I love this poem written by Donald Loudon. The first stanza of the poem says:
The circle of life is when we’re born,
When from our mother’s womb we’re torn,
Into a world of cold and hot,
Into a life of what is, is not.
Aging is a critical and necessary part of the loop or circle that is our lives. I believe it is the part that is most reverential, most special and in many cases most feared. As we age, many of us begin to see the future differently. We begin to look at the future as an ending to something rather than a beginning.
The good news is that with advances in medical technology, Americans are living longer and more productive lives than ever imagined. Millions are physically and mentally able to live independently well into their 80’s and 90’s and beyond.
As we approach retirement and begin to transition into a new phase of our lives, the important thing is to have a vision for how we want our lives, as we continue to age, to be lived. Embracing aging as a new and exciting adventure is both freeing and inspirational.
Part of that vision should be to recognize and plan for a time when you can no longer manage all of the Activities of Daily Living (ADL’s) without some or a lot of assistance from family, friends or outside caregivers. Having a plan and discussing that plan with your children, spouse or close family members is critical to making sure that your wishes are carried out and that the stress on those caring for you is minimized.
Some things to consider in determining how to manage your present and future care needs include:
- What health problems or conditions do you have that you feel may affect the quality of your life? What assistance would improve the quality of your life? What might happen if you do not have help?
- What medications do you take, how often, and what are they for? What are the side-effects and benefits?
- What do you want to happen when you can no longer care for yourself and how do you feel this can be accomplished?
- What is your current level of independence and what do you foresee given your current health condition (on a scale of 1-5, with 1 being extremely independent and 5 being extremely dependent)? How has this changed in the past few years? How might it change in the future?
Discuss these questions with your loved ones and get their input. Do they see things the way you do? If not, what might that say about what your future care plan should be?
Also consider whether you have a good supportive network of people to help you get things done. Do neighbors help out with yard work, housework, shopping and errands or home maintenance? Are you having to hire someone to perform these tasks or do you anticipate having to pay for this help in the future? If you own a home, who will be responsible for maintenance and upkeep when you can no longer perform those tasks? Would it make more sense to sell your home and move into senior housing to lessen the burden and cost of maintaining a home when you can no longer perform that function?
As we age, some basic activities will become more difficult for us to do along without assistance. Consider the following list and how you will manage doing these task as you age:
- Dressing, grooming, bathing. If you intend to live in your home, is it equipped to prevent falls? Are there stairs to climb? Is there a bathtub that may be difficult to get in and out of without assistance? Each year, one in every three adults age 65 and older falls. Among older adults, falls are the leading cause of both fatal and non-fatal injuries.
- Going to the bathroom or incidents of incontinence.
- Meal preparation and self-feeding. Frozen dinners, canned goods and snack foods should not be the only source of nutrition. Eating alone does not promote good appetite.
- Getting in/out of bed or chairs. Inactivity in not healthful. Reduced mobility and loss of physical fitness, increases the risk of falling.
- Walking. If balance is impaired even slightly, there is a risk of falling.
- Using the telephone, operating the television, radio, etc.
- Housekeeping and laundry. This is one of the first declines in “quality of life”.
- Managing money and paying bills.
- Transportation. Impaired vision and/or slow reflexes may cause loss of driving privilege.
- Social interaction. Isolation can lead to depression and diminishes the quality of life.
Having a plan for your care as you age significantly adds to your sense of independence and provides comfort and peace of mind to your family and loved ones. These decisions are not easy for a family to make. They evoke strong emotions from all involved. The more robust and well thought out your plan is, in consultation with your loved ones, the happier everyone will be. Some specific things to consider doing now include:
- Power of Attorney
- Medical Power of Attorney
- Financial Power of Attorney
- Living Will
- Advance Directives
- Long Term Care Insurance
- Savings (the more resources you have, the greater your options for care)
Having a plan for how you wish to be cared for as you age is the best gift you can give to your loved ones and to yourself.