Protecting Elderly Parents from Siblings – The Caring Generation®

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The Caring Generation® – Episode 78 March 24, 2021. On this program, Protecting Elderly Parents from Siblings, caregiving expert Pamela D Wilson talks about how favoritism and enabling behaviors can create dependent parent-child relationships that result in family conflict and potential financial or care abuse. Insights are also shared into mistakes families make that cause issues with Medicaid applications.

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Protecting Elderly Parents From Siblings

0:00:04.0 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation, with host Pamela D. Wilson. Is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.

0:00:37:52 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, elder care consultant, and guardian of The Caring Generation. The Caring Generation focuses on the conversation of caring, giving us permission to talk about aging, the challenges of caregiving, and everything in between.  It’s no surprise that needing care or becoming a caregiver changes everything. The Caring Generation is here to guide you along the journey to let you know that you’re not alone.

0:1:05:80 Pamela D Wilson: You’re in exactly the right place to share stories, learn tips and resources to help you and your loved ones to plan for what’s ahead. We’re here creating The Caring Generation.  Please invite your loved ones, family, and friends to listen to the show each week. This week we’re talking about protecting elderly parents from siblings. If you are a primary adult child caregiver for aging parents, you may find yourself in this protective role where family disputes over elderly parents are happening.

01:40: Pamela D Wilson: You might be asking yourself, how can I protect my elderly parent’s money from my brothers and sisters who rely too much on my parents even though they are grown up? Other situations might be happening where a brother or a sister may have moved in to take care of mom or dad but are controlling your phone calls and when you can visit. We’ll also talk about financial mistakes that elderly parents make that cause problems with Medicaid applications.

02:15:08 Pamela D Wilson: The errors usually involve parents giving money to adult children or grandchildren intended to be a loan but never repaid. Other times parents allow children to become dependent on them for cash and different types of support. There also may be situations where a disabled child living with mom or dad needs care while mom or dad may also need care. These are family situations where protecting elderly parents from siblings may be a priority but you’re not sure what to do without causing conflict in the family.

02:54:22 Pamela D Wilson: Let’s start this conversation by talking about situations that might be happening to you or situations that might be happening that you are not aware of—that can cause significant problems down the road. Let’s begin with the context of framing health and caregiving situations, where many issues about protecting elderly parents from siblings begin. Rarely do we think about this until we’re in a problematic situation where elder care sibling tensions are running high.

03:27:05 Pamela D Wilson: Everyone in their families should talk about health, aging, and caregiving—but we don’t. Why? So many reasons.  I’ll share a few of the big reasons we don’t talk about health, aging, and caregiving. The first is that—we didn’t know that becoming a caregiver was a possibility. We never imagined that our parents would need help—and a lot of it for years and years. This is a “how would I know this might happen issue?” that families don’t’ discuss.

04:02:72 Pamela D Wilson: The second reason is that we don’t talk or think about health, aging, and caregiving—this is NOT a likable, interesting or positive topic, so we avoid it. Very similar to the subject of protecting elderly parents from siblings. You may watch the relationship between your parents and a dependent brother or sister for years and say nothing. You know it’s not good, but it’s not a topic you want to bring up with your parents. Today, you’re afraid if you don’t speak up, the situation will get worse.

04:39:29 Pamela D Wilson:  Other delays in talking about health, aging, and caregiving include not knowing where to start because you have no idea what might happen or what is important.  Compare aging, health, and caregiving to other areas in your life like—saving for retirement or investing money. Many people don’t begin financial planning for the same reason— they are not sure what to do. The solution? Meet with a financial advisor. Read books about investing and retirement planning.

05:15:15 Pamela D Wilson: The answer for health, aging, and caregiving is similar. Meet with a caregiving expert or elder care advisor. Read a book about caregiving. Take an online course on my website at PamelaDWilson.com. No progress happens until you take action. The last reason that families don’t talk about health, aging, and caregiving is that parents are not sure or don’t believe they need a plan. Why would they? When they have you—their children. You—without any discussion or agreement, become their plan.

05:55:01 Pamela D Wilson:  Hint: everyone needs a plan. You can ignore health problems. Deny that you will age, and say that you will never need care or be a caregiver. But—digging your head in the sand like your parents may have done won’t turn out the way you expect.  When your children are talking to you about protecting elderly parents from siblings, you might be deep into the problem such that the issue has become a crisis. How does this happen?

06:25:63 Pamela D Wilson:  Elder care sibling tensions sneak up on families, and family disputes over elderly parents become ongoing concerns. Parents—have you enabled one or more of your children to be financially or emotionally dependent on you while your other children grew up, left home, and are successful? Do you have middle-aged children living in your basement who never moved out or who moved out, and you allow them to keep coming back? How about saying NO?

07:01:85 Pamela D Wilson:  If this is the situation, your children interested in protecting elderly parents from siblings may have valid concerns. Another area for elder care sibling tensions may be having a disabled brother or sister living with your parents without having a plan for what happens when your parents are no longer alive? This is another area where parents fail to make plans to help disabled children become independent. Ninety-year-old parents have seventy-year-old disabled children living with them.

07:38:36 Pamela D Wilson:  While you may feel that caring for a disabled child—by not encouraging them to live in an independent or supervised care situation is the kind thing to do. This isn’t responsible thinking. Imagine the difficulty of starting life on your own at age seventy. When you could have done this in your thirties. Disabled children are often left without the life skills you and I take for granted because parents sheltered them from the world. Life skills like how to cook, clean house, wash clothes, make friends.

08:17:20 Pamela D Wilson: I know all of this seems basic but if you are a parent who is withholding the opportunity to become independent away from a disabled child, know that your child will have a more difficult time adjusting to with life without you when you are dead. For responsible adult children, conversations about protecting elderly parents from siblings may be holding discussions about helping a disabled sibling become and live independently outside of a parent’s home.

08:49:11 Pamela D Wilson: You also may have to address the topic of a dependent brother or sister living in the basement and financially living off your parents. Conversations about protecting elderly parents from siblings are difficult but necessary conversations. Elderly parents may delay talking about these subjects because we don’t want to talk about health, aging, and caregiving.  No time. Don’t like thinking about it. Not sure what to do, and not considering a plan is needed.

09:22:85 Pamela D Wilson: Everything will work out. Not so. Waiting for a crisis situation to force decision-making usually results in worst-case scenarios where more options and choices existed before the crises that don’t exist today. Let’s talk about other protecting elderly parents from sibling situations that you might not realize can happen. Number one is isolation and control. This occurs when a child living in a parent’s home depends on the parent for housing, money, and emotional support—poisons parents against the other children.

10:05:18 Pamela D Wilson: You might think, this never happens. Wrong, it happens quite a bit. Even in situations where there is a primary adult caregiver who bears the majority of the care responsibility. Parents ask yourself if this child living with you tells you that your other children don’t care, never visit, and never call. How would you know if this is accurate? Do you answer the telephone, or does your resident child answer—and it just so happens the phone calls are never for you.

10:41:08 Pamela D Wilson: There are many situations where a resident child stops—or tries to stop outside contact—with children and other family members under the guise of “no one cares about you as much as I care about you.” Adult children who say or think this may be overcontrolling or lack boundaries that are the basis of balanced family caregiving relationships. More on the topic of protecting elderly parents from siblings after the break.

11:12:25 Pamela D Wilson:  Helpful tips, information, and online elder care courses are on my website at PamelaDWilson.com the place to help you and your family start thinking, talking, and planning for health, aging, caregiving, and everything in between. I’m Pamela D Wilson on the Caring Generation. Stay with me; I’ll be right back.

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12:05:99 Pamela D Wilson:  This is Pamela D Wilson on The Caring Generation, the only program of its kind caring to make your life easier by tackling uncomfortable and intimidating discussions about aging, caregiving, and everything in between.  If you want to avoid unexpected caregiving issues, not sure what to do, maybe things aren’t working out as you expected— becoming more educated is a solution.

0:12:29:94 Pamela D Wilson: The  A to Z of caregiving is in my online caregiver course called Stay at Home: Taking Care of Elderly Parents at Home and Beyond and in my course called How to Get Guardianship of a Parent on my website at PamelaDWilson.com. Let’s continue with the topic of protecting elderly parents from siblings and the subject of control and isolation. If you have a child saying or if you are a caregiver saying, “I’m the only one who cares about you,”

0:13:03:51 Pamela D Wilson: It may be time to question motives of trying to control, isolate, or create elder care sibling tensions about protecting elderly parents from siblings. If you are the caregiver, what are you personally gaining from “doing it all?” While caregivers will express concern about all of the things they do, many of the situations are self-created. Rather than starting with even expectations for participation, caregivers find it easier and more time-efficient to do it all and then realize that this “doing it all” was not such a good idea. But they don’t know how to reverse the situation they created.

0:13:47:98 Pamela D Wilson: Protecting elderly parents from siblings can be a positive action. However, this idea can backfire on the caregiver who continually finds her or himself exhausted and burned out. Let’s look at this topic from an opposite perspective, which may not be what you think. Instead of protecting elderly parents from siblings, this situation happens when the care of elderly parents consumes the lives of adult children to the degree that children give up their lives, income, homes, sometimes marriages, friends, and health to care for elderly parents who refuse to look at other options for care.

0:14:32:46 Pamela D Wilson:  Parents, how many times have you heard from your primary caregiver-child, “my brother John never helps. Why don’t you call John and ask him to help?” Instead of giving a direct response to your child, you ignore the statement because you don’t want to admit that John, your son, never shows up, calls, or offers to help. You also don’t want to get into the middle of a battle between your children.

0:15:01:99 Pamela D Wilson:  However, the reality is that you are right there. Stuck in the middle between children who bend over backward to do things for you, children you rarely see and who never help, and not taking responsibility for your own care situation by looking at other options for care. Instead of relying upon a sole daughter or son who you expect to do everything for you. These types of caregiving relationships are unhealthy and eventually damaging.

0:15:34:45 Pamela D Wilson:  Unless either side—the overburdened, exhausted caregiver or the elderly parent who expects everything speaks up to make changes. This relationship will continue to be filled with anxiety, anger, and conflict. A child with good boundaries may be looking in from the outside thinking about protecting elderly parents from siblings. All the while, your self-sacrificing caregiver sibling may be exhausted, burned out, and providing care that may be at the level of neglect for your parent because he or she can’t possibly keep going at the current pace.

0:16:13:57 Pamela D Wilson: Think about this. Who is protecting elderly parents from you? Is your helpful sibling protecting parents from you—the adult child who is not helping—because you don’t want to be dragged into an unhealthy family caregiving situation. Or should you be protecting elderly parents from siblings who are the primary caregivers? Can you see how protecting elderly parents from siblings goes both ways in sibling relationships then takes another turn when the expectations of elderly parents become unrealistic?

0:16:49:77 Pamela D Wilson: If you are listening, you might be thinking – wow, this is my family situation, and it’s not right. Let’s stay on this track for another moment and look at the parent side of needing protection from well-meaning children. How many of you have moved in with elderly parents or moved them in with you? Maybe you thought it was a good idea to sacrifice your career, quit a job, spend your money on care for your parents.

0:17:18:30 Pamela D Wilson: But now you find yourself in a situation where you have become dependent on living in a parent’s home because you don’t have a job and nowhere to go. Protecting elderly parents from siblings poses a mirror image of protecting yourself as a potential caregiver from elderly parents who need care. While you may not like thinking about this and don’t know how to talk about it,

0:17:44:83 Pamela D Wilson: these unintentionally abusive situations don’t change until one side, the caregiver, or the care receiver parent, starts looking for balance and acknowledging that the situation may be concerning. Let’s take this one step further for protecting elderly parents from siblings. You are the brother or sister who didn’t want to have anything to do with the care of elderly parents and didn’t realize how far your burned out or exhausted caring brother or sister would go.

0:18:17:73 Pamela D Wilson: Maybe your brother or sister added their names to the bank accounts of your elderly parents. And why not?  No one is watching. Adding a child to a bank account may seem logical—for making it easier to pay bills. Parents and others, doing this without any type of oversight also makes it easier for adult children to spend or steal your money. Let’s go yet one step further, your dutiful, helpful, self-sacrificing, do anything for your parents, brother, or sister who is protecting elderly parents from you—siblings who aren’t helping out— take your parents to an attorney.

0:19:04:74 Pamela D Wilson: Your parent names the caregiving son or daughter as a medical or financial power of attorney and writes the other siblings out of your parent’s will. This legal appointment gives the caregiving child more control over your parent’s life. It’s one thing if this is a child who will always do the right thing—it’s very different if this caregiving child is in a position of giving up everything, career, a home, a marriage, friends, or a family to care for parents.

0:19:40:69 Pamela D Wilson: These children can arrive at an unhealthy state of mind where they feel entitled to a parent’s home, property, and money. Sons and daughters in this situation may place an elderly parent in a nursing home and never visit. They may sell a parent’s house to recoup the money they gave up from selling their own home or giving up a career. Frustration and anger can push family caregivers to take actions that others might view as unreasonable or plain not right.

0:20:16:38 Pamela D Wilson: But, no one else in the family cared enough to watch over mom and dad. Until you are a family who becomes involved in protecting elderly parents from siblings, it’s challenging to realize the emotional stress, isolation, depression, loneliness, and desperation that can happen. Which is why we are talking about protecting elderly parents from siblings in the hope that you never allow your family to get to this point.

0:20:48:27 Pamela D Wilson: Talking about health, aging, and caregiving can be done proactively rather than responding to crisis situations. Caring for elderly parents does not have to end up in a situation where one child does it all—while the other children are not involved, and then you have an issue protecting elderly parents from siblings. You may be a spouse caregiver listening to these scenarios and finding yourself in a similar situation as the sole caregiving child. You are exhausted from doing it all.

0:21:30:13 Pamela D Wilson: There is little or no appreciation from your spouse. Maybe you are caring for a spouse with dementia who can’t help him or herself. It’s time to stop and regain perspective about what is reasonable in care situations. If the caregiver or the person needing care is not having their needs met—either because the caregiver has sacrificed everything or the person needing care requires more than the caregiver can give—it’s time to press the pause button.

0:22:05:67 Pamela D Wilson: After this, an archive interview with attorney Donald Vanarelli about Medicaid planning and potential financial issues. We will talk about spousal burnout situations that may bring up more questions about protecting elderly parents from siblings. I’m Pamela D Wilson. I help family caregivers and organizations talk about health, aging, and caregiving. Conversations are essential to understand decisions related to caring for elderly parents, navigating the healthcare system, and discussing financial and legal plans for care.

0:22:40:67 Pamela D Wilson: Applying this learning to life today can ensure that you are not passing caregiving worries and responsibilities down to the next generation—your children. Visit my website, PamelaDWilson.com, where you will find information about keynotes, webinars, online courses about elderly care, and all of The Caring Generation podcast episodes. Stay with me; I’ll be right back.

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0:23:35:00 Pamela D Wilson: This is Pamela D. Wilson, caregiving expert, speaker, and elder care consultant on The Caring Generation. The only program of its kind caring to make your life easier by tackling uncomfortable and intimidating discussions about aging, caregiving, and everything in between. Join me every Wednesday for The Caring Generation. The show is not limited by time zone or location—caregivers worldwide listen.

0:24:00:29 Pamela D Wilson:  Share and visit my website PamelaDWilson.com with others you know. One in 4 people are caregivers looking for hope, help, and support and don’t know where to turn or who to trust. You’re about to meet attorney Donald Vanarelli of the Law Office of Donald D Vanarelli in Westfield, New Jersey. Attorney Vanarelli provides a broad range of legal services for seniors, the disabled, and their families and families in conflict in the areas of estate planning, VA compensation and pension benefits, social security, nursing home law, and litigation, and other areas of family law. Meet Donald Vanarelli.

0:24:46:27 Pamela D Wilson: Can you talk about how often you see financial exploitation of the elderly that leads to problems when they need to apply for a public benefit like Medicaid?

0:24:55:22 Donald Vanarelli: Personally, I’ve seen it quite a bit in my practice. I think it’s common for an elderly or disabled person to entrust his or her finances to a third party. Sometimes the elder becomes overwhelmed by handling day-to-day finances. Often they will execute a power of attorney giving authority to a relative or a friend or might simply hand over the checkbook to a relative or friend. And the problems develop when that trusted friend or relative misuses the authority. As the elderly population continues to increase, I think you’ll see financial exploitation of the elderly becoming a serious, a more and more serious problem.

0:25:45:54 Pamela D Wilson: In your experience, is it usually a family member more likely than a stranger?

0:25:50:12 Donald Vanarelli: Yes, more likely than a stranger. I think a family member gets involved. Although I was involved in a case here in New Jersey where a friend took in a—an elderly person and ended up exploiting them, stealing about $170,000 and actually got convicted and was sentenced to seven years. And we managed to get a civil judgment against the exploiter in that case.

0:26:23:11 Pamela D Wilson: Thank goodness. A lot of people don’t understand Medicaid. Can you give an example of what might be considered normal spending versus a gift that causes issues with Medicaid?

0:26:34:97 Donald Vanarelli: Sure. Medicaid is a public benefit—it’s really a five-year look-back period. That is if you file for Medicaid today. They’re going to look back for five years to see if you made a gift. And really, everything counts. For example, I don’t know how many times I’ve been asked the question about the $13,000 annual exclusion amount under the gift tax is okay to give. That’s legal and it’s not. It’s fine under our gift tax rules. But it’s not fine under our Medicaid rules. Also, 529 plans for children and grandchildren are really forbidden under the public benefits, or IRAs. It’s not really a gift, but it’s a transfer of an asset. IRAs count as a resource. It’s a welfare program, and anything is really going to affect your eligibility.

0:27:36:58 Pamela D Wilson: Can you talk about what happens to somebody—let’s say they made a gift, and the person is unable to qualify for Medicaid because of that or because of exploitation. What happens to that person?

0:27:46:11 Donald Vanarelli:  Well, this— in cases all over the country, and really they’re all over the map on how they come out. Some courts—initially, you’re almost sure to be denied. But on appeal, some courts grant eligibility. Some courts deny Medicaid eligibility. And there seems to be factors that impact on the decision. Like is the elder or disabled person competent? Were the transfers authorized, or were there issues of family trust involved? How involved was the elderly person in making the transfers or the extent of control that was exercised by the wrongdoers? Those are some of the things the courts seem to look at in these cases.

0:28:41:87 Pamela D Wilson: And you worked for the social security administration can you talk about some of the more common issues you saw with individuals applying for any type of benefits that you were working with and why they were denied?

0:28:54:04 Donald Vanarelli: Sure. I was a social security claims representative before I became an attorney. I took claims for social security benefits. For retirement benefits, usually, there’s no problem. I mean, you’re either insured, or you’re not insured for benefits. In other words, you worked enough. Sometimes for self-employed people, there was a questionable retirement issue where people really retired, so that might hold up a social security retirement benefit. For disability benefits, again it was straightforward.

0:28:07:28 Donald Vanarelli: Did you work enough for the benefit, and did you meet the definition of disabled? And the issues that came up were more complicated. Sometimes in the supplemental security income—that’s the federal welfare benefit that the social security administration administers—because there you have to meet financial criteria. You have to look into somebody’s living arrangements, and you have to determine whether they are disabled or not. So the more complicated issues. The more avenues where people could be denied.

0:30:08:32 Pamela D Wilson There’s a whole idea out there. They call it Medicaid planning. What do you think about attorneys who legally help families shift assets to avoid money and property being used to pay for care? Is that okay because it’s legal?

0:30:22:54 Donald Vanarelli: Well, I think if you—the elderly person is competent and they have the choice. They’re presented with the choice of preserving money for their loved ones. That is by having Medicaid pay for their nursing home costs or other facility costs. They would choose to do that, and basically, that’s what Medicaid planning is, and it’s legally permitted under state and federal law. Here in New Jersey, I represented an elder’s adult children all the way. We lost, lost, lost, and finally got to the New Jersey supreme court in a case that involved Medicaid Planning. The name of the case was In Re: Keri and our supreme court confirmed that Medicaid planning is permitted under the law and in fact a court compared Medicaid Planning with Estate Tax Planning where taxpayers maximize their deductions under the tax laws to preserve income for their families. Even though estate tax planning also reduces the amount of money available to the government. So, you know, it’s legal and it’s been blessed by every court that’s considered it.

0:31:32:04 Pamela D Wilson:  So if somebody is considering it, how do they know when they should start planning ahead. Do you have any recommendations?

0:31:37:95 Donald Vanarelli: Well, it’s easier to say the sooner the better. I mean the reality is that people don’t start thinking about Medicaid and public benefits until their loved ones are—become less independent. As soon as—usually I’m talking to the adult children of the elderly parents and you know as soon as we can get started it’s better. But usually, it’s within the five years. It’s usually people start to need—have just started needing the caregivers. The children are alerted to the fact that these, providing care is very expensive and mom or dad is going to need it in increasing amounts as they get older.

0:32:29:11 Pamela D Wilson: So usually, then when somebody starts to need care, is there an average age that you see people do planning?

0:32:34:46 Donald Vanarelli: It’s gotten older and older in my practice. It seems when I started, I was talking to people in their late 60’s early 70’s. Now I have people come into the office, you know very typical 80, 90. The other day somebody came in who was 93. So I mean, the sooner you can do it, the better. But I don’t think people start to really focus on it until mom or dad has that health crisis point that makes you realize that you’re going to have to have a caregiver. They’re going to have to go to assisted living facility or even maybe even consider a nursing home.

0:33:14:83 Pamela D Wilson So for people in that situation, your recommendation is looking for help that they call an elder law attorney?

0:33:20:46 Donald Vanarelli: Yes there’s really not that much information available and you know, Medicaid is a super complicated program. It took me a long time to work my way through all of the regulations, and I don’t think I don’t know if there’s any way to really learn the program with what’s available. But there is stuff out there, like your website, I have a lot of information on my website, but it’s hard to—I think somebody just coming into it I think it would be hard to noodle their way through it.

0:33:56:76 Pamela D Wilson: It’s time for a quick break where we will return to talk about spousal caregiving relationships and exhaustion. The Caring Generation podcasts and the show transcripts are on my website at PamelaDWilson.com and all of your favorite podcast apps: Apple, Google, Spreaker, Podcast Addict, Pandora, Amazon Music, Stitcher, Spotify, I Heart Radio, Podchaser, Jio Saavn, Vurbl, and More. Add the podcast app for the Caring Generation show on the cellphone of elderly parents, in-laws, family members, and friends.

0:34:07:31 Pamela D Wilson: If you are an adult child or another family member considering guardianship of a parent or want help knowing how to manage, advocate, and navigate care, check out my two online webinars caring for elderly parent courses. The first is How to Get Guardianship of a Parent, and the second, Taking Care of Elderly Parents, available on my website PamelaDWilson.com. More helpful information about caregiving and aging is in my book The Caregiving Trap: Solutions for Life’s Unexpected Changes, available on my website at PamelaDWilson.com. I’m Pamela D Wilson on The Caring Generation Stay with me. I’ll be right back.

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0:35:41:61 Pamela D Wilson: This is Pamela D Wilson. You’re with me on The Caring Generation, the only program of its kind bringing caregivers and aging adults worldwide to talk about aging, caregiving, and everything in between. More information and support for caregivers, corporations, and groups are on my website at PamelaDWilson.com. There you’ll find information about keynote events, webinars, online courses, and more.  Let me know how I can help you, your group, or your organization by visiting the Contact Me page on my website and sending me an email.

0:36:14:28 Pamela D Wilson: Let’s return to talking about adult children and spousal caregiving relationships. Win-win caregiving situations happen when the caregiver and the person needing care both have their needs met. Lose-lose situations happen when caregiving is lopsided. The long-term effects of lose-lose situations are harmful to the caregiver and the person needing care. Protecting elderly parents from siblings goes in many directions.

0:36:44:25 Pamela D Wilson: Acknowledging that you are an exhausted or burned-out spouse caregiver can help avoid poor care for a spouse and physical and emotional health issues for the spouse caregiver. If you are an adult child watching caregiving situations escalate in your family between parents or siblings, schedule a family meeting. Seek outside support from a caregiving expert if your family won’t listen to you.

0:37:11:61 Pamela D Wilson: There may also be extreme cases where you have tried everything, and there are no other options but to report your family to adult protective services or the police for an investigation because you suspect financial, emotional, or physical abuse. Elder law attorneys like Donald Vanarelli can also be helpful in these potentially abusive situations. Let’s talk about Medicaid for a few minutes. For aging parents who have not saved money and do not have substantial savings or property to pay for care, the public benefit of Medicaid is an option.

0:37:50:05 Pamela D Wilson: As we discussed earlier, Medicaid has a five-year lookback period for assets given away. Protecting elderly parents from siblings means that any agreement to pay children for care must be carefully drafted and notarized to avoid Medicaid saying that the payments are unreasonable and decline a Medicaid application.

0:28:12:39 Pamela D Wilson: While some Medicaid programs allow family members to be paid for caregiving, the issue of giving away property or money that results in disqualification mainly occurs in the Medicaid application process. Before Medicaid is approved. Let me share an example. I helped a family complete a Medicaid application knowing that there was an issue. The issue was that grandma gifted her granddaughter $60,000 to pay for a wedding.

0:38:44:89 Pamela D Wilson: One year before her health changed and she needed to apply for Medicaid. Grandma was disqualified until her family could repay the $60,000. My advice if your parents are older—avoid gifts, avoid loaning money to other family members, avoid transferring property unless first you meet with an estate planning attorney well-versed in Medicaid who can guide you. While these cases can be appealed, appeals take the time that your elderly parent may not have if care services are needed today.

0:39:21:57 Pamela D Wilson: Next on the list of protecting elderly parents from siblings are cases of disagreement about care needs. Let’s say that one child has been appointed the medical and financial power of attorney for a parent with dementia. There are five siblings. All of who disagree about the care that mom or dad with dementia should receive. If you are a caregiver for a person with dementia, you know that after the disease progresses, it is challenging for a person to reason or rationalize information.

0:39:54:38 Pamela D Wilson: Most of the time, a person is very forgetful. This does not mean that mom or dad cannot be emotionally upset by a person. A brother or a sister, who wants to cause chaos within a family. Brothers or sisters may speak negatively to a parent about the actions or Intentions of a sibling who wants to cause family discord. This may result in mom or dad being angry at the son or daughter who was appointed agent under power of attorney.

0:40:24:84 Pamela D Wilson:  If you are this agent, you might feel vulnerable to the actions of your siblings. In this situation, you can take action to contact an elder law attorney to learn your rights. As an agent and a guardian, there were situations where I had to institute “supervised visits” between parents and children and even go to the extent of getting a restraining order against friends who appeared well-meaning but caused emotional havoc or who were interested in my client’s money.

0:40:57:10 Pamela D Wilson:  If you are appointed in a legal role, you have a responsibility to do the right thing regardless of how difficult this might be when you family members may be fighting your actions or disagreeing with your decisions. In the time we have left, let’s talk about protections that everyone can take in protecting elderly parents from siblings or other people who might intend to cause issues or take advantage of a vulnerable elderly person.

0:41:25:19 Pamela D Wilson:  If we are honest, there is no way that any of us can predict what we will be like when we are 80, 90, or 100. Will we be mentally astute, physically disabled?  There is no way of knowing. So, how can we avoid someone taking advantage of us? Create estate planning documents. A medical power of attorney, financial power of attorney, a living will, will, or trust. I recommend not downloading these off the Internet if you want the necessary protections to avoid abuse. Take this process seriously and consult a probate, estate planning, or elder law attorney.

0:42:06:59 Pamela D Wilson:  Include provisions about what it would take to change your documents. By this, I mean that anyone who might attempt to create a document after the originals are completed would have to take extra steps. For example, to contact the attorney or the law firm who drafted the original document. Make the document say that you have to have two or three witnesses who are not named in the will or the trust agree that at the time the documents are changed, you have the mental capacity to understand and implement the changes.

0:42:44:12 Pamela D Wilson:  If you establish a trust, establish a trust protector who can serve in a similar capacity regarding any trust changes. You would be surprised at the number of family members or ill-intended others who attempt to have wills, or other legal documents changed to their advantage. Sadly, this happens all too much. I am even aware of situations where attorneys have named themselves as a medical or financial power of attorney, personal representative, or trustee of an estate and financially profited.

0:43:18:85 Pamela D Wilson: Money makes people do strange things. On the other hand, I can say that I have worked with amazing, caring families with wonderful children who did the right thing for parents in my twenty years. There are as many good people as there are people who Intend to take advantage of the elderly in the world. As the population continues to age, parents and single adults will find it more challenging to “name” someone to make legal and financial decisions for them.

0:43:47:38 Pamela D Wilson: I know this because when I served as a professional fiduciary, I was named by many parents and single adults to act in these roles for them. Because they did not trust family to serve in this capacity. If you are In this position ask your elder law, probate, or estate planning attorney to recommend a professional fiduciary who can serve in this role for you—if you don’t have the family you wish to appoint or friends who don’t want this responsibility.

0:44:15:51 Pamela D Wilson:  Last but not least, let’s talk about the idea of transparency. Transparency means that information is available—out in the open and discussed with family members as much as it can be. This means that with your parent’s permission, you can disclose information about their finances and health to siblings who may be interested or have ill intentions. What this transparency does, is that it makes sure that all of your actions are according to the law.

0:44:45:61 Pamela D Wilson:  If you need advice about transparent activities, contact an attorney or a professional fiduciary who can talk to you about accounting procedures and medical decision-making. While withholding information may be easier, when information is hidden, more suspicions can arise. If there is an exchange of money desired by your parents and any family members, put this agreement in writing with the support of an elder law attorney who can look at the agreement from a Medicaid and legal perspective.

0:45:18:02 Pamela D Wilson:  Have witnesses for the document and have it notarized. If you are spending mom or dad’s money, keep receipts for everything. If you are managing the checkbook, keep a detailed checkbook ledger. Medicaid requires this type of information to verify that funds are being spent in a manner consistent with the care needs of elderly parents. Avoid using cash if at all possible. Use checks or credit cards that create a paper trail. Avoid gifts where possible.

0:45:48:57 Pamela D Wilson:  Rather than having your name added to the bank account of a parent, complete the estate planning process we discussed. Then have your name added as a legal financial power of attorney. Finally, one of the most difficult tasks to complete is to repair family relationships if possible—realizing that relationships may be fractured. You are not doing this for YOU because you probably would not. You are making this effort for your spouse or the parent for whom you are providing care.

0:46:19:63 Pamela D Wilson:  Taking these steps can avoid problems throughout caregiving situations that can potentially be legal battles that may be unnecessary. You can also prevent issues that can happen after a parent passes away, like a contested will. Your siblings may say that you exerted undue influence upon a parent and accuse you of wrongdoing that harmed their inheritance.

0:46:44:91 Pamela D Wilson:  These after-death battles can go on for years and cost a pretty penny in legal fees. If you can mend fences today through honest discussions about aging, caregiving, and health, I recommend doing this. Worst case, you attempted, and other family members refused to come to middle ground. Their refusals to mend fences are on their conscience—not yours. Best yet – avoid family disagreements by talking early about aging, health, and caregiving issues.

0:47:17:69 Pamela D Wilson:   When these issues are commonly discussed in families and when parents plan for their care needs, many caregiving families’ struggles can be avoided. Rather than having later years in a life filled with uncertainty, doubt, and struggle, start making plans today for the life you want to live. Become a proactive healthcare consumer. Learn about your health. How health insurance works, and all the actions you can take today to be healthy in your later years.

0:47:47:83 Pamela D Wilson:  If you have children, don’t shelter them from aging care discussions about their grandparents. Include them so that they know that aging is part of life. Use the opportunity of grandparent care to talk to children about aging and what happens in life. Prepare your children for the fact that you will likely pass away before them. The surprises of caregiving can be avoided when families talk about all of these things.

0:48:16:16 Pamela D Wilson:  Additionally, protecting elderly parents from siblings may never become an issue when parents realize how enabling behaviors or other types of favoritism can create divides in family relationships. Start talking about caregiving today in your family today. If you in a caregiving situation where you are not sure what to do or how to plan to for care needs, help is on my website in my online articles, caregiver courses, videos, and most of all in the support that I offer to groups and corporations interested in supporting caregiving conversations.

0:48:51:48 Pamela D Wilson:   Many caregivers worry about talking to employers about caregiving responsibilities. In addition to this show that can help you talk to elderly parents and family members, and your caregivers—I’ll be happy to speak with leaders in your organizations. Share my website PamelaDWilson.com with your human resources manager or the decision-maker in your company.

0:49:12:85 Pamela D Wilson:   And as for caregiving programs, I thank you so much for joining me on The Caring Generation – the only program of its kind connecting caregivers and aging adults worldwide to talk about caregiving, health, and everything in between. Invite your family and friends to listen each week. I am Pamela D. Wilson, caregiving expert, advocate, and speaker. Thank you all for being caregivers. God bless aging adults.  I look forward to being with you again soon. Sleep well tonight. Have a fabulous day tomorrow and a great week until we are here together again.

0:45:23:73 Announcer: Tune in each week for The Caring Generation with host Pamela D Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone here on Pamela D Wilson’s The Caring Generation.

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About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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