Preparing for and preventing falls should be part of any complete life and estate planning. In this article, we will focus on the steps needed to plan for a possible fall.
You may be asking yourself, “why talk about falls?” Well, the sobering statistics from the National Council on Aging are the following: “Falls are the leading cause of fatal and non-fatal injuries for older Americans. Every 11 seconds, an older adult is treated in the emergency room for a fall; every 19 minutes, an older adult dies from a fall.”
Even in the event of some other medical problem, following these steps will help you design a solid and safe caregiving plan for the future.
Previous statistics aside, falls can cause catastrophic damage to an older person. Hip fractures following a fall are very common; 95% of all hip fractures are caused by falls, according to the federal Centers for Disease Control and Prevention. As people get older, their bones are not as strong. Recovering from this type of fracture can be long and challenging. Other considerations:
- Complete recovery may not be possible. Depending on the person's prior health and fitness, they may never get back to their previous level of functioning. Any other medical issues will be exacerbated. If surgery is required, and it often is, there can be lasting effects from anesthesia and the trauma of the surgery itself.
- Going home may not be an option. If rehabilitation is not successful or complete, other care options may need to be considered. Just because a rehab stay ends, that does not mean that your family member is functioning independently. Far from it in many cases. More on this later.
- One fall increases the chances of having another. Even with complete recovery, many people have an exaggerated fear of falling in the future. This leads to a self-imposed restriction on activities that causes further weakness and decline.
- Falls can be costly. Depending on the insurance you have, there could be co-pays for treatment and rehabilitation. There may also be restrictions on choice of providers. Not to mention the out-of-pocket costs for care that insurance doesn't cover.
To put some of this in perspective, let's take a look at the typical trajectory of a fall and its aftermath. Most falls result in an emergency room visit where the extent of the damage is determined. Injury can occur in the hips, femur, head injuries, broken arms, wrist - the list goes on. Unfortunately, an injury to the lower extremities (legs, hips) can significantly limit mobility. Hospital stays are generally just a few days and then the patient is discharged to rehab or home. Medicare guidelines are changing with regard to covered in-patient rehab services. It is best to check with your insurance about whether any rehab will be covered at all. Don't expect to be given much time before being told that your family member is being discharged.
Also, don't underestimate the emotional impact that results from a sudden of loss of independence. Watch for signs of depression and emotional instability. Address these with a physician.
The most critical part of preparation is to practice fall prevention. That topic is beyond the scope of this article, but the Mayo Clinic is a great resource to refer to. Meanwhile, before a fall occurs put these things in place:
- Find out what you or your loved one's insurance covers. There are limitations and out of pocket expenses with most plans. There is a big difference between what Medicare Advantage plans and traditional Medicare cover. Educate yourself about your insurance coverage.
- Identify home health and rehab companies that are covered under your family member's plan. Knowing which companies are covered will save you significant time in the future. Not all home health and rehabilitation may be covered under insurance.
- Investigate these companies. Find out which companies have the best reputation. Keep track of their names, phone numbers and contact people. If you don't know how to evaluate companies, ask your health care provider or other people who have needed and used these services.
- Visit assisted living communities. Why? You may need one if your loved one can't come home. Being pressed for time while trying to make this decision will be stressful. Visit and evaluate assisted living communities in the area in case you need one. Get detailed information about base costs and add on pricing for additional care needs.
- Pick out your top three private-duty companies. It is not unusual for someone to need a lot of care following a fall. They may not be able to bear weight. This means help getting to the toilet, assistance with bathing, cooking, cleaning and transportation. Sounds like a full-time job, doesn't it? Except under unusual circumstances, most families can't provide this much care. Care agencies can fill in the gaps, helping with a whole host of tasks. Unless your family member has long-term care insurance this will be private pay. Find out which agencies have the best reputation.
- Have a family meeting to decide, when the time comes, who will assume caregiving duties. Caregiving can have a huge financial and psychological impact on family. The compassionate commitment of family caregivers is commendable. But it can come at a price. Family members who leave their employment to care for a loved one often have a difficult time getting back into the workforce. Even a leave of absence from a job means loss of income.
- Assess finances. All the planning in the world won't come to fruition if there is not a way to pay for it. It is critical to have an estate plan that factors in increasing care needs. Work with your retirement specialist to factor in costs for long-term care.
Falls can have a devastating impact on families, but with proper planning you can be prepared. Preparation is the foundation of a financial and caregiving plan that will give you and your family peace of mind.