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Care@Work / Care@Work Blog / December “Senior Sense”: The Top 5 Steps to Take for Long-Term Care Planning

December “Senior Sense”: The Top 5 Steps to Take for Long-Term Care Planning

Harry Margolis on December 01, 2019 04:49 PM


Unfortunately, with longevity comes the increasing likelihood of needing care, whether due to cognitive decline, short-term injury or illness, or more chronic disability. Family members provide the bulk of this care, but it can be a burden on families and some seniors don’t have family members available to provide care, especially if more intensive home-health care is required.

The alternative to hiring care is expensive, whether care at home or in an assisted living facility or nursing home. Often steps to get necessary care and to qualify for assistance in paying for it must depend on the circumstances in place and options available when care is needed. But taking a few steps in advance can make life much easier for both caregivers and care receivers.

Here are five steps, in order of priority, you can take in advance to alleviate the potential burden on your family:

  1. Sign a health care proxy or durable power of attorney for health care (different states use different terms). This appoints the person you choose to make your medical decisions when you can no longer do so for yourself. This also gives that person the right to talk with medical personnel, see your medical records and advocate on your behalf. If you don’t appoint your own agent, you may have no one to advocate on your behalf or someone else will choose for you. The absence of an appointed agent can require a court process to appoint a guardian, which can be expensive, time-consuming and lead to conflict among family members.


  1. Sign a financial durable power of attorney. Similar to a health care proxy, this document appoints an agent to step in on your behalf when you can no longer make your own decisions, but for legal and financial purposes rather than for health care. Similarly, the absence of a durable power of attorney in place can require court appointment of a conservator to handle your affairs, which can be expensive, time-consuming and lead to conflict. It also requires regular reporting back to the court and can require court approval of certain transactions. This oversight is protective, but at great cost.


  1. Consider buying long-term care insurance. Over the last couple of decades, long-term care insurance has matured. The good news is that policies sold today are better and more reliable than those offered in the past. The bad news is that they’re also more expensive. Unfortunately, this means that most Americans cannot afford long-term care insurance, but if you can, owning a policy can relieve you and your family from the uncertainty of future long-term care costs and save caregivers from penny-pinching when it comes to paying for care.


  1. Talk with your family. Clear communication about your wishes is vital. Do you want to stay at home? Move to an assisted living facility? Live with a family member? You may not be able to provide guidance when and if you need care and the result can be disagreement among family members about what’s best for you. Only you know what you would want under various circumstances. A conversation with your loved ones while you’re healthy can prevent a lot of strife down the road.


  1. Consult with an elder law attorney. All of the above can be complicated and decisions and communication can involve delicate issues. In addition, our only broadly-based system of paying for long-term care is Medicaid, an incredibly complicated federal-state program. Elder law attorneys have a depth of experience and training in the laws and practices in their states and can help both in planning in advance and when and if a need for care occurs. One good source of elder law attorneys and more information on elder law issues is You can contact your Senior Care Advisor for assistance identifying an elder law attorney.

If you take these steps, you will know that you have done all you can to plan ahead. The rest is up to the fates as well as the good will of all involved.

Harry S. Margolis, a 30-year veteran of practicing elder law, special needs and estate planning in Boston, Massachusetts, is author, most recently, of Get Your Ducks in a Row: The Baby Boomers Guide to Estate Planning. He also answers consumer questions free of charge at

For caregiving support, information and resources contact a Senior Care Advisor at We are master’s-level social workers specializing in adult and senior care. Call us today at (855) 781-1303 x3 or email questions to