When I retired in my 80's Hanny and I were both in good health. I was still traveling and heavily involved in voluntary philanthropic work. We always lived in the present and had such a full life that the years rushed by uncounted. We never paused to look ahead to the time when one or both of us might be seriously ill and need outside help but now, Hanny was beginning to suffer from macular degeneration. She was increasingly distressed by its effect on her day-to-day life. Her diminishing eyesight prompted me to start planning for the future. So we asked ourselves some hard questions. How much further might Hanny's eyesight decline? If we were suddenly ill or had some debilitating injury, where would we find medical help? If we were confined to our apartment, where would we turn for home care services? How would we cope if one of us were ill or disabled and were to expire first? We'd had friends and neighbors who didn't address concerns until it was too late, unfortunately, resulting in tragic consequences. Hanny and I were determined that this wouldn't happen to us.

Although it would have been wiser to plan for the unknown, twenty or more years earlier, we were fortunate there was still time. Hanny and I felt that a special objective of any plan was that, however old and ill we became, we wanted to remain in the same environment that we'd been accustomed to our whole lives. We wanted to remain at home and be supported by whatever outside assistance we'd need.

A Plan Is Born
Before long I had the bare bones of a three-phase scheme in my head. At its core would be a central document that we'd later call our Planning Papers. This would be a comprehensive information source not only for our reference, but for anyone who might take responsibility for our care in the future, both physically and financially. The document would contain contact information about family, friends, doctors, preferences regarding home care services, a detailed summary of our health history and medications, financial information, wills, living wills, and many other basic but important details. We felt that having this single compilation in one place would provide a road map for our care and could save caregivers hours of frustration searching for facts and figures. It would also ensure that our care would be provided the way we chose for it to be provided.

Identifying Resources
The next phase of the plan was to search for the best available health care services. This entailed visiting hospitals and choosing a team of physicians who would be familiar with our respective problems, know what we wanted, and, therefore, follow our instructions to the degree possible and inform us of our options. We wanted to establish a personal rapport with these individuals and we felt our plan would be easier to implement if medical services were provided under one roof.

The third part of the plan involved a search for in-home care and other support services. This included nursing, housekeeping, rehabilitation, provision of meals, shopping, and escorts who could accompany us to medical appointments. Here again, we felt that if these came from a single organization, the plan would be easier to manage.

The Planning Papers
Item by item, I began to compose the Planning Papers. The Planning Papers would consist of an order, first with information that was already available, then with details I would add about doctors, hospitals, and home care providers. Meanwhile, I compiled a summary of our health histories and medications, lists of names, addresses and phone numbers of our family physicians, dental, eye, and other specialists, friends and relations, details about investments, taxes, charitable contributions, insurance policies, our living wills, monthly payments to utilities, subscriptions, memberships, pension, social security, and a great deal of other information. Though it wouldn't be a part of the planning document, we updated and revised our wills with our attorney. At the same time we began the search for the doctors and hospitals. Luckily we were able to learn about Phyllis and Lee Coffey Geriatrics Associates at Mount Sinai Hospital in New York, one of the country's leaders in providing a comprehensive range of services for seniors under one roof. Medicare and supplementary insurance are accepted for the great proportion of the services of its army of doctors, who cover a broad spectrum of specialties.

When Hanny and I first visited the Coffey practice in 2002, they gave us a generous amount of uninterrupted time while they examined us and studied our medical records. Later Dr. Audrey Chun, who became our lead physician, developed a comprehensive plan that covered a range of potential problems and treatments. We registered with the Coffey Associates, our major health care provider of choice.

I knew little about the workings of home care, or where to find reliable information sources. But I'd learned over the years that research is always a key element in effective planning. Over many weeks I took a close look at how organizations all over the United States provide elder care services that make it possible for people who, though ill or incapacitated, can still live independently in their own homes. I visited or talked with every source I could find. These included local visiting nurse services in New York to managers of elder care services as far afield as Chicago, Los Angeles, and Tucson.

Advice from UJA-Federation
All this information was useful, but by far the best guidance came from UJA-Federation of New York, where I'd worked for many years as their professional public relations counsel and, since retirement, as a volunteer. Vice President, Bonnie Shevins, astutely assessed our needs and quickly put me in touch with not-for-profit Selfhelp Community Services, Inc., a leading provider of social services to New York seniors (www.selfhelp.net). Selfhelp has a sixty-eight year history of responding to those in need, having sprung forth as an organization that helped refugees who fled the Nazis in 1936 and beyond. Selfhelp is one of many organizations affiliated with UJA-Federation of New York that provide a broad spectrum of services for seniors. When I met with Selfhelp's CEO, Stuart Kaplan, we established an instant rapport and soon we were working together to develop a scheme that not only resulted in an ideal plan of non-medical home support services for Hanny and I, but is now offered to New Yorkers of all faiths and beliefs in a collection of services that we named Selfhelp Senior Source

Selfhelp Senior Source
Selfhelp Senior Source's many services include housekeeping, home and personal care, nursing, rehabilitation, financial management, companionship, providing escorts for medical and other appointments, help with claiming benefits and entitlements, collaboration with doctors, and many others. Its experts help enrollees understand complex information being delivered by physicians. Users of Senior Source pay a nominal fee for an initial interview and written assessment. After registering as members, they pay an affordable amount for only those individual services they choose. In the case of post operative care, many of these costs are covered by Medicare which Selfhelp helps to facilitate.

All newly registered members of Selfhelp Senior Source receive a visit to their homes by an experienced care manager, who makes a thorough assessment to ensure that services provided match the unique needs of each household. Stuart Kaplan, with his Administrator of Home Care, Evelyn Morales, RN, personally carried out such a survey in our Manhattan United Nations Plaza apartment, which included close scrutiny of security and safety issues, especially in areas where seniors are most prone to accidents. Selfhelp discussed security provisions and other emergency resources.

Of course, Selfhelp Senior Source is but one of many other effective, approved not-for-profit home care organizations from which New Yorkers can choose and which can be located with help from senior organizations, or on the Web, but it is the only one that offers seniors and their adult children an opportunity to pre-plan care and that's the most important thing. You must devise a thorough plan that makes provision for your anticipated needs––to think through these issues now, while you can, for what will always be an uncertain future.

By the beginning of 2003 our plan was complete. We made copies of our Planning Papers for the people and organizations that might later need to refer to them, especially our executor, the Coffey Geriatrics Associates, Mount Sinai Hospital, Selfhelp, and Robbie and Gerry Josephs, our nephew and niece who live in Chevy Chase, Maryland. We incorporated all of their suggestions, which were excellent and helped us iron out the plan. Now we could look far more confidently into our future, aware that we'd done everything possible to anticipate any kind of emergency.

Senior Source’s First Test
A year passed and then, by the oddest coincidence, as one of its originators, I became the first actual beneficiary of Selfhelp Senior Source. In August 2003, Hanny and I flew to Argentina, where I'd been a correspondent for various American newspapers in the 1940's. While there, we celebrated the anniversary of our wedding in Buenos Aires. It was a momentous trip, during which we met friends and colleagues from long ago. But our journey home turned into a catastrophe. While we were flying north I became so severely ill that the plane's captain decided it would be too risky for us to stay aboard the plane during the last part of the flight from Panama City.

With our baggage arrayed around us at the airport in Panama City, more than two thousand miles from home, Hanny and I were literally stranded. But Selfhelp Senior Source came to our rescue, so speedily and effectively that it's no exaggeration to say that they may, indeed, have saved my life. One of the cards in my billfold in Panama was our as yet unused Selfhelp Senior Source membership and in no time, armed with the information in our Planning Papers, their professional and clinical staff in New York City swung into action. They contacted the US embassy in Panama, negotiated our admission into the hospital there and linked up with my niece Gerry, whom they helped to get flights from Maryland to Panama, and whose thoughtful presence was so valuable to us both at that nightmare moment. Selfhelp Senior Source also hired an air ambulance to fly Hanny, Gerry, and I from Central America. They facilitated our speedy entrance to Mount Sinai Hospital when we arrived home. The whole process went like clockwork.

Doctors at Panama National Hospital diagnosed cancer of the kidney and a serious obstruction of the bowel, both of which needed urgent surgery. But we opted to return to New York as soon as possible, so that the surgery and all postoperative procedures could be done in the same place, by the same team, and in familiar territory.

Selfhelp–Always In the Loop
At Mount Sinai Hospital, New York, after a battery of tests, they successfully removed the infected kidney and cleared the obstruction, though they warned us that they weren't entirely sure that every trace of cancer had been removed. Within twelve days, I was ready to go home and Selfhelp Senior Source was back with us again, arranging for my discharge from the hospital. Every day, until I was back on my feet, one of their aides came to our apartment providing personal services that ranged from feeding and bathing me to acting as housekeeper, managing our home, and doing such chores as making beds and even shopping. She also gave wonderful moral support to Hanny who, with her eyesight greatly impaired, was much stressed by our emergency and frustrated by her inability to take full charge of our apartment.

Four months after my surgery, I returned to Mount Sinai for a further scan, which revealed that cancer had invaded one hip and that a fresh lesion had appeared in my upper back. Then, while I was actually in the hospital on a routine visit, the hip broke. Physicians at New York Columbia Presbyterian––another hospital with which we had registered for certain possible procedures–– carried out a hip replacement, under the direction of Dr. David Nanus and began extensive treatment of the cancer which had spread to my lungs. Again, Selfhelp Senior Source was always in the loop. After seventeen days of recovery and rehabilitation, Selfhelp Senior Source was standing by.

Now during recovery, Selfhelp Home Health Aide, Paula Gonzalez, spends many hours of every day with us, attending to our health related needs with knowledge, skill, initiative, and compassion.

That's the end of my story and I hope its simple message––plan while you can––is a clear one. There will come a time in most of our lives and perhaps in yours, when we are no longer able to take care of ourselves and our loved ones. Only by making a plan and expressing exactly how we wish to be cared for, can we be sure that those wishes will be fulfilled. The relative time and effort it takes to make such a plan will be more than fair exchange for years of peace of mind.
––As told to John Birch

Ray Josephs made his reputation in public relations and as a self help guru who has sold millions of copies of How to Gain an Extra Hour Every Day, How to Make Money from Your Ideas, in 27 languages, and Argentine Diary, the first exposé of Nazism in South America. He is a man of exceptional vitality and vision. In 2001, he was awarded the Ageless Achiever Award by New York State Governor George Pataki and his life story has been included in the book It’s Never to Late to Plant A Tree: Your Guide to Never Retiring, a compilation of inspiring stories about the post-retirement accomplishments of several extraordinary men and women, including former President Jimmy Carter.

Ray’s 5 Steps to Planning Ahead
Here are five major steps New York seniors and their families can take now to–plan while they can–for the certain eventualities in their advancing years. They’re based on my personal experience, so please adapt them to your own personal circumstances, which will vary with every individual.

1. Review your personal health status.
Determine, as far as possible, what your doctors believe may lie ahead for you and your spouse. I urge a full, fresh look at your medical history and prospects.

2. Review your prospective future care relationships.
Discuss and reach agreement with your children, family, and close friends, exactly who will do what in case of need. Write out the specifics and list them in large type. Include phone numbers, locations, and as much detail as possible.

3. Plan, project, and record your financial situation.
Keep records where you and your caregivers can easily access them. Include bank records, credit cards, investments, even your wallet and keys. This will be of great assistance should problems arise.

4. Discuss, record, and share your basic lifestyle desires with family.
Talk out and write down those issues as fully as possible, with those near and dear to you. Together do as much research as possible on alternatives. Make your desires known in full detail and add them to your Planning Papers.

5. Link yourself with an organization that gives both assistance and care.
Selfhelp Senior Source is the best place to start. 1-800-935-3701.

Questions about Selfhelp Senior Source
How does Selfhelp Senior Source work?
After joining, a Selfhelp Senior Source member is assigned a care manager who conducts a thorough assessment of care needs and living situation. Clients and care managers develop the most appropriate care plan together given specific needs, desires, and home environment. This custom care plan provides services that are paid for only when used and can be implemented fully or partially, at any time. Selfhelp Senior Source care managers monitor and coordinate care regularly to ensure its quality and consistency. If desired, families are kept informed.

Can I pre-plan my care?
Yes. Selfhelp Senior Source offers a unique pre-planning feature for individuals and families who don’t have a current need but who want a self-directed plan in place for the future. In this case, for a yearly membership fee, the plan and personal data are recorded, updated regularly, and kept on file. Clients and the Selfhelp Senior Source care manager have access to the information whenever it’s needed and can make changes at any time. Clients’ wishes are known and they can trust Selfhelp Senior Source to ensure they are followed. The care plan can be implemented simply and easily with a single phone call to the care manager and services are paid for when needed.

Can I afford care management?
Your can't afford not to have it! Managing care is complicated and time consuming. The average person has no idea what services are available or how to get them. Selfhelp’s knowledgeable professionals are adept at navigating the complex maze of care as well as understanding the many benefits and entitlements available to seniors. The time saved resolving problems, getting appropriate care, and having access to many different resources (medical, legal, social, financial, and more) is worth the cost.

Call today for a FREE phone consultation. 1-800-935-3701