How Do You Control Your Destiny in the Senior Years? Part 2 of 2

In Part 1 of this post, we looked at several aspects of a Senior Living plan that helps expand our range of choices.  In that post, we addressed finances, legal framework and healthcare security. To review, the message is this: the more you understand the common issues that creep into our lives as we age, the better you can plan for them.  Some of those issues may never happen, but having a plan helps minimize the stress and allows you to have control over your circumstances even if you are losing control over your physical and/or mental faculties. Here in Part 2 we address the progressive living plan, social support and mobility issues.


Progressive Senior Living Plan:  So maybe you’ve noticed a theme?  The word ‘plan’ sure seems to show up a lot in these blog posts and all over the Institute for Quality in Senior Living website.  So what is this plan we keep talking about. The nature of a progressive plan is to help you explore what quality aging looks like for you – it is certainly different for everyone – and then put some elements in place that allow you to execute the plan as your circumstances change.  The plan itself should certainly include the legal and financial instruments discussed in Part 1 of this post, but more importantly, it should outline details as HOW you want to live your Senior years.


For people who are in good health, absent of chronic progressive disease, a plan may seem superfluous.  But, when circumstances change, they are often not foreseeable and for that reason, having a plan that you share with your family and friends means you are prepared for the unforeseen.  


There is a prevalent concept called “aging in place.”  This means that the goal, as it sounds, is to age right where you are now.  The plan to age in place will require that you account for things that might change in your social, cognitive or physical ability.  For someone with a chronic disease such as Parkinson’s, there will be mobility challenges that necessitates planning in order to age in place.  This might be something as simple as moving a bedroom from the second floor of your house to ground level to avoid having to use stairs. For many Seniors that don’t have that type of chronic progressive diagnosis, falls are often one of the biggest threats to independence and increasingly common as we age.  So a progressive senior living plan might include identifying ways to mitigate falls where they commonly occur, such as in the bathroom. Installation of grab bars and other safety mechanisms like raised toilet seats or shower benches help us mitigate that risk and allow us to achieve our goal of aging in place.  Setting aside finances or counting on a family member for caregiving services such as food shopping, meal preparation and even activities of daily living like bathing and grooming should be part of an aging in place plan.


For others, they may seek more social interaction with less responsibility for cooking and cleaning as they age.  These people might view assisted living facilities as a terrific option. Indeed, many are very, very nice with amenities that are akin to country club style living.  In this case a progressive senior living plan might identify moving to an assisted living as a goal. The question then becomes; what are the triggers that would prompt a change to that environment?  In some cases, it might be the loss of a spouse or loss of mobility, or something as simple as loneliness. But the key here is to plan. If you want country club living, have you set aside the resources?  Do you live in a house that might provide some financial leverage to enable you to make that move? You’ll only know if you’ve planned.


There are many other options for Senior Living that continue to evolve all the time.  Rather than focus on examining all those options, our purpose in this blog post is to emphasize the need for having a progressive Senior Living plan.  It means understanding some of the common and natural challenges that come along with aging and how to incorporate those challenges into your personal lifestyle and goals.  That is how we ensure our Senior years are quality years.


Social support:  One of the things we often take for granted is our relationships.  Most adults in long term committed relationships envision aging with their significant other and rely on that person for their social support and interaction.  Others rely on relationships with family and extended family. More than likely, it will be one of these individuals that would make a good candidate for your Durable Power of Attorney (DPOA – discussed in the the first post) for either healthcare or finance decisions, or both.  


The importance of social support cannot be overstated and is something that is not accounted for enough in our healthcare system.  All throughout the healthcare continuum, there are social workers, but they are largely focused on resources for community services that augment the healthcare interventions.  In this context, social support is more likely helping coordinate those services on a daily basis, which social workers will not do in perpetuity. Things like arranging doctors’ appointments and making sure the Senior has a way to get there.  Filling prescriptions and making sure the Senior knows how to take the medications. Ensuring there is sufficient food, housekeeping and hygiene are all examples.


There is more to the social aspect too. Social isolation is real problem for Seniors.  As physical and cognitive faculties fade, it is more difficult for Seniors to leave the safety and comfort of their home.  There are numerous studies that show that social isolation exacerbates many disease processes, none more so than cognitive impairment.  


It is for this reason, that social support needs to be included in a progressive living plan.  For someone who plans to age with their spouse, they need to also have a contingency in the event they outlive their spouse.  If the contingency is family, it is important to be sure that the family is willing and able to provide the support the Senior assumes they will.  


Mobility issues:  Failing mobility is often a significant trigger that indicates that a Senior’s living circumstance warrants evaluation and change.  Mobility in most cases is a very typical casualty of aging. Even the very healthy experience normal wear and tear on bones and joints that make mobility painful and even dangerous.  While orthopedic surgeries have enabled Seniors to gain a lot of mobility back, the body experiences natural structural failure as we age.


So what do we do about that?  Well, for one, if there are emerging mobility issues related to normal wear and tear or due to chronic progressive disease, that should be factored into the progressive Senior Living plan.  With enough financial resources, advanced planning and social support (see a pattern? Good!) all options are on the table, including aging in place.


These two posts together are meant to help the reader understand some of the basic elements of planning for the Senior Years.  We will continue to expand these topics in subsequent posts and we welcome your comments and questions.

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