Editor’s note: Rajiv Nagaich is known throughout the nation as a tireless advocate for a unique perspective on long-term care planning. In over two decades of practice, Rajiv has noted with dismay how frequently the passionate desire of seniors to grown old in the familiar surroundings of home are overruled by well-meaning family members and outside experts who place a premium on personal safety at the expense of everything else. 

But as Frank, the protagonist in Rajiv’s article, might put it, “Why would I want to be 100 percent safe – and 500 percent miserable? 

 This article was written by Rajiv and published in early 2025 in Naela News, one of the publications of the National Academy of Elder Law Attorneys.  It not only reveals the heart of Rajiv Nagaich for those he serves, but it also explains, in Rajiv’s words, “the difference I bring to the table.” We’re pleased to present this important article here on the Blog. 

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If you have followed my work at all, you know it is about helping clients avoid institutional care 

without becoming a burden on their loved ones. It is, fundamentally, a perspective issue. 

Coming from India, where older adults often live out their lives without the fear that is so consuming for older Americans, I have had the opportunity to view the aging system from a different perspective. This case extends that thinking. 

A Love Tested 

Frank leaned back in his chair, staring out the window of the home he and Mary had shared for decades. The sunlight fell on the faded armchair where Mary used to sit, her hands busy with a book or knitting. Now, at 93, Frank’s hands trembled as he gripped the edge of the table. He had spent his life solving problems, managing people, and making decisions as a corporate executive. But nothing had prepared him for this — the relentless pull of time on the woman he loved and the family he had spent years building. 

Mary, his wife of nearly 50 years, was 87 and battling expressive aphasia with underlying dementia suspected. Even as her ability to make herself understood faded, her attachment to Frank remained unshakable. She might have difficulty expressing herself or lose track of faces 

and names, but she never forgot the sound of his voice or the warmth of his presence. Frank had vowed to keep her at home, honoring her wishes and preserving the life they had built together. But with each passing month, caring for Mary grew harder, and Frank knew he couldn’t do it alone. 

 A Plan Ignored 

Determined to ensure Mary’s safety and happiness, Frank reached out to elder care professionals to develop a plan. The plan was detailed, practical, and compassionate. It called for hiring 24-hour caregivers to provide the support Frank could no longer manage himself. It included a list of vetted agencies and contacts to make the process seamless. Frank, trusting 

Mary’s daughters to share his commitment to her well-being, asked them to take charge of making the arrangements. The daughters agreed to help — at least to Frank’s face. 

But the daughters had different ideas. 

Rather than following the plan, they began researching care facilities. A different perspective drove them: the belief that a professional environment, designed specifically for individuals like their mother, would ensure her safety and remove the uncertainty of home care. They saw their stepfather, aging and frail, as incapable of managing even with help. And so, the plan was quietly set aside, dismissed as impractical in favor of what they believed was a more reliable solution. 

Frank and Mary: A Bond That Endures 

Mary’s daughters saw their actions as loving and practical, but to Frank, it felt like a betrayal. He had spent decades being a father to them, standing beside Mary to celebrate their weddings and successes. Now, as he faced his greatest challenge, their dismissal of the plan stung deeply.  

For Mary, the prospect of being moved to a care facility was unthinkable. Despite her expressive aphasia, she managed to express her wishes with clarity. “I want to stay home with Frank,” she told her daughters repeatedly. She found comfort in their familiar routines — morning coffee by the window, evenings spent watching the sunset, and the quiet reassurance of knowing Frank was nearby. 

Frank knew the risks of keeping Mary at home. He even acknowledged that a care facility would guarantee her physical safety. But it wasn’t the kind of safety that mattered most to him — or to Mary. “She may be 100 percent safe there,” Frank admitted to the daughters one evening, “but we will both be 500 percent miserable.” 

To him, the equation was simple: 100 percent safe but 500 percent miserable, or 85 percent safe but 100 percent happy. Frank was willing to accept some risk if it meant keeping Mary happy and preserving the life they had built. He couldn’t understand why the daughters, who loved their mother, wouldn’t explore ways to honor her wishes while addressing their concerns. 

The Daughters’ Perspective 

For the daughters, the situation was clear-cut. Frank, as devoted as he was, was no longer capable of caring for Mary — at least not in a way they felt was safe. They saw the 

dangers lurking in every shadow: the risk of Mary wandering off again, the possibility of Frank collapsing under the physical demands of caregiving, or the chance that a hired caregiver 

might not show up on time. 

Their solution — a care facility — seemed logical, even inevitable. In their eyes, professional care meant peace of mind. They believed their mother would be in an environment designed to meet her needs, surrounded by trained staff who could provide her with security and comfort. It was a decision born of love, but one that ignored the emotional cost to Mary and Frank.  

What the daughters didn’t see — or chose not to see — was the toll their choice would take. They dismissed Mary’s pleas to stay home, rationalizing that she didn’t understand what was best for her. They didn’t consider how separating Mary from Frank might deepen her confusion and despair. And they didn’t explore ways to keep Mary safe while preserving her bond with Frank. 

A Clash of Values 

This was not just a disagreement about logistics — it was a clash of values and perspectives. Perspectives that one cannot truly appreciate until placed in the shoes of Frank and Mary. For Frank, autonomy and happiness were paramount. He believed Mary had a right to spend her 

remaining years in the comfort of her home, surrounded by love, even if it came with risks. For the daughters, safety was the overriding concern. They saw themselves as protectors, making tough decisions in the face of a difficult reality. 

Neither perspective was inherently wrong, but the refusal to compromise turned the situation into a battlefield. The daughters’ insistence on a care facility dismissed the possibility of creative solutions. Frank’s unwavering commitment to keeping Mary at home, even with professional help, was met with resistance at every turn. 

The Emotional Cost 

When Frank realized the daughters had abandoned the plan, he was devastated. Mary, too, sensed the growing tension, her moments of lucidity punctuated by fear and confusion. She clung to Frank, asking him repeatedly, “We’re not leaving, are we?” Each time, Frank reassured 

her, but the pressure mounted. The daughters, frustrated with Frank’s resistance, began to take steps to remove the decision from his hands entirely. 

They petitioned for guardianship, arguing that Frank’s own frailty made him incapable of making sound decisions. To Frank, this legal move felt like the ultimate betrayal — a dismissal of his love, his loyalty, and his ability to honor Mary’s wishes. It wasn’t just about losing control; 

it was about losing the life they had built together. 

Conclusion: Rethinking the Role of Planning in Elder Law 

Though I have lived in America longer than I lived in India as a young man, I still cannot help but 

feel that the American approach to aging leaves much to be desired. This reality is reflected in startling statistics: 70 percent of Americans do not get to live out their lives in their homes, and 69 percent of older adults at some point feel guilty about having become a burden to their loved ones. Frank and Mary’s saga is just one example of this systemic flaw — a flaw that offers the elder law community a unique opportunity to normalize a different approach to elder care planning. 

From a lawyer’s perspective, naming the daughters as agents under powers of attorney seemed like the right solution. But this approach critically missed a fundamental truth: as people age and face frailty, their perspective often shifts toward prioritizing happiness and connection over safety and risk avoidance. Elder law attorneys must learn to appreciate the perspectives their clients will adopt in their frail years and foster meaningful discussions with families early, while clients are still healthy. These conversations should clarify values, ensure alignment, and establish actionable steps to preserve the principal’s vision of happiness, dignity, and autonomy. They should also ensure acceptance of the client’s perspective on the part of people named as agents in the various documents. 

I truly believe that unless all these steps are followed, the conflicts that Frank and Mary faced will remain a sad reality for the majority of older adults. But, with different planning, we can minimize the conflicts while ensuring a more acceptable future for the clients we serve.  

(originally reported by NAELA News)