Six months ago your father was driving himself to the diner for breakfast every morning. Today he is on a rehab floor after a stroke, and the discharge planner is asking where he will go next. You have forty-eight hours to answer. You have never hired an elder law attorney or a care manager. You have no idea what your father’s finances look like. You are starting from zero.
Families who do well at this moment almost never do it alone. They have a team. Small, usually three to six people, each with a specific job, working together. Building the team takes some effort, but once it exists the decisions get easier and the panic goes down.
This is a guide to who belongs on that team, in what order to add them, and how to pay for them.
The principle: specialists, not generalists
Caring for an aging parent involves medicine, law, finance, logistics, and emotion. No single professional is trained in all of these. A good primary care doctor is not a lawyer. A good lawyer is not a social worker. A good financial advisor is not a move manager. Trying to make any one of them do all the jobs leads to mediocre work at best and disasters at worst.
The better approach is to assemble specialists who communicate with each other and with you. Each one covers their own lane, and the handoffs between them are where the family (or a care manager acting for the family) does the coordinating.
Here is what the team usually looks like.
The core team
These are the roles most families need, in roughly the order to add them.
1. Primary care physician, ideally a geriatrician
Everything else follows from good medical care. A geriatrician is a physician with additional training in the care of older adults. They know how drugs interact differently in older bodies. They understand the distinction between normal aging and disease. They take time with patients who move slowly and talk slowly.
If your parent’s current doctor is a family practice physician who has known them for twenty years and listens carefully, that is often good enough. If the current doctor is rushed, dismissive, or still prescribing medications that make an eighty-year-old dizzy, it is time to change. The American Geriatrics Society offers a find-a-doctor tool and publishes guides on what to look for in a geriatrician.
Cost: Medicare covers primary care visits. Specialists are also covered.
2. Elder law attorney
You want this person before the crisis, not during it. The job at this stage is narrow and essential. Draft a durable power of attorney for finances. Draft a healthcare power of attorney and advance directive. Review or create a will. If there are significant assets, a home, or a surviving spouse, review the estate plan.
You can go deeper later if Medicaid planning becomes necessary. But even if it does not, every family needs the basic documents in place before the ambulance arrives. Our comparison of elder law attorneys and Medicaid planners covers the credentialing question in detail. For now, find a NAELA member, preferably one with CELA certification, in your parent’s state.
Cost: $500 to $1,500 for the basic document package. $5,000 to $12,000 if full Medicaid planning becomes necessary later.
3. Geriatric care manager
Not every family needs one. If you live next door to your parent and everything is stable, you may not. But as soon as distance, complexity, dementia, or family conflict enters the picture, a care manager changes everything. They do the clinical assessment, write the care plan, coordinate with the doctor, hire and supervise aides, and attend the hospital meetings you cannot fly to. Our full geriatric care manager guide covers the role in depth.
Cost: $100 to $250 per hour, typically with a $400 to $800 initial assessment.
The extended team
These roles come in as the situation requires.
Financial advisor or planner
Care is expensive. Paying for it for years while preserving anything for a surviving spouse requires a plan. A good financial advisor can project how long the money lasts under different scenarios, recommend the right mix of income sources, and work with the attorney on tax-efficient strategies.
You want a fiduciary, meaning someone legally required to put your interest first. Fee-only fiduciaries, certified through organizations like NAPFA (National Association of Personal Financial Advisors) or holding the CFP credential, are the safer choice. Avoid advisors whose income depends on selling annuities or life insurance.
Cost: Varies. Fee-only planners often charge $2,500 to $7,500 for a one-time plan, or 0.5 to 1.0 percent of assets annually for ongoing management.
Medicaid planner (or more attorney time)
When the money runs out, or threatens to, Medicaid becomes the only option for most families. Our guide on when money runs out covers the decision. For most situations involving a home, a spouse, or prior transfers, this work belongs with the elder law attorney already on the team. In simple cases, a non-attorney planner or free assistance from the State Health Insurance Assistance Program can suffice.
Cost: Already budgeted as part of the attorney’s work, or free through SHIP.
Senior move manager
When the move is scheduled, add this person. They do the downsizing, the floor planning, the moving company supervision, and the setup at the new home. Full details in our senior move manager guide.
Cost: $2,500 to $10,000 flat fee, or $50 to $125 per hour.
Home care agency
Before and sometimes during a move to residential care, a home care agency provides aides for personal care, companionship, meal prep, and supervision. The Home Care Association of America publishes standards for member agencies. Ask about caregiver turnover, training, background checks, and whether the agency or the family is the employer of record.
Cost: $25 to $45 per hour in most markets. Medicare does not pay for this; Medicaid HCBS waivers sometimes do.
Hospice or palliative care team
When a serious illness is in the picture, palliative care (which is comfort-focused care alongside any curative treatment) can be added early. Hospice comes in when curative treatment stops and the prognosis is six months or less. Both are covered by Medicare. The National Hospice and Palliative Care Organization maintains a provider directory and publishes family resources. Adding this team earlier, not later, usually improves quality of life.
Cost: Medicare covers hospice in full for those who qualify. Palliative care is covered as a medical service.
Adult day care program
For families providing care at home but needing weekday relief, an adult day care program can extend the window before residential care is needed. It is often underused because families do not know it exists.
Cost: $70 to $120 per day. Sometimes covered by Medicaid HCBS waivers.
The role of the family itself
The team is not a substitute for the family. It is a support system that lets the family make better decisions with less suffering. Someone in the family still has to be the hub. That person (usually one sibling, sometimes with a co-lead) holds the medical records, attends the key meetings, signs as power of attorney, and makes the calls when consensus is needed.
If no one in the family can play that role, a geriatric care manager can, but the family still has to make the final decisions. No professional can tell you whether your mother should move into residential care or stay at home with aides. They can lay out the options and the consequences. The choice belongs to the family.
This is also the moment to have the harder conversations with siblings. Who has power of attorney? Who is the backup? Who will host Thanksgiving when Dad is in a care home? These questions are easier to answer now than at 11 p.m. in a hospital hallway.
In what order to add people
You do not need everyone at once. A rough order that works for most families:
First, make sure the primary care doctor is the right one. This takes zero additional cost.
Second, get the legal documents in place. Power of attorney, healthcare proxy, advance directive, will. One visit to an elder law attorney.
Third, if distance or complexity requires it, add a geriatric care manager. Start with an assessment and decide from there.
Fourth, if the money question is uncertain, add a financial advisor for a single planning engagement.
Fifth, when a move becomes likely, add the move manager.
Everything else gets added as needed.
How to afford it
Some of the team is free or covered by insurance. Primary care is covered by Medicare. Hospice is covered by Medicare. Free counseling is available through SHIP and your local area agency on aging, which you can find through the Eldercare Locator. The National Council on Aging BenefitsCheckUp can identify programs your parent qualifies for.
The paid professionals (attorney, care manager, move manager, financial advisor) are out of pocket for most families. The arithmetic usually works in their favor. One legal document that prevents a guardianship proceeding saves $10,000 or more. One care manager visit that catches a medication error prevents a hospitalization. One good Medicaid plan preserves assets that fund years of care. Families who skip the professionals often pay far more for the mistakes.
Your next step
This week, do two things. Call your parent’s primary care doctor and request a thirty-minute visit to review the care plan, not a fifteen-minute refill appointment. And schedule one consultation with a NAELA-member elder law attorney in your parent’s state to put the basic legal documents in place if they are not already. Those two calls are the foundation. Everything else is built on top.