Why Care Conversations Must Include Real Estate, Taxes, and Financial Strategy
Every day across the country, families begin the difficult journey of finding care for an aging parent. The conversations usually start with the same questions:
What type of care do they need?
Is home care enough?
Should we look at assisted living or memory care?
How long will this level of care be needed?
These are all good questions—but they are incomplete.
Too often, the care needs receive attention while their financial implications are addressed last, almost as an afterthought (…and how will we pay for that?) when both issues should be part of the very first conversation!
In a recent discussion between memory care consultant Luciana Mitzkun, senior care strategist Jessica Solomon, and senior financing specialist Mark Maimon, one theme became clear:
The senior care community frequently overlooks the financial strategy behind care decisions—especially when real estate is involved.
And for many families, the home represents their ultimate and largest financial asset.
Care Conversations Often Start Too Late
Through her consulting firm Home Choices for Mom and Dad, Luciana Mitzkun works closely with families seeking information on Alzheimer’s care, often encountering people who are already overwhelmed by the emotional side of caregiving. By the time financial questions arise, the family may already be in crisis.
A common scenario looks like this:
· A family realizes their loved one needs long term memory care, and it is not possible to provide it in their existing home.
· They assume the next step is to sell the home to pay for care in a memory care facility, and the sale happens quickly.
· They use the proceeds to pay for years of increasingly expensive care, hopeful (fingers crossed) that the assets will outlast the care needs.
It is only after the home is sold that they understand the devastating tax consequences and long-term financial impact of that decision.
For families who have owned a home for decades, the sale can result in substantial capital gains taxes that could have been avoided, or reduced, with better planning. This is especially relevant in high-value markets.
As Luciana points out, “families are trying to do the right thing for their loved ones. But without attention to the financial implications of their choices, they can unintentionally create additional stress or financial loss, significantly affecting their ability to provide for care over the many years ahead with dementia.”
Memory care is time consuming, exhausting, and expensive. We also don’t know how long it will be necessary, being that every individual will develop symptoms uniquely, at their own pace. In some cases, highly specialized care is needed for well over a decade.
Families need to gather and preserve every asset they have available to support the care, for they have no way of knowing if all what they have will even be enough for the long run.
The Tax Reality Many Families Don’t Know
One of the most overlooked financial concepts in senior care planning is the step-up in cost basis.
When a property is sold after the owner passes away, heirs often receive a tax adjustment based on the home's value at the time of death. This can dramatically reduce—or possibly eliminate—capital gains taxes. But when a home is sold during the owner’s lifetime, those taxes may apply immediately.
For families who have worked hard to pay for it and have now owned their home for decades, the difference can be substantial.
In some cases, selling prematurely can result in hundreds of thousands of dollars lost to taxes, instead of generating funds that could otherwise be used to support care needs.
This is why financial professionals often advise families to explore options that preserve ownership of the home, while still accessing liquidity.
“Too many families are making permanent financial decisions during temporary emotional crises. The reality is, senior care planning is no longer just a healthcare conversation it’s a housing conversation, a tax conversation, and a financial strategy conversation. If we don’t slow families down long enough to educate them on all the options, we risk helping them spend down assets that may have protected them for years to come.”, says Mark Maimon, mortgage strategist.
The Home as a Financial Anchor
For many seniors, the home is more than just a place to live: It represents stability, history, and often the largest store of wealth they possess.
Rather than rushing to sell the property, families would benefit from considering other available options, including:
• Home equity lines of credit
• Strategic refinancing
• Rental income strategies
• Long-term care insurance coordination
• Asset planning with financial advisors
Each situation is different, but the key takeaway is simple: Selling the home should not automatically be the first step. Instead, families benefit from evaluating the full financial picture before making irreversible decisions.
Why Senior Care Professionals Must Talk About Money
One of the biggest insights from this collaboration is the recognition that senior care professionals often avoid discussing financial issues with the families they assist.
Not because they don’t care, but because they may feel it falls outside of their expertise.
Luciana describes this challenge openly: “Those of us helping families navigate care options want to do the best job possible. But without financial knowledge, we risk leaving families without the full picture they need to make informed decisions.”
This is where cross-disciplinary collaboration becomes essential.
Care advisors, placement professionals, financial planners, and real estate specialists all bring different expertise to the table. When these perspectives work together, families gain something invaluable: Clarity.
A Better Model for Care Planning
Jessica Solomon has spent over two decades working with families navigating care decisions and housing transitions.
Through her work with Next Best Home, she has increasingly focused on one mission: Helping families understand the financial reality behind care decisions before crisis forces rushed choices.
According to Jessica, “Families often learn about the cost of care through collision. By the time they understand the financial implications, they may have already made catastrophic decisions that are difficult to reverse.”
The goal for the supportive professionals should never be pushing families toward any particular financial product or strategy, but instead promoting education and awareness.
Families deserve to understand:
• The cost of care over time
• The financial implications of selling assets
• The tax consequences of major decisions
• The options available to leverage existing assets
With this knowledge, they can move forward with confidence instead of fear and uncertainty.
Collaboration Is the Future of Care Navigation
The collaboration between Luciana Mitzkun and Jessica Solomon highlights a broader shift happening within the senior care landscape.
Care decisions should be addressed as if they were purely medical or housing decisions. They are also financial decisions, real estate decisions, and often, family legacy decisions.
Helping families navigate these difficult decisions requires senior care professionals who are willing to share knowledge, ask better questions, and work together across disciplines.
Because the reality is simple: Families don’t just need help finding care. They need help protecting the resources that will pay for that care.
And that conversation should start much earlier than it currently does.
