The Aging Household
Updated: Mar 29
During the past decade-and-a-half, I have watched numerous families navigate the inevitabilities of aging. Some of those families made their journey in dignity, with a sense of purpose. Some of those families suffered in many ways, including economically, when they didn’t have to.
I am not suggesting that if you adhere to these ideas, your own journey will be absolutely peaceful and devoid of surprises (far from it!). But I am sure, if you take these suggestions to heart, your journey will be less stressful and, in the end, more peaceful, than if you do not.
However, to be clear: I cannot give medical, legal or financial advice.
You should always consult a licensed, credentialed practitioner before you make any changes to your current affairs.
That said, I’ve ordered my suggestions into three categories: Medical, Financial and Legal. As you read each, I hope you’ll see how they work together to help you and your family navigate a trying journey; how they’ll make the journey be less stressful, as healthy as it can be, and maybe even less financially devastating.
MEDICAL Always discuss your medical concerns with your physician.
1) Ask your doctor if she thinks you need to be cognitively assessed.
The sooner an older person can get a medically-administered cognitive test result, the sooner their ‘baseline’ cognitive skill level can be recorded.
Why is this so important? Because many instances of insurance claim approval (especially Long Term Care insurance) is dependent upon the insured’s cognitive state at the time of the claim. If the insured’s cognitive state can be medically proven to have declined since the initial cognitive assessment was done, it will be much easier to file a successful (i.e. paid) claim.
2) Ask your doctor if she thinks you should be seen by a Gerontologist.
I’ve often observed that a long prescription list, accumulated over a lifetime, will be shortened by a Gerontologist. However… be guided in this quest by your own current physician.
3) Take your healthcare seriously.
Get a calendar. Write down appointment dates and times, always.
Ask someone you trust to join you at the appointment to take notes.
Share those notes with your family, if appropriate. They’ll want to know what’s happening… believe me! Keep an updated list of your meds handy at all times. Think about purchasing a mediset… to organize your meds a week-at-a-time. (You can even get medisets with tiny, built-in alarms that send reminder messages to your smart phone!)
FINANCIAL Who pays for medical care as we age?
Money Source No. 1: Government programs
Almost everybody gets this wrong.
You probably already have Medicare.
Medicare only fully pays for the first 21 days in a nursing home.
Medicare pays up to $167/day after that, up to the 100th day.
Medicare pays zero after that and it pays zero for Independent Living and Assisted Living settings.
Yes… zero. You’re on your own, even with Medicare.
The other government program is Medicaid. But: You do not qualify for Medicaid until you are destitute. In other words, unless your assets are almost gone, you do not qualify for this program. Sorry.
Money Source No. 2: Personal asset liquidation (‘Buying your way in’ to a care setting)
Nursing home care costs between $14,000 and $18,000 each month.
If you are able to apply to a nursing home with 18 or more months of care cost in the bank, you’ll probably get a very warm welcome. You’ll be able to choose (more or less) where you want to live. If not, your nursing home choices will become very limited (See Medicaid, above.)
Money Source No 3: LTC insurance
If you were able to buy Long Term Care Insurance… and if you did not allow it to lapse… you may have some peace of mind about how your care costs will be paid. But be wary… the current benefit may not cover all care costs. And LTC companies have become very strict about claim payments. You will have to jump through many, many hoops to get your first penny.
This is an aspect of aging most people misunderstand. (Be careful where you get your advice!)
LEGAL If you are not an attorney, hire one.
You need to think about having in place, right now, the three documents
I outline below.
They’re called Dispositive Papers and you need to speak with an attorney about them right now. (Having unsigned and unexecuted documents tucked away in a drawer doesn’t count!)
Do not attempt to create these documents on your own. Use an attorney, no matter how distasteful that may seem. Remember: Everybody hates lawyers… until they need one. If you don’t have your Dispositive Papers in place, you need to speak with an attorney right now!
Durable Power of Attorney
Expresses your legal/financial wishes when you cannot.
Health Care Proxy
Expresses, in detail, how you want to be medically treated,
when you cannot.
Last Will and Testament
Expresses, in detail, how you want your affairs settled after your death.
I hope this helps you or someone you love navigate the aging process.
I am always available for consultation at the phone number on this website.
© Ralph Ercolano, 2022