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Planning for your parents’ long-term care isn’t just a financial decision; it’s an emotional one. Conversations about aging, health and money can feel overwhelming, especially when you’re balancing your own family’s needs.

But starting early gives everyone more choices and peace of mind. A thoughtful plan that takes into account your parents’ finances and care preferences, supported by the right legal documentation, can help protect their comfort and independence while reducing stress for the entire family.

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WHY PLANNING FOR AGING PARENTS MATTERS

We all know the health care system is complex and expensive and can be bureaucratic. That might be even more true for older Americans, who tend to need more extensive and specialized care, under government-run health insurance (Medicare) that doesn’t always work the same as employer-sponsored insurance.

And senior health care eventually can include long-term care, which is a whole other level of complex and expensive. Here are a few reasons why:

• Costs are high and rising – the average cost of the most expensive type of long-term care in 2024 was over $127,000 a year
• Medicare generally doesn’t cover long-term care, and Medicaid will only cover it once almost all financial resources are exhausted
• It’s a varied ecosystem – long-term care can mean a nursing home, assisted living or at-home care, for example

For many families, the “traditional” option of children caring for their elders, while theoretically cheaper, isn’t possible, because of distance, other responsibilities, stretched finances or complicated interpersonal dynamics. And for the 1 in 4 U.S. adults who are caregivers, stress has to be considered as a factor. Caregiver health outcomes are often worse than those of non-caregivers.

It benefits everyone in the family to have a plan in place for potential long-term care needs, both financially and for health and peace of mind. While it might be a challenging topic to broach as the child, delaying the conversation risks additional financial strain and family conflict.

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STEP 1: START THE CONVERSATION EARLY

It’s wise to talk about the potential for your parents to need long-term care before it actually happens. The stress of dealing with this kind of massive life upheaval can add to an already sensitive and emotional discussion.

As you think about how to approach long-term care planning, remember that you’re really talking about the confluence of several potentially touchy subjects: aging, health and money. If you know these topics are triggers for your parents, tread carefully. Make sure not to use language that sounds judgmental or that challenges their autonomy. Emphasize your desire for them to be safe and comfortable.

You may not need to have all siblings and other decision-makers involved in all conversations (which could be intimidating or inefficient), but, depending on your specific family dynamic, it may be important that they know what’s going on and have the opportunity to be part of the planning.

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STEP 2: EVALUATE HEALTH AND LIFESTYLE NEEDS

The plan should start with your parents’ desires for aging. That said, the plan also needs to be flexible, because ultimately how their aging will progress is not totally within their control.

For example, do they prefer:

• To live in a community that offers increasing levels of care as they age?
• To live with their children or grandchildren?
• To age in place and bring in a caregiver if needed?
• To prioritize quality of life with a high-end care home that is likely to be quite expensive, versus a cheaper option that may not be as comfortable?

Once you understand your parents’ preferences, you should also consider the likelihood that their plan will align with their reality. For example:

• Do they have any health issues? What is the prognosis and expected progression?
• Did their parents have serious health issues that are genetically linked? Did they need long-term care?
• Given their own health issues and those of their parents, what is the likely extent of care that will be needed, and for how long?

For many people, aging in place or living with children are preferable options rather than “going to a home.” If this is true of your family, you’ll have to weigh safety considerations against your parents’ independence (And of course, if your parents want to live with you, you’ll have to sign off on that idea and be sure you’ve considered how that will impact you and your family).

For example, you may need to consider:

• Is anyone around during the day to monitor your parents or respond to an emergency?
• Is the ostensible caretaker physically capable of helping with the types of activities that may eventually be required (bathing, toileting and dressing, for example)?
• What is the cost and practicality of modifying the home to allow for potential future needs? For example, wheelchair ramps, a first-floor bedroom and full bath or accessible parking.

STEP 3: CREATE A FINANCIAL PLAN FOR LONG-TERM CARE

Once you know your preferred and backup options, you should estimate the financial costs. When older Americans need long-term care, it’s for an average of about 3 years. But it depends on gender (women tend to need it longer than men) and the health condition causing the long-term care need.

When you have the costs, look at what your parents have available to pay for them. It can include:

• Long-term care insurance
• Annuities and pensions
• Social Security
• Personal savings

If your parents don’t have long-term care insurance, it may not be too late. But policy premiums get expensive as you age, so we generally recommend buying a policy by your early 60s. After that, it will likely cost too much to be practical.

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STEP 4: ESTABLISH LEGAL PROTECTIONS

No aging parent checklist is complete without legal support. While these protections aren’t unique to planning for long-term care, you should ensure your parents have planned for – and legally documented that plan for – the possibility they become incapacitated. For example, they should have:

• A power of attorney to give someone (like you) the ability to handle their finances. This will become important if you need to access their money to pay long-term care bills (among many other potential scenarios).
• A health care proxy to give someone the power to make health care decisions if they can’t, and a HIPAA release to give important people (again, like you) the right to speak to their doctors and otherwise access important health care information.
• Someone designated as a “trusted contact” at their financial providers. This puts processes and permission in place if a provider is concerned that they can’t reach your parent or that he or she may be impaired when making decisions. They could reach out to the trusted contact (for example, you) in that case.

STEP 5: REVISIT THE PLAN REGULARLY

All the best planning can sometimes go out the window once reality hits. Your parents’ financial and health situations are likely to change over time, so you should revisit your plan at least once a year, and more often if something has changed. That includes making any necessary updates to legal documents.

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WHEN TO SEEK PROFESSIONAL GUIDANCE

No one automatically knows how to prepare for aging parents. If you notice growing complexity in or strain on your parents’ finances, increasing health issues or diminishing capacity, it may be time to involve professionals. In some cases, an elder law attorney or geriatric care manager may be helpful in addressing legal and health-related needs. This proactive approach helps reduce stress, minimize family conflict and ensure your parents’ comfort and dignity.

Helping elderly parents plan for the future isn’t about taking control; it’s about showing care and protecting their independence. Start the conversation today – it’s one of the most meaningful acts of love you can offer.