I have related that my journey into elder law began with caring for my grandmother. It would be nice if I could say we made all the right decisions at all the right times. But, that would be untrue.
When I started taking care of my grandmother (she was 88), she was living in her own home in Fort Worth, Texas. She was in a weakened state, and also suffering from macular degeneration. Between her weakened state and the macular degeneration, falls were not uncommon. Over the course of time, I made arrangements for different services in the home. Virtually all of them were rejected by my grandmother. Part of it had to do with her wanting to be private, and a large part of it had to do with money. I always had the feeling that my grandmother just wanted to crash and burn at home, and then go to a nursing home. In fact, she told me one time, “Honey, I know one day I will have to go into a nursing home; I just don’t want to know about it when it happens.” As long as she was cognitive, she wanted to stay at home.
Eventually, on two different occasions, my grandmother went on hospice, while living at home.
My grandmother was no different than many people. They have spent years and years accumulating what property they have, and are so afraid of losing it all. They are so afraid of losing it all, that they make decisions to reduce costs: eat less food; be frugal with their expenses such as medication, doctors’ appointments, utilities and the like. The reduction means they are not taking care of themselves, and any health issues spiral into something major, if not a crisis.
I remember a family a few years back. Betty was brought in by her son and daughter. Betty was still going strong, but at age 90 had become a high-risk person because of falling. In the course of talking with her, she expressed her strong desire to stay independent and to live in her home as long as possible.
I talked with her about having someone come in on a part-time basis. She assured me that she could not afford it.
As I began working with Betty , I discovered that she had quite a bit of land – in excess of half a million dollars. I eventually was able to talk to Betty about using a small piece of that property to help pay for care. With that money, we were able to bring someone into the home, so that she could stay there as long as possible. And she did, until near the time of her passing.
It seems silly to say, but sometimes we have to be reminded that the longer we stay out long-term care, the more money that we save. Similarly, the better health that we have, the more likely it is that we will not need long-term care. And, finally, the greater we reduce our health risk, the less likely it is that we are going to get into a health crisis.
One of the “jobs” of my office, and as an elder law attorney, is to show people how to access their resources, how to use those resources wisely, how to get care in their homes, and how to make their assets last as long as possible to help them achieve their personal goals of staying at home as long as possible, reducing the cost of long-term care, and most importantly, being safe. As we say, “how to find, get and pay for good care while maintaining your quality of life.” But, the first step is to convince our families to spend money now to take care of themselves now.
Let me go back to my grandmother. As I said, she went on hospice twice. The last time required that we move her from her home. I packed her up from Fort Worth, Texas, and moved her to Hays into an assisted living facility. Though everyone said she needed to go to a nursing home, I decided that I would rather marshal her resources, and let her try the assisted living facility. And, guess what? Once she got into the assisted living facility, and with the help of her doctor and one of our care coordinators, we were able to reduce her medications from 14 to 4; my grandmother started eating again, and started gaining her weight back; we got her to use a walker, reducing the falls; and more importantly, she became very socially engaged at the assisted living facility. One of the small exciting moments is after she moved up here, and though she had macular degeneration, I took her out to the north part of Hays one day. There, she saw her first wheat harvest. It was gratifying to see how happy she was, and how reengaged she had become.
By my grandmother “agreeing” to spend money on assisted living, she ended up with a much better quality of life than she had living alone. I am not advertising for assisted living; I am advertising for taking care of yourself now. We were lucky; if she had fallen at home and broken a hip, at her age it would have been an irreversible injury that would have led to a nursing home. As it was, by her spending money on herself in assisted living, she was able to stay out of the nursing home until the last 50 days of her life, when she was 96 years old.
Please, please, be willing to take care of yourself now. Taking care of yourself now will pay benefits in the long run.