“I am in great health, why should I be worrying about long term care?” my client asked. I smiled and said “I don’t want you to worry about it, I want you to plan for it so that you don’t end up in a crisis situation some time in the future.” I then proceeded to outline 5 reasons that advanced planning was in my client’s best interest:
1. Having a plan in place reduces stress when the crisis hits.
Whether the need for long term care results from a sudden event (such as a stroke or a fall) or from a progressive illness that can no longer be managed alone or by a family member (such as Parkinson’s disease or dementia), the task of determining the type of care that is necessary and appropriate, and making arrangements for the care is stressful. When the issue of paying for the care is added to the mix, the task is overwhelming. The clients who come to me in this situation are very anxious and emotional, and I usually have to walk them through the process step by step because they are unable to handle multiple instructions at a time.
If the client has investigated the available options for care and the cost associated with those options, and has a plan in place, then the task of implementing the plan is much more manageable when the crisis occurs.
2. Having a plan in place allows you to have a voice.
One of the unhappy consequences of “growing old” is the loss of control over your own circumstances. This is especially true when it comes to arranging for long term care. By planning early, you decide who makes decisions for you when you are unable to make decisions for yourself, and you have a voice in determining what type of care you will receive (whether it be a caregiver in the home or moving into a residential facility). You may also make specific decisions as to who your caregiver will be and how the care will be paid for. If a crisis happens with no plan in place, usually all of these things will be decided for you by others, and you may have little or no input.
3. Typically there are more options available for the type of care you receive.
When people hear the phrase “long term care” they usually think of the nursing home their grandmother lived in 30 years ago that smelled like antiseptic and looked like it should be a waiting room connected to the mortuary. Nobody wants to go there! But there are many more options available today, including assistance in your own home, independent living (basically an apartment in a facility that has people around to help you if you need help), and assisted living (a facility where you have your own room, but meals, transportation and housekeeping are provided). If you are pro-active and make arrangements before the crisis occurs, you can investigate all of the options and make a choice, which you may not have the time or the clarity to do in a crisis situation.
4. You can stay in your home longer.
I say this for two reasons: (1)Many times the crisis occurs when there has been a family caregiver providing care and the level of care becomes too much for the caregiver to handle, or the caregiver has his or her own medical event which makes him/her unavailable. Very often, the burden of taking care of another results in health problems for the caregiver. For this reason, it is imperative that you find out what assistance is available in the community and take advantage of any help that you can get as early as possible. By getting help early, the caregiver will stay healthier longer, to everyone’s advantage. (2) Crisis also occurs when someone who has “managed on their own” has a sudden problem that could have been avoided with proper care. By educating yourself as to the assistance available and getting help early (whether it is help with managing medications or meals, or having someone come in on a regular basis to assist with housekeeping or hygiene), you will stay healthy longer and prolong your own independence.
5. The cost of planning is less expensive.
Maybe I should have listed this as the first reason for planning early…! Obviously, if we are doing financial/legal planning in a crisis and everything has to be dropped to accomplish the plan, it is going to cost more. In addition, the planning itself can be much more complicated if it has to happen right away. If you plan before the crisis, the financial/legal costs will be less. Additionally, in terms of the cost of care, you have the ability to “shop” for services and consider alternatives. In a crisis, you typically have neither the time to shop nor the availability of multiple alternatives to chose from- you take what you can get and pay what you must.