Part of our goal at Keystone Elder Law is to educate seniors and their families about legal, financial, and health care issues that can impact their retirement years. Through education, we hope to encourage folks to plan ahead for the possibility of becoming frail in their later years so that they can maximize their options and are able to make choices if health care needs arise. When people fail to plan ahead, they may be forced to make quick decisions with little information if a crisis occurs.
Obviously, none of us have a crystal ball to see what lies ahead of us. Often, I believe this is a good thing – we don’t spend our healthy years fretting over future events that we cannot control. There are some steps that can be taken, however, to reduce the possibility of a health care crisis in the future. No, this isn’t an article about eating right, getting enough exercise, or quitting smoking (although these do contribute to better health). I’m referring to people who may be in a “danger zone” and not be aware of it.
As we grow older, our bodies undergo natural physical changes that affect the way we function. We hope for a very slow progression toward frailty, and most seniors I’ve met desire to maintain their independence for as long as possible. However, disease processes and lifestyle choices can accelerate the path toward greater dependence on others. The “danger zone” exists in the early stages of health status changes. When individuals begin to require help with routine daily functioning or disease management and do not receive any assistance, their risk for a more rapid decline or catastrophic health event increases. Remember the old saying “A stitch in time saves nine”? Well, it applies to your health too.
There are several reasons why people do not receive assistance and care during the early stages of a change in health. Some seniors may not recognize their limitations. If the changes occur gradually, people may adapt their lifestyles in small ways without thinking about the long-term effects of the changes. Then, a family member or friend who hasn’t seen the person in a while visits and is surprised and concerned by the altered functioning. Cognitive changes may also impair an individual’s ability to reason and understand that help is appropriate and/or necessary in his/her situation. If limitations are recognized, an individual may not be willing to admit that help is needed for fear of losing independence or placement in a nursing home. Instead, he/she may deny that an issue exists or minimize its severity, try to cover up the situation, or withdraw from contact with those who might recognize and try to address the limitation. Reluctance to receive help may be due to a spouse’s belief that no matter how extensive the care may be, he/she is the one responsible to provide it, and no one else can provide the same quality of care, or their loved one won’t allow anyone else to provide the care. Some people may not understand who to call or how to obtain the help that is needed. One final and very common reason for seniors refusing to obtain care or assistance is “It costs too much” or “We can’t afford it.” Well, if a little bit of assistance now is too expensive, what happens later when a higher level of assistance is needed because complications arise from the smaller issue that wasn’t addressed?
A variety of options exist to address a need for assistance, including home care, adult day services, senior centers, a comprehensive community-based program called Living Independence for the Elderly, and various levels of 24 hour care. Don’t let the “danger zone” catch you unprepared. Knowing when and where to get help may make a world of difference for you or a loved one.
Karen Kaslow, RN