It’s hard to plan for old age when the most critical factors are unknowable:
- How long will you live?
- How long will you be able to make decisions for yourself?
- What kind of care will you need?
- How long will your money last?
- Will your infirmities outlast your social network?
- What resources will be available to you?
While it’s likely that at some point you’ll need to be cared for by others, the key unanswerable question is, “For how long?” The answer can range from a few days to many years. The same holds for being unable to make decisions for yourself.
The length of these intervals makes a huge difference in their toll on finances and social circumstances. If you die young after a short illness, you’ll likely have more options regarding treatment and services. Friends may be able to fill many of the support roles that children usually assume. But if you languish for a long time with ever-increasing care needs, your funds and support systems are likely to dwindle, especially if your friends are also aging.
The nature of the care you need can vary dramatically, both medically and in terms of managing the activities of daily life. As your care needs grow, decisions will be necessary regarding treatment options and living arrangements. How long will you be able to make these decisions? If you develop Alzheimer’s or certain other chronic diseases, you may need round-the-clock assistance for many years.
Despite all this uncertainly, there are important steps you can take to plan for medical emergencies. Most important is preparing healthcare documents that detail your wishes and designate a surrogate. These take effect when you’re no longer able to speak for yourself and a doctor has signed off on your incompetence.
A declaration of incompetence may be appropriate following a health crisis like a stroke or other medical emergency, and may be revoked if you recover competence. (As for example, with temporary drug-induced dementia following surgery.) It also becomes appropriate somewhere along the path of decline typical of Alzheimer’s – though it may be hard to decide exactly when this point comes. The third instance where it may be appropriate is in the final weeks or days before death.
A declaration of incompetence often follows a health emergency. What preparations can you make beforehand for the time the emergency happens? Sensible preparation includes having your paperwork prepared and accessible, having an “emergency kit” ready that includes healthcare documents, location of information that your financial agent will need, personal amenities (e.g. your favorite nightgown, CDs with your favorite music, personal grooming items), a list of people to call, and other such items.
It’s also good preparation to make sure that you’re found quickly in the event of a crisis that leaves you unable to respond. Those call-alert systems widely advertised in materials aimed at seniors (like AARP publications) come to mind, but like most young old people, I know little about them. If you have used such a device, please share your experience.
Call alert systems advertise an instant response. A less instant responder, but one worth cultivating, is a friend or neighbor who checks in with you every day. Most senior facilities include provisions for a quick response if something happens to you.
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