QUESTION: My Mother recently died. I am the only survivor. I never married or had children and have no close friends. Who will take care of me if I become ill? What can a single person do to make her wishes known? I do have a will and POA.

I am impressed that you are looking ahead at how your life will unfold. Most people just live into their lives and are unprepared when serious, life changing events occur.

Here are some thoughts for your future. Having a will and Power of Attorney is a start but you also need an Advance Directive and to state the medical direction you want your life to take when you can no longer speak for yourself. Give this copy to your attorney and primary physician as well as any other doctors you may be working with.

Along with your Advance Directive you want to make someone your Durable Medical Power of Attorney. It can be the same person as your Power of Attorney but just having a POA does not give that person the control of your physical destiny. Being alone you will need to look to someone you trust, a good friend, your attorney. Sit down with this person and have a long conversation with them not only about the Advance Directive you have filled out but your inner thoughts about living and dying. You are giving them the power over your life and death. They will be speaking for you when you cannot speak for yourself so you need to be open and direct with them.

My thoughts for my declining years is that I will probably move in with one of my children as my parents and in-laws moved in with me and their parents moved in with them: Our family circle. Not everyone has that family tradition or even ability. I’m sure there are many others in your situation who have no family to look to for care. So what to do? Start looking at senior communities. Communities that offer independent apartments, assisted living, and in patient care. Begin your research now when you don’t need them and develop a plan.

Most American’s, in a relatively healthy body, can expect to live into their 80’s and even 90’s but may not be as independent as we want to be. The body gets harder to maneuver and maintain. As much as we all want to stay independent and in our own home, in the last year or six months of our life we will probably need some assistance. Having a plan of how and where you will physically live is a reassuring idea.

Financially, this costs money. Our health care system, Medicare, provides fairly well for diagnosis and treatment for cure and maintenance but is not so helpful when it comes to home care, end of life care and custodial care. (The majority of bankruptcies in the US are the result of medical bills.) What end of life care reimbursement needs is inclusion of in-home supervision and shift work.

In the months before death from disease (a gradual death) a person reaches the point where they cannot take care of themselves. Someone must be with them. Not everyone has the money to hire in-home 24 hour care.

To qualify for Medicaid a lot of hoops must be jumped through. Many people have too much money for Medicaid yet not enough money for in-home care. As good as some in-home care is, it is expensive and all private pay unless you have a policy for long term care: A policy that will pay for you to be in a nursing facility and will pay for in-home care. I strongly recommend you get such a policy.

Not that I expect our “good friends” to look after us when we are approaching the end of our life but we all need friends in our lives. People we can play with, relate to, have conversations with, share with, laugh with. Friends are an important part of living. Connecting and interacting helps keep us healthy. In your question to me you said you had no “close friends”. As important as it is to plan for our future as we approach our final act of living it is equally important to live fully and happily until we are dead.

Having friends, interacting with others, is an important part of that living. Even introverts need one or two people with whom to relate. I don’t know how old you are, if you are a “senior” yet, but no matter your age, make the goal for yourself to make some friends. Interact and build a small network of friends and acquaintances. Not to take care of you in your older age (you are developing a plan for that) but to fully live your life now.

Something More about The Only Survivor...

I have written more extensively on Advanced Directives and a Durable Power of Attorney in The Final Act of Living. Do Not Resuscitate, Funerals, Cremation, and Grief are also covered in the book with so much more. The Final Act of Living is a comprehensive book that offers information on all aspects of the end of life experience.