The end of the year provides a natural opportunity to review your loved one's care situation, update important documents, and plan for the coming year. Whether your family member lives in an adult family home, receives home care, or you're considering future care options, this comprehensive checklist ensures nothing falls through the cracks.
Care Quality Review
Evaluate Current Care
Take time to honestly assess how things are going:
- Is your loved one receiving the care they need?
- Have there been any concerning incidents this year?
- Are caregivers responsive to your concerns?
- Has your loved one's condition changed?
- Is the care setting still appropriate?
Schedule a Care Conference
Request a meeting with the care team to discuss:
- Health status and any changes over the past year
- Medication reviewâare all medications still necessary?
- Care plan updates needed for changing needs
- Goals for the coming year
- Any concerns from either side
Review Inspection Reports
Check the DSHS licensing database for any new inspection findings or complaints filed against the facility this year.
Legal Document Review
Essential Documents to Review
- Power of Attorney: Still valid? Does the designated person still make sense?
- Healthcare Directive: Does it reflect current wishes?
- POLST Form: Review with physician if health status has changed
- Will/Trust: Any needed updates based on life changes?
- Beneficiary Designations: Check retirement accounts, life insurance, bank accounts
Consider Updates If:
- Health has significantly declined
- Family circumstances have changed (births, deaths, divorces)
- Designated agents have moved or become unavailable
- Your loved one has expressed different wishes
- Laws have changed that affect planning
Consult an elder law attorney if significant changes are needed.
Financial Review
Analyze This Year's Spending
- Total care costs for the year
- Out-of-pocket medical expenses
- Insurance premiums paid
- How much was covered by insurance, Medicaid, or VA benefits?
- Any rate increases at the care facility?
Project Next Year's Costs
- Expected rate increases (typically 3-5% annually)
- Anticipated changes in care needs
- Medicare premium changes for the new year
- Projected income and available resources
Tax Considerations
- Review potential medical expense deductions
- Check if your loved one qualifies as a dependent
- Document caregiver-related expenses
- Consult a tax professional familiar with elder care
Insurance Review
Medicare (During Open Enrollment)
Medicare Open Enrollment runs October 15 - December 7:
- Review current Part D prescription planâstill cost-effective?
- Compare Medicare Advantage vs. Original Medicare
- Check if your loved one's medications are still covered
- Review out-of-pocket maximum and premiums
Long-Term Care Insurance
- Review current benefits and remaining benefit period
- Ensure claims are being filed correctly
- Check if benefits have kept pace with actual costs
- Understand what triggers benefit payment
Other Insurance
- Life insurance policiesâbeneficiaries current?
- Medigap/supplement policiesâstill appropriate?
- Dental/vision coverage needs
Health Management
Medical Appointments
- Schedule annual wellness visit
- Update all specialists on current status
- Get flu shot and any other recommended vaccines
- Annual eye and dental exams if due
- Request medication review with physician or pharmacist
Health Record Organization
- Create or update list of current medications
- Compile list of all healthcare providers and contact info
- Organize medical records from the past year
- Update emergency contact information
Medicaid/COPES Planning
If Currently on Medicaid
- Understand renewal requirements and timeline
- Report any changes in income or assets
- Keep documentation organized for annual review
- Understand how new year may affect eligibility
If Anticipating Medicaid Need
- Review current financial situation against eligibility requirements
- Consult elder law attorney about planning options
- Understand look-back period for asset transfers
- Begin application process if timing is right
Family Communication
Family Meeting
Year-end is a good time to gather family members (in person or virtually) to discuss:
- Current care situation and any concerns
- Financial status and projections
- Care responsibilities and how they're shared
- Contingency plans if primary caregivers become unavailable
- End-of-life wishes and planning
Document Decisions
Keep notes on important family decisions so everyone stays aligned and new information isn't lost.
Planning Ahead
Anticipate Potential Changes
- What if health declines significantly?
- What if the current care setting can no longer meet needs?
- What if funding runs short?
- Who steps in if the primary family caregiver can't continue?
Research Options
Even if not needed immediately, it helps to understand:
- Hospice services and when to consider them
- Higher-level care options if needed
- Respite care resources for family caregivers
- Support services available in the community
Frequently Asked Questions
When should we update the care plan?
Care plans should be reviewed at least annually, but also whenever there's a significant change in health status, after hospitalizations, when new diagnoses occur, or when current interventions aren't working. You can request a care conference with the facility at any time, not just year-end.
How do I know if it's time to consider hospice?
Hospice is appropriate when life expectancy is six months or less if the disease runs its natural course, and when comfort becomes the priority over curative treatment. Signs it may be time: frequent hospitalizations, significant functional decline, increasing pain or symptoms, or the patient expressing readiness to focus on comfort. Talk to the physician about a hospice evaluation.
What if siblings disagree about care decisions?
Disagreements are common. Try to focus on what your loved one would want (if known) or what's in their best interest. If one person has legal authority (power of attorney), they ultimately make decisions, but building consensus helps family relationships. A family mediator or geriatric care manager can help facilitate difficult conversations.
Are care facility fees tax deductible?
Possibly. If your loved one requires assistance with activities of daily living and is in a facility primarily for that reason, a portion of costs may qualify as medical expenses. Tax rules are complexâconsult a tax professional familiar with elder care deductions to maximize legitimate benefits.
How do I organize all the paperwork and information?
Create a central location (physical binder or digital folder) containing: legal documents, insurance policies, financial account information, medical records and provider contacts, care facility agreements, and important contacts. Share access with key family members. Update regularly. Consider a service like Everplans or similar for digital organization.