How to prepare for old age care

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By Brian Goslow

As her days as a textile worker in New York City’s Garment District were coming to a close, Zoe Louise Hansson wasn’t feeling as secure as she would have liked heading into retirement. Having always lived alone and never having had children, the then-Connecticut resident knew it was time to face the next chapter of her life.

“I called my lawyer and said, ‘I’m in trouble financially. What do I do?’ ” said Hansson, now 81. He suggested she take out a reverse mortgage on her home; she’s now had four. “I just renew them when I need more money,” she said. “A lot of people don’t believe in it. If you own your own home, remember, it’s a goldmine. To me, I feel, as long as I’m alive, I might as well enjoy life.”

Hansson has since moved to the Deer Isle-Stonington area of Maine, becoming a beloved member of a tight-knit community. Only recently has she found the need to ask others for help in her everyday chores. “One woman is in charge of getting volunteer drivers for me,” Hansson said. “That’s the biggest help of all.”

Just as many families put off the “what if” discussion on what happens if a parent suddenly gets ill and needs help, many people nearing retirement haven’t fully, if at all, begun to consider how their own everyday living and health emergency needs will be taken care of as they age. This becomes more of a problem if the person or couple has never had children to step into a caretaking role if necessary.

Childless folk reaching retirement age need to secure, if possible, long-term care insurance and carefully consider whom they’ll utilize as a caretaker and to carry out any health proxies if the need arises, said Kristine A. Kevorkian, who holds a doctoral degree in thanatology — the study and science of death and dying — and is an adjunct professor at Antioch University in Los Angeles.

It’s important not to underestimate the value of longtime friendships and social networks when considering a possible move to a new area, whether for a warmer climate or to be near relatives, childless or not, she said. Ideally, people would have long-term friends they can comfortably rely on not only for social friendship, but to assist them in time of need, especially when it comes to health emergencies. Having that support is crucial to a healthy state of mind, Kevorkian said.

“You should consider, ‘Do you have friends who can help you, someone you’ve learned to trust over the years?’ ” Kevorkian said. “It’s always good to network and find who’s around (who may have faced the same challenges). Often, people will find that there’s somebody else in their network that’s in the same boat with whom they can perhaps team up with in contracting for nursing or caregiving services.

“The options for caregiving as we age are not good for those who can’t afford it,” Kevorkian said. “If you need help and you can afford a caregiver, then that’s the way to go.” However, she said, many people who haven’t needed assistance yet are under the false impression Medicare will pay for caregiving, if needed.

If you’re in this boat, you don’t need to panic. What you do need to do is plan ahead and be creative in how you’ll have your needs met. Some people decide to grow old living with others in the same predicament. “Living with roommates helps,” Kevorkian said. “If two people require care, they can pool their resources and have a caregiver for two — or more. People can create their own form of family.” She noted some people are able to find great caregivers through their faith-based communities.

Living alone does leave older people prone to financial predators; that makes it important to do due diligence on whom you seek help from. “If you have money, your odds of proper care go up, as do your chances of being ripped off by a corrupt caregiver or family member,” Kevorkian said. “The number of ‘fiduciary elder abuse’ cases is increasing.

Finding a trustworthy friend — and professional help — is essential in planning your financial future, whether for living expenses, housing, health care needs or a funeral. “If you don’t have children, it’s great to have friends to help out with this — or a lawyer,” Kevorkian said. “I would definitely consider a trustworthy lawyer to help with drawing up all the papers for this, the powers of attorney for the advanced directive and making sure somebody’s in charge” that you feel is reputable to act as a guardian.

Kristi Webb, 56, of Chapel Hill, N.C., and her husband, Todd Woerner, have given very little thought to their retirement days. “All of our parents are hale and hearty, so this allows us to be in denial,” she said. The couple has yet to seek professional advice for retirement planning, but Webb admitted, “I keep thinking I ought to talk to Todd about whether we should get long-term healthcare insurance.”

She’s stuck on how to best approach the discussion. “I don’t want to be a burden to anyone, but I don’t want to go into ‘care’ if I can avoid it,” Webb said. “I don’t have anyone to be a burden to anyway  — although I have stepchildren — so doesn’t that dictate that I’d have to ‘go into care?’ ”

When she does think about growing older, Webb said, she tells herself, “Well, just take really, really good care of yourself.”

For many people, the biggest challenge to overcome is the fear they’ll be burdening others by asking them for help. “In this country we really do have this mentality of ‘pull your self up by the bootstraps’ so people aren’t as comfortable asking for help, no matter what their age,” Kevorkian said. “It’s very sad, the feeling of being a burden to someone.”

She shared the experience she had years ago with an elderly hospice patient. The woman didn’t have a family or children. “The people in her apartment complex were trying to help take care of her and she kept praying that she would die quickly so that nobody would have to be bothered to take care of her,” said Kevorkian. “In this spiritual community of hers, there was this young couple that was begging her, they wanted to take care of her, take her to their home.”

A chaplain interceded after learning the woman had been a teacher; he noted while she had always been the teacher, she had never been taught how to allow herself to be cared for. She finally acquiesced and agreed to move in with the couple.

“This patient of mine was so worried about being a burden, so worried about being alone, but she wasn’t,” Kevorkian said. “There were people who were asking to take care of her and she was refusing. Finally it came out to be such an incredible opportunity for everybody.”

The ex-teacher lived with the couple for her final two weeks, and “had an incredible epiphany, almost daily,” Kevorkian said. “It was such a mutual growth progression for everybody involved.” The young couple went on to be caregivers for other hospice patients.

For someone approaching retirement — or who has retired and is nearing their 70s or 80s — and is still in good health, now is the best time to face the likelihood that someday, they will face a health emergency and will, one day, pass on.

“Look around you (now) and see that there are some people who aren’t doing as well as you and be prepared,” Kevorkian said. “The first thing that I always tell people is complete your advance directive. Get that going; make sure if there is a medical event, that you have somebody able to speak for you if you’re not able to speak for yourself. Make sure that person knows what your wishes are.”

She suggests putting a copy of your advanced directives, along with a list of current medications, in a manila envelope and taping it to the refrigerator. “If there ever is a health care event, being able to find those forms right away is best,” Kevorkian said.

Another “proxy” that should be included in this envelope: desired funeral arrangements, including whether to be buried or cremated. This will prove invaluable for the family members and friends you leave behind.