Over age 50? Make long-term plans before they are needed

The best time to make decisions regarding long-term care is well before it’s needed. An unexpected illness or injury may force you or a loved one into making hasty decisions.

Long-term care is a set of services and supports for people who are unable to perform Activities of Daily Living (ADLs). ADLs are self-care activities, such as getting in and out of bed, walking, bathing, dressing, eating, and bowel and bladder management. About 70 percent of people turning 65 can expect to need some kind of long-term care services as they age.

Experts encourage everyone over age 50 to take the time, while you have it, to research options and make important choices. Long-term care planning means developing a personal strategy now for how things should be handled later when you or a loved one is in need of care. Important considerations include the following:

Staying in charge

An important part of long-term care planning is outlining how you would like things to be handled. Expressing preferences clearly about how any declines in ADLs should be handled, what financial resources are available, and who should provide needed care is a good way to retain control. All adults over age 18 should execute legal documents that appoint one or more individuals to make health care and financial decisions for them in the event they become unable to make decisions for themselves. Adults who lose the ability to make decisions before executing these documents must have the court system appoint someone to make decisions for them. An attorney can also prepare an advance care directive, which is a set of written instructions detailing what medical care you want or do not want.

Housing

Those who would prefer to stay at home for as long as possible should make a plan to do so, and consider making modifications as needed. Home modifications are often intended to allow maximum self-care, and to help avoid a fall. Avoiding a fall can help delay or avoid the need for long-term care. Typical modifications include widening doorways, adding wheelchair ramps, improving lighting, mounting stairway chair lifts, installing medical alert systems and adding handrails or safety grips. An important consideration for anyone planning to stay home is to ensure the bathroom can be used safely. Ideally, your residence should maximize your ability to continue performing ADLs, and help you avoid a fall.

Primary care

Maintaining a good relationship with a primary care physician is key. Regular check-ups can lead to early diagnosis of any physical, mental or emotional decline. Be honest and open about symptoms, daily habits or changes in appetite. Be sure to have the primary care physician review all medications. Ongoing medication management is an important part of staying healthy and avoiding a fall.

Family care

Unpaid family members are the most common source of long-term care help. But, they may not be able to provide all the care you need, or be there every hour of the day. If you intend to rely on family members for long-term care services be sure to involve them in your long-term care planning. Make sure they are willing and able to be caregivers for you.

Paid care

As part of your long-term care plan, look into caregiving services in your area, including in-home care providers and elder daycare centers. Find out about elder shuttles, meals on wheels and other low-cost services offered in your community. Several types of housing come with support services for people who cannot fully take care of themselves due to aging and/or disability.

Public housing is available for low-to-moderate income elderly and persons with disabilities.

Assisted living homes are group living settings that offer housing in addition to assistance with ADLs and other services, such as meals. Generally, they do not provide medical care.

Continuing care retirement communities provide a range of housing options, including independent living units, assisted living and nursing homes, all on the same campus.

Nursing facilities, or nursing homes, are the most service-intensive housing option, providing skilled nursing services and therapies as needed.

Take the time to familiarize yourself with the different types of facilities available in your area. Ask family and friends for any recommendations they may have and take advantage of information available on the Internet. Visit www.longtermcare.gov to find out more information about each type of facility and costs associated with long-term care. Your local Area Agency on Aging office also offers a list of resources available to the elderly in your area.

Having your long-term care plan squared away and clear, so there are no misunderstandings or second-guessing, can be the greatest gift you can give to your loved ones, and yourself.

For information, visit www.longtermcare.gov.