There are three truisms behind care disputes.

1. Every caregiving situation is unique.
2. Conflicts arise when making difficult care decisions.
3. There is no one care solution or dispute resolution that suits all cases.

To complicate matters further, the cost of care can easily escalate, and privatization of health care is expanding.

So, it is not surprising that people with financial resources are increasingly turning to private management for customized care solutions. Government-funded options are becoming more fragmented and more difficult to access on a timely basis. More than ever before, we need to rethink the management of care within a much broader context of client expectations and services.

My previous blog post, Insights into Resolving Care Disputes – Part 1 – All About Estates, discussed the importance of assessing the caregiving situation first before attempting to plan or resolve conflict. That article highlighted the Caregiving Situation Assessment Model as in the figure below.

Private Management for Customized Care Solutions

Using this Caregiving Situation Assessment Model, let’s consider a high-net-worth family.[2]  In this context, there will be different perspectives, more resources to spend on different solutions, and an expectation that different solutions and options will provide specific levels of client care and services.

Over the past decade, many clients referred to our practice from a family office group or wealth management professionals have requested an increasingly diverse set of services in relation to planning and/or managing care for an elderly or ill family member. For example, it is common for our practice to design bespoke services that include a diverse team of professionals. Recently, a client diagnosed with a neurodegenerative disease is asking for the development and management of a care plan over five years. It must include her professional trainer, physical therapist, naturopath, and concierge medical services so that she can travel to her summer home in Muskoka and her Florida home in the winter.

The client expects that before she approves the plan, the projected costs and the various plan stages will be discussed in detail with her various professional and financial advisors. As her disease progresses, other care providers will need to be added.

Management of Care as a Non-Financial Value-Added Service

In providing elder management services for wealthy individuals, how do we, as professional advisors, anticipate the different expectations? The Capgemini 2024 Report[3] has a section on the value-added services that wealthy individuals consider indispensable in choosing a wealth management firm. The services are broken down into financial and non-financial services. I would propose that the non-financial value-added services give us good insight into what the expectations for the management of care might be, including:

• Multigenerational advice. Decision-making is not consolidated with one person for care but instead takes a multigenerational approach.
• Bespoke solutions are designed to meet individual client needs.
• Concierge services are also expected in care situations.
• Lifestyle advice, including medical care coordination, personal care plans, and quality of life factors.
• View across multiple jurisdictions where the clients may travel or reside.

The First Step is Always the Caregiving Situation Assessment Model

As per the Caregiving Situation Assessment Model, resolving care disputes for wealthy families is dependent on a different context and set of circumstances. Before attempting resolution of a care dispute, consider the advantage of first completing a comprehensive assessment of the caregiving situation by an independent professional. This will then provide a clear and fact-based description of the situation. The caregiving context can be quite different for wealthy individuals, and it’s important to understand the facts and circumstances without making assumptions.

Proposing solutions in the care dispute of an individual should also consider individual and family expectations of the individual or family. Lasting solutions will require a cross-section of professionals working together to design holistic resolutions that address the family’s interest-based concerns.

In future blogs, this series will continue to discuss components of the Caregiving Situation Assessment Model.

 

[1] Image source. The Gerontologist. 2020 Fe; 60 (Supp 1): S14-S28.

[2] Definition of high-net-worth. Capgemini. “World Wealth Report 2024,” Page 11.

[3] Ibid. Cap Gemini. Page 32.