Why More Americans Need to Talk About Death

Happy seniors couple in love. Healthy teeth. Isolated over white background
Happy seniors couple in love. Healthy teeth. Isolated over white background

Aging in America isn't easy, and it appears to be getting harder with each passing year. Whether due to changes in the economy or the fact that people are now living longer than ever before, there's no denying that the reality of growing older in America is expensive and most people are unprepared to take on the financial burden.

According to the 2013 report from the Centers for Disease Control on the State of Aging in America, "two out of every three older Americans have multiple chronic conditions, and treatment for this population accounts for 66% of the country's health care budget." And while Medicare, which was introduced as a program by the federal government in 1966, provides varied degrees of coverage to seniors, a new survey by MoneyRates.com seems to suggest that most Americans are not financially prepared for end-of-life health expenses.

The survey found that almost 60 percent of Americans underestimate the cost of nursing home care, which on average costs roughly $81,030 each year for a semi-private room and $90,520 a year for a private room. It was discovered that "40 percent of survey respondents have set aside nothing for elder care, and a total of 67 percent have less than $75,000 set aside." The survey also notes that Medicaid only steps in to help with these expenses after you have "substantially depleted your net worth" and that "paying for assisted living with Medicaid can limit your options, including which facilities will accept you."

The Centers for Medicare and Medicaid Services have estimated that more than a quarter of Medicare spending goes towards the 5 percent of beneficiaries who die each year. This is due to the fact that the most expensive aspects of end-of-life costs include inpatient hospital stays, physician and nursing services and aggressive treatment plans at the end of life.

Perhaps because of the costs associated with dying in a hospital, another study published in the Journal of the American Medical Association found that fewer people are choosing to die in hospitals or institutional settings and more are receiving hospice care at home.

"What you pay for is what you get," said Dr. Joan M. Teno, lead author of the study, in an interview with JAMA after the study's release. "There are financial incentives to provide more care in fee-for-service care. We don't get paid to talk with patients about their goals or care or probable outcomes of care. We do pay for hospitalizations, and there are financial incentives for nursing homes to transfer patients back to acute care."

So what can we do to protect our finances and our dignity as we age? I spoke with Robin Cohen, MSW, who works with the elderly on Long Island, New York, about the best ways to help you or your loved ones deal with end-of-life issues. "Aging is such an important and growing concern," said Cohen. "It costs billions of dollars for families to care for their loved ones and leads to their lost wages. The caregiver burden is enormous and caring for the caregiver that gets ill adds to the dilemma."

Plan Ahead. Longterm care insurance can be vital to maintaining your financial security later in life. It will ensure that you not only have the funds to cover the medical services you need, but it also gives you a variety of options from which to choose. AARP's breakdown of longterm care insurance points out that "depending on the policy options you select, longterm care insurance can help you pay for the care you need, whether you are living at home or in an assisted living facility or nursing home. The insurance might also pay expenses for adult day care, care coordination and other services. Some policies will even help pay costs associated with modifying your home so you can keep living in it safely."

Longterm care insurance is a way to ensure that you're not draining your bank account while also providing you with more options for the type of care you want to receive. Plans can vary from state to state and also might have age opt-in requirements (you usually have to opt-in between 50 and 60 years of age), so be sure to ask your insurance representative what the best plan may be for you.

Start Living Your Best Life NOW. Sure, tomorrow might be a better day to start your diet, but why wait? According the CDC report on The State of Aging in America, "heart disease and cancer pose their greatest risks as people age, as do other chronic diseases and conditions, such as stroke, chronic lower respiratory diseases, Alzheimer's disease, and diabetes." Adopting better health habits early on in life can prevent many of these chronic diseases.

Being conscious of your food choices, like eating more fresh fruits and veggies instead of processed foods filled with sugar and preservatives, will not only keep the weight off, but it will also provide you with cancer-fighting nutrients like antioxidants. Implementing a regular exercise routine will also greatly benefit you over time -- even if it's just a 30-minute walk every day. Diet and exercise are a huge component in heart health, reducing your diabetes risk and ensuring that you'll remain mobile and active well into your 80's.

Be Proactive, Not Reactive. Taking your health into your own hands before there's a problem will help ensure that you are better prepared should an emergency hit. In the chaos that follows a health scare, the scramble to make a hasty decision could mean that you're not considering all of your options or being as thorough as you could otherwise. The Medical Guardian Caregiver Resource series was created with this in mind; keeping you in the know about everything available to you so that you can better care for the person you love.

Being proactive also means that we all have to change the conversation about aging.

"Here in the U.S., we don't like to think about the end, at all," says Cohen. "We need to bring death out into the open instead of shielding people from the inevitability of it. Maybe, if we celebrate and accept death, we won't be so afraid to face our future and prepare for it."