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Caring for Elderly Parents: Where to Start, and What Comes First
Start with the documents only your parent can sign, while they can still understand them. Then gather the records and find the local help.
By naveen · Updated · How we research our guides
What to know
- When caring for elderly parents, start with the documents your parent has to sign: a durable financial power of attorney, a healthcare directive, and written permission for doctors to talk to you.
- The National Institute on Aging suggests setting up a financial power of attorney "preferably while the person can still understand and approve the arrangement."
- Without one, the CFPB says a family member "might have to go to court to have a guardian appointed."
- The federal Eldercare Locator (1-800-677-1116) connects families to local services for older adults.
- Retirement Checklist asks four questions and puts the steps that matter most for your family in order.
When caring for elderly parents, start with the documents your parent has to sign themselves: a durable financial power of attorney, a healthcare directive, and written permission for doctors to share medical information with you. These depend on your parent being able to understand and approve them, which is why they come first.
Why does caring for aging parents feel so overwhelming?
Because so much arrives at once. The National Institute on Aging (NIA) notes that for a new caregiver "There might be tasks to organize, new medical terms to learn, and schedules to coordinate." The standard advice then adds Medicare, wills, trusts, home safety, driving, medications, long-term care, the house and the siblings, with no order to them.
NIA's own advice is to "Try to tackle one task at a time." It can help to pick the few things that matter now for your particular family and let the rest wait its turn.
What should you do first?
Start with the documents your parent creates and signs:
- A durable financial power of attorney, which, in NIA's words, "names someone who will make financial decisions for you when you are unable to."
- A healthcare directive. NIA describes advance directives as legal documents that "provide instructions for medical care and only go into effect if you cannot communicate your own wishes."
- HIPAA authorizations, because, as NIA puts it, "By law, you will need written permission to receive medical information about the person unless they are with you in person and able to give consent."
Without a power of attorney, a family that needs to act may have to ask a court for authority instead: conservatorship or guardianship. The Consumer Financial Protection Bureau (CFPB) describes that court process as lengthy, expensive and public. That is the main reason to start here.
What might already exist?
Documents may already exist, so ask before drafting anything new. NIA's checklist tells people to "Tell someone you know and trust or a lawyer where to find your important papers," so your parent may have done exactly that with a relative or an attorney.
Older documents may need a fresh look. NIA suggests reviewing plans "at least once each year and when any major life event occurs." A power of attorney found in a drawer is a different starting point from assuming there's nothing.
What information should you gather?
Gather one record of accounts, policies, advisors, doctors and key contacts, with a note of where the original documents are kept. NIA's checklist includes items such as "Names of your banks and account numbers" and the "Location of most up-to-date will with an original signature," and suggests keeping "important papers and copies of legal documents in one place."
Building that record is also a chance to check whether beneficiary forms still match the will.
What comes after that?
After the documents and the record, the order depends on your family's situation rather than a generic list. Coverage reviews like Medicare can come next. Then how care would be paid for: Medicaid and insurance. NIA cautions that most health and disability policies "include limited, if any, long-term care benefits."
Then where your parents will live as needs change, and how siblings share the work. NIA notes that "Caring for an older person often requires teamwork with family, friends, or formal caregivers."
How do you know what order to do things in?
The free tool on this site exists for exactly this. Four questions about where your parents are (their stage, what's already in place, where everyone lives, what makes it complicated) and it returns the five to eight items that matter most for your family, in the order that makes sense, each with a short explanation of why. No account required.
Frequently asked questions
Where do I start with caring for aging parents?
Start with the documents your parent has to sign: a durable financial power of attorney, a healthcare directive, and written permission for doctors to share medical information with you. NIA suggests setting up the financial power of attorney while your parent can still understand and approve it. Then gather records and look for local help.
What should I do first if there's a crisis right now?
Find out what already exists before assuming nothing does: a power of attorney or directive may be with a relative or an old attorney. Ask the hospital or facility what it needs from you. If your parent can no longer sign documents and nothing exists, an elder law attorney in their state can explain the court options.
Is there a checklist for aging parents?
Yes. The National Institute on Aging publishes a free checklist of documents and records to gather, from wills and powers of attorney to bank and insurance details. The tool on this site does something different: four questions, then the five to eight items that matter most for your parents, in order.
How do I bring it up with my parents?
It can help to frame it as a conversation about what they want, not a list of what you've decided. NIA suggests asking about their concerns and "who they might trust to make decisions for them." If your parent isn't ready, NIA suggests encouraging them to think it over and "plan to discuss them another time."
How do you talk to elderly parents about this?
One topic at a time can help. NIA suggests sharing what matters to you as well, explaining why planning matters, and listening carefully. It notes that the person "may feel more comfortable talking with someone else such as a doctor or someone in their spiritual community." Expect to come back to it more than once.
What if a parent resists help?
Respect that it's their life, and start smaller: one specific thing, framed around what they want to protect. NIA acknowledges that "many older adults will resist allowing someone else to take over their financial affairs" and suggests steps that respect independence, such as automatic bill payments. A doctor may be easier to hear than family.
What support exists for caregivers?
NIA points to caregiver support groups, respite care and adult day care, and to the local Area Agency on Aging for what's nearby. The federal Eldercare Locator, at 1-800-677-1116 or eldercare.acl.gov, connects families to local services. ACL's caregiver program funds counseling, support groups and caregiver training through the states.
Getting started
Every family's order is different. The plan this site builds asks four questions, including which state your parents live in, and puts the handful of steps that matter most for your family in order. It's free and takes about 90 seconds.
Sources
- National Institute on Aging, Getting Your Affairs in Order Checklist: The documents and records to gather, including powers of attorney, advance directives and permission for doctors to talk with a caregiver.
- National Institute on Aging, Getting Started With Caregiving: Where to begin as a new caregiver, the written-permission rule for medical information, and the Eldercare Locator.
- National Institute on Aging, Managing Money Problems for People With Dementia: Setting up a financial power of attorney while a parent can still approve it.
- National Institute on Aging, Advance Care Planning: Tips for Caregivers and Families: How to start and keep up the conversation about future care.
- National Institute on Aging, Frequently Asked Questions About Caregiving: Support groups, respite care, local agencies and paying for long-term care.
- National Institute on Aging, Sharing Caregiving Responsibilities: How families can divide caregiving tasks.
- Consumer Financial Protection Bureau, What is a power of attorney (POA)?: What happens when no power of attorney exists.
- Administration for Community Living, Eldercare Locator: The federal service connecting older adults and families to local help.
- Administration for Community Living, National Family Caregiver Support Program: Federally funded counseling, support groups and training for family caregivers.
More on what this tool does and doesn't do, or browse everything we've written.