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The Elder-Care Triumvirate

Advisors can serve an important role in helping clients and their families narrow the choices for appropriate care and cost effective solutions.

Helen Modly and Tommie Monez, 11/08/2012

Several years ago, we had very limited resources to find elder-care services. Now there is such a proliferation of services that it's hard to know where to start. Advisors can serve an important role in helping clients and their families narrow the choices for appropriate care and cost-effective solutions.

The Advisor's Role When a Client Needs Help
Aging, either in one's home or in a retirement community, is a significant financial event and costs can range widely. Unfortunately, clients often avoid advance planning when it comes to finding an assisted-living facility or moving to a home that is suited to aging in place. Quite often it takes a crisis to prompt the decision to move, and action becomes reaction. Making the wrong choices can make a big difference in quality of life and preservation of assets.

Clients may not plan ahead but the advisor can, so get to know the best provider services in your area. Not only will you be expanding the level and quality of client service, but elder-care providers can be great centers of influence to help build your practice.

The Big Three
Aging clients face three main questions, and there is a specialist to help in each area:

How will I manage when I can't live independently anymore, and where will I live? Solution: geriatric care manager

If I have to move, who will help me sell the house and downsize, and if I need to adapt my home, where will I find contractors? Solution: senior move manager

What if I can't keep up with paying my bills anymore? Solution: daily money manager

Finding the Right Geriatric Care
In-home or assisted-living care can run the gamut from very basic to comprehensive and may involve several providers. Geriatric care managers can help to streamline the process, assess the level of support that is needed, identify problems, and develop care plans. A geriatric care manager or care coordinator can be invaluable to families who are not local, are unable to help, or in the event there is no immediate family.

They may provide services directly or help with recommendations and referrals for the following:

--Screen, arrange and monitor in-home health companion services.

--Provide or arrange for transportation services.

--Act as a liaison between elders and family who are living far away by providing updates, identifying problems, and monitoring the situation. Some long-distance families will engage a care manager even if their parent is in assisted living to ensure that care standards are being met.

--Work with, or in place of, a senior move manager for transition to a retirement community, assisted living, or skilled nursing facility.

--Provide advocacy for the elder and their family concerning health-care services.

--Serve as a resource for the quality and availability of health care and living arrangements available in the community.

--Provide services or referrals for ongoing assistance with cleaning, meals, laundry, and what the industry calls "activities of daily living" (ADLs). ADLs include bathing and grooming, dressing and undressing, toileting, eating, transferring (in and out of bed, bathroom, etc.), and ambulation (moving about with walkers, wheelchairs, etc.)

Making the Move or Adapting the Home
Sometimes all that is needed is to downsize to a low-maintenance home or to adapt a home for an aging occupant. Senior move managers specialize in assisting older adults with the daunting process of moving and downsizing or adapting a home. They will patiently and respectfully work with families throughout the transition process. They can provide some or all of the following:

--Develop a plan for moving or adapting a home.

--Help with decisions regarding what to keep, what items should stay in the family, what to give to charity, and what can be discarded.

--Arrange auctions, estate sales, and consignments.

--Oversee the moving process including selection of a moving company and arranging shipments and storage.

--Assist with realtor selection and preparing the home to be sold.

--Work with a floor plan of the new residence to help with placement of furniture.

--Arrange for painting and repairs at the new home.

--Unpack and set up the new home, including hanging the family pictures on the walls.

Taking Care of the Finances
Sometimes help with daily financial matters is all that an elderly person may need. Physical conditions such as arthritis may make it hard to write checks, and problems with concentration, memory, and numeracy may require assistance in financial matters but not other aspects of daily living. Daily money managers (DMMs) provide personal financial and bookkeeping services including some or all of the following:

--Pay bills by preparing checks for clients to sign.
--Reconcile bank accounts.
--Maintain financial records.
--Review medical bills and health insurance reimbursements.
--Provide recommendations and referrals to attorneys, investment advisors, and tax preparers.
--Help prevent the financial abuse and fraud that ensnares many elderly people.

Narrow the Field
Your clients can find these specialists by asking for recommendations from professionals they trust, such as estate or elder law attorneys, physicians, and counselors. Friends, neighbors, and clergy are also good resources. Check Better Business Bureau ratings, Angie's List opinions, and other consumer publications, such as Retirement Sourcebook, which have comprehensive listings.  

Help clients prepare a list of questions to determine the scope and cost of services that will be provided. There may be some overlap or gaps in the services available, so needs should be well defined when interviewing providers. Before making a decision, the following questions should be answered:

--How long has the provider been in business?

--What type of training or background do they and their employees have?

--Exactly what services do they provide? What services do they subcontract?

--How are their employees supervised?

--Do they do background checks?

--Do they belong to a professional association with a standard of ethics?

--Can they provide references?

--Will they provide a written contract?

--How do they charge and are their fees fully disclosed?

--Do they cooperate with family members who want to help with some of the care-giving work?

Doing Well While Doing Good
Helping your clients investigate their options for senior living allows you to act as a sounding board for this important transition and also provides an opportunity to engage with family members. This is a great way to showcase the level of expertise and quality of care that your clients experience. Cementing a relationship with your client's family can help you expand your base of potential clients and may result in the continued management of the investment assets when they are passed to the next generation.

The author is a freelance contributor to MorningstarAdvisor.com. The views expressed in this article may or may not reflect the views of Morningstar.

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