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Published:
September 5, 2018

Navigating Your Later Years For Dummies

Overview

Long-Term Care: Planning for Finance, Medical, and Living Expenses

We’re living exciting bonus years—decades that our parents and grandparents didn’t have. But how to navigate this complex terrain? Questions abound around long-term care planning: Where to live? How to get the best medical care? What to do about advance directives, wills and trusts, and estate planning? And how to pay for it all after you retire? Getting accurate information and answers wasn’t easy. Until now.

AARP's Navigating Your Later Years For Dummies helps you and your family understand the growing range of opportunities. Even more importantly, it helps you chart the next steps to live the life you choose, as independently as you choose, no matter your specific circumstances and needs. This book:

  • Covers home modifications so that you can stay at home safely for as long as you like
  • Lays out the opportunities and costs associated with independent living, assisted living and other options
  • Gives you a range of driving and transportation alternatives
  • Helps you navigate the healthcare system, Medicare, and Medicaid
  • Sorts out the various sources of care at home
  • Reviews the legal documents you should prepare and update
  • Helps you determine whether you need long-term care insurance
  • Gives you guidance on talking with your family about sensitive issues, including your wishes as you age

With this new comprehensive book, you’ll get the credible information and resources you need to face the challenges facing us as we live the life we choose. Here, finally, is a roadmap for you and your family to best understand, and plan ahead.

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About The Author

Carol Levine directs the Families and Health Care Project at the United Hospital Fund in New York. She is an expert on aging, health, long-term care, and family caregiving, and writes on those topics for both professional and consumer audiences.

Sample Chapters

navigating your later years for dummies

CHEAT SHEET

People are living longer and healthier lives than ever before. How will you stay independent and in control? With a bit of forethought and a little investigation, you can break down the big picture into more manageable segments. Discover how to compare online information, get ready to set in motion an advanced directive plan, find what types of benefits are available to older adults, quickly identify warning signs for older drivers, and handle safety issues in order to prevent falls for older adults.

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Articles from
the book

The ten myths about aging and future care presented here are widespread beliefs about aging and long-term care, some based on a kernel of truth, that are deeply entrenched in American society. Some are relatively harmless, but others can lead to serious misunderstandings. Serious Memory Lapses Are Normal in Older Adults The myth that memory loss is naturally associated with aging is deeply engrained in societal attitudes toward older adults.
Wouldn’t it be nice if there were just one place where you can get all the information you need about planning for navigating your later years? Unfortunately, it’s not so easy. This article has some guidance to help you find what you need.In the U.S. federal system, much of the responsibility for healthcare, nonmedical services such as personal care and homemaker services, and social services falls within the jurisdiction of the states, even though there is federal oversight and funding.
Falls and burns aren’t the only sources of injury at home when you or a loved one is aging in place, but if you address them, you’ll likely prevent other kinds of injury as well.An important first step in deciding whether staying in the same home can work is taking a hard look at the home. Looking past a cherished home’s attractive features and focusing on its flaws and hazards can be hard to do.
When you’ve completed a safety checklist on your home and made all the easy fixes and repairs, you may find that problem areas still exist for safely aging in place. Some problems may be unsafe conditions, but others may be barriers that make it difficult for you or your relative to move about freely and to enjoy the comforts of home that make him want to stay put in the first place.
Websites offer comparative rankings and user reviews of everything from restaurants to electronic products to colleges. Similarly, dozens of sites offer comparisons of hospitals, nursing homes, and doctors. But how much weight should you place on any of these sites? And how do you compare the comparisons? What are their strengths and what do they lack?
Help at home is probably the most-often-needed service for an older adult, and it’s the area where Medicare coverage is weakest and private costs are highest. Medicare does pay for some home healthcare services, however, under these conditions: A doctor confirms in writing that he or she has examined the person within 30 days and that the patient needs skilled nursing care, such as care provided by a registered nurse or physical therapist.
Many adults in their later years are unaware that they may be eligible for a range of benefits, and it’s not easy to find them one by one. BenefitsCheckUp, a free tool from the National Council on Aging, is a good place to start. The website asks questions about you (or the person for whom you are seeking assistance) and then directs you to the agencies in your community that may be able to help.
For older adults and their families, driving is often a flash point. When is it time to give up the keys? Waiting until there is a serious accident is not advisable. Most drivers in their later years are safe drivers, but some monitoring and caution are appropriate. Here are some warning signs for older drivers from “We Need to Talk: Family Conversations with Older Drivers,” produced by The Hartford.
You’ve decided. Multigenerational living, with its pros and cons, is a good solution to your needs. You’ve done all the planning, designing, remodeling, and negotiating. Now it’s time for the move. Moving is one of life’s major stressors, way up there with illness and divorce, so take time to organize this event.
Sometimes the choice seems obvious: You live in a big house with plenty of room, and your parent or other relative has only a limited amount of space. Of course, your mother will come to live with you. Or the reverse may be true. Your mother is the one rattling around in a big house, and you desperately need more space.
If you were born after 1940, you probably grew up in a nuclear family: mother, father, 2.3 children. Maybe grandparents or other relatives lived nearby but not under the same roof. Although the nuclear family seemed the norm for middle-class Americans, it was actually an aberration lasting only a few decades. For most of human history, family members of all ages lived together, and they continue to do so in much of the world.
People are living longer and healthier lives than ever before. How will you stay independent and in control? With a bit of forethought and a little investigation, you can break down the big picture into more manageable segments. Discover how to compare online information, get ready to set in motion an advanced directive plan, find what types of benefits are available to older adults, quickly identify warning signs for older drivers, and handle safety issues in order to prevent falls for older adults.
Your options for the future are expanding — and that’s a good thing. There are many more alternatives for living at home or in the community, where the clear majority of people want to be. Technology is making it possible to have your healthcare monitored at home and to keep you in touch with family and friends.
Planning ahead for your healthcare is one of those topics that tends to get postponed until there is a crisis in your later years, when the planning is no longer “in advance” but “right now.” It’s difficult enough to do without placing all the emphasis on a single momentous conversation. A study by Terri Fried and colleagues at Yale University School of Medicine found that many people go through several stages of change on the path to actually taking action to complete an advance directive and name a healthcare proxy.
Preventing falls is critical. Falls are not only harmful in themselves but also often lead to declines in independence and function. Most falls happen at home, so that’s where you should start.Falls are often due to hazards that are easy to overlook but easy to fix. The following tips are from the Centers for Disease Control and Prevention’s checklist for preventing falls at home.
Creating a safe and comfortable environment is only one factor in staying in your home. Many older adults need at least some help at home. Some people need just a little assistance with transportation and shopping, for example, while others need a lot of help with personal care such as bathing and dressing. People with complex chronic conditions usually need help with managing medications, operating medical equipment, monitoring symptoms, and similar tasks.
Most of the work of downsizing involves sorting, organizing, decision making, and disposing of the things you no longer need or want. Hard enough, but unless you recognize the emotional toll this process can take, it will be even more difficult. It’s not just the items with obvious personal history such as wedding photos or grandparents’ silverware; it’s often ordinary items that bring back memories of childhood or places that you visited.
Another program worth investigating is the Program of All-Inclusive Care for the Elderly (PACE). Although supported by both Medicare and Medicaid, participants do not have to be dually eligible for both programs. However, according to the National PACE Association, more than 90 percent of participants are dually eligible.
Assisted living is a term that is often used as though everyone understands it in the same way. But that’s not the case. Assisted living is just a generic term like hotel or automobile that covers a lot of options. Before getting into the specifics, here's a simple definition: Assisted living is a residence where groups of people share meals and other activities and where individuals can receive personal assistance to maintain their independence.
The common desire to stay in the same home is often called “aging in place.” This is a term most often used by professionals and policymakers, although not by older adults themselves. It may be misunderstood as being unable to leave your home or having other negative implications. When people say they want to stay at home, they often are thinking not only of their physical home but also their familiar surroundings.
Planning should be a dynamic process. Where you want to live in your 60s may look very different from where you’ll want to be in your 80s. Your needs change based on your finances, family circumstances, health, and more. Someone considering moving from a single-family house to an apartment or assisted-living facility should think about whether this is a move that can satisfy future needs as well as immediate ones.
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