AI am a 77 year old man who is still in somewhat good health even though I am 8 yrs in remission of cancer and have been diagnosed with a genetic disease, which down the line, could be serious later in my life time.I live alone and have many doctors and hospitals near-by where I live. Plus I have a pendant, so if I fall, I can notify friends or an ambulance in case of an emergency. I also have a lock box downstairs with my keys since I do not have a doorman in my bldg. So I am thinking of the worse case scenario at the moment. All my relatives live in CA and I have a few friends who are about my age. I have yet to designate my healthcare proxy. If there was an emergency and I was taken to the hospital, how would I have people take care of my things while I am incapacitated: I know Medicare allows approximately 100 hours worth of nursing time but what about the other details. Do I really want to search around for caregivers while I am ill, or when I should already have that prepared.? I need someone as a "go btween" who can handle my bills, errands, etc and someone I can trust --I am searching for homecare or nursing orgs right now, however; I want to have it in place so I am not telling someone at the last minute what I need. Who would that person be if all else fails with friends? One of other thing: If it becomes necessary to go to assisted living/nursing care home, I have to find one that accepts medicaid after my savings have dried up and that would be probably be in a course of two years considering how expensive those places are.
What you need is someone to help you understand how Medicare and Medicaid work. Call your County office of Aging and see if someone can help you figure out what you will need as you age. This person will know more about what your area provides in LTC and Assisted Livings. How long your money may last. What resources you can take advantage of.
I would suggest you get financial and Medical POAs in place. Assigning one person for both. We see alot on this forum where someone assigns two different people and they have no idea where the line is drawn in responsibility. I had both for my Mom and it was so much easier.
Up to you to research all of the answers, really.
Start with, when you need to consider it, a facility that will take you into ALF and that accepts Medicaid after your funds are gone.
They are rare as hen's teeth. Most ALFs only take private pay; they are privately or corporately owned for profit institutions in which once the money is gone, so are you, but you can call and ask facilities in your area about this individually when more near the time, or hire someplace like A Place for Mom to do that research for you.
Bill paying and such is best in the hands of a paid Fiduciary. Any Elder Law Attorney will have recommends for you as they deal with Fiduciaries in court cases where there is no family. Sadly, a friend long distance simply isn't feasible.
I would now join any senior center in your area. Make friends close to home and get good options and pointers there for ongoing care. Here in SF we have On Lok and others. Provide lunches, BP checks, and socializing. Research in your area.
I wish you good luck. You list all the many problems that someone alone faces. Better to enter care early to my mind; I would pretty much enter ALF at now 82 were I alone. Because it's better not to have to think about all of the many problems that can go wrong, EVEN with just the plumbing, if you know what I mean.
Without a close relationship and good communciation and oversight, trying to get a 3rd party looped in when you are incapacitated will have many opportunities for things to fall between the cracks.
You need to assign a PoA who is at least 1 generation younger than you, is willing, competent, trustworthy and local. You need a Advance Healthcare Directive, POLST, Will, Pre-need Guardian form filled out, etc. Please invest in a consult with a certified elder law attorney. You may even find that a trust may be something to consider.
You should "shop" for a facility before you need one (and one that accepts Medicaid). Please understand that usually a Medicaid bed is in a shared room. You should consult with a Medicaid Planner for whatever state you choose to stay in because it can be possible to never qualify financially if your SS income is too high. There are strategies to get around this legally (like a Miller Trust).
My MIL is in a faith-based, non-profit facility that has continuum levels of care. It is a non-profit (Presbyterian Homes, has been around for 50+ years, very well run). My MIL is on Medicaid and has a private room, in a beautiful but not-to-fancy facility on a large recreational suburban lake 3 miles from our home (by chance!)
Just putting it out there that these places do exist.
You should plan to transition yourself into your chosen facility before you need it, so that it's not happening in a crisis. Also, you must consider that your mind may go before your body, and this is why you need all these back-up plans in place. No one ever wants to envision themselves with dementia but it happens to many people, even ones who did everything "right" to try to avoid it. Some dementias are hereditary, some are brought on by disease and some the aftereffects of strokes or chemo.
Avoid the temptation to romanticize how you will age. Plan for the worst and hope for the best.