Will You Age in Place or at a Multi-Functional Living Location?

If you are healthy and fully functional on your own, now is the time to give this serious consideration.

The best answer may be to age in place as long as feasible and then move into a multi-functional living location. The problem is you and your adult children may not agree on when is the best or most appropriate time to make this type of move, if ever. Your best defense is a good offense. Get out in front of this and plan for what is best for you and/or your spouse now.

First, let’s define our two terms. “Age in place” means you will continue to live in your home and when the time comes that you need help with activities of daily living, you will have someone come to your home to help you and provide these services.

To move into a “multi-functional living location” means you will live in an apartment at a location where three stages of care are provided. The first stage is independent living where the primary “care” provided is daily meals and weekly house cleaning. At this same location, assisted living is also provided and available for when that level of care is needed. And the third level of care provided is memory care. Memory care is specialized care for individuals with dementia or Alzheimer’s disease who cannot fully care for themselves.

There are two key questions to answer:

1. What are your desires and preferences?
2. What can you afford?

Does the answer change if you are alone? If your spouse passes away before you?

What if you can no longer drive, or better yet, shouldn’t be driving? Does this change your answer?

Do you want social interaction readily available, as would be the case in a multi-functional living location or are you just fine living by yourself in your home?

Many people do not plan for this stage of life soon enough. Instead, they get caught off guard and are forced to make hasty decisions due to a fall or other emergency.

When a little extra help is needed, this usually starts with meal preparation. Fixing meals for one’s self or for two people is a big chore and often falls by the wayside. Arthritis or a disability might make this down right impossible or so painful the elderly stop doing it. At this point nutrition and health become a concern.

After meal preparation, the next life challenges typically facing the elderly includes getting to and from doctor appointments, help with bathing and dressing, and successfully taking their medications.

None of us want to have an “intervention” where we effectively force our parents or loved ones into a living situation they do not want or are not prepared for, even when we know it is in their best interest. Exceptions to this often occur when a loved one has dementia or Alzheimer’s disease.

What obstacles might you run into when helping loved ones through this stage of life? Or, what might others run into when trying to help you through these decisions? Here are some things that you may encounter:

• “I don’t want to talk about it.” This can be a big problem if your loved one is not willing to have an open and honest conversation about what their desires are and what is feasible given their personal situation. Their personal situation includes health, finances, emotional state, cognitive ability, and physical mobility. We all need to recognize any of these personal situations can change very quickly.
• Financial limitations. They may not have enough money to support their preferred living choice and you may not be able to help financially either.
• Unplanned events or an accelerated timeline. An unplanned event like a fall or heart attack can cause the need for immediate action to be taken. Your loved one suddenly needs a walker or wheel chair to get around for the rest of their life.
• Physical limitations. The home where your loved one lives is a two story house with all bedrooms upstairs and no practical way to have a full bath and bedroom downstairs. They think they will forever be able to negotiate the stairs, or they say, “let’s deal with that when the time comes”. When the time comes may be too late or the available choices are severely limited.
• “No one is coming into my house, I don’t need any help”. This is often true, they do not need any help until they suddenly do.

Talk through these life choices with your loved ones well ahead of when decisions are forced upon you. The worst thing to do is not talk about these choices ahead of time and then have to deal with them when emotions are high and choices are limited.

As is often the case with significant life decisions, personal finances play a big role in the decisions to be made. This is especially true for these life decisions.

Here are a few things to think about:

• The best way to have the most options available is to have the house you are living in paid for. This takes a lot of planning, well before retirement. If a couple in retirement has a house payment and car payment and they are doing just fine financially because they both have pensions and Social Security, what happens when one passes away and there is just one pension or source of Social Security? Is this enough to support aging in place if that is your plan and desire?
• This could be a basic plan. As a couple, they live together in their home and “age in place” UNTIL specific life changing events occur. These events include but are not limited to the ability to fix their own meals, driving, mobility (first a cane, then a walker, then a wheel chair), cognitive ability to manage their own life, take their own medications on time, accurately, reliably.
• These things start out slow and evolve. The couple’s ability to fix meals degrades significantly but family members step in to provide home cooked meals daily. So far, so good. They stay in their home. Then the unexpected happens. It is required that either help comes into the home or they must move to a multi-functional living location. Is everyone on board with a pre-determined outcome because it has already been discussed? Or, will emotions and family strife take place because none of this was talked about ahead of time?
• We know elderly parents do not want to be a burden on anyone, including their adult children. We do not want to be a burden on our kids later in life either. So plan ahead and have the hard conversations ahead of time.

Here are two references:

• The first is a blog article that address the question: Do you have a plan for long term care?
• The second is the video-based online course by Aging Energized called: Medicaid For Seniors Basics. This is highly recommended if having enough money to pay for long term care is in question.