Guides
Every guide The Care Letter has published. Each one is independently researched, cites primary sources, and ends with a concrete next action.
17 guides · refreshed at least annually
Legal
Guardianship vs Power of Attorney: Which One You Actually Need (and When It's Too Late for a Choice)
Power of attorney costs $300–800 and takes an hour. Guardianship costs $3,000–8,000+ and takes months. The catch: you can only use a POA while the parent still has legal capacity. Once that window closes, court is the only path.
Updated June 2026Durable Power of Attorney: Why You Need One Before You Need It
A durable power of attorney costs $300–800 to sign. Court guardianship if you wait too long costs $3,000–8,000. Here's how to get one done in a single 1-hour appointment.
Updated June 2026Advance Directives Explained: The 4 Documents Every Family Eventually Needs
An advance directive isn't one document — it's four. Living will, healthcare proxy, HIPAA release, and (when illness is imminent) a POLST. Here's what each one does, where the templates are free, and the mistakes that make them unusable.
Updated June 2026
Financial
SLMB Medicaid Eligibility: The Medicare Premium Help Program Most Eligible Seniors Don't Know About
SLMB — the Specified Low-Income Medicare Beneficiary program — is one of four Medicare Savings Programs that quietly pay for a senior's Medicare Part B premium each month. Income limits are higher than people assume, and most eligible seniors don't apply because they don't know the program exists.
Updated June 2026VA Caregiver Support Program (PCAFC): What Family Caregivers of Veterans Actually Get, and How to Apply
The VA's Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays a monthly stipend, covers caregiver health insurance, funds respite, and provides training — for the family member caring for a seriously injured or ill veteran. Most eligible families don't apply because they don't know it exists or because the paperwork looks worse than it is.
Updated June 2026Qualified Income Trust (Miller Trust): The Document That Makes Medicaid Possible When a Parent Is 'Over Income'
If a parent lives in one of ~23 'income-cap' states and earns more than the Medicaid limit, a Qualified Income Trust — sometimes called a Miller Trust — is what gets them eligible. Without one, the family pays out of pocket. With one set up correctly, Medicaid covers nursing-home care.
Updated June 2026Genworth Long-Term Care Insurance: What Adult Children Need to Know About Their Parent's Legacy Policy
Genworth sold millions of long-term care policies in the 1990s and 2000s. Many are still in force, paying $3,000–$6,000 a month of care. Here's how to find out if your parent has one, how to file a claim, and what to do about the big rate-increase letters.
Updated June 2026Caregiver Tax Deductions You're Probably Missing
If you're paying for an aging parent's care, the IRS has at least four tax mechanisms that can offset thousands of dollars. Most families miss them because the rules are spread across three different IRS publications.
Updated June 2026FMLA for Eldercare: What Actually Qualifies and How to File
Federal FMLA gives 12 weeks of unpaid job-protected leave to care for a parent with a serious health condition. The eligibility rules, the paperwork, and the four states that pay you during it.
Updated June 2026Long-Term Care Insurance in 2026: When It's Worth It, When It Isn't
Traditional standalone LTC insurance is mostly closed to new buyers. Hybrid life/LTC policies have taken over. Here's the math, the trap, and how to decide if any of it fits your parent's situation.
Updated June 2026The Medicaid Look-Back Period Explained (And the Planning Mistakes That Disqualify Families)
The 5-year window the state examines before approving nursing-home Medicaid. What counts as a transfer, what doesn't, and the three things families do that cost them coverage.
Updated June 2026
Care decisions
The 30-Day Playbook After a Parent's First Fall
What to do in the 30 days after that 2 a.m. call. Discharge planning, home safety, medication review, and the long-term care conversation no one prepared you for.
Updated June 2026Hospice Eligibility Explained (The 6-Month Rule, The 4 Levels of Care, and the Misconceptions That Delay Enrollment)
Hospice isn't just for the final two weeks. Medicare covers it indefinitely as long as a physician recertifies prognosis. Families who enroll early get better care, lower costs, and more support — but most enroll far too late.
Updated June 2026In-Home Care: Hourly vs. Live-In, Agency vs. Independent, and How to Vet an Agency Properly
The choice between hourly visits, live-in care, agency care, and an independent caregiver determines roughly half of the eventual quality and risk profile. Here's how to choose the model that fits, then the 12 questions that separate a competent agency from a sketchy one.
Updated June 2026Memory Care vs. Assisted Living: How to Decide
The clinical, financial, and quality-of-life differences. The signs that suggest memory care is needed. The questions to ask on a tour.
Updated June 2026
Family
When a Parent Becomes Verbally Abusive: The Dementia-vs-Personality Reality
If your parent has suddenly become cruel, paranoid, or verbally abusive in ways they never were before, the cause is almost never that they finally said what they always thought. Here's how to tell what's happening and what to do about it.
Updated June 2026How to Talk to Siblings About Mom's Decline (The Conversation Script That Actually Works)
80% of family caregiving falls on one or two siblings. Resentment is the silent killer of these relationships. Here's a structured conversation that gets siblings aligned — even when no one wants to have it.
Updated June 2026
New guides go out in the twice-weekly newsletter first. Subscribe →