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The Harsh Reality You Probably Can't Avoid

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For ten years I worked at a posh retirement community in a tony suburb outside Chicago. My job as a clinical social worker involved helping older adults and their families cope with the process of aging. The busy times of the year for me were the winter holidays and Mother's and Father's Day—times when adult children visited their parents after sometimes months of separation.

I always steeled myself for these times, knowing they would involve a series of painful telephone calls and family conferences, working hard to explain that, yes, Mom was, in fact, different from just a few months ago. Aging is a process of erosion for many people. Our bodies can lose their efficiency in many ways—physically, cognitively, even emotionally.

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I saw this happen with both of my parents in the last year of their lives. My mom lived for 11 months after being diagnosed with an aggressive brain tumor. She lived with right-sided paralysis, cognitive changes, loss of speech and total dependence in her last year. My dad experienced acute neurological changes in his last five months of life, which resulted in months of hospitalizations and ultimately moving to and dying in an assisted living community he hated. His condition was a mystery and easy to chalk up to dementia because of his advanced age. It wasn't until days before his death that it was determined that the lung cancer he had been treated for just a few months earlier was responsible for his decline and all the changes that came with it.

My personal and professional experiences have amplified one roaring fact about aging in America: growing old is incredibly expensive.

A Pew Research Center study published this spring reveals that the number of adults aged 65 and older in the U.S. will almost double by the year 2050. And more so than some of our European counterparts (specifically Germany and Italy, two countries whose populations are at least one-fifth over the age of 65), the majority of Americans believe the cost of aging parents should be covered by either the older adult themselves or their families—not the government.

Don't wait until a crisis, as many choose to do through inaction.

Huh. I wonder if that will change as more and more Americans start to realize just how expensive aging can be.

It cost my father $10,000 to hire a private medical plane to transport my mom from Biloxi, Miss., where she experienced that hemorrhaging brain tumor no one knew she had to a Chicago hospital. The cost of 24-hour care for my father in the last three weeks of his life—care that was deemed necessary for him to remain in his assisted living room rather than make yet another move in what had been an extremely chaotic and disorienting time—was almost $25,000.

We are talking serious bucks.

My folks were working class, but those pennies saved over a lifetime add up and alleviated me and my siblings from having to scramble financially.

Another thing I have learned in both of my personal and professional realms of aging experience is that no one wants to talk about it. No one. Not the folks with money to cover these expenses, not the folks who will rely on the government to fund their later years via the No. 1 welfare program in the U.S., Medicare.

You do know that the government does not cover the cost of aging in America, right? Not even close. For most older Americans with Medicare, hospital expenses are covered, but rehab and home health and custodial care—things that if you live long enough you will most certainly need—are generally not. Or, if they are covered, it is for only very limited periods.

We don't know what is ahead for any of us, ourselves or our parents included. We don't all age gracefully.

I encourage any of you lucky enough to have parents still alive to initiate conversation about this topic sooner rather than later. Don't wait until a crisis, as many choose to do through inaction. Talk about it today, while passing the salt over the Christmas dinner table. Talk about it while driving Mom or Dad to the doctor. Keep bringing it up, even if they don't want you to. It's important. And a series of conversations over a number of years will guide you in more ways than you can ever anticipate when the time comes that answers are required.

My own family's story can be a lesson for your own. After my mom's experiences, it was clear to all that with my dad's independent nature that naturally bucked authority, he would never function well in a structured setting like a nursing home or assisted living community. We had had more than a few conversations, he and I, about how our home would always be open to him, when and if he needed us.

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The sad truth is that he did need us, but his specific needs made it impossible for us to care for him in our home. Neurological changes are no joke, and they impacted my dad in such a harrowing way that accepting help of any kind was challenging at best, impossible at worst. The moral of our story is that while our planning did pan out, it did help nudge decisions in the direction that provided resolution.

We don't know what is ahead for any of us, ourselves or our parents included. We don't all age gracefully. Sometimes it is gentle, many times it is not. Talk about all of it with those folks who brought you into this world. Talk about the good, the bad and the poopy, because, yes, there will be poop. Be the adult your parents raised you to be. Go there, with good intentions and no illusions.

You will all appreciate it when the time comes.

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