When the problem has been acknowledged—or ideally long before that point—families need to sit down and have a heart-to-heart conversation. Who is going to take care of what responsibilities? Who is going to take over the finances? Where are the valuables and what are the bank passwords?

Spickler says an elderly mother of one of her clients taped a valuable ring to a sink pipe so she wouldn’t lose it and then forgot about it. Luckily, the children found it when they cleaned out the house, but it easily could have been lost. All valuables should be inventoried while the parent still remembers where everything is, she says.

The caregiving landscape is going to continue to evolve with more baby boomers not only taking care of older parents but also taking care of their adult children who have moved back home or who have student debts to pay off. Merrill Lynch did an extensive study of this sandwich generation and the unique burdens many members face. The results were released in November in a Bank of America/Merrill Lynch and Age Wave caregiver study that included 2,010 caregivers.

“As we look to the future, we see four forces—longevity, demography, sociology and technology—converging to dramatically transform the caregiving landscape,” Merrill Lynch says. “Caregiving is not without sacrifice. Many caregivers report significant costs in terms of their finances, their health, their time and leisure, their work and their other relationships.”

However, caregiving is not all negative. “Caregivers often feel fulfilled by caregiving. Ninety-one percent say they feel grateful for the opportunity to help someone they care about. Seventy-seven percent of caregivers say they would gladly do it again,” the study says.

However, taking care of a loved one can create financial problems for the caregiver, Merrill Lynch says. Two-thirds of caregivers feel they could benefit from outside financial advice, yet only 20% have sought it out.

Fifty-seven percent of the study participants say they find navigating health insurance expenses to be the top challenge of financial caregiving, followed by 48% who say finding enough time to ensure finances are in order is a problem.

Caregiving is hard, and the details are often not part of an open conversation, Merrill Lynch says. There are 40 million family members and friends providing some kind of care for an elderly person in the United States, the Merrill Lynch/Age Wave study says, at an approximate cost of $190 billion per year.

“This is a really complicated issue,” says Maddy Dychtwald, co-founder of Age Wave, a think tank based in Emeryville, Calif., that concentrates on aging issues. “People are living longer, but that doesn’t mean they are healthy for that whole time. This brings up touchy and emotional issues.”

The problem is going to get worse. In 1994, 2% of people between age 65 and 74 had a living father, and 3% had a living mother, Dychtwald says. By 2013, the percentage with a living father had grown to only 4%, but the number with a living mother soared to 14%. The numbers were not broken down the same way this year, but in 2018, 16% of this age group had at least one living parent, she said.