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We've just taken the MIL from a nursing home to live with us. She has dementia but still loves life and her family. If we left here in the nursing home it was like we were passing a death sentence. How can I best prepare now for my own long term care arrangements?

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Follow all the good advice given above, especially POA, wills and end of life directives. If you have children do everything you can to make your care easier for them as you age. Have some serious disscusions now and commit outlines on paper as to you intentions. Please don't expect your kids to care for you in their homes till the end.
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I have a small home that will be comfortable and easy to live in as I get older. When I can no longer live on my own I am to be put in a nice care facility preferably with my own room and bath. If I am on any medications they are to be stopped at that time. The money I have saved will have to go to my care and when I'm out of it then I need to go on welfare or whatever is available at the time.
I absolutely DO NOT want my son or any of his family taking me into their home and caring for me as I have done for my parents. The greatest gift I can leave to my son and his family is their freedom. You never know how precious freedom is until you lose it to the daily responsibilities of caregiving.
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You know that's a good point on the health and fitness aspect. I have notes from the myriad of docs I take my mom to about how a lot of her issues could have been prevented or greatly reduced with a healthier lifestyle. High carb, high sugar, high fat and little exercise was a recipe for disaster.

Her heart doc said her walking on the treadmill and changing her diet to more good fats (omega3s, olive, coconut oils) with low GI veggies, baked/grilled chicken and fish and low sugar fruits along with her meds probably saved her life many times over despite the health issues. When said the treadmill walking and other active exercise helped grow new blood vessels in/around her heart I was stunned. She said it has a similar effect on the brain as well and that's why they stress exercise so much for recovery of heart attacks and other heart/brain events. She also said stress management and thought life is crucial. The PCP told me try to avoid diabetes to reduce having so many issues that often come with it (blindness, vascular disease, kidney decline, heart, amputation and dementia). She said eat more fruits and veggies, fish and reduce carbs (especially white ones, processed stuff) and sugar along with moderate cardio/strength training most days of the week is the best prevention. Not rocket science but to hear her many docs say the same things made an impression. They said it reduces health care costs, enabling them to live independently longer with a greater quality of life.
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On the other hand you could 'eat, drink and be merry' and plan to die early. I always have to chuckle to myself that none of us wants to live to decrepit old age but we're always advising each other to take care of our health ;)
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Exercise at least 35 minutes everyday. That is 4 hours a week. Something like walking. Eat a lot of fish. Not fish sticks, either. Real fish. Lots of veggies. I know you have heard it all. Forgive people. Be at peace with life.
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Kathy, good points. I would add to your recommendation that of weight bearing exercise, including the walking you recommended.

Also, be aware of osteopenia and osteoporosis and the recommended calcium levels as well as weight bearing exercises to counteract the devastating bone thinning effects.
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To add to gardenartist great advice, exercise. Lift weights so that when you fall you bounce rather than break. Falls are the number one reason people get placed in a nursing home. Walk, so your body works better, try for 3 miles 5 times a week, start slow and build. Read Dr. McCullough's "MY MOTHER, YOUR MOTHER" so you can plan ahead. Make your wishes clear to every child, about how you want to die, have the proper papers in place. Make a will, tell everyone involved, so there is no surprises. Lastly make friends, stay social.
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Speaking from another viewpoint, you can also protect yourself through healthy living habits (no, this isn't a pitch for spartan living!) If you eat them, cut out processed foods as much as possible, high sugar and high fat foods, grow as many of your own fruits and vegetables as you can, if you're able to garden.

Live healthier and longer and it will help you in your old age (Writing that, I almost feel like Mr. Spock with the Vulcan motto "Live long and prosper.")
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cwillie, great idea about moving closer to the doctors, shops, services. That is so very very important. I want everything within a 5 mile radius :)

When it comes to doctors, being in a metro area comes in handy, you have more than one doctor to choose for a specially. You have more than one Assisted Living and/or nursing home to choose. A ton of pharmacies. Lot of taxi companies if need be. And EMT's only minutes away.
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MaggieM, don't count on poor health as your easy out, my mother has careened from one health crisis to another, starting with major heart attacks and bypass surgery back in the 70's to sepsis from kidney stones in the 80's to macular degeneration and TIA's in the 90's and 00's; it only tempered her and made her stronger!
I bought a little home that could be easily modified in order to accommodate her now and myself in the future, and I have been putting money into upgrades like steel roofing today in case the money is less abundant in the future. I moved into town so we would be closer to doctors, and shops and other services less available in the country. My plan is to sell and move to an independent living community in the city at age 75, beyond that will depend on my health and finances. I have no kids, and although I have nephews and a niece I have no illusions about them taking care of me in the way I am caring for my mother.
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You are very smart to worry about planning for your own care this early. There are several strategies from prepaid expenses, insurance to asset protection.

Right now Irrevocable Trusts seem awesome for asset protection but also have major restrictions if you still need the money inside of them so consulting a professional is wise.

Long Term Health Insurance, like all insurance is a gamble slightly weighted on the side if the insurer so they can make a profit and stay in business. If it helps you sleep at night then for that sake alone, it is worth looking into.

Setting up a Durable POA with someone you trust is a great idea so decisions can still effectively be made about you even when you can no longer make them.

I pretty much advocate talking with a professional. I'm a CPA by trade and did a ton of web-research before talking with a trust advisor regarding my dad and found that I'd discovered a lot of the highlights but very few of the important details, as well as having missed some "gotcha" points altogether.
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Blindfaith, as mentioned its very important that you first and formost put your wishes in writing. If you check my profile page you will find a link to an article i wrote on the three forms every adult should have. Spell out in as much detail as possible what you do and dont want. This will make it easier on your family. Personally i have seen what caregivers go through and i dont want my only daughter to be put through that so i have made other arrangements so she can have a caregiver free life. Hope we never need care, maybe we'll be the lucky ones that go in our sleep. Take care Ruth Anne
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I started planning for my old age at about 55 when I bought my present home. It's a small ranch with a one-car attached garage...no basement...obviously no stairs...fenced yard for my dog...laundry right off the kitchen. Sliding glass doors to a railed deck.

That oughta do me until I am unable to live alone. I have health issues so I would be surprised if I lived past my ability to take care of myself sans a disabling stroke or a need for hospice.

My POA knows my wishes in that event -- nice nursing home.
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My plans for when I get older [I feel like an antique as it is] is to downsize from a house with stairs to a large apartment in a senior retirement complex. Some place where if I need to go to the bank, the hairdresser, gift shop, gym, or doctor's office, it's right there on the campus close enough to walk to.

I had saved for decades for a nice retirement, hopefully do a lot of travel, but that line item has been scratched off.... it wasn't until I started to get older myself that I realize that money will be used for a roof over my head.

In fact, I have no qualms about going into an Assisted Living/nursing home facility. I will welcome someone else doing all the cleaning and cooking :) And being around people of my own age group, and to be able to have some new BFF's.
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Thank you Sunnygirl1, I feel that you've headed me in the right direction.

MIL was in nursing home for rehab to help her walking. When evaluation meeting happened the medical staff explained that she couldn't remember OT or PT lessons from day to day so every day was "starting over" with her. 2 of her children wanted her to stay and 2 others didn't think she was ready yet as she has no other health issues and took her out of where she had made it clear for years that she never wanted to be,
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Dear Blind, I'm assuming that you have several shifts of caregivers set up to care for your loved one, and that you have caregiving contracts, rent payments and the like all set up through a lawyer. Many sad stories of dementia patients who turn on loving family members, accuse them of abuse, financial and otherwise and destroy their lives and finances.

I also hope that you have a doctor or at least a nurse who can provide home based health care. My mother tried to grab the steering wheel and attack the driver if we try to take her anywhere, so it's good that she's in the NH where the 4 bouts of pneumonia she's had in the past 19 months were able to be treated.

And that you've got podiatry, dental and opthamologist services on call. Also religious personnel who can give spiritual comfort a couple of times a week. And ice cream socials and barbecues.
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I would consult with an Elder Law attorney who can evaluate your situation and finances and provide you with sound estate planning advice. They can explain what options you have to protect your assets and pay for your care, as you age. They can also prepare documents that authorize your family members to act on your behalf, if you are not able, such as Durable POA, Healthcare POA, Living Will, etc.

Is there any reason you took your MIL out of the facility to live with you? I'm just curious why you thought you were passing a death sentence. Dementia is a terminal illness, so it will progress, regardless of where she is living. I suppose that all cases are different, but many dementia patients receive excellent care in Memory Care units and other facilities. From my personal experience, most families' efforts to keep dementia patients in the home is extremely challenging, due to the constant supervision and high level of anxiety involved with round the clock care. What has been your experience so far?

Caring for your MIL in your home should give you a good idea if that is something you would want your kids to do for your down the road, if the need arises. Based on my experience with dementia in my family, I would not want my family to try to care for me in the home. I don't think it's fair and I would want them to have a normal life, which is not possible with a dementia patient in the home, IMO. I want my family to know I feel this way. There seems to be so much guilt with so many people about getting seniors and the disabled the care they need, I want to make sure they don't feel guilty if they do that for me.

I wish you and your family all the best.
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