living will

Straight talk needed to choose health care at the end of life

Birth, childhood, adulthood, and death span the book of life. Unfortunately, many people tend to avoid thinking or talking about how they want the final chapter to read. For the seriously ill or elderly—and even those who aren’t—not expressing wishes and desires about health care at the end of life can lead to getting care you wouldn’t have chosen for yourself. Families often bear the brunt of delaying or avoiding a discussion about a loved one’s end-of-life preferences. That often leaves family members making decisions without knowing what their loved one would have wanted. Doctors in Canada just published recommendations for starting the end-of-life conversation. The Conversation Project offers a “starter kit” to help people prepare to discuss their end-of-life wishes. Another resource is Five Wishes, a planning document distributed by the Aging with Dignity Foundation.

Few plan for long-term care though most will need it

Faculty Editor, Harvard Health Publishing

Two of every three Americans who reach age 65 will at some point need long-term care for up to three years. Yet the majority of those age 40 and older have done “little or no planning” for how they might pay for long-term care when they get older. That’s a key finding from a new survey of 1,019 Americans over age 40 on the topic of long-term care. The survey was done by the Associated Press and NORC at the University of Chicago. Most people underestimate the cost of nursing home care (it averages $6,700 a month) and overestimate what Medicare will cover. And few people are setting aside money for long-term care even as most worry about key issues of aging such as memory loss or being a burden to family members. Without a crystal ball, it’s tricky to plan for the future. It’s easy to convince yourself that you or a partner won’t need long-term care. But the statistics suggest you should start planning now, even if your plan isn’t perfect.