You’ve probably heard the quote “Getting old ain’t for sissies,” which is typically attributed to Bette Davis. Most of us would agree! As we grow older, our bodies often start to feel the wear and tear of a lifetime of use, and in some cases, a health issue or even a health crisis may arise.
Some of these age-related conditions are more chronic in nature; they are problems that can come on gradually like osteoarthritis, high blood pressure, or memory challenges. As a result, we can plan for ways to deal with them in advance — such as a scheduled joint replacement surgery. But unfortunately, other health issues happen quite quickly, like a fall that results in a broken bone, creating the sudden inability to care for oneself or navigate the home.
And then there are even more serious emergencies — such as a heart attack or stroke. Not only can an acute health crisis like this be life-threatening at the time it occurs, it can be difficult to ever truly be prepared for the ways in which the patient’s life — and the lives of their loved ones — may be altered afterward.
So, what should you do if a loved one suffers a serious health crisis (other than calling 911 and getting them emergent care, of course)? What are the steps you should take in those initial hours, days, and weeks after a health crisis strikes?
Consult important legal documents
With any medical emergency or health crisis, it is often wise to hope for the best, but plan for the worst. For this reason, depending on your loved one’s unique medical situation and how grave their prognosis may be, one of the first things you may need to do when a health crisis occurs is review the patient’s power of attorney/healthcare proxy and advance directives (aka, living will) documents. This can ensure their preferences are honored.
A power of attorney document allows a person (the “principal”) to select an “agent” (also called a “proxy” or “attorney-in-fact”) who has the legal authority to make decisions should the principal become mentally or physically incapacitated. The attorney-in-fact should be someone the principal trusts to always act in the principal’s best interest such as a spouse/partner, adult child, relative, or close friend.
A durable healthcare power of attorney document (also called a healthcare proxy or healthcare surrogate) is a specific type of power of attorney that allows the attorney-in-fact to make healthcare-related decisions should the principal become incapacitated.
Advance directives, also referred to as a living will, allow a person to make their medical-related preferences clear should they become terminally ill, seriously injured, in a coma, in the final stages of dementia, or near the end of their life. Essentially, advance directives offer written guidance to help navigate the care choices that sometimes need to be made by healthcare providers and loved ones.
Of course, these legal documents are only helpful if they have been created by the patient in advance of a health crisis. If you or your loved one has not yet created these important estate planning documents, contact an experienced attorney who can help you with them.
Determine post-health crisis care logistics
Once your loved one’s health crisis is stabilized, you will need to consider who will care for them once they are released from the hospital and where. Depending on the situation, the patient may need some level of care for weeks, months, or even years. This question of post-acute caregiving is oftentimes one of the biggest challenges faced by families — both logistically and financially.
Let’s first consider the question of where a person will receive the care they need following a health crisis. Depending on the level of care required, they may need to initially be cared for in a residential rehabilitation setting or assisted living community, or even in a skilled nursing facility, which is staffed 24/7 by healthcare providers. In other cases, the patient may be able to return to their own home, while others may need to relocate — temporarily or permanently — to another private residence.
Factors that must be considered in the “where” decision include logistics like the person’s level of mobility. Are they wheelchair-bound or otherwise unable to navigate stairs? If so, is there a stair-free entrance to the home or a ramp? Is there a bedroom and a bathroom on the ground floor? Will modifications need to be made to the home to make it accessible to the patient, particularly if their condition may be permanent, requiring a “new normal”?
Establish caregiving responsibilities
Next is the question of who will care for the patient. If the person is returning to their own home or the home of a loved one, there are more or less two caregiving options. You can pay for a full- or part-time professional caregiver and/or you can rely on unpaid care performed by friends and family. Some families choose one option or the other, though oftentimes, there will be a combination of both. But make no mistake: Unpaid care provided by loved ones is not free. More on this later…
With any scenario that involves paid care — either in a residential care community or in a private home — the costs can add up quickly. According to Genworth’s Cost of Care Survey for 2021, part-time (44 hours/week) of in-home care from a health aide averages $5,148 per month. The cost of full-time residential care could well-exceed the costs of facility-based care, with an assisted living community averaging $4,500 a month and a nursing home costing approximately $9,034 monthly. Keep in mind, however, that the cost of facility care could be substantially higher in some areas.
Cope with the emotional impacts of a health crisis
As the hours, weeks, or months pass following a health crisis, it is completely normal for the patient’s loved ones to feel a wide range of emotions — from fear and anxiety to sadness, despair, and grief. Even frustration and anger are perfectly normal and understandable feelings. The patient’s world has been turned upside down, sometimes permanently, but so has yours.
It is important to remember that while the patient is of course the top focus during a health crisis, loved ones should not neglect their own well-being and self-care. Loved ones, and particularly caregivers, must continue to get sufficient sleep, remember to eat, take breaks, and ask for assistance when needed. It’s like they say on an airplane: You must put on your own oxygen mask before helping others.
But to this point, as noted above, unpaid care provided by family members is certainly not free. People often assume that they will save money by relying on unpaid family caregivers versus paid care — money which they will then be able to leave to loved ones after they are gone. But the reality is that there is almost always a price to be paid by the caregiver — emotionally, physically, and even financially.
>> Related: The High Price of Family Caregiving
Proactively planning for “what if”
A health crisis can be life-changing for both the patient and their loved ones. While it is difficult to ever be truly prepared for all of life’s “what if” scenarios, there are certain steps you can take in advance to be as ready as possible for whatever life may throw at you.
At the top of this list is ensuring your estate planning documents — such as a will/trust, power of attorney, and advance directives — are completed and kept up to date. Having your wishes written down clearly and in detail can lift a tremendous emotional burden from your loved ones’ shoulders in the event a health crisis arises and you are unable to make your preferences known.
Next, planning for your senior housing needs in advance can be a labor of love that can potentially save your family members from having to make difficult decisions about where you will live. This might come in the form of downsizing to a smaller, one-level home that would be accessible should your mobility decline. Or it might be opting to move to a 55+ retirement community, which will typically feature residences that are designed with wheelchair accessibility in mind.
Finally, planning in advance for your potential care needs can help protect your loved ones emotionally, physically, and financially. This may come in the form of purchasing a long-term care insurance policy, which would cover many of the costs associated with potential care requirements. Or for some people, it may mean proactively opting to move to a continuing care retirement community (CCRC, or “life plan community,” where residents are contractually guaranteed access to whatever level of care they may eventually need) while you are still in relatively good health.
Yes, of course we all want to hope for the best as we grow older, but it is still wise to plan for the worst — those innumerable “what ifs.” Taking some or all of these proactive measures can alleviate at least a portion of the stress and potential heartache your family may have to endure in the future, should you ever suffer a health crisis.
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