Intergenerational Caregiving: 10 Topics to Guide an Important Conversation

If you’re getting together with family and friends over the holidays, I’d like to gently encourage you to include some time for a cross-generational caregiving discussion. This probably does not make your normal holiday to-do list, I know, but there are important things that adult children and their aging parents and other loved ones need to say to each other, which might be best said face-to-face.

Before doing so, it’s essential for older parents to realize that their kids and other younger relatives are, well, not kids anymore, but grownups who have learned a lot. And kids need to confront the fact that their parents are not ageless and likely will need more help from them with each passing year.

As the insightful people at The Conversation Project have documented over and over, there are crucial caregiving and, especially, end-of-life issues that everyone should address. You’ve got to talk to each other, people! Sadly, many of these conversations never happen. And as those involved will testify, no regrets are as hard to bear as the ones that can’t be corrected.

Waiting has other costs, too. As people hit their later years, their cognitive skills often are impaired. So, as I say in my Medicare book, it’s essential to play your marbles while you still have some!

With that, here’s my list of 10 things you may want to talk about. By way of full disclosure, my own efforts to bring these things up with my children, ages 34 and 38, have been met with limited success to date. But I will keep trying, aided by the passage of time that is bringing me inexorably toward old age and beyond.

1 - End of Life Documents

Adult children and other caregivers should have access to their parents’ wills, living wills, physician orders for life-sustaining treatment (POLSTs) and any related documents. What should you do if you don’t know what these are and, especially, how they are governed by state laws where your parents live? Find out!

2 - Health Care Proxy

One or more caregivers should be designated as medical decision-makers by their parents or other older relatives, and this should ideally be done before a parent requires help. After all, the likelihood is close to 100 percent that a parent eventually will need serious medical care. When that happens, a child should be prepared to step up and provide informed support for the care their parent needs from doctors, hospitals and other medical personnel. If the parent’s spouse is still alive, they will need decision-making support from a child so that they can focus their energy on providing the kind of loving support their partner needs.

3 - Age-Friendly Living Needs

As parents age, their homes can change from being castles to prisons, and dangerous ones at that – full of steps, dark hallways and uneven and slippery surfaces that can cause devasting falls. How age-friendly is your parents’ home? Their surrounding neighborhood and community? Are their driving skills suspect? Do they know how to use Uber and Lyft? What about downsizing into an apartment or senior living facility or continuing care community? Who’s going to scout out these places, figure out what they cost and decide if they are affordable? The help of adult children is crucial here.

4 - Relief for Caregivers

Who is going to help the caregivers? Often, one daughter (and, overwhelmingly, primary caregivers are women) takes on the heaviest load for looking after one or both aging parents. This can lead to sibling bitterness, especially if the other children don’t step up and periodically provide assistance to their sister.

5 - Financial Planning and Budgeting

Many older persons fear outliving their money more than they fear death itself. One of the best gifts to give an older parent can be helping to build a life-long financial plan and accompanying household budget that will provide peace of mind and a pathway to having enough money in their later years. This is easier said than done, as many parents are reluctant to share this information, and many adult children don’t know where to start. Bringing in a financial professional can help on both fronts.

6 - Access to Bank and Investment Accounts

This may be a very sensitive topic, but if parents trust their kids, they should consider providing them online access to their bank and investment accounts.

7 - How to Crack the Nest Egg

A cardinal financial planning rule is that retirees should not threaten their own financial futures by providing too much money to their children. While that is a fine and dandy thought, it flies in the face of human nature for many of us. In the U.S., parents provide half a trillion dollars a year to their children and grandchildren, according to research. There is no right answer here but there is a right way to get to the answer that makes sense for your family. Talk about it!

8 - Social Security and Medicare Needs

I decided to write books about both topics because they are cornerstones for successful aging. For Social Security, informed decisions are crucial for deciding when to take your own benefits, how spousal benefits work, and the best strategies for maximizing survivor benefits when one parent dies. Medicare decisions are getting more and more complicated, and the opportunity to make the right (or wrong) decision presents itself every year during Medicare annual enrollment.

9 - Digital Communications

This one might best be left to grandchildren! Seriously, it’s important that multi-generational families know how to get in touch reliably and quickly.

10 - Access to Online Passwords

Parents should provide a list of important computer passwords to their children. I would also include here the benefits of providing clear verbal permission for their kids to access key accounts as part of a routine oversight process.


Journalist Phil Moeller is an expert on retirement and aging. He writes the “Ask Phil” column for the PBS NewsHour and is the author of “Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs” as well as the co-author of the updated edition of The New York Times bestseller “How to Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security.” You can follow him on Twitter (@PhilMoeller) or reach him via e-mail: