Who will care for Wiesman?
"I worry about dementia and longevity because they run in the family," she says. Perhaps, she says, she can turn to her three nieces.
As baby boomers age, the number of childless seniors, both couples and singles, is rising. Close to 19 percent of all women ages 80 to 84 will fall into that category in 2050, up from 16 percent in 2030, according to a study by the AARP Public Policy Institute. Recent research by a geriatrician at the North Shore-LIJ Health System in New York coined a name for these seniors: "elder orphans."
One of the first steps childless seniors should take is to draft legal documents that will protect them if they become incapacitated. On the financial front, you should create a durable power of attorney and choose an agent who will manage your financial, legal and tax affairs should you become unable to handle these tasks yourself.
Childless seniors often pick a niece or nephew to whom they are close -- or a trusted friend, cousin, sibling or clergy. Because of the potential work involved, "include in the document that the person should be compensated," says Wynne Whitman, an estate-planning lawyer at Schenck, Price, Smith and King, Florham Park, N.J.
If you don't have someone reliable who can take on the job, you could set up a revocable trust and assign a bank or trust company as trustee, says Martin Shenkman, an estate-planning lawyer in Paramus, N.J. You would move your assets to the trust, and the company would eventually take on financial tasks you assign to it, including paying bills and caregivers, processing medical claims, and overseeing your home if you're hospitalized or in a nursing facility.
You can even tailor the trust's provisions to ensure that your physical and mental health are monitored, Shenkman says. The document, for instance, could advise the trust company to hire a geriatric care manager to conduct periodic evaluations in the future, and to send a copy of the assessment to the person you choose as your health care agent.
You'll also need to draw up health care directives. One is a living will, which will define your health care wishes under certain medical conditions. You'll also need to name a health care proxy, who will make decisions on your medical care if you become incapacitated.
As you age, the proxy's role could intensify. He or she must keep an eye on your mental and physical state, hire caregivers and arrange for you to move to new housing if necessary. Your proxy "should be someone you have ultimate faith in and connection with," says Elinor Ginzler, senior director of the Center for Supportive Services at the Jewish Council for the Aging of Greater Washington, Rockville, Md.
If you don't have someone who can pick up the role, you may be able to hire a professional. Some elder law attorneys can become a health care proxy. And depending on the state where you live, you may be able to hire a professional fiduciary to oversee your affairs.
Wiesman's sister is her financial agent and health care proxy, but her sister at some point could become too old to continue in that capacity. Wiesman is close enough to her three nieces to consider asking one of them to take over in the future -- perhaps moving to the city where the niece lives.
"I don't expect my nieces to care for me on a daily basis," she says. "I would look to them to oversee paid help, and my funds would cover my care."
It's a good idea for a childless senior to widen the circle of potential helpers -- people and organizations that can keep an eye on you and pitch in if need be. Your network could include friends, volunteer organizations you work with, neighborhood groups and senior centers.
"The social network you create will be your safety net," Ginzler says. Her aging organization sometimes gets calls from worried friends and neighbors seeking help for a failing senior.
Perhaps a group of neighbors or a church committee could rotate visits to your home after you've been hospitalized, for example. Or maybe the senior center where you play bridge may notice you're not doing well and arrange for an assessment.
You could direct team members to exchange information, especially if your mental capacities decline. They could also watch out for financial elder abuse.
"I've had phone calls from CPAs who say, 'I did this tax return and it looks a little strange,'" says Evans. If the team is concerned, it could call the persons you've named as your health care and financial agents.
Your safety net should include an array of aging-related community services. While you may not need resources now, you can start investigating what's available. Services could include care managers, visiting chefs, handyman firms, escorted transportation, home aide agencies and senior centers.
You also should visit various types of senior housing to get an idea of the kind of place where you'd feel comfortable living. File the information in a folder that you or your designated helpers can use in the future.
You also could turn to one of a growing number of companies that offer elder-related services. One is Life Management Services, a division of Wells Fargo's Private Bank. The service, available to clients with $2 million in investable assets, will assess clients starting in their 60s or so and arrange for assistance as their needs change.
"We like to say that we walk alongside them," says Anne Tinyo, national manager of the program, which is available in 32 states.
A client in her 60s or 70s may start off just having Wells Fargo review and pay medical bills. As time goes on, a Life Management specialist could develop a plan of care, and set up meal preparation, physical therapy and other assistance. If the specialist determines a client needs assisted living, the specialist would find a suitable facility, coordinate the move and check in on the client regularly.
More than 350 communities have been designated as aging-friendly by the Milken Institute Center for the Future of Aging, a think tank in Santa Monica, Calif. (Check http://successfulaging.milkeninstitute.org.) Criteria include senior housing options, hospitals offering geriatric services and investment in public transportation. You can assess your own community's aging friendliness and compare it to others by using AARP's Livability Index at www.aarp.org.
If you want to live at home alone, build in extra support to preserve your independence as long as possible. A care manager can conduct a periodic assessment. If the time comes for more help, the care manager can work with your health care agent to find a home aide, assisted living or a nursing facility. You also can install medical-alert technology, which will notify a designated person if you fall or if you don't seem to be following your normal routine.
Another option is to live in one of 200 "villages," neighborhood groups that, for a membership fee, provide seniors with services such as transportation to doctor appointments, home repairs and meal delivery. (Find a village at the Web site for the Village to Village Network: www.vtvnetwork.org.) You could consider, as Wiesman is, living with friends.
But understand that these are "interim steps," says Andrew Carle, director of the Senior Housing Administration program at George Mason University, Fairfax, Va.
"Over time, a lot of people will outgrow what the villages are capable of offering," he says. And shared living arrangements may fall apart as housemates become infirm or develop dementia, he says.
CCRCs typically charge an entrance fee and then monthly fees that cover an independent living unit, meals, recreational activities and other amenities. The community may move you, at no extra charge, to the on-site assisted-living unit or skilled-nursing facility if you need care.
The CCRC will refer residents to a bank or a trust company if their financial agent falls down on the job, says James Petty, an ACTS vice-president.
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