Some facts about aging… 10,000+ of us turn 65 every single day We’re the biggest, most diverse cohort of “old people” our country has ever seen

More facts… Only about 5% of us live in facilities that serve older adults Increase in life expectancy has flattened a bit – in the US, our average life expectancy is 78.7 years. The longer you live, the longer you’re likely to live 4.2 percent According to the U.S. Bureau of the Census, slightly over 5 percent of the 65+ population occupy nursing homes, congregate care, assisted living, and board-and-care homes, and about 4.2 percent are in nursing homes at any given time.Oct 21, 2011 In 1900, men lived to 46.3, women to 48.3. When SS was enacted in 1935, 59.9 and 63.9. When Medicare came into play in 1965, 66.8 and 73.7. When ACA was enacted in 2010 – 78.7, 81.1

And some myths Old people have old ways of thinking Genetic health conditions can’t be avoided as people age People lose their memory as they age Elderly people are less adaptable to change Old people are crabby and depressed Old people are incompetent 4.2 percent According to the U.S. Bureau of the Census, slightly over 5 percent of the 65+ population occupy nursing homes, congregate care, assisted living, and board-and-care homes, and about 4.2 percent are in nursing homes at any given time.Oct 21, 2011 In 1900, men lived to 46.3, women to 48.3. When SS was enacted in 1935, 59.9 and 63.9. When Medicare came into play in 1965, 66.8 and 73.7. When ACA was enacted in 2010 – 78.7, 81.1

How on earth can you predict? 4.2 percent According to the U.S. Bureau of the Census, slightly over 5 percent of the 65+ population occupy nursing homes, congregate care, assisted living, and board-and-care homes, and about 4.2 percent are in nursing homes at any given time.Oct 21, 2011 In 1900, men lived to 46.3, women to 48.3. When SS was enacted in 1935, 59.9 and 63.9. When Medicare came into play in 1965, 66.8 and 73.7. When ACA was enacted in 2010 – 78.7, 81.1

Does your home suit your needs?

How does your home size up in terms of Your current home How does your home size up in terms of Accessibility Affordability Ease of maintenance Geography – access to errands, friends, family Features that support aging in place

Housing Options Stay put – no change needed Invest in changes/upgrades to stay put Downsize and move locally Move to be closer to family Explore facility-based living

Community-Based Living Independent Living Facilities Multi-level Campus Continuing Care Retirement Community Assisted living – 2 levels available Nursing home

How do you choose? Health Mobility Other support needs Resources Preferences

Minding Your Health Lifestyle matters well into advanced age Managing chronic illness has positive benefits Relationship with medical team helps Some problems are challenging to diagnose and treat When the waters get rough, get help with navigation early

Minding Your Resources PAYING FOR CARE Medicare – pays for things with beginning and end – SNF, limited home care, hospice Medicaid – pays for care for low income/asset level individuals VA – limited benefits for qualifying vets Long Term Care Insurance Private Resources – savings and investments

Minding Your Resources MEDICARE Medicare A Medicare B Medicare Supplement (medigap) Medicare D (prescription drug coverage) Managed Care Options – MC Advantage

Minding Your Resources MEDICAID Designed as program for poor moms and kids About 20% of its national budget now pays for long term care Financial eligibility Clinical Eligibility

Minding Your Resources VETERANS BENEFITS Aid and Attendance Program VA Disability VA Health Care System

Minding Your Resources LONG TERM CARE INSURANCE Elimination period Daily benefit Maximum benefit (time or $$)

Minding Your Resources HOW MUCH DOES IT COST?? Home Care – private agency - $30/hour Assisted Living - $5,500-7,500/month AL – Memory Care - $6,500-9,000/month Nursing Home - $11,000-13,000/month

Minding Your Resources YIKES! Get advice when sizing up your options Understand contract details – what’s included and what’s not Bed availability tends to be tight for better quality facilities

Minding Your Resources TALKING ABOUT YOUR MONEY Are you planning for one or two people? What is monthly income from all sources? What are the sources? How much of your current living expenses are covered by income? How much do you need to pull from savings?

Minding Your Resources TALKING ABOUT YOUR ASSETS What is the value of your real estate, savings, investments and other property? How are the assets titled? How are these organized in your estate plan for use later?

Minding Your Resources TALKING ABOUT MONEY IS HARD If you’re asking for financial assistance, every person who tries to help will help Planning to answer the questions ahead of time decreases a lot of stress

Other Resources FAMILY AND FRIENDS For practical support To work on your behalf if you can’t – using your DPOA designations Advocacy Personal care and supervision

What complicates planning? Planning for “unevenly aging” couples Planning with blended families Ongoing responsibility for an impaired adult child, grandchild or other person Family conflict

What can you do? Discuss your vision and wishes with your partner and/or trusted advisors to sketch out a plan Once you feel confident, share the plan with other family members and advisors Keep the plan up to date as things in your life change

MOST IMPORTANT You are more likely to stay in charge if you take charge Time is your friend – few decisions need to be made on the spot Don’t make big changes or commitments before reviewing with someone you trust Keep your advance planning documents safe and accessible – share as appropriate

I’m sorry!!

But also hopeful… YOU STARTED TODAY! Review your notes from today and discuss with your partner and/or advisor Ask questions, brainstorm – don’t think small Draft a useful, clear plan Repeat this process as needed

For more information Nancy Euchner – AgeQuest, LLC 195 New Hampshire Avenue, Suite 255 Portsmouth, NH 03801 nancy@agequest.com