As we ring in 2012, most of us take stock of this new beginning by creating New Year’s resolutions. We think about life’s everyday realities, such as what we eat, our exercise habits, our aspirations, and vow that this year will be different – better. As a physician, I encourage New Year’s resolutions, especially when they involve altering your lifestyle to support healthy aging. This year, I suggest a different kind of resolution, one that may be more difficult to consider. I invite you to think about what aging with dignity and independence means. Then take time to have the tough conversations with your loved ones about what is important to you as you grow older, and how you will get help should you require daily assistance.
Although not an easy discussion, it is vital that we know the preferences and choices of loved ones (and they know ours) regarding the kind of support you and those you love expect long before a crisis occurs. If you haven’t thought about this complicated and sensitive topic, you are not alone. Many Americans are dramatically unprepared, so there is no time like the present to think through and discuss these topics with the very people who will likely be part of your caring network.
To help you prepare, The SCAN Foundation has launched a guide titled, “10 Things You Should Know About Aging with Dignity and Independence.” It offers pointers that everyone should know about the cost and access realities of daily assistance along with five steps you can take today to help you age with dignity and independence.
Here are some key facts you should know. First, Americans live in an aging society whereby – thanks in large part to medical advances – we will live longer than ever before. Twenty years from now, 20 percent of our population will be over age 65. Tomorrow’s American senior will be better educated, experience lower poverty rates, and live in a more culturally diverse society. On the flip side, we will also live with more health problems and have fewer loved ones to help support us as we grow older. With this reality comes the fact that 70 percent of individuals who reach age 65 will need some form of daily living assistance, for three years on average. This is expensive care, and it is important to understand that right now Medicare does not pay for long-term care. Three options to pay for care include paying out of your pocket, having a long-term care insurance policy that are generally expensive and are not universally available, and being eligible for Medicaid, a poverty-based program that requires you to spend your life savings before getting help.
For the past two years, The SCAN Foundation has engaged California voters on this issue and found that once they are made aware of the realities of the cost and likelihood of needing long-term care, they become quite concerned and acknowledge they are not prepared financially or otherwise. They want their elected officials to take action on this matter as a “high priority” issue. This is true regardless of party affiliation, income level and ethnicity. The findings are not unique to Californians as additional polls from AARP and the Associated Press support our findings across the nation.
So back to your 2012 New Year’s resolution, here are some things you can do to be better prepared for a living into your later years. First, start having these conversations with your family members – and have them routinely. This isn’t a one-time discussion but an ongoing dialogue about how to save, what assets you have available, and the kind of life you wish to have, regardless of age, illness, or disability. Second, learn more about what resources exist in your community, whether it is a faith-based organization that offers support and resources, or your local Area Agency on Aging that helps coordinate and link people to a wide array of community services. Third, make informed decisions with your health care dollars. Find out whether you qualify for long-term care insurance and determine whether or not it is the right product for you.
Seek out medical groups or providers that offer an organized approach to coordinating care that put your needs and preferences at the forefront of health care decision making.
Use our “10 Things” document as a guide. Pass it along to your friends, family and others who might find it useful. It is meant to be a starting point to help facilitate these tough discussions. As you share your expectations with your loved ones about what aging with dignity and independence means to you, we are curious to hear your story, and what you learned in the process. We invite you to share your experience on our Facebook page. Also, visit our Web site and follow us on Twitter for more information about aging with dignity and independence. By talking now with loved ones about the kind of care that you expect, this 2012 resolution can truly be one that pays rewarding dividends in the years to come.
Bruce Chernof, MD, President and CEO of The SCAN Foundation. The Foundation is a sponsor of calhealthreport.org.