I am compelled to share these stories with you, sad as they may be. I hope you can learn from the way others handled what was supposed to be doing the right thing. Or so they thought.
I am compelled to share these stories with you, sad as they may be. I hope you can learn from the way others handled what was supposed to be doing the right thing. Or so they thought.
The Tribune News in San Luis Obispo reported the story with little detail, but did report that George Taylor was convicted of aiding and abetting the suicide, after the couple had long ago agreed to a suicide pact. They had been married since 1947, and apparently had this agreement to die together. Only George somehow failed in his own attempt.
One odd part of the story was why they chose to try to carry out their pact together at that particular time. Neither was suffering from a terminal illness, and they were financially secure. They had adult children. According to the report, they agreed with the philosophy of Dr. Jack Kevorkian, an advocate of physician-assisted suicide.
What Does the Light Sentence Mean?
Mr. Taylor had already served the two day jail sentence, so essentially, the consequence of the event was probation for him, and living with his failed attempt to keep the pact with his wife. He was ordered to get counseling.
The court’s light sentence may reflect an underlying philosophy that elderly people do have a right to die, even if assisted by a loved one. The result would probably have been very different if George had been a younger person.
Is our society evolving in its attitude toward elder suicide? It is clearly an emotionally laden area, with sharp differences in personal, religious and moral beliefs. Do we, as a society have a right to insist that someone who does not want to live must do so? If a loved one begged you to help him or her die, would you be able to do it? Would you be able to refuse, particularly if the person were suffering?
A Personal Story of a Suicidal Client
My only personal experience with this issue was in representing a client who was in the later stages of multiple sclerosis. She was wheelchair bound, paralyzed and had the use of only one arm. She was able to do some things for herself, but depended on a caregiver to help with all activities of her daily life. Her case had nothing to do with her disease, and it was resolved. Before she received her settlement, she asked me to find her a lawyer who would come to her apartment and draw up a will to specify who would receive her settlement funds. I did so.
She said that she would not be here any longer by the time her settlement came in. She gave me specific instructions as to how to distribute the settlement funds to her loved ones. She said that she was losing the ability to use her arm and that she soon would be unable to eat or drink by herself. She had decided long before that when she reached that point, she did not want to live any longer. Her time had come.
Although I suggested counseling, speaking to her clergy person and the suicide hotline, she was adamant that she had done all that already and her mind was made up. I felt sad, conflicted and yet resigned to do as she asked. I complied with her wishes, as my lawyerly duty required that I do.
I learned shortly afterwards that she had indeed committed suicide. No more was said about it by anyone. I mailed the checks to the person who was the executor of her estate and the file was closed.
For a long time afterwards, I thought about it. I believed that she did have the right to do what she wanted to do but I could not escape the feeling of sadness, my own tears, and somehow wanting her to feel that her life was worth living. The matter was under her control and no one had to decide whether to help her. She chose to exit before she lost that control.
Perhaps George Taylor and his wife also wanted to make their choices before losing control. Perhaps some change was going on that others did not know about and that was what prompted them to act when they did. We won’t know the answers. What we do know is that end of life issues remain controversial in our society. We confront our feelings about them in our own hearts. In the meantime, the idea to live each day as if it were your only day is a good one to embrace.
Until next time,
We hope you are well and that none of you have to go through the experience we just had.
The physical therapist didn’t get around to seeing my brother that day until after 4pm. After an assessment, the physical therapist cleared him to go home. The person who arranges transport of a patient to home at this hospital is the case manager. She was also supposed to see that everything was ready for the patient to leave the hospital, that all the necessary medications were available and that his personal belongings were with him on discharge.
My brother has aphasia since the stroke. It is hard for him to say what he wants some of the time. Another brother, who is the only family in his area, was told that discharge would probably happen that day. The case manager said she would call back when a time was firm for the transfer. But the discharge process didn’t get completed until after 5:00 pm. That was when things fell apart. The doctor was out of town that afternoon and the next day. I got a call from my hospitalized brother: ”When am I supposed to go home?” he asked. Some of his words weren’t clear but I got what he wanted to know. We all wanted to know. “I’m not sure”, I said . “Maybe they’re going to keep you there until tomorrow.”
There was no communication from anyone at the hospital with any family member about time of discharge or whether he was cleared to go. Nonetheless my brother was hustled into the ambulance and driven the short distance back to his apartment.
The scenario I am describing is unfortunately not a rare occurrence. The hospital discharge process is supposed to follow rules and procedures. The hospital is required by law to provide for a “safe discharge”. Sending a vulnerable person home without his needed medication is dangerous and could have deadly consequences. Human error in the chain of people who were in charge of my brother was repeated by several of them. These things happen often enough that you should never totally trust that they won’t happen to your family member. Things do not go smoothly sometimes. No matter how good a hospital is, there are risks and mistakes everywhere.
What Can Family Do To Help?
If you have a loved one who must be hospitalized for any reason, family members need to be on alert. Do not trust that every person involved in discharging your loved one will do as their jobs require. No one followed through to get the hospital pharmacy to give my brother a supply of his antibiotics to get through the next day or two until he could get a pharmacy to give him the required amount of his pills.
2. If the doctor has ordered anything new, ask about whether your loved one got what he or she was supposed to get. Too often someone drops the ball. Discharge errors are common, especially nights and weekends. Missing medication can be a life or death matter.
3. Keep a checklist of personal belongings and valuables he or she brings in and be sure it is checked off when your loved one leaves.
Until next time,
Mikol here. We hope this finds you well.
Today, I want to share with you an experience I had with my Mom, who was 86 when this happened.
My Mom, Alice, was computer phobic before Dad died. She wouldn’t even touch a computer and walked away when Dad tried to teach her. My Dad spent hours on the computer every day. She always refused learning. She was quite stubborn about it, too. Then, Dad was gone after a brief illness.
After we got her settled trying to learn how to live alone, she realized she would have to depend on her kids to pay her bills, not because she didn’t have money, but because Dad always banked online and she didn’t know how. She didn’t like the idea of being dependent on us. But even though her seniors community had computer classes, she was not willing to take a class. I was going to have to be her teacher.
I was able to convince her that she just had to learn to use the computer, at least a little. She told me she regretted not learning from Dad, but she was ready now. The motivator in her case was the unwillingness to be dependent. Maybe that will motivate your elder too. It’s worth a try.
I flew out to spend a couple days with her and I sat with her side by side as I showed her the most basic elements of a computer. She is not a particularly fast learner, but I am patient and she did learn. If you have an aging parent who is open to the idea, I encourage you to try this. If you can’t do it, a willing grandchild might be a good teacher too. Learning to pay her bills online made her so happy. She is really proud of her independence.
Many seniors are online now, but there are still a lot who aren’t. Of course the internet allows more and better connections to others, increased enjoyment of communication and the fun of mastering something new. It can also allow you to monitor your aging loved one’s financial activity, as a protection against scammers. It can open a new world of email, Skype and other useful applications.
Some elders may be embarrassed that they don’t know a thing about a computer and won’t go to a class for fear of showing their ignorance. In that case, a kind and patient attitude and offer by family to help teach them can get past their resistance.
As a caution, I need you to consider that some aging loved ones will not be able to learn something new. Any aging parent with dementia, Alzheimer’s or other cognitive problem will have trouble learning. It’s not their fault of course, but it is what to expect with cognitive impairment. For others, we wish you the kind of good luck I had in teaching my Mom to become basically computer literate. It serves her to this day.
Until next time,
Thoughts On Turning 66
66! Yikes! Isn’t that when you’re OLD?
I looked in the mirror and I didn’t see an old person, so maybe it’s a myth. I definitely didn’t see a young person though.
I had lunch with my daughter and she asked me if I feel 66. I said, “yes and no”. The “yes’ part is that life experience teaches us quite a lot. I’m very happy about that. I have more confidence as a 66 year old human being than I ever could have had as a young person. There can be no substitute for decades of dealing with and solving problems, of survival through hard things, of seeing our own progress in striving to get better at something. When we can make it through all that, we are “seasoned”. I rather like being seasoned. It certainly feels a lot better than being anxious, fearful that we won’t make it, unsure of our skills, or pressured to climb whatever ladder is before us. I’ll take seasoned any day.
The “no” part is that my image of 66 from the distortion of youth’s prism was that feeling 66 would be about feeling old. About slowing down or being less interested in having fun and adventure. We know that’s not true! , I’m happy to report that I’m having more fun than ever at this point. I work because I want to work, doing things I feel satisfied doing. I am using all those years of experience in nursing and in practicing law combined in an effort to be useful to people whose elders and parents are failing in their health. Their stories aren’t fun, but I like being able to help them solve their problems.
I am one of the lucky ones in excellent health at 66 and I am grateful every day for this. One thing a nurse can learn from working with thousands of patients and clients is to appreciate all we have in the body and mind that works. One spends a lot of days facing folks with body parts or minds that don’t work. You get perspective that way. A friend or classmate dies suddenly. You get perspective that way, too.
If I can take a walk on a beautiful day, it’s a gift. Every body part works fine. And going beyond a casual walk, I can jog, bike and run, sometimes all in the same event (triathlon). Never mind that in my county’s triathlon three months ago I was the oldest woman registered to complete the event. I can just celebrate being able to do it at all. And I do celebrate. With carrot cake.
I am among the millions of Boomers who have recently reached this milestone or who will do so soon. We are glad and sad about some things. We are already experiencing the loss of dear friends. It sobers us.
I also think it’s a time to celebrate a lot of things. I think about the political power we have as a group. I think about how we have changed society and will continue to do so, just because there are so many of us. I think about how we, as a generation are changing the concept of aging. I love it.
So, if you, too are a Boomer, celebrate with me. Raise a glass to a different and evolving idea of aging. Toast to the beauty of experience and being wiser than we were at 20. Find your joy in showing the younger generation that we know how to live these years in a meaningful way. We already changed the world when we were young. Now we can change it again as we get into the next phase of our seasoned lives. We can share life’s lessons with others. We can set an example of being responsible. We understand that we must savor the moment. We can have a wonderful time appreciating what we are and all we have. Let the beauty of this time of life shine on.
Carolyn and Mikol here.
As a nurse and attorney, I can tell you I really had a problem reading about a nurse who refused to give CPR to a dying resident in the seniors’ community where she worked. I got a sick feeling in my stomach. But there is a lot to this story.
The 87 year old woman who collapsed at Glenwood Gardens was Lorraine Bayliss. The nurse there was on the phone with the 911 dispatcher who was desperately begging the nurse to get someone else to give CPR when the nurse said she wouldn’t because of ”company policy”. It shocks us because nurses not only know what to do in emergencies like this, they are supposed to care enough to do it.
I was not surprised to learn that there was “company policy” about a nurse in an independent seniors’ residence not giving nursing care. The law does not actually allow what we think of as hands-on nursing to be given to residents who are not in a skilled nursing facility (nursing home). Neither the state nor federal departments of health license or regulate independent living or assisted living homes. However, the horrible image of a nurse standing by refusing to permit anyone else there to get emergency instructions from the 911 dispatcher is most disturbing, no matter what kind of a home this was.
If the nurse was precluded from giving CPR, what was she doing there in the first place? She was not working as a nurse, but as a resident services director. OK, but shouldn’t she deal with an emergency, even if it’s not her job?
A nurse who is on scene should be able to do what any trained lay person can do: administer CPR when someone stops breathing. If there is an Do Not Resuscitate order then no one should resuscitate the elder. The nurse should then see that no one calls 911 and the person’s wishes should be honored.
In this case, no Do Not Resuscitate (DNR) direction was in place. Ms. Bayliss’s family believed that she wanted “to die naturally and without any kind of life prolonging intervention”. Glenwood Garden’s policy about what the nurse should do in an emergency was sufficiently unclear that owner Brookdale’s public statement was to the effect that the nurse had “misinterpreted the company’s guidelines.” What those guidelines were is not certain.
We have legal documents that allow anyone to make quite clear what they want in an emergency such as stopping breathing. There is a DNR statement or order. There is an advance health care directive to guide others who must decide. This uncomfortable, ethically questionable, confusing scene over Ms. Bayliss’ end of life did not have to happen the way it did. If you don’t want to be in that kind of situation, you need to be responsible for deciding what you want and communicating it to everyone, including assisted living.
Either you want emergency intervention or you don’t. If you are clear that you do not want to be resuscitated when you stop breathing, let the people where you live know what you want and put it in writing. Post it in a prominent place and give it to the administrator of any seniors residence you choose as your home. If you don’t want resuscitation and you stop breathing, no one should call 911. Paramedics will attempt CPR every time. CPR is definitely life prolonging intervention. It is not always so straightforward as stopping breathing, or a sudden event.
Perhaps Lorraine Bayless left us all with an important wake up call. Independent and assisted living senior residences need clear written policies about resuscitation of residents. If nurses happen to be working there, they should not be frozen in place when a resident collapses and CPR can be administered by someone, including themselves. They also need to know residents’ wishes. Residents should be required to spell out their end of life wishes and emergency instructions and these should be available to those in charge. And each of us needs to face the reality that no one gets out of here alive. We need to think it out, write it out, and do our loved ones and those who help us the decency of making our wishes clear to them. If a person wants no resuscitation, we have to accept the idea that we don’t have to “do something” if they stop breathing.
If your loved one is facing terminal illness or a fragile medical condition and you haven’t figured out what your loved one wants at the end of life or in an emergency, now is the time to talk about it. If this is uncomfortable to the point you’re not doing it, let us help you. Get a free 15 minute consultation on practical expert tips to get the conversation going. CLICK HERE for your consultation request form.
Until next time,
We hope you are doing well.
We’ve been talking to Mikol’s Mom, Alice a lot lately about her house. Now that she’s 91, she’s considering that a large sprawling house is just too much. Sometimes, an elder stays on in the family home until the end. Then the family has to clear the place out, while sad and overwhelmed. Deciding what to keep and what to toss or give away can be agonizing. No matter when you do it, it’s a chore nobody wants.
In our case, we have been saved a huge burden by my mother in law, Alice. She’s taking on the task herself, at 91!
She has done us a gigantic favor by making a decision about the house. She is going to sell it and move to something smaller, and rent. She’s already packing.
Alice is doing really well, living independently, still driving during the daytime, and participating in life. She takes very good care of herself. She has been widowed for over 5 years now.
She’s doesn’t want assisted living, or even an apartment in an independent living situation. She considered those options and rejected them. The places she saw were too small, or not in her own retirement community where she has lived for many years. She thought she would have to give up too much if she moved from the gated, all seniors neighborhood where she has been for some time. She would lose her connection to all the social activities she enjoys there. They don’t let “outsiders” participate.
Besides, her frequent workouts are walking up and down in the lovely, Olympic sized pool and she really needs that.
So, she took a friend’s suggestion and found a great little house to rent. No more homeowner’s dues, or worrying about what happens if something breaks. No more responsibility of home ownership. It’s the landlord’s problem now. The size of the rental home is more manageable for a single person and she will be only a short distance from her old home, so she knows where everything in the community is already.
We’re impressed by her ability to manage this enormous task. She has help from the moving company with packing. She is right on top of changing her utilities to the new address, getting her mail forwarded, and all the details of a move that might baffle anyone, much less someone over 90. We are not only amazed, we’re very grateful.
She is cleaning out every closet, giving away unneeded items, selling some furniture, and choosing what she really wants to keep. She is saving us from doing all of it. We’re glad she is making her own choices about everything. Mikol and his sister will be there on moving day to help unpack and get her set up. The moving company helps with unpacking as well.
There are some sad parts to this move, as all of her memories of being with Dad, to whom she was married for 62 years are still there. She is bravely coping with this, and taking her time to get through it. Transitions are seldom easy. This one is done in a well thought out way that will likely be excellent for Alice as long as she can remain independent. As her health is good and she really works at keeping it that way, her doctor says she could live to be 100. So this may not be a short term proposition!
We’re cheering for Alice. The model of smart downsizing she provides might be something other elders would consider too. She is leading the way to make things better not only for herself but for her family as well. Here at AgingParents.com, we now have a recommendation for independent elderly parents who don’t want assisted living or apartment living, but are ready to give up the too-big house. Downsize. Consider renting a smaller place and make your own decisions. It makes a lot of sense to us.
Until next time,
When aging parents come to the point when assisted living seems like the best choice, it is usually their baby boomer children who see it first. Perhaps the adult children live in another state. Perhaps they are unable to visit Mom or Dad often enough to feel comfortable leaving them alone. The death of a spouse or a gradual loss of independence in self care—any of these reasons may lead to the adult child’s decision to move the parent. As an assisted living facility representative is likely to tell you, it is often the adult children who first come to look the place over, later bringing their parents to see the place for themselves. These adult children are the hidden consumers of services.
Assisted Living vs. Skilled Nursing
As the hidden consumers, what do the adult children of aging parents need to understand about these facilities? Very simply: what the facility can’t do. Invariably, the sales pitch tells you what the facility can do, which is fine, and to be expected. But as a consumer, you must understand the difference between assisted living and nursing care. First, an assisted living facility is not a nursing home with fancy furniture. Assisted living is not licensed to give nursing care. Typically, assisted living facilities are places where elders live in a supervised community, with some personal care services available. Meals, social activity, and help with the activities of daily living such as bathing and dressing are all usually offered at such facilities. The focus is on providing a healthy social environment and preventing social isolation. It is a worthy focus, as isolation is dangerous, and widespread among elders whose independence is declining.
If your parent is in fragile health and seems to be steadily declining physically or mentally, be cautious about choosing an assisted living facility over a nursing home (also known as a skilled nursing facility). No one chooses a nursing home first. Nursing homes are more like hospitals, which they must be to deliver skilled care to frail seniors. But if your aging parent needs nursing care, and must be watched day and night, or you believe that he or she is likely to need such supervision in the near future, it is the only choice. Assisted living facilities are not licensed by Medicare or Medicaid to give skilled care. Some have a separate skilled nursing facility on-site or nearby, but it will have its own license to deliver skilled nursing care. That license does not apply to the assisted living component, even the two facilities are located on the same campus or are operated by the same parent company.
Doctors & Nurses Not Required
Many assisted living facilities do not have any licensed nurse on staff, and may have no nurse connected to them at all. Because they are considered non-medical facilities, having a licensed nurse is not required by law. Even if a nurse is employed by the assisted living facility, the nurse cannot give hands-on care in the form of dressing a wound, administering around-the-clock insulin, administering oxygen, or other tasks that are defined by the federal and state governments as “skilled nursing care.”
Skilled nursing care may only be administered within a facility that is licensed to do so. Legally, it is called a skilled nursing facility, though it may have a different business name by which a consumer finds it, such as “extended care” or “long-term care”. Medicare and Medicaid designate these homes as skilled nursing facilities. Because skilled nursing facilities bill Medicare and/or Medicaid for this type of patient care, they must comply with many complex legal regulations and requirements. Assisted living facilities are regulated by the state Department of Social Services, not the Department of Health, which regulates nursing homes. Assisted living facilities do not have the same safety or administrative requirements as a skilled nursing facility, and they are prohibited from giving care they are not licensed to give.
Limitations to Specialized Care Waivers
There are exceptions to some of the federal and state government’s licensing requirements. For example, a licensed assisted living facility may take care of residents with dementias, including Alzheimer’s disease, if it has a waiver to accept this kind of resident. The facility must also have certain protections in place to prevent injury to its demented residents. However, it is still prohibited from restraining a demented resident who has a tendency to wander. There are many other limitations to what an assisted living facility can do, even with waivers. Taking care of residents with dementia can be unpredictable, and skilled nursing can become necessary as the disease progresses.
When an aging parent has to move out of the family home, or out of a long-term residence of any kind, the move can be difficult, even traumatic. If you are considering assisted living as an option for your loved one, be sure your focus is on the long run. Carefully consider what he or she will need a year down the road. Moving an elder twice within a short period can be extremely hard on both of you, so make your decisions based on the overall picture, not just on what the assisted living facility can do for him or her right now.
As hidden consumers, adult children must be fully aware of the limits of assisted living. Assisted living facilities can be wonderful and supportive environments for residents who don’t need skilled care. If you are considering assisted living for your aging parent, be sure this kind of place is a match for your parent’s needs.
Editor’s Note: For more information on this subject, visit AgingParents.com
Is Assisted Living Dangerous to Elders?
As many of your may know, my brother had a massive stroke and was hospitalized for weeks. He went to a rehab facility (aka nursing home) where he got physical therapy, speech and occupational therapy. When it came time for discharge, a decision had to be made: go to a less than ideal assisted living on a state program for low income people like him? Or, have family pitch in and pay for a much better place? Family decided to come together to pay the cost of care, beyond what his humble disability check would enable him to access.
After he was moved in to this reasonably priced, comfortable spot with great caregivers, in his own neighborhood, the family hassles began anew. ”We didn’t know it would cost that much”. They began to argue about why he was there, how long he would be there, how come he was so poor and why didn’t he just move out of the area altogether. One family member said he would essentially move my brother out and dump him on my doorstep 600 miles away, in so many words. ”Because of my medical expertise”. Right.
Remove him from his community, his friends, his weekly physical activity that is therapy in itself, his peace of mind and his recent adaptation to a new assisted living situation because you didn’t think it would cost that much? (Incidentally, this person can afford the contribution).
In discussing this with friends and colleagues, I am finding common ground. Many of us are involved with less than generous siblings who would rather criticize and blame than help. When it comes to THEIR money, they go to astonishing lengths to get out of helping the one in great need. If it’s not about finances, the refusal is about help with the work of caregiving.
A dear friend was describing how she had to save her ailing parents, living in a dangerous situation, from themselves and from a dreadful end. She brought them into her own home, in process of being remodeled, because the situation was so dire. With construction going on, there was only one bedroom available. She and her husband slept on a mattress on their living room floor to accommodate her ill parents. The need for care was constant. She asked a sibling for relief, so she and her husband could get away for a weekend. Her sibling said she would come for those days but wanted my friend to pay her for spending time with her parents for the weekend!
I can imagine that many of you have stories like these. Shocking, sickening, sad. Families are not made up of people we pick. That’s why we have friends after all, as they are our chosen family. In my own family, the drama goes on and could escalate. When you have a person with financial need it either brings out the best in family or it definitely brings out the worst. I am seeing some of the worst and one demonstrating the best. It’s very trying, and I am so glad I have a compassionate husband in Dr. Mikol Davis to help me through it. He does not hesitate to help both financially and physically. What a blessing! You can be sure I am grateful for every one of the 31 years we’ve been married.
What will happen going forward? No one knows. I have learned from Mikol that you do not have to engage with all the drama, you do not have to respond to every nutty email or demand from your family. That is a lesson worth sharing. From this, I hope any of you in a similar situation will take something from his wisdom. Not only does he have almost 40 years in the field of mental health, he practices what he preaches. He lives an upright life and does the right thing for its own sake. As for me, I know that I am also doing the right thing. I work on being at peace with that all by itself. I wish for you the peace of mind that comes from appreciating yourself.
Until next time,
P.S. For more on aging in a healthy way or for help if you are struggling with a loved one reaching the end of life, contact us at AgingParents.com for a complimentary 15 minute consultation. Click HERE to sign up now.
Who would ever think of a reverse mortgage being a form of financial elder abuse? There are some hidden dangers in these products and you need to know about them. Unsuitable mortgages are abusive. They are not right for some people over 62.
We’ve just come back from solving a very stressful family situation that got worked out. We’d like to share the experience with you.
After my 63 year old brother, already disabled, had a massive stroke, I wondered. How could he be cared for long term? He went from the acute hospital to a rehab facility for speech, physical and occupational therapy. He has been making steady progress, but as many of you know, Medicare does not pay for long term care. The limit of time in a rehab place like this is 100 days. One must be getting
better in order to even qualify for that much. The limit loomed closer.
The prospects about where he would go next did not look good. He did not have enough income to pay for assisted living, which averages about $4000 a month where he lives. He has no other resources. He simply cannot live alone, as he is single and has no children and he needs daily help with a few different medical issues.
A nursing home? The thought of a nursing home bed, long term, in a shared room under Medicaid was depressing. My brother is capable of doing most daily activities by himself. He would probably be the youngest person in the place, at least the youngest who could walk around on his own. He would not want a family member to take him in either. He wants independence.
Working out how to care for him was problematic. I have siblings, but no one was on the same page. Does this sound familiar? Lots of families argue with each other and mine certainly did. No one volunteered an alternative to sending him to his apartment, which would not work, or sending him to a nursing home, which was not a good alternative either.
I asked for a care conference at the rehab facility. Nursing, rehab and social services representatives met with the siblings and discussed my brother’s care needs going forward. Assisted living seemed to be the best solution. Then an unusual thing happened: all siblings agreed that it would be better to chip in for assisted living in a good place than any other option. They agreed to come up with enough to cover his costs in a very decent place close to his apartment, where he knew the neighborhood and where his friends can socialize with him. His income together with sibling contributions would be enough to make it work.
As we are in the consulting business for those with aging loved ones at AgingParents.com, Mikol and I are very familiar with assisted living and what it can and can’t do. I checked out the place one sibling had found. It was fine! He will have a small one bedroom apartment with a kitchenette. He likes to make his own snacks, so that is great. He can eat a healthy meal in the dining room anytime he wants, with their policy of flexible dining. The place is tidy and pleasant with a little deck outside his room where he can get some sun and sit in the warm Southern California air.
I brought him over to see it before the paperwork was signed. I was half expecting resistance. While I’m sure he’d prefer to be on his own, he knows he can’t be right now. He has trouble with words since the stroke but he did say something important when he looked at his deck: “This is nice”. I was hugely relieved.
So my normally dysfunctional family has shown up, separately or together to help pack up our brother and get his new place ready for him. As the only nurse in my family, it will be up to me to coordinate his transition with speech therapy and other care needs. A home health nurse, which I used to be myself, will visit his new place, evaluate him and send a speech therapist. It takes a lot to make all of this come together but it can be done.
If you are dealing with any of these issues yourself, we would like to hear how it’s going for you. For some states, an Assisted Living Waiver Program is available to pay for the cost of care homes for those who would otherwise be forced into nursing homes because of being low income. Waiver programs provide nursing in a limited way in assisted living or board and care homes. We checked out that option too, but found that the places on the list for state support through that program were not very good. If you can pay anything more than a loved one’s Social Security or disability check, you have more good choices.
Meanwhile, keep your fingers crossed that the move goes well and he settles in. We’ll keep you posted.
Until next time,
Carolyn Rosenblatt & Dr. Mikol Davis
We have posted a quick video thanking for being a part of our AgingParents.com family.
We offer you our heartfelt wish for a healthy New Year.
Holiday get togethers are a must for many of us. It’s tradition, or it’s expected, or it seems like the right thing. We can be stressed and we can also look forward to them a lot. They can be fun, even if it’s work to put it on or get there, traveling during a busy season.
Gone in a moment. I was so grateful that we had the party and so glad he came and enjoyed his time with everyone. I didn’t think or know that it would be the last time I would ever see him. It never occurred to me that a person my age would be gone so suddenly. Yes, we’re aging, and we’re boomers, but I didn’t think of him as “old”. He was my age.
Just this month my mother Alice at age 91 years young returned from a 15 day cruise to the Hawaiian islands with our daughter for her 30th birthday. We are blessed.
Only about 25% of older adults have taken the time to think about what would happen if they became incapacitated, and have filled out a healthcare directive. This seems pretty unfair to their adult children. Why put the burden on the kids? Each person has the right to decide what kind of care he or she should get near the end of life. Why do so many of us resist this subject?
No one likes to think about being incapacitated. Becoming incapacitated can happen to anyone. That’s when you need this document, and your family will wish you had one. A healthcare directive is not complicated, but it can save family fights, give you the security of knowing that your wishes are clear, and help everyone know what to do in the event that you are no longer able to speak for yourself.
What can cause you to be unable to speak for yourself? Lots of things: head injury, stroke, emergency surgery, being put on a respirator because of trouble breathing, and many more.
How do you get a healthcare directive? It’s not difficult to get the document, as it is available from your doctor, the hospital in your area, and on the internet, for free. It’s available on our website, AgingParents.com in the Toolkit, which you can download.
Filling it out takes some thought. What do I want to have done for me if I am near the end of life? What treatment do I want to have? Are there circumstances under which I would want treatment to be stopped? Who will have the power to decide for me if the time comes that I can’t speak for myself?
The person who makes decisions for you is called your “agent” or proxy. It’s very important to pick the right person for the job. The most emotional person in your family is probably not the one. An adult son, daughter, or other relative, or a trusted younger friend are persons to consider. Above all the person who is going to be your agent should be someone who will honor your words and your wishes, and be able to put his or her own feelings a
side if the agent does not agree personally with what you want.
It might make a good New Year’s resolution to take care of this basic responsibility right away. It’s an essential part of being a mature and considerate person. Although most of us are uncomfortable with the idea of being incapacitated, it is something we all must consider as possible for ourselves in the future. In considering the possibility, we can make things clear to those we care about so that no one is forced to speculate about it when it’s too late for us to say what we think.
You don’t need a lawyer to fill out a healthcare directive. It’s a good idea to speak to an attorney if you are not sure about what the document means, or you need help filling it out correctly. Otherwise, just get it done, give a copy to the person whom you appoint to be your agent, and keep the original in a safe place with your other important papers, such as your trust, will, and property records. Your family will be glad you took this step if the time ever comes when they must act on your behalf.
© 2013, AgingParents.com
Grandma Alice age 88 years old demonstrates how to use a Apple Ipod, technology she never thought she’d learn to use. She has a message for all other senior citizens about how powerful this new tecnology can be a real practical solution for senior loneliness . “This is good if you’re alone. It’s good entertainment. I can fit 16 books on this little thing”. Watch this brief video for practical solutions for helping and coping with loneliness
And you may be thinking about some past problematic holidays and hoping this year will be different. You know that saying, “you can’t change other people, but you can change yourself”? Well, you can change how you manage these events with a strategy to deal with the difficult people you may encounter. They could be your elderly relatives or anyone you’ll see at holiday time.
Holiday visits bring people with underlying issues together. Otherwise, they may avoid each other. Unfortunately, family conflicts can heat up at these get togethers.
Meanwhile, we both wish you peaceful holiday gatherings and may your own personal stresses be kept to a minimum.
Until next time,
Carolyn Rosenblatt and Mikol Davis
Sometimes, there’s just no substitute for a face to face visit. Adult children may be getting a wake-up call this season when you visit aging parents. Little things you can’t learn in a phone call can come to light.
Their health may be a concern because you see visible changes on your visit, such as weight loss or the appearance of neglect. Their cognitive skills may be a worry because you notice that they are having trouble tracking the conversation. Or the memory loss you chalked up to “just getting old” is now a significant problem. Sometimes, they just look frail.
What to do?
My colleague who markets for a large assisted living facility says inquiries and visits to see the place are way up at this time of year. No wonder. Adult children who live out of their parents’ area want to know what to do if there is a “next step” needed. That makes sense. The problem with that is, you’ll likely face parental resistance. They don’t like change and especially don’t like the idea of giving up the family home. Approaching the subject requires finesse and respect. Get professional advice if this entire area overwhelms you. If you plan what to say and when to say it, you will do better than moving ahead without thinking too much about it.
A visit to your parents during this time of year is an opportunity. If you don’t see them every day, use the visit as a reason to take stock. Take your cues from what you see to take action. Here are five essentials you need to know.
1. Do they have legal documents, such as a durable power of attorney for finances, and a health care directive (“living will’?). If they dont’ have them, perhaps you can help get them going. One can prepare them without an attorney if you are comfortable with this, and the documents themselves are free. One day, you may be very glad you did get these in order . If your parents do have them, learn where they are stored. It can help to get a copy for yourself, especially if you are named as the “agent” on one or both of these documents.
2. Are there any plans for managing at home with help if they need it? If grocery shopping, cooking, or bathing is getting difficult, it’s time to consider who could help and how to arrange for help at home. How to finance the help must be discussed.
3. If you are worried about their isolation being at home without help and without social contacts check out suitable alternative living situations. Do your research and visit a few prospects. It may get the conversation going about necessary change.
4. If paying bills on time and keeping track of finances is an issue, find out if your parent is willing to accept your help with managing the money. Offer to take over the responsibility. Perhaps you can get your parent’s permission to open an online account and automate the bill paying task with your oversight or help.
5. Learn what to do if a health emergency arises. You’ll need to keep a record of your parents doctors, medications, diagnoses, and day to day health management. This can save you from panic when the time comes. It’s just about inevitable with aging parents that some health crisis is going to come up sooner or later. And this is where the discussion needs to happen about end of life wishes. Prepare yourself by being sure of what your parents want with the legal document (#1, above) you will need.
Holidays can be so busy, it may be easier to just overlook any danger signs you see with aging parents. Here’s hoping you won’t overlook anything. Take a deep breath, prepare yourself to face these responsibilities and lead the way. As your parents continue to age, you will feel much greater confidence when you are prepared. And as I tell my husband, the work of being prepared good modeling for our own kids. I want them to have it easy and know just what to do when it’s our turn to be the aging and maybe frail parents. According to our 20-something kids, we’re already the aging parents!
Until next time,
Carolyn Rosenblatt & Dr. Mikol Davis