Care Planning in Five Crucial Steps

In my work as an advisor to multigenerational families, I share the joys and sorrows of what my clients are experiencing in their lives.

In many meetings, there is a blessing to celebrate together: selling a business, retirement, the birth of a grand/child, moving to a new home, a family wedding, etc. Other times, the news is more difficult: a challenging health diagnosis, a sudden passing in the family, a friend or relative who is going through something difficult.

Not long ago, I sat down with a married couple in their early 60s. I’ll call them Ramona and Rupert. They shared the very tough news that Ramona has been diagnosed with early-onset Alzheimer’s. Instantly, the nature of their questions shifted, from “Are we ready for retirement?” to “How does Ramona’s diagnosis change anything and everything?” Blindsided by the sudden change, it’s all too easy to feel stuck and rudderless. In some ways, Ramona and Rupert were already grieving the loss of what they thought their retirement together would look like.

After listening with compassion and validating their feelings with care, it was time to roll up our sleeves and help them get started. By creating a manageable set of next steps, we wanted to help Ramona and Rupert clarify the path ahead, knowing that planning for care is never finished, just updated as new information arrives. Here’s the plan we developed together

1. Define & Document Care Wishes & Preferences.

With the progression of Ramona’s diagnosis unknown at this early stage, it was important to document the little things that make up Ramona and Rupert’s daily lives together. The plan was intended for personal guidance rather than legal instruction. The goal was to help educate a future caregiver (who would not be Rupert) on Ramona’s routines and preferences. In addition to documenting the day-to-day operational items, it was critical to pass along a sense of Ramona’s values, priorities, interests, hobbies, and what brings her joy. It was important to commit these details to paper while she was able to share them in her own words – she was, essentially, writing her own instruction book for future caregivers.

Ask your advisor for a sample or template to start your own letter of wishes, or letter of intent. We also often recommend services like StoryWorth as an affordable way for aging clients to tell their story in their own words, guided by thoughtful and approachable question-and-answer prompts. For example, each week for one year, Ramona could receive a question by email. She could type or voice record her answers, and at the end of the year, her responses could be printed and bound into a keepsake memoir book that could serve as a family treasure and future caregiver resource. It also makes a great gift for close family members!

2. Build Your Care Team.

Today, Ramona and Rupert live independently in the house where they raised three children. We challenged them to think about who would step in today if Ramona needed more help and Rupert wasn’t able to fully meet those needs. That support could come from an adult child, another family member, a friend or neighbor, a caregiving professional, a financial professional, or, in many cases, some combination of the above.

It was important for Ramona and Rupert, especially, to know that they were not doing this alone, so identifying future caregivers, advisors, and decision-makers early was key to improving peace of mind. It could also help prevent rushed decisions later. Once they identified their list (adult son, close family friend, neighbor up the street, etc.), I encouraged them to have a conversation with each person to share the news and talk about what could happen next.

3. Understand the Costs of Care and How They Fit into Your Financial Plan.

Since Ramona and Rupert became our clients a decade ago, we have helped them build and update their financial plan each year, including expected income, lifestyle needs, savings, protection strategies, and legacy goals. Ramona’s diagnosis means that their housing needs could change, based on their wishes and her care needs. For a time, they could continue living at home and bring in caregiving support during the days/nights as needed. In the medium-to-long term, they may need a residence that could offer more support and resources, such as an independent living community for adults 55+, assisted living, nursing care, or memory care.

As their advisors, we modeled the annual costs of various housing options to help Ramona and Rupert better understand the benefits and drawbacks of each and how their housing decision could impact their overall financial situation. We could also evaluate their current financial and insurance resources to determine the best path to cover Ramona’s current and future costs of care. If our planning reveals significant gaps in coverage or projected asset shortfalls, we could help them address those issues sooner rather than later.

4. Establish A Legal Structure for Decision-Making.

It is essential for Ramona and Rupert to review their existing estate documents while they are mentally competent to understand their current plan and determine if any changes are needed to better align with their financial resources and care goals. At a minimum, Ramona and Rupert should revisit their:

• Financial power of attorney, which nominates an agent(s) to make financial decisions when incapacitated
• Healthcare power of attorney, which nominates an agent(s) to make medical decisions when incapacitated
• Living Will, which states a person’s end of life care wishes, preferences for artificial hydration/nutrition, “do not resuscitate” orders, organ/tissue donation intentions, desired funeral/memorial arrangements, etc.)
• Last Will & Testament, which nominates 1) an Executor to administer assets upon passing and 2) a Legal Guardian for any minor children
• Revocable Trust, which nominates a Trustee to manage assets during life, during periods of incapacity, and upon passing.

Though Ramona and Rupert have a reasonably current estate plan that was last updated in 2024, it’s still a good idea to revisit the documents in response to Ramona’s diagnosis. As a couple, they may want to make changes to the key personnel named in their documents (agent, executor, trustee) to include the future caregivers they have identified, such as their adult son, close family friend, and neighbor up the street. Their attorney could advise them on the finer points of legal incapacity and make any necessary changes to their documents.

5. Regularly Update and Share Your Care Plans.

With the right team in place, an analysis of possible future care costs, the proper legal structures established, and some written guidance on Ramona’s preferences and wishes drafted, Ramona and Rupert have a solid start for the coming days, weeks, and months. The next step is to share their plans with the team and keep them up to date. As Ramona and Rupert learn more about how her diagnosis progresses, revisiting this planning framework regularly will be essential.

Not everything needs to be solved all at once, and life will change over time. However, a clear starting point and a sense of direction are where all good plans begin. Is it time to build or revisit the plans for your family’s care or your own future care needs? Connect with us today to start the conversation. At Foster Group, truly caring for our clients means taking the time to learn what’s in their hearts and helping them pursue their goals.