What’s Your “Master Plan” As You Get Older?

Q. My wife and I are 59 and 60, respectively, and we recently got to talking about our “master plan” for the future. We haven’t had an in-depth discussion of this sort until now, as we have been focused on other things that are occurring in the present. Another reason is that we have become simply overwhelmed by all the different issues we have to consider about our futures. Where should we live? How much money will we need?  How can we generate income that will last the rest of our lives? How can we manage our health, our illnesses and, ultimately, our deaths? There are so many things to think about that it can seem easier to procrastinate about doing anything.

So, we decided to tackle one issue at a time. The first topic we want to think about is “aging-in-place.” This is an issue that my wife and I are having to face right now for my mother who has dementia, so it’s at the forefront of our minds. I know most people want to grow old in their homes and plan to do so for as long as possible. But, is it really best to age-in-place and ask your loved ones for help, or to enter assisted living or a nursing home when you need more assistance than they can handle? Aren’t nursing homes and assisted living facilities astronomically expensive…but then again, isn’t in-home care also? I’m thinking about this seriously now, because whether we need to make home modifications in the future or pay for long-term care or both, we need to plan in advance. Thanks for your help!

A. Many of us can get overwhelmed thinking of all of the things to plan for when it comes to aging. As we approach our late 50s and 60s, we may become even more determined to ignore the reality facing us. It is wise that you and your wife are taking the time to discuss your “master plan” and focusing on issues that will likely affect you both in the future.

“The Senior Years Master Plan” Helps You Plan in Advance

“The Senior Years Master Plan,” a book written by Ralph Mroz, brings up many issues people need to consider before they retire.  Mroz wrote the book as a guide to all of the practical aspects of aging that require planning and action, often years in advance. According to Mroz, “(a)s I watched my parents’ generation suffer in old age from lack of choices, or poor choices made decades earlier, the question in my mind was, ‘So what do we need to do now to plan for the best outcome in our old age?’”

Topics in the book include housing and care options, aging-in-place, pets, cessation of driving, and establishing a team (consisting of your doctor, an elder law attorney, financial planner, personal trainer, maintenance people, care manager, nutritionist, and more), and planning your funeral.

The book stresses the need for practical action. Each chapter lays out various options, presents some hard truths, and stresses the need for planning. Most chapters stress the need for professional assistance, such as engaging the help of an experienced elder law attorney or of a nutritionist, care manager, etc., as mentioned. However, no chapter tells the reader what they should do, but rather how to evaluate the options or how to engage an appropriate professional. For more details about this book, visit Amazon.com.

Should You Age-in-Place When You Get Older?

Surveys show that most people would prefer to grow older in their own home. This is a very important topic and it’s wise that you and your wife are exploring it ahead of time. Recently, Next Avenue explored aging-in-place, excerpting from Mroz’s book that is described above.

According to Mroz and other subject matter experts, aging-in-place lets you remain in your familiar surroundings, close to friends and possibly family. And there are other advantages, including:

Familiarity: One reason older adults want to age in place is so that they don’t have to leave the comfort of their familiar surroundings. It’s only natural to feel attached to a home filled with happy memories. After living in the same place for many years, it can be hard to say goodbye.
Consistency: Nobody likes change, and it can be particularly difficult for older adults to adjust to the changes that come with moving from their longtime home. By staying at home, older adults are able to maintain their same routines and habits, without the need to adapt to a new environment.
Convenience: Downsizing a home filled with a lifetime of belongings is no small task. The process can be physically, mentally, and emotionally draining. For this reason, some older adults try to put off the decision to downsize as long as possible.

But, let’s say, as you mentioned, that the time comes when you can’t be adequately cared for in your home, and that things get harder when you are older and experiencing declining health. What if you become isolated, especially if you can no longer drive? Caregiving help can also get expensive and hard to find in the home if you need it. Your home may also become a burden, with its continual needs for maintenance and upkeep.

It’s easy to think that aging-in-place will be less costly than moving to a retirement community, assisted living, or a nursing home. But this reasoning overlooks that your stay-in-home costs will increase, because you will need more care as you age.

In his book, Mroz goes into detail about the disadvantages of aging-in-place. Here are some things to keep in mind:

Loneliness and isolation: Even with friendly neighbors and family nearby, older adults who live alone may still feel lonely and socially isolated, as is the case now during the coronavirus pandemic. Loneliness and isolation can be connected to serious health concerns such as anxiety, depression, obesity, and heart conditions. One of the biggest advantages of living in an assisted living community or a nursing home is that residents have access to meaningful social contact and engaging activities (not right now, during the pandemic, but in general).
Health declines and safety concerns: A typical home can be full of fall hazards and other safety concerns for older adults who maydevelop mobility issues as they age. Hazards such as poor lighting, loose rugs, stairs with unsecured railings, or slippery bathrooms can lead to dangerous falls or accidents. While certain home renovations can be made to mitigate these risks, it is often more cost-effective to relocate to an assisted living community or a nursing home facility, which is designed to accommodate the needs of older adults.
Home maintenance and upkeep: Over time, it can be challenging for older adults to maintain a larger home on their own. Chores that involve a lot of physical work such as yard work, laundry, vacuuming, or grocery shopping and running errands can become stressful and burdensome. Failing to perform home maintenance tasks may also lead to expensive repairs down the road.
You’re dependent on your spouse or partner: If you are aging in place as a couple, you may depend on one of you to be more competent in a given area. One person may be good with repairs and cooking, the other with financial and medical issues. But when one half of an aging couple dies or declines significantly, what happens then?
You may decline mentally: Mental and cognitive decline as we age is inevitable for most people, although it of course affects some more than others. This kind of decline could become dangerous or unhealthy. You might not remember to take your medications or eat properly. You might ignore problems withelectrical wiring, gas lines, faulty appliances, etc.

When it comes to deciding whether to age in place or to move to an assisted living community or a nursing home facility, there’s a lot to think about. Ultimately, the most important factor to consider is quality of life. While it’s never easy to leave the comfort of a familiar home, many people find that moving to an assisted living community or a nursing home facility is the best option for their or their loved one’s overall health, safety, and well-being.

As you mentioned, all of these options are expensive, so you should make sure you have a plan in place! Having the conversation is a good start, but a prudent course of action would be to plan in advance with an elder law attorney and financial planner, such as myself, who can help you prepare legally and financially for what the future may bring.

As a Baby Boomer, the researcher and author described in this article, Ralph Mroz, researched many aspects of aging in order to plan effectively for the upcoming decades and to write his book. Now retired, he is well prepared for his future and currently volunteers at his local dog shelter in his home state of Massachusetts.    

When Aging-in-Place is No Longer an Option

What happens when you or a loved one can no longer age-in-place? Nursing homes in Northern Virginia and the rest of the Washington, D.C. Metro area cost $12,000 – $14,000 per month, which can be catastrophic even for wealthy families. By being proactive and planning for long-term care in advance, you can help ensure you can always receive the care you need without worry or financial struggle. You’ll further avoid many costly legal headaches that often result when people are not prepared for incapacity or ongoing care needs. It’s never too early or too late to get started. Reach out to us to make an appointment for a no-cost initial consultation:

Elder Care Fairfax: 703-691-1888
Elder Care Fredericksburg: 540-479-1435
Elder Care Rockville: 301-519-8041
Elder Care DC: 202-587-2797

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