Meeting the Needs of the Elder Population: Atlas Planning Manual

By Stephen F. Rutz

Meeting the Needs of the Elder Population: Atlas Planning Manual, explores "counties" and "cities" we may visit in our last life-journey. Whenever this "journey" begins, its success depends on the planning put in place with spouse and family members. Like the atlas you use to plan a family trip, this "atl

• Language: English
• Publisher: Stephen F. Rutz Sr.
• Release date: Feb 16, 2023
• ISBN: 9781958066201

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Meeting the Needs of the

Elder Population

Atlas Planning Manual

Stephen F Rutz sr

Copyright © 2015 by Stephen F Rutz Sr

Meeting the needs of the elder population:

Atlas planning manual

by Stephen F Rutz Sr

Printed in the United States of America.

ISBN 9781958066294

All rights reserved solely by the author. The author guarantees all contents are original and do not infringe upon the legal rights of any other person or work. No part of this book may be reproduced in any form without the permission of the author. The views expressed in this book are not necessarily those of the publisher.

Dedication

My life-journey would have no meaning except for those I make it with, who enrich the experience. In particular this includes my wife, Nita, who has shared all the adventures of my professional, religious and political struggles over fifty-three years; and our children, Steve Jr. and Beth, who now have their own families. But today I dedicate this book to our grandkids: Carolina, Andrew, Emily and Sebastian. They, and their generation, will look back someday on grandpa’s life-journey, and I hope they will say, I think he had it right!

Acknowledgments

I want to recognize a number of people who helped make this book a reality. In particular, the significant input from our Faith Viera Lutheran Church Senior Committee in organizing the six three-hour symposiums that were held in 2012 and 2013. These events generated the majority of the subject matter in this Atlas manual. More particularly, I acknowledge Mary Foster, Dartha Hilbert, Dave Rutz, and Ed Willis for contributing edit and comment observations to improve the ultimate quality of this book. In addition, significant observations were provided by Bill Bethauser, Jack England, Carol Fairchild, Leslie Heumann, Bob Lee, Paul Marek, Phil Shoemaker, and Harold Thompson.

Bless you one and all!

Table of Content

Dedication

Acknowledgments

Preface

Chapter 1 Atlas Manual Purpose and Background

Chapter 2 Atlas Manual Overview: The Big Picture

Chapter 3 Quality-of-Life Current Definition County

Chapter 4 Quality-of-Life – Elder Years Definition County

Chapter 5 Future Year Cultural Challenges to Planning Options County

Chapter 6 Legal Issues

Chapter 7 Caring for the Caregiver Rest Stop

Chapter 8 After Leaving the Rest Stop

Chapter 9 In-Home Healthcare

Chapter 10 In-Home Support Service

Chapter 11 Independent and Assisted Living Communities General Description

Chapter 12 Independent and Assisted Living Communities Service Similarities Checklist and Description

Chapter 13 Retirement Financial Planning

Chapter 14 Lthc Insurance and Education Ramificfations

Chapter 15 Budget Preparation and Analysis

Chapter 16 Budget Future Options Analysis

Chapter 17 Financial Advisor Selection

Chapter 18 Memorandum of Information (Moi) Summary

Appendix A Independent/Assisted Living Research Rental Options

Appendix B Independent/Assisted Living Research Buy-In Options

Appendix C Unsettled Tax Issues

Appendix D Chapter and Section Index

About the Author

Preface

Ho

w old are you? The answer to this question will trigger your enthusiasm for the subject matter in this book – today! Those in their forties and fifties are too consumed with daily events to even want to consider the topics herein at this point in their life-journey. Yet, as statistics continue to recycle in God’s creation, the elder years end of the life-journey calls for early attention.

So, how to get this message out to all stakeholders involved (kids, grandkids, parents, and siblings), to raise the need for appreciation of these issues early in life before the health crisis hits? The answer is word-of- mouth!

Those of you, regardless of age, who see the utility of this book need to share your views with others accordingly. My personal experience with my generation (seventies) has been very positive in that regard. However, it is the younger generation (not up for the topic) who need this insight now! Only your word-of-mouth will make it happen.

To cut to the chase, in this regard, I suggest you go directly to the last, Chapter 18 – Memorandum of Information Summary, to grasp an immediate context of how prepared you are for this aspect of your life- journey.

The life-journey into the elder years reflects changes in quality-of-life activities constrained by health capability and the financial means to afford them. The retirement years are a notion in the mind of the beholder – one- size-does-not-fit-all, and different-strokes-for-different-folks. Yet, final trip events, in God’s will, can show up any time.

Why should you read this atlas manual? Before approaching the answer to this question I will define an atlas manual. An atlas is generally a book of maps depicting nation-states, their respective counties and cities. A manual is a handy book of facts, instructions, etc., for use as a guide, reference, or the like. This book is written in the format of an atlas manual showing how to prepare for life’s journey final year trips, similar to how we prepare for a trip across three states as we go to visit someone dear. Using this guide in this matter will be no different than if you are planning such a trip. May your journey be safe and successful as you reach your destination.

Now, in this context, the answer to this question on why you should read it is targeted on four generational age groups: those in their forties, fifties, sixties, and seventies. While the answer is different specifically for each group, there is a commonality that runs for all. We are all engaged in a life- journey that involves family trips that engage in activities outside the routine day-to-day of life, and which ultimately will end in a final trip, till death do us part. The focus of this atlas manual is on planning for that final trip. So what are the priorities for each age generation in the context of this final denominator? The first thought in answer to this question deals with quality-of-life (QOL).

Quality of life (QOL) is the general well-being of individuals and societies. QOL has a wide range of contexts, including the fields of international development, healthcare, politics and employment. It is your personal satisfaction (or dissatisfaction) with the cultural or intellectual conditions under which you live and the activities you engage in. Your general well- being is defined in terms of health and happiness, rather than wealth.

We are all engaged in quality-of-life activities that require a financial underpinning to achieve them. Both of these factors change as the life- journey continues. Quality-of-life activities vary depending on education, training, careers, family development, social focus, politics, and world events. Financial status similarly evolves with varying priorities to pay for life’s existence, educational development, home ownership, credit card payments, savings for daily use, retirement investment for later use. Thus, this atlas manual is a roadmap for your life-journey years forty until death, in essence. Our focus begins with the age environment we are enduring. The forties environment is your current age, not the 1940s.

Forties Generation: Against this backdrop, those in their forties generally couldn’t care less about their future journey out years, their lives are too full of meeting daily life demands. For them, the final life-journey trip could be next week and they don’t have a clue as to what that might be, let alone what to do about it. This atlas manual introduces them to topics that all they need to know at this point is that stuff is coming. For example, kids’ college education financial demands tend to focus toward the end of this forties generation. Scanning the manual provides insight into these topics that can now be addressed as the life-journey continues and priorities refocus.

Now, the atlas manual can be taken off the shelf, just as the trip atlas is for any family excursion, to meet the needs in that moment. However, one major point of emphasis in this manual is that initiating retirement planning from the financial perspective needs to begin now! Every couple should be able to find $50 per month to begin the investment process. I did thirty years ago, to significant financial success today. Thank you, God!

Fifties Generation: Now the family trip has achieved midlife. Some consider this a crisis timeframe, as priorities are shifting dramatically in terms of quality-of-life activity and the resources to pay for it. Perhaps support of elder parents becomes an issue. Children are now out of advanced education, and the finances incurred for that endeavor are now available for other things, or maybe loans continue to be paid off.

As the kids now take care of their own existence, the couple’s budget offers significant opportunity for readjustment to include career changes. Now, the $50 per month begun in the forties generation can now be expanded significantly, particularly when a company’s 401(k) program will match your contribution. Why you need these insights, and where you go with them, is the purpose of this atlas manual.

Sixties Generation: Unlike in your forties, with no clue as to what the last trip of the life-journey might look like, you are now beginning to get an idea. You have the experience of your parents’ situation as their last trip materialized and may still be going on as you read this. How involved have you been with them? Legal implications of powers of attorney and healthcare surrogates become major topics as they continue to age. And here, another major emphasis point raises its head for attention: Long-Term Healthcare Insurance (LTHC). Routine life insurance has been a part of your life-journey, recognizing the need for immediate financial support should the breadwinner pass unexpectedly. You look ahead in this regard for your personal life-journey final trip.

You have continued to survive and now face other financial implications as your lifestyle decays in your seventies or eighties, if not next week. The financial retirement plan that you began in your forties (or not) now becomes a major resource (or not). This atlas manual puts all of this into perspective to give you (and your family) insights now as to what may be coming, if not next week, certainly into the future years.

Seventies Generation: Your parents are now gone, debts have been neutralized, Social Security, if eligible, is now being delivered, and retirement pensions have replaced job income. At seventy-and-a-half, IRA mandatory withdrawals are coming from your retirement account. Your Retirement Portfolio continues to grow as a result of monthly dollar cost averaging, meaning that even as the stock market goes up and down periodically, over time its general trend is an upward direction.

Managing your Retirement Portfolio in this regard is significant to your quality-of-life options now, as well as in the future. At some point healthcare demands rise from periodic $18 per hour care to $200 per day 7 x 24, and ultimately $300 per day skilled nursing support. (Please note, dollar values presented throughout the atlas manual are based on 2013 or 2014 costs, and are subject to change in the future.)

In short, you should already be doing this, but in case you haven’t been, BUDGET your life NOW. Clearly, this atlas manual puts all these concepts in context for your current age, recognizing your current financial status and the quality-of-life demands it supports. Now, more about the atlas manual objectives.

Atlas Manual Objectives

There are two purposes for reading this book: First, to get insights into the future elder years of the life-journey trip that is coming at some point and what potential impacts that might cause to your current life-journey quality-of-life; Second, to recognize that this book is actually an atlas manual to assist you in planning to accomplish that life-journey last-trip when it becomes immediate. One-size-does-not-fit-all, it’s different- strokes-for-different-folks. Your family trip atlas gives you the facts of the counties and cities you will visit along the way, but does not tell you what to do there along the way. This book has the same constraints and uses the metaphor of a family trip that all have experienced, to enhance understanding of these issues.

If you currently keep a budget and govern your quality-of-life activities accordingly, you are in great shape to appreciate the context of this atlas manual. If you do not currently pursue a formal budget life-style, you need to read this book to appreciate the value of the formal budget process to your current and future happiness in the final trip of your life-journey existence.

Please scan the rest of this preface to gain appreciation for why this atlas manual needs to reside on your, your parents’, your kids’, your friends’ bookshelves.

First and foremost, we need to put the definition of final trip of the life- journey into perspective. Each day of our existence in God’s creation is a day in the life-journey trip in the moment. We normally don’t consider these daily events as a trip compared to a non-routine break that we normally refer to as a vacation trip.

This is a significant understanding of appreciating the difference in routine QOL activity versus not routine. When the routine life-style of activity, which includes social, physical, mental, medications, etc., begins to dramatically change, we are now into the last trip of the life-journey.

There is no free lunch unless you are on Medicaid. If that is your given situation, this atlas manual is of no value to you, so put it back up on the sale shelf. However, those of you in better financial shape will want to stay that way. Your financial state contributes to your QOL happiness, which is driven by your health status, and that is what this document is all about – what are your options in the new final life-journey trip and what does it cost to pursue? What is your financial status today and for years to come? The answers to these two questions are what this atlas manual is all about.

In short, whereas the Rand McNally Atlas covers the Nation of the USA and its fifty States, this atlas manual covers the Nation of Meeting the Needs of the Elder Population, with three states sharing a border with each other. The States are: QOL Definition, Health Issues, and Financial Preparation. Chapter 1 describes this atlas context and the background that led to its creation.

Chapter 2 provides the atlas manual subject overview in the big picture perspective. As you read through, recognize the references to Brevard County, Florida, and point-of-contact designations therein are offered as examples that you must replicate in your life-journey situation. Different- strokes-for-different-folks.

Final Preface Comment: Most people ignore this topic as outside their immediate sphere of activity events. I’ll deal with it when I need to later in life. If this is your attitude, you are putting yourself, your family, and your future QOL stress level in great jeopardy.

Chapter 1

Atlas Manual Purpose and Background

1.0 PURPOSE OF BOOK

This first chapter presents the logic foundation for the remainder of this atlas manual. Your first read-through will reflect repetition of subject matter here, there, and everywhere. This is intended for two purposes: first, to reinforce the interrelationships of subject matter in discussion. Second, to allow you to re-investigate specific subject matter you skimmed over, and/or recognize potential relationships to other subject matter you may need to investigate.

You have all heard of the topics in this book, here, there, and everywhere. Each topic is mind-boggling in its own right, let alone recognizing their interrelationships. Read this book and ask yourself the question: Am I comfortable in the future plan for my life-journey? If the answer is yes, are your kids also comfortable in their future years of transition planning? If yes, again, then put this book up on the shelf. Why? Because as the life- journey continues, you will reach a point of UNCOMFORTABLENESS! Out-of-sight, out-of-mind, but now the journey has hit a detour and it is time to pull the atlas manual down and again begin transition planning.

The title of this document, Meeting the Needs of the Elder Population: Atlas Planning Manual, documents research topics that imply such planning should begin in middle age generations. As presented, these complex interactive subjects embed the notion of an atlas or manual. Webster’s Dictionary defines atlas as a book of maps, tables, charts, illustrations, etc. He defines manual as a handy book of facts, instructions, etc., for use as a guide, reference or the like; a handbook. The fact is, this book is a little bit of both.

It is significant to emphasize right up front that you, or someone in your family, will confront the topics in this atlas manual sooner or later. How this occurs is on a case-by-case basis, one-size-will-never-fit-all. Dollar values throughout this book are snapshots of 2013 business models that adjust for each support industry organization over time, based on inflation, technology, congressional laws, competition locality, and God’s will. Thus, the dollar numbers referenced herein are starting points for trend purposes in planning what if in your life-journey process. Punchline: you must use this atlas manual as you would for any other family trip. You now have the big picture: fine-tune it, good luck, and God bless.

In the sense of an atlas, it uses the metaphor of a journey or trip that progresses from the current time, and physical point A, across various counties, passing through respective cities. As in the planning for such a trip that culminates in a final destination, it requires the selection of potential routes to execute the trip. Five major themes are involved in this planning process:

1 – Trip purpose objectives,

2 – Construction obstacles,

3 – Potential weather disruptions,

4 – Quality-of-life considerations, and

5 – Financial practicality.

These last two are the driving themes of the life-journey. What is the definition of quality-of-life? Financial practicality has a definition of its own, from the perspective of Adam and Eve to that of billionaire Warren Buffett. So now let’s check out these considerations from the perspective of your possibilities.

1.1 FAMILY TRIP METAPHOR DESCRIBED

By way of example, a family trip is used for an analogy.

1. What side stops do we wish to take along the way toward our final destination? The theme park or similar attraction could influence this family discussion in the planning process. Now, with initial decisions made, preparation for the trip commences. What clothes to pack, designate spending money for activities, money for gasoline replenishment, etc. And now the trip begins.

2. Oops! An unforeseen construction project ahead signals a detour, requiring analysis to limit potential delays. I am now off the three-lane interstate onto a side road.

3. Oops again! A weather disruption is now encountered with heavy downpours. Now, aside from the construction detour, my stress level is increased as I attempt to drive safely with that limited visibility.

4. Trip QOL suggests comfortable, safe driving conditions that vary with the type of road the journey routes require. Three-lane-wide interstates are far less stressful than single-lane roads that include passing constraints, let alone in the middle of a thunderstorm. The family trip at this point suggests a need to pull into a rest stop to refresh the situation. How well did my financial planning prepare me for these deviations from the original trip plan?

5. Thus we come to the fifth theme of the planning process, financial practicality. Financial planning in this regard assesses the overall mileage length of the journey in comparison to the vehicle’s miles-per-gallon average performance. The current economic gasoline rates at the time of the trip suggest a financial commitment for just this one aspect of the trip. Now we add in additional expenses: meal stops, overnight accommodations, side stop attractions, toll roads, etc. Okay, trip planning in this regard was completed and the journey reality must now be confronted.

The atlas map aspect of this journey planning is now complete. We now turn to documents in the sense of a manual to assist our decision making in the moment. AAA, or immediate GPS recommendations, are examples or metaphors for our options. As the journey progresses, events materialize that were not thought about in the prior planning mode.

1. We need a rest stop for gas, bathroom, snacks, or all of the above. Can the family agree on a particular stop? Perhaps a car breakdown occurs. The manual provides guidance on these options to include motel pamphlets, AAA insurance, directions to target, etc.

2. All these deviations have now delayed the trip, increased mileage, repair expenses, and an extra overnight stay. Did my financial planning include a dollar reserve to meet unexpected deviations of this nature until I reach my final destination and return?

Okay, the family trip metaphor is described. We’ve all been-there-done- that. So, we use this framework to understand the comparative apples in the latter year trips of our life-journey, a trip most of us are not yet into, and know little about.

1.2 FINAL JOURNEY METAPHOR CORRELATIONS

1.2.1 Trip Objectives: First, concerning the trip purpose objectives. Our trip correlation here represents five possible options for this future trip: First, remain in current residence; Second, move in with family; Third, sell residence and move into a commercial rental condo; Fourth, move into rental retirement community; and Fifth, move into a retirement community with an upfront buy-in commitment. These last two retirement community options include independent and/or assisted living facility accommodations.

In each of these options, the accommodation of healthcare represents sub-options in play as well. As the family considers these options, it is recognized that family member opinions are based on respective values- structure observations. As one ages, values-structure accommodates continuing experiences in one’s personal life.

We are all unique in this regard, and thus, family conflicts arise in seeking consensus on the initial planning process. Similar conflict can occur in the future as the deviation routes are assessed as the journey progresses. In short, who defines QOL activity in the respective moment? Thus, this subject of QOL becomes the initial focus in this atlas context.

In this atlas manual metaphor, the perspective is a nation comprised of three states. The Nation is called Meeting the Needs of the Elder Population. The three interrelated States are named Quality-Of-Life Definition, Health Issues, and Financial Preparation. The major subjects that define each aspect of the journey are considered cities (and respective neighborhoods) in the county that I pass through along the way.

1.2.2 Construction Obstacles: These physical events for automobile travel translate directly into physical events for human bodily travel. With knee or hip issues, I can no longer run and perhaps even have difficulty walking. Quality-of-life activities are refocused.

Just as road detours are governed by laws as I progress through various cities, my human physical journey also has legal implications. Thus, after reviewing the first state of QOL Definition with its three counties of Current, Future, and Challenges, I am ready to visit the second State of Health Issues with its seven counties. The first county in this regard, in my atlas, is Legal Issues with its cities typical of Preparation of Advance Directives. Within this particular city we visit neighborhoods (Living Will; Health Care Surrogate; Durable Power Of Attorney; and Preneed Guardianship). Neighborhood titles are reflected in parentheses in each chapter city index. And what part does stress play in this process?

1.2.3 Weather Disruptions: A metaphor thunderstorm for this topic, suggests considerable mental stress as the journey progresses through the situation. I clearly seek relief with a temporary rest stop. In this context, the rest stop is reflected by the caregiver who provides all the relief needed to progress through this early, temporary phase of the trip. This includes early coordination of