Have you noticed that life sometimes comes in “bunches” — similar events clustering together over a condensed period of time?  Joyful bunches include graduations, weddings, and babies.  I can recall a time when it seemed like all of our married friends were expecting.  Melancholy bunches include news of illness and deaths, and it is a recent melancholy bunch that inspires me to write to you today and encourages you on to action.

The condensation of time that defines a bunch also makes it easy, and sometimes inevitable, to compare the individual events that comprise it.  Over the last few months I have witnessed how different families have navigated through the aging, illness and then death of a loved one, and the settling of the estate, and have distilled a key learning:  Early planning for these events is critical, but it is equally important to engage our family along the way, to communicate our vision of our last decade, and to discuss our plans and the resources we may or may not have available to support them.  In doing so we leave a legacy of not just things, but of our values – ourselves.

As our family members age, their needs can change dramatically and quickly.  Growing old takes a lot of courage.  It involves successive losses of physical stamina and strength, vision, motor skills, and often memory.  Aging almost always brings with it a loss of independence, and it is downright humbling.  At the same time as their independence is waning, our elders lose the very companions, spouses and friends upon whom they have relied, to whom they have looked for comfort in their adult lives.  The need for assistance, love and caring from family peaks. The need may come as a shock to family if the elder has been very independent and/or family bonds have been historically weak or more currently stressed.  Resources available to meet the elder’s needs vary greatly, as do a family’s skills and inabilities for identifying and employing appropriate resources.  While the elder may not wish to be a burden, it’s almost inescapable that one or more family members will assume a decision-making role at some point.

The family’s ability to meet their elder’s needs will naturally depend upon resources, including both money and time, as well as their proximity to their elder.  Medical and financial issues are frequently complicated, and here the family’s ability to assist their elder is heavily dependent on time, savvy, and often sheer tenacity.  While resources available to seniors and their families are growing rapidly, they are not consistent in quality and convenience, and can vary greatly by location.  Services exist to help seniors and their family find suitable providers; however, this, too, requires time. An elder’s need for assisted living for skilled nursing care may frequently require a move to senior housing.  Unfortunately, very few families have conversations with their elders before a need arises, and many seniors are inclined to resist until a crisis occurs and placement options are limited to what’s available.

Each family has a set of skills and inabilities that they will draw upon as they attempt to meet their elder’s needs.  I define skills in this context as the ability to do something well.  In contrast, I’m using the term “inabilities” to refer both to the absence of a skill or skills and to behaviors or personalities that complicate meeting the elder’s needs or prevent it altogether.  Most often, inabilities surface as multiple family members interact.  Quite simply, siblings (or others as the case may be) often disagree, or just don’t get along, and things can even get nasty.  I find some level of disagreement is more often the case than not; if you think your family is alone in its dysfunction, you’re wrong.  The Waltons was a TV show, not reality.  Think about your own family members and imagine them interacting to make decisions about your housing or care. Think about a worse-case scenario, just for a moment.  Consider which family members may have the skills and time to help you, or how you might otherwise meet your needs.

Everyone should have a will and/or trust, elect a health care agent, and create a durable power of attorney enabling someone to take care of financial matters in the event of incapacity.  But that’s not enough.  It’s not brilliant or novel to exclaim that communication is the oil that keeps the machinery of relationships from breaking down, but it’s true.  Why is it that we forget or ignore that?  Why are we more apt to believe that someone can read our minds or should know what we want, than to express how we feel and what we want?  Why is that talking about money seems so taboo?

Here are some things you can do to help your family help you in your last decade:

  1. Consider writing an ethical will and sharing it with your family. If you are not familiar with this topic, search online for the term and you will find lots of information.  You will find templates to guide you in leaving a legacy of your life’s lessons and your values.
  2. Start a discussion with those who you envision may be involved with your care. Start it now while you are healthy and independent.  Don’t wait.
  3. Write your thoughts and wishes down. Who have you chosen for certain responsibilities, such as power of attorney, and why? Create a journal of what you are experiencing and your current wishes.  What situation worries you most?  What are your wishes if you find yourself in that situation? What should your family members know?
  4. Share financial details with those likely to assist you in the last decade (and with settling your estate) so they become familiar with your resources and your filing system. Where is your Social Security check deposited?  What are your computer passwords? These things are critical.
  5. There will come a time when you give up your car keys. Some seniors do that on their own, others willingly at the family’s request or by court order if an accident occurs.  How will you know when the time is right? Will your family feel comfortable sharing their observations with you?
  6. What if your family feels that you should be in assisted living, but you don’t want to leave your home? How will you work through that together?  Consider a decision-making framework upon which you and your family might agree.
  7. Pre-plan your funeral, cremation, memorial. What type of service, if any, do you want?  Which songs? Who would you like to speak, and about what?  Your family will appreciate a thoughtful and detailed description of your last wishes more than you can imagine.

This is not a comprehensive list and taking these steps will not prevent disagreements or avoid all problems.  Taking these steps will go a long way toward ensuring quality of life in your last decade.  You may be thinking, “How do I know when my last decade is?”  Exactly.  Start now, it’s never too early.

Resource: Assisted Living Research Institute – Assisted Living options for People with Disabilities