I’m going to try and not make this sound horrible. But there’s something you need to know about the net result of arranging or providing “good care” for your geri-loved one, and it’s this very simple, but extremely profound equation: the better the care, the more prolonged the situation. I’m not saying that’s good or bad, it’s just something to be aware of as you’re pondering deep, dark, wtf thoughts late at night or worrying about how the future will pan out under your current circumstances.

That probably sounds bad. Of COURSE we all want and will provide the best “good care” we can for our loved ones, and hope the same for ourselves. I’m just saying we should all factor this into the grand plan.

Let me give you a real life example. The woman I oversaw care for in South Florida was immobile and uncommunicative in her bed and in pretty dire straits on all fronts when I hired a geriatric care manager to assess and shore up her care situation. The nurse who took on her case immediately lined up hospice care, which included multiple weekly visits and personal assistance (bathing, medications, pottying, etc) and 24-7 in-home caregiving. This was a big step up from the infrequent assistance she’d been getting from a housekeeper turned helper and a husband who was battling issues of dementia and alcoholism. The geriatric care manager described my woman friend’s condition as “end stage Parkinson’s disease.” I asked her how long this would go on, because I was over in the corner sucking my thumb and counting pennies trying to figure out when the money to pay for all this care was going to dry up completely. The nurse said she probably had six months, tops. I thought to myself, darkly, that there was probably enough in the kitty for six months tops. Six months tops could work.

If it had only been six months. Two years later and still in the throes of end stage Parkinson’s and the plus plus pluses, this couple’s financial picture looked like one of those hurricane spaghetti models — confusing and unpredictable and rife with anxiety, PTSD and WTAFs. Two years was not exactly part of the spreadsheet modeling. But there in the center of the storm sat two very well cared for individuals who were clean, nourished, tended to and quite comfortable for a couple facing end stage Parkinson’s and crippling dementia.

Here’s a similar, though slightly different perspective. When my dad was sick with double pneumonia at the end of his life, he was on a ventilator in the hospital getting good care — unresponsive-ish with oxygen levels that were deplorable and scary. We kept him on it probably longer than we should have because neither of us wanted to make “tough choices.” So the hospital care continued and Dad remained alive, kind of, as if being breathed 24-7 by a machine is really alive-ing. We kept it going and there he stayed, comfy-looking, sorta. Once it was pretty clear my dad’s situation wasn’t ever going to make big turnarounds in miraculous, life-giving ways, we let another kind of caregiver takeover — I think hospice was only on the scene for a few minutes. In my retrospective mind, that was the “good care.”

One more example: My father-in-law is 95 years old and lives independently with minimal assistance. He has weathered and continues to face some pretty serious heart conditions — stuff that might have taken him up to the pearly gates a few times during the past 30 years. But in recent years, he’s been on a strict diet that one of his children prepares each night for him in his home. He has a little extra help each week with his medication and socialization and by golly, he’s doing great. There is no doubt in my mind the meticulous care he’s been getting from loved ones will deliver him into his next century!

So here’s the thing with “good care.” If you’re a caregiver or manager, the goal is always to provide the very best situation money and resources can afford. You never want anything less! I certainly want my person to approach my needs with the same attention and love. But don’t ever lose sight of the fact that good care not only slightly improves whatever situation you or your loved one may be facing, it usually prolongs it. And nine times out of 10, that means putting a few open-ended extra years on the cost balance sheet — be it time, resources or dollars. Expect that and prepare for it.