•  Margaret Danilovich

  • I am sure none of us could have imagined the myriad ways that life would be different because of a global pandemic. One of the key lessons we have learned is the importance of preparing for the future, even unexpected health emergencies.

    In the context of aging, planning for the unknown is essential. As we get older, the likelihood of experiencing dementia, frailty, or falls increases, which often forces older adults and their loved ones to make difficult caregiving choices. Without plans for how we want to live in older adulthood and the types of care we want to receive, families often make urgent caregiving decisions on our behalf in the wake of health crises.

    As a physical therapist and health researcher, I have frequently seen families struggle over determining the best place to live and the amount of care needed for their loved ones.

    These challenges are compounded by the financial, physical, and mental stressors of being a caregiver, and are exacerbated because family members often assume responsibilities quickly and without training or knowledge of their loved ones’ healthcare wishes in emergency situations.

    While almost 60% of family caregivers assist with medical or nursing tasks, only 14% report that they are trained to do so. Because of this gap, there is greater stress and reduced safety for both the caregiver and their care partner. Even with training, the choice in becoming a caregiver impacts health. A research article that I wrote, published in the Journal of Aging and Health, showed that the feeling of choice in taking on care responsibilities was associated with a fourfold increase in the odds of better health in response to caregiving compared with people for whom the caregiving role was thrust upon them.

    To minimize the challenges of caring for an older family member, one solution is to identify the preferred caregiving arrangement prior to an urgent health issue. Plans could be for a family member, a paid caregiver, or services like adult day programs. Importantly, plans should include all family members discussing, well in advance, who will provide care and to what extent. Planning in this way allows people the choice of accepting or declining these responsibilities, which can lead to reduced stress, strain, and better health for the caregiver.

    No one wants or expects to lose their independence as we age. But, according to the Centers for Disease Control and Prevention (CDC), nearly 25% of all older adults have a moderate-to-severe functional limitation that impedes their ability to live without assistance. Being prepared by creating a caregiving strategy helps to plan for the unexpected.

    Without a plan in place, older adults may suffer most when the unforeseen occurs. In a health crisis, older adults are often less able to voice their preferences for care, limiting their ability to receive the services they desire in the location of their choosing. Th is can lead to increased anxiety, depression, and a decline in overall health. It's time to begin preparing for the unexpected and have conversations about who, when, and where we all want to receive care before a health change occurs.

    To take advantage of CJE’s many supportive resources for older adults and their family caregivers as well as assistance with advance healthcare planning—including legal documents to prepare families for an emergency— visit or call 773.508.1000.