Episode Description - Scared of Aging Alone? The Truth About Solo Aging
Aging alone is one of the quiet fears that few people talk about, but that a lot of divorcing people harbor – especially those going through a grey divorce. In this podcast episode, Dr. Gerda Maissel, a physician and medical navigator with C-suite healthcare leadership experience, breaks down what solo aging means in a healthcare system that often overlooks or overwhelms patients —especially older women.
From navigating complex diagnoses to making life-or-death decisions, Dr. Maissel explains how healthcare isn’t just about treatment—it’s about advocacy. She dives into why traditional support systems are vanishing, how solo agers are disproportionately affected, and why creating intentional community—what she calls “circles”— is as vital to health as any prescription. She also pulls back the curtain on hospital economics and shares why understanding a hospital’s financial incentives can change how you approach your own care.
If you or someone you love is worried about how to navigate aging alone, this episode will provide you with tips, techniques, and the insight you need to make that journey with confidence and grace.
Show Notes
About Dr. Gerda Maissel
Physician patient advocate & medical navigator Dr. Gerda Maissel provides advice to improve medical outcomes and optimizes doctor communication. Dr. Maissel understands both the clinical and business sides of medicine. She works with clients in the hospital or at home to ensure the best outcomes.
Connect with Dr. Gerda Maissel
You can connect with Dr. Gerda Maissell on LinkedIn at Gerda Maissel and find her website at My MD Advisor. For tips, stories and commentary on American healthcare subscribe to The Foglight by Dr. Gerda Maissel.
Key Takeaways From This Episode with Dr. Gerda Maissel
- Dr. Maissel helps patients navigate complex medical systems, serving as an intermediary between patients and healthcare providers to ensure better communication and outcomes.
- Hospitals and hospice programs often make care decisions influenced by hidden financial incentives, such as discharging patients quickly due to fixed payments per case.
- Solo agers are individuals aging without traditional family support, such as spouses or nearby adult children, and must plan proactively for their health and care needs.
- Dr. Maissel emphasizes intentionally creating diverse social networks—such as through clubs, religious groups, or fitness classes—to replace familial support as one ages.
- Hearing loss is strongly linked to dementia risk; early correction is critical, but many resist using hearing aids due to stigma.
- Solo agers must proactively manage their health, accept outside help, and be more responsive to signs or suggestions of health issues since no family may be urging them to act.
- Essential Legal Documents: Three key documents for aging individuals include:
- Healthcare Power of Attorney
- Financial Power of Attorney
- POLST/MOLST (Physician/Medical Orders for Life-Sustaining Treatment) Unlike living wills, this physician-signed form ensures EMTs and hospitals honor end-of-life wishes (e.g., DNR orders) during emergencies.
- It's vital to communicate clear healthcare wishes and medical care preferences to prevent confusion and conflict among loved ones or proxies.
- Solo agers must plan financially for care as many may require hiring help (companions, aides, nurses), so consulting a financial advisor and planning for these future expenses is crucial.
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Transcript
Scared of Aging Alone? The Truth About Solo Aging
SUMMARY KEYWORDS
solo aging, medical navigator, healthcare advocate
SPEAKERS
Karen Covy, Dr. Gerda Maissel
Karen Covy Host
00:10
Hello and welcome to Off the Fence, a podcast where we deconstruct difficult decision-making so we can discover what keeps us stuck and, more importantly, how we can get unstuck and start making even tough decisions with confidence. I'm your host, Karen Covy, a former divorce lawyer, mediator and arbitrator, turned coach, author and entrepreneur. And now, without further ado, let's get on with the show
With me today, I have the pleasure of speaking with Dr Gerda Maissel, and Dr Maissel is a physician, patient advocate and medical navigator who provides advice to improve medical outcomes and optimizes doctor communication. Dr Maissel understands both the clinical and business sides of medicine. She works with clients in the hospital or at home to ensure their best outcomes. Dr Maissel, welcome to the show.
Dr. Gerda Maissel Guest
Why, thank you.
Karen Covy Host
I wanted to have you on and I'm super excited about having this conversation about solo aging, because it's something that I've seen so many people are concerned about. I mean, whether they're divorced or not, it's a growing concern given our lifespans today. But before we do, before we dive into that, you call yourself a medical navigator. What is that?
Dr. Gerda Maissel Guest
01:40
Well, so many people have difficulties when they get into complex medical problems. They can get stymied by who do I ask this question to? What does this doctor mean? Who do I trust? Who do I go to? How do I know if they're doing the right thing by me? How do I know if the advice is good and I help people sort all those things out.
Karen Covy Host
02:03
Interesting. So what kind of people or what kind of people in what kind of situations? Maybe is a better question. What kind of situations would warrant a medical navigator, or where can you be the most helpful for people?
Dr. Gerda Maissel Guest
02:19
So sometimes it's an emotion. In other words, if you're feeling really frustrated or overwhelmed or angry about a medical situation, it may be time to reach out and get some help from somebody like me who's an insider in healthcare and who can guide you through what's needed. Typically, I'm hired either by somebody who's on their own and needs a sounding board, wants somebody to really help them make sure that their care is the best possible, or I'm hired by the children of somebody with a parent who either the child, the adult child is having trouble finding the time to really help the parent and they want to make their process more efficient, or sometimes they're just so frustrated because they perceive their parent is getting lousy care. And often with older people and especially older women, the medical system has a tendency to discount you. To not take your concerns seriously, and people feel that and want help to know what do I say? How do I get my point across?
Karen Covy Host
03:43
So, if I'm understanding you, you would come in and be almost an intermediary between the patient and the healthcare system, the care providers, the doctors, the specialists, the nurses, that kind of thing.
Dr. Gerda Maissel Guest
03:50
That's right, and what I do on terms of a task basis really depends on the person, so in some cases, I'm reading records explaining to the person. Here's what it means talking with them about. Here are your choices. And then they go off and they do most of the interactions themselves. In most cases, though, I'm joining them virtually for doctor's visits, talking with their doctors. If they're in the hospital, I might be talking with the nurses or the hospitalists or the specialists. The exact tasks depend on the person and their style.
Karen Covy Host
04:29
Does it depend on the person's medical condition, Like does it matter if the person has cancer or diabetes or a heart condition or whatever? Does that play a role in whether someone uses you?
Dr. Gerda Maissel Guest
04:43
No, it doesn't. In the beginning, when I first started doing this and I've been doing this five years now I thought that it would be like oh okay, if somebody's got a spinal cord injury, that's really complicated. That means I'll be doing X, y or Z, and if somebody has heart failure or a heart attack, then it's not so complicated. But the reality is that everybody's different with the amount of medical information they want. Everybody's different with their family dynamics, and people are different with their emotional needs in terms of how they go about problem solving. Some people need a little bit more space to emotionally talk about what's going on and other people need more space to read things. And it's not really about the medical condition itself. It's about how to best help the person.
Karen Covy Host
05:39
And are these people who are dissatisfied with their care, or they just don't understand what's going on?
Dr. Gerda Maissel Guest
05:49
It's mostly dissatisfaction of some sort, but underneath that that dissatisfaction is a lack of knowledge. It might be lack of medical knowledge, but it's not necessarily. I've had plenty of clients who understand the medical point issues. I mean, there may be some subtleties that I tweak, but nobody knows the hidden economic drivers. And what I mean by that is, for example, when you're in the hospital.
06:20
Hospitals are paid not for every day that you're there, a per diem. Hospitals are paid a case rate. So if you're there three days or 13 days with the same diagnosis, the hospital gets the same amount of money. So there is this economic driver across all hospitals in America to manage lengths of stay very tightly. It's kind of like a restaurant, right, the restaurant gets a certain amount of money. They got to turn the tables. They'll get more money with three seatings a night than two seatings a night.
06:53
Well, a hospital, if they make a little tiny margin on each person, the more often they fill those same beds, the more chance they can make a little bit of a margin or lose less money. So hospitals have tremendous incentives to turn the beds. And those kinds of economic drivers change the behaviors of the people that you meet as a patient. When you understand that, you understand why that case manager who's saying mom needs to go to subacute is incented to get you out, not to get you to the best place for mom, but to get you out Now. A good case manager will try to help you sort through, but in general their incentive is move them in, move them out, move them in, move them out.
Karen Covy Host
07:42
Wow, that is so fascinating. I mean I just as a lay person to the medical world. I just assume they got paid per day.
Dr. Gerda Maissel Guest
07:52
Of course you did. Everybody does. It's natural to assume that, and there's a million examples of hidden economic drivers in healthcare that change the way people conceptualize and speak to you as a patient or a family member about medical conditions.
Karen Covy Host
08:12
Because if I'm filling in the gaps here correctly, let me know. But that's because they speak to you differently, because they have an economic incentive to speak to you differently. Am I getting it?
Dr. Gerda Maissel Guest
08:24
Yeah, as well, as at times and I just I write a regular blog and I was just thinking about this today there's a little bit of, shall I say, misdirection. That happens on a regular basis and it's not necessarily intentional. Let me see if I can give you an example of that. Hospice wonderful, all about hospice. Everybody says you can't go on hospice too early. Well, yeah, you can, because hospice is also paid for a block of time. They get a fixed amount of money for every 60 or 90 days and everything related to that hospice diagnosis is covered under that umbrella. So I'll use my mom as an example.
09:17
I almost started her on hospice after she got a terminal diagnosis and we talked to the hospice people. But mom was still seeing a few specialists. She had some issues, for example with her bladder, and she wanted to go and see this particular specialist. Well, the hospice would have had to have paid for her to go to see that person, because everything goes under that one umbrella. And so they're like oh no, she can just see the nurse practitioner. No, no, mom had already done all that and she wanted a specialist.
09:53
So we waited a little bit of time till mom had said goodbye to some of her specialists, as well as seeing this urogynecology specialist, in order to finish up some things that mattered to my mother. Yes, she was dying, but she also I mean, she didn't pass for like a year and a half after that it doesn't always happen right away and she had wanted to be less incontinent. It mattered to her. So the clinician talking to us said oh well, you know. Oh, no problem, we can take care of you, it's easy. But behind that, whether the clinician knew it or not, was the economic driver of hospice. Would have lost some money or wouldn't have made as much profit if mom had gone to see the specialist.
Karen Covy Host
10:51
That's fascinating. How did you learn all this stuff? I know you're a medical doctor, but how did you get information about the economic drivers?
Dr. Gerda Maissel Guest
10:56
Well, I got sucked into leadership early and often so. I eventually got pulled up to the C-suite level, serving in a number of roles inside of health systems you know vice president of medical affairs, chief medical officer, president of large medical groups and it was during those times where you really understand how things work behind the scenes, Because when you're in leadership at a high level in a health system, there's a lot that you have to deal with in terms of the money.
Karen Covy Host
11:27
Yeah, and just if I'm understanding from this conversation, the people on the front lines, like the nurse, may not actually know what those economic drivers are. She just knows that her marching orders are due. Blah, blah, blah, blah, blah. That's exactly right, right? That's mind blowing, because the reason that I say that is my experience with the majority of physicians and nurses is they really care, they really want to do a great job, they want to help people and they want to heal people, but they have their marching orders and it would seem to me that if they had the same level of knowledge that you did, sometimes they might balk and say, no, we're keeping this person, or we're doing the right thing, even though it might cost us some dollars.
Dr. Gerda Maissel Guest
12:22
Yeah, it can set up what is sometimes called moral dilemmas or even moral injury. If you read about physician burnout something that, as a physician leader, I did a lot one of the terms is moral injury in terms of contributing to physician burnout and it's knowing that you have pressure to see a lot of people, for example, to churn the patient, see a lot of people in the office and feeling like you don't have the time to do the right things and so you're in a moral conflict with yourself and it can be very hard and I'm just using I know the doctor world better but the nurses but it is not uncommon and it contributes to burnout nurses, but it is not uncommon and it contributes to burnout.
Karen Covy Host
13:16
Wow, it's not surprising. But it's surprising, right. I guess I didn't really realize. And just sort of as a generalization, and I know every hospital will be different, but do hospitals run on a big profit margin or are they pretty tight?
Dr. Gerda Maissel Guest
13:28
They're tight and it's only gotten tighter with time.
13:35
That's why so when you see industries in consolidation where you get little places are being bought up by bigger places, it's because margins are tight. And healthcare right now, I'm sure you've noticed, if you had a community hospital near you, it's likely been taken over by a bigger system and that may be a medium size health system, and then that one may have been taken over by a bigger one and a bigger one. There's a lot of big fish eating smaller fish and all of what's driving that is a desire for economies of scale. We're getting into the business side of medicine now, but it's because margins are tight. If you can buy a catheter for 10 cents a piece instead of 30 cents a piece, then you buy it for 10 cents a piece. And if you can employ less overall administration because you reduce redundancy, you know, because if each hospital has a fill in the blank chief nursing officer and now you can have one chief nursing officer over two places, well, you've now reduced your overhead. So healthcare in America is an industry that is consolidating rapidly.
Karen Covy Host
14:50
Wow, that's fascinating, but let's bring this back. I mean, I could talk to you forever, but let's bring this back to the topic at hand. And the reason that I really wanted to have this conversation with you is because of what you've called or coined the term of solo aging, Because in my world, so many people especially great divorce is a thing. The biggest demographic of divorcing people are those who are 50 and above, and those are the same kinds of people for whom aging, you know, and getting sick and having someone to take care of them, is a bigger concern than I mean. It's bigger when you're 50 or 60 than when you were 20 or 30, right.
15:35
And so I've seen this in so many people on both sides of the fence, so to speak, where people don't want to. They're afraid of getting a divorce. They're in a miserable marriage, but they don't want to get a divorce because they need someone. They want someone there to take care of them if they get sick, when they get older. And, conversely, I've seen other people who see their spouse going, starting to decline, and they haven't gotten along for years anyway, and now they're saying I don't know if I want to be part of this. So tell me what does your work with solo aging entail and what does that term mean to you?
Dr. Gerda Maissel Guest
16:19
Well, solo aging simply means that a person is getting older without the supports traditionally provided by family.
16:30
So a hundred years ago we lived not just in our family, with who we married, and then the children moved away like they do today.
16:40
The children would live nearby, there'd be aunts and uncles and cousins, and you'd have a network of people around you. And now our society is far more mobile. Sure, some people have children living nearby, but many people don't. And many people don't have children, or if they have children, they're estranged from their children or their child has an issue or is simply unable to provide care. So not only do people have less children generationally, and it's very, very clear and even if we have children, our children are not producing grandchildren who might then help take care of us when we're 90. So we're having less children and those children are not around. And if we get divorced, or even if our spouse, if we have a long-term partner, as you said, that partner may have their own issues and may not be able to take care of us. So many people are finding themselves in the position of having to make plans for their own aging on their own, without being able to depend on those traditional supports.
Karen Covy Host
17:51
So if someone is concerned about ending up in that situation, for whatever reason I mean it may be that they think they're going to outlive their spouse, or that they're going to be divorced from their spouse, or their kids are gone, or whatever the reason. So someone who's concerned about getting old alone, essentially, what should they do?
Dr. Gerda Maissel Guest
18:16
Well, a couple of things. From a health point of view. One of the things that people are most afraid of is developing dementia, because if you develop dementia, you have less choice, less control over your life, you don't get to direct your care if you aren't there cognitively, and you become more dependent. So there are a number of things that we can do in terms of choices to reduce our chances now of getting dementia. They've been studying it for a while and about 50% of dementia is considered. Whether you say preventable or you can reduce your risk, and it is the things that you already know exercise regularly, watch your cholesterol, you know. And one that I'll mention in terms of reducing dementia risk is correct your hearing, hearing loss is strongly associated with dementia, and you think of all those people who you've seen, the old people.
19:21
They finally get their hearing aid and they're going huh, huh, what'd you say and then they don't wear their hearing aid, it's because they waited too long.
Karen Covy Host
19:29
So Wait. What do you mean by waited too long? It doesn't work anymore, or what?
Dr. Gerda Maissel Guest
19:35
If you wait too long to correct your hearing loss, you lose the ability. It's called discrimination. You cannot discriminate words, and so, even though you hear the sound, the word doesn't mean anything to you, and that's why, when they finally get their hearing aids, they can't understand. A person can't understand. The sound is louder but the words don't make sense. And so correct your hearing early and often. It's really really important, because corrected hearing, no problem with dementia. Non-corrected hearing, you may lose the opportunity to correct it and it's related to getting dementia.
Karen Covy Host
20:20
That's fascinating, I realize, because my mother-in-law is up in years and is to the point where we couldn't have a conversation on the phone with her anymore because she can't hear it right. There's no point in having the conversation, and I think she's another one of those people who just didn't want the hearing aids. Didn't want the hearing aids and, yes, it's a problem
Dr. Gerda Maissel Guest
20:42
and I don't understand why we're perfectly comfortable wearing glasses, but we don't want to correct our hearing.
Karen Covy Host
20:55
Is there a problem with the hearing aids? I've heard people complain that they whistle or they make weird noises. Or is that an issue?
Dr. Gerda Maissel Guest
21:04
The only time they whistle is if you put if something gets very, very close. They whistle is if you put if something gets very, very close. But no, and these days the technology is really very good, you can adjust your hearing aid on your phone. It's, it's tends to be an acknowledgement. It's sort of like people have to get over wearing readers, you know, in their forties. It's an acknowledgement of aging for many people and they just resist the idea.
Karen Covy Host
21:34
But this is. This is fascinating, and I think a lot of our listeners also are caught in the sandwich generation, where they're taking care of kids and they're taking care of parents. This is a good. I think you're arming them with a lot of good arguments to go talk to their aging parents and say, hey, this is why you should get a hearing aid or get this checked or that checked.
Dr. Gerda Maissel Guest
21:59
Yes, and that's why if you're on your own, you are at more risk of having medical issues. Because and I will use myself as an example and I'll use hearing as an example I got hearing aids in my 50s because my kids you know, my adult kids and my husband teased me. They're like ah, you're going deaf, go get your hearing checked. And when I went and got my hearing checked I was told oh, you know, it's just very mild hearing loss, you don't have to correct it. And they said well, when you're in it because back then I was doing the corporate thing they said but when you're in a meeting you probably just won't have to work as hard to hear people. And they were right. So I got my hearing corrected very, very early.
22:43
But if I had lived alone, I wouldn't have done it because I didn't perceive I had a problem. I went to shut up my family. I went because they were bugging me, and that's one of the problems or the risks when you're a solo ager, you don't have those people necessarily bugging you to do things. And so if you're a solo ager, if you get some ideas or a friend or somebody gives you a hint that maybe something's going on. Take it more seriously than you might have otherwise, because you become more responsible for yourself and it's harder, but it will serve you well in the long run.
Karen Covy Host
23:27
Let's say, somebody is a solo ager, for whatever reason divorce, death, kids are gone, whatever it is what can they do? I mean, besides taking other people's comments a little more seriously than they might otherwise do? I mean, what are their biggest risks and what steps can they take to alleviate those risks?
Dr. Gerda Maissel Guest
23:54
Well, one of the things that we can all do, and I'll use my friend, Sue, who's given me permission to use her name, as an example. In her early 70s Sue moved to a new community. She didn't move into an aging community, she just was at it. She had gotten divorced, she was at a time in her life she moved to a community about half an hour away from her sister. She loved her sister but she didn't want to live in the same exact town.
24:22
And Sue, who is kind of a quiet person, a sweetheart but a quiet person deliberately set out to build what she called her circles. So she had her book club circle, she had her water aerobics circle, she had her Bible study circle, she had her neighbor's circle and there were a few overlapping people, but they were different people, all in these circles of friends. Now that was over 20 years ago and back then she, every time I would see Sue, she was always making chicken salad and bringing it to one of her friends. Somebody was sick. We were talking about how she has continued to live in the community in a condo on her own. But all these friends she's now in her 90s, but all these friends over time repaid the kindness when they could, so she had been good to them. But then when she needed her front, step something done, whether they did it for her or they just knew a guy. She was connected.
25:28
When she struggled with health issues, she had friends that took her to get the treatment for her cancer. She had a community already built in, because one of the things solo agers worry about, one of the things we're used to counting on family to do, is to take us to those medical appointments or to solve a logistical problem. That's a pain in the neck to solve. But Sue had a wide enough net that she had people that were willing and able to help her solve her problems.
26:02
And when I talked to her about it the other day because this was a few months ago again, I write this blog called the Fog Light and I was writing about the importance of developing community on purpose Sue said yeah, and one of the things I have to do is regularly assess my circles because they're getting smaller. They're shrinking as I'm getting along in age. One friend moved. One friend no longer drives. She's like, yeah, I'm glad we're thinking about it. She's like I got to go make a few new friends and she was very deliberate in making friends and continuing to make friends, and it is something that comes naturally to some people, but it can also be something one does very deliberately.
Karen Covy Host
26:54
I love that, especially because it seems to me maybe I'm making this up, but it seems to me that as people, as we age, our number of friends, like we have friends from when we were younger or at different stages in our life, but the older we get, the less new friends we make.
Dr. Gerda Maissel Guest
27:14
Oh, absolutely. And then something happens to those friends, and it's natural. It's normal, especially if you make it into your nineties. You're surviving when not everybody does.
Karen Covy Host
27:29
Yeah, no, I have longevity in my genes. I have two of my grandmother's sisters who are still alive. One is, I think, 97, the other is 102. Yeah, and it's you know. Their circles have shrunk very, very much because they've outlived everybody.
Dr. Gerda Maissel Guest
27:51
Yes, that's right, and so many people you know Sue has been able to stay in the community, but other people make choices to move to someplace where they can get the support that was traditionally provided by family. The assisted living communities which you don't have to be even assisted living, many of them have independent living as part of them have mushroomed as baby boomers have gotten older. There's tons of them now, and so there are a lot of and we'll just call them senior housing options, because many people, whether they're in a couple or on their own, are in this position where they need to make new friends and new connections. They need a certain level of services, like some of these facilities have a pharmacy or a little store or a van that'll take you to the grocery. They provide some of the support that perhaps a generation or two ago your daughter would have done for you.
Karen Covy Host
28:56
Yeah, 100%. But let's you know, maybe it's the lawyer in me that's starting to think but if you're a solo ager, like all of the things that we've talked about are important, but so are legal documents right? So, in your experience working with solo agers, what do they need when they're thinking about, okay, if I'm responsible for my future and I am how can I plan for that? What documents do I need to put in place so that, if something happens to me, everybody's not scrambling?
Dr. Gerda Maissel Guest
29:38
Great question, and when I talk to other lawyers about it they have a long list. I have a list of three things that I think are the most important from my point of view as a healthcare advocate. One is that healthcare proxy. It's also called a health care power of attorney. It goes by a couple different names, but it's a designated person or persons who, when you can't speak for yourself, can say this is what she wanted. And let me come back to that, because I'll give you the other two. The second is a financial power of attorney, so that if you can't get to the bank, somebody else can pay your bills. And the third and again we'll come back to it is a most or a post, and that's the one that's least known.
30:19
So first, on the healthcare power of attorney or the healthcare proxy, it's not enough, in my opinion, just to designate somebody. You need to have a series of conversations about your wishes and about your approach, because sometimes people think, oh, they'll decide for me, they'll do what's right. Don't put that person in that position. I've seen times when two daughters are both named healthcare power of attorneys or healthcare proxies and nobody knows what mom really wanted. And now the time has come and mom, to survive, is going to need a tube in her belly. And one daughter says you can't kill mom, you can't. You got to keep feeding her. And the other daughter says I don't think she would have wanted this. And now those two people are suffering because both are convinced they're right, both want to do the right thing by mom and it's, it's painful, it puts families in terrible pain.
Karen Covy Host
31:21
Yeah, I've. I've seen that happen as well and from my perspective, I would always encourage people. If you're mom, if you're the person who might need the help in the future, write it down, because people's memories are faulty and you know, daughter one and daughter two like to your point. They both think they're doing the right thing and you don't want. The last thing you want to do is drive a wedge between your children when you die, because each one thinks the other one's doing something terrible.
Dr. Gerda Maissel Guest
31:55
That's exactly right, and whether it's your children or a good friend, the more that you can tell them about certain things, about how you feel, about things like would you ever want a new tube in your body About what you're feeling about? When is it time to not resuscitate me? It can be hard to know exactly what you would and wouldn't want, but you can convey to a person if I get fill in the blank or I'm in this or that condition I don't think it's worth being around or I don't want this kind of procedure on me, so that the person who is a healthcare proxy can have the confidence that they're doing what you would have wanted. It is your decision about your body. Please help that proxy know what to do for you when the time comes.
Karen Covy Host
32:52
Yeah, that's a great piece of advice and also there's an interesting distinction in what you just made between somebody the healthcare proxy doing what you would have wanted had you been able to speak up in that situation, versus having the healthcare proxy do what they think is best for you, and I think you know. Tell me if I'm getting this right, but in my mind that would be an important conversation to have, because sometimes people have this tendency to help a little too much to do what they would like to have done to them, and it's not about what you want at all.
Dr. Gerda Maissel Guest
33:38
And that's exactly right, and it causes those moral dilemmas that really eat you up inside. It should always be about what the person with the medical condition would want if they could speak for themselves and relieve the person who has to say it from the burden of that decision.
Karen Covy Host
33:59
Right, awesome, so that's. Your first document was the power of attorney or healthcare proxy, and then you said we were going to come back to the other two.
Dr. Gerda Maissel Guest
34:09
Yep. So the financial power of attorney, from my point of view, is more straightforward. You designate somebody who can access your assets and pay your bills and just keep things going in the way that you would want them to do. So the reason for that, of course, is that if you can't do it yourself, it's a practical thing Somebody else needs to make sure that things are okay, and they've got to be someone that you trust.
Karen Covy Host
34:35
Right, that makes a lot of sense and it's something for people to understand that they don't think about. Well, what if something happens and they're sick and incapacitated or in the hospital for a month, or they're in a recovery facility or they just don't have the mental or emotional energy to take care of their finances for a month or two while they're sick? You need somebody in there who can do that for you. So that's the financial power of attorney. What's this third document? I don't think that I've heard about that.
Dr. Gerda Maissel Guest
35:07
Yeah. So the third document is not one that lawyers often know about, but and many times the public doesn't know about it exists in all 50 states and it's called either a MOLST or a POLST and it stands for either medical or physician orders of life sustaining treatment, and it is most appropriate for somebody who is at that stage where they don't want things done. So many people, as they get older, are like you know, I don't want to have chest compressions done, like if I get to the point where my heart stops, enough, already I'm done. You know, like I'm good, I've lived a good life, I'm good, and I mean literally back in the day, people would tattoo DNR on their chest. Oh, my gosh, you know, because they and well, so do you know? So if you go to the hospital and you're in the hospital, okay, they ask what do you want? And okay, he or she's a DNR. Well, if you go down in your house and the EMTs show up, they don't know whether you're a DNR or not. Even if you wrote it into your will that you were a DNR, well, that will is sitting in a file cabinet somewhere.
36:21
So this form, this process, came up to solve that problem, because the EMTs aren't going to look at a person and say, ah, she looks like she might be a DNR. They're going to resuscitate you and that could involve breaking your ribs or things, and if you don't want that, there had to be a way for those EMTs to have a physician's order that covered them. So every state has this, and it's usually a bright pink or a bright orange form. You go to the doctor, you say I want DNR, but IV fluids are okay. I mean, there's a variety of things that you can choose from. And then the doctor signs it.
37:06
So now the EMTs are covered. The people in the ambulance are covered from their legal liability if they don't intervene. And then that form goes on your fridge. It sits there and every EMT in the world looks for that form when they walk in the door, and if it's on your fridge, they can also bring it with them to the hospital. And then it says, okay, yes, Mrs Smith can't speak for herself now, but she's a DNR, but IV fluids are okay. And then those orders then go in place in the hospital too.
Karen Covy Host
37:36
Okay, so I just have to ask so tattooing DNR on your chest isn't going to do it.
Dr. Gerda Maissel Guest
37:43
Not a good idea because it won't cover them legally. They need physician orders to not resuscitate you, and some of these places sometimes it even includes things like do not hospitalize. I know someone who has said I never want to go back to the hospital again and that's their right, and so they're like if EMTs come, I don't want to go back. And I said you need a MOLST or a POLST on your refrigerator so that if you go down they know not to take you.
Karen Covy Host
38:18
So fascinating. So this is. I think that anybody watching or listening would be well advised to get these documents, no matter what even if you're not in or you don't think you are in urgent, you know, or in immediate need of them. You never know. I mean, life is strange and things happen. So it sounds like that would be a good idea. But just to sort of bring this full circle, is there anything else that, if someone is worried about becoming a solo ager, anything else that they can do, so that, from my perspective, I'm looking to help them be as prepared as possible so that it can reduce their anxiety, so that they can live their life while they're alive and not stay in an unhappy marriage or leave a marriage or do whatever it is that they're going to do with their relationships, with their business, with their careers, simply out of fear that I don't want to do this alone, what else? Is there anything else important that they need to be thinking about?
Dr. Gerda Maissel Guest
39:25
Well, we've covered the medical and we've covered the social, and I would say and we've talked about the documents I would say the only other thing to consider and this is where speaking with a financial advisor is helpful is to understand how much money you do or don't have because you might have to hire help. If you're on your own, it may involve hiring help and sometimes there's a generational bias against doing so, but there's a lot of help to be had out there. There are a lot of companions and aides and nurses, doctors, other people out there, and so, as part of your planning out there, and so, as part of your planning, talk to your financial advisor and expect or plan to spend money in those last few years of life on help, even if you have family, family can't do everything, and many times even with family.
40:25
people are hiring aides to be with either themselves, or often it's the children are hiring aides, or whoever is the guardian is hiring aides in order to help a person still have dignity and a decent quality of life.
Karen Covy Host
40:41
Yeah, that is such good advice. This is such an important conversation. Dr Maissel, thank you so much for being here and for sharing your wisdom and experience with the masses.
Dr. Gerda Maissel Guest
My pleasure
Karen Covy Host
So for those of you who are watching, for those of you who are listening. If you enjoyed today's conversation, if you'd like to hear more of it, do me a big favor give this episode a thumbs up, like and subscribe. And, Dr Maissel, where can people find you if they're looking for you?
Dr. Gerda Maissel Guest
41:09
Well, if people are interested in looking for me, the best place to go is my website, which is www.mymdadvisorcom. So my business name is My MD Advisor, and if they just want to read about these sorts of issues, I'm on Substack called the Foglight. If you go on to Substack or substack.com and you just put in the Foglight or you put in Gerda Maisel, you'll find me and then you're welcome to subscribe. It's free. Some people charge for what they put out. I just enjoy doing it. So it's free, with a lot of tips and comments, and I keep the essays short, like you know, a thousand words kind of level, so that it doesn't take all day. So, either at mymdadvisor.com or on Substack with the fog light.
Karen Covy Host
42:06
That sounds wonderful. And even if you know, for those who are watching and listening, even if you might think you don't need this yet, life has a way of surprising you. Even if it's not for you, it could be for an aging parent, it could be for a friend. So go to Substack, subscribe to Dr Gerda's newsletter, go to the website, and I look forward to seeing you all again next time.
