Afford Anything - The Brutal Math of Caring for Aging Parents, with MarketWatch Columnist Beth Pinsker

Episode Date: November 14, 2025

#660: Caring for an aging parent can morph into a second full-time job, and even the most financially savvy adults get blindsided. Bank accounts freeze, home sales stall, and family savings disappear faster than anyone expects. In this episode, we dig into what really happens when you take over a parent’s financial life, from the first power of attorney to the final tax return. We explore the emotional and logistical realities of dementia care, Medicaid, trusts, probate, and why a single smartphone setting can determine whether you can access the information you need. Veteran financial journalist and certified financial planner Beth Pinsker joins us to share the hard lessons she learned while managing her parents’ money, housing, and estate. She opens up about the “you don’t know what you don’t know” moments that hit even experts. We look at why almost every caregiver reaches a breaking point, the two documents that can save a year of stress and tens of thousands of dollars, how a forgotten zero-balance home equity line nearly torpedoed a real estate deal, and why phone access now belongs at the center of estate planning. We also confront the brutal math of long-term dementia care, the real differences between Medicare and Medicaid, how to evaluate facilities beyond brochures, and what happens when a parent dies without updated paperwork. Through it all, we focus on how clear conversations about wishes and values can reduce guilt and burnout for the people left steering the ship. Key Takeaways Financial caregiving comes for almost everyone eventually, and even experts hit roadblocks, so the goal is not perfection but reducing avoidable chaos. Power of attorney and healthcare proxy documents are foundational, often more urgent than a will, and they need to be current, state-appropriate, and shared with the people who may need to use them. A locked smartphone without a legacy contact can become a financial brick, cutting caregivers off from essential clues about accounts, subscriptions, and bills. Long-term dementia care can run five to six figures per year, outlasting even solid nest eggs, so families need to confront the realities of Medicaid and state-specific safety nets before the money runs out. How assets are titled, from bank accounts to real estate, determines whether heirs inherit smoothly through a trust or spend years and thousands of dollars navigating probate. The most important “plan” is knowing a loved one’s wishes for quality of life and end-of-life care, so financial and medical decisions feel like honoring them instead of guessing in the dark. Key moments (0:00) Why financial caregiving blindsides even the experts (05:18) The hidden home equity line that almost killed a real estate deal (10:54) Two documents every adult in your life should have (14:29) The critical phone setting that protects access to accounts and memories (21:23) What Prince’s estate taught us about wills and inertia (31:39) Planning for a decade of dementia care without going broke (35:16) How Medicaid really works and why “running out of money” is a process (38:46) The menu of care options from in-home help to CCRCs and nursing homes (44:31) The “smell test” for evaluating facilities in the real world (51:06) What to do in the first weeks after a parent dies (54:38) Trusts, titles, probate, and how one frozen account cost $5,000 to unlock (01:01:04) Knowing their wishes so money decisions feel like honoring, not guessing Resources and Links Beth Pinsker’s website: bethpinsker.com Beth’s retirement and financial planning columns at MarketWatch Beth’s book, My Mother's Money, on financial caregiving and planning for aging parents and loved ones Share this episode with a friend, colleagues, and anyone who is thinking about caregiving: https://affordanything.com/episode660 Learn more about your ad choices. Visit podcastchoices.com/adchoices

Today, we're exploring one of the biggest financial challenges that touches nearly every family, and that is the intersection between money and caregiving for aging parents. Almost everyone listening to this either has cared for aging parents or will care for aging parents, and that's going to have a big impact in many areas of your financial life. Today's guest is Beth Pinsker, a retirement planning columnist at MarketWatch, and a certified financial planner. She's been covering personal finance for more than 35 years. She was the money editor at the Wall Street Journal.

She spent eight years at Reuters, and she won an award from the Society for Advancing Business Editing and Writing, Sabu, for her work on financial caregiving. But in spite of all of that expertise, when Beth's own parents got sick, it was tough. And she was stressed, and she was navigating this really confusing maze of obstacles that she did not see coming. and she literally lives and breathes this stuff for a living. Even for the experts, it's tough. So how do we, as mere mortals, navigate that?

That's what we're going to learn today. Welcome to the Afford Anything podcast, the show that knows you can afford anything, but not everything. This show covers five pillars, financial psychology, increasing your income, investing, real estate, and entrepreneurship. It's double-eye fire. I'm your host, Paula Pant. I trained in economic journalism at Columbia. And today, Beth joins us to share what she learned the hard way. She recently published a new book called My Mother's Money, a Guide to Financial

Caregiving. And in our upcoming conversation, we're going to talk about power of attorney documents. We're going to talk about how to have tough conversations with your parents about money and end-of-life care. We're going to discuss what to look for when you're visiting care facilities. We're going to discuss the practical steps that you need to take after someone passes away. Beth is going to tell a story about a forgotten home equity line that almost ruined everything. And she's going to explain why something as simple as your phone settings can make a huge difference in a crisis.

This conversation is all about preparing for that intersection of family, money, and caregiving, which is something that touches every single one of us. Here she is, Beth Pinsker. Beth, you write a retirement planning column with MarketWatch. You've been with MarketWatch for over three years, but you've been a journalist largely covering personal finance and financial planning for over 35 years. You were the editor of Wallet Pop. You have been in this world for a long time. You're also a certified financial planner.

So you seem like the person who, based on all of your knowledge and experience, would be best poised to have a smooth experience when it comes to financially caretaking for elderly parents. And yet, when the time came, even for someone with your depth of knowledge, it was a challenge. Absolutely. We did so many things right, and it was still really hard. The thing I find fascinating about financial caregiving is that it's hard for most people. Almost everybody I spoke to, and I spoke to like 100 people who were both experts and just family caretakers, everybody had a breaking point over something. There's no way to be perfect about everything. There is something that's going to get you in this process because there are just roadblocks and obstacles everywhere. And the thing that really touched my heart with all of

this was that we do it anyway. Like nobody ever gets out of it. You can't buy your way out of it. You can be super rich. You can be the most successful person in the world. And Taylor Swift is still out there talking about putting together her father's shower seat when she took care of him this past summer. We all are going to go through this no matter what our incomes, no matter what our parents were like, no matter if we like our parents or don't like our parents, whether we're close to somebody or there's an aunt, four states away that you probably have never even met before. caretaking is and caregiving is coming for you at some point. And it's not a perfect process. Can you talk about some of the challenges that you encountered?

So my dad passed in 2018. And then my mom got sick about four years later and she died in 2023. She had a back surgery and then about eight months of complications, ups and downs and hospitalizations and rehab and the whole nine yards. of it all smashed into eight months for us. She couldn't pull out of it and she passed away. Then I had to do all of the things you have to do after somebody dies, which a lot of people just sort of gloss over. But when you're the person who has to do it, there's a lot of stuff that has to be done. And not any of it is any easier than the stuff that you have to do to take care of somebody

when they're alive and sick. That part of it took just about a year from the time she died to the time I filed her last tax return and was able to close out any of the estate processes. So basically a year and a half of my time was wrapped up very intensely in this process. There were things that we did that made that easy. Like, for instance, my mom had a trust for her apartment. It passed immediately to me and my brother with no legal entanglements, and we were able to put it up for sale very quickly and find a buyer. It was a very particular selling season when we had an opportunity to put it up for sale

and were busy people with jobs and kids. And we had this very tight window of time where we could get down there to clean it out and put it on the market. We had to hit that window and find a buyer. It had to be a cash buyer. We hit all the marks. We got the house cleaned out.

We put it on the market. They took pictures. We got a buyer. we were set for closing. And this is when disaster always strikes, right? Everything's going fine. And we're going to get through it and it's going to get done. And then I get this call from the title agent, the title attorney or whatever they're called. And the tire screech and everything comes crashing to a halt. And this was my breaking point. Because I was almost out of it. We were almost clear of this big task. And the lady said, your mom had, uh, home equity line of credit open on the account and you can't close on the apartment until you clear that line of credit. And I'm like, what line of credit? I don't know anything about this. And she's like, I don't know anything about it either, but you're going to, it's your responsibility to find out about it and do something about it. I had to stop everything I was doing two days of my

life and try to unravel this mystery that my mother had left behind of a home equity line of credit on her apartment that she had never mentioned and had no paperwork or documentation for. I had to tear open boxes and look through every piece of paper I had to try to find some piece of paper that said there was a home equity line of credit. I put every search word I could think of into her AOL mailbox that I still had access to. And I finally came up with something there was like a little thread to keep winding. And I found reference. to a home equity line of credit that she had opened when my father first got sick in 2014, because she was afraid that she wasn't going to have access to any money if he was incapacitated.

He was in the hospital. She didn't know what was going to happen. He wasn't able to answer any questions or sign any papers. And she was like, I can't pay the mortgage. What am I going to do? So she opened up a home equity line of credit. And then my dad came around and was able to sign a power of attorney. And she was able to get funds out of their retirement account.

And she never, ever took any money out of the Home Equity line of credit. So those two days of my life were all about a zero balance account that was lingering on the record. And it cost us $10 to close it. Wow. And then we were able to proceed with the sale. But if I hadn't stopped everything and done all of that, we couldn't have closed on the apartment. The deal would have fallen through. Wow.

That's the kind of thing that you face as a financial caregiver. My mom should have told me about that. There should have been paperwork. There should have been documentation. And she was good about so many things, but there's always something. There's always some lingering piece of paper. I have a couple of other examples of people who found long-lost life insurance policies. There was one lady whose grandmother had taken out a life insurance policy on her mom,

when her mom was 10 years old, and her mom died in her 90s. So we're talking, like, a long time ago, a single sheet of paper that was documentation of this life insurance policy, and the company didn't exist anymore, but had been sold and sold and sold and sold, and they wouldn't help her. But she was due money. So she wasn't going to stop. Who knew what it could be worth at this point in time? And so she kept at it, and she found a way to get authorization of the policy, and

got to claim the life insurance payment. You would just have to be relentlessly tenacious about all of this stuff. I want to talk through all of the various things that a person needs to think about because there's so much of you don't know what you don't know. And I imagine for many of the people who are listening, many people are likely thinking, all I don't even know where to begin. Yes. What are all of the areas that I should be considering? Yes. So I'd like to work through that methodically. We'll do this in a couple of phases, but let's start with things that a person needs to deal with while a parent is still alive. Yes. And in fact, I want to subdivide that into two different categories. There are things to think about while a parent is alive and need some

physical caregiving, perhaps activities of daily living, but they are cognitively great. We'll start there and then after that we'll go into what to do if you have the situation you mentioned earlier celebrities if you have the situation that Jay Leno has with his wife where Jay Leno's wife is suffering from dementia and that creates a whole other so we'll start we'll start with parents are alive physically they may need some help but cognitively everything's excellent yeah so there are two very very easy things to do one is to get a person power of attorney and a health care proxy. This is what Jay Leno didn't have. Presumably a man or a family that has the means and the wherewithal to have managers, lawyers, agents, financial

planners. Nobody in their life got them to get a power of attorney. If he had had that power of attorney, we would know nothing about his situation. But he had to go to court to get conservatorship over his wife because he didn't have that power of attorney. And then that becomes a public process. So that's why you know so much about Jay Leno and his situation was because he didn't have that piece of paper. These are very simple legal documents that are, they're contingency based. They're not handing control of your entire life to somebody else. They are saying that if something should happen to me, I give the power of my financial life to this person and that person can take care of.

things for me as if they're me. And the same thing on the health care side. If I am incapacitated, then this person that I name can make medical decisions for me. They're two separate legal documents that you need. One doesn't cover both of them. So if you have really not just your parents, anybody over the age of 18 in your household. And what I suggest is send off an email blast. Find out where everybody is on this. Does your kid have a, um, power of attorney. You're 18 year old, your 19 year old, your 27 year old. Do your parents have power of attorney that names somebody besides either one of them as power of attorney or as a sibling or somebody besides two people in a couple? Your aunt Sue, your uncle Joe, your neighbor down the

street, find out anybody that you think you would be responsible for in an emergency. If they're going to call you from the hospital. You want to make sure that you have that health care proxy and that power of attorney. I did this when my kid turned 18. He was going to have some minor surgery and then go off to college, right? So the first thing I did was go to the internet, download the power of attorney and the health care proxy, print them out, have him sign them, march off to the notary. And I couldn't sit with him in the waiting room while he was having surgery and not have those things. But they come in handy anyway. I needed to make him a follow-up doctor's appointment. He's 19. They wouldn't let me. They're like, you need a piece of paper in order to make a

regular appointment for your 19-year-old. Change car registrations, like deposit a check in his bank account while he's away at school. Any of those kind of things, you need a power of attorney for him. We are legal adults and other people cannot do stuff for us without legal. pieces of paper. So you have to realize that for every person that you would be responsible for in your life. It's very simple. You just email them and say, hey, do you have a power of attorney and am I the person that you've named on that power of attorney? And if you don't have a power of attorney, can you get one? Here's a link. And if you're going to make me that power of attorney, I want a copy of it, please. And just make sure everybody in your life has a

done. The second thing you want to do is make sure you have access to the phones of the people that you would be responsible for. Phones are so, so important. And this is a 30-second fix. With older people, you might need to walk them through it, like if you're going to visit your parents. And you say, mom and dad, pull out your phone, go to their settings, have them name a legacy contact on their phone. Even if they tell you their passcodes, passcodes change. People change their passcodes without even thinking about it. If there's any sort of cognitive problem, people could change their pass codes and

forget them. Even the FBI can't get into a locked phone. So if something happens to somebody you love and you go to their phone and it's just a brick, if you don't have that legacy contact, information, you're out of luck. You can't do anything with that phone. You need that phone. You're like, I want my phone. I know. I'm like looking around for my phone. Okay. Go get your phone. Okay. I have heard so many sad stories of somebody gets in a car accident and the spouse can't get into the phone. Right. You lose your pictures. You lose nostalgia items.

But you also lose access to things like what apps were they using? What accounts did they? have opened. What was their email? If you have their phone, you can get a picture of everything that was going on in their lives. If you open my phone right now, you would know what my car insurance was, you would know what banks I use, you would know where all of my money accounts are, you would know I'm paying a monthly fee to Ancestry.com and my newspaper subscriptions. Like you would know everything I was up to financially. Everything in my life is on my phone. All right, so how do you set up a legacy content? You just go to your settings.

I'm in settings. You go to your account here, just where your name is. Oh, okay. So on iPhone, you press account where your name is. No, I'm going to sign in insecurity. Sign in and security. There it is. Oh, there it is.

Okay. And what it does is you name a legacy contact. You put identifying information in for whoever that's going to be. And then it gives you like a QR code and you print that out. and then you tuck that in with all your important documents, if something were to happen to you, your contact, your legacy contact, could take that QR code and log into the Apple system

and verify themselves and gain access to your phone. Wow. Easy as that. But if you don't have that, this is one of those things where like, oh, that doesn't sound so hard. If you don't have it, the answer is basically no,

and there's nothing you can do about it. Wow. Just no. there's not any wiggle room on that. And with a lot of the stuff that you need to do for somebody financially, it's kind of like that. If you don't have that power of attorney document, the answer is no. This can be big stuff like I can't get into my mom's bank account and I can't pay anybody. I can't pay her mortgage.

I can't pay her electric bill. I can't pay any caregivers. I have to pull all this money out of my pocket until we straighten this out. And straightening and out means going to court. And going to court means hiring a lawyer. And you're like immediately out $18,000 and a year of your life. So if you have that power of attorney, you can go to the bank and you can say, hey, I'm this person's, I'm my mom's power of attorney. Now, banks make it really hard.

So that's like not the only step you have to do, right? What I found with my mom is that any time she had an interaction with the company that she was paying them, they were perfectly happy to take my money and didn't care who I was. Any time she had money somewhere and I wanted access to it for some reason, they were like a brick wall. Right. So her retirement accounts, her checking account, her safe deposit box, I had to jump through so many hoops to get that done. and everybody I've helped with this since then has faced an even worse time than me. I spoke to one estate attorney who actually had to sue a bank to get the bank to accept the client's power of attorney.

And she had drafted the power of attorney documents. She's like, I know these documents are just fine. You're going to have to take them. And the bank's like, no. She's like, I'm going to sue you. And the bank's like, go ahead. We can't accept your documents. So she sued them.

And of course, there are statutes all in every state in the country that, say that they have to take these documents and they settled the lawsuit and they took the documents. You shouldn't have to take it that far. But there is a lot of feet stamping and holding your ground that needs to take place with every single one of these kind of things. And starting with the power of attorney, it takes a lot of feet stamping. You have to go into the bank and be like, you are going to take these documents one way or the other. But you have to make sure that your documents are valid, right? So my parents moved from Pennsylvania to New Jersey to Florida. After my father died, I said, you have to update all of your documents. You live in Florida now.

You're a single person. You need new documents. And so she did that. My mom had valid power of attorney documents that had been done within the past five years when I went to use them. And I knew that that was the rule, and I knew that they were good. If my mom had not updated those documents, and I was trying to use power of attorney documents from Pennsylvania, they wouldn't have been good. I would have been stuck. Some people, they do the power of attorney documents with their whole will and the state planning things and 15 years go by and nobody's touched anything.

And the rules have changed. Life has changed and none of it applies anymore. And so you've got to make sure that these things are recent and good before you stamp your feet. Yeah. Because you can stamp your feet and still not get anywhere if. if they're not valid. Right. My parents actually just had an attorney look over all of their estate planning documents and their medical directives and everything because they had originally

gotten it done 17 years ago. Yeah. See? That's a long time. And so I remember I came with them to the appointment. The first question that the attorney asked is, well, what prompted you to come in here today? And my dad said, well, it's been 17 years. I figured it was time for a look over, right? A lot of people have that sudden awareness and then just dawns on them, oh, I should do something about this. And that gets them moving. The only thing I've ever seen move the needle on any of this was Prince dying. I've been studying this and covering the artist formerly known as. The artist formerly known as died and didn't have a will. His parents were gone. He had a whole bunch of siblings, but he wasn't married, didn't have kids. And this big legal battle ensued. And this big legal battle ensued.

And somehow that was the cautionary tale that a lot of people needed to start the process of getting a will or a trust or whatever it is that they needed. Wow. I tracked it in the months after he died, all of the willmaking services that existed at that time were seeing spikes. And then slowly, because it's been since I think about 2016, since that happened, it all then eventually reset back to the same. old numbers that we've had for decades, which is that 30% of people in this country eventually get a will and 70% do not. 70% of people. And most of those are younger people. So the numbers skew a little bit better when you get above the age of 70. Like 70 year olds can sometimes on sub-surveys hit the 50% mark. Like 50% of 70-year-olds, whether they're rich or poor, this even goes for a very

wealthy subsets of the demographic, it can hit 50%, but it doesn't go over 50%. Half of everybody out there, at least, doesn't have anything done on this score. For me, having gone through this, it's terrifying that more people have to have the heartache and the pressure and the tension and the expense that they don't need. At that particular moment in time, it's a really hard moment in time when a loved one dies. You don't need anything extra on top of it. Like, you don't need any extra trouble. Tony Shea, the founder and CEO of Zappos, he also died without a will, without a trust, without an estate plan.

Same situation. He was not married, no children, and he had invested $300 million into the revitalization of downtown Las Vegas, meaning he owned properties all across downtown Vegas. In fact, at one point during his life, if you were to look at an aerial map of Las Vegas, he began buying properties that were spread out in such a way that his properties formed the shape of a llama because he likes llamas. Okay. So he had a scattering of properties across Vegas. I don't know how it turned out, but I was living in Vegas at the time. And I remember talking to a couple of attorneys who were not. directly involved in the case, but we're hearing gossip at the local bars about it. And it was

apparently just a gigantic disaster. Yeah, that one, property is the hardest thing. If you don't have a clear passage of title, it just sits there. And it collects fees and taxes and the mortgages pile up. And nobody can do anything because, again, passing property, selling property is one of those things, it's very encumbered legally and financially. And if you don't have clear title, you can't sell it. So if there's no clear path to inheritance, you can't do anything. And then somebody's still responsible for all of those payments. I've seen this happen in so many families where even I talked to one guy from my book who's now a tax expert, right? So this is his livelihood. and his mother passed, and she had left the house to him in her will.

Well, it takes a while to probate a will. So he had to sit on this house for a year before he could legally sell it, because that's how long the will took to probate in his state. So imagine if you then add on an intestate estate, which means that there's no will, right? And the court then has to decide first what's going to happen and who's going to inherit. If you have somebody who doesn't have immediate apparent errors, right? There's no children and you got to go looking for cousins and aunts and uncles and whatnot. And then all those aunts and uncles are going to fight over who gets what.

It could take years. Right. There are still legal fights. I mean, there's Tony Bennett's estate is in a legal fight. You can go through because when you get to the court level of things and a judge has to decide, it's all public. That's why we know so much about the finances and the heartache of these celebrities who didn't have a plan in place. When a celebrity dies and all of their assets pass through a trust, we don't know anything about it. Right.

It's better that way. Wow, there are probably celebrity journalists who are just court watchers. Yeah. Yeah, all this goes. Like, for instance, I'm divorced. when my ex-husband's mother died, all of the documents went through the probate courts. And so I'm able to see all this. Do you want your ex-spouse looking at all that stuff?

You don't have to be a celebrity. You can just be a regular person and say that I don't need other people up in my business. And I don't need my neighbor to know how much I'm inheriting. It doesn't have to be any big amount. or anything like that. You don't have to be special or famous or rich or anything. Everybody's entitled to their privacy. But if you don't fill out some of these forums and do some of this work ahead of time, it's all open for everybody to see. You know, when I was a kid, I remember on Christmas morning, I got lots of toys, lots of books,

lots of clothes, gifts. The books were always my favorite. I'd spent all of Christmas Day just reading and reading and reading. But, you know, none of those are things that I have anymore. They wonderful in the moment, but decades later, I have no idea where any of those things went. But by contrast, when you give a gift that brings somebody financial security, that's something that lasts a lifetime. Now, when it comes to financial security, nearly half of American adults say that if they lost their primary income earner, they would suffer financial hardship within six months. And so if you want to secure your future before the new year it begins, Lock in your life insurance today

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need some physical help, but who cognitively is in excellent condition. Now let's move to what you should do if you have an aging parent or grandparent who is in some level of cognitive decline. Yeah, those, I mean, my case was really fast. Those situations, because nothing's wrong with the body, they can last 10 years, 12 years. You really have to do some financial planning for those circumstances because it could be a long time. Your case was fast, meaning your mother's declined. My mother's declined. Yeah. My dad was sick for about four years, but my mom was his primary caretaker. My mom was sick for eight or nine months. The costs of that were not the same as if she had lived for 10 more years. There are very few fortunes in the world that can

sustain dementia illness for 10 years. I talked to one woman for my book, and her mother lasted, I think she was in memory care for 12 years altogether, and she outlasted her money by a month and a day. So this costs like $12,000, $15,000 a month. She had a pretty good nest egg to begin with, but the years grind by and grind by and grind by, and then the person is still alive and it needs to be taken care of with the same degree of love and everything that they had at the beginning. But the money's gone. Everybody needs to think about what that means for their family because everybody has a different level of wealth and has a different standard of living, different thoughts about quality of living, different thoughts about end-of-life

care and what they want in terms of heroic measures. These are things that are are very personal and that you have to talk through. But in terms of the legal documents, you'd be surprised how many legal documents you can get signed with somebody who is in cognitive decline. That's terrifying. It's a little terrifying. I went through my all this paperwork when I inherited all these boxes and I found a power of attorney that my grandfather had signed in the nursing home when they put him in with dementia. How did this happen? How did anybody allow my grandfather to sign this document. And apparently I talked to some lawyers and there is a very different standard for being able to sign that form. And people have good days and they have bad days.

And so just because somebody is diagnosed with Alzheimer's or another cognitive issue does not mean that it's game over, that you can't get that document signed. There are lawyers who will go to nursing homes. They will assess the situation and they will get documents signed when they can get them signed because the alternative is so onerous that there's some leeway, but that window shuts. So if you can sneak in under the window, do it fast. Get that done. So the first lesson is get those documents, those powers of attorney done as soon as you can. The sooner, the better, while everybody's good and fine, you want to do it. But then once you're into a cognitive illness, you really got a plan for a long time. You never know what's going to happen. Routinely, it's seven to ten to twelve

years. It's hard. Like, you are on task for all of that. And it wears people out. It's a very hard thing to do. But you have to, the advice I got from people who have lived through this is paste yourself, do what you can, make sure you take care of yourself. And there are social safety nets in the U.S. They're very difficult to use and they're always in jeopardy, now maybe more so than ever. But when you do run out of money, when your parent is literally at almost a zero balance, there are safety nets that will pay for care. There are some safety nets that will pay for you to care for them if you're qualified or for them to go into a caregiving facility. state. There are a lot of requirements to me, and there's a lot of red tape, but we do still have

social safety nets in the U.S. And some of those are state-by-state specific, right? They are all state-by-state specific. So the amount of money and the qualifications for being an at-home caregiver are different in every state and more generous in some, like New York, is particularly generous. Level of income you're allowed to have and the level of assets you're allowed to keep hold of is different in every state, but it's still really low, no matter where you go. The federal limit is set somewhere around $2,000. So you have to wait till a parent gets down to their last pennies, basically, before you can put them on Medicaid and get the facility covered by Medicaid. And then, of course,

you face all the practical hoops and obstacles that you have to jump through. You can't just put your parent in any facility and get Medicaid to pay for it. That facility has to accept Medicaid, and many of the good ones do not. My grandmother, for instance, was in a facility, an assisted living facility. She lived there for 12 years, and she went through the various levels. So she started out as independent, and then she moved up to the nursing care unit, and then she ran out of money. And they took Medicaid for those nursing care beds, and she was able to talk herself into one of those Medicaid beds, and she lived there for the rest of her life with Medicaid paying for it.

I called that facility to see what that cost these days, and they don't take Medicaid anymore. They don't have any association with Medicaid. So my grandmother could not have aged in place in that facility if she were still living today. Think about that. What would happen if you had your parent in a facility and they ran out of money and they didn't take Medicaid?

What would you have to do? You have to move them. And I have a friend. she was in this exact situation. Her mother was in a facility. She and her husband were helping pay for it. The mother ran out of money. So they took over the full payment of it. It's like $12,000 a month. Then she got divorced. And her ex-husband no longer wanted to pay for his ex-mother-in-law to be in this facility for $12,000 a month. And she said, I can't afford it on my own. So I need my mom to go on Medicaid. But the facility didn't take it. So then that meant moving her mother. So now she's going through a divorce. force and having to move her mother and still having to figure out some way to pay for it because most of the facilities that you deal with require you to pay for several years before you can put them on Medicaid. So they require two to four years of full pay before you can then switch over to Medicaid, even if you're eligible. And these are what you would call, you know,

the good ones, right? Like these are the facilities you want your parent to be in. And so she went looking for a facility that would accommodate her mother. She called one of those services that you can call, and she got a referral. It was far away, and she's sitting at a bagel shop complaining about this situation and being in misery about it to a friend of hers, and somebody leans over from another table and says, those places that give you referrals only give referrals from the places that pay them to give referrals. But there's this other place right down the road, and they don't go with that agency,

but they're really good. My mom is there. You should check it out. Wow. And she went to check out that facility, and she liked it, and that's where her mom ended up. And it strikes me how much that whole story hinges on chance, random chance. It also hinges on the fact that you could be in any bagel shop, in anywhere in America, and somebody else at the next table is going through this too.

And we all have to share information with each other. You can't be afraid to talk about this stuff because somebody might have a piece of information that you could use or they have gone through it and they have a trick that could help you. Which also kind of speaks to how much information asymmetry exists in this arena. Yeah. There is nothing out there that covers every situation. Everybody's a little bit different. Everybody's in a different place. It's maddening. We need to up the education and up the information level on all of this because we're all good. to be dealing with this, either for somebody we love or for ourselves. Like, we're all going to get old, too. And I think the people who have read my book so far have told me that this really opens their eyes to what they need to do for themselves, too. And it certainly did for me, dealing with all my mom stuff, like, really made me see that I was putting some obstacles

in place that my kids would have to jump over if something should happen to me. And I've been doing my best slowly to, like, clean all that mess up. I want, to die and then have my kids be able to be just like, we loved you, everything's good, and I leave no mess behind. I want to leave no problems behind. I want to go out clean and not have anybody have to deal with my stuff and whether they can part with a clip of an article I wrote in 1993 that I'm still holding on to. They'll just be able to press a button and say goodbye. But then my significant other keeps buying things.

And I'm like, well, what are the kids going to do with this after we go? They'll have China to dispose of at some point. Can we walk through the various care options? You mentioned assisted living. But I want to walk through the menu of choices because there's in-home care. Yeah. There's what's it called the? Continuing care communities.

Yes, yeah, yeah, that's the one. CCRCs. CCRCs, that's it, right. Those are what I call the condo model. There's the rental model and the condo model. The rental model is like your assisted living where you like rent an apartment, you pay a monthly fee and you get to live there. And they usually have several levels of care that go up, that you ratchet up as you need it.

The catch with those places is usually there's like a monthly base fee and then you have to upsell they upcharge for all the ancillary services. So in the CCRC, it's like you buy a condo, and then you pay a monthly maintenance fee. And on top of that, sometimes they upsell for other charges. You want a cleaning lady to come in once a week. You want physical therapy. You want meals delivered to your room instead of the dining hall. There's upsells for all of those kinds of things.

And then you get to your pure nursing care situations. then you get to facilities that are only private pay, where you have to pay the full cost of the facility. And depending on where you live in the country, it could be anywhere from $4,000 or $5,000 a month to $20,000 a month. Then you have facilities that are mixed. Some residents are private pay. Some residents are getting paid through Medicaid. And then you have Medicaid-only facilities. those are typically less bells and whistles because the Medicaid rate of reimbursement is

much lower than the private pay. The government is not paying the Medicaid nursing homes $12,000 per resident per month. And so just by fact of that, you're getting less in those places. The staffing is less. The food is of a lesser elegance kind of thing. You can't order a grilled she's on demand in a lot of those places. If you've ever had a parent who is sick in any way and they have to go to rehab after a hospital stay, you will be given a list at the hospital of places in your geographic area that will take a Medicare patient for a short-term stay. And Medicare will only pay for this short-term rehab. A lot of people are under the impression that Medicare will pay for the nursing home. No. I have a sidebar in my book of answers you don't want to

hear about Medicare. The number one is Medicare pays for long-term care. No, it doesn't. Medicaid pays for long-term care, but you have to qualify. And Medicare will pay for a short-term stay after a serious illness. But this is where most people encounter these choices. You get this list, And then if you're diligent about it, you go around and you visit all the different places. I did this both for my mom and my dad when they were in the rehab phase of things. It's immediately clear when you step over the threshold of any of these places, what the payment structure is. Like, you can literally smell it. We call it the smell test.

Like, you have to go to these places and you have to walk in the front door and you have to see what's going on and you have to smell what's going. on. You will know the difference viscerally immediately. And you will say, I don't want mom or dad in that place. And you will cross that place off the list. And I'm not saying that all Medicaid places are bad because you can walk into one and it can be great. But there's more money in the other places. And so when there's stuff money can pay for and staff is one of them and staff clean stuff, and buys new furniture and pays attention to the lighting and those sorts of things. You really have to go boots on the ground for that sort of thing. You cannot go by a star rating from the Medicare system.

You can't go by what somebody says. You really got to go. You got to see how many patients are lined up in wheelchairs around the nurses station. You got to see what the dining hall looks like and what the people look like who were sitting there. You got to hang out there for a while. Yeah. Like I went to one nursing home.

I remember they were bringing the patients in for lunch at 10.30 because they didn't have enough staff to bring people sooner. And so the staff would go and bring one person in, and then they'd go and bring another person in. And then the residents just sat there at their long tables for like two hours, waiting for lunch service. And they would be brought in one by one as. staff was available and they were just sitting there waiting for lunch to happen. And then the

same thing happened after lunch was served. They were all slowly shuffled back to their rooms. That was sad. I didn't like that place. But you can't know something like that unless you go and visit. And when you're going to put your parent in a place and you're not going to be there every day, you need to know what's going on. You really need to see that. make sure it's what everybody's on board for. Let's move to what a person should do if a parent, a grandparent, somebody that they're caring for, passes away. What do you need to know as a financial caregiver? Well, the first thing is, is that you can take a minute for yourself.

I got COVID at my mom's funeral. I was like completely incapacitated. And it was the first time I had gotten COVID too. I wanted to do things and I would have done things. And COVID prevented me from doing things. And that was probably the best thing that could have happened to me. I needed a minute. And this is why I say that power of attorney is almost more important than any of these post-death documents like a will and a trust.

Everybody says will, it's Kleenex. Like, it's a brand name. Like, you die, you need a will. But I think power of attorney is more important because when somebody is alive, there are deadlines. When somebody dies, you have a minute. Nothing's going to happen the next second. And so you can take a deep breath and you can mourn the person. The most important thing I did, and I learned this from a financial planner I interviewed years ago, forward the mail.

like do one thing forward the person's mail to yourself if you're the one responsible anything that happens or that you need will come to you and as long as you have access to their email now too like mail and email are synonymous you need all that stuff coming to you so that's the one thing i did when my mom died went to her computer you went to the u.s postal service online thing and i forwarded all her mail to me for the longest period of time The mistake I made, of course, because there's a mistake you make everything you do, I didn't forward my father's mail because I figured he's been dead for five years. I don't need to forward my father's mail to myself. But apparently he was still getting mail. If you've been trying to reach my father and he hasn't responded to you, it's because he died five years ago. I'm sorry, I don't have his mail anymore. You now need documents in order to go and forward somebody's mail, like you you know, death certificate and all of that. So if you don't do it right away and forward their mail to yourself, like you're going to get stuck in like a red tape vortex. So try to set that

up. Not everybody gets warning about a death coming. Not everybody has the ability to do that. Do whatever steps your local post office says and get that mail forwarded to yourself. And then take a deep breath. Relax for a minute. Do your funeral, whatever procedures your family has for doing that. Every culture has its own rigmarole around death. Don't worry about any of the rest of it because it will all happen at some point and there's no rush for any of it. I wouldn't have listened to that advice of somebody had given it to me. So I understand people out there, they get in a frenzy, they've got to clear things up, they think bills are due. I understand all of that. I would have done the same exact thing. I got too sick to do it. I literally couldn't talk. I was lying in bed. You know how COVID makes you.

You're literally just flat out. That was the only thing that kept me from meddling in everything and driving myself insane. So once I got better, I realized that, like, you can't do anything until those death certificates show up. And depending on your state and where you live, it takes a while for those to show up. and you can get very antsy waiting for them. But I had a 10-day period where I was sick and incapacitated. So by the time I got better, the death certificates had shown up. And I was able to then start doing things.

Now, the doing things part is where whatever you've done before death makes it easier for the person after death. There was not that much I needed to do for my mom because she had a trust. So if you are the person responsible for cleaning up the mess after somebody dies, if the person doesn't have any documents, you're in for a world of pain because you have to take the death certificate and go down to the courthouse, get yourself a lawyer, and file for some sort of letters of administration is what they call them in my experience, but your court could call them something different. You need to file to be the administrator of that estate. If there's no documentation that you've been assigned by the person who died as the administrator, then the court will have to make a decision about it. You have to put in a petition. And then you start this like year to two year process of being named the person who can do stuff for the dead person. If your loved one had a will, you can take the will to the courthouse and you can file it and you can begin that process.

It sort of short-circuits that to the second phase. If the person had a trust, anything that's in the trust is immediate, right? So, like, my mom left me and my brother, her apartment and all her worldly possessions, and they just belong to us immediately. So all her jewelry and all the stuff in her apartment and all of that just ours. Life insurance. She named us as beneficiaries. Just filled out a piece of paper.

Money showed up in our accounts. The accounts that we were named as beneficiaries on, like her retirement accounts, filled out a piece of paper, that took a little bit longer. Everything's difficult in the financial system, but it was a process. It wasn't hard. Then we got to one bank account that wasn't properly titled. And the money that was in there got locked. So we had to go to probate. and then probate took about a year.

Probate's horrible. Like, it's just time-consuming and tedious, and I don't understand the purpose of all that tedium, but it exists. And if you have assets that you can't get to, you have to go through it. You want to avoid it if you can. And you avoid probate by having proper titling of assets in bank accounts. Like, we had this one bank account. It was a joint checking account that my mother and father had.

And after he died, she had never taken his name off the account. When we went to try to fix it, we had to bring all these documents with his death certificate and all of that. And she was sick by that point. And we just never got to it. So I was power of attorney. But power of attorney ends when somebody dies immediately. Like, dead, no more. So I couldn't do it.

anything with the account after my mother died because power of attorney ceased to be helpful. And so I literally just, they just froze the account. And there was $12,000 in the account and cost $5,000 for the lawyer. So you have to do this mental calculus. Okay. I have $12,000 there. I have to spend $5,000 to get it. This was my story and my mom's story. Most people would shy away from talking about those kind of financial details, but I ask people every day to tell me those kind of financial details for the purpose of helping other people. I'm telling people exact amounts because I want to help them. And it doesn't help if I just talk about things generally, right? So if you can think and understand that if you have $12,000 in a bank account, which was carefully calibrated to cover all of the expenses in the month my mother's,

died. We had caregivers to pay. We had her mortgage to pay, her premium for her Medicare supplement. I calculated very carefully what the exact number I needed in that bank account to cover the outgoing money. And it just got locked there. In order to get it out, I had to spend $5,000 to get it out. In the story that you just told, we started this interview by establishing that you have the most bona fides in this world that anyone could, you're a CFP, you literally write about retirement planning for MarketWatch, you've been in the financial journalism space for over 35 years, and yet there were still blind spots. There was still these elements of you don't know what you don't know and you don't realize in any anticipatory manner what you're

overlooking or what you're missing, what then can people who don't literally immerse themselves in this as their day job? What chance do the rest of us have? Well, the things that the financial system doesn't do well and makes hard for people are really all about psychology and family communication. If you are a family that can talk to each other, you will make a lot of this easier on yourself just by being in communication with each other. That's not possible in every family and not with every single family member, but it makes things a lot easier. Like my mom's situation with the bank account was more psychological than it was structural, right? She could have gone and changed that bank account earlier, but it felt bad to her so she didn't do it.

If we could have talked about that, that's more of a psychological issue. And in a emotional issue than really a banking problem. This is where a financial therapist might also come in handy. Yeah. And I'll say that the number one thing we did right and that made my life much, much easier. Like all these other problems I would take over not having this problem, which was that I knew what my mother wanted. I knew what quality of life she wanted.

I knew what was important to her. And I was absolutely clear about it because she was clear about it. When you are the person responsible for another human being, making hard life decisions is, it's terrifying and it's, it just, it can really mess with your head. To make end of life decisions for somebody else is just, it's just really hard. I knew what my mom wanted, and I never had to second guess myself or question anything. and that made everything else acceptable to me. I could deal with the Social Security office because I knew what my mom wanted out of her life. That made it all worth it for one thing, but like I didn't have to torture myself.

I didn't have to deal with guilt or negative feelings of any kind because I felt like we were in it together. I felt like I was honoring her by taking care of her. in whatever capacity I was supposed to. I didn't have to help her in the bathroom. We paid somebody to do that. But taking care of her money was a way of honoring her and showing her that I loved her. And honoring her wishes as to how she wanted to live her life was part of that, that she didn't want to be intubated, that she wanted to do not resuscitate order at a certain point, that she wanted to go home on hospice at a certain point in her journey. these were all things she was very clear about and that I did not have to decide for myself

for her. And that made a huge, huge difference to me psychologically and emotionally. And all the money stuff was all secondary to that. But that's also a money decision at the end of the day because how she wanted to be treated medically cost money at every stage of the way. So like going home on hospice sounds like it's a medical and emotional decision, but it's really a financial decision. You have to make that happen. Somebody's going to pay for it. So I feel like we got the big stuff right. And the little stuff took care of itself. But the reason I wrote about it is so that I could help people with that stuff and let them concentrate on the big things. Like don't let this little stuff run your life. Here's a book that explains you how to do all of it, all the stuff

you need to take care of. Do it, put it on the back burner, take care of the big stuff. Spend your energies on the stuff that matters, not where's my dad's last social security payment. That's a problem that can be fixed. Deal with your relationship with your loved one and focus on that. That's my message to people. That's beautiful. Thank you for spending this time with us. Where can people find you? I am just my name everywhere. So beth pinsker.com is my website on Beth Pinsker on all social media. On MarketWatch, you can find me as Beth Pinsker. Just Beth. Thank you, Beth. What are three key takeaways that we got from this conversation? Key takeaway number one. Power of attorney matters more than you think. Many people obsess over

estate planning, which is great. That's really important. But power of attorney to documents are also incredibly critical because when somebody's alive but incapacitated, there are urgent deadlines and there are bills to pay. Just no. There's not any wiggle room on that. And with a lot of the stuff that you need to do for somebody financially, it's kind of like that. If you don't have that power of attorney document, the answer is no. This can be big stuff like I can't get into my mom's bank account and I can't pay anybody. I can't pay her mortgage. I I can't pay her electric bill. I can't pay any caregivers.

I have to pull all this money out of my pocket until we straighten this out. That is the first key takeaway. Key takeaway number two. Your phone is the portal to everything. Your phone holds the keys to everything. In today's world, getting access to someone's phone might be the most important estate planning step because that holds the roadmap to their entire financial life. If you open my phone right now, you would know what my car insurance,

was you would know what banks I use. You would know where all of my money accounts are. You would know I'm paying a monthly feed at Ancestry.com and my newspaper subscriptions. Like you would know everything I was up to financially. Everything in my life is on my phone. I have heard so many sad stories of somebody gets in a car accident and the spouse can't get into the phone. Right. You lose your pictures. You lose nostalgia items. but you also lose access to things like what apps were they using? What accounts did they have open? What was their email?

That is key takeaway number two. Finally, key takeaway number three, you need to physically visit care facilities because if you're choosing where your parent is going to live, there is no substitute for showing up in person and what you find when you visit might surprise you. You have to go to these places and you have to walk in the front door, and you have to see what's going on

and you have to smell what's going on. You will know the difference viscerally immediately. And you will say, I don't want mom or dad in that place. I went to one nursing home. I remember they were bringing the patients in for lunch at 10.30 because they didn't have enough staff to bring people sooner. And so the staff would go and bring one person in and they'd go and bring another person in.

And then the residents just sat there. at their long tables for like two hours. Those are three key takeaways from this conversation with Beth Pinsker. Thank you so much for being an afforder. If you want to talk to other members of the community, head to afford anything.com slash community. And please sign up for our newsletter, afford anything.com slash newsletter,

where we send out special newsletters on topics that we don't cover here. It's totally free. afford anything.com slash newsletter. If you enjoyed today's episode, please open your favorite podcast playing app and leave us up to a five-star review, write a few words, share what you enjoy about the show. Make sure you hit the follow button so you don't miss any of our amazing upcoming episodes. And most importantly, above all else, share this with the people in your life. Share this with anyone who is thinking or who should be thinking about care.

about how to be prepared for it, please send this episode to them because that is the most important way that we spread the message of great financial practices and great financial health. Thank you again for being an afforder. My name is Paula Pant. This is the Afford Anything podcast and I'll meet you in the next episode.