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If you wait until you’re 70 to think about long-term care, you’re already late.
With the national annual median cost of a private room in a nursing facility at $102,200, according to insurer Genworth’s 2019 Cost of Care Survey, lacking a thought-out plan can be a costly error.
In fact, you don’t even have to leave your house for expenses to pile up. The annual national median cost of in-home skilled nursing is $87.50 per visit, Genworth found.
A dwindling pool of insurance companies offer long-term care insurance policies, and it will take more than that to cover the cost of aging.
“There are a lot of out-of-pocket costs,” said Carolyn McClanahan, a physician and certified financial planner at Life Planning Partners in Jacksonville, Florida. She spoke at the TD Ameritrade LINC conference in Orlando, which began this week.
Expenses that people fail to account for include the indirect cost of unpaid caregiving, which largely affects women who are looking after infirm spouses and parents.
More than 34 million people provided unpaid care to other adults in 2015, with an economic value of $522 billion per year, McClanahan said.
There’s also the stress family members face as their loved ones experience cognitive decline and require more intensive aid.
The best time to start plotting out how you’d like to spend the latter years of your life is when you’re about 60, McClanahan said.
“That’s when most people have seen it with their parents and other older people, but they’re still young enough that they’re with it and healthy and happy enough to have those conversations.”
Here are four key components of a long-term care plan.
1. Living transitions
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Whether you want to age at home or you’re planning on heading to a continuing care retirement community, discuss your wishes with your family members and strategize with your financial planner on how to pay for it.
If you plan on staying at home, don’t forget to think about the quality-of-life issues that will pop up: How easy is it to get around? Do you have access to medical care nearby?
Loneliness is another issue that elderly people confront, so the plan should account for interactions with others, as well as whether you’re willing to use technology to help family and friends monitor your well-being, said McClanahan.
Draft formal agreements in advance, particularly when it comes to deciding when you’ll move to an aging-friendly home, she said.
2. Driving transitions
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Knowing when to turn in your car keys can be contentious.
“How important is driving for your independence?” asked McClanahan.
Head off conflicts by considering other transportation alternatives you might be willing to use once you lose your ability to drive safely.
This can include getting familiar with ride-sharing via Uber and Lyft or learning about your local public transportation options.
Occupational therapists and rehab centers also provide driving assessments for $300 to $500. They will tell you if your license needs to be pulled, said McClanahan.
3. Financial caretaking
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Cognitive decline can start as early as age 53, leading people to become more impulsive, overconfident and subject to poor judgment, said McClanahan.
Early signs of trouble include forgetting to pay bills, paying twice and forgetting accounts, she said.
Get your power of attorney in order, and be sure to refresh it periodically, said McClanahan.
A power of attorney authorizes a trusted individual to oversee your finances in the event you’re incapacitated.
Simplify your finances by capping the number of accounts you have.
Limit your credit cards to no more than three: one for use in public, one for automatic bill-pay and one for online purchases.
This way, if one of the credit cards you use for shopping is compromised, you won’t have to change all of your automatic bill-pay arrangements, said McClanahan.
Pay off the cards every month.
4. Health-care transitions
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Draft your advanced directives, in which you state how you prefer to receive health care if you’re unable to communicate your wishes.
Failure to have this document adds an average of $18,000 in out-of-pocket expenses in the last year of life, said McClanahan.
Think carefully about who should make health-care decisions for you if you’re incapacitated.
This individual should respect your wishes, which may mean knowing when to end medical interventions.
“Your spouse or your child may not be the best choice,” said McClanahan. “If you know you don’t want to be kept going, pick someone who will honor your wishes.”