My Dad (83) is a Vet and in good health. What steps should I take now to prevent any concerns in the future as he ages?

Jessi, you're very wise and insightful to think now about what might happen in the future. I think you'll get a wide variety of responses from people who have hindsight perspectives in the art of caregiving.

1. I too handle many of my father's financial and legal affairs, but my father also has a complete estate plan which he created after my mother died. So I would start there, just because we never know what might happen, or when.

a. I would first find an Estate Planning and/or Elder Law attorney in that great old whaling town of New Bedford or environs. (What a place to live - all that history!!) I'm partial to mid size law firms with an EP or EL practice, as opposed to single practitioners. I've seen and am currently encountering single practitioners who just don't have the professionalism, savoir faire, experience or contacts and support that a law firm offers. A well respected firm also has standards of conduct, that I've often found lacking in solo practices.

b. A good law firm will also provide you with a checklist of documents, issues, assets, etc. to complete before the first meeting, so you can discuss the full gamut of your father's assets in conjunction with the best ideas for preserving and transferring them.

c. You'll want to get a Durable Power of Attorney (DPOA) which authorizes someone (presumably you) to handle legal and financial affairs, a Living Will, or Medical POA which authorizes someone to make medical decisions if he's unable to do so. Discussion should also be whether a Will or Living Trust is appropriate.

d. If your father selects a Living Trust, be sure to ask about the issue of "funding" the trust, by which assets (such as a home, financial products) are retitled in the name of the Trust. Of specific concern are IRAs, because the taxation rate on IRAs in Trusts is a compressed rate and can be a tax nightmare.

2. Prepare (a) a list of medications and (b) medical history for your father. Dad and I both keep the med list (printed on a 3" x 5" index card) with us at all times. The med history includes vital information such as name, contact numbers, family, Medicare and secondary policy information and policy numbers, then specific sections for meds, allergies, pacemaker data, current conditions, hospitalizations, past but possibly relevant illnesses, and contact info for all treating physicians.

When we go to the ER or a new doctor, I give them the history (about 8 pages of data, generally in table format and indexed by table of contents at the beginning), to copy what they want to (one category/topic per page so they can copy only the pages they want).

I sometimes keep copies of the Living Will with the history, all in a 1/2" 3 ring binder that fits nicely into the "go bag" I also carry (which has gardening magazines for me and a legal pad for notes), sometimes chocolate and sometimes a jar of cinnamon for stress reduction (that's for me, not Dad!).

3. I don't think you'll be able to get any insurance policies at this stage. Did your father have VA term life policyi? If so, that will mature eventually (I can't remember the life span or maturation conditions), but it will be a nest egg on which he can rely.

4. Review his VA data to determine if he gets anything beyond health benefits, if he has a service connected disability, if he's eligible for glasses and hearing aids. VA now has a CHOICE program under which someone who lives more than 40 miles from the nearest VA can alternately choose doctors in the community as part of his/her VA supported health care. That's a lot more convenient than a trip to the VA.

But think seriously about not taking advantage of the VA prescription medicine program. We withdraw after a VA research doctor acting as a PCP changed a cardiac med w/o consulting Dad's treating cardiologist, who did NOT want Dad to take that med. We had to pay for it even though Dad wouldn't be using it. So we opted out of the VA pharmacy program.

5. This is just my personal opinion, but I researched pharmacies and specific drugs to find a pharmacy that gets meds primarily from American or Canadian or industrialized country pharmaceutical manufacturers. Since there's so much competition with small grocery store and other pharmacies, I found that some of them get meds on a cheaper basis, but they're sourced if not manufactured in emerging market countries with dubious if any quality control. I won't buy meds if they're manufactured in an emerging market country.

6. Emergencies. Stock your car with heavy duty winter clothing, emergency gear, blankets, OTC medical supplies, energy munchies, and take water whenever you drive. In your blizzard area, being caught outside in one with an older parent could be fatal. I make as many appointments as I can before winter and try to slide through the winter months without taking my father out except on warmer sunny days when the pavement is dry.

7. Become knowledgable with assistive devices - canes, grabbers, walkers, rollators. Know their different purposes, strengths and weaknesses in case your father eventually needs assistance.

8. Evaluate his living space for grab bars; consider having some installed before the need becomes critical.

9. If he lives alone, consider making and freezing meals for him in microwaveable containers so he can heat up meals for himself on those days when blizzards are keeping people inside and warm.

10. Consider a back-up heat source, such as a gas fireplace in one room where he could stay if a power failure occurs, or better yet, a generator. Stock the room with extra blankets, thermal gear, etc., in case he needs to hunker down and can't get to your house before the blizzard.

11. Let your father help plan - consider it a mission (maybe "Mission Aging"?) and your discussions as mission briefings. The military mind seems to go into high gear when planning is on the agenda, and this way he can become part of planning for contingencies of his own life.

12. Depending on his interests, explore activities at senior centers, libraries, and free summer concerts. We usually find 2 or 3 free ones a summer, so that provides a nice stimulation to get out into the fresh air, be with others even though they're strangers, and listen to foot stomping music in usually a park setting.

13. Think of what might keep him interested during the cold winter months that doesn't require battling snowstorms. If he reads, stock up on books, or e-books if that's his preference. My father gets military magazines, he has a collection of WWII books, and can keep himself entertained for quite a while. Sometimes when he needs human contact I suggest he contact various friends living out of town or out of state, perhaps once a week, just to keep in touch.

14. Check with neighbors to see if they're willing to provide "eyes and ears" to just keep an eye out for your father if he's walking around the neighborhood, and alert you if they think he needs attention or isn't feeling well. I got some of the best insight from my "observers".

15. For winter, make sure to arrange for a service to take care of sidewalk and driveway clearing, especially for emergency services. Same with mail; sometimes neighborhood children will get the mail and deliver it to the house (assuming your father has roadside, not porch mail delivery) for some nice little treats.

16. Meals on Wheels might also be an alternative if your father isn't driving.

17. The ROMEO (Retired Old Men Eating Out) group gets together once a month; it could be one of his military groups if he's involved with some, or maybe folks with whom he's formerly worked. One of the restaurants we visit has a dedicated military corner for the vets who meet there for breakfast on a regular basis.

18. If he needs assistance in keeping up the house, start now and don't wait until it's much later. He'll feel more comfortable if he doesn't have to deal with dishes, laundry, vacuuming, and heavier levels of maintenance.

I'm sure that by the time I get this finished you'll have a lot of other answers, especially about planning for caregiving and in-home assistance, so I'll stop now and let others have a chance to contribute as well!

There are some good check lists and articles on this forum with great info for you questions. Search the site for this info.

I would suggest as priorities you look into the following:

POA. Power of attorney

End of life/ living will documents. Including DNR and organ donor decisions.

Funeral and burial arrangements

Updated will

It's great that you are thinking ahead!

My Dad had Alzheimers & my Mom sugar coated everything. He had had this illness for awhile. I started taking care of bills, checkbook, & watching over all the mail & avenues where my Dad had his finances tucked away & putting the pieces together. My Mom had been taking care of my Dad for so long & herself til she needed double ingunial hernia surgery. I got their POA just before she had surgery & tucked my Dad into a nursing home in the memory care unit. He walked in & we got him all set. His memory was good sometimes & scanty other times. He needed alot of assistance-nearly 90% at least. I visited him as often as I could. It took longer for my Mom to recover. My brother stayed here couple months & then, returned to his home. I didn't have people (like home health care, CNA's or sitters or house keeper) in place to help me manage. My Mom blocked most of the people I had interviewed cause she didn't really want anyone invading their space. I totally understand now how she feels. I moved my Dad as they wanted from the nursing home to the War Veterans Home into their memory care unit. BAD, BAD MISTAKE!!!!They do not take care of your loved ones as they promise. The doctor said to me let us take care of your Dad that's what we do best. My Dad was in WWII & he wanted nothing from the federal government. He was buried in a fox hole, his feet frozen & had terrible memories of thing he saw & witnessed that he spared me, my brother & sister from so we didn't really know how bad it was. If he hadn't been a good old country boy, he wouldn't have endured the really bad stuff over in Europe or made it back to the USA. Those guys like my Dad were teenagers yanked off the farm & out of school to give up their lives for us & realize, I wasn't even born yet. My Dad walked into that war veteran home on his own power just like he did into the nursing home & after just two (2) months they took such good care of him I Buried Him on May 2nd, 2015 He was 89 yrs. old. If you're thinking straight, spend all your Dad's money get him on Medicad & he already qualifies partially because he's a veteran & old. And if he got a pension, the VA will redo his house, furnish him all sorts of things I couldn't even begin to get or even touch for my Dad. But I now have CNA's sitting with my Mom round the clock private pay in a nursing home. She fell at home & then, fell again at the nursing home & then, I hope I got smart. Now, she isn't ever alone cause she fell on their watch & I Don't Trust anyone especially the facilities. The staff members wear different color uniforms but most staff don't actually know what the other colors staff wear do there. They don't understand short term memory either. The classes they teach aren' t enough. The old ways we were 1st told don't work. There are not enough people per resident to take care of our loved ones. My life is on hold. According to the rules & regulations my folks don't qualify for assistance, not VA, not Medicad only Medicare & private insurance. You need to be bleeding, broken something or your dying before your GP doctor will help you at the particular clinic & hospital my folks use for even home health care as bad as my Dad's needs were. Oh, medicare will pay & 2ndary pays a little but everyone has their hands out to get paid. My Dad got a job & worked very hard throughout his life to support his family & lived frugually & saved what he could for retirement & still ended up not qualifiying for nothing. Oh, medicare is so far behind paperwork wise & denying they even received the electronic bills from doctor's, hospitals, clinics, & please resubmit that charge. Who knows how many US citizens & all those people servicing us can't even wait til I mourn my Dad & now, my Mom is in PT at a nursing home before they start sending out past due notices & calling or turning your deceased loved one over to a collection agency, can you imagine. Now my problem is, the Physical Therapy folks are 60 yrs younger than my Mom & seem to be very joyful about these really old folks getting PT & tell them they are doing so good until like my Mom she could care less because she is so over medicated & the PT isn't really helping but the PT folks are really trying. She can't walk...after breaking her leg the 2nd time & 66 days later its wheelchair to bed to wheelchar for what..ever? Her progress sucks. This was supposed to be one of the better NHs in the area. But get this, she has meet her PT goals...she was walking real good before breaking her same leg the 2nd time. I finally got the doctor & nurse to hear me & reduce her pain medicine from 4 doses Tramadol 50s to 2 doses & they were giving her 3 zanaflex muscle relaxers a day so that is now PRN-can you believe she was really getting that much medicine. The doctor changes the day he decides to come so I miss him everytime but the nurse either calls on Fri or Wed evening to let you know what they added. But ya still got to ask what else did they take away? They are trying to KILL my MOM with drugs & to meet the 3 grullying hours of PT the RESIDENT HAS TO DO PER DAY & TO BE ABLE TO SHOW PROGRESS SO MEDICARE WILL COVER THE 1-20 days 100%, 21-100 days 80%. Now, I am Private Paying for her room & board. I'm thinking PT is turned into restorative exercise & they come up with, we will still be able to do PT for your Mom so she won't go down while waiting before I move her to assisted living. A new Home Health Company will evaluate her the day she arrives & they report their findings. Oh they figured out that there is $3000 left under her Medicare Part B they can use in 5 weekdays cause her 100 days through Medicare is up. I figure PT may be able to get 5 days maybe before I move her to assisted living so that equals about $600 per day. She can't stand up, her strength is gone, she's losing muscle mass & I can't see how they can't see that & they think 5 days will make any difference since they've already had 100 days. Something is very wrong with our system. I see all these people lying in their bed or sitting in a chair & their so drugged that they can't do anything, can't get out of their room & there's nobody there to rescue them or help them or visit. I lost my Dad cause I was oblivious & believed what these medical people told me..don't wait be prepared. I'm still not prepared enough for my Mom. CareGiving is so hard & time consuming. Nobody can prepare you. Stuff can be all figured out but stuff happens & it changes in a flash. A fall to the floor. An incident could be a scratch but her skin is so thin & she lost her left breast. The PT person isn't strong enough to hold up your 5'10" Mom & she loses her balance & the PT person isn't really ALERT lets say & an incident occurs & they have to call you about either one. These young PT's, CNA's, Nurse's or whatever tell you they've been to college..that's like telling us it's in the Computer. My Mom didn't go to college but she had plenty jobs & wore many hats & had 3 kids & up til the last few years could still outwork me. No telling what you could be doing at that very moment..but you can't be here every second nor can they..but usually they make it appear that it's your persons fault. So who's watching? You better be. They allow you to have sitters but the facilitys don't want them asking any questions but I get more calls from my ladies than the facility. I know before the staff usually calls or texts me that something happened. So be prepared for $6000 per month plus 24/7 sitters if your person is really in need. That's 31 days per month times 24 hrs = 744 hrs. @ $12 - $20 per hr. So lets say low end $12 per hr. = about $9,000 a month plus NH rate of $6,000 for a total of approx. $15,000 per month ($180,000 a yr.) every how long your love one needs assistance.JS...Oh medicine, lab work, hospital stays, clothes, toiletries, & anything else extra that Medicare doesn't pay for you'll need money to cover. You will sign your name so many times if you are the POA. But roles reversed you get frustrated as your loved one. You don't want them to hurt or be hurt & you don't want to hurt inside or feel guilty but you do or I do. Just be watching or have someone help you watch. Ya'll take care I really needed to vent. Sorry but thanks.

All of the major points have been discussed but I wanted to throw one more item out there. Encourage your dad to sign papers at his Dr.'s office that would enable the office staff to discuss his medical issues with you. If/when your dad goes into the hospital do the same thing.

First let me Thank all of you for sharing your intimate experiences with a stranger. Your responses have been extremely helpful & posed scenario's I had not thought of.
Fortunately I have a network of caregivers, RN's, HHA, & CNA's within the family I would be likely to rely on if health concerns rise to that level. Unfortunately I have first hand experience at caring for a couple of my siblings with terminal illnesses that ended their lives at a very early age. That experience educated me on the Health Care Cost & Care along with the "business" of Funeral Expenses. My dad has also witnessed how death in our family can emotionally & financially be straining. This is the origin of our "pre-planning".
As a military man for decades who raised 12 sons (men) & 3 wonderful daughters he is an strong, independent man who has never asked for anything. It is MY privilege to do whatever needs to be done...after all HE raised me!!!!!
My objective through the next several years, as my dad ages, that he will never feel like a burden. That it is our time to take care him. God Bless all & again, Thank you!