How Not to Pull Your Family Apart: A Guide to Creating a Care Plan

Rev. Beth Long-Higgins 00:07
Welcome, To the art of aging, part of the abundant aging podcast series from United Church Homes. On this show, we look at what it means to age in America and in other places around the world with positive and empowering conversations that challenge, encourage and inspire all to age with abundance. Today, we are talking about the world of families and care needs, especially those that come with surprising price tags, needs that many of us don’t really understand, let alone plan for our guest today is Caroll Golden, who brings to us a rich experience in financial solutions and innovation, which is especially relevant to this conversation, because as we know, there is very limited Long Term Care Benefits and Medicare, and we need to get better prepared. But she’s also passionate about family caregiving, and the family dynamics that are involved in organizing support for loved ones at times of need. She writes about in her best selling books, how not to tear your family apart, which she designed for financial insurance professionals, and how not to pull your family apart, a practical guide to caregiving and financial stability, which she has written for consumers. Welcome, Caroll.

Carroll Golden 01:19
Thank you, Beth. And thank you for having me as a guest.

Rev. Beth Long-Higgins 01:23
So Carol, and as a way of helping us get to know about you. Why have you come into space? What? Why are you so passionate about family pet caregiving?

Carroll Golden 01:33
My own experience with family has inspired me, but also my career. Originally, as an international translator, I had the opportunity to go to different countries, South America and Asia, etc. Observing how they treat aging is very different from the way we treat aging in the US. We are a very youth oriented country. And that’s great, except we are all ages so I started to really look at how we could help change that dialogue? Because it’s the lack of dialogue that inevitably causes families, friends, it doesn’t matter how you define family, whether it’s family by blood, or whether it’s family, by their good heart and their good deeds. The fact is, we haven’t developed any processes or ways to really age with grace.

Rev. Beth Long-Higgins 02:39
Thanks. And it’s such an interesting path that you’ve taken, gone from being a translator between languages, and now you’re kind of a translator between other parts of your career and into this space of caregiving. So you were a translator? And then you ended up working as a financial planner and in financial services? Correct? How is that? How does that part of your career fit into this trajectory?

Carroll Golden 03:10
Well, I started to work in the financial planning arena. And in doing these plans that we do, we try to parcel out money, parcel out investments and assets, so that some are for immediate needs. Some are intermediate and some are long term. Well, what happened was we had a client who missed his annual review. And so I sought him out. And when I saw him, I thought he was ill, because he really didn’t look well. And he sat down and I said, What is it and he said, his wife had a stroke. Now his wife happened to be a Vogue model. She was about 5455, just beautiful. And when she had the stroke, she didn’t actually recover. One side of her is permanently paralyzed. So he was investing in putting an elevator in their home. It wasn’t a one story home. That was another thing that started to strike me. So many of our homes are not really designed for aging. And that was their case. Long story short, Beth, the entire plan blew up, because long term care expenses really started to kick in. And especially if they you know, last year after year, it becomes more and more difficult to manage the finances. Seeing the finance made me observe that it creates tension it creates for caregivers, many of them have shortened life periods, because there’s physical, psychological, financial, and family issues and challenges that were on both the care recipient and the caregiver side. They started to really want to help.

Rev. Beth Long-Higgins 05:21
I have seen that myself as I served in local churches, where the healthy partner who was the primary care supporter, in the midst of their journey ends up very ill. And they ended up passing away sometimes before the person who had the chronic diagnosis. So yeah, absolutely. That stress is very real and has very, very definite and long lasting effects. So how did you get from being a financial planner to writing your first book, which was really for other people who are in the same business? Right?

Carroll Golden 06:04
Well, what I observed when I started to think about why I had not prepared clients for longevity, that is a blessing for us, but that we don’t think too much about. And then I started talking with other financial planners. And they also said, well, one, families don’t want to discuss this, because as Americans, we don’t like to talk about aging, that I believed. And then too many times they were very honest, not only the financial advisors, but community people. It’s a question of not only starting the conversation, which is difficult, because you don’t go to your mother or father and say, so when you can’t manage things, well, that’s not going to lead to a very constructive conversation. So I thought, Well, the issue here is that not only don’t we know how to start it, but we don’t really know how to continue it to some positive end. So COVID locked us all down. And I had a lot of time to think about this. So I started to put together all the experiences that others had shared with me, and realized what we really need is some sort of a process a formula, some way to approach it, so that we don’t have to stumble around and focus only on the fact that this person is getting older, because no one wants to focus particularly on what happens as we get older and older. Yeah, absolutely.

Rev. Beth Long-Higgins 07:53
I think I’ve heard it referred to as present bias, we are biased to think that however we are in the present moment is how we’re going to be in the future. And none of us have crystal balls. And we don’t like to think about, you know, the possibilities that are down the road. And I think it involves both an inability and a lack of desire to talk about our own aging, or the aging of those we love as well as the end, which is death. But I think that perhaps in this culture, maybe I don’t you’d be interested to have your perspectives on this. To some degree, we are a little bit more accustomed to talking about death than we are about the process of getting from here to there.

Carroll Golden 08:38
No, I totally agree with you. Yeah, yeah.

Rev. Beth Long-Higgins 08:41
We know that we need to talk about wills and those kinds of things. But yeah, absolutely. So you wrote this book for professionals, helping to give a process. But you put that out in the world, and you realize, there needed to be more.

Carroll Golden 08:59
Actually, it was the financial advisors, because the first book has 92 or 93, footnotes, references, because it seemed to me that if you were professional, and you were reading the book, and you wanted to know more about say how an HSA might help with paying for care, or premiums, or whatever the need is, how do I advise a client about that, and other words, it’s very technical. And it wouldn’t be something that you would send to a client. And then a few of them came back and said to me, you know, what would be really helpful is if I sent them a book and said, I’m handling your retirement, I’m handling your investments or I’m handling your wills. What I would like you to do is take a look at this book and see if you’re in here. Do you face any of the challenges that these people faced in this story? Now I did Beth make it a positive thing. It’s multigenerational. Because I’m sure that you and I both agree. Caring doesn’t happen in a vacuum. When someone needs care, it affects your friends, your family, your community, your faith, everything becomes involved, so I made this multigenerational. They face getting through a process, which opens the dialogue, but importantly, continues the dialogue. And so I wrote a second one that is simply a story that some of my publishers sent me. I need to send this to my sister, because it’s all falling on me, which is not uncommon, either. So that’s why I wrote the second one.

Rev. Beth Long-Higgins 11:03
Okay, so we’ve been talking in vague terms. And but you have a shorthand way to help explain, what is this process? What do you think about individuals thinking about these hard conversations and the planning that needs to happen?

Carroll Golden 11:23
Well, again, pulling from my own experience, I decided that there were three steps that I could create. And I don’t care where the people start with any one of them. But the first step, I thought, is just gathering information. How do you help somebody if you really don’t know what their situation is? So the care guide is not just about health, but it’s about passwords. You know, where do you find the passwords? If someone says, “Please go home and do something, ” then they can’t remember themselves? The password? It involves what you mentioned, Beth, have you got an update? Well, have you got a do not resuscitate if you want that? So in the book, I framed the care guide, so that, for example, Grandpa resisted, he said, You know, I’ve been handling grandma and grandpa’s, my own and grandma’s things, for years and years. So why now, and of course, grandma’s getting frail. Actually, it was his granddaughter, who turns around in the book and says, grandpa, that’s the point, you have been in control. Only if something happens to you, not to grandma. We don’t know that she knows what to do. And worse, you want to be in control. None of us have any idea how to handle that. The other thing, of course, is making it inclusive. And saying all of us need to do a care guide, because it’s true. Beth, to your family and friends know what your wishes are. So you don’t have to share it, you can seal it. The younger generation in the book, they do it on an app, not a surprise. And step two was that same theme of inclusiveness. I got that from friends whose sisters and brothers expected them to handle everything. And they had gone to, you know, their advisor. And their advisor said well, what can we do to help? So what you can do is what I call the care squad. Some people don’t live close by; they feel very excluded. Instead, you assign yourselves, what works with your personal situation with your location. All of the medical things come electronically. So the person who isn’t living close by well, they can handle that. Maybe someone who is very garrulous, maybe we do a phone chain so that they do call their community or their healer or their guidance, and those people are included. And when we talked before that you made a very good point. Many times the hospital or the doctors, they’re not able to really catch colds because of HIPAA, and rightfully so. But the family starts to get very nervous and upset when they don’t know what’s happening. So the cold chain is a very good way for the care squad, not to get over overwhelmed with the lack of communication. The third step was called the care planning team. And in the book, everyone is assigned something that would relate to their generation, the son has a couple of children, and his mother is now caregiving for his grandma. And he goes, Well, I can’t really afford too much. So we give him term insurance with an endorsement, the parents who have seen how relieved they are not to be, if you will, blind caregiving, they now turn around and say, we better look into things for ourselves. Again, it’s just a matter, Beth, of pulling together, no matter how you define family pulling together. And those three steps have families working together. And even for when you have somebody in the family, who is not on board, let’s say they can never say you didn’t try to include them. And you can walk away feeling you did your very best not to have stress and misery, surrounding somebody’s needs.

Rev. Beth Long-Higgins 16:36
Well, and I think it actually enables the person for whom all of this is being done to have more control on the process, at that point, when they don’t really have as much control. Because you’ve made the plans ahead of time. And there’s so many stories going through my head as illustrations, I could add to the stories for all of these, but the one that comes to mind is my aunt. She became ill over Labor Day weekend, and took about a week or so to be diagnosed. And she was a business person, that office person for the family business, which is a pretty good sized business. And she ended up passing away within six weeks. And she was sick to the point where during those six weeks, she knew she needed to, you know, share passwords, not only for their personal finances, but for the business. And she just wasn’t in a mental emotional state to do that. And I believe this has been about 20 years now. But I believe they had to hire a tech person basically to hack into the business, and all of their family, online things because she had, she was the security person and she had kept all that stuff to herself. And for me, I don’t want my FaceBook page or my LinkedIn page to exist after I’m gone. So you know, taking the steps. And in assigning someone, this is your job, you know, if you want to leave it up for a while, okay, but take it down, please, I don’t want people getting notices about my birthday, 10 years after I’m gone. So, you know, we live in very complicated worlds based on all these electronics, and how to think about all those things is really important. Okay, let’s put out some other scenarios here for you. You are trying to talk to your mom or dad about future needs and care and they completely shut down. They’re not even willing to discuss it. So what do you suggest might be some ways to enter into that conversation?

Carroll Golden 18:41
Well, first of all, if they completely shut down, I would do somewhat like what the granddaughter does in, I would be honest with them that, you know, share something like the story that you just shared about an aunt who was in charge and say, This isn’t something that we want you to experience. Also make sure they understand that you’re trying to help not handle them. I think that you have to be very open and say this is about all of us. As a family. I’m going to do one, because we’re not talking about just being older. This happens to anyone at any age, there are accidents, there are illnesses unexpected or expected. So I think in order to not be stonewalled, you really have to sit down and say, Would you like us to do me first so that you can know that if something happens to me, it sometimes is necessary to show them that you created a care squad and that they have a role in it. And then you might say Hey, why don’t we reverse it? Is this the same scare care squad that you would want? So now you’re dialoguing without pointing fingers without saying you’re a problem, or you have to be handled. So I think when you get to the care planning team, maybe you start with the conversation about, I want to know that the legacy that I want to leave won’t be impacted if I need long term care, and you haven’t said anything to them about their legacy, or the finances, or the impact of you. So sometimes, it’s better not to go directly to the steps with them. Do it yourself, because frankly, we all need to do that kind of planning.

Rev. Beth Long-Higgins 20:51
Yeah, absolutely. You know, back to my illustration way, I was 56. She was, you know, in today’s world, that’s really pretty, pretty young. So let’s do another one. Another scenario here. We need support, we need to support mom and dad, and I have a sibling that is not engaging, does not want to help. What should I do?

Carroll Golden 21:15
At that point? I think you turn around and you say to the sibling one, like my publisher, send them the Book and say, What about you, you’re not engaging with mom and dad. And I am. And I’m planning. So of course, if something happens to you, you haven’t engaged with any of us, I hope you have some sort of a plan, because we won’t be able to be there for you. Because you’ve shut us out. That would be one thing, not really guilting them into it, but making them think about it in a different way. The other thing is what happened with my husband, his brother, and he did not agree on the care and the expenses that were being spent for their mother. Ultimately, he and my husband stopped speaking, they still do not speak, sometimes you just have to accept that they’re not going to cooperate. And look to your extended family. Look, look to others that are caring, whether it’s your community, your church, your synagogue, whatever faith based organization you belong to, if they’re not going to sometimes we just have to accept that and say, Okay, I still need to do this with others. And if they won’t, and you’ve tried, they can never come back and say, You excluded me.

Rev. Beth Long-Higgins 23:00
Yeah, the reality is families are complicated. And every family is complicated, and some just happened to be healthy, complicated, and some are not so healthy, complicated. And yeah, so kind of accepting and understanding how those things work. You know, I would add to that, in thinking about who our care planning teams are, that if you’re a member of organization, or a faith community, and you’ve had conversations with those in the in those organizations, you know, I have colleagues who, who have shared, and this is happening in the past 10 years more and more regularly as adult children don’t live near their parents as they age and they’ve moved away. And for them, church and faith may not have the same role. colleagues share that they have folks who’ve been members of their congregations for 25-3040 years. They don’t hear about when they’re sent to the hospital because hospitals don’t call churches they used to, they don’t do that anymore, because of HIPAA. And the congregant, the member of the congregation passes away. And they’re never notified because it didn’t make any difference to the family. And yet, the pastor said, you know, I’ve got a file drawer. I’ve kept notes with conversations with these folks, but what they want to have happen, you know, at the service, then celebration of their life. And just because it’s not important to the next generation doesn’t mean it wasn’t important to mom or dad who passed away. And even if the adult child does not want to be there for that service, there are those people in those other organizations in the neighborhood in their congregations who have known them for 25-3040 years who are grieving. And that service is really important to be able to help them in that process. So it becomes a quandary, then does the church go ahead and have a memorial service, even if it’s if the family isn’t present, but the church knows that it was important to the person who passed away. So all of which is to say, what are the roles of those folks, like you said, who are not related, but who are part of the ecosystem related to their physical health, their spiritual health, their social networks, who need to be a part of that, that care squad in to be involved, not only in the caring process while that person was living, but what happens afterwards?

Carroll Golden 25:40
Well, I think the opportunity there is to actually use the care guide, because there’s documentation in the care guide. And they can obviously demand that this is their wish, and so on, and so forth. So that could be included in the care guide for the care squad, if their family is told, and given, you know, it’s just a simple chart, really simple chart. So you make a copy of the chart, and you mail it to members of the family. Now, they at least know that your wishes to you also mail it to the family by their good carrying. You’ve known them for 20, you give them a copy, so that they know that you have authorized the family to contact them. And that this is the expectation. There’s nothing wrong with that. It’s a living document, that it just expresses that these are people in the care squad, they’re part of your squad, and then whoever you choose to be part of your care planning team. One of them can be in the book, the caregiver, the main character, she and her husband had been friends with his childhood buddy, forever since grade school. He’s part of that care planning team. He’s also part of the care squad. So the other family members know, this is someone who’s showing up on Zoom, when we do the planning, even if it’s only one family member that you’re zooming with, you can have somebody from your faith based or from just your community in general, be part of this. It puts it out there. And basically Beth, what we’re talking about is creating lines of communication. That’s what all of the book is about. It’s about caring. But more than that, the fact is, we need to not only start the conversation, but we need to continue the conversation so that our aging becomes something that we accept as a process. But there’s no guilt. There’s no blame. There’s no finger pointing. Why? Because we’re planning it instead of reacting to a crisis situation.

Rev. Beth Long-Higgins 28:31
Exactly. And it’s better to have a plan that you have to change than to have no plan and start from scratch in the midst of an emergency. Yeah. Yeah. So what is emerging in the world of insurance and financial solutions for long term care that you are particularly excited about?

Carroll Golden 28:49
I would say that more and more people, fortunately, are asking me to talk about this, as I said, opening lines of communication. I think the states are playing a certain role. You know, in the state of Washington, they have created a publicly funded program. And it doesn’t matter whether you’re in favor of it or not in favor of it. The fact is, even the state is trying to say to their constituents, Medicare and Medicaid will not take care of what can be a very expensive ordeal for the lack of any other word. A plan takes the ordeal out of it, you know what’s coming, you adjust the plan accordingly. So, the fact that there are 15 states in some level of either studying, forming a Task Force looking at tax incentives, gives the states starting to look at these things, which I think helps communities and individuals to say, Oh, is this something I really need to know about? Something I am misinformed about. So carriers, insurance carriers are creating new types of products for the more modern way that we approach the aging process, because we’re all living longer. That’s the good news. But not necessarily healthier, forever, so they’re starting to look at life stage products, they’re starting to look at, well, the combination and the hybrid products are very popular. So the states which are communicating more with their constituents about not having government programs available, insurance carriers that are trying to respond with new products, and you and I, and other people who are trying to say, it’s not a terrible topic, there’s a way to go through some of these steps and you’ll personalize the steps. And, as we said, no matter how you define family, get your family, get yourself so that you have a plan.

Rev. Beth Long-Higgins 31:28
Well, thank you, Carol, this has just been a great conversation. And I think we had shared with you ahead of time that as we come to the end of our podcasts, there are three questions that we’d like to ask each of our guests. So are you ready? Can I start asking the questions? Sure. Okay. Question number one, when you think about how you’ve aged, what do you think has changed about you, or grown with you, that you really like about yourself?

Carroll Golden 31:56
I think what I am pleased about is that I am no longer struggling with aging, I have kind of accepted the youth orientation. And I am now saying you’re only as young as you feel. So try to look at mental, physical, and psychological ways that you can remain healthy. And I think that I have, I am really engaged in doing that.

Rev. Beth Long-Higgins 32:32
Great, great. Okay, question number two, what has surprised you most about yourself as you’ve aged?

Carroll Golden 32:40
I think what surprised me most is how much energy I have. The stereotype of growing older is that you know, you want to retire, you want to slow down and so on and so forth. Somehow, the older I get, the happier I get, that I have time still, to engage and to do and to try to add something back to my industry, which has provided me a wonderful existence, and to spend the time with people I love, but not look at it as if it’s the only thing I should be doing. Because frankly, we become a little burdensome if we depend on them to help us engage in things. So it’s the level of

Rev. Beth Long-Higgins 33:35
indulging. Great, great. And finally, the third question, is there someone that you’ve met or who’s been in your life that has been a good example for you in your aging someone that inspires you to age abundantly? Well, I

Carroll Golden 33:49
I think on a personal level, my own mother, my mother was a person who engaged in life and was struck at what I think is fairly young, and in her mid 70s, with pancreatic cancer, and to the day that she was beyond continuing, she never stopped living. She always said, Nobody cries, we can do that later. Let’s enjoy ourselves, let’s play a game of cards or something. And I thought to myself, this was a person who carried a disease that was very nasty, but didn’t let it define her. And I think that has really influenced me and on a professional level, I would say can die with the age wave and all the positive people, places and information that he makes available to those who want to understand some of the more informative ways of aging with grace.

Rev. Beth Long-Higgins 35:04
Well, thank you very much, Carol, before we close out completely, I want to tell people how they can find you, and your books and your resources.

Carroll Golden 35:15
Yes, thank you for asking. I will make it simple. I have a website called Caring conversation.com. And I can reach back out if you go to the website, and I would love to engage. Thank you.

Rev. Beth Long-Higgins 35:35
Well, thank you very much, Carol. And thank you, our listeners for listening to this episode of The Art of aging part of the abundant aging podcast series from United Church homes. And we want to hear from you what’s changed about you as you’ve aged that you love? What has surprised you most and how do you find abundant aging and who is your abundant aging hero or influencer, you can join us at abundant aging podcast.com to share your ideas. You can also give us feedback when you visit the Ruth Frost Parker Center website at UnitedChurchHomes.org/Parker-center. And Carol, thank you, thank you. Thank you for being with us today. And the caring conversation, Is that that’s the website for folks?

Carroll Golden 36:25
Yes, it’s the caring conversation.com

Rev. Beth Long-Higgins 36:27
Well, thank you for having this caring conversation with us today and helping us all think about how to have those conversations for ourselves and with those whom we love.

Carroll Golden 36:41
Thank you.