Few people my age talk about waiting for the grim reaper to show up at their door. Conversely the subject is daily conversation for many of my clients who are older, have several chronic health conditions and are just tired of living. Individuals over 100 years of age in the U.S. are increasing and currently number about 84,000.

Many never planned to live this long, nor did the social security system expect to provide for them for another 35-40 years after retirement Statistics show that we are simply living longer. And while the main concern is funding our own retirement, many are just now considering the need to support aging parents and siblings. An article in the Chicago Tribune reports that 25% of adults worry about having to support their siblings and the same adults, 40%, worry about having to support their parents.

Read more: Living Longer The Paradox of Health and Retirement

Hospital owners and administrators are screaming. Congress is considering legislation that cuts Medicare reimbursement for hospitals re-admitting patients within 30 days of being discharged for a particular diagnosis. I realize that hospitals have the responsibility of care, however in my opinion equal responsibility rests with the patient to make sure they are not a revolving door back to the hospital. Fining a hospital for an issue for which they have only partial control isn't fair. Why not fine the hospital and the patient equally by reducing reimbursements for related care? The current administration with its excessive spending fails to realize that reduced reimbursements to hospitals will only increase cost shifting to other parts of health care, for example to individual insurance plans, which is a separate issue under controversy.

Read more: Stopping the Revolving Hospital Door

The alcoholic daughter of a woman I know frequently threatens her mother with nursing home placement "if she doesn't behave". In another family, a son has taken over the responsibility of care for his mother because the mother alienated her daughter and they no longer speak. Another son tried to have his mother declared mentally incompetent so he could have her placed in a facility and take over the family home.

Unfortunately these stories happen more often than not and are due to a lack of planning by parents. In many cases, the parents failed to plan ahead and give thought to which family member or child would be best suited to be the Power of Attorney for health and financial matters. The question parents fail to ask themselves is "which child will truly act in my best interests and according to my wishes". Some fail to ask at all and then when something happens, family members fight for power. Others choose the wrong child and later regret their decision.

Read more: The Gift of Grieving and the Foresight of Planning

A client I met decided to support her mother, Ida, by inviting her to live in the basement apartment of the home she shared with her husband and two children. When Ida first moved in six months ago she was fairly able to take care of all of her own needs. Then Ida fell and fractured her pelvis and several vertebrae in her back. The fall resulted in a hospital stay and two months of rehabilitation at a local nursing facility.

The daughter again, believed she could take care of Ida. Upon release from the nursing home, Ida was a fall risk, had difficulty with mobility, was in pain due to the previous fractures, unable to remember to take her medications at the proper times, did not have much of an appetite and needed assistance with personal care. After six weeks of day and night care the daughter became distraught and angry for allowing Ida to move in with the family. Her husband finally told her she needed to get help as the situation was tearing apart their previously happy family.

Read more: Procrastination is Expensive

Martin wants to rehabilitate his father. Henry (names have been changed) was an active 93 year old until he had a stroke last August. After hospitalization and a nursing home stay for rehabilitation, he returned home at the beginning of December. In spite of having physical and occupational therapy at home, Henry continued to decline. Martin works nights so he can be home during the day to care for his father. Martin is fortunate to sleep six hours a day. His wife works during the day while their children attend school. Martin's desire to care for his father has caused a strain on the family. The physical stress on Martin is visible.

But -- Martin believes in the value of life regardless of an individual's age. In the case of his father, he has retained assistance twice daily. The care not only includes personal care, necessary because of his father's limited mobility and inability to manage continence, but also exercise and speech therapy. Henry desires to improve and regain mobility and strength in spite of being virtually bed bound and nearly paralyzed on the left side of his body.

Read more: The Value of Life

"I don't know why I'm still here," or "This is it, I won't see you again". I frequently hear statements like these from clients. What is it about the latter years of life that makes us look back and feel we have little left to contribute?

A friend has fabulous stories of her early life in Germany and her journey to America yet said, "there were so many others that went through the same thing, my life was nothing unusual". In truth, her life is extraordinary. She began journaling recently and now feels that she has a purpose again.

Read more: Purpose In Later Life