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Negotiation Techniques for Adult Children of Aging Parents

August 11, 2023 / David Russell

In an insightful article published on KFFhealthnews.org by Judith Graham, titled “Negotiate with Resistant Aging Parents: Applying Business Strategies,” researchers at Northwestern University explore the application of negotiation and dispute resolution techniques from the business world to defuse conflicts arising from caregiving and financial decisions involving elderly parents. As we strive to provide the best care for our aging loved ones, this article sheds light on strategies to navigate complex situations while respecting their autonomy and dignity. The article delves into a training curriculum designed to help professionals and family caregivers approach caregiving as a collaborative effort and offers valuable insights for fostering productive conversations.

Reaching an impasse with aging parents in their late 80s who resist the idea of receiving home assistance can be frustrating. Negotiation and dispute resolution techniques commonly employed in the business world have shown potential for resolving such conflicts, according to a group of researchers at Northwestern University.

The team has developed a specialized training program focused on negotiation and dispute resolution. Aimed at social workers, care managers, and healthcare professionals working with resistant older adults, this curriculum encourages professionals to engage in collaborative caregiving approaches that honor the individual’s preferences, rather than imposing decisions.

Lee Lindquist, the chief of geriatrics at Northwestern University’s Feinberg School of Medicine, who leads this initiative, highlighted the prevalence of conflicts among older individuals and emphasized the program’s goal to de-escalate such situations, ensuring older adults receive the necessary support while maintaining their dignity.

A significant component of this project is the development of a computer-based training program for family caregivers dealing with mild cognitive impairment or early-stage dementia in their loved ones. Dubbed “NegotiAge,” this program employs avatars of older adults to simulate negotiation scenarios. Through practice, caregivers can refine their negotiation skills and techniques.

This project, funded by the National Institutes of Health with nearly $4 million, strives to make NegotiAge widely accessible after evaluating its effectiveness.

For family caregivers seeking to navigate conflicts with aging parents, the article outlines several proactive steps:

1. Prepare: Before entering negotiations, thorough preparation is vital. Jeanne Brett, a member of the NegotiAge team, suggests addressing fundamental questions, identifying issues, involved parties, their positions, motivations, and potential consequences if an agreement is not reached. Document your goals for the upcoming conversations.

2. Identify Common Interests: Finding common ground among the parties involved is key. Emphasize shared goals and interests, such as maintaining the older adult’s independence, safety, and social connections.

3. Ask Questions: Avoid making assumptions about the reasons behind a parent’s stance. Engage in open-ended discussions to understand their perspective. Show empathy and genuine concern.

4. Brainstorm Strategies: Emotions can run high during negotiations, particularly within family dynamics. Shift focus from conflicts to collaborative problem-solving. Encourage creative thinking and explore multiple potential solutions.

5. Third-Party Involvement: If resolution remains elusive, consider involving a neutral third party, like a mediator or healthcare professional. External input can provide a fresh perspective and facilitate productive discussions.

Applying these strategies can lead to more effective communication, allowing families to navigate challenging decisions while preserving relationships and respecting the autonomy and dignity of aging parents. As the Northwestern University research advances, caregivers and professionals alike stand to benefit from enhanced tools and approaches to address the complexities of eldercare.

To read the full article by Judith Graham on KFFhealthnews.org, visit: Negotiate with Resistant Aging Parents: Applying Business Strategies.

How to Have Difficult Conversations About Senior Living Options

July 21, 2023 / drussellcfp

As our parents age, there may come a time when we need to have challenging conversations about their future living arrangements. The topic of senior living options can be sensitive and emotional, but it’s essential to address it with empathy, understanding, and respect. In this guide, we’ll provide insights and strategies on how to approach these conversations effectively, ensuring that your loved ones’ wishes and needs are considered.

1. Choose the Right Time and Place: Initiating a conversation about senior living options requires careful consideration of timing and environment. Choose a comfortable and private setting, and make sure there are no distractions. Avoid discussing this topic during busy family gatherings or when emotions are running high. Opt for a time when everyone is relaxed and open to discussing the matter calmly.

2. Listen with Empathy: Approaching the conversation with empathy and active listening is crucial. Your parents may have a range of emotions and concerns about the idea of transitioning to senior living. Take the time to listen to their thoughts, fears, and desires. Acknowledge their feelings and validate their experiences to create a supportive atmosphere where they feel heard and understood.

3. Focus on Their Needs and Preferences: Every individual has unique needs and preferences when it comes to senior living arrangements. Some may prefer to stay in their homes with in-home care, while others might feel more comfortable in a retirement community or assisted living facility. Respect their autonomy and choices, and involve them in the decision-making process. Be open to exploring different options together, considering factors like proximity to family, medical care, and social activities.

4. Address Safety and Care Concerns: Safety and care are paramount considerations when discussing senior living options. Express your concern for their well-being and highlight how certain living arrangements can enhance their safety and provide access to essential support services. Share information about the benefits of professional caregivers and the sense of community they can experience in senior living communities.

5. Involve Other Family Members: If possible, involve other family members in the conversation to show a united front and demonstrate a shared commitment to your parents’ best interests. Discussing senior living options as a family can provide a broader perspective and may alleviate any feelings of isolation or pressure on your parents.

6. Provide Information and Support: Share educational resources and information about different senior living options to help your parents make informed decisions. Provide brochures, online resources, or arrange visits to local retirement communities or assisted living facilities. Offering emotional support throughout the decision-making process can help alleviate anxiety and stress.

Discussing senior living options with aging parents can be challenging, but it’s essential to approach these conversations with compassion, active listening, and respect for their autonomy. By choosing the right time and place, focusing on their needs and preferences, and involving other family members, we can navigate this sensitive topic together, ensuring our loved ones receive the care and support they deserve in their later years.

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A Guide to Recognizing Common Health Issues in Aging Parents

July 20, 2023 / drussellcfp

As our parents age, it becomes increasingly important for us to be vigilant about their health and well-being. While aging is a natural process, it often brings about specific health challenges that may require attention and care. Recognizing common health issues in aging parents can enable us to provide timely support and improve their quality of life. In this guide, we’ll explore some prevalent health concerns faced by seniors and offer insights on how to identify and address them.

Cognitive Decline and Memory Loss:

One of the most common health issues experienced by aging parents is cognitive decline, which can include mild memory lapses or more severe conditions like dementia and Alzheimer’s disease. According to the Alzheimer’s Association, approximately 5.8 million Americans age 65 and older are living with Alzheimer’s in 2021, and this number is expected to increase significantly in the coming years. To recognize cognitive decline, observe any noticeable changes in memory, confusion, or difficulty performing daily tasks. If you notice these signs, consult a healthcare professional for an evaluation and proper diagnosis.

Chronic Conditions:

Aging often coincides with an increased risk of chronic health conditions such as diabetes, heart disease, arthritis, and hypertension. According to the Centers for Disease Control and Prevention (CDC), about 80% of older adults have at least one chronic condition, while 77% have two or more. Pay attention to your aging parent’s symptoms, medication management, and any changes in physical abilities. Regular medical check-ups and adherence to prescribed treatments are crucial for managing these conditions effectively.

Mobility Issues:

With advancing age, seniors may experience reduced mobility due to joint pain, muscle weakness, or other factors. Falls are a significant concern among the elderly, with one in four Americans aged 65 and older falling each year, as reported by the National Council on Aging (NCOA). To mitigate the risk of falls, ensure that their living environment is safe and free from hazards. Consider installing grab bars in the bathroom, providing adequate lighting, and encouraging the use of assistive devices like canes or walkers if necessary.

Vision and Hearing Impairments:

Vision and hearing loss are common age-related issues that can significantly impact daily life. The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that approximately one in three people aged 65 to 74 have hearing loss, and nearly half of those over 75 have difficulty hearing. Regular eye exams and hearing tests can help detect and manage these impairments early, leading to improved communication and overall well-being.

Conclusion:

Being proactive in recognizing common health issues in aging parents is vital for providing them with the care and support they need. Regular communication with healthcare professionals, attentiveness to changes in their physical and cognitive well-being, and maintaining a safe living environment are essential steps in promoting their overall health and quality of life. By staying informed and observant, we can be better prepared to navigate the challenges of aging together with our loved ones.

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Supreme Court hears case of 94 year old’s home foreclosure by the state.

May 12, 2023 / drussellcfp

The US Supreme Court heard arguments in a case involving a 94-year-old woman who lost her home over unpaid property taxes. While the woman, Geraldine Tyler, does not dispute that Hennepin County had the right to foreclose on the $40,000 property, she argued that the county had violated the Constitution’s takings clause by keeping the $25,000 left over after the property was sold. Tyler’s attorney argued that the county should have taken Tyler’s condo, sold it to pay her debts and then refunded the remainder to her. The Biden administration filed a “friend of the court” brief in which it agreed with Tyler that the county’s actions violated the takings clause.

Whether the Court sides with Tyler or not (although it does appear that it will), it highlights the importance of having a trained and attentive financial caregiver who can pay any property taxes or other obligations that, if unpaid, can severely impact the older individual.

Source: Justices appear likely to side with homeowner in foreclosure dispute – SCOTUSblog

Article on the Importance of Human Connection

May 1, 2023 / drussellcfp

A recent study by Harvard Medical School found that older adults who had in-person interactions with friends, family, and healthcare providers during the first months of the COVID-19 pandemic experienced fewer mental health problems than those who relied on digital connections. The study suggests that digital technologies may not be suitable for the needs of older adults and may cause anxiety and depression.

Another study by Harvard’s Joint Center for Housing Studies found that older adults living with a spouse or partner during the pandemic had fewer functional difficulties and disruptions to their finances or personal assistance than those living alone.

The studies emphasize the importance of in-person interactions and better technology to meet the needs of older adults. Seniors over 75 were found to require more assistance with daily living. Click here to read the full article.

Caring for Family Doesn’t Have to Be Unpaid Work – WSJ

March 28, 2023 / drussellcfp

Interest in providing financial support for family caregivers is growing due to the workforce crisis in the care industry.

A recent Wall Street Journal Article reported that relatives providing care to aging or disabled family members may qualify to be paid by their state’s office of Medicaid under certain circumstances.

According to a report by AARP and The Alliance for Family Caregivers, nearly 44 million family members are providing care to an aging or disabled loved one. These numbers along with a shortage of available paid caregivers have prompted many states’ department of Medicaid Services to expand some of their waiver programs to allow family members to be paid an hourly wage for providing caregiver services.

Source: Caring for Family Doesn’t Have to Be Unpaid Work – WSJ

Indiana Case Highlights Family Tensions in Selecting Financial Caregivers.

March 27, 2023 / drussellcfp

Most people should be able to choose a loving and honoring adult child or family member as a financial caregiver. An Indiana case highlights the importance of integrity when making the choice.

In the case of Biggs vs Renner, Terri Renner and Sherry Biggs are siblings locked in a court battle over their mother’s care, with Terri claiming that Sherry abused her position as agent under her mother’s Power of Attorney, and used their mother’s funds for her own benefit. Court records would confirm Terri’s fears.

Sherry admitted to converting her mother’s accounts first to a joint account, and then to accounts only in her name. She offered a promissory note to court as evidence that she intended to pay the money back, but the the note was largely unenforceable due to her mother’s incapacity, and no payments had been made so far. In addition, Sherry allowed her daughter and husband to live rent-free in her mother’s home and paid several thousand dollars of improvements from her mother’s accounts that did not directly benefit her mother.

Terri sought a court’s intervention to remove her sister as attorney-in-fact, and to insert a disinterested third party as guardian of their mother’s estate. The court granted Terri’s petition, but Sherry objected on appeal.

A Power of Attorney is a legal arrangement whereby one person grants authority (let’s call that person the grantor) to another person to act in their behalf as attorney-in-fact, or agent while they (the grantor) are alive but unable to act for themselves. Acting as agent under a power of attorney is a fiduciary responsibility that obligates the financial caregiver to exercise the powers granted solely for the benefit of the grantor. A financial caregiver has to keep accurate records and is prohibited from using the property of the grantor for their own purposes. Being a financial caregiver is an honorable position when conducted honorably.

Why name an adult child as financial caregiver?

It is understandable that an older person would want to name an adult child as financial caregiver on their behalf. We want to believe our own children would act honorably on our behalf, or perhaps we have regrets about our own parenting and feel guilty if we do not atone ourselves by putting them in charge. Sometimes a parent will name an estranged child in hope that the trust shown by the parent will mend a broken relationship. Parents will often do whatever it takes to keep a child close to them. However, the selection of a financial caregiver should place emphasis on the dependability and the integrity of the individual over familial connections. This may require difficult decisions and may even alienate family members, but if early and intentional discussions on the subject can be held with the appropriate family members, perhaps these kinds of conflicts can be avoided.

Note: The information above is for general information only and should not be relied upon to make legal or financial decisions Advice as to the preparation and use of Powers of Attorney should only be provided by a qualified attorney licensed in your state.

IRA Funds Protected from the Claims of Guardian

August 24, 2022 / drussellcfp

A Florida Appeals court has ruled that a special appointed guardian does not have a claim for guardianship expenses against a deceased’s IRA accounts. ( Araguel v. Bryan, (Fla. Dist. Ct. App., No. 1D20-2789, August 17, 2022).

According to the court transcript, In October of 2019, Jane Kaigler Araguel became unable to care for herself. As a result, both of her children, Patrick J. Araguel, III, and Leslie Ladon Bryan, petitioned the trial court to become her emergency temporary guardian and the guardian of her person and property. Instead of appointing either of the children, the trial court appointed a professional emergency temporary guardian. In June of 2020, Ms. Araguel died.

After Mrs. A died, the trial court approved the Guardian’s motion to use her assets — including her IRAs — to pay for the guardian’s expenses, his attorney’s fees, and other costs associated with the guardianship.

IRA Creditor Protection

IRA’s are considered contract property, meaning that the owner of the IRA contracts with an IRA Custodian, to hold and invest the IRA funds, and to pay the funds directly to the contract’s named beneficiary(ies) upon the death of the IRA owner. As such, IRA assets do not pass through the owner’s Last Will and Testament, unless the owner’s estate is listed as the IRA beneficiary.

Protection of IRAs from the claims of creditors depends on the state of residence of the IRA owner. Most states have adopted some kind of creditor protection for IRA assets similar to the protection available for qualified retirement plans (ie. 401k, Profit Sharing, Pension Plans, etc.) that are governed by a Federal Law under the acronym ERISA. Simply stated, these assets are excluded from creditor claims such as bankruptcy and litigant claims, except for fraudulent transfers or a divorcing spouse. For a more detailed discussion about IRA creditor protection, click here.

Back to the Case

Mrs. A’s son appealed the trial court’s ruling, arguing that the IRA contracts were not subject to possession and management by the guardian upon Mrs. A’s death and that the death proceeds should have been immediately delivered over to the IRA beneficiaries. Furthermore, he argued that the IRA’s were protected from creditor claims under Florida law, and should therefore not be available to the Guardian for expenses incurred by the Guardian.

After a discussion of the specific meaning of words contained in the various Florida statutes, the court applied a “plain meaning of the terms ‘claim’ and ‘creditor,’ to rule in favor of the Plaintiff, Mrs. A’s son, and reversed the lower court’s decision. To read the full court transcript, click here.

Key Takeaways

A properly executed Durable Power of Attorney granted to one or both of Mrs. A’s sons could have avoided a court-appointed guardianship and allowed either or both of them to manage her assets upon her incapacity.
A revocable living trust that owned Mrs. A’s assets could have been used along with a Durable Power of Attorney to ensure continuity of the management of her financial affairs upon her incapacity.
IRA’s often represent a significant percentage of an individual’s estate, yet what happens to them upon the owner’s death is controlled by a single piece of paper on file with the IRA Custodian, not the owner’s Last Will and Testament. Beneficiary forms should be regularly reviewed.
Seek the advice of a qualified estate attorney when drafting any of these legal arrangements.

Being Social May Be Key to ‘Sense of Purpose’ as You Age

August 22, 2022 / drussellcfp

Researchers from Washington University in St. Louis found that positive connections with other people were associated with a sense of purposefulness in older adults. Having a sense of purpose is defined as the extent to which a person feels that they have personally meaningful goals and directions guiding them in life.

Source: Being Social May Be Key to ‘Sense of Purpose’ as You Age – Consumer Health News | HealthDay

Nursing Home’s Arbitration Agreement Found ‘Unconscionable’

August 19, 2022 / drussellcfp

In 2021, The 8th U.S. Circuit Court of Appeals gave the green light to a federal regulation that allows nursing homes to use arbitration agreements with residents, but prevents them from making the agreements a prerequisite for admission. Several nursing homes had filed a lawsuit against the Centers for Medicare & Medicaid Services (CMS) challenging the new regulation. However, the court upheld the regulation, stating in its opinion that,

“In our view, it is reasonable for CMS to conclude that regulating the use of arbitration agreements in LTC facilities furthers the health, safety, and well-being of residents, particularly during the critical stage when a resident is first admitted to a facility,”

A recent case in Pennsylvania ruled that a nursing home’s arbitration agreement requiring a resident, “Fay V.” to pay half the costs of arbitration was “unconscionable.” Kohlman v. Grane Healthcare Company (Pa. Super 118, J-A25034-21, July 5, 2022). The ruling arose after the estate for Ms. V., who died three months after admission, filed a wrongful death lawsuit against the nursing home and other defendants.

According to the court transcripts, at the time of her admission, Fay V. was 67 years old and was suffering from a number of conditions, including congestive heart failure, diabetes, and pressure ulcers. The nursing home’s assessment of her condition at the time of her admission reported that “she was alert and oriented and had no memory problems or dementia, but that she was also suffering from anxiety and sometimes had trouble concentrating.”

It’s assessment also reported that ‘Fay’s vision was impaired to the point that even with glasses, she was ‘not able to see newspaper headlines but can identify objects.’ Yet upon her admission to Highland Park, she signed a number of documents, including a seven-page Nursing Services Agreement, a two-page Agreement to Arbitrate Disputes (the Arbitration Agreement), and a Resident Representative Agreement concerning the handling of her finances, in which Decedent designated herself as her representative.

In trial court, the court ruled the Arbitration Agreement as unconscionable (excessively unreasonable) because Decedent was in pain and was medicated at the time that she signed the Arbitration Agreement, Decedent was alone when she was asked to sign the Arbitration Agreement, had no opportunity to read the Arbitration Agreement and was not given a copy to review, and the provisions of the Arbitration Agreement were not fully read or explained to Decedent.

Source: Nursing Home’s Arbitration Agreement Found ‘Unconscionable’ — and Unenforceable — in Wrongful Death Suit

Wealth and Honor