The adjectives used to describe our elder years are rarely kind or uplifting, and for many, getting older can feel scar
y and filled with uncertainty. But it doesn’t have to be.
It’s an age-old narrative, but the things we do today to prepare for tomorrow make all the difference in the end, from taking care of our health to developing a life plan that clearly explains how we want to be cared for at the end of life and in death.
Rajiv Nagaich, founder of Life Point Law and the educational platform and radio show Aging Options, offers perhaps the most poignant explanation of how the dominoes often fall as we age. Life is a continuum: Our health impacts our housing, which impacts our finances, which can impact the legality of who can help us make decisions and handle our affairs, which impacts our friends and family.
Typically, as we age, our health is the first domino that tips and affects those four other aspects of our life, which is why it’s so critical to have affairs in order while you’re young and healthy. Nagaich has spent the last two decades trying to change the narrative on retirement planning and encourage people to take action when they’re middle-aged.
But Nagaich’s work as an elder law attorney is more than a career: it’s a calling, and his passion for life planning was triggered when he met his wife, Jamie.
Thirty years ago, Nagaich was living in Chicago and rising through the ranks at Allstate Insurance when he met Jamie and, subsequently, met his father-in-law, Bill. After moving to Washington, Nagaich and Jamie visited Bill at a nursing home, and it was the first time Nagaich had ever seen one in person.
“We’re about to leave and Bill was hanging onto Jamie thinking she was going to take him home, and she was just balling,” Nagaich said. “We walked out of there with Bill still stuck there. It just didn’t leave me.”
According to AARP, 52 percent of Americans who turn 65 will need some kind of long-term care or services at some point in their lifetime. Having been born in India where the cultural expectation is to allow your parents to live with you, Nagaich wants to help people safely stay in their homes for as long as possible by ensuring family members have the tools and support they need.
To do so, Nagaich went to law school, after which he began working with clients to revolutionize the way they approach end-of-life care. Obtaining legal documents (power of attorney, will and testament, living will, etc.) is a first step, but it’ll hardly get you anywhere, he said. Sure, you’ll have the legal power to make decisions, but when a problem arises, then what do you do? The power of attorney document, for example, should function as a blueprint with clear instructions on how to care for a loved one when they need it, but instead, the person who holds the power of attorney often has to figure out all the logistics themselves.
This is where Nagaich and his team step in. Nagaich calls it life planning, and he’s essentially created a suite of businesses — from social workers to lawyers — to help clients with every aspect of their end-of-life plan. It’s difficult to understand the intricacies of elder care until you’re in the thick of it, Nagaich said. If you have the power of attorney for someone, there are no guidelines for how to react when that person needs you. If Mom’s health fails, who do you call? What questions do you ask? What do they need from a financial planner? Do they qualify for Medicare? How do you get Medicare? What should you request from an insurance agent?
He and his team spend roughly a year with clients understanding the intimate details of how they want themselves and their affairs handled — details that translate into specific guidelines for their loved ones to follow, all the way down to what nurses to call and questions to ask. In other words, you not only leave with the necessary legal documents, you leave with a blueprint for how to react when your loved one needs you. If someone is in an emergency state, he said this process is shortened to about three weeks.
When talking to Nagaich, his passion was palpable. After all, he’d still be in the insurance business if it hadn’t been for his father-in-law.
“I left my own country to come here, so there must be a purpose and a higher reason for that,” he said. Others have balked at his attempts to rewire the way people approach their elderly years. He’s trying to make a paradigm shift in the way society reacts to people getting older, one law professor told him. But Nagaich said he knows he won’t change the entire industry.
“I care to change the paradigm one person at a time,” he said.
When it comes to prevention planning, the legal work Nagaich does is often top of mind for people, but because health tends to be the tipping point of the life continuum, we turned to Overlake Medical Center’s Dr. Chitra Fernando, who specializes in geriatric medication (among other things), to learn more about what tends to ail people as they get older and how to prevent it.
Common health issues that can plague our later years — high blood pressure and cholesterol, cardiovascular diseases, diabetes — often derive from smaller problems that are much easier to treat when we’re younger, Fernando said.
Take high blood pressure and cholesterol, for example. Both tend to arise from a poor diet and lack of exercise, and if left untreated for too long, Fernando said it can cause damage to our organs and result in something more serious, like a heart attack.
Sleep apnea — a sleep disorder that causes breathing to repeatedly stop and start back up again — also is common in adults; Fernando has seen many patients who leave it untreated for years and begin to experience other health issues are a result. When the brain and heart aren’t getting proper oxygen at night, it can cause depression, anxiety, memory loss, difficulty concentrating, and could eventually lead to more serious cardiovascular and lung diseases.
Many of the health issues Fernando sees in elderly patients stem from diet, exercise, and stress. Addressing all three are the best preventative measures a person can make, she said.
“The oldest patient I have is 105,” Fernando said. “She still travels and doesn’t use a cane. I asked her, ‘What is the secret?’ She said, ‘Drink a lot of water, talk to a lot of people, and pray.’”
Fernando said for this patient, praying helps manage stress, which impacts our health significantly. Fernando is very interested in helping patients reduce their stress so they can live happier, healthier lives.
In terms of diet, she recommends the Mediterranean diet, which includes lots of vegetables; fruits; quality protein, like chicken and fish; whole grains; and olive oil. She recommends steering away from any processed foods — stick to whole ingredients — and stay away from red meat and shellfish. Of course, drink lots of water, and take a multivitamin, Vitamin B, and calcium.
“The main things to take care of if you want to have a happy life after retirement or toward the end of life is to pay attention to stress, sleep a lot, take care of anxiety, depression, sleep apnea, diabetes, hypertension, and cholesterol,” she said.
Oh, and dance — either physically or metaphorically.
“People who are happiest have a good sense of humor, have lots of friends, and take things easy,” she said. “I also had a patient who plays music and dances every day. There was another patient who feeds birds and she said she was spending more money to buy bird food than
for her own food.”
In short, do what you can to continue living a mindful lifestyle filled with good, quality food and good company, and don’t worry about the rest, Fernando said. There’s so much we can’t control and worrying about it does more damage than good.
And do have a healthcare plan, she said,
Many of us live to become elderly, and how we plan for it often dictates the reality of those final years.