Thursday, May 23, 2024

The Best Expert Advice On How To Create Long-Term Care Plans For Loved Ones

At some point, many adult children will find themselves in a position where they need to assist in the planning of long-term care for a parent. The choices are overwhelming. Mary Jo Saavedra, a gerontologist and Certified Aging Life Care Professional (CMC), wrote Eldercare 101: A Practical Guide to Later Life, Planning, Care and Wellbeing. It provides comprehensive, straight forward information that is indispensable to those navigating through the process. YouAreUNLTD caught up with the author to get a few of her best tips.

What inspired you to write Eldercare 101?

Like many people in professional service roles, I was greatly influenced by my own caregiving experience. After caring for my mother through the end of her life, I wanted to do something meaningful with my gerontology training to help other families experiencing similar challenges of being in crisis with no idea of where to turn for help. I began in private practice as an aging life care professional and navigated for many families as they faced complex and challenging care situations.

The hardest aspect of my practice was when I had to turn people away for capacity reasons. I decided that a more impactful way to help many more people than I could reach one-on-one was to share my six pillars of aging wellbeing in a book, so others could have the basic approach to empowering themselves as caregivers and their loved ones to live their best lives. Eldercare 101 is a toolbox that allows you to find the resources you need with ease and clarity.

What are the top three mistakes you see with families making arrangements for their loved ones?

  1. There is a natural tension between caregivers, usually adult children, and the person they care for. Done out of love and a need to keep parents safe, adult children often think they know what is best for an aging parent and often overlook what the parent wants. I help my clients by helping them find middle ground where the older individual, who has been making independent decisions all their life, maintains autonomy and the older children gain safety.
  2. Not doing thorough research or asking for help from trusted professionals is often overlooked in fear of expensive fees. Going it alone and reinventing a wheel that is already available can cause costly mistakes and heartache. For example, many adult children think that selling mom’s house and moving her closer is the smart choice. There are many things to consider besides ease of location. You will be taking that older person from their friends, doctors and routine. They may not want to move, cost of care and cost of living may be much more expensive in a new area, there may be higher taxes. It could have negative impacts on their financial wellbeing. It may also cause worse medical issues in older individuals who already have dementia or other chronic illnesses.
  3. Not knowing that as a caregiver, nearby or far away, you are enough. It is sacred work to take care of another person and doing your very best is always going to have a margin of error. We don’t know what we don’t know, so mistakes naturally happen. Do your best to surround your older person with the right resources and council and then accept that this is a journey, a type of long goodbye in many cases, and both you and older person may find yourself cranky, sad, and feeling rather frustrated. Be gentle with each other and know that showing up, being with a person on their journey, and accepting this is the greatest gift you can give.

What changes are you seeing in long-term care facilities and their roles?

It is a dizzying market if you are looking for your forever home in a community environment. There are so many choices. It seems that every month a new type of community option emerges as the Baby Boomers flood past age 65 every day. Graduated care type facilities play an important role for many older individuals, especially skilled nursing homes. There are every type and design of community living, some quite homey and others quite swanky. They are not our grandmother’s old folks’ home of yesteryear. Competition has bumped up the quality, oversight and expectations of what is provided.

I always advise my clients to identify first what is most important to their lifestyle and needs. Consider what is your best location, community size, cost of care, walkability, lifestyle support, access to important services, and if it supports your priorities and dreams. My best nugget of advice is to always be sure all contracts are reviewed by an elder law or estate attorney before you sign up for community living to ensure you fully understand what you are getting into and how to get out of it without any unexpected negative consequences.

Many people find the discussion on this subject difficult. What advice can you provide to deal with the awkwardness and get the conversation started? 

It is common for older individuals to have challenges talking with grown children or other loved ones about their aging transition plans and end of life wishes. It is also common for grown children to not know how to approach the topic with parents. Family dynamics and cultural expectations can make conversations around aging and independence very hard. Luckily, there are meaningful and effective tools to help break the ice and guide you in these conversations. Start with the Conversation Project’s toolkit. This resource will provide you with the guidance to successful conversations. Keep in mind that you will tailor the conversation to a specific person. Sometimes it is one discussion of sharing and for others it will take a gradual approach. Being patient, prepared and meeting the other person where they are in their experience will go a long way.

In your book, you talk about the six pillars of aging wellbeing (legal, financial, living environment, social, medical, and spiritual). Which is the most challenging?

The six pillars of aging wellbeing are designed to address the whole person. Very few professionals are willing to do this and many simply can’t depending on their professional role. So, I have to say that all are equally important and won’t work best for an older person unless you address all of them together.

I would say the most challenging is the legal pillar. It is the most straight forward and direct, but it is hard to get clients to see that nothing else works to its full potential if the legal protections and empowerments are not in place to protect your care and home wishes. For one’s self it is often hard to imagine needing these tools and even harder to imagine what you will say on them.

As a caregiver, you can’t do the role of care without the documents and as the older person, you will risk financial and medical catastrophe without them. This is true of any person not just older individuals. Many people don’t even have a will. I jar my clients to their senses by pointing out that if they don’t have their legal documents in order then the government gets to decide what happens to their estate and they take a piece of the financial pie as well.

Caregiving can feel overwhelming at times. How can caregivers maintain balance in their lives?

This is the most important area to focus on with caregivers – self-care. I liken it to the flight attendant telling passengers to secure their oxygen mask first in an emergency, THEN help the person next to them. Caregivers suffer declining health in most caregiving roles if they don’t have good self-care strategies. We offer many ideas for this in Eldercare 101. Using local resources for respite support, developing spiritual practices, like mindfulness and prayer, and having a full caregiver toolbox for your situation are just a few of the ideas you‘ll want to build into your routine.

Can you talk a little bit of how best to deal with a crisis, if one strikes? 

Crisis will hit all of us at one time or another. There are many situations a person can plan for, like having your legal documents in order and having conversations with your representatives about your home and care wishes. But there will always be crisis that we did not think would happen to us or couldn’t even imagine. When this happens, the shock tends to turn you into a deer in the headlights, not knowing what to do or where to turn. In Eldercare 101, we have you build your own village of support for your aging transitions. As part of this village, you will identify professionals who can help you once crisis strikes.

About the author:
Mary Jo Saavedra is a gerontologist, Certified Aging Life Care Professional (CMC), Certified Senior Advisor (CSA), Certified Aging in Place Specialist (CAPS) and a Certified Spiritual Director, based in Washington state. She has had her own private practice for six years and now works for a large corporation as a Life Planning Professional building services to help prepare clients for their best life.


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Michele Sponagle
Michele Sponagle
Michele Sponagle is a prolific lifestyle journalist based in Paris, Ontario, who has contributed to many leading media outlets, from the Washington Post to Canadian Living.