Seven steps to proper care in old age
By Maria Smit*
Most of us don’t like thinking about getting older, especially when it means we might need help. But talking about it and planning ahead can take a huge weight off your shoulders – and your family’s.
Planning for long-term care is not just about your future. It’s also about making things easier for the people who care about you.
The real cost of growing older
Getting care in later life is expensive in South Africa – and it’s only getting worse. Private frail care homes can cost between R20,000 and R40,000 a month. If you want to stay at home, a carer could cost you anywhere from R8,000 to R25,000 per month.
And that’s before you add the cost of medication, adult nappies, walking aids, or even just getting to the doctor.
It’s easy to see how this can overwhelm families, especially if your savings have taken strain or haven’t grown enough to keep up with rising costs.
Why this is a bigger problem in South Africa
The state is simply not equipped to provide quality long-term care to its ageing population. State-run old age homes are few and far between, with long waiting lists and underfunded facilities.
The SASSA old age grant – currently R2,180 per month – doesn’t even begin to cover the cost of basic needs, let alone professional care. Medical aids offer limited support, especially for non-medical daily assistance.
Hoping the government will step in or that your children will somehow manage is not a realistic plan. With limited resources and increasing demand, the public system cannot be your fallback.
If you want reliable, dignified care in your later years, you need to provide for this yourself.
In years gone by, many South Africans had the expectation that they’d be caring for their parents in old age. But modern life has made this harder. Adult children are often juggling jobs, raising their own families, or living abroad. And the reality is that they probably don’t have the time, skills, or resources to manage care themselves.
This places a heavy emotional and financial burden on families. Caregiving without proper support often leads to burnout, strained relationships, and unplanned debt.
Steps you can take now
It’s never too early – or too late – to prepare for care. Here’s a 7-step plan that offers practical ways to start:
Talk about it: It’s not always easy but have the conversation. Tell your spouse or children what kind of care you’d want, where you’d like to live, and who you trust to make decisions if you can’t.
Include care in your retirement plan: Don’t just plan for travel and groceries. Talk to your financial advisor about the cost of care and how to build that into your retirement plan.
Create a care fund: Set aside some money just for future care. Use tools like tax-free savings or a living annuity. You could also look at offshore investments to protect against the ups and downs of the local economy.
Look at your funding options: Long-term care insurance isn’t common here, but you can still plan. Hospital plans, gap cover, and flexible income from investments can help. A trust can protect your assets and make sure your care is paid for.
Sort out your legal documents: Make sure you have a Will. Set up a Power of Attorney while you’re still healthy. A trust can also help if you can’t manage things later on. Ask a legal or financial expert for advice.
Check your medical aid: Does it cover the kind of care you might need? Look for things like palliative care, step-down facilities, or disease management. If your current plan falls short, consider upgrading while you’re still in good health.
Think about your home: Is it safe and easy to live in as you get older? Would a retirement village with on-site care be better? Downsizing now could free up money for future medical needs.
It’s not selfish, it’s responsible
Planning for care doesn’t mean you’re giving up control. In fact, it’s the opposite. You’re making sure your wishes are known, and your family isn’t left to guess – or struggle – later.
Plan now, choose later
We can’t predict the future. But we can make choices today that will give us more options tomorrow.
Start now. Your future self, and your family, will thank you.
* Maria Smit CFP® professional is an advisor at Brenthurst Pretoria maria@brenthurstwealth.co.za