Bright Dickson (00:09):
Welcome to Money and Mindset with Bright and Brian, a podcast exploring the connections between good financial habits and positive psychology to help you find greater happiness and confidence. I am Bright Dickson, Truist's resident expert in positive psychology, and I'm here with my friend and co-host Brian Ford, who's the head of Financial Wellness at Truist. Good to see you, Brian.
Brian Ford (00:29):
Hey, Bright. It's good to be here. Today we're going to talk about getting older and some of the things we need to think about regarding aging. The good news is, Bright, that we're living longer. The average lifespan for U.S. adults is about 79.5 years. So I think the question we need to ask today is how do we help make those golden years more enjoyable? And as our parents' age, how do we decide what caregiving they need and how do we plan for it financially and emotionally? To help us find the answers to those questions, we'll be talking to Brian Levy, who's the Chief Relationship Officer of Manchester Care Homes and Cambridge Caregivers based in Dallas. Brian has these conversations with family members every day.
Bright Dickson (01:15):
I think this is a really important topic because as we all get older, we hope, right, that's the goal, there are so many sort of complex emotions surrounding caregiving for everyone involved. The person receiving care, especially if it's a parent receiving care from a son or a daughter, they have to deal with the emotions of role reversal and the caregiver has to deal with the emotions of watching a loved one age. So there's a lot going on in all these situations. There's also this other component that sometimes gets overlooked. What are the emotional needs of the caregiver? How can caregivers protect their emotional well-being when there are so many demands they have to deal with? I'm glad we've got Brian Levy here to talk about the many angles of this important topic. We've got a lot to cover, so are you ready to get started, Brian?
Brian Ford (02:01):
I am ready. Let's do it. Today we're talking about how to care for an aging loved one and for yourself. Our guest is Brian Levy, who's the Chief Relationship Officer for Manchester Care Homes, which provides boutique assisted living facilities in the Dallas area, and Cambridge Caregivers, which provides private in-home care. Brian also hosts the Manchester Living Podcast and provides information to families navigating the challenges of caring for aging loved ones. Welcome to the podcast, Brian.
Brian Levy (02:39):
Good morning. Thanks for having me.
Brian Ford (02:40):
Yeah. Hey, we're starting out with Brian and Brian. I mean, Bright, Brian and Brian, we're going to confuse you all morning, Bright. That's all right.
Bright Dickson (02:49):
Triple alliteration.
Brian Ford (02:51):
We'll get this thing down.
Bright Dickson (02:53):
Brian, welcome. We're so happy to have you. And as we talked about earlier, the emotions and the financial requirements of caring for aging parents are complex, but the very first step is having a conversation about when it's time to start care and what that care scenario should look like. I think these conversations can be really difficult because adult children, most of us, aren't used to asking these questions, and parents aren't used to thinking about the answers. So there's often deflection, avoidance, misunderstanding.
(03:25):
For example, I have a family member who I think I'll probably eventually need to help care for, and I asked what she wants to do sort of when the time came, sort of started this conversation. And what happened was she gave me a detailed run of order for her funeral, which she had all planned out, all the hymns, everything. But I wasn't really asking for that. I was asking, "What do you want to do before? How do we talk about this? How do you want to be cared for?" And I think adult children and relatives are the ones most often tasked with finding or providing care, and that's a tough responsibility because it's the parents who have historically been in charge and now those roles are reversing. So Brian, how do you do it? How do you have these essential and often awkward and difficult conversations with your parents?
Brian Levy (04:13):
They are essential, and it is extremely uncomfortable. It's role reversal. I mean, you grew up not having confidential conversations with your folks. They didn't talk about their income or crises or problems. You were the child and they were the parent and they were doing their thing, and now the roles are reversed and you're managing their finances, managing their care, watching them decline and teetering on crossing some boundaries to, oftentimes during the holidays, it gets very hectic when adult children come home to their aging parents' house and brother looks at the sister and says, "Well, I didn't know mom was on a walker." And the brother's looking at dad saying, "You didn't tell me that mom fell and broke a hip." Parents typically don't tell their kids their problems. And so it's the adult children's responsibility to open that subject and explain to their parents that they're here to keep their parents healthy and safe as their parents did when they were raising them. I tell adult children all the time, your parents taught you how to use a spoon, be patient with them, but be stern.
Brian Ford (05:19):
Yeah, that's so interesting. I didn't really think of it that way as far as role reversals. Okay, so say we've had kind of the difficult conversations and everyone agrees that caregiving is necessary. Next, I would think comes some of the more practical questions like what kind of care is needed? Who's going to do the research to find it, and who makes the decision on location and cost? Can you help us understand how to figure all that out starting with-
Brian Levy (05:48):
Absolutely.
Brian Ford (05:49):
I would say start out with identifying the right level of care.
Brian Levy (05:52):
Yeah. Part of it is just identifying what kind of care needs to take place and learning and observing. Imagine you're thrown into crisis mode and you're making a lifelong decision and a really expensive decision that has to be made today, not tomorrow, not next week, but today. And it's high stress, it's chaotic and it's expensive, and so as much advanced planning as you can do, the better. Nobody wakes up and says, "You know what? Next week mom might fall, or next month dad might get a diagnosis." And so the more advanced planning you can do with regards to not just finances, but what the wishes are of your loved ones. And I always say mom and dad, but it could be an aunt or a grandmother or whomever, but have the conversation and explain to them that you're not being nosy, but you care and you want to do right by them. You want to honor their wishes, and part of honoring their wishes is to know what they can afford. It's an expensive proposition. Elder care is not inexpensive, and so there's a lot of negotiation with someone who is declining.
Bright Dickson (07:03):
How do you sort of make decisions around when and where to move if you're going to go somewhere versus staying at home? How do you think about that decision?
Brian Levy (07:17):
Great question. So I call it the continuum of care. Most people want to age in place. I mean, that's the dream come true, is just to live your golden years at home. It's an expensive proposition, in-home care is expensive. It's not covered by Medicare, it's not covered by insurance. It's private pay or long-term care insurance. So your other option is to move to assisted living. There are many different kinds of assisted living. I call them the big boxes, the facilities with a big monolithic building with 300 bedrooms or apartments, if you will. There's movie night and happy hour and a dining hall, and you're social and you're cruising around and you're playing shuffleboard and having fun with your elder friends. And then as you decline, the continuum goes to no man's land where you're not going to movie night and definitely not playing shuffleboard, but you're not ready for full care. And so there's that no man's land.
(08:12):
And so when I'm working with families to talk about their options, it's real simple. Do you want to move once or twice? Because if you're not going to stay at home, you have to decide do you want to go to assisted living and enjoy those amenities? And oftentimes mom and dad aren't enjoying those amenities. The adult children want them to because they want their parents to stay strong and healthy, but they don't care about movie night. They're not even doing arts and crafts. They're not going to the dining hall, they're eating in their rooms. And so make the decision, do you want to go to assisted living or do you want to just move into a care home where there is full care? And I think the care home concept is fairly new to a lot of people, especially the sandwich generation. Back in our day, it was just a nursing home. Now there are residential care homes that imagine a home in a neighborhood with bedrooms and caregivers caring for them. Some are not licensed, but most are licensed, and it's a nice option when you need full care.
Bright Dickson (09:13):
And those financial implications obviously can be enormous, and the cost can really differ from one facility to another. And I think with the cost, but different structures of cost too, right?
Brian Levy (09:25):
Yeah.
Bright Dickson (09:25):
When you're getting into researching places based on price and testimonials and reviews, I don't know, what are some of the factors that you should consider when you start your search and how does that search actually go?
Brian Levy (09:41):
Well, it's chaotic because typically you're in a crisis mode. Again, people aren't coming to Manchester saying, "I think I might move mom in next year." It's, "Mom's going to get discharged from the hospital. We have to have a safe discharge. We have a place to go and we have to make a decision by four o'clock this afternoon." And I tell people, "Pump the brakes. This is a huge decision. It's emotional, it's financial, and it's a really big decision." So whatever you have to do to buy yourself time, if that's convincing the hospital that it's an unsafe discharge and you need three days, or if it's bringing mom and dad home and having private duty in-home care until such time as you have all your ducks in a row and you want to make a really wise decision. Part of that's understanding the finances because you don't want to move mom into a facility and then six months later go, "Oh, wait a minute, now I'm looking at her bank account, we can't stay here." Moves increase the rate of decline exponentially, and you don't want to make multiple moves.
(10:42):
Back to your original question, what to look for, whether it's a care home, a facility, assisted living, memory care, whatever it is. People are so focused on mom and dad and what their needs are, people ask me all the time, "Well, dad was a veteran. Do you have any veterans in your care home?" Or, "Mom likes to knit. She has to have a partner to knit with." And I appreciate that and I love that, but you really have to change your paradigm and focus on the care, focus on what matters. And people walk into our care homes and I tell them, "Look at the ownership. Look at management. Look at cleanliness. Look at the food, look at the clinicals, talk to the nurse. And at the end of the day, talk to the caregivers. The caregivers are the ones with their hands on your loved ones. They're the ones that matter, not is the shuffleboard in the backyard or the front yard. Is there movie theater? What time's happy hour? It's really about the care."
(11:37):
And when you shift your paradigm and you focus on the care, everything else falls into place because you start to realize that the variables don't matter as much as what's static. Yes, it'd be great for dad to have a veteran to talk to, and that's lovely and I love that. But at the end of the day, that's no guarantee. That could change tonight or tomorrow or next week. The staff are static, they're staying. And so better understand who has their hands on your loved ones. What's their training, what's their background, what's the retention rate like? And ask a lot of hard questions.
Bright Dickson (12:12):
Yeah, I think all that specificity and all that detail is really important because when you're going in there, you're under the gun. But it's really helpful to hear that, Brian, to know really what to look for. And I think for many of our younger listeners, parental caregiving may seem like a really faraway topic, like it's not going to happen tomorrow, but really the more you can plan, the better. So we'll discuss various caregiving options and ways you can start now to prepare yourself emotionally for what's ahead.
Brian Ford (12:51):
So I'm a finance guy, and one of the most important things I talk about with folks is the need to plan ahead and for personal finance, that's creating a budget, setting up an emergency fund and investing in a retirement account. But Brian, when it comes to helping loved ones plan ahead financially for their caregiving needs, what should we be thinking about and how can we be proactive?
Brian Levy (13:15):
Plan ahead. Planning ahead is so important and it's so overlooked. It's amazing how many people just fly by the seat of their pants and don't talk to their loved ones. They don't know what the finances are, they don't know who the power of attorney is. Everybody should have a fiduciary power of attorney as well as a medical power of attorney, and everybody should know who those people are because they're holding the playbook and without their involvement, you're stuck. Like you said, have a budget. Know what your budget is and what you can afford and what you can't. People tell me every day, "Oh my gosh, this is so expensive." And my comment is, "This is what your rainy day fund is for. This is what retirement plans are for." And so the more advanced planning you can do with anything, especially this scenario, the less chaotic and crisis mode you will find yourself in.
Brian Ford (14:04):
Yeah. Tell us a little bit more about the actual costs. What can you tell us about the costs? I know we've kind of spoke in general terms, but give us a little bit more concrete idea of what we can expect if we've got some aging loved ones.
Brian Levy (14:16):
I've done quite a bit of market research coast to coast, but let me just talk in general terms. In-home care, if you want to have a caregiver in your home, it ranges between 30 to $35 an hour. Assisted living ranges everywhere from you could find a care home, for instance, from between 4,000 to maybe $12,000 a month. And it depends on who, when, where, and what. There are the boutique assisted living like Manchester Care Home, that's like the Ritz-Carlton of elder care, is definitely on the higher side, all of our rooms are master bedrooms with two caregivers and luxury. There are also places that have renovated bathrooms with shared rooms with a curtain down the middle. They're lovely, but they're not as private. And so it runs the gamut in terms of options.
Bright Dickson (15:09):
I feel like once we sort of have those sort of costs in place, you need to start putting some sort of hard things down. Like you mentioned, establishing that power of attorney and make sure that you're saving as the adult child, maybe a particular bank account just for that. I feel like that's really important too. You've got to do a lot of stuff.
Brian Levy (15:33):
You do, and it's a conversation that has to happen that is so uncomfortable, someone has to speak up. And it's typically during the holidays when the adult children come home and they're like, "Hey, mom, dad, we're going to have a really uncomfortable conversation, but it's about me caring for you as you cared for me. And it's going to have to start with the most uncomfortable element, which is money, and I'm going to be in the position to spend your money on your behalf. Let's talk that through."
Bright Dickson (16:01):
And that can be really stressful. So I've been in this position, I did this with my dad. He died a few, well, 10 years ago now, but before that, it's a very stressful situation, and there are a lot of demands, right? Demands can be physical if you have to help with mobility or even just running errands, cooking, cleaning, performing daily tasks, it's absolutely emotionally challenging.
Brian Levy (16:29):
It is emotionally challenging, and it's extremely stressful to have these conversations with your parents who don't want to share the information, and they don't want to talk about it at all. And so you're put in hands down the worst position ever. You're the bad guy. You're taking keys away. You're talking about them moving and what they can afford and what they can't afford, and you just have to keep reminding them that it's for their best benefit to keep them healthy and safe, but you need to know how much money they have so you know how to spend it responsibly.
Bright Dickson (17:02):
Absolutely. And I think the other thing that adult caregivers, sort of whatever role you're playing, they need to think about the time it's going to take and plan for that, because we've got jobs, we've got kids, we've got things in the community we want to do. We have full lives. And this is another huge task on top of that, and that's sort of not counting the emotional piece, but the time is a big one too.
Brian Levy (17:29):
It is a full-time job, and especially for the sandwich generation who are taking care of their kids and their parents. My kids used to ask me why my phone rings so much at night, and I explained to them that's when adults with aging parents are putting their kids to bed, and then they finally have an hour just to deal with this situation. And I think it must be said, the more education you can do for yourself ahead of time in terms of pricing, in terms of what your folks' needs might be, I mean, it's educate, educate, educate. Look at every frequently asked question section of every website you go to, and whether you're learning about a diagnosis, whether you're learning about how to communicate with your folks who are declining and maybe experiencing brain change. Not to get frustrated with them, but to understand you're there to help them, from all the finances, all the way to keeping them healthy and safe.
Bright Dickson (18:30):
Brian, what tips do you have to help caregivers deal with the stress? How can they keep their emotional needs in the priority list? Maybe it's not number one because that's a big ask, but how do they keep tabs on them?
Brian Levy (18:47):
It is so important. Self-care. I'll tell you a quick story. We had a resident recently who was moving into the care home and she was declining, and her husband was just, he was remarkable. He was cruising around in his little sports car showing me how to use his iPhone, and he had exhausted himself, and he came to me and he said, "I hate to do this, but it is time. I'm wearing myself out. I need to move my wife into your care home." And he moved her in and got her settled and got all the finances settled, and he was so exhausted that he died. He died first because he wore himself out. When we talk about caregiver fatigue, that's exactly what it is. It is caregiver fatigue.
(19:32):
And so, for one, you have to take care of yourself. You have to give yourself a break, whether it's respite care and you send your loved one to a place to rest, or you have care come in the home, you take a vacation, even go to dinner or go to a movie. Even the little things, they count. If you keep going, remember, you're in for the long haul. And so really, really take care of yourself. All the way down to grief counseling. Our caregivers are, if you think about it, they're caring for people that are dying. And when they do pass, it's emotional. And so we actually do grief counseling for our staff on a monthly basis where they can come in and talk to a professional grief counselor about the loss and how they're feeling so they can gear up to go to the next engagement. And that's the same with a family member. Even if you have care, you're still caring for that person. And so to educate yourself on how to care for them and then how to care for yourself as well.
Brian Ford (20:31):
Yeah, Brian, those are some really important things to keep in mind. Thank you. I've got another question for you. This is my last question for you, and it's future-oriented because many of our listeners are younger. Because of medical advancements and a focus on the importance of positive lifestyle, people are living longer and better, which is great, but with each passing year, healthcare costs are only going to rise. What should people think about now, even if their loved ones are years away from needing care?
Brian Levy (21:06):
What should loved ones think about now? What they want, what their needs are and what they want to happen. So there is a national program called The Conversation Project, and it's one of my favorite programs ever because it takes all of your needs and your wishes in the event that you're incapacitated and cannot make your needs known and it puts the responsibility on whomever you determine is going to hold those keys. And so the conversation starts with everything from, "Okay, if you want to die at home, you want to go home from the hospital or facility, wherever you are, where do you want to be? The bedroom or the living room? Do you want your glasses on or glasses off? Teeth in, teeth out? Grandkids in, grandkids out? Do you want the shades open, the shades closed?" Everything you can ever imagine through this conversation project. So if you can't make your needs known, they're already there for you. I think that's really important in terms of planning ahead. You don't have to guess.
Brian Ford (22:09):
Yeah, that's good advice. What about when they're thinking about the costs and even inflation and things going up, what can you tell us about just kind of planning ahead as far as the future cost?
Brian Levy (22:20):
Right. That's like a mathematical equation. I mean, you take a look at inflation, I mean, inflation during COVID compared to today, which is still high, everything's getting more expensive, including elder care. And it comes down to food costs, it comes down to labor costs. I would advise people to meet with a financial planner, meet with someone who is a professional that can deal with what you have and how long it's going to last. And like you said, establish a budget. But I wouldn't go at it alone. I would enlist the help of a professional to do the math.
Brian Ford (22:55):
Yeah, I agree with you, Brian. I think not only a financial professional, whether that's a financial planner, a really good insurance agent that's got the heart of an educator, not just like the polish of a salesperson. Certainly our listeners should be thinking about and looking into and researching and talking to their financial planner about long-term care, but your professionals really can help you with that. I think those are great ideas.
Bright Dickson (23:18):
Yeah. Thanks, Brian. This has been so insightful and important, and I think one of the things that I'm taking away is start now. It's never too early to start broaching these topics and doing your research and getting ready. And I think that having an open discussion with family members and friends is a good first step, and I think that's just what we did just now. So Brian, thank you so much for being here.
Brian Levy (23:48):
Thanks for having me. I appreciate it. It's an important conversation and I appreciate you bringing it to light.
Brian Ford (23:53):
Yeah, Brian, I gained so much from this conversation as well, and one of my big takeaways is to have that conversation. And even though I'm a finance guy, it doesn't come down always to the numbers. It sometimes is about the conversations, and that's what I'm going to take away from today. And I loved what you said when you had this idea of how to start that conversation with maybe our aging parents, which is you said something like, "Hey, mom and dad, you did such a lovely job of taking care of me. I want to talk about how I can take care of you." And that struck an emotional chord with me. I liked that line. It was such a loving way to address a tough, difficult conversation.
(24:30):
And I think when we start that conversation off on the right foot with gratitude for what our parents have already done for us, I think we can have a much more meaningful conversation. So I appreciate that. Thinking about what it takes to care for aging loved ones, it can be complex, it can be a tough subject. And Brian, you helped us hone in on a few actions we can take right now. Thank you.
Brian Levy (24:50):
[inaudible 00:24:51]. Thanks for having me.
Brian Ford (24:54):
That's it for this episode of Money and Mindset with Bright and Brian. We hope you found this discussion helpful and came away with some actionable steps. We want to thank our guest, Brian Levy. You can hear more from Brian on his podcast, manchesterlivingpodcast.com. Thank you so much for listening, and thank you too, Bright.
Bright Dickson (25:14):
Yeah, thank you, Brian. You can listen to other podcast episodes and also find great articles and tools at truist.com/money-mindset or do what I do and Google search Truist Money Mindset. We'll be back soon with more episodes that are designed to help you boost your financial confidence. See you next month.
Speaker 4 (25:46):
This episode of Money and Mindset with Bright and Brian is brought to you by Truist.
