If there was one message I wish I had received from my father, it would have been his wishes for life as he aged.
My father and I talked often about day-to-day life. When he first became ill, he told me exactly who and what were important to him in life, and why. But, during our discussions, we never dug into the details of his hopes for aging. When he was no longer able to answer those questions for himself, I had to make several difficult decisions on my own.
As his daughter and as a long-term-care specialist, I did my best to help ensure he received the care I believed he would want and that I paid for the care with the resources that he would have chosen. However, to be candid, saying that each choice was challenging is a massive understatement. This role was one of the most difficult and emotionally taxing things that I’ve ever had to do.
Seven years after my father subsequently passed away, I found myself still wrestling with these unresolved feelings. Had I chosen what he wanted? Did I act in accordance with his wishes? These are a few of the impossible questions that echoed in my mind.
To give myself a sense of clarity and closure, I wrote a letter to myself from my father’s point of view — the letter I wish he had written to me detailing where and how he would like to receive care and how he would pay for it. It’s the letter that would have instilled in me the guidance and confidence that comes from knowing whatever decision I made, my father supported me and loved me. Writing that letter was cathartic for me, but to my surprise, it was transformational for others.
Weeks later at a conference, I casually spoke with a man in his 60s, and we exchanged the typical niceties people share about what they do in their careers. During our conversation, I mentioned that I had written a letter from my father’s perspective and he asked if he could see it. I obliged and he quietly read what I had written.
When he finished, he turned to me with tears in his eyes and said, “Now I know what I’m going to do on my flight back to New Jersey. I’m going to write a letter to my family.”
Writing a letter to the future is powerful. In recent years, I’ve helped hundreds of clients write their own deeply personal letters to their families, describing their preferences for care within the context of their own family situations. Most important, these letters provide an invaluable guidepost for managing care decisions when the time comes.
Caregiving is a family affair
Over the past few years, caregiving has moved to the front of the national consciousness. The pandemic highlighted the challenges — physical, practical, emotional, and financial — that come at the intersection of age and health.
According to Northwestern Mutual’s 2021 Planning & Progress Study, more than half of Americans (53%) say the pandemic has changed their views on long-term care. As a result, many are taking specific steps toward preparing for their time of need, including increasing their savings, incorporating long-term care into their financial plan, and talking to their financial adviser.
The research also highlights the impact of long-term care on caregivers. One in five (21%) Americans reported they are currently providing care for someone. Among them, six in 10 (59%) say they had to take on new or expanded caregiving responsibilities during the pandemic. The impacts go well beyond the emotional and physical demands on caregivers: on average, nearly a third (31%) of current caregivers’ monthly budgets go toward providing care.
We are a country of planners in so many ways: education, careers, family life, homes, travel, retirement…the list goes on. However, we still don’t meaningfully talk about and plan for how we will manage aging. According to the U.S. Treasury, half of Americans who live to age 65 will have a need for long-term care services at some time in their lives—and the costs can be significant. That’s why planning for the cost of long-term care is often an important part of retirement planning.
Pick up a pen today
Creating a long-term care plan is one of the most loving things someone can do for their family, and anyone can start today by writing their own letter. Yes—an actual letter. There is real power in handwriting in a digital world.
My father and I didn’t have a conversation about his wishes until he was ill, and we certainly never had anything written down. I wish it had been a plan on paper. I would have referenced it hundreds of times during the time that he needed care — not because it had all the answers, but because it would have given me more confidence in the decisions I was making on his behalf.
This letter is not a legal document, it is a love letter.
Here are a few prompts to get you started:
Share your family history of parents or grandparents who needed care.
Where was the care received?
Who provided the care and how long was the care needed?
How did this experience impact your family financially, emotionally, physically, and relationally?
What does this experience tell you about how you would want to be cared for?
As you imagine yourself needing care, detail what matters to you.
Where would you want to live and why? Would you want to be close to family?
Are you in your forever house and do you want to age in place? Is it practically set up to support at-home care for a long period of time? Does it have a first-floor bedroom and bath?
Perhaps you want to move to a retirement community that provides various levels of care. Describe what that would ideally feel like and/or name the community if you have already identified a good fit.
As you think about the best living environment, consider whether you are very private or if you like to be surrounded by others with opportunities for a variety of activities.
Share how you envision the role of your family and friends.
Who will be responsible for various aspects of care?
Who would help with important financial and medical decisions if you can’t make them alone?
How important is your community to you?
Are you willing to be separated from your spouse if your care needs differ?
Help your family understand how your care will be funded.
Do you have savings or long term care insurance to help cover long-term care costs? Provide as much detail as you can including the contact information for your financial adviser.
Are there other assets or income streams that are earmarked to pay for care?
Which assets do you hope will never be sold to cover long-term care costs?
Finally, the plan should say thank you. Whether your loved ones are the caregivers or are managing the caregiving, it is hard work. Let your family know that best-laid plans change. Tell them you know that you may be argumentative and difficult when the time comes that you need to receive care. Above all, let them know that you trust them to do the right thing and that you love them.
None of this is easy but the process can be beautiful, and I feel so blessed to be able to guide my own clients through it.
If the day comes when I need long-term care, I know it will still be hard for me and my family — just as it was for my dad and me. But the letter I wrote and the conversations I had will make what can be an emotionally fraught and scary time a little easier.
Write that letter. Have that talk. And do it now, before it’s too late.
Barbara De Berry has been a Northwestern Mutual financial adviser for over 26 years and specializes in helping individuals and families prepare for the future.