An great article from the Star Tribune

Where to live late in life? It’s a decision best made early
Ross Levin, Special to the Star Tribune I was talking with a 94-year-old client who said, “There are three stages in life: infancy, adulthood and you’re looking good.” Coincidentally, I ran into someone I had not seen for a while. When he saw me, he said, “You’re looking good.” I thought, “Oh no! I’m stage three!”I have discovered a few things about stage three through working with our clients — it starts before you are ready, it lasts an indeterminate time, and the sooner you accept it the more options you have to make it amazing. Stage three is one of contrasts. While it may be a time of great gains through grandchildren, special interests and free time, it also leads to periods of loss of friends and capabilities.One of the most complicated decisions that eventually needs to be made in stage three is where to live.We have been working with several clients recently on helping them determine appropriate living arrangements. Some clients are steadfast in the belief that they want to stay in their house as long as possible. There are several reasons for wanting this — it is comfortable, it is something to which they are accustomed, they can’t imagine what it would take to move. But it may also be because they don’t want to give in too soon to their advancing age. We have seen staying in place work well. Clients have successfully hired home health care coordinators who work with a family member to determine their appropriate plan.

We have also seen this not work well. As client couples begin to need additional care, it often falls on the healthier partner to provide it. And while tending to someone can be quite fulfilling, it can also be exhausting. The caretaker often feels tremendous guilt about their fatigue, making it hard to ask for help. In-town children may chip in, but this can lead to broader family issues around caring for aging parents. When one person eventually passes, the home can feel isolating for the survivor.

If you are not firmly entrenched in the growing old in “my” place concept, there are going to be a number of interesting options available to you. These are some things that our clients who have successfully made the transition have considered:

• Find a place where you feel you will develop a social network. Developing friendships is an antidote for loneliness and isolation that often can lead to health issues. In early stage three, you may look at the community when determining where you wish to retire. This is equally important when deciding the type of facility in which you may wish to spend your later days. We have had several couples who did not want to be separated move into places that had a memory care option where the partner suffering an early onset of dementia or Alzheimer’s could eventually move. This enabled them to build relationships with people in similar situations and, far more important, created a sense of normalcy when it came time to move the other spouse because of their need for greater care. This permission was a tremendous relief to the spouse not suffering dementia.

• Traditional nursing homes are not the only options. We have had clients enter co-ops (where you pay for any in-home health services) and continuous care facilities (where you may move from independent living to assisted living as your needs change). These arrangements have meal plans, a variety of internal activities and active outings.

• Well-vetted facilities may provide you with security. Clients who enter into communities before they need it often do so because they want to feel that when they need care, they can get it. Especially for those alone, this can create tremendous piece of mind.

Advance planning means that you are making a decision when you are most equipped to do so, not when you are the least equipped. If an event such as a death or disability triggers the need to move into a care facility, it may not be one that you would have chosen had you had the time to prepare. Events are traumatic and the best choices are not usually made under periods of great stress.

Some people prefer to move once and on their own terms. One of our clients is in good health but chose to move because she wanted to do so when she was ready. She wanted to go through her things and determine what she no longer wanted. She wanted to build her community while she was still vibrant and active. She wanted to learn from others older than she was so that she could give back to those younger than she was when they move in.

There are different types of facilities and each has its own strengths and weaknesses. For example, continuous care facilities may make the choice for you when they feel you require more help. Some places may not accept an elderly waiver, so if you end up spending your assets, they may move you into a facility that does take this. Places that require a large down payment may not refund it unless they can find a replacement for you.

This decision is one of the biggest ones you will make. It’s important to make it when you’re looking good.


Ross Levin is the founding principal of Accredited Investors Inc. in Edina.

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