Overcoming Challenges in Guardianship Cases for Older Adults

Takeaways

• Guardianship becomes necessary when an older adult cannot make decisions and lacks a valid power of attorney.

• The guardianship process can be complicated by family disputes, difficulties in proving the adult’s incapacity, and challenges with ongoing guardian responsibilities.

• Strategies such as mediation, naming successor guardians, and meticulous record-keeping can help prevent common issues in guardianship cases.

When an older adult with dementia or another cognitive disability can no longer make important decisions for themselves, such as how to manage their money or what kind of care they need, a trusted person may have to step in and make these decisions for them.

If the incapacitated older adult has a valid health care and financial power of attorney in place, they have already nominated someone they trust. This person has the legal authority to make decisions for them.

However, sometimes there is no valid power of attorney. The older adult may not have executed one, no one can find the document, or the agent(s) they nominated are unavailable.

When there is no agent with the power to act on behalf of the older adult under a valid power of attorney, families face a significant hurdle. The older adult may no longer understand what a power of attorney is and what powers they would give their surrogate decision-maker. If that is the case, they are unable to create a valid power of attorney. In this situation, the older adult lacks someone with the legal authority to make decisions for them.

Guardianship of an Incapacitated Adult

Guardianship presents itself as a solution. In a guardianship, the court appoints someone to make decisions for the incapacitated adult.

There are different types of guardianship (some states use the term conservatorship). Total (full or plenary, in some states) guardianship gives the guardian the most control. A guardian or conservator of the estate manages finances. In a limited guardianship, the court specifies what the guardian can and cannot do. Courts generally favor limited guardianships where possible.

Petitioning the court for guardianship over the older adult is a much more involved legal process than becoming an agent under a power of attorney. Becoming a guardian requires proving that the adult is unable to make personal or financial decisions for themselves in a court of law and assuring the judge that the petitioner is a suitable guardian.

Guardianship Case Challenges

When challenges arise, filing for guardianship over an older adult can be lengthy and complex. Families may encounter several problems throughout the guardianship process. Disagreements about whether the elder needs a guardian and who should fill the role can create tension. Proving the older adult’s incapacity requires relevant and timely medical evidence and testimony, which can involve significant preparation for the guardianship hearing.

After the court has assigned a guardian, complexities can arise if family members bring accusations of improper conduct, the guardian seeks to resign, or the person under guardianship wants to replace the guardian or end the guardianship.

An elder law attorney can help family members navigate such challenges. Having an attorney with experience can be particularly helpful for those involved in complex guardianship matters.

While each case is unique, the following are challenges families may encounter in a guardianship case involving an older adult.

Disagreements About the Need for Guardianship

Full guardianship requires that the adult be incapable of making personal or financial decisions. One of the first challenges that can come up in a guardianship case is when family members disagree about whether a guardianship is even required.

To overcome this obstacle, the older adult may undergo a medical evaluation by a qualified physician. The physician may assess their condition to shed light on whether the individual has the mental capacity to make their own personal and financial decisions. Should the guardianship case go forward, the physician’s report becomes an important piece of evidence.

When the older adult can still make decisions but could benefit from some assistance from a person they trust, less restrictive alternatives to full guardianship may be more appropriate. The court may decide a limited guardianship is most suitable.

Alternatives to guardianship that preserve the older adult’s autonomy include creating power of attorney documents or setting up a supported decision-making arrangement, which is an informal relationship where an older person chooses someone to help with certain decisions.

In instances where someone needs help specifically with managing their Social Security benefits, the government may appoint a representative payee, which can be a less restrictive alternative to full guardianship or guardianship of the estate.

Difficulties Proving Incapacity

Proving incapacity is central to guardianship of an adult. Guardianship is only needed when a person has lost the capacity to make their own decisions.

Families can run into difficulties with this when they petition for guardianship without the proper medical evidence. They will need a recent medical evaluation, known as the physician’s report. If it has been some time since the proposed protected person has been to the doctor, the court may decline to order the guardianship or may order a new medical evaluation. This can lead to delays.

To avoid this complication, family members seeking guardianship over an older adult with a disability should make sure that the adult has had a recent medical evaluation and include the physician’s report with the petition.

Family Disputes About Who Should Be Guardian

Even when families agree that guardianship is the best course of action, disputes can arise about who should take on the role. Siblings may be at odds over who should take care of aging parents. Children from prior marriages and current spouses may also both want to assume the role.

When there are multiple petitions for guardianship over an adult, the court will make the final decision. People who get along and can work together may serve as co-guardians.

Families facing conflict may be able to avoid lengthy litigation and preserve relationships through alternative dispute resolution such as mediation. Generally, mediation is a voluntary process. Rather than finding a winner and loser, the process seeks to foster common ground. A neutral third party, called the mediator, listens to both sides, and facilitates communication and compromise.

Missing the Annual Report

Guardians must file an annual report with the court, which typically details the kind of care the person under guardianship has received. Not filing the annual report can spark accusations of mishandling. The court may remove the guardian and penalize them.

Guardians can avoid problems with annual reporting in several ways, including the following:

• Keeping detailed records, including an accounting of spending from the estate

• Hiring a professional, such as an accountant

• Staying organized and on top of deadlines or working with an attorney to file the report on time

Guardian Resigning

If the guardian dies, resigns, or becomes unable to serve, families may not know who should make decisions for their elderly loved one. A guardian who no longer wants to serve must get permission from the court and explain why, such as health reasons, conflict, or moving away. The court will review whether the request is in the ward’s best interests. Those with financial responsibilities still must file an annual accounting.

Nominating a successor in the initial guardianship petition can make a smoother transition if the first guardian can no longer continue. The court will appoint this person if it remains in the best interests of the older adult.

Ending a Guardianship

A guardianship is an arrangement that can limit a person’s personal agency. If the person under guardianship is unhappy and is able to tell the court, they may try to end the guardianship. If the person remains unable to make decisions for themselves but is dissatisfied with the arrangement, the court may replace the guardian with someone else who can act in their best interest.

In cases where the individual under the guardianship has regained capacity, medical evidence may show that the guardianship is no longer needed.

Strategies for Preventing Challenges

Petitioners in guardianship cases can anticipate and avoid these common challenges in several ways, including:

• Working with a mediator to resolve family disputes

• Naming a successor guardian in the guardianship petition

• Maintaining good records for the annual report

• Acting in an ethical manner and in accordance with the best interests of the older person under guardianship

Additional Reading

• How Mediation Helps Resolve Elder Care Disputes

• Wendy Williams Case Shines Light on Guardianship

• What to Do If Appointed Guardian of an Older Adult

How to Prevent Long-Term Care Insurance Claim Denials

Takeaways

• Understanding your long-term care insurance policy and its specific requirements (benefit triggers, covered services, elimination periods) is crucial to preventing claim denials.

• Common reasons for claims denials include insufficient medical documentation, preexisting condition exclusions, failure to meet elimination period requirements, and administrative errors.

• To help prevent denials, make sure you thoroughly understand your policy, confirm that your care providers meet policy requirements, maintain detailed medical and care records, and accurately track the elimination period.

• If a claim is denied, you have the right to appeal and should carefully review the denial letter, file an appeal promptly with supporting evidence, and seek help from state insurance departments or elder law attorneys if necessary.

• State-level consumer protections also offer safeguards such as limitations on preexisting conditions, written explanations for denials, and appeal rights.

Long-term care insurance can provide necessary financial support when someone needs help with daily activities such as bathing, dressing, or eating, whether they live at home, in an assisted living facility, or in a nursing home. However, when the time comes to use the benefits, some policyholders are surprised to find their claims denied. Understanding why denials happen and how to avoid them can save families significant stress and expense.

Why Long-Term Care Insurance Claims Get Denied

Long-term care insurance claims may be denied for various reasons, including those described below.

Lack of Medical Documentation

One of the most common reasons for denial is insufficient medical evidence to show that the insured meets the policy’s “benefit trigger.” Most policies require that a doctor or licensed health care professional certify that the person needs help with at least two activities of daily living (ADLs), such as eating, bathing, or dressing, or that the person has a severe cognitive impairment. If medical records don’t clearly document these limitations, insurers may reject the claim.

Preexisting Condition Exclusions

Some older long-term care policies exclude coverage for preexisting conditions for a certain period after the policy begins. If the need for care arises during that exclusion period, or if the insurer believes the condition existed before coverage began, the claim may be denied.

Not Understanding What’s Covered

Many denials occur because policyholders assume that all types of care or facilities are covered. For instance, some policies cover only licensed home health agencies, not independent caregivers or family members. Others may exclude assisted living facilities unless they meet specific licensing or staffing standards.

Failure to Meet Elimination Period Requirements

An elimination period is like a deductible measured in time rather than money; it’s the number of days the policyholder must pay for care before the insurer starts to pay. If documentation doesn’t show continuous care during that period, the insurer may delay or deny payment.

Administrative or Technical Errors

Sometimes denials stem from paperwork mistakes, missing signatures, or incomplete claim forms. Even small administrative issues can cause delays.

How to Prevent Claim Denials

Having an insurance claim denied can be a hassle and can lead to a long appeals process or unplanned care expenses. Here’s how to help prevent claims from being denied.

Understand Your Policy Before You Need It

Review your policy carefully, ideally with the help of a trusted family member, attorney, or financial advisor. Take note of the following:

• What types of care and facilities are covered

• The definition of “benefit triggers” (ADLs or cognitive impairment)

• Elimination periods and daily or lifetime benefit limits

• Exclusions or limitations for certain conditions

Keep copies of your policy, correspondence, and any amendments in one place so they’re easy to access later.

Confirm That Your Provider Meets Policy Requirements

If your policy only covers licensed providers, verify that your caregiver or long-term care facility meets those qualifications. Before beginning care, call your insurer to confirm that the provider is eligible under the policy terms.

Maintain Detailed Medical and Care Records

Ensure your doctor, home health agency, or facility keeps detailed notes about your limitations and the level of assistance you need. Ask for copies of care plans, assessments, and progress reports. They can make a difference during a claims review.

Track the Elimination Period Accurately

Keep receipts, caregiver timesheets, and invoices for all care provided during the elimination period. Gaps in documentation can delay benefit payments.

If Your Claim Is Denied

Fortunately, a denial doesn’t necessarily mean the end of the road.

Read the Denial Letter Carefully

The insurer must explain the specific reason for denial. This letter is your roadmap for next steps, whether it’s providing more documentation, clarifying a misunderstanding, or filing a formal appeal.

File an Appeal Promptly

Most insurers have internal appeal procedures with strict deadlines. Follow them closely and include supporting evidence such as updated medical records, physician statements, and care logs.

Seek Help if Needed

If the appeal fails, consider reaching out to your state’s Department of Insurance, which oversees long-term care insurance regulations. Many states have consumer protection units or ombudsman programs that can review your case and help mediate disputes.

Certified long-term care insurance specialists can provide guidance and can assist in filing claims and appeals. Elder law attorneys can also provide guidance and can represent you in appeals.

Consumer Protections

Long-term care insurance is regulated at the state level, but many states have adopted model laws based on standards set by the National Association of Insurance Commissioners (NAIC). These regulations include protections such as:

• Clear definitions of benefit triggers and covered services

• Clarifications regarding limitations on preexisting condition exclusions

• Requirements that insurers provide written explanations for claim denials

• Appeal rights for denied claims

Knowing your rights under state law can help you hold insurers accountable.

The Bottom Line

A long-term care insurance denial can feel overwhelming, especially when you or a loved one needs care right away. However, in many cases, denials can be avoided or overturned with preparation, documentation, and persistence.

By understanding your policy, keeping thorough records, and knowing your appeal rights, you can increase the chances of receiving the benefits you’ve paid for and planned on receiving.

Additional Reading

For additional reading on topics related to long-term care insurance, check out the following articles:

• What a Good Long-Term Care Insurance Policy Should Include

• When Should You Purchase Long-Term Care Insurance?

• Deducting Long-Term Care Insurance Premiums in 2025

• Questions to Ask Before Buying Long-Term Care Insurance

• Who Should Purchase Long-Term Care Insurance?

• Older Adults Lack Information in Search for Long-Term Care Services

How Medicare Changes in 2026 Will Affect Older Adults

Takeaways

• Medicare is implementing changes in 2026 to lower prescription drug costs, enhance consumer protections, and test new care management approaches.

• New negotiated prices for some prescription drugs and an annual out-of-pocket cap of $2,100 for Part D covered medications will lead to lower drug costs for many enrollees.

• A new special enrollment period will protect beneficiaries who choose a Medicare Advantage plan based on inaccurate provider directory information.

• A prior authorization pilot program will be implemented in six states for certain services and equipment in traditional Medicare.

• Beneficiaries can opt to spread their prescription drug costs evenly over 12 months.

Medicare is rolling out several important changes in 2026 that are intended to lower prescription drug costs, strengthen consumer protections, and test new ways of managing care. If you’re enrolled in Medicare, or will be soon, here’s what you need to know.

Lower Negotiated Prices for Some Prescription Drugs

Starting January 1, 2026, Medicare will begin using newly negotiated prices for a group of commonly used and expensive prescription drugs. These are the first medications selected under the Medicare Drug Price Negotiation Program.

What This Means for You

If you take one of these drugs, you may see lower costs at the pharmacy. Savings will vary depending on the medication and your Part D plan. Check with your plan or pharmacist in late 2025 to see whether any of your prescriptions are on the negotiated list.

Annual Cap on Prescription Drug Costs

In 2026, the most you will have to spend out of pocket on prescription drugs covered by Medicare Part D will be $2,100. Once you reach that amount, you won’t pay anything more for covered medications for the rest of the year.

Why This Matters

This cap on out-of-pocket costs for medications offers financial peace of mind for people with serious health conditions or expensive prescriptions. Many older adults will see significantly lower yearly drug costs compared with past years.

New Safety Net for Choosing a Medicare Advantage Plan

It’s not unusual for Medicare Advantage plan directories to list doctors or clinics incorrectly. To protect beneficiaries, Medicare is giving people who join a plan based on inaccurate provider directory information a special opportunity to switch plans.

How It Works

If you enroll in a Medicare Advantage plan and later discover that your doctor or hospital was incorrectly listed as in-network, you will have three months after your coverage begins to change plans.

Tip

When you choose a plan, take screenshots or print the provider information you relied on. That documentation may help you if you need to use the special extension period to switch plans.

Prior Authorization Pilot Program in Six States

Medicare is testing a new prior-authorization program in six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. This pilot program will apply to certain services and equipment in traditional Medicare.

What This Means for You

If you live in one of the pilot states, you may need prior approval for certain procedures or medical equipment. The goal is to prevent unnecessary care, but some people worry it could lead to delays. If your doctor orders something that needs approval and it’s urgent, ask about expedited review options.

Option to Spread Drug Costs Throughout the Year

If your prescription costs usually pile up early in the year, you can ask your plan to spread your costs evenly over 12 months instead of paying large amounts at once. This, option, which has been in place as of 2025, is known as the Medicare Prescription Payment Plan. It seeks to help Medicare recipients enrolled in a prescription drug plan with budgeting and will continue in 2026.

For example, someone expecting to pay $2,400 in out-of-pocket prescription drug costs may opt into the plan and divide their total cost into payments of about $200 per month. To sign up for the payment plan, review your plan’s materials or call their customer service line to ensure this option is available and suitable for your situation. (Note that some plans will automatically reenroll you each year unless you opt out.)

What Older Adults Should Do

Here are some things older adults can do during the 2026 health care coverage enrollment period.

• Review your current list of medications and your current plan during open enrollment to make sure you’re getting the best prices.

• Ensure that your current health care provider and preferred pharmacy are still in-network, especially if you are enrolled in a Medicare Advantage plan. Keep documentation if you rely on Medicare’s plan directory when picking a plan.

• Ask your doctor’s office whether any of your services will require prior authorization in 2026, especially if you live in a pilot state.

• Consider using the monthly drug payment option if you expect high medication costs.

• Make sure your plan has your most up-to-date contact information on file. You don’t want to miss out on notices about network updates, renewals, or other changes to your plan.

In 2026, Medicare brings improvements for older adults, especially related to prescription drug affordability and protections for those enrolled in Medicare Advantage. Though the prior authorization pilot program may bring some extra steps for those in pilot states, the changes are aimed at making Medicare more reliable, transparent, and affordable.

Projected 2026 Costs (Subject to Final CMS Announcement)

Note that the Centers for Medicare & Medicaid Services (CMS) has not yet released the premium, co-pay, and deductible costs for Medicare in 2026. However, some of these costs are projected to increase, according to several sources. For example:

• The Medicare Part B monthly premium is projected to be $206.50 (up from $185 in 2025), and the annual deductible about $288 (versus $257 in 2025).

• The Medicare Part D plan deductible is expected to rise as well, to a maximum of about $615 (up from $595 in 2025).

Again, all official final figures have yet to be released by the CMS and are due to be confirmed later this year. Check back for updates.

Additional Reading

For additional reading on topics related to Medicare, check out the following articles:

• Medicare’s Extra Help Program for Prescription Drug Coverage

• Can People With Medicare Get Alcohol Counseling?

• Medicare Coverage Basics: What You Need to Know

• Can Oregon Launch a Universal Health Care System in the U.S.?

Medicare Open Enrollment Scams: How to Protect Yourself

Takeaways

• Medicare open enrollment periods are a target for scammers who use deceptive tactics to steal personal information or enroll beneficiaries in unauthorized plans.

• Protect yourself by being wary of unsolicited calls, emails, or visits, and by using official Medicare resources or trusted advisors for plan changes and information.

Medicare’s open enrollment period, which runs from October 15 through December 7, is the time for millions of Americans to review their health coverage, compare plans, and make changes for the upcoming year. A second open enrollment period for Medicare Advantage plans will follow from January 1 through March 31.

Unfortunately, these times also bring a surge in Medicare-related scams, as fraudsters exploit a confusing health insurance system and the flood of legitimate marketing to trick beneficiaries into giving up personal information or switching to fake plans.

How Scammers Target Medicare Recipients

During open enrollment periods, beneficiaries are bombarded with advertisements for Medicare Advantage plans and Part D prescription drug plans. This legitimate activity provides cover for scammers, who mimic real insurers and use deceptive tactics to steal personal data, commit identity theft, or enroll people in unauthorized plans. Common scams include:

• Unsolicited phone calls or robocalls: Scammers pose as Medicare representatives or licensed agents, offering “better coverage” or claiming your current plan is expiring. They often pressure you to share your Medicare number, Social Security number, or bank account information.

• Phishing emails and text messages: Fraudsters send messages that look official, often using Medicare logos or similar language. They may direct you to fake websites that collect your personal information.

• Door-to-door visits: Though some legitimate insurance agents do home visits, Medicare itself never sends representatives door-to-door. Scammers may use this tactic to obtain sensitive documents or signatures.

• High-pressure sales tactics: If someone insists you must “act now” or lose coverage, it’s a red flag. Legitimate agents are required by law to give you time to review your options and cannot enroll you without your consent.

• Fake enrollment forms or plan offers: Some scammers mail counterfeit materials that appear to be from Medicare or well-known insurance companies. These forms often ask for personal or financial information that can later be used for fraud.

What to Know About Plan Solicitations

Remember that Medicare will never call you unsolicited to sell a plan, ask for payment, or request personal information. You should also be wary of anyone claiming to be a “Medicare representative.” Though licensed insurance agents may contact you, they must follow strict rules, including getting your permission before calling and providing clear information about the plan they represent.

To make changes to your coverage or explore new options, the safest ways to do so are:

• Visit the official Medicare website at Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

• Contact your State Health Insurance Assistance Program (SHIP). SHIP counselors provide free, unbiased, and confidential help with Medicare choices. Find your local program at shiphelp.org.

• Work directly with your current plan provider using the phone number on your plan card.

How to Protect Yourself From Medicare Scams

You can minimize your risk of becoming a victim by following a few simple precautions:

• Guard your Medicare card and number like a credit card. Only share it with trusted health care providers or verified plan representatives.

• Hang up on unsolicited calls claiming to be from Medicare or an insurance company. Use the official number on your card to verify anything.

• Avoid clicking on links in emails or texts about Medicare plans. Go directly to the Medicare or insurer website instead.

• Do not feel pressured to make quick decisions. Take your time comparing plans and seeking trusted advice.

• Report suspected scams to Medicare at 1-800-MEDICARE or the Senior Medicare Patrol (SMP) in your state (smpresource.org).

Stay Informed, Stay Secure

Medicare’s open enrollment periods offer valuable opportunities to find better or more affordable coverage. But the same openness that benefits consumers can also be exploited by criminals. By staying vigilant, using trusted sources of information, and knowing how Medicare actually operates, you can make informed choices and avoid becoming a victim of fraud.

Additional Reading

For additional reading on topics related to Medicare, check out the following articles:

• Medicare Coverage Basics: What You Need to Know

• Entering and Leaving Medicare Advantage Plans

• Turning 65? What to Know About the 4 Parts of Medicare

• Medigap: Plugging the Holes in Medicare

How the Government Shutdown Could Affect Older Adults

Takeaways

• Many older adults rely on federal programs for income, health care, and support services, making them particularly vulnerable to disruptions caused by a government shutdown.

• While core benefits such as Social Security and Medicare payments are largely protected, administrative functions, customer service, new claims, and certain services (like some telehealth) may experience delays or reductions.

• A prolonged shutdown can lead to increased stress, significant backlogs, cash flow issues for health care providers, and potential long-term changes to certain programs.

• Older adults can mitigate risks by using online tools, planning ahead, documenting interactions, proactively communicating with providers, staying informed, and budgeting conservatively.

A federal government shutdown affects more than just the headlines; it creates deep uncertainty for many Americans. Perhaps no group of Americans feels the effects more than older adults, since many of them rely on federal programs for income and health care coverage. The effects of the federal government shutting down may not always seem direct or immediate, but the risks and disruptions are real.

Why Older Adults Are Especially Vulnerable

Older Americans tend to rely on federal programs for their primary income (Social Security, Supplemental Security Income), health coverage (Medicare, Medicaid), and support services (nutrition assistance, long-term care, home- and community-based services). That means even modest disruptions in government operations can ripple through their finances, access to care, and quality of life.

During a shutdown, programs funded through mandatory spending (essentially, those with existing, continuous funding) are more protected than those that rely on discretionary appropriations (annual budget allocations). But protected does not always mean unaffected. Administrative slowdowns, reduced staffing, delays in processing, and uncertainty are all possible, even in mandatory programs on which many older Americans rely.

Social Security and Supplemental Security Income Payments

Social Security and Supplemental Security Income (SSI) are considered mandatory spending, which means they don’t depend on yearly government funding bills. If you receive these benefits, your checks should continue arriving on schedule. Local Social Security Administration (SSA) offices will also remain open.

Because of staff reductions during the shutdown, some administrative and customer service functions might slow down or pause. The SSA may temporarily reduce or delay noncritical services like:

• Verifying benefits

• Making corrections to earnings records

• Handling and overpayment reviews

These delays can make it harder to get help with certain issues and may cause worry among seniors concerned about their payments.

In addition, the shutdown could delay the 2026 cost-of-living adjustment (COLA) announcement. COLA works like an annual raise that helps Social Security and SSI recipients keep up with the rising cost of things like food, gas, and housing. The COLA depends on inflation data from the U.S. Bureau of Labor Statistics, which has paused some operations during the shutdown.

This delay means seniors won’t know their exact benefit increase as early as usual, making it harder to plan their budgets for the coming year.

Though many SSA operations will continue, there could be delays for things such as new claims, appeals, and appeals hearings, especially if the shutdown continues for a long period. People already receiving benefits are mostly protected in the short term, but those applying for benefits, making corrections, or needing other administrative help might experience disruptions.

Medicare Coverage

Medicare is partially protected from the effects of the shutdown, but not entirely immune. If you’re enrolled in Medicare, you should still be able to see your doctor, go to the hospital, and fill prescriptions as usual. Your core Medicare coverage remains intact.

Medicare relies on Medicare Administrative Contractors (MACs). These are private companies that help the federal government run the program by processing claims and handling other key functions. Because this work is considered essential, many of their operations keep going during a shutdown.

However, the Centers for Medicare & Medicaid Services (CMS) has asked MACs to temporarily delay payments to providers for up to 10 business days. This short pause is designed to give Congress time to restore funding or pass a temporary spending bill, and to prevent the need for MACs to reprocess claims later. This delay affects payments to doctors and hospitals, not your coverage. You can still receive medical care, and you won’t receive a bill because of this delay.

Other essential functions and some oversight activities will continue, but could experience delays amid reduced staffing in certain areas.

Telehealth coverage may be more affected. Medicare’s pandemic-era telehealth waivers expired on September 30, just before the government shutdown began. Medicare will continue to cover some telehealth services, such as for mental health and substance use disorder treatment.

However, other types of visits may not be covered. Contact your health care provider to confirm which their telehealth services remain covered under your plan.

Some oversight and quality monitoring activities, such as complaint resolution or enforcement, may be paused, which could lead to delays in resolving problems. The shutdown also means Medicare won’t issue replacement Medicare cards. However, you can still print an official copy from your online Medicare account.

If you are turning 65 soon or enrolling during Medicare’s open enrollment period, you may face longer wait times and slower assistance. Start the process early and use online resources whenever possible.

Medicaid and Related State Programs

Medicaid is a bit more complicated because, while the federal government provides much of the funding, states run and manage the program. This means the shutdown can affect Medicaid differently depending on your state.

If you’re enrolled in Medicaid, your coverage for required services should continue without interruption because existing funding typically remains in place.

However, some states may experience slower processing of new applications or changes in eligibility, especially if they depend on federal systems, guidance, or staff that are affected by the shutdown. This could make it harder to get help with complex cases or to update your benefits quickly.

Other programs that depend on discretionary federal grants or contracts, such as aging services, meal services, or home- and community-based care, are at higher risk. If funding runs out, these state and local services may face cuts or pauses.

Veterans Affairs medical centers are generally considered essential services and will continue operating. However, nonurgent services, support programs, or new applications could face delays.

Possible Longer-Term or Secondary Effects

Even as many core benefits continue, a prolonged or repeated shutdown can deepen risks on multiple levels. These include:

• Uncertainty and stress. Seniors living on fixed incomes may worry about whether future benefits or services will continue, making budgeting and planning harder.

• Administrative backlogs that persist. Administrative delays can quickly accumulate. Once services resume fully, it may take months to catch up on appeals, corrections, and new claims.

• Effects on health care providers. Health care providers, home health agencies, and community service contractors may face cash flow issues if reimbursements are delayed, potentially forcing service reductions or closures, especially in rural or low-margin settings.

• Interdependence of programs. Some services depend on multiple governmental layers (federal, state, local). Disruption in one layer can cascade to other layers.

• Political changes. Repeated shutdowns or budget instability may spur reevaluation of program structures or cost controls, which could lead to future program changes affecting older adults.

What Older Adults Can Do to Mitigate Risk

Even though most essential programs, such as Social Security and Medicare, will continue during the shutdown, service disruptions and delays can still cause real stress. Here are some practical steps for those affected by the current government shutdown:

• Use online tools first. For Social Security, Medicare, or SSI matters that don’t require in-person visits, use secure online portals, such as mySocialSecurity, to avoid making a trip to an office that might be closed.

• Plan ahead as much as possible. If you are nearing a deadline for applying, enrolling, or changing an address (such as during Medicare open enrollment), try to start the process early, and expect longer wait times for things like processing new claims.

• Keep detailed documentation. Save records of claims, applications, denials, and correspondence. If delays occur, it helps to have evidence.
  You may also want to keep copies of your personal records, including your Medicare card or proof of benefits letters, on hand. This can be helpful to show proof of coverage during service slowdowns.

• Ask providers in advance. Do you have upcoming medical care or prescriptions you need to fill? Ask your doctors and pharmacies if the shutdown might affect scheduling, billing, or coverage. If you use virtual care, check with your provider to confirm whether the specific services you rely on are still covered.

• Stay informed. Follow official updates from agencies like the SSA and CMS, and trusted advocacy groups, for alerts about service changes or temporary policies.

• Budget conservatively. Monthly payments for core benefits should remain intact, so use cash reserves for noncovered costs and refrain from major spending decisions until benefits increases are confirmed.

During the government shutdown, administrative delays, reduced customer service, delayed data and announcements, and strain on provider networks all pose real risks, especially for those entering programs or needing more intensive assistance.

In a best-case scenario, the shutdown will be short and agencies will recover quickly. But if the shutdown lingers, the ripple effects could compound, making life harder for older Americans who are least able to absorb uncertainty or interruption. With thoughtful planning, you may be able to lessen some of the negative effects.

Additional Reading

For additional reading on topics related to government benefits for older adults, check out the following articles:

• Get Social Security Benefits by Check? Prepare for Change

• How to Apply for Social Security Retirement Benefits

• How Do You Qualify for Social Security Disability Benefits?

• Are Social Security Benefits Taxed?

• Medicare Coverage Basics: What You Need to Know

Emotional Wellness Among Older Adults in Long-Term Care

Takeaways

• Emotional wellness is critical, but often overlooked, for older adults in long-term care.

• Approaches that do not involve medications (e.g., gardening, reminiscence therapy, social activities, and technology) show promise in improving emotional well-being.

• Families can also play a vital role in supporting residents' emotional health through visits, advocacy, and promoting autonomy.

Mental and emotional health affect every stage of life — especially older adulthood. For millions of older Americans, especially those living in long-term care settings such as nursing homes, assisted living communities, or memory care facilities, emotional wellness is vitally important, yet often overlooked.

The Growing Challenge

Older adults in long-term care face notable emotional health challenges. According to data from 2022, depression affects more than 25 percent of residential care community recipients. A 2024 study found that up to 56 percent of residents in long-term care report loneliness.

These conditions often go unrecognized or untreated for reasons that can be complex. For one, many long-term care facilities don’t have systemic screening protocols for depression. Staff in these settings may also lack mental health training. Symptoms that could signal depression may be mistaken for “normal” aging.

The COVID-19 pandemic amplified these challenges. Many residents spent months isolated from loved ones and with communal activities restricted. Rebuilding connection and community has since become a central focus for many facilities.

What Can Help

A growing body of research points to approaches that support mental wellness without relying solely on medication. A recent study found that therapies such as gardening and exercise reduced depressive symptoms in long-term care residents.

Gardening in particular has proven effective. This may include having residents tend to small indoor plants, help maintain a garden, or simply spend time outdoors. Forms of therapy that encourage older adults to share life stories, photos, or music from their past, can also rekindle meaning and connection.

Social connections are also essential. Facilities that combine group-based and leisure activities delivered face-to-face may be especially effective at reducing loneliness. Activities such as group exercise classes or art projects may help residents reconnect with others and strengthen community bonds.

Emerging Innovative Approaches in U.S. Senior Communities

Across the country, long-term care providers are rethinking how to make emotional wellness a core part of daily life. Some facilities are piloting “small household” models, like the Green House Project. In these settings, about a dozen residents live together in a home-like environment with consistent staff, shared meals, and flexible daily routines. These models have been linked to higher satisfaction and lower depression rates compared with traditional institutional settings.

Health care settings are also using technology creatively. Virtual reality experiences, for example, let residents “travel” to destinations from their past or explore calming natural settings. Some facilities use robotic pets or sensor-based music therapy to soothe agitation in residents with dementia. While these tools are still emerging, early results suggest they can supplement, though not replace, human connection.

Other programs integrate emotional wellness directly into daily life through mindfulness workshops, stress management sessions, and peer support groups. Such initiatives reflect a growing understanding that mental wellness is not a luxury — it’s necessary for healthy aging.

The Family’s Role in Emotional Health

Families remain a cornerstone of emotional wellness for residents in long-term care. In the U.S., family caregivers for older adults rose from about 18 million in 2011 to over 24 million in 2022. Many continue to visit, advocate for, and emotionally support their loved ones even after a transition to residential care.

Regular visits, meaningful conversations, and shared activities have profound benefits. Bringing photo albums, familiar music, or mementos can spark memories and conversation. For some residents, a 10-minute chat about old times can lift spirits more effectively than any medication.

Families can also play an active advocacy role to help ensure that emotional wellness remains a care priority. They may ask facility staff how they monitor depression and loneliness or suggest therapies like gardening. Supporting a loved one’s sense of autonomy is also important. For example, older adults should be able to make choices about their daily routine, meals, or activities whenever possible.

At the same time, families must care for themselves. Caregiver stress and burnout are widespread. Support groups, counseling, and respite services can help family members maintain their own mental health while remaining engaged advocates.

Barriers and Opportunities

Despite progress, challenges remain. Many long-term care facilities still face staffing shortages, and caregivers often lack formal training in geriatric mental health. Other disparities also persist. For example, Black and Latino long-term residents often have less access to quality resources.

Addressing these issues may be possible through several strategies:

• Expanding routine mental health screening in long-term care facilities

• Increasing reimbursement for therapies that don’t involve medication

• Investing in staff education on how to recognize and respond to depression and loneliness

• Advocating for lawmakers to view emotional well-being as an important measure of quality in long-term care

The Path Forward

Emotional wellness in older adults is not just about preventing depression. It also involves helping them feel connected, valued, and alive. For long-term care residents, even small steps can make a significant difference. These might include a garden walk, a shared story, a visit from family, or a moment of laughter in a group activity.

As the U.S. population ages, emotional wellness must be seen as a central pillar of quality care. The goal is not simply to sustain life but to enrich it by ensuring that older Americans in long-term care have opportunities to feel purpose, joy, and belonging each day.

Additional Reading

For additional reading on topics related to emotional wellness, check out the following articles:

• Make New Friends and Keep the Old: It’s Good for Your Health

• The Loneliness Epidemic: Helping Seniors Stay Connected

• How Mental Health Apps Can Help Older Adults

Getting Help for a Parent With Memory Loss

Takeaways

• Seeking a timely diagnosis for memory loss or cognitive decline in an aging parent is crucial for early intervention and future planning.

• Despite potential challenges like the parent’s denial or fear, adult children can encourage seeking professional help through sensitive conversations and by utilizing at-home cognitive tests as a prompt for medical evaluation.

When an aging parent shows signs of memory loss, confusion, or cognitive decline, getting them to seek help can be a challenge. Delays in obtaining a diagnosis of dementia are common, with Sci Tech Daily reporting that it takes an average of three-and-a-half years between noticeable symptoms of cognitive decline and a diagnosis.

Yet obtaining timely diagnoses can be crucial. Accessing early interventions can lead to better outcomes. As Time reports, Alzheimer’s treatments implemented early are more effective.

When families know a loved one has dementia, they can prepare for decisions about long-term care and caregiving roles. The older adult may also still have time to execute a valid power of attorney nominating a trusted decision-maker.

While helping a parent with cognitive symptoms can be challenging, children of older adults with such symptoms can take steps to help their parents seek out a medical evaluation.

What Is Dementia?

Approximately one in 10 of adults 65 and older have dementia. Dementia describes a group of progressive illnesses that affect thinking and memory and involve damage to nerve cells or their connections in the brain.

The most prevalent cause of dementia is Alzheimer’s disease. The Alzheimer’s Association reports an estimated 7.2 million people in the United States live with Alzheimer’s. Other types of dementia include vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia, which has multiple causes.

Sometimes, dementia-like symptoms are caused by an underlying medical condition. For instance, urinary tract infections can cause confusion, especially for older adults. Treating the underlying condition may help restore cognitive function.

Dementia Symptoms

According to the Mayo Clinic, symptoms of dementia, which may get worse over time, include:

• Noticeable memory loss

• Difficulty communicating or finding words

• Getting lost more easily

• Reasoning or problem-solving challenges

• Trouble planning and performing complex tasks

• Diminished coordination

• Confusion and disorientation

• Psychological changes like agitation, paranoia, anxiety, and depression

Many people mistake dementia symptoms for normal aging. However, memory problems and marked cognitive decline are not considered a normal part of aging and should be assessed by a medical professional.

Why Parents May Delay Getting Help

Convincing a parent to accept that they may need a medical evaluation can prove challenging. Parents may dismiss memory issues and cognitive challenges as a normal part of getting older. When an older adult experiencing early-stage dementia recognizes signs that something may be wrong — misplacing objects, forgetting names, repeating the same story — they may deny their symptoms because of fear of social stigma, loss of independence, or burdening family members. People with dementia that has progressed further may lack insight into their condition, not understanding that they need help.

Encouraging a Parent to Seek Help

Adult children of individuals who may be showing signs of dementia can encourage them to seek help. But there are several important considerations that can shape how the parent responds.

When a parent is in the early stages of cognitive decline and still able to recognize a problem and make decisions, one strategy is to plan a conversation with them. The Alzheimer’s Association recommends preparing for the conversation by noting what symptoms the individual seems to be experiencing and if anyone else has noticed a change.

The adult child may have the conversation or ask another trusted individual to do so. Because of family roles and expectations, some people may be more receptive to another older family member or friend than their child. Whether the adult child or someone else is stepping in, the conversation should be intimate. Staging a large intervention risks alienating and angering the parent.

The conversation should take place as soon as possible, but when the individual is comfortable, calm, and alert. During the conversation, the child or other trusted person can gently bring up the symptoms they have noticed and offer to go with them to the doctor for an evaluation. It may be necessary to have multiple conversations.

At-Home Cognitive Tests

For families navigating this complex situation, at-home cognitive tests can be a helpful starting point. While an at-home test cannot diagnose Alzheimer’s disease or another cause of dementia, a test may prompt a family to seek professional help for their loved one.

One popular test that helps family members assess whether their loved one might be experiencing dementia is the Short Form of the Informant Questionnaire on Cognitive Decline in the Elderly. It includes 16 questions that aim to shed light on the loved one’s cognitive ability. The informant is asked to consider how their loved one’s cognitive abilities have changed compared with 10 years ago.

Another short cognitive assessment is a self-test: The Self-Administered Gerocognitive Exam (SAGE). Developed by Ohio State University, the SAGE test includes questions that capture different cognitive skills. It includes a question about how to draw a clock, which can illustrate problems with spatial awareness and memory.

Potential Downsides to Self-Tests

Since at-home cognitive tests are not diagnostic, they might also provide false reassurance. This is why it is best to seek medical advice from a doctor and obtain a referral for an evaluation by a neurologist or other professional. If you or a loved one chooses to use a self-test, it can be helpful to bring it with you to the appointment.

Ensure Your Elder Law Attorney Understands Medicaid Planning

Takeaways

• Working with an experienced elder law attorney who understands Medicaid is crucial for long-term care planning and applications.

• Red flags indicating an attorney’s inexperience include a lack of specific Medicaid knowledge, inadequate assessment of individual situations, and insufficient planning for asset protection.

• Unprofessional consultations and a lack of clarity regarding legal timings and processes can also signal an attorney’s inexperience in handling Medicaid cases effectively.

Navigating the Medicaid program can be daunting. You may be seeking help with long-term care planning for a senior family member or are ready to apply to Medicaid yourself. In either case, working with an experienced elder law attorney who understands the complexities of Medicaid is crucial.

Why You Need an Expert in Medicaid Planning

Nursing home care in the United States can cost more than $10,000 a month depending on where you live. Medicaid has become the default form of long-term care coverage for millions of aging Americans. However, an estimated $1 trillion in Medicaid cuts are likely in store over the next decade.

Meanwhile, many people mistakenly believe that Medicare, a different program, will cover the costs of long-term care. However, Medicare does not cover long-term custodial care. (Custodial care includes assistance with daily living activities such as getting dressed, eating, and moving from place to place safely, such as from a bed to the bathroom. It does not encompass medical treatment that requires a licensed nurse or doctor.)

Medicaid planning is a complex area of elder law that focuses on qualifying for Medicaid benefits without depleting one’s assets unnecessarily. To be eligible for the program, you must meet strict income and asset limits. In most states, you cannot receive Medicaid benefits if you have more than $2,000 in countable assets to your name.

In part, this is why Medicaid planning is so important. Planning involves reviewing all your assets, including bank accounts, retirement accounts, real estate, vehicles, and life insurance. A professional can help you with this and with distinguishing between your “countable” and “noncountable” assets. In addition, with the help of an expert, you can pursue legal strategies that allow you to spend down your assets so that you can qualify for the program.

5 Hidden Red Flags

Here are five red flags that may indicate an attorney’s inexperience with Medicaid planning.

1. Lack of Specific Medicaid Knowledge

Elder law is a specialized field, and not all attorneys have the expertise required to handle Medicaid cases effectively.

• Vague answers on Medicare coverage. If the attorney cannot clearly explain what Medicaid covers with regard to long-term care services, this may signal a lack of familiarity with elder law nuances.

• Ignorance about recent program changes. Medicaid policies can change frequently. An adept elder law attorney should be aware of and able to discuss the latest updates and their implications.

2. Inadequate Assessment of Individual Situations

Every Medicaid consultation requires a personalized approach, given that financial and health care needs vary widely among seniors.

• Generic advice. An elder law attorney lacking experience might offer broad, generalized advice instead of recommendations tailored to your individual circumstances.

• Failure to ask detailed questions. A seasoned attorney in this area of law will dig deep into the client’s financial well-being, health needs, and family circumstances to offer precise guidance.

3. Insufficient Planning for Asset Protection

Protecting assets while qualifying for Medicaid is a key aspect of elder law.

• No strategy for asset transfers. If an attorney cannot provide a clear plan for how to legally transfer or protect assets, this can indicate a lack of expertise.

• Ignoring look-back periods. An attorney experienced with Medicaid knows the importance of the Medicaid look-back period and should clearly explain how it affects eligibility.

4. Unprofessional Consultations

The manner in which consultations are conducted can reveal much about an attorney's professionalism and experience.

• A lack of documentation. An attorney’s failure to provide written summaries or detailed documentation post-consultation can be a red flag.

• Poor communication skills. An inability to communicate complex concepts in an accessible way may reflect inexperience or insufficient expertise.

5. Misunderstanding Legal Timings and Processes

Understanding the timelines and processes involved in Medicaid applications is crucial.

• Confusion about application timelines. If an attorney is unsure about when or how long it takes to file a Medicaid application, this can indicate inexperience.

• Inaccurate processing guidance. Misguidance about the steps involved can jeopardize the outcome of your application.

Additional Reading

Engaging with a skilled elder law attorney who is well-versed as a Medicaid planner is vital. Checking for these red flags can help ensure you or your loved ones receive knowledgeable and effective legal support.

Learn more about the various aspects of Medicaid as well as long-term care. Visit the Medicaid website to determine whether you are eligible and check out the following articles:

• Survey Shows Long-Term Care Costs Continue to Rise

• Medicaid’s Benefits for Assisted Living Facility Residents

• Pros and Cons of a Medicaid Asset Protection Trust

• Medicaid Applicants: Protecting Your Healthy Spouse in 2025

• What a Good Long-Term Care Insurance Policy Should Include

• Medicaid’s Coverage of Nursing Home Care

Get Help With Medicare Enrollment Through Your Local SHIP

Takeaways

• State Health Insurance Assistance Programs (SHIPs) offer free, unbiased guidance to Medicare beneficiaries, helping them navigate complex options and avoid costly mistakes.

• Recent budget cuts and proposed structural changes to the Administration for Community Living (ACL), which oversees SHIP, threaten its operations and could lead to reduced services and access for vulnerable populations.

Anyone who has shopped for health insurance plans knows that a plethora of options is available. Yet trying to find the plan that best fits your needs can be daunting. Not only do the plans have many features but what they cover and how much they will cover can also be hard to discern.

The federal government’s health insurance program, Medicare, can be as confusing as the open market. If you are eligible for Medicare and need help navigating the system, you can turn to your local State Health Insurance Assistance Program (SHIP).

What Is SHIP?

Congress established SHIP in 1990 to give free, unbiased guidance to help people understand their Medicare options. The SHIP network receives federal funding via the Administration for Community Living (ACL), which is part of the Department of Health and Human Services (HHS).

More than 12,000 paid and volunteer staff serve at over 2,200 SHIP sites across all 50 states, plus Puerto Rico, Guam, the U.S. Virgin Islands, and Washington, D.C. In 2022, SHIP counselors provided one-on-one assistance to over 4 million Medicare recipients and caregivers.

SHIP Services

SHIP provides valuable services to current Medicare recipients and those who are eligible for Medicare. Individuals who are new to Medicare, such as those who are turning 65 or who have a qualifying disability, can get help figuring out whether Original Medicare or Medicare Advantage is best for them. They can also obtain guidance on the various parts of Medicare, such as Part D and Medigap.

Medicare enrollees can get assistance from SHIP each year during open enrollment to review and switch plans if needed. SHIP also offers support with appeals and grievance processes, provides education on resources that help pay for Medicare, such as the Extra Help program, and may also hold local outreach events and share fraud prevention tips.

Why SHIP Matters

SHIP provides value in various ways for all those who use it.

Complexity of Medicare

With multiple parts (A, B, C, D), plus supplemental (“Medigap”) coverage, private Medicare Advantage plans, and various savings program options, Medicare can be bewildering. SHIP provides guidance in the form of neutral, trustworthy help.

Unbiased Advice

SHIP counselors do not receive commissions or indirect incentives tied to plan enrollment. As a result, they are generally considered more trustworthy and less biased than brokers or agents who may have financial ties to insurers.

Access and Local Help

SHIP can be a valuable resource in many rural or underserved areas for personalized help. Local offices know the particulars regarding local providers and which plans may be effective in a specific area. This information can help enrollees avoid mistakes, like picking a plan that doesn’t include the local pharmacy or certain specialists.

Cost Savings and Preventing Harm

By preventing enrollment mistakes, helping people get needed coverage and benefits, and aiding with appeals or understanding rights, SHIP can help prevent higher downstream costs, such as unexpected out-of-pocket costs and uncovered services. SHIP also helps protect older adults from being steered into inadequate or expensive plans.

Recent Budget Cuts and Policy Changes

In recent several months, some proposals and actions have put SHIP at risk.

ACL’s Reorganization

The HHS is dissolving the ACL and moving its programs into a new division. ACL currently houses SHIP, among many other aging, disability, and elder care support programs. Roughly half of ACL’s staff has been laid off, affecting staff levels in leadership, policy, budget, and regional offices.

Potential Cuts to SHIP Funding

A leaked budget draft from the HHS’s Office of Management and Budget proposes eliminating SHIP’s $55 million in discretionary funding. This roughly 80 percent cut in overall funding for the program would leave only $15 million in mandatory funds intact. However, as of early September 2025, the discretionary funding remains in the budget for 2026.

Discretionary funding supports key parts of the program, such as training, advertising and outreach, organizational infrastructure (phone lines, local offices, websites), and volunteer support. Without such funding, state and local SHIP offices would have to scale back operations or possibly shut down.

Flat Funding and Rising Demand

SHIP has been operating with relatively flat federal funding for years, while the number of Medicare beneficiaries has grown. That means per-beneficiary resources have been shrinking. Inflation, rising medical costs, greater complexity (more Medicare Advantage plans, more drug options, changing regulations) all increase the cost of counseling and outreach tasks.

Effects of Staffing Cuts and Structural Reassignments

Amid these changes, administrative oversight and support functions, such as grant administration and guidance to states, are at risk. These operations are essential for ensuring coverage of SHIP services across the many local offices.

Reassigning SHIP supports to a new agency may introduce disruptions, delays, or loss of institutional memory. Local sites depend on stable funding, consistent guidance, and coordinated training. Sudden policy shifts may degrade that.

Consequences of Staff and Funding Reductions

If the proposed cuts go through, several harmful effects could follow, such as:

• Reduced access to in-person or personalized help. Many smaller or rural SHIP offices might close, reduce hours, or shift to more virtual-only help. People without good internet access or who prefer face-to-face assistance would suffer.

• Longer wait times and less assistance for appeals and complex cases. Without enough trained staff or volunteer infrastructure, SHIP may be unable to serve people with complicated needs, such as changing plans and filing appeals for coverage denials.

• Reduced outreach and education. Without discretionary dollars, less money will be available for advertising SHIP services, and less outreach means fewer people benefiting.

• Greater risk of being steered toward less-desirable options. Without reliable, neutral, local sources of advice, people may rely on agents or brokers who have financial incentives or knowledge only on Medicare’s centralized resources (which may not be sufficient or tuned to the local context). This may lead people to make choices that are less financially or medically optimal.

• Worsening inequities. Vulnerable populations, including low-income, rural, and non-English-speaking people and individuals with disabilities, may be disproportionately harmed. They tend to rely more on free local help and may be less able to navigate complex systems without assistance. If SHIP offices scale back, these groups will likely lose this support.

• Potential for higher health costs downstream. Errors in enrollment, misunderstandings leading to lapses in coverage, or failure to access the most beneficial plan could cause higher out-of-pocket spending, more use of emergency health services, and lower preventive care uptake.

Policy and Political Status

Though current budget proposals include cutting discretionary funding for SHIP and dissolving ACL, Congress still controls appropriations. In some recent appropriations bills, discretionary funding remains intact.

The Older Americans Act (OAA) , which authorizes many ACL programs, needs to be reauthorized by Congress. Continuing resolutions have provided funding for OAA programs through fiscal year 2025. However, SHIP’s future relies on timely reauthorization, adequate appropriation levels, and other statutory mandates.

SHIP plays a vital role in helping millions of older Americans, people with disabilities, and caregivers make sense of a complicated and shifting Medicare landscape. Because it provides unbiased, individualized, and locally based advice, it fills a gap that other entities, like insurers and brokers, can’t or won’t fill as effectively.

However, the combination of flat funding, proposed discretionary budget cuts, staff cuts, and ACL’s dissolution and restructuring threatens SHIP in significant ways. Many local SHIP offices may be forced to cut back or close, reducing access at a time when more people are relying on them.

Life After Caregiving: What Family Caregivers Can Do to Heal

Takeaways

• Family caregivers often experience a dual loss — the loss of their loved one as well as the loss of their caregiving identity — which can lead to profound grief, guilt, and burnout.

• Moving on involves acknowledging these losses, addressing guilt, reclaiming a personal identity beyond caregiving, prioritizing self-care, and finding new purpose.

Caring for a family member who is unable to fully care for themselves can offer a sense of purpose and meaning. However, it can be an all-consuming responsibility. For one, many family caregivers sacrifice their careers to care for a loved one who has a chronic illness or disability.

In some cases, forfeiting work isn’t a factor, such as with retired couples. Nevertheless, the caregiver may still end up sacrificing their social life, hobbies, and even time to relax and recharge. But what happens to the caregiver when the care recipient dies?

How Loss Affects Family Caregivers

When a caregiver loses the loved one they have been caring for, whether it was a parent, a spouse, or another family member, the grief can be profound. Not only is there the pain of losing someone they love, but many caregivers also experience a second, less obvious loss: the loss of their role and identity as a caregiver. For months or years, their lives may have revolved around appointments, medications, meal preparation, and emotional support. When that ends, the sudden quiet can feel disorienting.

At the same time, former caregivers may feel drained from years of constant responsibility, experiencing physical and emotional burnout even after their duties are over. Feelings of guilt – for not doing enough, for feeling relief, or even for wanting to move forward – may also surface.

These experiences are normal and valid. The challenge lies in acknowledging them and finding a path to healing, self-compassion, and renewed purpose.

Acknowledge the Dual Loss

The loss of one’s loved one and the loss of one’s caregiving role both deserve recognition. Suppressing or minimizing either can make it harder to heal. Journaling, talking with a trusted friend, or joining a grief or caregiver support group can provide space to name and process these feelings.

Navigating Feelings of Guilt

Family caregivers may also experience guilt after their care recipient dies. You may replay decisions in your mind, question whether you did enough, or feel guilty for any moments of frustration or exhaustion.

Remember that caregiving is a long process in which most caregivers are learning how to do it as they go along. No caregiver can do it perfectly. Accepting that you did your best under challenging circumstances can help ease self-criticism. If guilt lingers, speaking with a counselor, therapist, or faith leader can offer guidance and perspective.

Reclaiming Identity Beyond Caregiving

Caregiving often becomes central to a person’s identity. When the caregiving role ends, there may be a sense of “Who am I now?”

The answer begins with rediscovering yourself outside that role. Consider the things that brought you joy before your caregiving role started. Whether you were interested in painting, gardening, or traveling, revisit those passions.

Consider new opportunities you can explore, such as volunteering, taking a class, or joining a community group. These activities can open fresh pathways for connection and meaning.

Reflect on how you want to invest your time now. You have given a portion of your life in service to someone else. This is a chance to turn some of that energy back toward yourself.

Caring for Yourself After Burnout

Years of stress and responsibility can leave caregivers physically and emotionally exhausted. After the responsibility of caregiving has passed, be sure to prioritize your own health.

Schedule medical appointments you may have postponed. Take time to focus on rest and recovery. Sleep, exercise, and nourishing meals are all restorative.

Before rushing into new obligations, give yourself permission to pause. Healing takes time, and self-care is not indulgent — it is necessary.

Moving Toward a New Chapter

Some former family caregivers find purpose in helping others by volunteering with hospice organizations, supporting other unpaid caregivers, or advocating for elder care resources. Others find meaning in pursuing long-set-aside goals or simply enjoying time with family and friends.

Every caregiver will face their own unique circumstances; there is no single right way to move forward. What matters is allowing yourself to grieve. Acknowledge the complexities of the caregiver’s journey and gently create space for who you are beyond caregiving.

Resources and Additional Reading

Caregiving is an act of love and sacrifice. When it ends, the transition can be overwhelming. By acknowledging the depth of both loss and burnout, processing feelings of guilt with compassion, and slowly reclaiming identity, former caregivers can begin to heal. Life after caregiving does not mean forgetting; it means honoring what was given while allowing space for what comes next.

Organizations such as Family Caregiver Alliance and National Alliance for Caregiving provide resources for caregivers.

For additional reading on topics related to caregiving, check out the following articles:

• The Effects of Family Caregiving on Older Adults

• Support for Family Caregiving Gains Momentum

• Unpaid Family Caregiving Is Worth a Six-Figure Salary

• Becoming a Family Caregiver for an Ailing Loved One

• How Parents Can Provide for a Caregiver Child

• Healthier Living for Seniors Through Adult Day Care Services