No one knows what will happen as they age.
It’s almost impossible to predict the events that may have an impact, such as illness, disability, neurological impairments, or the need for long-term care. Impossible to predict, but not impossible to plan for. That’s why it’s important to hold age-related discussions with spouses, adult family members, trusted friends, and legal and financial advisors in advance to ensure that decisions are made in accordance with your wishes.
Experts say four areas should be addressed:
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- Housing. What are your options if your home no longer meets your needs? Surveys show that 85 percent of older adults want to “age in place,” but that’s not always possible. For example, homes with stairs may become inaccessible as an adult ages. Tubs and showers may put seniors at risk of falling. Narrow hallways and doorways may impair mobility, especially if a wheelchair becomes necessary. In addition, certain household tasks may become difficult without assistance. While homes may be modified to address these concerns, it may be more practical to move to a location without such limitations, such as a one-story home or a senior living community, where there are options for assistance as the need arises. State your preferences in writing and make sure those who may bear responsibility for your care have access to the document.
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- Health Care. It is vital that an Advance Health Care Directive be prepared to clearly define your wishes when faced with a critical illness or injury, or the end of life. Who do you want to make health care decisions about your care if you are unable? Who should have access to your medical records? Are there situations in which you do not wish to be resuscitated? What care should be provided if you lapse into a vegetative state? When should life support be removed? Do you wish to be an organ donor? In addition, you should address such issues as when residence in a skilled nursing home facility is permissible (some may defiantly oppose it) or whether hospice care is to occur at home or in a private care facility. Health care decisions are hard and discussions about end of life can become emotional. A good starting point is The Conversation Project at https://theconversationproject.org/.
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- Legal Issues. While your property is distributed to heirs upon your death, a variety of issues regarding that property may arise when you are alive. If you have a living trust, for example, property and other assets should be titled in the name of that trust. In addition, you should execute a financial power of attorney. This grants the person you name the right to handle your financial affairs when you are not able due to illness, disability, or incompetency. Your representative can pay bills, manage bank accounts and investments, collect insurance or government benefits, and conduct other financial transactions on your behalf. The power of attorney is in force only as long as you are unable to take care of your financial affairs. If you recover from a serious illness, it is no longer active. The creation of a joint account to ensure household expenses and other bills are paid may be desirable, but it is important to ensure that the intent behind the account is clearly spelled out to the joint owner. It is also necessary to regularly review and update other estate planning documents, including trusts, wills, and beneficiary designations.
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- Incapacity. Experts say one of the biggest risks of aging is dementia. It is estimated that 50 percent of the population 85 and older suffer from the disease. In addition, other illnesses and conditions may impact an older adults’ ability to make sound life choices, and remain safe and secure. While an emphasis on wellness—staying active, mental stimulation, social activities, a healthy diet, and exercise program–can minimize the cognitive impact of aging, there are no guarantees. It is important to discuss how any negative changes should be handled. For example, if dementia becomes evident, what measures are appropriate? Will a spouse act as the caregiver or should an aide be hired? Will it become necessary to seek guardianship or a declaration of incompetency? When should a memory care facility be considered? What attributes are a priority if moved to a memory care facility (a music program, gardening, etc.)?
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A certified Aging Life Care Manager (ALCM) can help guide these discussions. Formerly called Geriatric Care Managers, ALCMs are trained to assist you in creating a roadmap for the senior years. In addition, they help with navigating red tape and pinpoint resources once the need arises. Above all else, they are advocates for older adults.
Generally, ALCMs assist in the discussion of a wide range of issues related to aging, including alternative living arrangements, care resistance, caregiver burnout, coping with a new diagnosis, elderly driving, fall prevention, family conflicts, living with chronic conditions, hoarding, mental health, and social isolation. They are skilled at guiding discussion, suggesting solutions to anticipated problems, and mediating family disputes.
Although ALCMs aren’t required to be licensed, it’s best to first consider those with certification from the National Association of Social Workers, the National Academy of Certified Care Managers, or the Commission for Case Managers. They have been fully trained in issues that affect the elderly and have access to the appropriate resources.
No one knows what will happen as they age, but that doesn’t mean you don’t need to be prepared. Making decisions outside of a stressful and emotional environment ensures that the focus will be on the issue, rather than the need to make a hasty decision to resolve the issue. To ensure your life as an older adult proceeds as desired, plan ahead.
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