Need Care – ?

Centers for Medicare and Medicaid Services (Me...

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My widowed mother became legally blind in her late 60s. She was sharp as a tack, but blind as a bat, and needed help at home. That was her reward after she had given a lot of years to my father, who had been bed-ridden by rheumatoid arthritis, Guillain-Barré Syndrome and other degenerative factors. I was at home as a care-giver for part of that experience. I now want to share some thoughts and resources to help anyone, who needs or is giving care right now.

Consider:

  1. We’re all getting older. Either our bodies will work tolerably well into old age or something will break down along the way. It only takes two of six essential skills for a person to officially require care.
  2. Despite our best efforts, we can not predict what will happen in the future. Although most of my school chums and I are reasonably healthy and well, I have lost friends and family to brain cancer, ALS, degenerative diseases, and suicide.
  3. You can never assume that “help is around the corner,” or “my kids will take care of me.” Although volunteers (including family) may be willing to help, they have lives as well…and changing your diapers, cooking three squares per day, and helping you find your remote 24/7 may not be possible for them for an extended period.

Where to begin? Try these points to start:

Relationships –  A recent article in The Ensign magazine entitled “When One Needs Care, 2 Need Help” by Nancy Madsen-Wilkerson describes the challenges faced by family caregivers. The author experienced the trials of providing care to family members, and spent a week herself in the hospital recovering from complete exhaustion. The article touches on several vital points:

  • Preparation – like any hazard, forewarned is forearmed.
  • Advance Directive – your written, legal decision about your care, used when you are no longer able to say how you want it.
  • Durable Power of Attorney – you name the person(s) you trust to make decisions when you are no longer able to do so.
  • Coordinated care – plans for who can help, when, and under what conditions.

The article is a good read and will plant some seeds of preparation in your own mind and spark discussion in your family.

Insurance and Professional Help – If you have assets and want to preserve them for your survivors, consult your planner about Long Term Care (LTC) insurance. LTC insurance is designed to do two things: 1) pay a professional to take care of you  in your home or a facility of choice (you pay pennies on the dollar for care-related fees when needed), and 2) preserve your assets. If you die on Medicaid, most states require that your estates pays back the expenses after you die (the government LTC site explains this). The pool of care money created by LTC insurance alters that equation.

Admittedly, there are many considerations to discuss in this very personal decision, it is essential for you to consult an expert in the field. AND – this is a BIG AND –  don’t wait until you need it to buy it. You must be physically and financially healthy in order to purchase LTC insurance.

Choosing Care – Visit facilities in your area. Good ones should be forthcoming about the services they offer, including pricing, levels of care, etc. They are businesses, and are in competition for your trade. It will pay you in the long run to understand when you or your loved one can say at home and when it is time to move.

My Experience – My mother was very aware of the importance of planning. When I moved back home to take care of her, she was very specific. “Jim,” she said, “Here is my will. Here is the key to my safety deposit box. You’ll find all of my documents, my life insurance and everything else you’ll need. And here is the attorney that you will consult when I go.” When she passed, every instruction was as good as gold. I was spared the burden of guessing. I cannot tell you how tremendous her last gift was to me and what a difference it made when it was time to exercise it.

If there is a moral to this story it’s this: if you think planning is tough, imagine life without it. Then get to work.

Resources:

White House Conference on Aging

Administration for Community Living

Alzheimer’s Association

Long Term Care (info)