By Mark Friedman
Over the past several months, this column has focused on one core idea: successful aging does not happen by accident. It happens when individuals and families take time – before a crisis – to think through how they want their aging journey to unfold.
In earlier columns, we explored what an aging plan really is, why a well-informed circle of care matters, and the broad range of issues that deserve attention long before decisions are forced by circumstances. We discussed aging in place, the realities of caregiving, how to navigate care options, and why difficult conversations are not something to avoid – but something to prepare for.
This article is designed to bring all of that work together and help you take the next step: defining your priorities and tradeoffs so that, when action is required, decisions are made under your direction – not in the middle of a crisis.
Why most decisions still happen in crisis
Despite best intentions, most families still make aging decisions during moments of upheaval.
• A medical incident changes daily function overnight.
• A fall raises safety concerns that can no longer be ignored.
• The loss of a spouse alters both emotional and practical support.
• Or, there is an undeniable change in physical or cognitive ability.
What is striking is that many people have done far more planning for what happens after they pass – wills, estates, and legal documents – than for the years leading up to that point. Yet it is those years that often bring the greatest complexity, stress, and need for thoughtful decision-making.
The purpose of an aging plan is to prevent those moments from becoming unmanaged emergencies.
An aging plan is not a single decision
As we discussed earlier in this series, an aging plan is not just a will, a financial plan, or a future housing decision. It is broader and more personal than that.
An aging plan:
• Means different things to different people
• Involves emotional, practical, and relational considerations
• Requires ongoing conversations with yourself, your partner, and your circle of care
• Forces clarity around tradeoffs between what you want and what you may need
This is why there is no “one-size-fits-all” solution. The plan must reflect your values, your priorities, and your tolerance for change.
Wants, needs, and the tradeoffs between them
One of the most important concepts we have introduced in this series is the relationship between wants and needs.
You have wants: independence, privacy, familiarity, control.
You have needs: safety, support, health management, connection.
The more clearly you document the tradeoffs you are willing to make between these two, the more effectively your support can unfold your way.
For example, you may want to remain at home, but recognize that accepting help with transportation or personal care is a reasonable tradeoff. You may want minimal disruption, but understand that certain changes buy you time and independence in the long run.
When these preferences are documented in advance, your circle of care is no longer left guessing. Decisions are made with confidence rather than conflict. And, decisions are made the way you want them to be made
Moving from concepts to an actionable plan
In previous columns, we outlined:
• How to think about aging in place
• What the caregiving landscape really looks like
• Why difficult conversations are essential
• How to evaluate care and service options
This final step is about integration.
The most effective aging plans are based on evidence-based methods that help define care needs objectively while honoring personal preferences. These approaches look at the major factors that consistently drive success – physical function, cognitive health, environment, support systems, and social connection – and use them to create a plan that can adjust over time.
Rather than reacting to change, this creates a “smart plan” that evolves as needs change, allowing for thoughtful transitions instead of rushed decisions.
Empowering your circle of care
A recurring theme throughout this series has been the importance of a well-informed circle of care. This final step gives that circle the clarity it needs to act appropriately on your behalf.
When priorities, preferences, and tradeoffs are documented:
• Care decisions are aligned with your wishes
• Family stress and conflict are reduced
• Professionals can support you more effectively
• Actions are taken with intention, not urgency
This is not about giving up control. It is about preserving it.
The bottom line
Planning for aging is not easy. It requires honesty, reflection, and a willingness to address topics many of us would rather postpone.
But the alternative – having decisions made for you during an uninformed crisis – is far more difficult.
The work you do now allows you to remain the driver of your next chapter. It ensures that when change comes, it is met with preparation, clarity, and respect for both your wants and your needs.
Aging is inevitable.
How you experience it is not.
About the Author: Mark Friedman is the owner and Chief Education Officer of Senior Helpers Boston and South Shore. Passionate about seniors and healthcare, the goal of his agency is to change the trajectory of aging for his clients and their families first by delivering an exceptional homecare experience in a combination of highly trained and high-touch caregivers, and second by providing education and guidance with and connection to resources and services in the 43 communities his company serves. Contact Mark at MFriedman@SeniorHelpers.com or visit www.SeniorHelpersBoston.com.
