If you are in your 60s, give or take, it may seem like only yesterday that you were having “that talk” with your children. You know, the awkward one about the birds and the bees. Before you know it, it’s time for another uncomfortable conversation – the one that begins with, “We’re not getting any younger …” and covers an equally awkward, but essential subject:
How would you like to manage your extended and end-of-life care?
Or, maybe you’re in your 30s, give or take, and wondering if your parents have been thinking along these lines but you’ve never talked about it with them.
Doing Something About It
Whether you’re thinking about your own future or your parents’ extended and end-of-life care, if your family has not had that second talk, we encourage you to use this article as your call to action. There are a number of reasons you don’t want to postpone it.
You already know it’s a good idea. Surveys tell us there’s a significant gap between most families’ good intentions versus implementation of their end-of-life planning:
- In a 2013 Conversation Project national survey, 90 percent of the respondents agreed that talking with loved ones about end-of-life care is important, but only 30 percent had done it.
- In a 2012 survey by the California HealthCare Foundation, 82 percent agreed that it was also important to put their wishes in writing, even though only 23 percent had done so.
Life happens. There’s never a bad time to discuss your extended-care needs. If you put it off until you face an imminent need, it’s far more likely to stress out your finances and your family.
Consider a 60-something couple we met with recently. Granted, that’s not very old these days! With today’s medical advances, many people at or near the traditional retirement age of 65 are enjoying the time of their lives.
Unfortunately, this particular couple had been hit with bad news. The husband had suffered a broken hip, followed by a cancer diagnosis. When they reached out to us about updating their estate plan, it paved the way for equally important conversations about extended care and end-of-life concerns. Hopefully, if worse comes to worst, they and their children can at least be comforted by having appropriate arrangements already in place.
The odds aren’t in your favor. As you enter your 60s, there is a good chance that, sooner or later, one or both of you may need extended care. The Department of Health and Human Services has estimated that “almost 70% of people turning age 65 will need long-term care at some point in their lives.” We hope the odds are in your favor, but in case they’re not, appropriate preparation for your most likely risks seems warranted.
The stakes are high. The possibility of needing extended care is something that everyone should be thinking about and discussing with their loved ones. Whether it’s an expected event or one that hits you blindside, a healthcare crisis can have an overwhelming impact on your long-term financial security.
Having “That Talk”
Are you ready to get started? A great first step is to set aside some time to hold those detailed discussions you’ve been putting off.
Every family’s situation is different. In a best-case scenario, you have a big, nearby network of ready caregivers to turn to. More typically, some or all of your immediate family may live elsewhere or otherwise be unavailable to provide extensive care. Whatever your circumstances, it’s best to have those objective conversations before you need to depend on the results.
In his article, “The Elephant in the Room: Addressing Aging Issues with Family Elders,” BAM ALLIANCE colleague Joe Delaney of Lifeguard Wealth interviewed elder law attorney and mediator Carolyn Rosenblatt, RN. Rosenblatt echoes our sentiments that one of the most important steps toward successfully confronting family aging issues is to start talking about it.
“One of the most common issues I see is initiating conversation with the aging parent about what will happen in the future,” says Rosenblatt. “We don’t like to talk about what might happen to us. Many people don’t like to sign wills and other documents because it means they might die. Yes, they ‘might!’ Also, we’re death- and disability-phobic. People fail to anticipate that they might not be 100 percent capable until they breathe their last breath.”
Once you have gotten over this hurdle and simply brought up the subject, you can more realistically determine what is fair and reasonable to expect from whom. Your loved ones also have the chance to ask questions, point out details you might have overlooked, and think through and prepare for their potential responsibilities.
Topics of Conversation: Extended Care
To get you started, here are some key talking points related to extended care:
- Should the time come when you can no longer live independently, is there a loved one who is capable and willing to care for you?
- In which setting(s) do you prefer to receive care and under what circumstances?
- Do you have the means to pay for extended care?
- If you may not have the means – or if you hope to preserve as much wealth as possible for legacy goals – what steps may be warranted to cover the costs should they arise?
About those costs. According to a Genworth 2016 Cost of Care Survey, a Chicagoland resident can expect to pay $53,000–$95,000 per year for extended care, depending on the nature of the care and whether it’s at home, in an assisted living facility or in a semi-private or private nursing home setting. The costs also can vary widely by state, so check out Genworth’s survey results to determine what you can expect for your region.
Topics of Conversation: End-of-Life Care
It’s also imperative to hold discussions about end-of-life preferences, lest you leave your loved ones guessing about what you would have wished. Here are some talking points to consider:
- Who do you want to make decisions for you if you cannot make your own?
- Do you want life-sustaining treatment?
- How comfortable (i.e., medicated) do you want to be if you are at the end of your life?
- What other preferences might you have about your personal and medical treatment plans
- Do you want to be buried or cremated, and what kind of service do you want?
- What do you want your loved ones to know and remember about you?
These and many other topics should be discussed with anyone who may be making decisions for you. Some of these points also require legal paperwork to make them stick – such as powers of attorney and a living will (advance directive). Or you can use a Five Wishes document, which meets the legal requirements to serve as an advance directive in 42 states and Washington, DC.
Cogent Conversations About Extended and End-of-Life Care
While not pleasant to think about, we all know we are going to die someday; we just don’t know when. If you are 60 or older, odds also dictate that extended care may be in your future.
Having conversations with your loved ones before extended or end-of-life care needs arise can make a world of difference. If you are uncomfortable discussing these issues, The Conversation Project is dedicated to helping people talk about them.
Talk is a vital first step. Follow-through is important too – and where best intentions often fall short. For that, The Cogent Advisor is dedicated to helping families take the next critical steps. We can help you convert conversation into action by overseeing the necessary follow-through with estate-planning attorneys, long-term care providers and other specialized professionals.
We hope you’ll be in touch with us soon to schedule a Cogent Conversation®