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My wife and I have no children. We have some nephews and nieces in other states who may or may not be willing and able to see to our elder care. Barring global meltdown etc we should have sufficient funds for our elder care. We have up to date wills and medical directives. Can we set up a trust with an administrator to follow and pay for our directives for elder care facilities, medical directives, end of life care and cremation/memorial plans?

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Please don't count on out of state relatives to see to your care. See an Estate Lawyer and develop a plan or establish a Trust. Personally, I would rather have an attorney be the Executor, because it is no simple task.
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I agree with Pam above, hire an Elder Law attorney to take care and manage these items. If there is one hospital in your area that you have frequent, they usually would want a copy of both of your medical directives. Also see if your primary doctor would want a copy, too.

I wouldn't have any nieces or nephews involved unless they have been extremely close to your both, like on your doorstep weekly close, and their own parents both have passed on. Otherwise, they may in the future be already caring for their own parent(s).
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You can plan and pay for your funerals. That helps a lot. Also, I am 61 and we have gotten rid of 2 other properties. And I am getting rid of "stuff." I am going through it and hauling it out of here. No one will want your stuff.
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