Sep 19

Written by:
9/19/2011 12:23 PM 

First of all, the operational implementation issues are many and not totally resolved yet although we are quickly approaching an October 1, 2011 implementation date. I don’t know how the family with a loved one waiting for hospital discharge on the weekend will be able to take the next step in moving into an assisted living without waiting for a counselor or a special code. Or how hospital discharge planners, working with county workers, will be able to easily move a person with mental illness out of the hospital psych unit into a housing establishment. Or how families who have been planning the next step in their loved one’s journey for years will feel about calling the Senior LinkAge Line and waiting for 10 minutes before they can leave a message for a counselor who may tell them their planning is flawed. All of these operational issues will likely sort themselves out with time — there will be many bumps in the road and upset stakeholders; but at the end of the day, there will be a new process in place called mandatory transitional consultation for anyone wanting to move into most housing with services establishments.

Which leads me to the philosophical issues that have been crossing my mind as I am asked repeatedly by policy makers or reporters: “what is the big deal about getting some information?” Although the new law applies to all housing with services settings, including those serving persons with mental illness/chemical dependency, my thoughts focus on the implications to seniors and their families. The big deal to me is the assumption built into the law that once we reach a certain age we need external guidance from the government (yes, Senior LinkAge Line counselors are government employees) before making some of the most important decisions of our lives.

Up until some magic age when someone says “you are a senior,” we make all sorts of financial decisions either on our own or with the guidance of friends and family. We buy our homes, our cars, and our recreational vehicles all on our own — even if we are paying more than what we should be paying or even if we are living beyond our means. We make decisions to buy a lake home (or not). We decide to take a big vacation with family members even though we should be saving for our children’s college or our long-term care. We decide how much we will be contributing toward our children’s education. We give generously to family at Christmas and birthdays. We donate to charities. All of these life decisions, which ultimately impact the amount of money we have during our last decade or two of life, are made independently. Why then are we questioning the ability of seniors (with or without family input) to make decisions toward the last years of their life? When does a person go from independent thinking and decision-making to dependence and being in need of counseling??

When this law first passed, I reflected on what I would say to my nearly 80-year-old mother about this if the time comes for her to move from her single-family dwelling into a senior apartment with services. I know she would first be outraged that the government is questioning her decision-making abilities. She would then turn to her children for advice, and we would dutifully call the counselor for her to get some sort of code that reflects we are refusing the counseling. Inconvenient? Yes. Even more inconvenient for us to memorize another number — especially the 15-digit code we are expecting.

But, then I thought about myself — and my generation of baby boomers. How will I respond to this “help” from strangers? Not very positively — baby boomers have been in charge of their lives from day one. I have spent the past few decades making financially sound decisions on my own. I am fully aware of the options available and that it will be cheaper for me (and the government) if I stay in my single family dwelling until I die. Who doesn’t know that?? I know that if I pilfer away my “nest egg” on fast cars, good wine, and a villa in Italy (hmmm ... sounds pretty good, eh?) in my 60s or 70s that my resources — and thus my choices — for long-term care and supports will be limited when I consider myself a senior in my 80s or 90s. The reason we now have mandatory transitional consultation is a financial one — there are state savings, if we assume the counseling will ultimately reduce spend down and reliance on government funding. This assumption, however, is based on the belief that people are uninformed and that counseling will give them the information they need.

So I say to those who ask me what the big deal is with this law (rather indignantly), how dare you assume my mother is uninformed! Or that I am uninformed! We get it. Give the counseling to those who want it, but leave the rest of us alone.

Copyright ©2011 Patti