HARD CHOICES PLAN NOW    

By: Nansi Smith    

I can't tell you how many times I've been with families faced with the difficult decision of "what to do with mom... or dad... or grandma... or grandpa.... " During the session, someone invariably says "It could be worse, we could be sitting in a funeral home."

You know what? It's much more difficult to put a loved one in a nursing home than to put a loved one in the ground. The choices you make in a funeral parlor are aesthetics.... what to wear... to cremate or not to cremate.... the casket... the programs...

When you're faced with a loved one who is still living, but unable to care for themselves, the choices go far beyond arrangements for one final day.

I can walk you through what to do with your elderly loved one, but today I'd like to address what WE can do for our children who will someday face our disposition.

Every time I find myself lugging Mom's wheelchair from the nursing home to one doctor or another, I say a little prayer, "God, please don't let me do this to MY children."

Here are five things we can do for our children so that their decision day will be less painful:

1) Look into long-term care insurance. The younger you are when you enlist in an LTC policy, the lower the premiums. I have a friend who is in her 60's. She recently signed on and pays nearly $300 per month. Don't rely on Medicare to cover nursing home expenses, they don't. The most you can hope for in Medicare reimbursement for nursing home care is 100 days. That's the outside best hope and after 20 days there is a huge daily co-pay.

2) Talk to an estate planner or elder law attorney. There are programs out there for protecting your assets in the event of a need for Medicaid assistance for long term care expenses. I gave this advice to a lady who, along with her husband, had substantial cash assets. The attorney was able to convert them into income-producing annuities, thus sheltering that asset. Speaking of assets, the days of signing your house over to your kid for $1 to avoid having to sell it to pay for your care are over. The new "look-back" period is five years. This means that any sale of assets below market value will result in a period of ineligibility equal to the value of the asset. An estate planner will know how to protect your home and assets.

3) Get a will. Don't leave it to the government to decide who gets what.

4) Get a living will. When I worked in a nursing home there was a gentleman who was basically a vegetable. He had been a dignified business owner--a man of means and accomplishment. Now he's being spoon or tube fed and having his diaper changed. I often thought he'd rather be dead. But there had been no living will. He spent the last EIGHT YEARS of his life like this. Have a family conference and put your wishes out on the table. What heroic measures are you willing to take to prolong your life? DNR? Tube feeding? Life support?

5) Medical Power of Attorney. While you're still "with it" choose someone you trust to become your Medical Power of Attorney. This person would step in if you became incapacitated and make medical decisions on your behalf.

I cannot tell you how much I wish my mother and I had done these things. The weight of her well-being weighs so heavily on me. I pray every day that my children don't EVER have to stand up under this same weight. It's up to me to turn my prayer into a reality by following five simple (?) steps.

"Beautiful young people are accidents of nature, but beautiful old people are works of art." - Eleanor Roosevelt

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