Haims: Planning for aging at home or assisted living
Last week’s column spoke about the decision process of choosing between aging at home and moving to an assisted living community. While I touched on financial implications and personal needs, these are only two factors — there are a number of other factors that may affect one’s decision.
In both my personal and business experience, finances are at the pinnacle of the decision process. Thus, condensing such a complex matter into one column is not possible. While there are many books that deal with this subject matter in detail, I can share this — it often breaks down into two things: Can you afford to age in place or go to an assisted community? And will you be able to leave anything financially to your loved ones?
As I shared last week, my mother chose to share with my brothers and me her wishes for aging in place. In doing so, she thoroughly shared all details of her finances and had one of my brothers added to all of her financial accounts. Further, she provided me access to all of her medical information and medical providers, as well as her plan for her care as things changed.
It has been my experience that not many aging loved ones are not so forthcoming. For example, my in-laws have been contemplating selling their two-story home and moving to a single-story condominium that is closer to one of their daughters, where they can have easier access to the support of family. While they have discussed their reasoning for downsizing and desire to be closer to the support of their daughter and grandchildren, they have not shared much about their wishes as their health care needs change. Nor have they shared much about their aging plan that includes estate planning, advanced directives, and a living will.
Many times I have asked my in-laws to share with their children their plans, wishes and desires as they age. Repeatedly, I’m told that their kids know what they want. This is only partly true. One child says they know what their folks’ wishes are should they become incapacitated, and thinks they know about burial wishes. One says they have a general idea of finances and investments, and another child says they know little but believe the other sibling will get it all managed. No secret to how this situation ends — not well, I’d guess.
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Both choosing to age in place and moving to an assisted living community involve financial decisions that, in many cases, should be discussed with loved ones. Why, you may wonder? Because affording either move often involves a mix of emotional, cultural, psychological and practical reasons.
While not all parents feel this way, many feel compelled to leave an inheritance to their children and thus may choose to make decisions that may not be in their best interest or the best interest of their loved ones.
Aging in place involves a combination of emotional, financial, practical and psychological reasons that may include an emotional attachment to the home, familiarity and comfort, sense of independence, and avoiding a disruption of downsizing or moving into a new and unfamiliar environment. It also involves many variable costs such as personal care (caregivers), household maintenance, utilities, meals, transportation and safety.
On the other hand, a move to an assisted living community offers more controllable costs, social connection and access to care. Many assisted living communities offer a continuum of care that can meet a person’s changing needs over time. Such communities provide a seamless transition to independent living, assisted living, memory care, skilled nursing/rehabilitation, and hospice/palliative care. Thus, these communities support individuals throughout the aging process, providing the right care at the right time.
Further complicating the decision of aging at home and an assisted community may be the parents feeling compelled to leave a financial inheritance. Why would leaving a financial inheritance be a “complicating” issue, you wonder? This is why: Often our aging loved ones sacrifice their own needs in an effort to fulfill a perceived moral obligation or a desire to provide for their children’s future. Sometimes, it may even be a way to express their love and appreciation.
My in-laws feel this way. Unfortunately, while a financial gift may be appreciated, it will likely be overshadowed by the potential mess that could be left. When aging parents fail to include their surviving loved ones in their financial and medical directives, a host of legal, emotional and logistical problems can arise. Such a situation can be emotionally and financially draining, especially if the children are already managing their own families, careers or retirement planning. Here are some common issues that contribute to this burden:
- No one has the authority to act: Without a designated durable power of attorney or health care proxy, no family member or spouse may have the right to manage finances or make medical decisions.
- Court intervention is needed: In absence of directives, family members may have to go to court to be appointed as a guardian or conservator, which can take weeks or months and cost thousands in legal fees.
- Multiple people vying for control: If several family members feel they should be in charge, it can spark legal battles and divisions.
When evaluating the costs of aging in place versus relocating to an assisted living community, the choice ultimately depends on the individual’s health, finances and personal preferences. The best time to think about aging in place or an assisted community is before you need a lot of care. Planning allows you to make important decisions while you are still able.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. He is an advocate for our elderly and is available to answer questions. Connect with him at jhaims@visitingangels.com.
