DAD'S HOME ALONE, Caring For Your Elderly Parent

2012-04-19T20:49:00.002-07:00

WALK-IN BATHTUBS: Is one right for you?

They are promoted for "mobility challenged" and "elderly" people, allowing you to "age in your own home". But, they are not for everybody; and there is a safe bathing alternative.

My friend, Sue, recently saw an ad for a walk-in bathtub and asked me what I thought. She has diabetes, difficulty walking and fears she may not be able to walk in a few years. She has trouble now getting out of a wet bathtub. She was excited at the prospect of a good soak in the tub. This was my word of caution:

Walk-in tubs have been available for years, but recently we're seeing a flood of ads for them. They are the answer for those seeking to soak away aching muscles and joint pain or to just relax in a tub of water, but have difficulty or are not safe stepping in and out of a bathtub. Before you part with your hard-earned cash and prepare your bathroom for a make-over (removal of the existing tub or stall shower and any necessary expansion) consider these things:

1. You must be able to "walk-in" and to negotiate a step up of at least 4". If you have a condition that limits your ability to do that or could progress to that point in the future, this tub will not be accessible
to you. A stroke, severe arthritic pain and/or joint limitation in the hips or legs, paralysis, inability to bear weight on both legs/feet, and extreme fatigue are just some of the conditions that make this tub inaccessible. You won't be able to get into it.

2. They are expensive, thousands of dollars.

3. You sit upright; I prefer to recline on those occasions when I'm seeking a relaxing soak.

There's another bathing option if you have a bathtub, but can't step into or out of it, safely.

A bathtub bench over a standard bathtub allows you to sit on the end of the bench that extends beyond the tub edge, then slide in over the tub as you, or a helper, lift your legs in. If you are unable to stand or bear weight you can do this from a wheelchair using a slide-board transfer. It will not allow you to sit down in the water, but with a shower hose you can safely and thoroughly bathe. The bench is designed to accommodate a shower curtain that will keep water inside the tub. It has an armrest on the inside end, back rest, and the legs are adjustable to fit most tubs. Some are padded, they are stable, and easily cleaned.

Go for it if you can afford the walk-in bathtub, but remember, bad things sometimes happen to good people and you could end up not being able to use it in the future. And those bathtub benches, available for under $100, do not work with the walk-in tubs

Read about "Useful Gadgets" in Dad's Home Alone, Caring for Your Elderly Parent, for more good ideas for safe and independent living.

2012-03-16T11:36:00.001-07:00

SHARE THE (PARENT) CARE: 6 STEPS

“My sisters/brothers don’t lift a finger; I do everything for dad!” (read below about the “50-50 rule”) and “My mother’s become my child!” Common cries among adult children caring for elderly parents at home. I ask in return, “Why are you the caregiver?” It’s an admirable job; after all they raised you and loved you as you were growing up; now it’s your turn. Or is It? Why only you and not your siblings? Is there another way to care for them and still show your love? There is a high incidence of caregivers’ health failing before their loved one goes.

It is a stressful job. It’s often a 10 hr/day,7 day/week job, if not 24/7, without breaks, days off, vacations, or even pay. It is one that involves chef and shopper, chauffeur, self-care manager, social events and appointment scheduler, bath aide, nursing attendant, laundress, companion, financial manager, and …. Then mom complains because you don’t do it right. And that’s just your job with her. What about your own life?

When siblings stop by to visit they see the two of you sitting there saying “everything is fine”. Or they hear you complain, but see that everything looks in order and mom tells them she is “fine”. From their point of view it looks like a pretty cushy job; how hard can it be staying at home all day? These issues can lead to family strife and conflicts that permeate throughout the rest of your lives.

The “50-50 rule” developed by Home Instead Senior Care network refers to the age when most people start planning for, or are caring for elderly parents, as well as the necessity of sharing that care among family members. Remember, the jobs get more complex as your loved one declines.

1. Plan ahead. Who is best suited and most willing to be the primary caregiver. Consider your relationship with your parent and with your own family. All family members including your parent should be a part of these discussions, as well as share the care.

2. Divide the duties: what’s needed and who can take it on? Can the money-savvy sister take on the bills and banking? And handle insurance issues? Who can take mom to the doctor, drop her off at the senior center, grocery shop, or pick up prescriptions?

3. Food preparation: can a sister or other family member prepare meals ready to eat or for the freezer several times a week of month?

4. Care for the primary caregiver: who can spend the day, or weekend with dad to give her a break? If not family members, is there a student aspiring to be a nurse, or a retired nurse/caregiver at the church? No one can be expected to do a 24/7 job, especially one this stressful.

5. Outside resources: who will contact the senior center or other organizations to find out about activities, services, and senior lunches? An outing for your parent a couple of times a week, or every day will give the primary caregiver a few hours break to handle his/her own life. And check out respite care and caregiver support groups when the going gets tough.

6. Reduce the risk for falls: modify the house for safety by using a room-by-room safety checklist (see a comprehensive one in the book Dad’s Home Alone); provide grab bars, shower seat, and a high toilet or raised toilet seat, for bathroom safety. Don’t forget a medical alert pendant or wristband. In case of a fall help is just a press-of-the button away. Falls can’t be prevented. Gravity is the same whether in a nursing home, at home, or standing next to a loved one.
Remember, elderly people, just like you and me, want to remain as independent as possible. Respect who they are and make sure your parent weighs in on the decisions. But also, know that they may not be as realistic about their safety and care needs. You are there as their safety net, not their “parent”.

2012-02-09T08:29:00.000-08:00

Advance Directive and POLST – Helping Your Parents to Help You

Is your mother elderly, you are the one who likely will be the caregiver if she needs help, and she has no Advance Directive or POLST? Do you even know her end-of-life wishes? If not, you are not alone; that’s not the kind of conversations most of us have with our aging parents – albeit, it should be. I was talking with a woman recently who’s mother, a proud, fiercely independent woman, suddenly had a stroke and lost, not only her ability to live independently, but her ability to speak. Her mother always said she would take care of herself and didn’t want her daughter to worry herself; she refused to talk about it. The daughter, during this emotionally trying time, had to figure out how to navigate the legal jungle to become the power of attorney (POA of healthcare); the legal role necessary to make the medical decisions. Then she was left to make decisions about her mother’s care, and later, her end-of-life choices; she could only guess and her siblings had other ideas. This added undue stress to an already difficult role of being the caregiver!

Have that difficult discussion NOW! And complete and file the Advance Directive and the relative new document: the POLST. This Physician’s Orders for Life Sustaining Treatment ensures that one’s wishes defined in the Advance Directive will be followed by all medical personnel including EMT, emergency room doctors out of your home area, even your own doctor. I’m sure you have heard stories, as have I, that requests in the Advance Directive were ignored by well-intending medical providers who thought differently. The POLST provides clear orders about medical interventions you want or do not want: 1. CPR or not (known as DNR for “do not resuscitate”); 2. Degree of medical treatment: comfort only – relief of pain and suffering; limited intervention only - pain relief and IVs for fluids and antibiotics, if needed; or, full medical care as needed, including hospitalization and intensive care. Additional details can be written in if the patient and doctor see fit. 3. Your wishes about the use of feeding tubes: none; short-term through NG tube (in the nose); or if necessary, a
gastric tube inserted into the stomach for long-term feeding.

The POLST form must be signed by the individual (your parent) or legally recognized decision maker (spouse or POA), and by the physician. It then is filed in the medical record. If you have a chronic or life-limiting illnesses or are elderly file copies in your living will or trust at home and with family members in case of emergencies where EMTs are involved.

As of the end of 2011 there were fifteen states with POLST programs and about 20 states in the process of developing programs. The POLST form carries no legal weight in states without a POLST program. Check online at www.POLST.com to see if your state is included and download a form.

And while you are at it, complete your own Advance Directive (you never know when something bad will happen to a good person); your children will thank you. Download forms at: www.caringinfo.com. Or better, spend a little time with an elder law attorney.

2011-04-23T20:00:00.000-07:00

WHEN DO I PLACE MY ELDERLY PARENT IN THE HANDS OF SENIOR CARE EXPERTS?

This is a difficult decision and one that many families confront, often with conflicting ideas, when their aging parent shows signs of decline. The only universal answer is, “It depends”. There is no one answer that fits all.

What does your parent want? If it’s to stay in their own home
, as is often the case, can you or other family members provide a safe environment and the necessary care to keep them there? Consider the costs to you, emotionally, as well as financially. Too often, a loving caregiver’s health declines faster than the one they are caring for.

If you are caring for your parent now or considering doing so, keep this in mind: you must recognize the stresses on you and your family; your spouse and children need you, too. Once your parent is gone, at some point they will be, will you still be there for your own family? Here are some things to consider and to discuss with other family members: siblings as well as your spouse and children.

1. What is your relationship with your parent? Are you or your parent often impatient, short-tempered, continually critical or demanding of each other? Or, are you caring for your parent now and exhausted?

2. Dementia posses challenges when wandering or other behaviors are beyond your control and are a risk to your parent and others. You can restrict their wandering by keeping outside doors locked as long as someone is with them, and it does not interfere with escape in case of fire or other disaster. You cannot lock them in a room or tie them down.
Adult protective services will step in, as they should.

3. Does he or she require intimate personal care (injections, incontinence, bed sores, other wound care, etc) that goes beyond your ability to provide? Some people are able to remove themselves from the discomfort of those tasks and provide the care, no matter what. If that is not you, don’t force it.

4. Fragile health requiring skilled nursing care is more difficult to manage at home, though not out of the question. If the doctor thinks your parent has less than 6 months to live, and you really want to keep them at home, you can engage the services of Hospice. They will provide the necessary skilled care wherever your parent is, whether it is at home or in a facility.

5. Social interaction with friends and family are important to all of us. For elderly people, who are limited in their ability to get out on their own, socializing with others where they live is important. If aging-in-place (remaining in their own home) means loneliness and isolation, then they are likely to decline more rapidly.

If any of the above applies, then hiring caregivers to provide in-home care or placing your parent in a care facility are your best options. There are numerous in home caregiver agencies. Hire a care manager to assess your situation and make recommendations. Assisted living residences are available, from homes in residential neighborhoods accommodating 5-6 individuals, to large multi-story complexes for many individuals and with many services. Some of them are sponsored by different faiths. Skilled nursing facilities, i.e., nursing homes, take individuals who, as the name suggests, need skilled nursing care. If your parent is transferred from an acute care hospital at the doctor’s recommendation, then Medicare will cover the cost for up to the first 100 days. If you admit your parent from home, you must pay the bill.

I am a proponent for keeping a loved one at home whenever possible, if that’s where they want to be. Trained caregivers are caring, nurturing people, and they are more removed emotionally, than you are. This distance enables them to manage the more difficult aspects of care while still treating them with respect, and hopefully humor. In my own experience (many others have reported this also), my father didn’t listen to me, his “child”, despite the fact that I was an elder care professional. He ignored me or often did the opposite when I made suggestions; but when his caregiver gave the same advice he would say, ”good idea”, and do it willingly. I stepped aside, supervising from a distance, and let it flow organically.

When the time comes for you to make this difficult decision, discuss it with your parent, siblings – all of them, and your own family. If you can’t all meet in person then have phone conferences, or email “conversations”. Don’t leave anyone out of the discussions – it will come back to bite you later if you do. If you parent isn’t capable of making realistic decisions include them anyway. They need to feel included and know they have a voice in the matter.

2010-12-11T11:13:00.000-08:00

Your Parent’s Caregiver: To Be – or Not To Be

7 Points to Consider

When your elderly parent is no longer able to live alone safely and independently, and he or she wants to remain at home, a caregiver will be needed. Deciding who that person should be and
what their duties need to include, involves lengthy discussions, over time with family and much soul-searching. Include your parent, and maybe an eldercare health professional and an elder law attorney.

If you decide to be the caregiver consider these 7 points.

Relationship : Of course you love your parent, But do you enjoy being around each other and see eye-to-eye on things that matter? I loved my dad and we had many good times together, but we did not agree on many things, we were both stubborn, and he, as my dad, viewed me as the child – he thought he knew better. Much of the time we were at loggerheads with one another. For that reason I hired the primary caregiver; and he and I spent quality time together.

Patience: Can you to listen to and wait for your parent to respond at her own pace even if memory and/or judgment interfere? It’s important to allow your loved one to do all of those self-care and daily tasks they are capable of, regardless of how long it takes them. Only step in to help if they clearly cannot complete what they are attempting to do, or if time is critical. If you take over tasks they are able to do, you are fostering their dependence on you and you are taking away their sense of self-respect.

Nurturing: can you help with bathing, toileting, dressing or whatever other intimate care is required without judgment, resentment, or being turned off? It is important to maintain your respect for the person your parent is regardless of their capabilities.

Your own lifestyle: do you currently have a job? Can you afford to lose an income and benefits to take on a caregiver job with neither income nor benefits? Do you have a family who needs you? Consider what it will do to your relationship with your husband or kids/grand kids?

Did you choose to do it or did your siblings pick you? You will harbor resentment if you let them talk you into it. Be sure it’s your choice. It is a hard job, both physically and emotionally, and though it may only be a few daytime hours to begin with, it could turn into a full time job or beyond – it could eventually require 24 hours a day, 7 days a week.

Respectful: Can you treat your parent with respect, regardless of their state of mind or physical abilities, or lack thereof? Though you may think she has reverted to child-like behaviors, she is not your child and she deserves your respect. She will sense it and resent it if you treat her in a child-like manner.

Insist that your siblings participate in some way. If one lives far away, can he or she be responsible for finances? Routine bills, property management and investments can be handled online. Ones who live close can come in one or two days a week (at least a half a day) to give you time off. You will need it and deserve it, as in any job, and it gives others a chance to see just what is involved in caring for your parent. If additional funding is needed (groceries, incidentals, bills) be sure the expenses are shared by all. Don’t spend down your own resources or make sacrifices that will later impact your long term care.

Helping one’s parent age with dignity at home is one of the most loving things you can do. It has it rewards, but as the primary caregiver, it can impact your life with your siblings and your own family after your parent is gone. Consider these 7 points and know that even if you hire a caregiver, whether full or part-time, you are providing your parent with the chance to age in place with love and dignity.

Read more about these and other eldercare issues in About this Book.

Gail McGonigle, author, Dad’s Home Alone, Caring For Your Elderly Parent.
Email me: gmcgonigle@att.net

2010-12-08T09:43:00.000-08:00

VISITING ELDERLY PARENTS OVER THE HOLIDAYS?

6 Safety Signs to watch for

Planning for the Holidays includes the anticipation of spending time with loved ones. But, often there’s that lurking question: “Is mom or dad ok at home alone?” The realization that our parents are no longer the vibrant folks we knew is distressing. You may start wondering
if caring for an elderly parent is in your future. Eldercare experts report senior care facilities have an increase in inquires and admissions after the holiday season.

Before you plan visits to care facilities, look for these 6 warning signs, indicators that mom or dad at home alone might be problematic. With the right equipment and a little support many people age in place throughout their life span.

As people age, everyday activities become more difficult. Physical limitations, decreases in strength and energy, and loss in mental acuity means changes will be needed for them to remain safely at home. These 6 warning signs will help you focus on specific problems you can do something about.

Driving: unlike when we start driving, there is no age when we should stop driving. Skills need to be assessed:

Recent driving history: have they had accidents or tickets? Are there scratches or dents on the car?
Ride with them driving. Do they use good judgment? Can they see in all directions? Do they hear a siren or motorcycle approaching? How are their reactions times – do they brake appropriately?
If you have any concerns, schedule a behind-the-wheel driving test with DMV. It clarifies what problems exist, if any, and what can be done to correct them. My dad was beyond help, but refused to quit driving, despite my and his doctor’s urging, until DMV revoked his license.

Nourishment and hydration: Do meals consist of snacks with little nutritive value? Dad often had a bowl of cereal for dinner. That’s fine for breakfast, but “where’s the beef” (protein)?” Stock the freezer with easy to prepare microwave dinners. Or, look into Meals on Wheels provided by the local senior center. Dehydration is the basis for many problems. Be sure they drink adequate fluids. An easy to fill and carry, non-spill container helps.

Finances: Are bills being paid on time? Are there frequent overdrafts? It may be time to assume bill-paying responsibilities. If it has not already been done, have your parent assign power of attorney for finances to someone else (a family or a professional outside the family) before there are problems.

Falls: Does your parent fall or have difficulty with balance? Falls happen, at home as well as in hospitals, but if they happen often, or they have difficulty getting up, then get them a medical alert pendant or bracelet. It won’t stop the falls, but help will come at the push of the button.

Memory changes: Are there signs of forgetfulness that could compromise safety? A pot left cooking on the stove? Medication not taken? Frequently missed appointments? Inappropriate medication could be the culprit; talk to their doctor. There are sensors, and “pill-minders” to help with some of these problems.

Behavior changes: Is mom wearing clothing with stains on it, or not groomed in her usual manner? Are there signs of depression, loneliness, or alcoholism? As with memory changes, it could be medication-related, so talk with the doctor.

These problems are not indications that your parent can no longer stay at home. They may, however, indicate that proper equipment, or occasional help are needed to continue living at home safely. Bring in a care manager or other geriatric medical professional to assess the situation and make recommendations.

Read more about these and other problems/solutions at www.dadshomealone.com.

Gail McGonigle, author, Dad’s Home Alone, Caring For Your Elderly Parent.

2010-12-01T13:00:00.000-08:00

BOOMERS BEWARE!

If you are part of the baby boomer generation, then caring for your elderly parents may be the next job you face. Will you be ready for them when they need you?
With the miracles of modern medicine,
millions of folks will reach that frail elderly stage when they can no longer live alone safely. Will one of them be your parent?

With a family of your own, a job – hopefully - and the challenges of maintaining a lifestyle you've worked hard for, finding yourself in the "sandwich generation" and suddenly needing to care for an aging parent, too, can be the final straw that unravels everything. You can’t take your aging parent out of the equation, but you can eliminate the “sudden” part of it.

You can, and should, start the difficult discussions with your parent, your own family, and your siblings now. Know what your parents want to do when they can no longer live alone.
   1. Where do they want to live? Their own home, your home, or a long term care home.
   2. Who they want to help them, if they do not want to move to a care facility?

   3. Are their legal affairs in order – advance directives, powers of attorney, will or trust?
   4. Is there long term care insurance or investments available for their care? Medicare does not pay for long term care.

Start these conversations while your parent is still active and independent. Be clear with them that you don’t think they are failing. You just need to know their wishes while they can express them, so that if something should happen, a serious accident, a stroke or dementia that renders them unable to think clearly or communicate, you and your siblings will be able to make the difficult, but necessary decisions based on their wishes. This can help eliminate sibling battles that arise out of their own wishes and opinions. “I think Mom wants …” can no longer be used as an argument. Knowing what mom wants will eliminate a whole lot of arguments and family battles later. Record mom’s wishes so that you and your siblings’ memory lapses and hearing-things-differently are minimized when in the midst of a crises. What "mom wants" should be written down or better yet, make a You Tube of your discussions with mom and send it to all the family members. Be sure to keep a copy tucked away safely with her will or trust.

When you are visiting over the Holidays, start this difficult discussion. Knowledge is empowering. Gather the information and file it away so that if and when the time comes you will be somewhat prepared to be the caregiver your loved one deserves.

The book, DAD’S HOME ALONE, Caring For Your Elderly Parent, is a great resource for these and many other issues concerning your parents’ elder care. To read about it click on "About this Book" on this website and at www.amazon.com

2010-07-16T10:40:00.000-07:00

PART OF THE SANDWICH GENERATION?
LIFE AIN’T EASY!

Got kids who still need you? And you are wondering about Mom? or Dad?

“Almost every time he called (dad) had another car ‘incident’ to tell me about. I had nightmares about him causing a serious accident
in which he or someone else would be killed or suffer traumatic injuries.” I tried everything, but it wasn’t until I had his drivers license revoked

that he stopped driving. Initially there was anger and guilt, but he was safe, and we got over it. And he got a "chauffeur"!

And then there was the first time I visited his new doctor with him. “He had his agenda and I had mine. When I finished discussing my concerns, it was dad’s turn. He asked about Viagra!”

Maril Crabtree (Kansas Senior Press 3/2010) says, ” … I wondered if I’d learn anything new in McGonigle’s account of caring for her father from a distance while he remained in his home.”
Caring for her own mother-in-law from a distance, Maril thought she was doing all she could, but the nagging question remained, “… can we do more?” After reading the book, she was reassured that keeping mom at home was the best approach since the book points out “…people live longer and age better when they are able to be at home”. But, “… most important, the rich harvest of up-to-date resources … showed us there was, in fact, more we could do.”

Cheryl Phillips, MD and president of the American Geriatric Society, says, “This resource is to caregivers what ‘Dr. Spock’ was to parents. And if you remember Dr. Spock’s parenting guide, then you probably need to read this book!”

“It’s a good read … sprinkled throughout the how-to chapters, this book comes alive with warm, often humorous anecdotes..."
“Whether we are caregivers, or the ones receiving care, (this) book is a treasure.”

So if you’ve got an elderly parent or loved one, or you plan on getting old yourself, check out Dad’s Home Alone, Caring for Your Elderly Parent, at www.dadshomealone.com. It’s available on www.amazon.com. Then tell me what you think.

2010-05-23T17:13:00.000-07:00

THE CAREGIVERS DILEMMA

“…Mom fell again…”, “I’m worried about her, I’m afraid she will burn the house down. She forgot she had the pot on the stove and walked out of the room”. Sound familiar? You have a parent in their declining years and you are starting to think it’s time to move her to a care home? She will fight you all the way, unless it’s her idea and she is young/alert enough to decide on her own to move into a senior residence, or assisted living home. If not, there is an alternative.

Most people want to stay in their own homes. I imagine I will. But if your parent isn’t safe alone, you will need to decide two things up front: When do they need someone around, and who should/could that person be?

Care 24/7 usually is not necessary unless
one has declined a lot physically, or has moderate to severe dementia. Otherwise, it’s likely they will be OK on their own through the night. Do they need help in the morning? Bathing? Probably. Getting dressed? Or getting breakfast? Maybe, maybe not. How about setting out the right pills? Likely. Maybe, for now, Mom just needs someone there in the mornings, someone to prepare meals for her, and someone close by - reachable by phone - in case she falls. Meals-on-wheels and a medical alert pendant or bracelet to call for help, are simple, inexpensive solutions. And senior day programs are a good option a couple of days a week.

But when your parent does need more care at home, get an expert – a Care Manager – to help you determine how much and what kind. The cost for that assessment will save you big dollars and much stress and agony in the long run. And the resulting decisions (the person your parent blames) can be put on the care manager, not you.

Now the dilemma. Who should be the caregiver? You? A joint effort among siblings and/or a grandchild? Or someone you hire? There really should be only two choices: a joint effort among family members, or hiring a caregiver. Making that decision depends on you and your parent. Hiring a trained person, in many ways is easier. But it will cost some money (not as much as any of the long-term care facilities outside the home) and require someone to oversee them. Is there social security, a pension, investments? Hiring part-time help might be the best way to go. Then you can spend quality time just enjoying your parent without the embarrassment (theirs) or frustration (yours) of having to deal with those difficult personal care issues. There are agencies you can hire caregivers through, but I could not find one who would come just the hours we needed. Check through the church or club you or your parent belongs to. There may be a retired nurse looking for just a few hours. Or a student studying in a health related field at the local college.

Just because you love your parent isn’t enough of a reason to take on this job. I loved my dad, but we didn’t see eye-to-eye much of the time and it was way too stressful for both of us. If you decide you are the compatible, patient, problem solver, easy going, not currently employed, best family member available for the job (and remember this is a job), then there are many rewards along with the stresses and frustrations. First thing to remember is you have to take care of yourself, too. No one can do a job, any job, 24/7. You have to enlist family members to help. You need to have days off, regularly. You need nights that you can sleep through. You need to eat well, get regular exercise, and a massage, or at least a long soak in the tub, once in a while. Too often caregivers work themselves into a physical or mental breakdown before the person they are caring for passes on. Then where are you? Get a sibling to cook meals a couple of times a week. And an other one to handle the finances, Medicare/insurance paperwork, maybe pick up prescriptions, or take mom to the doctor.

When there are expenses beyond those that can be covered by mom’s resources (her investments are there primarily for her long-term care - what’s left over is the family’s inheritance), then pull the family together, explain the needs, and insist that everyone share in the costs. You are putting your time in, you should be paid (though you probably won’t be), and you certainly should not be spending down your own resources. Someday you may need them for your own long-term care.

And get support, someone to listen to you and cheer you on. You are doing an extremely hard job, doubly so since it is a loved one you are watching decline. You deserve pats on the back, Hail Mary’s, and chocolates!

2010-04-01T09:42:00.000-07:00

PLAN FOR IT!

Will it kill you to plan for your death? These were the topics of a recent workshop and a radio community health forum on end-of-life issues. Talking about death and planning for it are difficult for all of us. “Life is about living; when death comes, then I’m gone, so why should I care!” This is a typical response to questions and attempted discussions.
         Death is part of the life cycle. You don’t get one without the other. And there is no bargaining yourself out of death. It will happen. We just don’t know when or how.
        Let me illustrate, in a couple of ways,
why it is important to plan ahead.

       When my father passed away at 92 I was not there. I could have been. He was in the hospital after a fall, one of many. His caregiver and I were planning the details for upping the care plan at home. He was like the Duracell Pink Bunny – he kept “ …going …and going ….and going”. I had no doubt he would come back home. Even when, after his fifth day in the hospital, he said to me, “I’m not going home”. I said, “Of course you are. We will take care of you”. I didn’t listen. I left saying, “See ya tomorrow”. I didn’t. I denied myself the opportunity to say “Goodbye”. I’ve always regretted it. Don’t do that to yourself.
       My story is the easy one. Many go through long drawn out declines when the parent is not lucid, not capable of making rational decisions, and the tough decisions fall on the family. Time and again, family members disagree; “Mom wouldn’t want to live like this”; “No, we can’t turn off the ventilator now”, or some other form of quality-of-life, end-of-life questions.
      An advance directive takes that decision off the shoulders of the family. It is a form hospitals require before a surgical procedure. It is a form everyone should have, no matter your age. All you need to do is read the news to know that no one is too young to die. Once you have completed the form, make numerous copies. Give one to your primary care doctor (each time you change doctors, too); the hospital, if you go into one (even if it is not for surgery); your adult children – all of them; the person you have selected as your power of attorney (if you don’t have one you should have – for the same reasons); keep one in your car glove box; one in your suitcase, if you travel; and one at home with your will or trust (you should have one of those, too).
      The will and/or trust will take care of the rest of the “stuff” of your life, so your loved ones know your wishes. Get an elder-law attorney to draw one up with you. Do not fill one out you find on line, or get a brother-in-law to do it for you; or even have your lawyer (who is not versed in elder law issues) do it. Many families have ended up in probate court anyway because the trust was not clear or complete.
      The power of attorney is a person you select who is close to you, knows you well, and can carry out your wishes when decisions must be made that are not covered by the advance directive or the will. This may be a spouse, a family member, or a life-long friend.
      Talk about where you want to live and who you want to care for you if you can no longer safely live alone. Do you really want a daughter to give up her career or take time away from her family or lifestyle to care for you? If so, talk to her about it ahead of time.
      And what about after you die? Do you want to be buried? In a fancy, expensive box? Where? Or cremated? Where do you want your ashes? A friend of mine, who never got her dream red convertible, wants her kids to drive one along a beach tossing her ashes to the winds.

TALK ABOUT IT!

2010-02-18T11:08:00.000-08:00

The Elderly are Prime Targets for Scammers!
     While talking with a friend recently she told me she's not worried about her mother. "She is 91, in great health, lives alone, does her own yardwork, housework, drives and 'takes care of old folks'".
"That's great!" I said. But is she watching out for telemarketers and con artists"?
     Unscrupulous scammers, from the local handiman who repairs the roof before the winter storms (a roof that didn't need repairs), to the telephone calls from companies pushing products that "you can't live without", to the "good samaritans"
who endear themselves to her and eventually gain her trust and her personal ID (that she unwittingly divulges over time), are in abundance and find an easy mark in elderly folks. Adult Protective Services workers and elder law attorneys across the country are reporting a rise in financial abuse aimed at the elderly.

What you can do:
      Talk to or visit your parent often. Listen to what they say. Is there a new handiman around? Check that person out. Are products arriving in the mail that seem unlikely? Ask about their finances.
Report concerns you have to Adult Protective Services in your parent area.

      Offer to take over the finances. If it really isn't a job they want to spend time doing, they may be willing to let you do that. But often, they view handling their own finances as one of the dwindling responsibilities they still have control over. Its an important indicator that they are still independent. Or, as many of them see it, "Its still my money and I'll do it myself, thank you!"

       Set up a durable power of attorney. Experts say anyone with their own assets (or over the age of eighteen) should have one. Your parents may be reluctant, but if something should happen to them and they become incapacitated, in other words, unable to talk, or make decisions (that can and does happen suddenly in cases of a stroke or automobile accident), then you would have the power to handle the legal and financial matters immediately. Your parent (not you) names a person to handle these matters if and when and to what extent your parent wishes. She sets the limits when setting up the documents. If, for any reason, she doesn't want you to be that person, then she can designate her attorney, sister, or anyone she choses. So long as she choses someone who is capable and reliable to step in when she needs help. The best way to do this is to engage an elder law attorney (some county senior centers offer this service at a low or no fee).
Protect your parents' assets and their path to a comfortable future.