Advice For Elderly Parents Care From Guest Expert Asha Paulose

Welcome, Asha, to the podcast. I'm excited to have this conversation today around aging parents and Medicaid and how that affects our financial planning and looking forward to the future. But before we dive into that, can you tell us a little bit about who you are, what you do, and how you help people? Oh, thank you, Dillian, for having me. I am an estate planning attorney and elder law attorney, so I mainly handle retired individuals that need to kind of figure out long term care and how it fits in with their retirement planning. I work mainly in New York and in the lower Hudson Valley and New York City area. I'm so glad to bring your expertise onto here. Long term care planning, I think, is something that is not talked about enough. And I did my own exploration after caring for my mother and, you know, chose what was best for me. I'm grateful to have somebody come in and help listeners make that, that part of life easier. I mean, it's not an easy road and it can be tough, but you know, knowing these things can help us make it an easier road. So my first question is, what are the first legal steps families should take when they begin assisting aging parents with their financial and medical decisions? I, I think speaking to an attorney would be extremely helpful, very low pressure. Just tell mom or dad, Hey, let's just talk to an attorney. We're not signing anything. We're not telling them all our business. Just let's just have a conversation. And so I think it eases them in. There's a lot of clients that come to me and do like a one hour session. I'll go through just the basics. It's a little scary to talk about long term care, but I talk about it with them, explain it. And then they may not come back to me for a couple of years even, you know, but they have with them armed with that conversation and maybe even a couple of recommendations and writing with for me. Sometimes the kids will come back with that and say, Hey, remember this three years ago, let's chat. So it's nice to do that. And I'm sure that gets them thinking. That gets them on the same page with their parents. So, going back a step, how does that child or children start initiating these conversations with their parents? To even get them to go visit you or, you know, an attorney and start talking about this. I know it's such a vulnerable topic to talk about and then to have it with your kid that you, you change that person's diaper, you know, like you help them through high school worries and now you're like, Oh, now I have to listen to you. Like, no, that's, that's a lot on them. And I'll tell you the worst thing a child can do is try to just take care of it all in one weekend. That's the worst thing. So they'll call me on Monday and say, we want to sign documents on Friday. And I'll, I'll be on a flight in on Friday and come back Sunday. And, and that's, it's such a dangerous way to approach it. Your parents will instantly know that their voice is not being heard and, and you just want to be in control. So I think the best approach is to do it early and often and to have these conversations to how you do it. I'm still struggling with that in my own families. But what I found is some people like to do it by mentioning a story about their what happened to their friend and their parents or did you hear what happened to this neighbor and then kind of subtly talk about it. Or some people really love. Hey, mom, next week, 5pm. We're going to talk about this. I know it's going to suck. You know, it's going to be uncomfortable, but let's just have a chat, you know, no, no pressure. I'll hear you out. Not going to say anything. You know stay silent while you talk about your concern and, and, and approaching it that way might be helpful to the parent as well. I love that approach. You know, especially if you're just wanting to talk and you don't have a story. Maybe there's not something that's happened to be able to like, give them that time to plan and prepare. I also think another, having been through it, you know, another good thing is like, I need your help and this is what I need your help with. We're going to talk about it more in depth. I think that is great. It is a difficult topic, I think, for both sides. So approaching it, I love your idea of approaching at very simple steps, small steps, you know, taking advantage of those different things. So yeah, if you have a story, go talk to them. I love that. So what essential legal documents should families have in place to protect their parents and making sure that their wishes are honored? Yeah, before you even get the documents, I always tell the clients two things. One is, and you can work on it with your, you know, you as the adult child can help your parents with this. It's not being very intrusive that you're not asking for account numbers or exact values of everything, but it's nice to know what assets a person has. So if you know, The name. Oh, I got something in Citibank. Okay, great. We got to know at least that what type of account it is. Is it a checking? Is it a savings? Mom? What do you think? And then who the owner is? There's a lot of people that are like, well, I pay the bills and it's under my eye. I control everything. But it actually has my sister's name on it, you know, so it is crucial to know who owns everything. Is it jointly owned? Is it singly owned? And then who the beneficiaries are. Once the attorney has like an idea about that, it just makes the planning all that easier. To have a beneficiary on things means that that controls. So if you have a checking account with a beneficiary, Well, if your will says to all of my kids evenly, but you have one child as your beneficiary, well, that's what controls, you know, the one child gets that full amount. So it's nice to kind of know who your beneficiaries are. And then once you have that list, I kind of tell people to write who's on your team. And you know, that includes who are the people you want to take care of you when you're sick, to come into the house. You know, to visit you, to help you with your finances, to pay the lawn guy, you know, who's in your team. And as an adult child, you have to be okay with Well, maybe I'm not part of that team. You know, maybe I'm going to help mom get all these documents, but I'm not going to be the one on that team, and we just have to kind of accept that as a role, and that's going to be hard, but everybody kind of has their strengths and weaknesses, and mom feels more comfortable with sister handling all the crucial health care decisions. I gotta be okay with that, because I'm doing something else for her. I'm being a better mom. benefit in other ways. And then once you got all that down, you come to the attorney. You get these basic planning documents. Every attorney will say the basic planning documents are crucial. There's three different categories. I kind of put it as one is your, all your health care talks. It feels like every single decision is a separate document. So, you know, that's just how it is. That's just how the healthcare system is, much like the healthcare system in general. It's all complicated. So you have one person for your medical decisions if you're not able to. Every state is different. So you might be Googling as an adult child. How can I help my parents? And oh, here's a template for a health care proxy. Well, that actually was for a Michigan template. You got to make sure you're Googling correctly and it's for the actual state that you live in. So health care proxy or health care power of attorney in some states, it's called kind of assigns. the one person that's going to be in charge of your medical decisions if you're not able to. What does that mean? When you're on death's door, yes, that is what it means, but it also means a lot of other things. When you're heavily medicated and you broke your leg and you just need a little assistance and you need someone to be there, the doctor, to say, how much of this should I take a day? And What are the side effects? It's nice to have someone else there. Or in a lot of cases, we're going to be dealing with families that have dementia parents that have dementia. And so, yes, there should be someone there and the doctors or any, any kind of situation where they can make those medical decisions or just at least listen to what the doctor or the nutritionist or whoever else is talking. So the healthcare proxy is important. There's other documents, and I call them the supplemental documents that you might want to put your, the other kids names in, you know, because they're not as important, but they're important. So one of them is like the HIPAA form who can access your medical records. It's really for that. emergency situation where the ER doctor needs your cardiologist report. Okay, I'll get that for you, doctor. No problem. And then there's the living will. A lot of people get weary of this because you don't want full instructions on what to do. What exactly you want to happen in every single case. You want someone else taking care of that. We saw that a lot during COVID. You know, you don't want something set in stone, but it's nice to have guidelines for your healthcare proxy agent. You know, hey, what do I want when I'm older? What, what kind of care do I want? Is it okay if I'm in a nursing home? You know, is mom going to get mad at me if I put her in a nursing home? Like, well, let's talk about it in the living well, what are some circumstances that you would be okay with? And then there's something called a burial disposition forms. Who handles all of your needs when you pass away, the funerals and all that. Those are the health care documents that, that that are surrounding. And once I talk about this, people want to nap. They want to just forget about, you know, everything. So I try to leave that to the end. The other two documents, the other two parts of the area is who is a power of attorney, which in my mind is the most important document. A power of attorney essentially says. Who is going to speak or act or sign on your behalf? Not for medical stuff, but for everything else. So again, who's gonna pay the lawn guy? Who's gonna, you know sign off on getting a ramp for that, for the home outside so that you can come comfortably go in and out? Who's gonna apply for Medicaid if needed for long term care? And then who's going to access the funds in my bank account? So who is going to sign for you? Who is going to access your account? Who do you trust the most? That is the person you should put as your power of attorney. The mistake I find is that you, you put somebody who's really good at math. So, oh, my nephew went to Harvard. I'm going to put him. No, no. You don't put the person that's smart. You could outsource. You can't outsource trust, so you should always put someone you trust. And the other mistake I see is that people only put one person. Well, you can't, you can't count on this one person if God forbid something happens. So I always say at least two people placed on your power of attorney. And then the last, which I don't give a lot of deference to, is the will. I know it's important. People come to me, they call me and say, Asha, I need a will. But nowadays, 2025, it's a, it's a catch all document. If you didn't do anything else during your lifetime to plan for your life, then fine. You're going to force your loved ones, your kids to go to court and deal with it in front of a judge. But if you've made some smart decisions, not even involving an attorney, adding beneficiary designations, filling out all the correct forms, then you don't need to use that will in your lifetime. I tell my clients all the time, I hope they never have to use it, but we sign it anyway, just in case. Okay. So I have a question and maybe listeners do as well. What is the difference between a will and a trust? Sure. So a will is a document that is a letter. It's like a list of instructions you are showing to the judge. No one else is looking at this well, the judge is looking at this well in court. So that means. A judge is involved, a court is involved, there's filing fees involved, and it is public. And so, these are all things that we want to avoid nowadays. So when you write, hey, when I pass away, these are all the things I want to happen, that is for the judge in court, in public. And a trust, same thing, list of instructions. But it's only for your trustee, someone you trust, a person you designate, and it is completely private. And when you pass away, it discusses all of the things that are already in your trust during your lifetime you've transferred into, what will happen to those things when you pass away. So two things have to happen for you to avoid probate. One is to, you know, court, judge, will. One is to create a trust. And the second is to transfer things into the trust. So that second part is really difficult for people. And so if you're an adult child, you have to know, you can't just tell mom, Hey mom, you know, create a trust and then walk away and pat your back. Like, no, no, no. You need to do that second part, which is the grunt work, you know, like filling out the forms, transferring all the assets into the revocable trust. So many clients. That I've spoken to have said, Oh, Asha, don't worry. We created this trust. We paid the thousands of dollars to purchase this trust, but it's not funded, which means there's nothing inside it. And so it's absolutely useless because when you pass away, nothing will privately be transferred to the children. It will be. In court public in front of the judge. Thank you for that explanation. There is a lot. But like you said at the very beginning, I think if everybody can just take it nugget by nugget, hopefully you have time to do that. As I was thinking, yes, as Gen Xers, a lot of us are helping or moving into that and aging parents, but what about us? We are in that situation where we need to do this for ourselves and start informing our children. So that's another good reminder right now. So what are some common mistakes families might make when managing their parents finances or care needs, and how can they avoid them? Thank you. Yeah, I think this trust is a big one where they just think, Oh, we'll just get mom a trust and everything will be fixed. Well, you know, sometimes it's not, not necessary. Maybe mom doesn't own a home. She's got all her accounts and beneficiaries. A trust is very costly. Why go through all that? And so, you know, maybe it's just a way of getting the right beneficiaries in the assets and getting the right documents in order. So, to, to just go into the, talk with your lawyer or, you know, if you do online documents, which is not recommended, but I know people do it, it's just assuming that you know what the documents are that you need. The other mistake that I see, well, the two common ones I see all the time is one The parents don't plan what to do with the house, and so the default is it goes through court and they get so nervous as they age and they're like, Oh, my God, I don't want it to go through court. I don't want the government taking my house. And so they quickly deed it to their children or to one of their children. And so, They think they have done the greatest thing and deeded it to their children done. But in reality, it is hurting them in two ways. One is in most states, there is a huge tax implication for the adult child. So this adult child thinks, Oh my God, mom gave me the best gift ever. But once mom passes away and you try to sell this home, you are hit with such a large capital gains tax. So, before you, when mom calls you and says, I want to give you this house, just say, wait, hold on one second. Let's talk about this. The other thing that it does is it hurts you with Medicaid. And so if you need long term care in the future, they will say, well, did you make any big gifts recently? And so you have to admit that you made this large gift to your son or, or daughter. The other mistake that people do is mom or dad will go to the bank and say, Oh my goodness, I need my kids to kind of help me with my finances. The bank teller. Is not your attorney. It's not your Medicaid helper. They are answering your question rightfully correctly. As a bank teller, they're answering your question and they will say, yes, you're correct. Adam as a joint account owner easiest way to fix your Problem you came in with the problem. I solved it. But in reality, it's such a huge mistake. And so what happens is Mom will say no. No, they don't touch my account. I use it. I pay my bills and I do everything They're just on it in case something happens to me. But in reality their name is in the account They should be filing it under their taxes because they own this account and that 20, 000 you may have in your checking is really a 20, 000 gift you gave your son. Because your son has now access to that amount, legally he can withdraw that at any time. He doesn't have to ask mom, he can just take it. And if he pre deceases mom those funds may not automatically go to mom. It The way the account is listed, it might actually go to his family. So, that's another tension you don't want to deal with. And then, finally, if the son actually gets into any legal trouble, bankruptcy, divorce, whatever it is, things that, again, no one wants to think about. That account is now attached. So you're holding yourself so vulnerable to other people's and in reality, you're losing control. So I think those are the two big mistakes that I have to like, like, take a breath when someone tells me that they've done this and see how we can undo it. Yeah, yeah. Those are great insights. And you mentioned Medicaid. So, how does Medicaid play a role in long term care? You know, and how do we plan for that? How do we know when to use that? Yeah, when you when you retire, when you turn 65, you can apply for something called Medicare. And that is There is no threshold like, oh, you have to have a certain income or you have to be where it's you turn a certain age, you get that insurance. And when you think of Medicare, you should think it's just like my work insurance. It is. It covers my doctor's appointments. It covers my hospital visits. I still have to pay a co pay. I still got to pay co insurance. It's just like your okay work insurance, you know, nothing to brag about, but that's Medicare. And so what people do is instead of paying that co pay or co insurance, they get supplemental insurance for their pharmacy needs and everything else. So, so that's Medicare. When you look at Medicare or your supplemental insurance, they're a business just like any business. So they will pitch these things to you that are not really true. And one of them is that they will cover nursing home or care at home and things like that. But like everything else, there's so many caveats details that are in fine print. And so they essentially do not cover long term care. If you needed. AIDS at home. We are living longer. We are, we are, we are desiring to age at home. So AIDS at home is the way you age at home. And so these AIDS cost money. They're about 20, 25 average around the country and so per hour that's, that's, that's a lot and they, Medicare might cover that for a couple of hours a week, but not 24. And when you go into a nursing home, Medicare might cover The first 10 days, they promise 100, the first 10 days, 20 days, but nothing more than that. And so what do people do, you know, like what, what do you do when you can't cover the rest of it? The nursing home is demanding money. The home care agency is demanding it. They're really only three options that people have. One is to privately pay. I just. Told you some numbers a little scary. You work really hard all your life and now you've got to pay five grand to some aid who rightly deserves it, but it's frustrating. You want it to save that money for your grandkids or your kids. The other thing is nursing home costs way more than anybody thinks it might, it might have. It's like college. It's baseline is 12, 000, but it can really creep up to 20 and so you have to prepare for, you know, like a 20, 000 a month bill that you privately pay for. You worked hard for that 401k and you might want to start liquidating that for that 21, 000 and. When mom drains out all her accounts, what I see a lot is that the kids start using their funds, maybe taking out a second mortgage or a loan and all that. This is not what anyone needs or deserves after working hard for 40 years, you know? So private paying should be the last option. The next option is long term care insurance. A lot of people have it through their work, or, you know, they purchased it and continued on especially if you got something before 2000, 2001, 2000, it's, it's okay. It's amazing. Keep those products, pay for it, do what you need to do. However, nowadays, the cost of long term care is extremely expensive. What you're paying for is not having to go through Medicaid, going through the government. And so, That's the high cost of it. It's like, Hey, I know the care is not going to be that much, but I'm paying for peace of mind that I don't have to go through Medicaid. So that 2, 000 a month bill that you've been paying since you were 70 is worth it to some people because they don't have to go through Medicaid. What long term care insurance does is say, hey, we'll cover the cost of AIDS even if it's 24 7 or nursing home payment and things like that. They may have their own fine line, fine print, or whatever, but most of them have, have, have that daily care accessible and available. And then lastly, there's Medicaid. And so when people think Medicaid, they have this stigma of welfare and, and they're like, oh, that's not for us. We're over resourced. We have a home and it, it, it's immediately removed from everyone's minds. And I am here to say that it does not hurt to just check, just ask when you're doing that roadmap hour with your attorney. Hey, why not just ask when you're retiring and you're like any chance I could qualify for Medicaid if I needed it in the future. Ask the question, because I think you would be surprised how, how readily attorneys will say yes, you are available, you are eligible. Medicaid for seniors is different. The government knew that long term care would cost a lot for seniors. They, had a vision back then that it would be too much for for many seniors. So they expanded the requirements. For seniors, there are two kinds of Medicaid. There's long term care at home and nursing home. Different names, different states, but basically care at home, one application, care in the nursing home, another one. And there's different requirements for each. So it's good to ask your specific state attorney. You might have a cousin that's an elder law attorney in a different state. No, you got to ask that attorney in that state. What Medicaid will do is say, hey, you need to be under this certain threshold and certain assets, certain income. But what I tell people is, it's just like when I, you know, when you get when you get write offs for your tax, when you filing for taxes, no one thinks twice about doing those write offs. They're like, Oh, that's a write off. That's a write off. You know, and so. You worked hard for this income and you want to make sure you're maximizing everything so you don't have to pay too many taxes. And so it's the same, same approach you should take with Medicaid. You know, I need to get the best care for mom. And if I need to move some money around so that mom is eligible, well, I'm going to do it, you know? And if I need to get a power of attorney so that I can Access mom's funds to move her money around. I'm going to do it. It might feel strange and weird to like, take control of mom's money mom who's been helping me all my life to for me to like, get in there and get into the accounts, but it's helping her in the long run. It's helping her save her money. Protect it from paying for long term care and to give it to the people that she wants. So yeah. Yeah. Oh, that was so helpful. I I probably was one of those like Medicaid, okay, we don't qualify, but such great advice to just ask the question. It doesn't hurt anything to inquire and explore with somebody, especially like yourself, who is knowledgeable in that and understands that. As we close, is there any other tidbit or advice or something that we didn't cover that you would love to share with listeners? Yeah, I think this slow and steady wins the race for helping your parents, but I also think women especially wealthy women have to be a little kinder to themselves. They don't have to take on this huge responsibility. Financially and personally to take care of their parents. They can ask for help. They can be a little bit more mindful of protecting their own interests as well. I find a lot that especially women will You know take a leave off from work, you know, and, or use their savings to help mom, to help dad. And I'm not saying you shouldn't go above and beyond for your parents. I just think there are other smarter ways to do it. And because we're so compassionate and caring and loving towards our parents, especially older women, I just think we won't think twice. About using our own funds and our time. And I think we should just take a step back and think, Hey, how can we help each other, you know, both mom and me. Yeah. That's why it's not to lose yourself in that. So thank you for that. Listeners, if you would like to connect with Asha, her links are down in the show notes and again, thank you for being here. Thank you for having me. I'm so appreciative. I love your podcast. Thank you so much. Welcome, Asha, to the podcast. I'm excited to have this conversation today around aging parents and Medicaid and how that affects our financial planning and looking forward to the future. But before we dive into that, can you tell us a little bit about who you are, what you do, and how you help people? Oh, thank you, Dillian, for having me. I am an estate planning attorney and elder law attorney, so I mainly handle retired individuals that need to kind of figure out long term care and how it fits in with their retirement planning. I work mainly in New York and in the lower Hudson Valley and New York City area. I'm so glad to bring your expertise onto here. Long term care planning, I think, is something that is not talked about enough. And I did my own exploration after caring for my mother and, you know, chose what was best for me. I'm grateful to have somebody come in and help listeners make that, that part of life easier. I mean, it's not an easy road and it can be tough, but you know, knowing these things can help us make it an easier road. So my first question is, what are the first legal steps families should take when they begin assisting aging parents with their financial and medical decisions? I, I think speaking to an attorney would be extremely helpful, very low pressure. Just tell mom or dad, Hey, let's just talk to an attorney. We're not signing anything. We're not telling them all our business. Just let's just have a conversation. And so I think it eases them in. There's a lot of clients that come to me and do like a one hour session. I'll go through just the basics. It's a little scary to talk about long term care, but I talk about it with them, explain it. And then they may not come back to me for a couple of years even, you know, but they have with them armed with that conversation and maybe even a couple of recommendations and writing with for me. Sometimes the kids will come back with that and say, Hey, remember this three years ago, let's chat. So it's nice to do that. And I'm sure that gets them thinking. That gets them on the same page with their parents. So, going back a step, how does that child or children start initiating these conversations with their parents? To even get them to go visit you or, you know, an attorney and start talking about this. I know it's such a vulnerable topic to talk about and then to have it with your kid that you, you change that person's diaper, you know, like you help them through high school worries and now you're like, Oh, now I have to listen to you. Like, no, that's, that's a lot on them. And I'll tell you the worst thing a child can do is try to just take care of it all in one weekend. That's the worst thing. So they'll call me on Monday and say, we want to sign documents on Friday. And I'll, I'll be on a flight in on Friday and come back Sunday. And, and that's, it's such a dangerous way to approach it. Your parents will instantly know that their voice is not being heard and, and you just want to be in control. So I think the best approach is to do it early and often and to have these conversations to how you do it. I'm still struggling with that in my own families. But what I found is some people like to do it by mentioning a story about their what happened to their friend and their parents or did you hear what happened to this neighbor and then kind of subtly talk about it. Or some people really love. Hey, mom, next week, 5pm. We're going to talk about this. I know it's going to suck. You know, it's going to be uncomfortable, but let's just have a chat, you know, no, no pressure. I'll hear you out. Not going to say anything. You know stay silent while you talk about your concern and, and, and approaching it that way might be helpful to the parent as well. I love that approach. You know, especially if you're just wanting to talk and you don't have a story. Maybe there's not something that's happened to be able to like, give them that time to plan and prepare. I also think another, having been through it, you know, another good thing is like, I need your help and this is what I need your help with. We're going to talk about it more in depth. I think that is great. It is a difficult topic, I think, for both sides. So approaching it, I love your idea of approaching at very simple steps, small steps, you know, taking advantage of those different things. So yeah, if you have a story, go talk to them. I love that. So what essential legal documents should families have in place to protect their parents and making sure that their wishes are honored? Yeah, before you even get the documents, I always tell the clients two things. One is, and you can work on it with your, you know, you as the adult child can help your parents with this. It's not being very intrusive that you're not asking for account numbers or exact values of everything, but it's nice to know what assets a person has. So if you know, The name. Oh, I got something in Citibank. Okay, great. We got to know at least that what type of account it is. Is it a checking? Is it a savings? Mom? What do you think? And then who the owner is? There's a lot of people that are like, well, I pay the bills and it's under my eye. I control everything. But it actually has my sister's name on it, you know, so it is crucial to know who owns everything. Is it jointly owned? Is it singly owned? And then who the beneficiaries are. Once the attorney has like an idea about that, it just makes the planning all that easier. To have a beneficiary on things means that that controls. So if you have a checking account with a beneficiary, Well, if your will says to all of my kids evenly, but you have one child as your beneficiary, well, that's what controls, you know, the one child gets that full amount. So it's nice to kind of know who your beneficiaries are. And then once you have that list, I kind of tell people to write who's on your team. And you know, that includes who are the people you want to take care of you when you're sick, to come into the house. You know, to visit you, to help you with your finances, to pay the lawn guy, you know, who's in your team. And as an adult child, you have to be okay with Well, maybe I'm not part of that team. You know, maybe I'm going to help mom get all these documents, but I'm not going to be the one on that team, and we just have to kind of accept that as a role, and that's going to be hard, but everybody kind of has their strengths and weaknesses, and mom feels more comfortable with sister handling all the crucial health care decisions. I gotta be okay with that, because I'm doing something else for her. I'm being a better mom. benefit in other ways. And then once you got all that down, you come to the attorney. You get these basic planning documents. Every attorney will say the basic planning documents are crucial. There's three different categories. I kind of put it as one is your, all your health care talks. It feels like every single decision is a separate document. So, you know, that's just how it is. That's just how the healthcare system is, much like the healthcare system in general. It's all complicated. So you have one person for your medical decisions if you're not able to. Every state is different. So you might be Googling as an adult child. How can I help my parents? And oh, here's a template for a health care proxy. Well, that actually was for a Michigan template. You got to make sure you're Googling correctly and it's for the actual state that you live in. So health care proxy or health care power of attorney in some states, it's called kind of assigns. the one person that's going to be in charge of your medical decisions if you're not able to. What does that mean? When you're on death's door, yes, that is what it means, but it also means a lot of other things. When you're heavily medicated and you broke your leg and you just need a little assistance and you need someone to be there, the doctor, to say, how much of this should I take a day? And What are the side effects? It's nice to have someone else there. Or in a lot of cases, we're going to be dealing with families that have dementia parents that have dementia. And so, yes, there should be someone there and the doctors or any, any kind of situation where they can make those medical decisions or just at least listen to what the doctor or the nutritionist or whoever else is talking. So the healthcare proxy is important. There's other documents, and I call them the supplemental documents that you might want to put your, the other kids names in, you know, because they're not as important, but they're important. So one of them is like the HIPAA form who can access your medical records. It's really for that. emergency situation where the ER doctor needs your cardiologist report. Okay, I'll get that for you, doctor. No problem. And then there's the living will. A lot of people get weary of this because you don't want full instructions on what to do. What exactly you want to happen in every single case. You want someone else taking care of that. We saw that a lot during COVID. You know, you don't want something set in stone, but it's nice to have guidelines for your healthcare proxy agent. You know, hey, what do I want when I'm older? What, what kind of care do I want? Is it okay if I'm in a nursing home? You know, is mom going to get mad at me if I put her in a nursing home? Like, well, let's talk about it in the living well, what are some circumstances that you would be okay with? And then there's something called a burial disposition forms. Who handles all of your needs when you pass away, the funerals and all that. Those are the health care documents that, that that are surrounding. And once I talk about this, people want to nap. They want to just forget about, you know, everything. So I try to leave that to the end. The other two documents, the other two parts of the area is who is a power of attorney, which in my mind is the most important document. A power of attorney essentially says. Who is going to speak or act or sign on your behalf? Not for medical stuff, but for everything else. So again, who's gonna pay the lawn guy? Who's gonna, you know sign off on getting a ramp for that, for the home outside so that you can come comfortably go in and out? Who's gonna apply for Medicaid if needed for long term care? And then who's going to access the funds in my bank account? So who is going to sign for you? Who is going to access your account? Who do you trust the most? That is the person you should put as your power of attorney. The mistake I find is that you, you put somebody who's really good at math. So, oh, my nephew went to Harvard. I'm going to put him. No, no. You don't put the person that's smart. You could outsource. You can't outsource trust, so you should always put someone you trust. And the other mistake I see is that people only put one person. Well, you can't, you can't count on this one person if God forbid something happens. So I always say at least two people placed on your power of attorney. And then the last, which I don't give a lot of deference to, is the will. I know it's important. People come to me, they call me and say, Asha, I need a will. But nowadays, 2025, it's a, it's a catch all document. If you didn't do anything else during your lifetime to plan for your life, then fine. You're going to force your loved ones, your kids to go to court and deal with it in front of a judge. But if you've made some smart decisions, not even involving an attorney, adding beneficiary designations, filling out all the correct forms, then you don't need to use that will in your lifetime. I tell my clients all the time, I hope they never have to use it, but we sign it anyway, just in case. Okay. So I have a question and maybe listeners do as well. What is the difference between a will and a trust? Sure. So a will is a document that is a letter. It's like a list of instructions you are showing to the judge. No one else is looking at this well, the judge is looking at this well in court. So that means. A judge is involved, a court is involved, there's filing fees involved, and it is public. And so, these are all things that we want to avoid nowadays. So when you write, hey, when I pass away, these are all the things I want to happen, that is for the judge in court, in public. And a trust, same thing, list of instructions. But it's only for your trustee, someone you trust, a person you designate, and it is completely private. And when you pass away, it discusses all of the things that are already in your trust during your lifetime you've transferred into, what will happen to those things when you pass away. So two things have to happen for you to avoid probate. One is to, you know, court, judge, will. One is to create a trust. And the second is to transfer things into the trust. So that second part is really difficult for people. And so if you're an adult child, you have to know, you can't just tell mom, Hey mom, you know, create a trust and then walk away and pat your back. Like, no, no, no. You need to do that second part, which is the grunt work, you know, like filling out the forms, transferring all the assets into the revocable trust. So many clients. That I've spoken to have said, Oh, Asha, don't worry. We created this trust. We paid the thousands of dollars to purchase this trust, but it's not funded, which means there's nothing inside it. And so it's absolutely useless because when you pass away, nothing will privately be transferred to the children. It will be. In court public in front of the judge. Thank you for that explanation. There is a lot. But like you said at the very beginning, I think if everybody can just take it nugget by nugget, hopefully you have time to do that. As I was thinking, yes, as Gen Xers, a lot of us are helping or moving into that and aging parents, but what about us? We are in that situation where we need to do this for ourselves and start informing our children. So that's another good reminder right now. So what are some common mistakes families might make when managing their parents finances or care needs, and how can they avoid them? Thank you. Yeah, I think this trust is a big one where they just think, Oh, we'll just get mom a trust and everything will be fixed. Well, you know, sometimes it's not, not necessary. Maybe mom doesn't own a home. She's got all her accounts and beneficiaries. A trust is very costly. Why go through all that? And so, you know, maybe it's just a way of getting the right beneficiaries in the assets and getting the right documents in order. So, to, to just go into the, talk with your lawyer or, you know, if you do online documents, which is not recommended, but I know people do it, it's just assuming that you know what the documents are that you need. The other mistake that I see, well, the two common ones I see all the time is one The parents don't plan what to do with the house, and so the default is it goes through court and they get so nervous as they age and they're like, Oh, my God, I don't want it to go through court. I don't want the government taking my house. And so they quickly deed it to their children or to one of their children. And so, They think they have done the greatest thing and deeded it to their children done. But in reality, it is hurting them in two ways. One is in most states, there is a huge tax implication for the adult child. So this adult child thinks, Oh my God, mom gave me the best gift ever. But once mom passes away and you try to sell this home, you are hit with such a large capital gains tax. So, before you, when mom calls you and says, I want to give you this house, just say, wait, hold on one second. Let's talk about this. The other thing that it does is it hurts you with Medicaid. And so if you need long term care in the future, they will say, well, did you make any big gifts recently? And so you have to admit that you made this large gift to your son or, or daughter. The other mistake that people do is mom or dad will go to the bank and say, Oh my goodness, I need my kids to kind of help me with my finances. The bank teller. Is not your attorney. It's not your Medicaid helper. They are answering your question rightfully correctly. As a bank teller, they're answering your question and they will say, yes, you're correct. Adam as a joint account owner easiest way to fix your Problem you came in with the problem. I solved it. But in reality, it's such a huge mistake. And so what happens is Mom will say no. No, they don't touch my account. I use it. I pay my bills and I do everything They're just on it in case something happens to me. But in reality their name is in the account They should be filing it under their taxes because they own this account and that 20, 000 you may have in your checking is really a 20, 000 gift you gave your son. Because your son has now access to that amount, legally he can withdraw that at any time. He doesn't have to ask mom, he can just take it. And if he pre deceases mom those funds may not automatically go to mom. It The way the account is listed, it might actually go to his family. So, that's another tension you don't want to deal with. And then, finally, if the son actually gets into any legal trouble, bankruptcy, divorce, whatever it is, things that, again, no one wants to think about. That account is now attached. So you're holding yourself so vulnerable to other people's and in reality, you're losing control. So I think those are the two big mistakes that I have to like, like, take a breath when someone tells me that they've done this and see how we can undo it. Yeah, yeah. Those are great insights. And you mentioned Medicaid. So, how does Medicaid play a role in long term care? You know, and how do we plan for that? How do we know when to use that? Yeah, when you when you retire, when you turn 65, you can apply for something called Medicare. And that is There is no threshold like, oh, you have to have a certain income or you have to be where it's you turn a certain age, you get that insurance. And when you think of Medicare, you should think it's just like my work insurance. It is. It covers my doctor's appointments. It covers my hospital visits. I still have to pay a co pay. I still got to pay co insurance. It's just like your okay work insurance, you know, nothing to brag about, but that's Medicare. And so what people do is instead of paying that co pay or co insurance, they get supplemental insurance for their pharmacy needs and everything else. So, so that's Medicare. When you look at Medicare or your supplemental insurance, they're a business just like any business. So they will pitch these things to you that are not really true. And one of them is that they will cover nursing home or care at home and things like that. But like everything else, there's so many caveats details that are in fine print. And so they essentially do not cover long term care. If you needed. AIDS at home. We are living longer. We are, we are, we are desiring to age at home. So AIDS at home is the way you age at home. And so these AIDS cost money. They're about 20, 25 average around the country and so per hour that's, that's, that's a lot and they, Medicare might cover that for a couple of hours a week, but not 24. And when you go into a nursing home, Medicare might cover The first 10 days, they promise 100, the first 10 days, 20 days, but nothing more than that. And so what do people do, you know, like what, what do you do when you can't cover the rest of it? The nursing home is demanding money. The home care agency is demanding it. They're really only three options that people have. One is to privately pay. I just. Told you some numbers a little scary. You work really hard all your life and now you've got to pay five grand to some aid who rightly deserves it, but it's frustrating. You want it to save that money for your grandkids or your kids. The other thing is nursing home costs way more than anybody thinks it might, it might have. It's like college. It's baseline is 12, 000, but it can really creep up to 20 and so you have to prepare for, you know, like a 20, 000 a month bill that you privately pay for. You worked hard for that 401k and you might want to start liquidating that for that 21, 000 and. When mom drains out all her accounts, what I see a lot is that the kids start using their funds, maybe taking out a second mortgage or a loan and all that. This is not what anyone needs or deserves after working hard for 40 years, you know? So private paying should be the last option. The next option is long term care insurance. A lot of people have it through their work, or, you know, they purchased it and continued on especially if you got something before 2000, 2001, 2000, it's, it's okay. It's amazing. Keep those products, pay for it, do what you need to do. However, nowadays, the cost of long term care is extremely expensive. What you're paying for is not having to go through Medicaid, going through the government. And so, That's the high cost of it. It's like, Hey, I know the care is not going to be that much, but I'm paying for peace of mind that I don't have to go through Medicaid. So that 2, 000 a month bill that you've been paying since you were 70 is worth it to some people because they don't have to go through Medicaid. What long term care insurance does is say, hey, we'll cover the cost of AIDS even if it's 24 7 or nursing home payment and things like that. They may have their own fine line, fine print, or whatever, but most of them have, have, have that daily care accessible and available. And then lastly, there's Medicaid. And so when people think Medicaid, they have this stigma of welfare and, and they're like, oh, that's not for us. We're over resourced. We have a home and it, it, it's immediately removed from everyone's minds. And I am here to say that it does not hurt to just check, just ask when you're doing that roadmap hour with your attorney. Hey, why not just ask when you're retiring and you're like any chance I could qualify for Medicaid if I needed it in the future. Ask the question, because I think you would be surprised how, how readily attorneys will say yes, you are available, you are eligible. Medicaid for seniors is different. The government knew that long term care would cost a lot for seniors. They, had a vision back then that it would be too much for for many seniors. So they expanded the requirements. For seniors, there are two kinds of Medicaid. There's long term care at home and nursing home. Different names, different states, but basically care at home, one application, care in the nursing home, another one. And there's different requirements for each. So it's good to ask your specific state attorney. You might have a cousin that's an elder law attorney in a different state. No, you got to ask that attorney in that state. What Medicaid will do is say, hey, you need to be under this certain threshold and certain assets, certain income. But what I tell people is, it's just like when I, you know, when you get when you get write offs for your tax, when you filing for taxes, no one thinks twice about doing those write offs. They're like, Oh, that's a write off. That's a write off. You know, and so. You worked hard for this income and you want to make sure you're maximizing everything so you don't have to pay too many taxes. And so it's the same, same approach you should take with Medicaid. You know, I need to get the best care for mom. And if I need to move some money around so that mom is eligible, well, I'm going to do it, you know? And if I need to get a power of attorney so that I can Access mom's funds to move her money around. I'm going to do it. It might feel strange and weird to like, take control of mom's money mom who's been helping me all my life to for me to like, get in there and get into the accounts, but it's helping her in the long run. It's helping her save her money. Protect it from paying for long term care and to give it to the people that she wants. So yeah. Yeah. Oh, that was so helpful. I I probably was one of those like Medicaid, okay, we don't qualify, but such great advice to just ask the question. It doesn't hurt anything to inquire and explore with somebody, especially like yourself, who is knowledgeable in that and understands that. As we close, is there any other tidbit or advice or something that we didn't cover that you would love to share with listeners? Yeah, I think this slow and steady wins the race for helping your parents, but I also think women especially wealthy women have to be a little kinder to themselves. They don't have to take on this huge responsibility. Financially and personally to take care of their parents. They can ask for help. They can be a little bit more mindful of protecting their own interests as well. I find a lot that especially women will You know take a leave off from work, you know, and, or use their savings to help mom, to help dad. And I'm not saying you shouldn't go above and beyond for your parents. I just think there are other smarter ways to do it. And because we're so compassionate and caring and loving towards our parents, especially older women, I just think we won't think twice. About using our own funds and our time. And I think we should just take a step back and think, Hey, how can we help each other, you know, both mom and me. Yeah. That's why it's not to lose yourself in that. So thank you for that. Listeners, if you would like to connect with Asha, her links are down in the show notes and again, thank you for being here. Thank you for having me. I'm so appreciative. I love your podcast. Thank you so much.