Recently, I asked a group of people, including readers of my column and caregivers, to complete this sentence: When I can no longer take care of myself, I desire _____.

Some of the answers were surprising. Almost one-third of the respondents indicated they would be ready to “fly away,” although they didn’t use those exact words. This seems to indicate many people hope to never find themselves in the position of care recipient.

Throughout history, care for the elderly has been provided by family members at home. In modern times, several changes in our culture have given rise to care being provided by hired non-family caregivers or in institutions. Decreased family size and geographical dispersion of family members have contributed to this change. Another factor is greater life expectancy. In 1960, 69.77 years was considered a probable life span; today it is almost 80 years. Although it sometimes appears that a large proportion of the elderly live in nursing homes, the average nationwide is about 5%.  For those over the age of 85, that number increases to about 15% of males and almost 30% of females.

The majority of people surveyed would definitely prefer to be cared for at home by their families. However, several noted that they did not want to become a burden and had talked to their children about placing them in a nursing home if that seemed to be the best option. One woman, a caregiver herself, wrote: “I have already given my children permission to place me in a nursing home – just don’t do so and forget me! We have been taking care of my mother for 13 years, the first ten in her home, hiring someone to stay with her during the day and family members taking turns nights and weekends. I was always torn between my children/husband’s needs and being the caregiver. My children were troopers for the most part, but I missed many of their ball games, etc. I resigned from all my church jobs and activities. Anyone can carry a heavy load for a short period of time, but when it becomes long term, it takes a toll on the whole family. So, I don’t want my children to have to go through that.”

Another respondent listed those things she hoped her caregiver – whatever her living situation – would provide to make her life comfortable: food, television, telephone, make-up, jewelry, and matching clothes.

Several others made their wishes known concerning end-of-life care. “No machines!” wrote one. Another stated she did not want to be kept alive by any artificial means.

Each of us should look down the road and consider how we want to live our last days. Discussing your wishes with your family is a good start, but it is important to put them in writing.  Don’t delay conferring with your health care provider and completing a living will, MOST form, or the Five Wishes document. That is the best way to insure that the loved ones you leave behind will carry out your final wishes.