly.

1210

Rosa
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Rosa » Sat Jul 13, 2019 11:20 pm

1210sda wrote:
Sat Jul 13, 2019 10:43 pm
Rosa wrote:
Sat Jul 13, 2019 9:31 pm
1210sda wrote:
Mon Jul 08, 2019 2:30 pm
Recently I posted about using a bank trust dept to administer our (spouse and me)affairs.

Rosa, thank you for your thoughtful advice. As I am alone (or will be soon), have no family or close friends, I may do as you suggest and hire a lawyer to draft a good will and LRT (when I figure out the beneficiary details). But the issue that keeps nagging me is who do I designate as a Trustee to administrate? In your case, if I may ask, who did you designate? The lawyer who drafted the LRT? Does he charge a annual administrative fee or a final fee upon execution of the LRT/Will?
Hi 1210sda, you are the trustee, then you choose anyone you want as a successor trustee who'll become the trustee when you die. I designated this lawyer who drafted my LRT as well as ALL the complementary documents necessary. Also a good thing is she designated another successor trustee in case the present successor trustee dies, retires or something. I made it so that the successor trustee (my lawyer) is silent until I become incompetent or die, in which case she takes over to the end.

My situation is simple and she charged $1500 for everything and I never yet paid anything more and it has been almost 2 years plus she's very accommodating. Of course she'll have to get paid for her work so after death (or incompetence) by law she'll charge a certain percentage from my assets and will withdraw all necessary money for expenses on my behalf. Also needed, which she said she'll take care of, is an executor, but I'm sure, according to what I read extensively in the internet, she'll hire whoever is needed to complete the job. If you happen to live in or near NYC, she doesn't charge for consultation. But I'll be glad to give you more info on this if you want it. Perhaps through the PM here? Meantime, good luck to us! :wink:

P.S. To insure that the estate won't go through probation even with a LRT, one must be sure to re-title each and every bank or other financial accounts or properties of any kind into the trust. IRAs and annuities are not re-titled but you can use a POD (paid on death which won't be probated).
Rosa, thank you for the comments, but it was Zonian59 not 1210sda who was asking the question. Perhaps he/she will see your post and respond accordingly.

1210
Oh no! I was wondering if I clicked on the right OP! It gets a bit confusing. I'll try to find his post and repost my answer to him/her. Thanks.

Rosa
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Rosa » Sat Jul 13, 2019 11:48 pm

TO Zonian59, I just wrote you an answer to what I thought was your questions. I hope you find it but I'm disappointed that in this forum I can't tell who wrote what. If it was you who asked the questions I hope you'll find my answer here. I mistakenly directed my answer to 1210sda. :) Rosa

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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by fru-gal » Sun Jul 14, 2019 7:18 am

1210sda wrote:
Wed Jul 10, 2019 1:41 pm
dm200 wrote:
Wed Jul 10, 2019 1:11 pm
visualguy wrote:
Wed Jul 10, 2019 1:09 pm
dm200 wrote:
Wed Jul 10, 2019 12:58 pm
I am getting depressed just reading all this! :oops: :?
Yeah, that's the problem with digging into these things... Blissful ignorance or being in denial truly is a better way with some things unless there's something you can actually do to put your future on a different path. The younger you are, the easier it is to influence how things develop, but it's also easy to be oblivious of anything related to needs related to aging when young.
Maybe "Blissful Ignorance" is the answer! ;)
I can't say you're wrong. Everyone's case is individual.

However, my intent in starting this thread was to learn from the experience of others. For me, I prefer not to be blissfully ignorant. I'd rather prepare for the worst, hoping of course, that the worst case doesn't happen.

A couple of philosophies that I use to keep me grounded are: 1. I cried because I had no shoes until I met a man with no feet. 2. I have to play the hand that I was dealt. 3. I cannot control (much of) what happens in the future, I can only control how I react to it.

1210
Here's another one: The outcome of any given situation will not necessarily be the worst possible outcome.

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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Shallowpockets » Sun Jul 14, 2019 10:34 am

Sounds like could be an opening for some entrepeneur to start such a service. How many people are out there like that with this need?

Luckywon
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Luckywon » Sun Jul 14, 2019 11:28 am

afan wrote:
Wed Jul 10, 2019 2:43 pm
I did not find any bank that I thought would be useful for guardian-type decisions.
Shallowpockets wrote:
Sun Jul 14, 2019 10:34 am
Sounds like could be an opening for some entrepeneur to start such a service. How many people are out there like that with this need?
In California, this service is licensed/regulated by the Department of Consumer Affairs. Licensees are "Professional Fiduciaries" and will manage medical and/or financial needs. I called a few of the licensees in the Los Angeles area to see what they charged. Range was between $150-$250/hour. Bear in mind that these people will be managing your affairs and billing possibly with little meaningful oversight. It's easy to imagine fees approaching $100k/year, if you expect them to visit regularly to check on your welfare.

From the California Professional Fiduciaries Bureau website,the main requirements for becoming a licensee are 30 hours of approved education courses and passing an examination. Rather low barriers for entry, IMO, and I would not be surprised to see people entering this field with less than noble intentions. I am not sure at this point how to identify available licensees that are ethical and competent.

So hiring someone in California to handle your affairs in the event of incapacity is an option, but potentially expensive and perilous. I am still investigating the best way to prepare for the situation where I would need these services, but at this point it would be along the lines of
-Nominating a corporate trustee, likely Schwab, to manage financial affairs.
-Designating couple of close friends/younger relatives to have springing power of attorney and also be "Trust Protector".
-Provide in my Trust that whoever is serving as my power of attorney be paid reasonable fees and also authorized and expected to retain a professional fiduciary to manage my day to day personal and medical needs.

I am still in the process of investigating all of this and would appreciate greatly feedback/information from others on this.

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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by tibbitts » Sun Jul 14, 2019 11:40 am

Cuzz35 wrote:
Wed Jul 10, 2019 2:39 pm
I still need to go through and read this thread but I have a similar problem.

I currently have a grandmother who lives in rural Wyoming and has her entire life. Her only child, my mother, passed away 20 years go and I am her only living grandchild (I'm 33 with 3 young children). I live in Atlanta and have my own family and job that takes up my time. Grandmother is starting to suffer from dementia and Alzheimer's. She currently gets help from two of her sister's that are a little younger but their age makes it difficult to visit as much as they used too. It really didn't dawn on me that I would be responsible for her at some point until a year or so ago. My grandmother has very little assets as far as I know and I myself don't do well enough to pay the expense of visiting frequently to take care of her. She has no interest in moving. The women in her family have typically lived to 100 (my great grandmother lived to 99) and at some point she is going to need continuous care but more importantly, someone to make difficult decisions for her.
How do the sisters feel about her situation? It will be much easier if you are on the same page. You aren't going to be able to convince your grandmother of anything if her sisters are pulling her in another direction.

visualguy
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by visualguy » Sun Jul 14, 2019 11:59 am

Shallowpockets wrote:
Sun Jul 14, 2019 10:34 am
Sounds like could be an opening for some entrepeneur to start such a service. How many people are out there like that with this need?
I don't know the statistics, but it doesn't seem to be a common problem to have no one because you don't hear much about it. Anecdotally, I haven't encountered anyone with that problem at my mother's nursing home, although I don't know everyone there, of course.

The problem definitely exists for some people, and it's one of the reasons for court-appointed guardians, and also cases of abuse that you hear about once in a while.

Not sure about the legitimate business opportunity because the need is primarily in managing someone's care, monitoring it, and advocating for their interest. This person may stop cooperating and be hostile because of common effects of dementia, so it becomes difficult even for family, not to mention some business. If there is some family remaining, conflict and lawsuits may emerge.

Also, substituting for the kind of care and supervision that family can provide is one of those things that business is just inherently not good at... You would need someone to supervise this business, so ultimately someone who really cares needs to be involved, and if no such person exists, it's a very tough situation.
Last edited by visualguy on Sun Jul 14, 2019 12:01 pm, edited 1 time in total.

Zonian59
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Zonian59 » Sun Jul 14, 2019 12:01 pm

Rosa wrote:
Sat Jul 13, 2019 11:48 pm
TO Zonian59, I just wrote you an answer to what I thought was your questions. I hope you find it but I'm disappointed that in this forum I can't tell who wrote what. If it was you who asked the questions I hope you'll find my answer here. I mistakenly directed my answer to 1210sda. :) Rosa
Rosa, yes I recognized my question. Thank you for your thoughtful answer. It's good you found a good attorney who took care and will take care of things for you after your final exit.

It gets complicated and lots to think about when you really have nobody to look after you in your twilight years.

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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by montanagirl » Sun Jul 14, 2019 12:37 pm

I've thought about this a lot, and took care of a retired officer friend years ago at end of his life, and am now watching out for a friend I met through that guy's family. Neither of us had children.

In the case of the officer, he went into his bank when he couldn't balance his checkbook. Luckily the gal who straightened it out for him took a look at his bills and ending up managing things so that he was easily able to live within his means, with that good pension and all. She became a family friend and then went on to manage bills for the guy's disabled son. She must have gotten a percentage but I never knew. I took care of the old man after he had a stroke and shuttled him in and out of hospitals and SNF's that last year. He passed at home. He had other grown kids who flew to town regularly to check on him because they were suspicious of me but it all worked out well in the end. That was ideal. He had no estate to speak of, just a house with no equity.

Anyway I learned all about Medicare nursing home coverage, and the difference between Medicare and Medicaid (which he didn't qualify for). That has served me well. It amazes me how often people confuse the two, and I have to correct them all the time!

My best friend, I moved her out of her apt when she broke her hip and started using a walker. No family. She put me on her living will and POA. I got her into Independent Living and after a year or so of her hating it, things really worked out for her. They keep an eye on her and she has been to the hospital at least once without my even knowing it. The front desk coordinates things like that. She gets out and around a lot more than I do! They'll get her to the hospital, which will discharge her to the nursing home when it gets close to the end. Her bills seem to be all automated now.

Me, I'm married but expect to outlive DH. No family of my own here and just an older brother 1200 miles away. Ideally I'd get our house sold and move into that same Independent Living place or something like it. There are several nice places here I would consider. That will reduce the number of bills like utilities and the rest can be automatic. I may have to authorize pulls from my account, unfortunately.

Then I would be dependent on the Independent Living or Assisted Living place to watch out for me I guess. It could get nasty at the end, without any sort of advocate. I have a lot of experience at one nursing home and I trust them as it stands now...but in the future, who knows. I honestly don't know how they can keep those places staffed.

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Sheepdog
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Sheepdog » Sun Jul 14, 2019 12:44 pm

RadAudit wrote:
Tue Jul 09, 2019 8:37 am
bsteiner wrote:
Tue Jul 09, 2019 8:31 am
The advantage of a bank is that it minimizes the risk that someone misappropriates the money.
For various reasons, I've come to the reluctant conclusion that - when DW goes - I'm going to be hard pressed to find someone who I can trust to handle the expenses and not misappropriate the funds.
Thanks for the heads up.
Good question and will bring a lot of thought. Our sons live hundreds of miles away. If my wife dies first or becomes incapacitated, I can handle things. If I die first, my wife will have a lot of problems...she knows very little about our investments and how withdrawals are made. She doesn't use a computer or smart phone. She will have a problem. She can pay bills just fine, but most reoccurring bills are automatically paid, but she won't know how to change them. I have had many conversations and pleading with her to become involved. She just says always "Don't worry about it" But I do to no avail. Sighhhhhhhh
It's not what you gather, but what you scatter which tells what kind of life you have lived---Helen Walton

fru-gal
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by fru-gal » Sun Jul 14, 2019 12:45 pm

tibbitts wrote:
Sun Jul 14, 2019 11:40 am
Cuzz35 wrote:
Wed Jul 10, 2019 2:39 pm
I still need to go through and read this thread but I have a similar problem.

I currently have a grandmother who lives in rural Wyoming and has her entire life. Her only child, my mother, passed away 20 years go and I am her only living grandchild (I'm 33 with 3 young children). I live in Atlanta and have my own family and job that takes up my time. Grandmother is starting to suffer from dementia and Alzheimer's. She currently gets help from two of her sister's that are a little younger but their age makes it difficult to visit as much as they used too. It really didn't dawn on me that I would be responsible for her at some point until a year or so ago. My grandmother has very little assets as far as I know and I myself don't do well enough to pay the expense of visiting frequently to take care of her. She has no interest in moving. The women in her family have typically lived to 100 (my great grandmother lived to 99) and at some point she is going to need continuous care but more importantly, someone to make difficult decisions for her.
How do the sisters feel about her situation? It will be much easier if you are on the same page. You aren't going to be able to convince your grandmother of anything if her sisters are pulling her in another direction.
Can the sisters live together?

CascadiaSoonish
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by CascadiaSoonish » Sun Jul 14, 2019 12:59 pm

My experience and point of view is similar to previous posts. I'm managing finances for a parent in skilled nursing. It's not difficult, everything can be done online, and distance is irrelevant.

Managing care is an entirely different matter. My sibling has medical experience and lives near my parent. The sibling is able to deal with the care system and handle the often-patchy coordination and communication within the system. It's a thankless, time-consuming responsibility that requires knowledge and experience to handle well. If I didn't have my sibling I'd be looking at one of the paid services for care coordination, but that on top of the $9K/month for the nursing facility probably makes it financially out of reach for a lot of people.

sawhorse
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by sawhorse » Sun Jul 14, 2019 6:52 pm

I know plenty of cases in which "trusted relatives" were not so trustworthy. There are relatives that use this granted power to do selfish things that are not in the person's best interests. There are some that outright steal from their relatives. I know someone who did this to his father. We've also seen threads on Bogleheads about people realizing that one of their siblings is stealing and financially abusing their parents. Just saying.

visualguy
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by visualguy » Sun Jul 14, 2019 7:01 pm

sawhorse wrote:
Sun Jul 14, 2019 6:52 pm
I know plenty of cases in which "trusted relatives" were not so trustworthy. There are relatives that use this granted power to do selfish things that are not in the person's best interests. There are some that outright steal from their relatives. I know someone who did this to his father. We've also seen threads on Bogleheads about people realizing that one of their siblings is stealing and financially abusing their parents. Just saying.
True, but falling into the hands of court-appointed guardians is a lot more dangerous:

https://www.huffpost.com/entry/court-ap ... 26e3f44d4e

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GerryL
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by GerryL » Sun Jul 14, 2019 9:47 pm

As I ponder these issues, I've been seeking out books at the library on the subject of solo aging. I ended up buying this one: "Essential Retirement Planning for Solo Agers: A Retirement and Aging Roadmap for Single and Childless Adults."

One point the author makes right up front is that singles are not the only solo agers. Many formerly marrieds end up aging solo.

visualguy
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by visualguy » Sun Jul 14, 2019 10:36 pm

GerryL wrote:
Sun Jul 14, 2019 9:47 pm
As I ponder these issues, I've been seeking out books at the library on the subject of solo aging. I ended up buying this one: "Essential Retirement Planning for Solo Agers: A Retirement and Aging Roadmap for Single and Childless Adults."

One point the author makes right up front is that singles are not the only solo agers. Many formerly marrieds end up aging solo.
Yes, one spouse typically dies first, and the other remains solo if there are no children or other close relatives. It's a bit more common for women than men because women tend to live longer, and it's common for the wife to be younger than the husband.

Luckywon
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Luckywon » Mon Jul 15, 2019 1:41 am

GerryL wrote:
Sun Jul 14, 2019 9:47 pm
As I ponder these issues, I've been seeking out books at the library on the subject of solo aging. I ended up buying this one: "Essential Retirement Planning for Solo Agers: A Retirement and Aging Roadmap for Single and Childless Adults."

One point the author makes right up front is that singles are not the only solo agers. Many formerly marrieds end up aging solo.
The book sounds like it may be very useful. What did you think of it, beyond the first point that you mentioned above? Thanks very much for mentioning the book.

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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by dm200 » Mon Jul 15, 2019 8:51 am

In the case of my late father, when he could no longer handle his finances, my brother and sister-in-law - living next door were able to take this over.

Today, as families are smaller and there is more mobility - this financial problem and challenge seems to be growing and will grow in the future.

In terms of actual care, also a growing challenge.

In my small rural home town, there was a woman who took care of many elderly folks - all for very small/modest compensation. She believed strongly that folks should be able to live at home. I think she was a real "saint".

Such "saints" seem rarer these days.

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GerryL
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by GerryL » Mon Jul 15, 2019 1:29 pm

Luckywon wrote:
Mon Jul 15, 2019 1:41 am
GerryL wrote:
Sun Jul 14, 2019 9:47 pm
As I ponder these issues, I've been seeking out books at the library on the subject of solo aging. I ended up buying this one: "Essential Retirement Planning for Solo Agers: A Retirement and Aging Roadmap for Single and Childless Adults."

One point the author makes right up front is that singles are not the only solo agers. Many formerly marrieds end up aging solo.
The book sounds like it may be very useful. What did you think of it, beyond the first point that you mentioned above? Thanks very much for mentioning the book.
Well, Of the various books I checked out of the library on this subject, this title is the only one I felt was something that would be useful to have at hand. At the same time I bought the Nolo book Get It Together: Organize your records so your family won't have to.

To be honest, I haven't yet started acting on my good intentions yet, beyond reading and buying books. But it is a start. Too busy right now traveling and planning more travel.

bampf
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by bampf » Mon Jul 15, 2019 2:34 pm

Arlington2019 wrote:
Wed Jul 10, 2019 4:19 pm
As a healthcare risk manager, I am often called to the bedside for a consult when a patient is brought in and there are no living or available relatives, guardians or even friends involved in their care or their life, or the family members do not agree on what should be done.

If I could wave a magic wand, every person in the US by the age of 45 would have the following documents (completed while you are competent) printed in hard copy and readily accessible at home and a copy would be filed in your primary provider's medical chart or state registry:

1. Living will or advance directive
2. POLST form if you don't want to have the aid unit/medic one resuscitate you at home
3. Durable power of attorney for health care
4. Durable power of attorney for financial matters
5. Your wishes in terms of funeral, body disposition, etc.

It makes it really difficult for us in the hospital when Grandma is dying, the family members don't agree on treatment, and some people think that Grandma would have wanted to just die, but of course Grandma never got around to writing this down or completing a form. Many state laws set an order of priority for who makes the decision, but if there is more than one person in that class, they usually have to all agree, and that is where the trouble comes in.

My other pet peeve is the people who download a power of attorney form from the Internet, fill it out, and then present it when Grandma is unconscious and incompetent in the hospital. I have to tell them that they downloaded the wrong form, and the power of attorney they have is for financial matters only, and it gives them no authority over healthcare.
This really made me think, so thanks for that. I don't suppose you know of an easy/cost effective way to do this short of consulting an attorney?
Thanks in advance.

--Bampf

Zonian59
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Zonian59 » Mon Jul 15, 2019 4:01 pm

GerryL wrote:
Mon Jul 15, 2019 1:29 pm
Luckywon wrote:
Mon Jul 15, 2019 1:41 am
GerryL wrote:
Sun Jul 14, 2019 9:47 pm
As I ponder these issues, I've been seeking out books at the library on the subject of solo aging. I ended up buying this one: "Essential Retirement Planning for Solo Agers: A Retirement and Aging Roadmap for Single and Childless Adults."

One point the author makes right up front is that singles are not the only solo agers. Many formerly marrieds end up aging solo.
The book sounds like it may be very useful. What did you think of it, beyond the first point that you mentioned above? Thanks very much for mentioning the book.
Well, Of the various books I checked out of the library on this subject, this title is the only one I felt was something that would be useful to have at hand. At the same time I bought the Nolo book Get It Together: Organize your records so your family won't have to.

To be honest, I haven't yet started acting on my good intentions yet, beyond reading and buying books. But it is a start. Too busy right now traveling and planning more travel.
GerryL, thanks for the suggestion of the book and helping to identifying the term "Solo Agers". Without that identifier, I had a hard time finding articles and books that relates to my situation as a "Solo Ager/Elder Orphan."

Arlington2019
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Arlington2019 » Mon Jul 15, 2019 7:11 pm

bampf wrote:
Mon Jul 15, 2019 2:34 pm

This really made me think, so thanks for that. I don't suppose you know of an easy/cost effective way to do this short of consulting an attorney?
Thanks in advance.

--Bampf
Sample forms are usually readily available on the Internet if you have a good sense of what you are doing in terms of modifications. Other good sources may be the websites of your state medical association or hospital association. Failing that, I would Google the form name with your state, such as 'durable power of attorney for healthcare Missouri' and see what you get.

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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by bowtie » Tue Jul 16, 2019 9:30 pm

GerryL:
The book you have from the library on "Solo retiring" - the essentials - is it fairly recent? I haven't seen that one in my travels. As you say, the once-marrieds, widows/widowers, etc., 'all' become individuals in that type of category later on, despite the title.

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GerryL
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by GerryL » Tue Jul 16, 2019 10:01 pm

bowtie wrote:
Tue Jul 16, 2019 9:30 pm
GerryL:
The book you have from the library on "Solo retiring" - the essentials - is it fairly recent? I haven't seen that one in my travels. As you say, the once-marrieds, widows/widowers, etc., 'all' become individuals in that type of category later on, despite the title.
The copy I bought has a copyright of 2018. I think I first saw it referenced in a magazine article. Found it in the library but then decided to buy it.

I think the observation about people becoming solo agers is intended to indicate that solos are not some exotic demographic that can be ignored. At least, that was my interpretation.

walker46
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by walker46 » Tue Jul 16, 2019 11:09 pm

wm631 wrote:
Mon Jul 08, 2019 7:10 pm
whodidntante wrote:
Mon Jul 08, 2019 6:29 pm
So I surmise that you have trustworthy people in your life, but no one close. I think this will be OK as long you can afford help and the distant person wants to keep a close eye on things. It may cost more than you realize to have people running errands for you and to fly out the distant person to check on you every couple of months. It will be easier to get them to come in the winter. :happy

If you truly have no one, I do not know of a way to buy trust, especially with no one checking up that the person is actually trustworthy.

As for funeral arrangements, myself I do not care about this, and have suggested this modestly priced receptacle to my friends:
Image

You may wish to make funeral arrangements in advance, however.
Love it. I actually used this specific scene (thank you, YouTube) on my Facebook page a couple of years back as instructions to my favorite nephew (he got the joke (?) - "Lebowski" is one of his favorite movies). I helpfully warned him to make sure his sister is downwind at the time, though.
Here is what we did to avoid the wind problem as portrayed in the movie when we buried at sea (in our case off a pier in Lake Michigan) my in-law’s ashes: the night before we mixed water with the cremains in old Dream Whip containers and put them in the freezer. Next morning, after a solemn and respectful ceremony, we slipped the frozen remains out of the containers at the end of the pier and they sank right to the bottom.

goaties
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by goaties » Wed Jul 17, 2019 1:41 am

Arlington2019 wrote:
Wed Jul 10, 2019 4:19 pm
As a healthcare risk manager, I am often called to the bedside for a consult when a patient is brought in and there are no living or available relatives, guardians or even friends involved in their care or their life, or the family members do not agree on what should be done.
What does a "healthcare risk manager" do? I've not heard of this position before. In the case of a senile patient who has no relatives, are you the one who decides where they go after hospitalization?

I think the problem we've been discussing in this thread is less about end-of-life and more about how to insure a decent quality of life even when mentally or physically incapacitated. With no one to name as your healthcare or financial POA,what's an elder orphan to do? Let the largely unregulated state "guardianship" system take over?

Arlington2019
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Re: If there are no close or trusted relatives close by, who will care for you, pay your bills, etc.

Post by Arlington2019 » Wed Jul 17, 2019 9:52 am

goaties wrote:
Wed Jul 17, 2019 1:41 am

What does a "healthcare risk manager" do? I've not heard of this position before. In the case of a senile patient who has no relatives, are you the one who decides where they go after hospitalization?

I think the problem we've been discussing in this thread is less about end-of-life and more about how to insure a decent quality of life even when mentally or physically incapacitated. With no one to name as your healthcare or financial POA,what's an elder orphan to do? Let the largely unregulated state "guardianship" system take over?
The classic definition of healthcare risk management is: risk management in healthcare comprises the clinical and administrative systems, processes, and reports employed to detect, monitor, assess, mitigate, and prevent risks. By employing risk management, healthcare organizations proactively and systematically safeguard patient safety as well as the organization’s assets, market share, accreditation, reimbursement levels, brand value, and community standing. In a nutshell, I actively address patient safety and other enterprise or operational risks and liability exposures to add value and prevent, reduce or mitigate injury or loss to the patients, employees and assets of the healthcare organization. This is the elevator speech I give when someone asks what I do for a living. You typically find healthcare risk managers in hospitals, healthcare systems and larger healthcare settings. I have worked in the inpatient, ambulatory and corporate settings as a risk manager/director/vice president.

In regards to your question about where to send a patient after discharge, it is generally the attending physician and the discharge planners who make that decision. It is primarily driven by the patient's clinical condition: are they safe to live at home or do they require a higher level of care, such as an assisted living facility or skilled nursing facility. With a patient with no relatives, family or friends and with little or no assets, it can be very challenging to find a place for them, depending on the locale and if they are not able to be discharged home. In some cases, in the absence of anyone else, the local or State government eldercare or Adult Protective Services agency gets involved in terms of handling the financial, living and healthcare affairs of the person.

And these issues not only come up in the case of mental incapacity but also 'end of life'. They are but sequential chapters in the same book.

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