This article originally appeared as a column for the Cleveland Jewish News.
When we think about life care planning, we think about many aspects of aging. Obviously, financial planning is important. A retirement plan will help to ensure income into the future. A will can ensure that your estate is passed to your heirs in the way you want it to be and a living will can ensure that your family and medical providers know and honor your wishes on dicey topics such as life supporting measures.
We think about insurance policies to provide for our loved ones. We think about our health. But living arrangements sometimes aren’t considered until someone else is faced with making the decision for us. In this area, we can plan better.
Our population is aging. Birth rates have declined even as medical advances have increased the average life expectancy. The U.S. Department of Health and Human Services estimates that around 15 percent of the population is over age 65. That number is expected to increase to about 22 percent by 2040.
Unsurprisingly, options for elder care are increasing and improving as a result. Even as prior generations thought about individuals either living at home or going into a “rest home,” thankfully the options are now much broader and can be tailored to meet the care needs of the individual.
At its most basic, elder care can be divided into two major categories: skilled care and custodial care. Skilled care is provided by trained and licensed medical personnel. Custodial care involves assistance with normal living activities such as dressing and bathing, and sometimes household tasks such as food preparation and laundry. Both types of care may be used either at the individual’s home, or in a nursing, assisted living, rehabilitation or other facility.
Home care can include one or more skilled professionals, providing a wide array of medical assistance. However, most often it involves little to no medical training requirements. A home health care provider may check an individual’s vitals and assist with in-home medical equipment and much more, but most of the provided help consists of personal care and help with errands, transportation to doctor appointments, administration of already prescribed medications and the like.
Adult day care options can be helpful to keep a loved one with family while allowing a primary caregiver to work outside the home during the day. Adult day care options typically include meals and a wide range of activities. Medical services often include a variety of therapies, and are often as robust as a nursing home facility.
Of course, live-in options can range anywhere from independent living facilities (that may provide security, transportation and recreational opportunities, but no care) to assisted living arrangements (that provide assistance with daily living tasks, recreational activities, as well as some basic health services), to facilities that offer 24/7 care, depending on how independent the individual may be. More recently, a range of continuing care communities have developed, allowing individuals to remain in a single location even as health and autonomy declines.
The options are varied. The problem is that we talk little about them until they become a necessity. But maybe these conversations should happen earlier. Whether we are talking with our parents about what they want for their golden years, or talking with our children about what we want for ours, communication and planning is important. Cases quickly can become very time consuming, expensive and contentious when loved ones disagree on a course of care. Doing as much of your life care planning as possible and encouraging your loved ones to do the same will go a long way toward preventing family arguments and allowing everyone to keep the focus on living the best life possible.
*Andrew Zashin writes about law for the Cleveland Jewish News. He is a co-managing partner with Zashin & Rich, with offices in Cleveland and Columbus.