Who enjoys having squishy emotionally complicated family conversations, raise your hands.  Yeah, that’s what I thought – no one, myself included.  I moderated a workshop on ethics this week and one of the topics that came up was discussing long-term care plans with clients – not long-term care insurance, but long-term care planning and I thought that would be a good something to chat about today.

Few people are really talking about what those last years might look like and yet, of all the conversations out there, that’s one we should be having.  Sure, we talk in generalities about “I don’t want this or that” or “That will never happen to me” but we don’t drill down and talk about specifics.  We’ll spend more time scoping out the details of a new car than we will our last couple of years.

For the vast majority of the population, incorporating the cost of a quality long-term care insurance policy into their cash flow simply isn’t a reality but that doesn’t mean the topic stops there.  With or without long-term care insurance, most of us are going to grow old and some of us aren’t going to do it well.  And even if you do have a policy in place, the type of care and your wishes still need to be outlined so those insurance dollars are taking care of you in a manner you would prefer.  Let’s hit some highlights then I would suggest you grab yourselves some Highballs and talk it out.

How we want to live out our final years starts way before we hit our final years.  For instance, what does growing old [gracefully] mean to you?  For some, it’s a time driven question – “I will get as many years out of this life as possible, regardless” – and for others it’s a quality comment – “When I’m not contributing to society / When someone else needs to take care of me, I’m outta here.”  Once you’ve answered that question, you can start to think about the “how” of things.  Let’s say you are in the “live long, come hell or high water” camp – how is that going to happen?  Do you have family members locally who will be able to help you maintain your home and lifestyle?  Do they know that you’re counting on them to step up when you need them to, regardless of what’s going on in their own lives?  If you don’t have family locally, do you have the resources to move into a facility that will help you, such as independent living or assisted living?  Have you scoped out the options around you so you know where you want to go and how much it will cost?  Let’s say you’ve done that – have you had a conversation with your family to outline how you want your assets to be spent?  You wouldn’t believe how many people come through my office pretty sure that there will be some money from Mom or Dad to close that little gap in their own retirement plans.  An even larger percentage come in and comment that they weren’t prepared, emotionally or fiscally, to carve out the average 10+ hours per week to help out with an aging parent.

If you are considering the “contributing to society / need care” camp – have you thought through how you are defining your exit ramp?  What level of care is your threshold – needing someone to vacuum is a far cry from needing someone to help you get dressed.  Once you’ve defined your threshold, have you considered your options?  The “end of life” discussion is wide and varied and certainly heating up now that Baby Boomers are watching their parents age and thinking that perhaps that’s not for them.  I would encourage you, if you’re in this category, to write down your “I Don’t Wants” now so you, and your nearest and dearest, have something to reference later on.  You can always change your mind if one (or more) of those issues comes to pass.  Given that our health tends to decline gradually, having a point of reference can be useful to avoid sailing right past our intended wishes and on into a situation we would never have asked for.

Adding a complication to an already complicated conversation is the fact that an increasing number of people, primarily women, are aging right past any family and are now elderly and alone.  If you are single, have you built a circle (however small) of people who understand your wishes and are willing to be there to help out when the time comes, whether it’s the helium / butterscotch & barbiturate pudding route or a plane ticket to Belgium?

My challenge to each of you is this – sometime during the next six months, spend some time thinking about what you want your last years to look like.  Write it down, put it away for a bit then pull it back out and ponder it some more.  Once you’ve defined your intentions, spend some time letting those closest to you know your thoughts.  With everyone on the same page (or not, since families are complicated), make sure you have some documentation to put your wishes in place.  Our medical structure falls firmly in the “live long, regardless of quality and cost” camp which can be devastating both to you as the pin cushion and your loved ones who have to watch if they have nothing to fall back on to explain your wishes.

The Foundation for Women’s Financial Education sponsors two seminars that can help with this topic – “What to Know Before You Go,” a primer on end-of-life care and death planning, and “Mom Needs Help… Now What?” a seminar for those who are starting to experience aging questions for their loved ones.  The latter is being held on Thursday April 18th at our office – if this is a way to jump start your planning process.