Creating a Care Journey Plan

This Planning Stuff is Really Important

Creating a Care Journey Plan (CJP) is “the thing” that makes a Bridge of Life Plan work. For those of you who may have missed our previous discussions on Bridge of Life Planning, let me digress. In simple terms, a Bridge of Life Plan is an estate plan comprised of necessary Legal Planning Documents. The aforementioned documents are prepared after meeting with an Elder Law or Estate Planning Attorney.  You will find a description of the legal documents included in a Bridge of Life Plan in our “Estate Planning for Momma – A Simple Way to Avoid a Cruising for a Bruising” blog post.

However, in addition to a well drafted estate plan, a Bridge of Life Plan has two critical additional pillars:

The Care Journey Plan

The first pillar of a Bridge of Life Plan is the “preferences” portion called your “Care Journey Plan”. In this portion, you have the opportunity to detail your preferences as to what you want to happen in the event that you become incapacitated before you die. Sometimes the family is comfortable simply stating these preferences or wishes in a document, trusting that their family or trusted agents will make them happen. However, sometimes these “preferences have teeth”. In these cases, they are incorporated into the estate plan itself with requirements that they “must be done”.

In cases where you don’t think that your family would honor your long term care preferences, a bank trust department can be named as trustee of a trust with the duty of carrying out your long term care preferences. Since a trust department is a neutral third party, they “don’t have a dog in the hunt”. Meaning  they are not encumbered with the same emotional baggage that family members often have. By law, they are required to carry out the terms of your trust. State agencies regularly audit and monitor these departments to ensure that they “toe-the-line” in their trust administration work.

Advanced planning allows you to clearly establish your own health care preferences.
Download The Help Me Help Momma Stay at Home Care Journey Plan Outline today!

The Money Part

The second pillar of a Bridge of Life Plan is to review your Long Term Care payment options (usually private pay or government assistance). This part makes a lot of sense if you think about it, but it is commonly overlooked. Without a plan in place, your preferred methods to pay for your Long Term care needs may not happen! Please review our prior blog post, “This Health Care Stuff Costs Money”, for a complete description including private pay and government assistance options to pay for long term care.

This Planning Stuff is Really Important

The subtitle “This Planning Stuff is Really Important” is the truth. Sadly, most people do no planning at all. Oftentimes, if they do anything, usually it’s just a will. A more comprehensive plan, such as a Bridge of Life Plan, is important because it greatly increase the probability of getting the type of care that you want in your declining years. Failure to plan means that if you become incapacitated to the extent that you can’t make your own decisions (ex. Alzheimer’s) you agree to the “whatever” strategy. By not planning, you will have forfeited the right to choose. Your failure to plan is an “agreement” that “whatever” happens to you and with your care is O.K. by you.

I can only assume this is not what you want at all. Otherwise, you would not be reading this blog post. You DO care what kind of personal assistance that you will receive in your “golden” years.  You choose NOT to simply “roll over and play dead” and forfeit the right to choose. You want the be the decider of your fate and not leave it to chance, the Courts or for someone else to decide. If I’m describing you, then you are in the right place!

There are 3 Primary “Legs” of a Care Journey Plan

The purpose of a Care Journey Plan is to ensure a good quality of life for YOU, in your own home, as long as possible. If it becomes necessary for you to transition from your home to a facility, it will help those you have chosen if you have clearly indicated the following preferences in writing, in a document we refer to as the Care Journey Plan.

  1. What type of care do you want (if you become incapacitated)?
  2. Where do you want to live?
  3. Who do you want to help you in the future?

Specifically, the description of the “Legs” of the Care Journey Plan are as follows:

1) What type of care do you want if you become incapacitated before you die?

We like to think we will live at home in perfect health with loved ones until the day we die. However, neither of these things may turn out to be true. Either our physical or cognitive (or both) health may fail. Medical care in our home or at some facility may be required for a period of time before we die. In your Care Journey Plan, it is important to state your preferences. Would prefer to receive home care supplemented by medical and/or non-medical care providers? Or rather, would you prefer to receive facility care, where you can receive therapeutic or nursing assistance 24/7 if necessary.

2) Where do you want to live?

There are two parts of the “where do you want to live” question.

  1. The first part has to do with geography. Would you prefer to live in your hometown? Conversely, would you be willing to move out of state to live closer to one of your children? Moreover, would an area with better medical facilities than where you live now be the best option?
  2. The second part of the “where do you want to live” question has to do with whether you continue to live at home and receive care there; or whether you live in a facility, such as
    • an independent living facility with non-medical Home Care coming in
    • an assisted living facility
    • a Skilled Care Nursing Facility

3) Who would you like to provide your care in the event you are unable to care for yourself?

If your answer is a particular family member, you need to hold a family meeting where you can discuss your preferences with them. At the meeting, they can share their ability or willingness to personally provide the future care that you may need. If your family is unable or unwilling to provide all care needed, do you have the finances or willingness to bring in outside medical or non-medical “helpers”?


We cannot stress how important advanced planning really is. Click below to learn even more about crafting a Care Journey Plan.

Your Care Journey Plan is a Roadmap

The Care Journey Plan portion of your Bridge of Life Plan is not a legal document in the same sense as your Will, Trust, Power of Attorney or other estate planning documents. Rather, it is a roadmap which you have prepared in advance of your death or incapacity. It is a roadmap you are making available for your trusted agents to follow in regard your future care.

The agents you appoint to implement your Care Journey Plan have the appointed duty to carry out your wishes stated. Depending on the Legal Documents that your attorney puts into place, your agent may have a legal duty to act on your behalf, or may only have a moral or ethical duty to act for you. Either way, it’s important to choose someone you trust to carry your your wishes. Your life and day-to-day well-being is literally in the hands of the person you have chosen.

Once your Care Journey Plan has been completed, you should meet with a Financial Advisor and Elder Law Attorney. It is critical to structure your resources to provide enough income to finance the quality of life that you want. The appropriate legal documents will ensure that the proper people will have the legal authority to make healthcare and financial decisions for you. in the event that you no longer can. In some instances, you will not select an individual, but an institution to implement your plan. Institutions, such as the trust department of a bank,  are less personal. However, because of much stricter oversight, institutions must adhere closely to the directives contained within your estate plan.

Troubleshooting your Plan in Advance

The Bridge of Life Plan is like a three legged stool. If one leg is missing, the stool will have to be propped up (extra care provided by family members, out of love) or it will fail. Failure in care planning can result in unwanted institutionalization in a nursing home and depletion of resources.

  • You can’t be assured of a good quality of life unless your Caregiver knows what you want. Commit your plan to writing and go over your plans with your agent and your family at a family meeting. Read our Family Meetings for Momma blog post for more information.
  • When you run out of money, you run out of options. The key is to not run out of money. Plan in advance. If you discover that you won’t have sufficient funds for your desired care plan, then look at all options available. See “This Health Care Stuff Costs Money”.
  • If you haven’t given authority to the healthcare and financial decision makers of your choice, via the appropriate legal documents, to act on your behalf, they may not be able to act in a timely manner, if at all, without a Court’s intervention. The key is to act soon while you can. Doing this will greatly increase the probability that your decisions will be implemented. and greatly decrease the probability of forcing your children to go to Probate Court to secure the authorization to act on your behalf.

It’s Never too Late (or Early) to Plan Your Care Journey

As life goes, we grow up, leave the security of our parents’ home, journey into the world to raise our own family and pursue our career. We enjoy that freedom and independence as long as possible. There may come a time when you may need assistance. Your needs may be a result of the passing years or perhaps declining health. Either way, the need for assistance may arise. If so, who is your first preference to act on your behalf? Will your family members or friends provide assistance to help you maintain your quality of life and independence? The goal of this type of planning is to answer some of these questions way before the actions become necessary. The only way to increase the odds of your preferences being implemented is by taking proactive actions yourself.

If you are one of the adult children reading this and your parent has already declined physically or cognitively, just know that much good can be done by planning. Even last minute planning can be very successful! If you are a Senior looking to set up your Bridge of Life Plan, or if you are one of the Family Caregiver children acting in good faith in an attempt to assist a declining parent, the key is to meet with an Elder Law Attorney or life care planner in your area as soon as possible.

For step-by step guide for starting your Bridge of Life Plan, visit and sign up. Inside this subscription site, you will find a course on Bridge of Life Planning, along with much helpful information.

In the meantime, if you haven’t already done so, download The Help Me Help Momma Stay at Home Care Journey Plan Outline. Best wishes as you work to establish your Bridge of Life Plan.

About the Author

Doug & his wife Cindy have not only helped hundreds of families with their estate planning and elder law needs over the years, but have personal experience as caregivers and advocates for their Loved Ones as well.

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