THE BLOG

Who Is Going to Take Care of You in Old Age?

22/04/2014 15:19 BST | Updated 22/06/2014 10:59 BST

Who will care for you in your old age? Big question. Particularly for people who don't have children, so I've been reminded lately.

But here's the thing: having children doesn't secure a carer any more than it does fulfilment. Yes, some 64 million people in the US are unpaid caregivers, according to the National Alliance for Caregiving, and almost seven million in the UK, according to Carers Trust.

However, the stark truth is that not every adult child is able to take on care for one reason or another, and some of those who can are not always willing. Almost everyone I know with an ageing relative has a story about descendants who don't see it as their responsibility to help with care. I've read endless articles about this, too.

Furthermore, many of the millions who do so willingly are ill-prepared. Owing to their own family and work responsibilities, most carers quickly become overwhelmed, sometimes leading to their own physical and mental health problems. Others become angry and frustrated and, therefore, mishandle the situation.

No wonder so many organisations now offer advice on how to prepare for and manage care. While much of the information targets adult children grappling with the question of care for their parents, adults without children might learn a thing or two along the way as well.

The optimum word is 'prepare'.

When my husband and I faced this issue a few years ago, with the declining health of both his parents and then the sudden death of his father, we wished we had planned.

A couple of years later, my siblings and I, like many others, are in the middle of sorting out care with minimal preparation. Even with goodwill, we find ourselves fumbling way too often, and I'm sure we're not the only ones.

According to the American Association for Retired People (AARP), it doesn't have to be that way. In their resource Prepare to Care, they outline five simple steps to make care manageable.

The first step is to start the conversation. Sounds easy, eh? But talking to relatives, even well in advance, about care -- personal care, nursing homes, assisted living, finances, the whole shebang -- can be like walking into a hornet's nest.

By the time we approached the subject with my in-laws, the nest was buzzing, causing our words to either fall on deaf ears or make for uncomfortable discussions. Two years before they died, I wrote a letter, apologising for sounding pushy. In response, they did open the door slightly, but as soon as we stepped out to get back to life in London, they closed the door and fired the care agency, the cleaner etc.

Lesson learned, right? Not really. I still find it hard to discuss care with my own parents and siblings. The subject is not only loaded with emotions, but it is also tainted with horror stories. Even so, talking well in advance has to be better than doing so under pressure.

Fortunately, there is help out there. For example, Age Concern UK is a tremendous resource, as is AARP. Both offer general information on various matters, such as social and private care, to make difficult conversations easier.

Next AARP says it's important to form a team. Who will help?

Many years ago, rightly or wrongly, it appeared that most elderly people went into social care, but somehow that doesn't feel appropriate anymore. Today, families struggle with guilt associated with care outside of the home, and as a result of the horror stories are highly suspicious of social and sometimes private care.

My mother-in-law did not wish to go into a nursing home, nor did we want her to. Fortunately, we were able to care for her at home, not only with the help of other family members, but also professional carers. That was our team.

Statistics show, however, that almost always one person somehow naturally assumes the role of primary caregiver, whether there are several siblings or none at all. Perhaps a neighbour, relative or friend steps in, but under no circumstances should anyone go at care alone, reminds Carers UK in their 'Quick Guide to Caring'. If others refuse to join the team, it is time to get some practical help: fourth on AARP's list. Aside from looking to wider family and friends, they suggest seeking out community resources.

Wherever help comes from, it is key is to make sure that team members are committed, no matter how small the role. They need full knowledge and understanding of health issues, dietary matters etc. This is a crucial part of planning; step three.

Without planning, care happens under duress or perhaps by default, which is often disastrous for those in care, as well as the carer.

Perhaps, this is why lastly, AARP suggests taking care of oneself as a priority. Carers UK echoes this, explaining the importance of respite care for caregivers as crucial to the person who is being cared for, too. When the caregiver becomes negligent, everyone suffers.

While taking care of my mother-in-law, I remember going to the doctor, who said that often when we take care of others, we subconsciously let go of ourselves. Some people suffer through anger and frustration. Through that experience I learned a key lesson: I was only as good for her as I was for myself. This was not a licence to sidestep responsibility, rather a reminder to act responsibly.

So who is going to take care of you in old age? Who is going to look after me? To be honest, I don't have a clue, but it's good to know that I'm in the driver's seat. I can start the conversation, instead of waiting for someone else to do so. Fantastic!

In the meantime, I rather like the idea of living for today and planning for tomorrow.