Planning to Live

It used to be that when someone got a serious illness or disability of some kind, they would just die. These days, medician and science have made to where a serious illness is not a death sentence. This is probably the first time in history this has happened. In many ways, it's very cool. In other ways, however, new challenges are going to present themselves, especially as people grow older.

For people who have been ill for years, growing older may get scarier and darker than it would for those who are healthy. There are many reasons for this. Some ill people do not have the support system, emotional or otherwise, that many elderly need in order to maintain a decent life. They may not have people to take them to doctors, to help bring in groceries, or to even check on them.

Depending on the illness, damage and breakdown of the body may happen at a far younger age. If your condition causes you to walk and feel like you're in your 70s when you're only in your 30s, what is it going to be like when you finally hit your 70s? What will your state of mind be like? If you only had ten spoons' worth of energy when you were 25, how many will you have at 65?

Most people who are ill or in a state of disability are fairly sure it's not going away. Given that, I believe it's important to plan for the future in a realistic manner. When you're ill and in your 30s/40s, as unfun as it may be, you need to take stock of the fact that you could possibly live for a long time and how you're going to manage that. Actually, this is probably something everyone should do, but for people who are already feeling wear and tear, it's critical.

RESOURCES

What are your physical resources? And by that, I mean yours and only yours. Not ones you have access to right now from someone else. Not something you may or may not inherit. Yours. You cannot and should not base your future on anyone else, not even a spouse. They may die. They may leave. You may leave. When planning for the future, you should only consider what you bring to the table because that is all you can reasonably control.

Make a list of them and then assess how much they can actually help you . . . also, how much they may harm you. After all, owning a home is only as useful for you as you can maintain it. Just ask Edie Bouvier Beale.

PHYSICAL CAPACITY

This is going to be different for everyone, of course. Each illness or condition is going to have its own possible problems. Sure, your disease may not kill you because of your medications, but how likely are you to go blind? Will you go deaf? How likely are you to lose your ability to walk? To feed yourself? How likely are you to develop incontinence?

I think an assessment like this should always, ALWAYS play to the worst case. It may not happen, but what if it does and you weren't prepared? I think it's also important to assume your health isn't going to improve. It may and if it does, that's great. But for many people, that's a long shot.

The thing is, if you're teetering around like your grandma when you're in your 20s, you have to face the fact that this is, honestly, the best you may physically be from now on. If that's the case, what do you need to change?

MENTAL CAPACITY

I had two surgeries last year that required pain medications and anesthesia. There are whole parts of the year I just don't remember. I do mental training games to help improve it, but it's possible that part of my capacity for memory is gone. This is something I'm coming to terms with, and I know that for many people, the mental toll on their health is far more extreme than even this.

Again, like with the physical assessment, I think it's safest to assume your current state is the best it will be and that things may go downhill from here. Look up research on your meds. Meds, long term, may cause issues to your mental condition. If they can, assume they will.

EMOTIONAL CAPACITY

I think for a lot of people, this is a big one. If you've ever been around older people, you know that the emotional conditions can get pretty scary. It's understandable. You're on the downhill stretch to death. And for people who have been ill or broken for a while now, you know this slide never gets any easier.

What can you handle now? Do you freak out when you get a flat tire? Are you in tears when something about your usual day goes wrong? Do you write five blog posts about having to change doctors (yes, that's me)? If so, you need to realize that the spoons you have for handling the emotional aspects of your life are very few. As you grow older, there will be even less.


MAKING A PLAN

Once you have the assessment of where things will be headed for you, it's time to start making plans to put yourself in the best position you can. For people who own homes, consider if the home is too big for you to maintain. And even if it's small, will you have the physical, emotional, and mental resources to handle the damage that life will do to the home over the years?

There are other things to consider as well. Do you live in a place where your medical needs are easily met? Do you have to drive distances to see your doctors or specialists? Will you be able to make that drive in 20 years? Or even in ten?

My best guess is that for a lot of people with chronic illness or disabilities, finding a safe and decent old age facility is going to be the best answer. I know a lot of people have issues with retirement homes/rest homes, and with good reason. However, there are worse alternatives. And look at what you may gain:

• There will be a lot of other people there. Yes, a lot of ill people find this terrifying. I spent a few years being basically a shut-in, so I understand. However, other people around you provide your mind with stimulation. You might hate the old lady across the hall, but annoyance at someone is better than feeling nothing. And many ill people lose touch with their friends and family, if they ever had that at all. Others make friends with other ill people, who often die before they do.
• There will be activities. I think this one is vital. When you have very few spoons to work with, doing things for fun become low priority. Holidays may become nonexistent. However, in a place that provides both without you having to lift a finger, it becomes easier to participate. 
• Someone else handles the day to day work. There are cooks. There are people who clean. There are people who handle security. There are people who fix stuff when stuff breaks. All of the things that are possibly causing your stress now will be taken care of by someone else. 

And yes, I know there are expenses to keep in mind. And yes, I know it sounds invasive and terrifying. For many people who aren't yet old, it may even seem like a depressing future to consider. However, it's better to make this assessment and start planning now, while you have time to put things into motion, than to wait until you're more ill and the decisions are taken out of your hands.