Not financially, practically, what can you do to prepare for old age

[Blanketfull]

Or illness?

DH died a long slow death. I cared for him at home until the end. We had some visiting carers but if I hadn't been there he'd have died in an institution, which is what happens for many I guess. However, before that he relied on me a lot for getting to appointments etc. He couldn't have managed in a taxi without help. He wouldn't have been safe at home alone. I doubt he'd have even gone to the hospital the first time, as he was stranded in the bath when things suddenly took a turn for the worse.

My Dad is now in a similar situation. He can manage at home because mum is there and I'm round the corner, he's not so bad he needs to be in a care home, but without mum he probably would be.

I'm a widow and my sons live a distance away. Financially I can pay for what needed, but how do I actually arrange this kind of help, should I need it?

The other thing that really scares me is the idea of being in hospital without anyone to advocate for me. Having seen the way patients without visitors were treated and the way we had to fight for basic care for bith DH and DF. E.g. being told to soil the bed if he really couldn't want for someone to take him to the loo. A patient without the use of his hands being given food and drink but not help to eat/drink it. I know that's not how it should be but I've seen enough to know it often is.

What can I do now to prepare?

I'm talking about my experience of supporting people who have done everything right, but still finding themselves in a position where I don't know what would have happened to them without support from someone like me. In DH's case cancer, and in my Dad's case living to a long and active old age, but still facing an inevitable decline in the end.

OP you can only do so much. There is no magic answer.

Being blunt, you will either die at home (hopefully in your sleep, painlessly from old age) or you will go into a nice care home, or in hospital.

My Dad died at 92. Two weeks in hospital at the end.
My Mum is still living independently in her late 90s (fingers crossed).
A dear old friend of mine literally shut her eyes and went to sleep (died) in her lounge at 96.

You don't know what will happen so all you can do is make sure you have the means to make it as comfortable as possible.

I'd spend your energy on living your life not worrying about the way you will die. You can't control that other than have money set aside to make it comfortable if you need care.

I agree with all this. You can't hold off old age for ever, however healthily you live.
I'd go with a living will, poa, being sensible about where you live with the future in mind, keeping up to date with technology and putting money aside for bringing in paid help when it's needed. I also think having a bit of help aroud the house and garden slightly ahead of time means you're better prepared to accept help when it's really needed.
Now to take my own advice...

I'm sorry for your loss. I'm not surprised you're worrying about it. I think accepting that you may need residential care in care home to be safe one day is really an important part of planning ahead. I agree with you I think the advice to exercise, socialise, play sudoku etc is all well and good at this stage but irrelevant once you're struck down with something. In my experience of fit, healthy, intelligent, active, sociable relatives in their 80's who had absolutely no intention of ever going into a care home, their 90's have been an absolute nightmare because of that independent mindset. They wrote their wills so many times but never considered what their wishes were if they lacked capacity. Having to watch them forced into separate care homes, by the police, and lose absolutely everything because they had no power of attorney in place I would say the best thing you can do to look to the future is to check out all of your local care facilities to see where is acceptable to you, and make a clear statement of your wishes, get power of attorney in place, and if you've got items of sentimental value you wish would be given to specific people give them to them now because that's the only way you can be sure they'll really get them. I would also have a carry bag with a few days of hospital items and essentials ready that includes sentimental items, because losing access to their home when they were taken into the care homes suddenly meant they couldn't even get their favourite slippers or family photos. Even if you do have power of attorney in place family don't always know what to get for you from home so having at least a list of what you'd want bringing for you if you couldn't speak for yourself could really help. For my relatives banking and access to money became a big problem as they lost capacity gradually and started to go without food because they would lose their bank cards or put the wrong pin in too many times. Having backup options for food is important. But more importantly is accepting help before you get to this stage.

Yes, and that was the reason for my post.

I have the means, but what do I "do" with it? I don't know how you go about paying for the kind of support I gave to DH, the fighting to get his pain properly managed, for example.

It is difficult as you can’t predict how much help you might need. I certainly would look at an over 55s flat but you need to be careful about T & Cs and service charges.

You can’t avoid it but looking after oneself does give you a much better chance of either avoiding or delaying problems and being physically capable of fighting health issues in old age.

It’s not lost on me that the ‘elderly’ smokers I’ve known of all died before early 70s with either COPD, lung cancer, head and neck cancer, stroke, oesophageal cancer and brain haemorrhage. That’s been my experience, sure old age would have got them eventually but their long term disregard for their health meant they never had a chance.

I’m confident a family member who died from a stroke in her 50s would probably have swerved the drinking and smoking entirely had she known her future was to leave her DC and grandchild behind so early.

Thanks for this thread @Blanketfull.
Its something that worries me too.

I really love this. Thank you for sharing.

OP I am only 35 but without children. Lost my Dad to cancer a couple of years ago and I have similar concerns to you. I feel I will outlive my husband but who will be there to care for and advocate for me if needed. I hear horror stories regarding care homes and carers and it scares me!

Off the top of my head I think have advanced directives about how much medical intervention you want depending on what stage you are at. Sort out as much as you can while you are fit and able - consolidating savings with one financial institution for example - and get your POA set up and ask your relatives to have it ready to go when needed.

Sorry because personal experience is leaking in here - save your close relatives for medical interventions and get in cleaners and home help, possibly more than you need. Your nearest and dearest will be more likely to have juice in the tank for hospital stays if they haven’t spent the previous years/months battling with you over getting the paid help you need or just giving up and doing it themselves.

Also it sounds like your DH had a poor hospital experience.Not all hospitals are like this.

Hospices
Live-in nurses ( there are many agencies who offer this.)
Nursing homes (not care homes- homes with qualified nurses.)
Sheltered accommodation - a flat in a block where there is a communal lounge etc and 'care' 24/7.

Age UK can help with this (advice).

Your children will have to get a grip on it when the time comes. Even if they live away they will be able to help.

My late MIL was ill for 20 years and at the end she had carers going in 4 times a day. (we lived 5 hours away.)

For the last 6 weeks of her life she was in a care home because she kept falling out of bed at home in the night.

Talk to your sons about your preferences and what you want.

Sorry because personal experience is leaking in here - save your close relatives for medical interventions and get in cleaners and home help, possibly more than you need. Your nearest and dearest will be more likely to have juice in the tank for hospital stays if they haven’t spent the previous years/months battling with you over getting the paid help you need or just giving up and doing it themselves.

That's an excellent point. When DH was ill I threw money at everything I could to ease the load domestically so that I'd have the energy to deal with the rest. I'm still not sure how someone who wasn't emotionally involved could have managed "the rest" though.

Yes I know all of this, DH had a lot of it, but it still took a lot of effort from me to make sure those things were running properly. Not all carers are good, for example and I had huge struggles with the Hospice to get him adequate pain relief at home, even worse when he was in hospital, when they simply wouldn't believe the doses he was prescribed by the hospice were correct.

I find myself thinking about this a lot. I lost my husband last year, and have parents in their 90s who I think hoped that everything would be 'ok' so battled on to a situation where my mother's determination to be independent is now causing problems for me (the only child).
My thoughts are find somewhere to live where you don't have to drive to get basics, declutter, make local connections.... I live somewhere gorgeous at the moment, but I need a car for everything, and I worry about that. I don't really want to move, and have to rebuild all my connections, but I will have to if I want to live a happy life when I am 20 years older than I am now.

Money solves many problems, but good carers who you are happy sharing your space and very personal needs with are hard to find, and my parents had to accept many OK people along the way.

I think there is such a person as a medical doula who could perform this role, though I have no experience of hiring one.

Advance care planning would also go a long way but I agree that sometimes what you need is someone to ensure basic care is being provided appropriately. Totally agree with the advice to ensure your family have the energy reserves (and brownie points with their employers and families) to deal with this acute care.

I agree that having an advocate is important. Hence telling your family and friends what you want to have happen to you.

I hear what you say about your relatives and DH who did lots of good stuff. But were still.impacted. of course illness can happen to anyone no matter how fit and healthy. But we can help ourselves and our views on what's needed has evolved. My mum is of the view that lots of walking, yoga and eating well is sufficient. It isn't. She has never done weights. She has never taken HRT. She's never done anything for her bone density. And she has now got osteoporosis so every time she falls she's breaking something. Twice in the past year. I know that being in hospital is basically a disaster at her age and she's likely to come out worse than she went in. So not breaking anything is critical but she hasn't helped herself, despite me encouraging her to try to do some weight training. So whilst she looks amazing and has no bad health conditions, she's probably another fall away from being in a bad way. And it frustrates me because she c9uld have done something to help. Of course she may still have fallen and broken something, it is just maximising your chances

I’m so sorry for your loss OP.

Suggesting exercise etc is just people trying to believe that you can escape the bad luck of horrible illnesses. My Mum was obsessive about health and my Dad who drinks and is overweight and used to smoke is now much healthier than her sadly. I’d rather she’d have eaten a bit of cake when she wanted it.

The big big things for me are LPAs and Wills being sorted and regularly updated if needed. Also having all your finances and account information laid out and organised for your loved ones if needed.

The other would be considering moving to a more retirement friendly house or bungalow. If a house somewhere that possibly has a downstairs bathroom so if needed you could live downstairs.

I think you thinking about it though is a massive thing. My parents definitely avoided it as it was too painful and now it’s harder.

Get rid of bath and have double walk in shower with a seat and hand rail installed instead. Room for you and a carer if need be to help you shower. Getting in and out of a bath is awful for some elderly people especially if their balance is poor.

If you appoint more than one attorney, it should preferably be ‘jointly and severally’ so that if one is e.g. away/out of contact, one can act alone.

Re ‘advance directives’, after too much experience of dementia, dh and I have added this paragraph to our Health and Welfare Powers of Attorney.

“if I should develop dementia, or any other condition where I am unable both to care for myself, and speak - with full mental capacity - for myself, then I emphatically do not want any life-saving or life-prolonging treatment. I ask for palliative care only.’

It's not about trying to stave off illness - of course even healthy capable people are struck down with dementia, Parkinsons, strokes, cancer etc.

It's about making sure that stage of poor health/lost capacity isn't made even worse for you and everyone around you by lack of planning and a support system. You can't anticipate everything, but many people find there are things that could have been done better in hindsight.

It's one thing having carers, friends and relatives kept in touch by technology, suitable environment or a good care home. Quite another to be struggling with unsuitable accommodation, travel problems, the cycle of fall/crisis/hospital/infection/fall which is exhausting for your relatives, on top of your main illnesses/conditions.

My mum is so frail that just falling over from standing is enough to break bones, and she's been on medication for osteoporosis for years.

@Blanketfull So what exactly are you asking here? (I'm sorry to hear about your H and I will most likely be going through that sometime too with mine.)

I'm still unclear what you're asking.
There is no 'blueprint' of care in older age.

You have sons- maybe you need to talk to them about what you want if you become too frail to live in your own home. They need to know your feelings. That's what families are for. They would need to advocate for you.
Do you see them much now?

My mum has made it clear she never wants to go into a home but if she has to, she's named one which has a good reputation. We for our part have said we will do everything we can to help her stay in her own home.

You can't predict the future. I'm not being flippant but you could be run over by a bus, die in your sleep, or any manner of ways and never need care.
Only 3% of the elderly go into a care home.
Most die in hospital.

Yes, both my parents have made it clear, and I think have it in writing, that they don't want any attempts to extend life if they lose capacity.

I will say the same to my kids and do the paperwork

Your GP may have the form.
My mum has one which is updated regularly, along the basis of do not resuscitate after a heart attack etc if she would not be 'aware' and have any quality of life.

You can also inform your POAs and what they should ask for if you can't speak for yourself.

There is tons of excellent advice on this thread. And I have supported my parents in hospital too, and worked as an NHS nurse. The issues you talk about where you had to fight for care, or others have mentioned where pain relief is inadequate, food is uneaten, toilets are inaccessible, that all comes down to healthcare standards. We don't pay our healthcare staff enough, we don't ensure adequate staffing levels and standards are low. Individually there is not much you can do about that OP, but I wish we all realised just what can await us if we don't have an advocate and fought for things to be improved. That's not going to be free though.

I just think the advice to stay healthy and plan to pay for care/support is all good, but only goes so far.

DH was phoning me from hospital, crying in pain in the middle of the night, then needing hours of my time to chase doctors and other HCPs to get him the help he needed. Who would I call and how can I plan for that?

Who would help me when the man in the next bed has taken my phone and the ward staff are too busy to get involved?