Time to Talk : Baby boomers and their aging parents often shy away from discussions about money, estate planning and health care. But to avoid emotional and financial pain later, now is the ...

Beth Witrogen McLeod knew something was wrong when she stepped into her parents’ Wichita, Kan., home. Her mother smelled bad and her clothes were dirty. The normally immaculate house was cluttered and filthy, the floor spotted with food stains. McLeod later realized her mother, who suffered from Lou Gehrig’s disease and early-stage dementia, had been trying to bring food to her cancer-stricken husband but often lacked the strength to handle the tray.

Thus began McLeod’s yearlong struggle to care for her parents, an experience that wiped out her savings and that of her once-successful mother and father. Only death spared the elderly couple from bankruptcy; they died within weeks of each other after being moved to a nursing home. Because of poor planning, life insurance proceeds and retirement savings that could have gone to McLeod went to pay creditors and lawyers’ fees.

Bay Area resident McLeod, who wrote about her experience in the new book “Caregiving: The Spiritual Journey of Love, Loss, and Renewal,” knows now that at least some of the emotional and financial pain could have been spared had her family discussed some important issues of aging: estate planning, health care and dealing with incapacity.

But before the crisis, both parents and child resisted.

“They were immortal,” McLeod, 43, said wryly. “My father told me he was going to live forever, and I believed him.”

Denial, busy lives and reluctance to confront difficult issues keep many families from having these discussions, elder-care experts say. Parents can see their children’s efforts to broach such topics as attempts to take control, while the adult children may shy away from intruding into their parents’ lives. Money issues can be particularly touchy. So both sides put off asking and answering questions.

“Often it’s, ‘We’re going to get around to it someday,’ ” said Marty Richards, a Seattle social worker and geriatric-care manager with 32 years’ experience in aging issues. “Then the crisis comes and they’re not ready.”

The issue of long-term planning is a particularly pressing one for baby boomers, who stand to inherit some $10 trillion from their parents but who may also become increasingly responsible for their elders’ care as people live longer and government care systems become strained.

So far, many boomers have been able to all but ignore parental aging, thanks to their elders’ relatively good health. Three-quarters of those age 65 to 74 who aren’t in a nursing home or hospital rated their health good to excellent in a 1992 study, according to the U.S. Census Bureau. The proportion of older people who rate their health good to excellent has remained about the same since the 1970s, when the question was first asked.

Improvements in medical care and longevity mean that far more may live to a ripe old age. In 1940, only 7% of those aged 65 were expected to survive to age 90, Census Bureau statistics show. Today, more than 25% can expect to live that long.

With increased age come increased problems, however. The Census Bureau cautions that even with further advances in science and medicine, longer lives may mean higher rates of chronic illness, long-term disability and dependency. Living longer also means more people are expected to experience Alzheimer’s and dementia, debilitating illnesses that can require 24-hour care.

Of those over 85, at least one in four lives in a nursing home, and many more need help with serious health problems. Other studies cited by the Census Bureau show that half of those over 85 need some help with basic living activities, such as dressing, using the toilet, preparing meals and housekeeping.

Clearly, more baby boomers will be faced with parents’ declining health and increasing needs; McLeod likens the phenomenon to a tsunami whose first waves are now crashing ashore.

Many boomers will also be dealing with the costs and details of inheritance. High probate costs in some states, particularly California and New York, mean that even relatively modest estates can benefit from some estate planning. Estates worth more than a certain exemption amount, now $650,000 but scheduled to rise to $1 million by 2006, are also subject to federal estate taxes that can go as high as 55%.

Lack of planning can be expensive, even with parents who have few assets. After her parents’ death, McLeod discovered that her parents’ will had not been updated since 1961 and that her father’s life insurance policies and retirement savings named her mother as beneficiary. Since no contingent beneficiary was named, the money went into the estate, where it could be attached by creditors instead of passing directly to McLeod.

Because her parents hadn’t taken steps to avoid probate, the estate languished in probate court for four years, which cost $12,000 in attorney’s fees.

The attorney “was a good guy . . . but he wound up with a third of the estate, what was left of it,” McLeod said.

Yet in some families, talking about money is more difficult than talking about sex--which makes estate-planning discussions painful to start, social worker Richards says.

“It’s sharing information that they’ve [parents] kept very secret over the years,” she said. “It’s about power and control.”

The fear of losing control has been cemented in many older adults by their experiences during World War II and the Depression, Richards said. Self-sufficiency is often prized, and any form of help is often frowned on--whether it’s help from their children or from government-sponsored aid such as Meals on Wheels, respite care or other programs that can help alleviate a caretaker’s burden. Some have trouble even contemplating the possibility that they may not be able to care for themselves someday, Richards said.

“They’re the original up-by-your-bootstraps generation. They’re not going to ask for help now,” she said.

It may be particularly difficult for parents to seek or accept help or advice from children simply because it’s an uncomfortable role reversal, said Geraldine Champion, an elder-law and estate-planning lawyer in San Luis Obispo.

“You can be 50 years old and they’re going to look at you and still see the infant in diapers,” said Champion, a former board member of the National Academy of Elder Law Attorneys.

Pride can be a roadblock as well. Some parents may not have their financial information well organized, or they may have suffered investment reversals or other financial setbacks that they’re unwilling to share, said Victoria Collins, an Irvine certified financial planner who has a doctorate in psychology.

“They may not have been as successful as they’ve led their children to believe all these years,” Collins said.

Adult children can be equally conflicted. They may be concerned about appearing greedy or uncaring if they ask their parents questions about their assets or estate planning. And bringing up issues about incapacity--who should make decisions about finances or health care if the parent is unable--can spark suspicions in the parent that the child is trying to take over. It can also lead to conflicts with siblings.

The result: Some boomers may be even more reluctant than their parents to start these discussions.

Huntington Beach lawyer Ellen Lowe, who creates estate plans for many Leisure World residents in Seal Beach, said many of her older clients complain they can’t get their children to participate in discussions about incapacity or estate planning.

“They say, ‘My kids don’t want to talk about it.’ That happens a lot,” Lowe said.

For many adult children, facing their parents’ mortality involves facing their own. The conflicts can be so great that one or more siblings may fight attempts to discuss even a clearly deteriorating parent, insisting that everything is fine.

Old family patterns and problems can interfere as well. Some siblings may believe others will get favorable treatment in a will or estate plan, and attempts to talk about planning can deteriorate into “You were always the favorite!” accusations.

At the same time, parents may indeed play favorites and may resist hearing a message from one child that they would take seriously from another.

“There always seems to be one child that is more trusted than any of the others,” Champion noted.

Despite all of these potential obstacles to initiating talks about the future, experts say the stakes are so high that few families can afford to ignore the subject. Issues of serious future financial burden may well be avoided by better planning early on.

Champion often suggests that children meet first as a group to determine what needs to be discussed, then meet with parents--again as a unit--to outline their concerns. Both discussions should stay on point as much as possible, with a goal of maintaining family harmony rather than rehashing family problems, she said.

“The holidays are coming up now and families will be getting together,” Champion said. “It can be a good time for the group to say: ‘We’re really concerned. Not about your estate--we want you to spend all your money and enjoy your life--but about preserving the highest quality of life for you as long as possible.’ ”

Some families may find it helpful to bring in a professional, such as an elder-law attorney or financial planner skilled in dealing with older people, to facilitate these discussions or to at least be available for later questions, Champion said.

Other families find a more indirect approach is needed. Richards advised looking for what she called a “teachable moment”--a time when the other party is receptive to talking about issues involving death or health care. Some use the death of a friend or neighbor or a relative’s health crisis as a springboard for discussion. Others use newspaper or magazine articles, Richards said. “They can say, ‘I read about how all of these older women become impoverished after the death of their husbands, and I want to make sure that doesn’t happen to you,’ ” Richards said.

One of Richards’ friends made estate planning a three-generation event. She invited her mother to join her and her twentysomething daughter in creating living wills, physician’s directives and other estate-planning documents as an offbeat way of celebrating her birthday.

“That took it out of the realm of ‘Mom, you need to do this,’ since she and her daughter were doing it too,” Richards said.

Still, it may take a crisis of their own for some families to be ready to talk, Richards said.

“You always run the risk of alienating the parent . . . particularly in a family where there’s been some distance and suspicion over the years,” Richards said. “They may only hear this when they’re ready to hear.”

In the meantime, Richards recommends boomers take a little of their own medicine by making their own estate and health-care plans.

“We should be planning ahead as middle-aged people,” Richards said. “What do your kids know about your wishes?”

Times staff writer Liz Pulliam can be reached at liz.pulliam@latimes.com.