Six phases, in the order they actually matter
Not six easy steps. Six phases, each with a reason it comes when it does. If you are in a crisis today, phases one and two are the ones that matter. All of it is free to read, always.
Become allowed to help
Every other phase depends on this one, and this one has a closing window. Authority has to be granted while your parent has the capacity to grant it.
- Durable power of attorney for money and property
- Health care proxy for medical decisions
- HIPAA authorization signed at each practice separately
- The institution's own forms, which banks and Social Security require regardless of what else you hold
Build the picture
You cannot make a single good decision without these six pages, and assembling them under pressure is what burns the first month.
- Every medication, dose, and prescriber on one page
- Every doctor, with a phone number a person answers
- Income in and fixed bills out, monthly
- Where the accounts, the deed, the will, and the policies physically are
Assess the day, not the house tour
Visitors see a tidy living room. What matters is the ordinary day: the stairs, the stove, the night, the driving, and what is quietly no longer happening.
- The six activities of daily living, scored, in writing
- The bathroom, the stairs, and the path from bed at 3am
- Driving, addressed before an incident rather than after
- What the refrigerator and the mail pile tell you
Bring help in before you need it
Help arranged in a calm week is chosen. Help arranged in a crisis week is whoever answers the phone. Waiting lists are real and they are long.
- Intake with the local Area Agency on Aging
- In-home aide hours, starting small and on a trial
- Adult day programs, which most families never look at
- Respite booked on the calendar, not held as an idea
Face the long horizon
Most planning quietly assumes eighteen months. Plan for eight years and the eighteen month version takes care of itself.
- The five year lookback audit before the next gift
- Long term care insurance, and what actually triggers a claim
- The payer map: Medicare, Medicaid, private pay, VA
- Your own exposure: lost wages, leave, and retirement contributions
Keep the family in one document
Most family fights are not about values. They are about one sibling holding information the others cannot see. A shared document ends more arguments than any conversation does.
- One shared file every sibling can open
- A standing monthly call, short, with an agenda
- Who does what, written down, including money
- The wishes conversation, revisited as things change
Why the order matters more than the list
Phase one comes first because it is the only phase with a closing window. A durable power of attorney and a health care proxy require your parent's capacity to sign. Miss that window and the remaining path is guardianship, which means a court, months of time, several thousand dollars in most states, and a judge making decisions your family would have made.
Everything after that is recoverable. You can hire an aide late. You can assess the house late. You cannot sign a power of attorney late.