Elder Care for Seniors Without Family – The population of aging seniors without family caregivers is growing. It is estimated that 22% of Americans 65 years and older are in danger of being, or already are, in this situation. Women comprise most of this population. According to a recent report by AARP, it is projected that by 2030 approximately 16% of women will be between 80 and 84 years old and childless, compared with about 12% in 2010. This population, called elder orphans, must plan for themselves since there is no structure in place to handle their daily living, medical and economic needs.
This does not have to be a bad thing. With good advance planning, this population can age gracefully and with dignity. Here are some major considerations:
- Wills and trusts. In combination, a person’s will and the trusts set up under it allow the elderly person to control how his or her assets are used and/or distributed. With a living trust, the person has control until or unless they become incapable of having it. If that happens, a successor or co-trustee (e.g., a CPA, lawyer or trusted friend) takes over. There are other types of trusts as well, including irrevocable lifetime trusts, where someone else is designated as trustee from the beginning.
- Health care directives. Everyone, not just this segment of seniors, should consult an attorney to put certain key documents in place, to help ensure the person’s wishes regarding his or her health care will be respected. The documents need to be compliant with the laws of the state where the person resides; consequently, a person who resides in two or more states needs to have documents drafted in each state. If someone dies without these three documents in place, state laws and guidelines determine what happens.
- Health care proxy. This document designates a person to act as the patient’s agent in making medical decisions if the patient is unable to do so. If there is no family member able or willing to take this responsibility, a friend or a trusted advisor may be asked to take on the role.
- Living will. This document spells out the kind of treatment that a person wants or does not want when he or she is unable to express consent.
- Do-not-resuscitate order (DNR). This is a written instruction to medical personnel not to perform CPR or advanced cardiac life support (ACLS).
- Durable power of attorney. This is another legal document everyone should have in place. This document designates an agent to act on behalf of the elderly person in legal, financial and health matters. The agent’s powers, which can be limited or not, begin as stipulated in the document, remain effective even if the person becomes incapacitated, and end when the person dies.
- Financial matters and money management. It is important to have someone in place, such as a CPA or other financial advisor, who can, for example, pay bills, reconcile bank statements and handle investments.
The elderly have multiple options, based on their preferences, health status and financial situation:
- Staying in one’s home is generally the preferred option, but it may require making modifications. For example, installing grab bars in showers, ramps, chairlifts on staircases or door handles that are easier for arthritic hands.
- Assisted-living facilities are available in many communities, although cost can be a factor. These facilities provide varying levels of support services, such as community meals, laundry services and social events. They may also provide access to aides who can help with the activities of daily living at an additional cost.
- Continuing care retirement communities are an option, but they often are quite costly. They offer “stepped” arrangements for housing and other services that adapt along with the resident’s needs. Residents start in independent living housing and, if necessary, eventually transition to assisted living or nursing home care.
The bottom line is that you should work well in advance, with trusted advisors, to find out what works for you.
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