Living a Long Life

The fastest growing segment of the American

population is over the age of 85.2 In contrast, a

hundred years ago the average person lived into

their late 40’s to early 50’s.1 Each subsequent

generation since then has lived longer than the

previous. The majority of us will live longer than

our mothers and fathers will live.

As we live longer, the need to plan for longevity

in retirement is critical. Have we saved enough?

Will we be able to sustain our current lifestyle?

How do we account for the additional years

we may live and the fact that we may need

more reserves to fund caregiving needs as

we age? Have we taken the right financial

and legal steps? Have we thought about

medical preparedness, made the best

housing decisions, and engaged our family

in necessary conversations? Engaging in

this planning process now may make all the

difference down the road for ourselves and

our families.

Living A Long LifePreparing for Longevity

The GreatestComponent ofFrailty Risk

We all want to live as long as we can. And yet, we o�en fail to fully consider the inherent risks of aging. According to the New England Journal of Medicine (2000) over 4 in 10 people who live to 85 will become frail enough to need full-time care. Each additional year lived has an exponential impact on function and independence.

The reality we often seem to miss is that

AGE is the most predictive factor in physical

and cognitive frailty. According to the

Alzheimer’s Association, 1 in 3 Americans

over the age of 85 has Alzheimer’s.3 Some

of these individuals live long enough to

experience the devastating consequences

of the disease. Others may die before the

disease becomes severely impairing. Frailty

is inevitable, assuming we live long enough.

In fact, longevity itself plays the largest role

in estimating the risk of frailty.

02

Thinking Differently

Thinking differently about aging can help us

plan better for ourselves and our families. We

inherently want to associate the risk of frailty

solely with chronic illness or disease, especially

when we perceive ourselves as healthy. We

understand that we may live longer than the

previous generation, and perhaps even healthier.

Consequently, we may think that chronic illness

may not be in our future as we make healthy

choices. However, this does not account for the

fact that the longer we live, the greater our

chances of needing assistance at some point.

If we are able to make this shift in our thinking we

will be better able to plan for the road ahead.

03

04

Perceived Risk

If our parents lived into their late 80’s,

90’s or beyond, and experienced a loss of

independence, we are far more likely to

embrace this view of aging. If, however,

they died quickly without reaching the age

at which they would inevitably experience

frailty, this then becomes the dominant view

of how our own life might unfold. The reality

is we all see life through a set of lenses

that are shaped by own experiences.

Caring for a frail loved one also dramatically

shapes our view of aging. Caregivers intimately

understand the impact of what a loved one’s

loss of independence means for the family.

They have lived the physical, emotional, and

financial stress, and may even experience

shortened life spans associated with this

stress.4 Due to this personal experience,

caregivers are the first to prepare for a time

in life when they may need to be cared for.

Our parents most o�en define what aging might look like for us. Watching their aging process shapes the lenses through which we see our own future.

05

Protecting Others

Unfortunately, this perspective largely misses

the point. The challenges of an unforeseen need

for care are not born by the person who becomes

frail - he or she will receive the assistance they

need one way or another. Instead it is the spouse

and family who are at risk. Most who proactively

plan for this stage of life do so out of an inherent

desire to protect others and not themselves.

We all want our families to live as freely as

possible, without unnecessary burden. Planning

for the potential consequences of living a long

life is a gift to those we cherish. It means

taking steps that allow our loved ones to live

with less burden, be more autonomous, grow

and thrive, and live with more margin in their

lives to give generously to those they love.

Preparing for Longevity Beginning to consider preparations for aging

(long before they are urgent) can make all the

difference for those we love. While it may feel

premature while we are still young (50’s-60’s)

and fully independent, it is wise to begin the

process of long-term planning. Some decisions

may not be acted on for years, while others

can be costly if delayed or postponed.

The following lists are not intended to be exhaustive

of all the decisions associated with aging. They are,

however, intended to initiate planning that is often

overlooked or neglected until proactive choices

are no longer available. Hopefully, by starting the

discussion early we will not fall victim to a human

tendency to take action only when crisis hits. Best

wishes in your preparation for Living A Long Life.

Many people believe their own personal risk of age-related frailty is low. They are comfortable “rolling the dice,” so to speak. A�er all, they feel the odds are in their favor, so “why waste effort” planning for something that “may never happen”?

1. Sources: Department of Health and Human Services, National Center for Health Statistics, Centers for Disease Control and Prevention; National Vital Statistics Reports, Web: www.dhhs.gov ; www.cdc.gov.2. U.S. Department of Health & Human Services, https://www.nia.nih.gov/espanol/about/living-long-well-21st-century-strategic-directions-research-aging/introduction3. Alzheimer’s Association, Alz.org4. Accelerated Telomere Erosion Is Associated with a Declining Immune Function of Caregivers of Alzheimer’s Disease Patients, J. Immunol., Sep 2007; 179: 4249 – 4254.

Housing/LifestyleConsiderations:

Home entry walkways or ramps – rather than stairs

Zero-threshold entry doors

Roll-up access to all parts of bathroom - sink, toilet, and shower should be walker/wheelchair accessible

Zero-threshold shower - or roll-in shower if possible

Wide hallways (48”) and doors (36”) - to accommodate walkers and wheelchairs

Grab bars, door handles (not knobs), and easy-to- open cabinet pulls

Minimize or eliminate stairs - inside and outside home

Main floor laundry

Ensure adequate lighting - in all areas of home

Avoid throw rugs - or other tripping hazards

High speed internet - for “connected” medical equipment

Consider “connected” lighting - controlled by remote or phone

Consider video monitoring equipment

Appliances adapted for aging - large displays, safety features/alerts

Close proximity to medical care

Visit retirement communities - before you may NEED to move

Vehicles should be as easy as possible to get in and out of - neither too low or too high

Decide ahead of time at what point you will relin-quish driving privileges

Determine to stop using ladders

Legal Considerations:

Establish Powers of Attorney - for health and finance

Create Health Care Directives

Update or create wills

Create any trusts needed

Complete a FIVE WISHES document(www.agingwithdignity.org/five-wishes)

Provide all documents to Powers of Attorney (P.O.A)

Provide all documents to legal and financial advisors

Make a list of all advisors - with contact information

Make a list of all legal documents - include stored locations

Provide both lists (above) to Powers of Attorney and all advisors (legal, tax, financial)

Store legal documents in a fireproof location (wills, trusts, powers of attorney, heath care directives, etc.)

Store other important documents (insurance policies, financial account documentation, pass-ports, vehicle registration, military papers, birth certificates, marriage certificates, children’s birth certificates, and also copies of: health insurance card, social security card, and driver’s license)

Consider digitally-encrypted document storage

Review ALL legal documents and beneficiary designations - every time there is a significant life change for you or your representatives, powers of attorney, or executors

Destroy any OLD documents (wills, powers of attorney, etc.)

Financial Considerations:

Make a list of all financial accounts and insurance policies - include account numbers, passwords, websites, contacts and associated advisors

Provide this list to your Financial Power of Attorney

Provide the above list (without passwords) to your financial, legal and accounting advisors

Create a list of monthly bills - provide them to your Power of Attorney

Establish a sustainable retirement budget with your Financial Planner

Establish a realistic budget for age-related “frailty care” - include realistic expectations for inflation, varying costs of care and durations of need

Trouble test a variety of cost scenarios for care-giving needs - use modelling software (with your Financial Planner and Long-Term Care Planning Expert) to evaluate sustainable income

Evaluate if caregiving costs could compromise income sustainability - for self and partner

Establish funding sources for potential care needs -

these resources should not be needed for income needs

Evaluate Long-Term Care Insurance - vs. self-funding with your own income (seek the assistance of an LTC insurance expert)

Clearly define attitudes/goals about leaving financial legacies - to heirs or charities

Evaluate if care costs could compromise legacy planning goals - inheritance or charitable goals (this can also be modelled with the assistance of your Financial Planner)

MedicalConsiderations:

Make a list of all physicians - include contact info

Keep an updated list of all medications

Keep an updated list of all current health conditions

Collect all medical records - ask for a copy at each visit

Inform Health Care P.O.A. of the location of this information

Establish any online portals to medical records –

provide list of websites and passwords to health care power of attorney (P.O.A)

Provide a list of portals (& passwords) to your Health Care P.O.A.

Provide a copy of your insurance to your Health Care P.O.A – Medicare Cards, Medicare Supplemental Coverage, and Long-Term Care Insurance

Create a POLST (if ever needing Hospice services) - provide a copy to your Health Care P.O.A.

Understand your Skilled Nursing Facility (rehab) options - many Medicare HMO’s may limit which facilities you can use

Understand all of your “frailty care” options -

Home Care, Assisted Living, Adult Family Homes, and Memory Care

Understand mobile medical alerts systems - prior to a crisis

Understand automated medication dispensers -

most individuals need medication assistance in their frailty years

Follow home safety guidelines to minimize fall risks

(www.stopfalls.org)

Family(Or Support System):

Share your aging goals and desires

Discuss potential for caregiving needs

Define concrete goals and boundaries for family involvement - recognizing that family often wants to do more than they will be able

Define safeguards to caregiver burnout - recognize that caregivers most often give more than is healthy for themselves

Define plans for supplemental care or respite care

Define when facility care is appropriate (Assisted Living, Adult Family Homes, or Memory Care)

Select a small group to be a support system –

these are individuals who can fully take over all caregiving in an acute situation or in the event of caregiver burn-out

Determine to plan in a way that offers your family more freedom and autonomy

When appropriate agree to disagree

Tell family OFTEN that you LOVE them

Attempt to mend broken relationships (The most profound regrets people have late in life are relational)

Living a Long Life

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