Hey everyone.
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I'm thinking about what type of financial and health planning I would need in place to protect it and me in the event I wasn't able to appropriately make decisions for my welfare.
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Has anyone else considered this potential future? Is there something I could put into place with advisors? Or, should I get out of my comfort bunker and start making friends, joining a church or club STAT?
Thanks all.
How timely. I'm on my third relative with dementia, currently serving as primary care giver for two of them (and two is too many). I think plenty about how it will go when it's my turn to be dependent.
The first one had a nice chunk of change saved, a decent pension and long term care insurance. She also had an advanced directive and a niece appointed as P.O.A. Bless her for doing all of that! What she failed to do, however, was make her own home accessible. Since her home wasn't livable in the months after a broken hip and later, a broken femur, she spent longer in nursing homes than she wanted. And because that time was necessitated not from her medical condition, but because of her house, LTC wouldn't cover long stretches of it. It only kicked in when her Alzheimer's advanced to a certain point.
The take-away for me was twofold: Get rid of all the trip hazards and make my home accessible BEFORE I need it to be accessible. My aunt tripped and fell in her own home. She couldn't navigate the steps during recovery in order to bathe, which required more time in a facility. Fortunately she was well cared for in one of the best places around and had enough money to cover the expenses until she passed. But one month's fees for assisted living would more than have covered the necessary modifications. She didn't do it and spent 10x that much on monthly rent for a really cute assisted living apartment, desperate to go home again.
The second relative to get dementia is my Mom. No LTC, but her estate planning paperwork is in order. Her home is not one floor, but it is navigable for her in her declining state. An extra set of handrails on each staircase has been a tremendous benefit. She's had a few friends in the closest nursing home in our town and has expressed that if/when the time comes, that is the one she wants to go to. It is also one of the better ones. For now, she's still at home. She weighs about 125lbs. I can lift her when needed.
Next take away: Don't weigh too much. Get enough exercise to maintain physical strength, especially upper body strength. Reinforce handrails and put in grab bars where I will find them useful. Evaluate the places near me to choose which one I would accept when the time comes.
The third is not yet diagnosed with dementia, but it's there. This isn't my first rodeo. He's an even bigger challenge because he still retains just enough control over his own life to be dangerous to himself and others. Numerous car accidents, can't manage his own medication, can't prepare food for himself or arrange to feed himself. Won't bathe. Won't stay put for a home health aid or Meals-on-Wheels to bring food to him. He wanders. Destroys technology, like cell phones or TV remotes and then goes banging on neighbor's doors at all hours demanding immediate help. He's been sexually inappropriate (like millions of other men in cognitive decline). He weighs 220. I can't lift him, even with help. Every time he's fallen or is stuck in a chair, I need to call 911.
The take away: Don't spend all my money on Nascar collectibles and lottery tickets. Take care of my teeth. Bathe.
People make (and talk about) vague plans to ensure they don't face the same fate. Or they have a concrete plan to commit suicide before becoming that far gone. But there can be a really long road between the beginning of the decline and the end of life, where people live beyond the point they said they would make the drastic move and they are no longer capable. Perhaps I'll be like my father, no cognitive decline but with failing eyesight, unable to drive for about 10 years before he died. Can I hire a car-service or walk to everywhere I want to go when driving is no longer possible? Maybe I'll be like my aunt with several falls & breaks. I wear the type of watch that will let my husband know if I've fallen. He can track my location when I'm out on a training run. We're remodeling now (in our 50's) making everything as accessible as possible in our single story home. I decided I need the curb-less shower before I need the curb-less shower.
I'm heeding my doctor's advice on preventing dementia. I've been told there is a connection between untreated hypertension in one's 50's and vascular dementia later on. I've also been told they call Alzheimer's "Diabetes Type III" and believe there is a link to sugar intake.
I think there is a catch-22. My mother & her sister were healthy living, vegetable eaters who got plenty of exercise and were never overweight. They lived into their 90's and had long stretches of dementia. My father's family was full of smokers. Their declines were shorter, involved vision loss. My in-laws were alcoholics. Death was sudden and swift, each of them before age 75. It's tempting to pick up a really bad habit so I don't outlive my money.
In the meantime, I need to refresh all my in-case-of-emergency instructions, advance directive stuff. I do have a spouse, so there is a 'primary' person. I also have quite a big extended family.
I would encourage you to get out of your comfort zone and join a church. People need people. Even introverts. A faith community is a group committed to each other, it is where those in need can meet those with something to offer. And what organized religions all recognize is that people move between these states of needing and being needed throughout their lives, of being dependent and of being able to help. The Abrahamic religions all have this in common. So do groups like the American Legion or recovery communities and very likely some dedicated agnostics or other groups I'm unqualified to speak about.
Long before you begin that decline into dependency, you will probably have needs. Some of them might even be right now or within the next few days. You may also have something to offer to someone near you who needs it, even if it's just toilet paper. Really, join a church or whatever.
As far as your legal affairs, there is quite a bit you can do with a trust. The trustee doesn't need to be a friend or family member. But whether or not it is financially worthwhile can depend on the size of your estate. Talk to the eldercare or family law person who prepares your Will, POA, Advanced Directive or Healthcare Proxy. Your executor or emergency contact can still be that BFF who lives far away.
