Professor Sharona Hoffman (CWRU Law) recently published a book on preparing for aging (Aging with a Plan, 2015) and I had the opportunity to interview her about her impetus for writing the book and how she tackled the writing process, bearing in mind that she wanted to make the book accessible to both lawyers and non-lawyers.
Here's what she had to say ...
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Q: Preparing for aging is an unusual topic for a book. What led you to write about it?
A: The book grew out of a very difficult period in my life. During 18 months in 2013 and 2014 both my parents died, my mother-in-law died, and in October of 2013, my husband, Andy, was diagnosed with Parkinson’s disease at the age of 55. As I went through these experiences, I learned a lot about the legal, social, financial, medical and other challenges of growing older, getting sick, and facing the end of life. As a Professor of Law and Bioethics, I already knew something about theories and doctrine related to many of these issues, but there is nothing like life experience to enliven your knowledge and imprint lessons on your mind.
I realized that I had a lot of knowledge to share, and I wanted to take my professional and personal experiences and put them to good use helping others. Writing this book seemed like a natural choice.
Q: Who is your intended audience? How accessible is the book for folks without a legal background?
A: The book is designed first and foremost for baby boomers, people in middle age who should be thinking ahead and planning for taking care of elderly loved ones and for their own aging. As I have learned the hard way, when you are in the midst of crisis, it is very difficult to make good decisions if you know nothing about the problems you are facing.
I believe the book is quite accessible to people without a legal background. I use an interdisciplinary approach that draws on my background in law and bioethics. However, I combine thorough scholarly research and analysis with a wealth of personal anecdotes to make the book engaging and a fairly easy read. I also provide a preparedness checklist at the end of each chapter that summarizes take-away messages and outlines practical next steps for readers.
Q: What are the main topics that you cover in the book?
A: I try to make this a one-stop shopping opportunity and cover all of the issues that I consider vital for what I call aging preparedness. The book addresses legal, social, financial, medical, and other challenges of aging.
I begin with a chapter that focuses on finances and discusses what expenses people should expect in retirement, how to formulate a savings plan, and what you should know about particular financial products including long-term care insurance and reverse mortgages.
I then discuss different options for residential settings later in life. I argue that “aging in place” is not necessarily the best option for everyone and that it is important to think about retirement communities and make sure you have a robust social life and opportunities for intellectual stimulation and civic engagement. I also talk about how people who do not have children or other support networks can find service professionals that will help with finances, medical care, managing the home, and more.
As a law professor, of course, I have a chapter on legal preparedness. We all know that we should have wills, even though over 40% of baby boomers have not prepared a will. But there are also a lot of other documents people should create in the process of planning for aging. For example, you want to make sure that you have decision-makers for finances and health care if you lose decision-making capacity because of dementia or a traumatic injury.
I also dedicate a chapter to the issue of driving, which is a sensitive and complicated one for many families with elderly loved ones. A different chapter discusses the various long term care options: nursing homes, assisted living, and in-home care.
Finally, I have two chapters on medical care and end of life decision-making. I talk about the importance of coordinated care, especially if you see a lot of different specialists. I also emphasize that people should become active members of their own medical team and be sure to have strong advocates and adequate support when they are ill. In addition, I discuss a variety of options for the end of life, such as hospice, do not resuscitate orders, and assisted suicide in a handful of states. You have to think about your values and priorities for the end of life. Do you have relevant religious beliefs? Do you want everything done to lengthen life or is quality of life more important to you?
Q: What was the most difficult thing for you about writing the book?
A: It was quite difficult to decide how much of the personal to include in the book. I am usually a fairly private person, and I worried about revealing too many personal details. In the end, however, I decided that this would be a much better, more interesting book if it was somewhat autobiographical. Finding the right balance between research, advice, and my own stories was quite a challenge.
Q: You do indeed share a number of personal anecdotes in the book about your own experiences with illness, loss, and planning for the future. Were there any stories you thought twice about sharing with readers? Are there any you feel particularly happy about sharing?
A: At the end of his life, my father, who was a rabbi, developed dementia, which made him angry, upset, and difficult to interact with much of the time. I struggled with whether to discuss his suffering in the book. However, in order to be respectful and protect his dignity, I decided against doing so.
One of my favorite stories is about my mother. In 1994, she was diagnosed with breast cancer and decided she wanted to be treated at MD Anderson Cancer Center in Houston. It just so happened that I was single and living in a 1-bedroom apartment in Houston, so she announced that she would move in with me. At first, I approached this arrangement with some trepidation, but it turned out that we had a wonderful time together throughout her 9 months of treatment! I saw a fun-loving, gregarious, and even adventurous side of her that I had not gotten to know before. And she did extremely well – she lived for 18 years cancer-free after that.
Q: What is the most important piece of advice you would give someone about planning for their own future, or the future of a loved one?
A: Well, first of all, everyone should read Aging with a Plan…. Beyond that, you should seek advice from professionals to make sure you are prepared for the future. Go to an attorney and have your will, advance directive, durable power of attorney for finances, and other documents prepared. Visit a financial advisor to formulate an investment plan. If you have the money, turn to geriatric care managers and home care aides to help with elderly loved ones. There are a lot of planning steps one can take and available resources – you just need to take initiative and implement them.
Thanks to Sharona for sharing her thoughts on the book. I'm sure she welcomes any comments readers may have about it.
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