Risk and Fear

 2 Mar 2016                            -7-

The positive side of life is having the confidence to fulfill your ambitions. “Live well and die young.” (Die young is young in spirit, not in years.) The negative side of life is managing risks.

The same risk can be perceived differently in different situations. Familiarity, habit, and addiction change our fear of a risk, or of being aware of it at all.

Falling is a high-risk event in residential care. One resident continues to use her 4-wheeled walker, just in case. She can walk without it; but the fear of what might happen (and what has happened to others) overrides her confidence.

In normal life, we can measure the degree of fear by the cost of managing the risk: insurance (car, house, life, health, long term care, and funeral). Law requires minimal car insurance. Hospice is free.

Long term care comes in two forms, home and residential, and in a variety of flavors. Home care is the lowest in cost (in money), and for most people with a spouse, or other relative, the only option. Most risks are managed by 911.

The tension between risk and fear increases when spouses have different health care needs and do not qualify for (or cannot find) Medicaid beds in a nursing home. We still have a number of unsettled risks and related fears (costs).

RISK/ACTIVITY	HOME CARE	RESIDENTIAL	FEAR/COST
Wandering	Monitor/Care Giver	Monitor/Residential Assistant (RA)
Falling
Memory Care &	$22/hr	One Apartment	$5,000 + $1,500
Assisted Living		Two Apartments	$5,000 + $5.200
Provision Living  Level of Care Two		Dressing, Grooming Escort to Activities	$600/mo
Skilled Nursing	$25/hr	Hospital, 24 hr/day Nursing Home	Insurance & Medicaid
Medication	$0	$650/yr Co-Pay	Accurate Delivery
Meals	Individual	Group Activity
Bouncing Ball	One-On-One	Group Activity	Greatly Enjoys
Care Giver	Three hour period  $66/period	RA Available Around the Clock
Air Quality	Clean Air	ScentAir	Allergies
Back Pain Score	2-9	1-3	Stress?

The properties of the above cell contents are not directly comparable as money, risk or fear. Skilled marketing can also manipulate their relative values.

Did we make the right choices last year? Yes. A three-month respite has made my back manageable; my wife’s health status has been determined; and after 16 years, part of the furniture is out of the house for easy repainting of interior walls.

Now I need to drop independent living and to add nursing homes to my spreadsheet while considering the above risks and fears.