Author Topic: End of life plans and how much do you value your"golden" years?  (Read 2284 times)

Adam Zapple

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For those in the US, an important factor in retirement planning is end of life care.  A perfectly happy, healthy and frugal retiree one day can get sick and be "forced" into a $10k/month lifestyle.  I wonder how others are planning for this.  For those who have cared for aging parents, did sick parents have a strong will to live despite illness/pain?  What happened when the money ran out? 

I think my plan is to dig a 6-ft deep, ADA compliant hole in the woods that I will wheel, hobble or crawl into when the day comes that I will be completely reliant on others to complete day to day tasks.
« Last Edit: June 03, 2019, 08:33:13 AM by Adam Zapple »

dcheesi

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Re: End of life plans and how much do you value your"golden" years?
« Reply #1 on: June 03, 2019, 08:30:19 AM »
As others have commented in similar threads before: It's easy to say you'll take the quick way out when you're planning for the distant future, but it's a whole other thing when it's an immediate reality. Not to mention the chances that you might not be mentally sound enough to put your "plan" into action when the time comes...

hops

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Re: End of life plans and how much do you value your"golden" years?
« Reply #2 on: June 03, 2019, 08:42:18 AM »
We're planning for it by saving a lot of money that we hope will ultimately fund scholarships instead. We're also observing what happens to friends and family and trying to learn from their experiences.

Our feeling so far is if you plan for the future, even if you run out of money there are still ways to receive quality care. The people who've ended up in the situations we'd most like to avoid generally lived life pretending they'd never be old and infirm. They were convinced they'd live to 95 while enjoying good health and die in their sleep, like their mom or dad. Or they'd kill themselves once they started to lose their minds. I'm uncomfortable assuming I'll be consistently aware of, or unduly troubled by, my own senility.
« Last Edit: June 03, 2019, 08:47:41 AM by hops »

BTDretire

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Re: End of life plans and how much do you value your"golden" years?
« Reply #3 on: June 03, 2019, 09:03:40 AM »
As others have commented in similar threads before: It's easy to say you'll take the quick way out when you're planning for the distant future, but it's a whole other thing when it's an immediate reality. Not to mention the chances that you might not be mentally sound enough to put your "plan" into action when the time comes...

  My mother had a DNR, when she went into the hospital with severe breathing problems. When the staff ask, "you have a DNR, do you want us to install a breathing tube?" She said yes, I'm not sure if she just didn't want to die by suffocation, or if she wanted the extra 6 months of life she got.

wenchsenior

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Re: End of life plans and how much do you value your"golden" years?
« Reply #4 on: June 03, 2019, 09:27:16 AM »
For those in the US, an important factor in retirement planning is end of life care.  A perfectly happy, healthy and frugal retiree one day can get sick and be "forced" into a $10k/month lifestyle.  I wonder how others are planning for this.  For those who have cared for aging parents, did sick parents have a strong will to live despite illness/pain?  What happened when the money ran out? 

I think my plan is to dig a 6-ft deep, ADA compliant hole in the woods that I will wheel, hobble or crawl into when the day comes that I will be completely reliant on others to complete day to day tasks.

The active will to live is a different thing from the active desire to avoid death.  There are certainly some individuals who have active will to die when their quality of life deteriorates, but they are not the norm, and I suspect most people who tell themselves they will 'end it' and not waste away with age or illness are fooling themselves.  If most people were actually capable of bringing themselves to kill themselves when they felt their quality of life was terrible, then we wouldn't have people who continue on after terrible accidents that make them paraplegic; or survive tragedies that kill their families/kids/friends; or leave them struggling with incurable chronic, debilitating illness; or leave them mostly bedridden in a nursing home.  But in reality, most of those people DO continue to live. In fact, research even shows their baseline 'happiness level' often remains pretty close to what it had been prior to their current situation (barring intense active pain and suffering) once the shock of the change wears off. 

In reality, the will to keep living is by evolutionary necessity one of the strongest characteristics of life, and logic and long term consequences be damned. And aging is usually a more gradual process of 'loss' that starts in middle age, when your family and friends begin to die and many people begin to deal with the first age-related health conditions.  And that just increases, gradually over time, and you acclimate to each change, until you are one of millions, spending your last few years in situations that would have horrified your youthful self.
« Last Edit: June 03, 2019, 09:29:03 AM by wenchsenior »

wenchsenior

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Re: End of life plans and how much do you value your"golden" years?
« Reply #5 on: June 03, 2019, 09:38:08 AM »
As to cost. What happened in my family is that the more affluent side had a grandfather who died young in a car accident, and a grandmother who paid for care at home until the last couple of months. She had a bunch of kids very close by, who were able to help out (one actually lived next door to her) and she still burned through a huge part of her substantial estate.  The less affluent side of the family: grandfather was in a Medicaid paid nursing home for 3 years (lien was put against the house, which my grandmother was still living in).  Then my grandmother, after resisting and resisting going to the home (thus forcing the lives of 2 of her 3 daughters to revolve around taking care of her for 5 years), finally had to go into the home b/c she was a danger to herself, where she then lingered in miserable quality of life and essentially blind for more than 5 years.  But despite her misery, she still fought for every breath to the end.

It was unbelievably miserable for my grandmother, and it messed up her daughters psychologically as well as driving wedges into the sibling relationships.

There's no easy answer here:  If we're lucky, we get very short illnesses and then die. If not, then a tiny portion of us will be willing and able to carry out a 'plan' to end it.  The vast majority of the rest will run out of money, be helpless, and be supported by the state.

We plan for this by working longer and saving an extra 250K (for me, who doesn't qualify for LTC insurance) and buying LTC insurance for my husband.

Dogastrophe

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Re: End of life plans and how much do you value your"golden" years?
« Reply #6 on: June 03, 2019, 10:07:39 AM »
In the past 5 years I watched my elderly grandfather burn himself out being the primary caregiver to my grandmother. 

Then I watched my father burn himself out trying to look after them (while in poor health himself) for several years before they ultimately ended up in separate nursing homes (and have since passed).

For the last two years my mother has been primary caregiver to my father and has burned herself out (she is too stubborn to ask for or accept help).  My siblings and I have been after her to sell house and move into an accessible apartment so she didn't have to navigate stairs, didn't have to worry about upkeep, etc.  She has been been adamant that she can do everything herself.  Two weeks ago she had a massive seizure caused by an undiagnosed brain tumour - she is now in hospital (a few days post-surgery - prognosis unclear 12-15 mos); he is in a different hospital as no one can look after him.  He is going to be forced into a nursing home; she is going to need some form of home care - not sure what's going to happen when we (and the doctors) tell them this.  Will be a full on shit-show.

All this has prompted my wife and I to start discussing what to do when one (or both) of us get to the stage where we need full time care.  I certainly don't want her to sacrifice her health and well-being to look after me 24/7.
« Last Edit: June 08, 2019, 03:07:59 PM by Dogastrophe »

Cassie

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Re: End of life plans and how much do you value your"golden" years?
« Reply #7 on: June 03, 2019, 11:36:23 AM »
I helped my mom care for my dad for 14 years.  My mom stayed home until a week before she died but required the 3 of us to stay with her for a few weeks at a time when she fought cancer repeat. We are 75 and slowly declining.  It sucks.  Of course we are hoping to avoid a nursing home.

SotI

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Re: End of life plans and how much do you value your"golden" years?
« Reply #8 on: June 03, 2019, 02:21:08 PM »
Tough topic.
Seems to me that dying is not that easy. My elderly mother has been told already 2-3 years ago that she only has a couple of months to live (expected kidney and heart failure). She's been saying she can't wait to die (especially since she broke her hip last year).
Her health is deteriorating to the extent she will have to move to a nursing home next month. Still, she whines about being sick to be alive, but still is hanging on.

When her money is gone (probably within a year of moving into the nursing home), my siblings and I will have to fund it, somehow.

I am planing to take a voluntary exit. Just trying to figure out my exit criteria. But it will involve some advance planning. And ofc, "the best laid plans ..." etc.

SachaFiscal

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Re: End of life plans and how much do you value your"golden" years?
« Reply #9 on: June 03, 2019, 04:31:30 PM »
I lost both my parents to terminal illnesses.  My father was somewhat lucky as he didn't have to suffer for too long before he passed away.  My mother had a few months of suffering after being diagnosed.  But in the last few weeks she did suffer greatly especially the last few days. I have an uncle who was diagnosed with dementia a few years ago and is in the late stages now.  I've spent some time with him and the disease terrifies me.  All these experiences have made me wake up in the middle of the night in a panic and furiously research ways to end my life without such suffering if end up with dementia, cancer, stroke, etc.

I'm going to fill out an advanced directive which states I don't want to be kept alive by artificial means in a variety of circumstances including locked-in syndrome (had a relative who went through that). Basically I don't want to be a vegetable.  I don't want to be force fed and kept alive if it is not likely I will recover.

I live in a state which offers assisted suicide for terminally ill patients who have been diagnosed with less than 6 months to live.  If I get a terminal diagnosis of less than 6 months, I will take this option.  Basically you have to see a doctor twice 15 days apart and state that you want the assisted suicide option.  You also need to submit a written request.  I'll get the prescription and the meds, then hang on as long as I can until I'm in too much pain or if there is a chance I will lose the ability to administer the medication to myself (could be a bit tricky).

If I get dementia or some other disease that impairs me mentally so that I can't function and don't recognize the people around me I will try to get diagnosed in the early stages and go to the Dignitas clinic in Switzerland to complete the assisted suicide process.  From what I've read, it takes about 4 months to go through the process (getting approved, getting an appointment) and costs about $10K.  This will be the hardest to do, I think, because it is undetermined how long of a normal life I will have before the disease progresses too far.  I plan on getting the preliminary steps done, then postponing the actual act until I feel like I will lose the ability to do it myself (then it will be too late).

If I get a stroke and cannot communicate, that will be the worst.  I won't be able to do the assisted suicide.  In this case I will try to do VSED (voluntary stopping eating and drinking). I heard that this can take anywhere from a week to 3 weeks to do. I have fasted before for several days so hopefully I will be able to do it.

I plan on writing out my wishes in detail and giving copies to my husband and family. My husband is willing to respect my wishes but if he changes his mind because he just can't bring himself to do it, my other family members will be there to oversee him and convince him.

My husband probably won't take any of these options if he is in these situations because of his religion.  I will take care of him as best I can at home with the help of caregivers in that case. I won't ever put him in a nursing home.  We live in a HCOL area so we can sell our house and move to a LCOL area in order to pay for extended care if he needs it for several years.  There is a lot we can cut out of our annual spending so I'm not worried about being able to support him.




Cassie

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Re: End of life plans and how much do you value your"golden" years?
« Reply #10 on: June 03, 2019, 05:30:17 PM »
Sot, make sure your mom goes into a facility that will take Medicaid when the money runs out.

NV Teacher

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Re: End of life plans and how much do you value your"golden" years?
« Reply #11 on: June 03, 2019, 06:46:57 PM »
My mother died three months ago after about six months of living in an assisted living facility.  It was hell to watch.  After her last fall and hospitalization the assisted living facility ($5000/month) wanted to put her out and have her moved to a skilled nursing care facility ($10,000/month for a shared room).  We were able to keep her there with help from Hospice and family members being there 4-6 hours every day.  Luckily she had saved a good chunk of money from her school lunch lady job and had money for her care.  Iím following her example.  Building the biggest nest egg I can as well as having a long term care policy.  And every day I pray that when the time comes I can die quickly and relatively painlessly.

Pigeon

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Re: End of life plans and how much do you value your"golden" years?
« Reply #12 on: June 07, 2019, 06:07:38 AM »
I've watched many elderly relatives die over the past several years.

It's very easy to say you'll just end it instead of ending up in a nursing home/assisted living.  It doesn't generally play out the way people think it will.  For many elderly, dementia in one form or another sets in.  That changes everything.  Even if you have a terminal disease in a medically assisted suicide state, you typically have to be in sound mind and have less than X months to live for that to be applicable.

You may be perfectly fine and have a sudden traumatic event that lands you in a nursing home before you have any opportunity to go visit that hole you'd dug in the woods.  My father, who was active, pretty alert, completely enjoying life and playing golf a couple of times a week at 91 tripped and shattered his shoulder.  He died a couple horrible years later in a nursing home with terrible dementia, never  having gone home after the fall.  Something very similar happened to my FIL, only his fall broke his back.

My biggest fear isn't dying young, it's dying really old.

mozar

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Re: End of life plans and how much do you value your"golden" years?
« Reply #13 on: June 08, 2019, 12:01:38 PM »
Falling is a really big deal. I've already talked to my parents about falling techniques and some places offer falling classes.
My aunt in law's mother fell in her basement and luckily one of her daughters found her after she had been laying there for 12 hours.
I've done a lot of research on suicide and I don't believe any of you are going to do it. All animals have self preservation instincts (such as jumping back when you touch something hot) . It's very difficult to override them.
Based on the research, people who commit suicide all have that in common.
Also it may seem terrible from the outside for a person suffering from dementia but to them it might not be so bad.

What I've seen in elderly people that I know is that they are perfectly sound of mind but refuse to take action until it's an emergency and put their children a position where they have to be involved but live far away. It's control by inaction. My mothers mother kept falling but refused to use a cane, and refused to get better in physical therapy.
My mother felt that she had to take a 3 hour flight to see her once a month for the last 2 years. Granma kept missing her bill payments so her eldest son had to force her to give him her account information so he could pay the bills.
I secretly collected all of her investment statements because she refused to tell anyone how much money she had and where it was invested. When she found out she was so mad. I think she expected her late husband to come back from the dead and take care of it.

I think this will fall on deaf ears but how about instead of griping about nursing care,  you all advocate for a better system? Nursing/hospice care doesn't have to be terrible, that's a choice we make as a society. Most of us are going to end up there anyway.

dmc

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Re: End of life plans and how much do you value your"golden" years?
« Reply #14 on: June 08, 2019, 12:15:01 PM »
We put my dad into a assisted living home a year ago.  Itís  pretty nice, but cost a little over $50,000 a year in SE Missouri.  He is 83 and has dementia.  I figure he can stay there till he is 95, but if he gets worse, and needs the memory center care, at $8,000 a month we will have to get him into the VA home.

For my wife and I we can afford assisted living and have enough for some pretty good care.  I hope the kids put us somewhere nice and donít start worrying about their inheritance dwindling away.

Cassie

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Re: End of life plans and how much do you value your"golden" years?
« Reply #15 on: June 08, 2019, 12:46:39 PM »
The people I have known with dementia are miserable.  It can be hard to get into a VA home unless you have a pretty high rating for a service connected disability.

E_Monkey

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Re: End of life plans and how much do you value your"golden" years?
« Reply #16 on: June 09, 2019, 10:52:40 AM »
One of the most important things I've noticed is that it's important to plan to "MOVE TO" accessible living with services once you reach 70. When I say "MOVE TO" I mean viewing the move as not moving away from a home that one loves, but moving TO a new home with exciting possibilities--like, say, a pool you don't have to maintain yourself.

The older people around me have either lost interest in or become unable to perform basic functions of living alone such as cleaning and cooking as they aged.

  • Rather than have an older relative repeatedly checked into a convalescent home for malnutrition, it would have been simpler to have her living in an apartment complex with a cafeteria meals were served.
  • Rather than have the older neighbor across the street living in a house with extensive water damage on the top floor they were unaware of because they couldn't get upstairs, it would have been easier to have them living in an apartment with all roof maintenance taken care of by the management company.
  • Rather than have another older neighbor not have a working phone because the phone company had "some nerve to charge $12.99 a month when I rarely use the phone!" it would have been simpler to have them living in an a utilities-included-in-rent complex.

Yes, it's thousands of dollars A MONTH for these types of living situations. And not all assisted living is terrific. BUT, I don't see enough realistic planning for realistic living situations among Mustachians for the ages between ages 80-100+
« Last Edit: June 09, 2019, 10:56:28 AM by E_Monkey »

Linea_Norway

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Re: End of life plans and how much do you value your"golden" years?
« Reply #17 on: June 09, 2019, 11:03:17 AM »
My DH's grandfather lived in a country where euthenasia is legal. He was always telling ut that he would take "the pill" if he would ever get into an elderly home. Later, when living there, ge wiuld take "the pill" if he would ever end up in a wheel chair. Eventually he used a wherl chair and died much later of natural old age. Obviously the will to live can be bigger than anticipated beforehand.

Linea_Norway

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Re: End of life plans and how much do you value your"golden" years?
« Reply #18 on: June 09, 2019, 11:09:51 AM »
My parents in law retired early. MIL ended up with dementia and needed to be living in a private home for dement people. This cost a lot of money, about hotel prices per night. DH wasn't looking forward to this economic situation lasting for many years. MIL had written in her will ages age that she didn't want to receive life saving treatment when dement. So the home knew this. FIL found out that if they officially lived in seperate places, their old age money (sort of SS), would be higher for singles. This helped economically. She still had to live there for 1,5 year. FIL spent a whole lot of money on het, like buying her new clothes twice a year. Just to give her a hint of good life. He is not fully mustachian. From what we have understood, there is still a large stash left, but it has to last FIL's life.

jodelino

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Re: End of life plans and how much do you value your"golden" years?
« Reply #19 on: June 09, 2019, 01:23:11 PM »
Our parents (on both sides) saved well and planned well, with various combinations of LTC insurance, advanced directives, and early entry into retirement communities. That didn't spare them illness, pain, fear, and dependence towards the end, which, fortunately for all of them, was not all that long. Nor did it spare us the challenges of providing and overseeing their care, or--in one case--the anguish of enforcing an advanced directive when we felt that its terms had been met, and it was time to honor the parent's long-ago-stated wishes. But they were a good model for us, and, with our care of them, we hope that we provided a good model for our children.

We are preparing with LTC insurance, advanced directives, savings, and good communication with our lawyer, doctors, children, and each other about our wishes. We know that not everyone is granted a swift and clear-headed demise and we try to be realistic and forward-thinking.
« Last Edit: June 09, 2019, 01:51:25 PM by jodelino »

Cassie

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Re: End of life plans and how much do you value your"golden" years?
« Reply #20 on: June 09, 2019, 01:30:25 PM »
Emonkey,  people are not that old at 70.  My mom lived alone until 89 and died a week later. My 94 years old aunt lives alone in a apartment. At 90 she quit cooking and eats lean cuisines. She now has a cleaner.  I am 65 and yesterday threw a big party for 13 people with a home cooked meal.

marion10

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Re: End of life plans and how much do you value your"golden" years?
« Reply #21 on: June 09, 2019, 02:17:28 PM »
We have moved into a two bedroom with den condo in an elevator building in a walkable neighborhood. We pay a lot of taxes - but there are good social services. We have LTC care insurance, though I hope I don't need it.

Malkynn

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Re: End of life plans and how much do you value your"golden" years?
« Reply #22 on: June 10, 2019, 05:48:50 AM »
Emonkey,  people are not that old at 70.  My mom lived alone until 89 and died a week later. My 94 years old aunt lives alone in a apartment. At 90 she quit cooking and eats lean cuisines. She now has a cleaner.  I am 65 and yesterday threw a big party for 13 people with a home cooked meal.

There's a huge range.

I see it daily, people in their 70s who are youthful and vital and people in their 70s who are very frail and rapidly declining.

Most people don't realize this because they don't have knowledge of the age of most seniors they encounter. They see older people and assume that the older looking ones are older and that the younger looking ones are younger.

Meanwhile, in my extensive experience with treating seniors and having access to their birthdates, I've found it's actually tremendously difficult to judge age after ~70.
A fit and healthy 85 year old can appear infinitely more youthful than a frail 70 year old.

I legit thought my neighbour was in her 90s when she died recently. She was very frail, on oxygen 24/7, and couldn't manage to walk her dog.
She was 67.

Level of vitality after ~70 starts having everything to do with the condition the body is in and virtually nothing to do with age. So yes, for some 70 is still young and not very different from 40 in terms of lifestyle. For others, 70 is one foot in the grave.

For me it was a HUGE wake up call that what I do now in my 30s will have a far larger impact on my senior years than I ever imagined.

Dogastrophe

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Re: End of life plans and how much do you value your"golden" years?
« Reply #23 on: June 10, 2019, 06:35:01 AM »
I see it daily, people in their 70s who are youthful and vital and people in their 70s who are very frail and rapidly declining.

Most people don't realize this because they don't have knowledge of the age of most seniors they encounter. They see older people and assume that the older looking ones are older and that the younger looking ones are younger.

Meanwhile, in my extensive experience with treating seniors and having access to their birthdates, I've found it's actually tremendously difficult to judge age after ~70.
A fit and healthy 85 year old can appear infinitely more youthful than a frail 70 year old.

I legit thought my neighbour was in her 90s when she died recently. She was very frail, on oxygen 24/7, and couldn't manage to walk her dog.
She was 67.

Level of vitality after ~70 starts having everything to do with the condition the body is in and virtually nothing to do with age. So yes, for some 70 is still young and not very different from 40 in terms of lifestyle. For others, 70 is one foot in the grave.

For me it was a HUGE wake up call that what I do now in my 30s will have a far larger impact on my senior years than I ever imagined.

+1 on this.  My father is 73 - his health (physical and mental) has been declining for years - he looks 80+.  My mother (72) was in seemingly perfect health until her brain tumour was discovered 3 weeks ago  - she would pass for mid-60s easily.