John and Eva had ongoing conversations about their home which was now far too big for their needs and lots of trouble and expense to repair and keep up.  John said, “It’s the yard, the leaves, the painting, and general repair and replacement problems.  What’s next to go?  The refrigerator or me?”  Eva was tired of shopping and cooking.  Her arthritis was slowing her down.  She told John, “Ok, you retired from work, but when do I retire from cooking?”  Also, they were beginning to lose contemporaries and their social life was shrinking.  There was a growing sense of isolation.  Their children and grandchildren had busy lives and couldn’t be part of their daily life.

The started looking around at continuing care retirement communities (CCRC) and found lots of options and a fair amount of confusion about what might be future costs.  They were leaning toward a “Type A” CCRC, but each of those had somewhat different costs, though they were much more inclusive than Type B or C, the latter being fee for service.

But the headaches were just starting.  They had raised four children who were now on there own, but the remnants of their possessions were still in their house along with “stuff” that they had inherited from prior generations.  John read an article about “possession paralysis” in the New York Times and shared it with Eva.  “It fits us doesn’t it Eva.  We’re both pack-rats and we have been putting off moving partially due to all the “stuff” we have.

So they began to downsize — trips to the library to donate books, trips to Goodwill to donate, giving things away to family, but this hardly made a dent.  “We have all this china, crystal, and silver but there’s just no market except for the silver metal.  Don’t kids entertain any more?”  The children began to step in with craigslist, eBay, and hauling stuff out to their own homes and an estate sale.

The finally found the CCRC they were hoping for and it came time to do a pricey buy in which was painful even though their estate would get 80% of it back.  The housing market was beginning to bounce back and it seemed like a good time to put their home on the market, get a “bridge loan” and plan a move.

Both John and Eva found the whole experience stressful, but couldn’t see anyway around it except to continue on in their own home, and hire in help eventually if needed.  Eva said she was so emotionally attached to family things that “possession paralysis” felt very real to her.  Yet she didn’t want to handle all the house issues if something happened to John.

It took about 6 months for the house to sell, the CCRC move to occur, and almost that long to dispossess themselves of all their “stuff.”  Selections were finally made, charity trucks carted off many boxes, and the “kids” came with U-Haul trucks.

Eva remained in good heath, but within a year of moving into the CCRC, John developed rapid onset Alzheimer’s.  He was moved to the memory care unit, while Eva could stay in her independent apartment in the same complex.  She was able to participate in John’s care without being overburdened by worry about safety or costs.  His long term care was fully covered and their were no additional expenses.

Comment:  We are on the cusp of having the Boomer generation entering into the final phases of their lives.  The problems and expense will be huge.  Very few folks have long term care insurance and some still assume that Medicare covers long term care — it doesn’t.  We aren’t well prepared as a society to deal with these problems. 

Jim deMaine is a pulmonary physician who blogs at End of Life – thoughts from an MD.