Planning ahead can help to demystify aged care and reduce stress levels. With awareness and pre-planning, you can maintain control and choice, have access to the financial resources to pay for care and minimise the stress on you and your family. Using a simple action plan, this article helps you prepare for when you may not be able to look after yourself and need extra supportive care
Frailty Years: Important steps to help prepare an action plan
As we age, we often find ourselves swapping ideas and experiences with friends about what we do to help us live healthier and happier lives. These types of discussions are usually focused on our mental, physical, sexual and spiritual approaches to positive ageing and for good reason, as it hopefully provides us with practical strategies to reduce or maintain our biological age.
But, as we know, the path of life have many unpredictable twists and turns. Worst case, we can crash. Then what? What will happen to you or your partner if you are no longer able to care for yourself?
Peace of mind
Use the experience of going on a road trip, we need to prepare for potential adversities. For example, if driving on rural roads, we need all the right equipment just in case of a breakdown. If in the city, we are more likely to have a pile-up collision, therefore adequate insurance is essential. Basically, if the thinking is done ahead of time, you can generally sit back and enjoy the drive because you have prepared for all the potential obstacles ahead. Even for the most cautious of drivers, accidents do happen.
Last year, three in ten people over the age of 85 and almost one in ten people over 65 have dementia . The leading cause of death in senior Australians is Coronary Heart Disease, Dementia and Alzheimer’s disease, Cardiovascular Disease, Chronic Obstructive Pulmonary Disease and Heart Failure .
Having a plan for the any physical or cognitive decline in late life is no different to having an insurance policy. You may or may not use it, but you have the peace of mind just in case. Most importantly, having a plan empowers you to maintain control of your life choices.
The story of Marg & John*
I would like to share a true story about a couple Marg and John, two active people who were enjoying their retirement. John recently left work because his diagnosis of vascular dementia was slowing him down. Since dementia is incurable and shortens the lifespan, Marg left work so they could spend quality time together . Overall, with assistance in the home for cleaning and gardening, they were managing very well until Marg learnt of her diagnosis of ovarian cancer. Following major surgery and chemotherapy, Marg and John lifestyle was forced to change.
Marg now needed supportive care most hours of the day. Her dying wish was to stay at home with John. To arrange this, they needed nursing assistance because John was not in a position to care for Marg. With immediate access to government services such as a home care package or palliative care and funds to employ a private nurse, Marg’s wish may have been possible.
Marg was too weak to start contacting the relevant providers and professionals to put the home care in place. For example, MyAgedCare, the doctor, Centrelink, the bank, financial planner , the lawyer - the list goes on. Instead, thinking it was all too hard to organise, their children supported the decision to send Marg and John into permanent residential care.
This went against Marg’s wishes.
At the time, no permanent residential homes were available with a shared room, so the lifelong couple were separated causing great angst for Marg and John. A truly heart breaking and unhappy outcome for everyone involved.
I shared this story because planning ahead ‘for your frailty years’ to help get what you want is very achievable, particularly if you follow this simple action plan
Where do you want to live if you can no longer support yourself?
Dismayed by some of the recent examples in the press about permanent aged care facilities, it is fair to think all facilities are there to make us feel miserable. Thankfully this is far from the truth.
Take time out to research an aged care facility locally or in an area you love, like a coastal area or a suburb close to your family. Once you have confirmed the location, arrange a site visit. Visiting a facility will give you a feel for the level of care provided, the cost (is it affordable to you?) and services offered (e.g. gym, occupational therapy, hairdresser).
Permanent residential aged care is not the only choice for high-supportive care. Even at a time if you need 24 hour care, a private team of nurses can be arranged, a live in carer or relocation to another state to live with family. Anything is possible if you plan ahead.
You will need to have ACAT/ACAS approval before you can access a government subsidised home care package or residential care. You can book an appointment directly with ACAT/ACAS on 1800 200 422.
If you have decided on permanent residential aged care, you can fill in an application form to add your name to the waiting list. You can put your name on the waiting list for more than one service to increase your chances of finding a place.
How will you pay for your aged care?
Once you have decided about what aged care option you want to support your potential high care needs, the key will be to assess if you afford it.
How much you have to pay may depend on:
The service you choose
Your assessable assets
Your assessable income
Engage your financial network, such as a qualified financial planner who is accredited in aged care or have a deep understanding of the area. Share your plans, the estimated costs and hypothetical timelines. For example, Mary lives alone and decided, should anything adverse happen to her health, she wanted to relocate to Canberra to be close to her daughter. Her daughter lives in the inner North Canberra, where the refundable accommodation deposits for the facilities she preferred are $550,000. Her financial planner worked together to set a few strategies, to ensure she had the financial freedom to make this choice, should this happen.
Action: Your adviser can help you to understand the fees as the total amount payable can be very hard to calculate without good advice. An adviser can review your full financial situation and provide advice on how to:
Make appropriate decisions
Structure assets to pay for accommodation and as well as create sufficient cashflow
Minimise fees or maximise Centrelink or Veterans’ Affairs benefits
What are the key legal documents I need to put in place or update?
As dementia is a leading factor behind the need for care services, when the time comes it is likely that the client will need to delegate financial decisions to someone else. This is easier if an enduring power of attorney (and guardianship) is in place. So it is important to have the appropriate powers in place before a person has lost legal capacity as once capacity has been lost, it will be too late to set up the powers and a trip to the Guardianship Tribunal will be needed.
Anytime your circumstances change it is important to consider the impact this has on your estate plans. This includes when you move into aged care.
Check your will, ePoA and estate plans are available and up to date. You should speak to your solicitor about the ability to review and redraft your will to reflect your wishes.
Identify who will be responsible (when you can’t) for Financial decisions, Medical decisions and Living arrangements
We are often reluctant to think about a potential move into care. This means we fail to plan and ignore the warning signs until a crisis emerges. At this point, the time available to evaluate options is limited and decisions may be rushed. Also, our families may start to argue and conflicts arise.
Action: Start with a family meeting to make shared decisions. Use this meeting to:
Discuss options and preferences
Explore each person’s concerns
Decide who needs to be involved in any planning
Frank and open discussion is the first step to an effective decision-making process.
Ask your adviser to facilitate your family meeting. He/she can provide advice as well as offer an impartial and objective view.
While it may be less fun to think about the potential for physical and cognitive decline in the later part of retirement – our frailty years - this is an important period to plan for if we want to maintain independence for as long as possible.