Clear skies. Less humid. Low 62F. Winds NNE at 5 to 10 mph..

Clear skies. Less humid. Low 62F. Winds NNE at 5 to 10 mph.

The Gospel of John recounts the appearance of Jesus before seven disciples in Galilee following His resurrection. He said to Peter, “When you were younger you used to dress yourself and go where you wanted; but when you grow old, you will stretch out your hands, and someone else will dress you and lead you where you do not want to go.” (John 21:18)

Jesus said this to indicate the kind of death by which Peter would glorify God. But Jesus also described our life’s journey from birth to death, from the robustness of youth with the excitement of goals fulfilled and milestones achieved, challenges met and difficulties surmounted as we progress through adulthood, and a potential final endgame circumstance. Every caregiver, care giving professional, and the patient cared for knows this journey well. The loss of major bodily functions is not a respecter of age, as young and middle-aged people experience stemming from accidents, battlefield injuries or illness. But somewhere beyond age 60 the potential impairment of mental and physical functions encompassing decision making, mobility and independence increases, along with the likelihood of needing care.

Per the Center for Disease Control and Prevention (CDC), the leading causes of death among those ages 65 and older are heart disease, cancer, stroke, chronic lower respiratory diseases, flu and pneumonia, Alzheimer’s disease, diabetes, kidney diseases and accidents. Death often is preceded by a period of needed care. This is why providing for short-, intermediate-, or long-term disability or care is a financial and estate planning concern for one’s self and family members, and for loved ones who are caring for family members or other cherished persons and those who may be called to do so in the future.

A 2020 report from National Alliance f0r Caregiving and American Association of Retired Persons revealed a jump in the number of family caregivers from 43.5 million in 2015 to 53 million in 2020, an increase of 22 percent. Of the one in five Americans who are caregivers, 61 percent are women and 39 percent are men. This is a particular challenge to “sandwich generation women” caught between children needing care and aging parents and grandparents, presenting time and financial squeezes, and often, job and career pressures. Twenty-one percent of caregivers report their own health as only fair to poor.

For many of the medical conditions cited as a prelude to death, a point may be reached when a “medical fix” is not feasible. Keeping the patient comfortable becomes the primary concern. There are growing efforts by states and the federal government to facilitate home- and community-based services. When a loved one is hospitalized, the question is, “After discharge, what’s next?” One option may be “hospice at home.”

Does the patient no longer want aggressive treatment or chemo? Does he or she desire not to go back to the hospital? Is the loved one plagued with uncontrolled pain, frequent ER visits and hospitalizations, ongoing urinary tract infections, wounds that won’t heal, confusion and weakness, significant weight loss, frequent falls or risk of falling, sleeping more, decreased food and liquid consumption, increased need for assistance with activities of daily living?

Hospice care is 100 percent covered by Medicare and Medicaid, paying for 24/7 on-call nursing services; medications related to the patient’s primary diagnosis; costs of medical equipment such as a bed, wheelchair, walker or oxygen; personal supplies such as diapers, underpads, wipes, shower chair, etc. The caregiver and patient gain a team of doctors, home aides, nurses, chaplains, social workers, grief counselors and volunteers. The team can arrange for respite care for the caregiver and other help if one needs to be away. If the patient’s needs outstrip the capabilities of the family caregiver and the hospice at home team, other alternatives can be presented.

Many hospitals have professionals on staff who can advise family members on palliative care and hospice care options. In addition to financial concerns, the health and welfare of caregivers is important in the choice of care for a loved one. Senior citizens should explore options before a crisis ensues. When a loved one needs to be rushed to the emergency room, often the first phone call is to 911. After the patient is stabilized, who in the family will get the second call? Usually that’s the go-to “alpha child,” the daughter or son who may be called to step in as a caregiver and decision maker at some point. What does he or she know about your wishes and affairs?

Your financial adviser can arrange for a meeting to discuss caregiving and end-of-life options and planning, in addition to a family meeting at some point. Key legal documents should be reviewed with an attorney well-versed in living and testamentary estate and trust planning. Religious needs and preferences should be considered. Decision-making at a time of pressure and grief rarely is optimal. Planning for the certainty of death and the uncertainty leading up to death is a gift to loved ones, with a “peace of mind” dividend for you.

Lewis Walker, CFP®, is a life centered financial planning strategist with Capital Insight Group; 770-441-3553; lewis@lewwalker.com.  Securities & advisory services offered through The Strategic Financial Alliance, Inc. (SFA). Lewis is a registered representative and investment adviser representative of  SFA, otherwise unaffiliated with Capital Insight Group. He’s a Gallup Certified Clifton Strengths Coach and Certified Exit Planning Advisor.

Lewis Walker, CFP®, is a financial life planning strategist and longtime columnist for Appen Media and the Dunwoody Crier.

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