Moving Mom to Assisted Living

Four weeks ago my mom contracted a stomach virus and was sent to the hospital to recover. While she was there the Doctors discovered that she also had a urinary tract infection. After a week in the hospital she was sent to a nursing home for rehab. When I visited her there I noticed that her memory had deteriorated dramatically. She thought I was my Dad (who died 10 years ago) After three weeks in rehab. she had gained enough strength to return to her independent Living Retirement home. But we were told that she would need round the clock aides for a few weeks.

A week has gone by now and it looks clearer that she will need extensive care for some time. Using aides from a service firm is costing her $400 a day. Her memory has improved somewhat but she is still confused and gets up several times during the night to see if the door is locked and to go to the bathroom. We cannot continue to pay for private aides because it will end up costing $12,000 a month.

Unfortunately we live 3 hours away from Mom’s home. We have decided we have to find a facility closer to us, possibly an assisted living facility that helps those who are memory impaired. The most difficult step now is to convince her to make that move. She has a number of friends in her community. But the real question is will she miss those people? Will another move cause her fragile memory to deteriorate even more? Do we need to tell her what to do or get her approval.?

We are meeting with her doctor on Friday. Out of that meeting we may convince her that the doctor recommends that she move close to us. I am very anxious about telling her she’s got to move. I don’t know how she will respond and what the result will be. I know one thing. The current situation cannot go on for very long or her assets will disappear and she will have no choices.

Preparing Yourself For The Family Meeting

Once you have created an agenda for the Family Meeting and discussed it with your parents and their trusted adviser, you are ready to have the meeting. Although it seems like a very difficult and perhaps impossible task, I assure you that once the Family Meeting occurs, everyone in the family will be thankful. For many families, issues like finances and death have carefully been avoided at family gatherings for years. But it is on everyone’s mind. It’s like the big white elephant that sits in the middle of the room that everyone tries to avoid but cannot overlook.

Once communication has opened up, a burden has been lifted from the family. There is a lightness and freedom to discuss topics that were left unsaid for a long time. Future family gatherings will be less stressful because doubt has been removed and everyone knows where he or she stands. Your parents will experience much more comfort and less anxiety facing the problems of growing old knowing now that the family is working with them.

You may find that one or two family members will try to undermine the meeting, using the excuse that it will upset your parents or will uncover old issues that shouldn’t be discussed. But don’t let them deter you. Consider the alternative. Do you want to keep everyone in the dark until after your parents have passed away and then deal with everything in a crisis mode? Or do you want to discuss things rationally and clearly with your parents and siblings so that everyone is included? The choice is yours.

But if one of your siblings does not want to participate or warns you that an open conversation with your parents is dangerous, thank them for expressing their opinion, but do not be deterred from having the meeting. Encourage them to attend. Consider either audio or video recording the meeting and providing them with a copy. Get them involved in any way you can. You do not want them coming back to you five years after your parents have died and inferring that everything was done your way and they didn’t have any say. Don’t give them that weapon to use against you.

Elder Mediation Resolves Family Conflicts

“My daughter is insisting I move in with her,” complains Martha. “She just wants to control my life and take away my freedom,” she continues.

Jenny, Martha’s daughter worries that her mother keeps falling, and fears one day she will break her hip or hit her head.

“I’ll take my sister to court before I will let her get control of mom and my inheritance,” exclaims Jim about Jenny’s desire to move her mother in with her.

It is amazing how quickly formerly cordial relationships between family members will sour when the family has to deal with care of elderly parents or inheritance at their death. Sometimes the consequence of dealing with the final years of elderly parents can break families apart and create long-lasting animosity.

The National Care Planning Council has seen an increase in requests from caregiving children for help in solving disputes with siblings. In one case, the caregiver was being sued by her sister for abusing their parent and stealing the Social Security checks. In another, the caregiving child would not allow siblings to see their mother, claiming they would take advantage of her.

A lot of times it is a “she said,” “he said” situation with neither party really understanding what the elder person needs or wants.

Some families find it hard to communicate with each other when their parent is in need of care. Perhaps when they grew up together they were not accustomed to come together as parents and children to work out problems. And now those children are older and taking care of parents and they don’t have this family council strategy to rely on. It may seem unnatural to them. But that is often exactly what is needed, especially in situations where perhaps one child is caring for the parents and the others are left out of the loop.

Children all have a common bond to their parents and as a result a common obligation or responsibility to each other. When disagreements arise, suspicions begin to grow. Suspicions or distrust often lead to anger and the anger often leads to severing the channels of communication between family members. This can occur between parent and child or between siblings or between all of them.

It is often at this point that a neutral third party can come in and repair the damage that has been done and help correct the problems that have come about because of the disagreement.

A practitioner experienced in elder mediation is a perfect choice for solving disagreements due to issues with the elderly.

Dementia Dilemma

For the past several months my 88 year old Mom has had difficult moments. On a few mornings she woke up and thought she was in her old home  and not at the independent Living Community she had moved into. Once in awhile she thought she was at the Senior Center waiting for a friend to pick her up, but every time I went to see her she recognized who I was and seemed relatively lucid.

Then things changed. She caught a very uncomfortable stomach virus and had to go to the hospital to get treatment. While she was there her alertness diminshed dramatically but she still recognized who I was.  After four days in the hospital she was moved to a rehab. facility. I went to visit her there and she surprised me by calling me by my father’s name. I had become my father. After an hour visit I told her that I had to go home and would be back in two days. She was very angry with me expecting me to stay there with her. There was nothing I could do to diminish her anger. She expected her husband to stay with her or at least visit her every day. When my father was very sick with Parkinson’s she visited him every day in the nursing home and she expected him to do the same for her.

How do I respond? Do I go along with her and become my father for her? Or do I continue to remind her that I am her son. She was very angry today when I called her, asking why I was not with her. Then she asked me how long we had been married. I was in a no win situation. I told her I would see her three days this week and she was very unhappy, expecting more.

Dementia is a very elusive force, slipping into the background one moment and returning with power a few hours or days later. It seems to appear in stages, at first a moment or two here and there, then just in the mornings and now as a full time agressor. I felt very confused and depressed when I first noticed that my mother no longer recognized me as who I was. I had always feared that this would occur someday. But now it is here and I must come to grips with it. Should I embrace it as part of my Mom’s existence or fight it and her every chance that I can?

Do Your Parents Have a Durable Power of Attorney?

Estate planning is such an ominous term. Most of us try to avoid it as long as possible because it deals with our death and ultimate demise. I would rather we rename it “Transition Planning”. It is the planning we must do for our parents and ourselves to avoid legal delays and complications when the ownership and/or control of our assets shifts to another person or entity.

I have observed a number of situations where estate planning was not done properly. One that is still vivid in my mind involves one of my clients who was a retired physician. He was failing both physically and mentally when his wife decided to place him in a nursing home. She began making decisions regarding his finances, continuing to use their joint check book to pay the bills and make purchases, etc. Then without warning, she was contacted by the attorney of the Doctor’s first wife’s family stating that she had no authority to act in his behalf even though she was his second and current wife.

The family alleged that she was acting irresponsibly and making financial decisions that would result in the depletion of the Doctor’s assets so that nothing would be left for his  children. Unfortunately,she had no document that stated she had the right to act in his behalf. She was forced to go to Probate Court to prove that he was incompetent and become his conservator. (A conservator has the legal right to act on behalf of a mentally incompetent individual.)

She had to testify before a judge in probate court that her husband was incompetent—an event that proved very embarrassing for the whole family. The judge ruled that the Doctor could not handle his own affairs and his wife was named as his conservator. But the legal process took more than a month.

The whole mess could have been avoided if the Doctor had signed a very short three page document called a “Durable Power of Attorney” while he was still healthy. This document gives an individual the right to make financial decisions for you when you are no longer able to make decisions for yourself. A regular power of attorney only allows you to act in the person’s behalf if they are mentally competent. The “Durable” power works regardless of the individual’s mental state.

The Magic Of The Family Meeting – Part One

Transforming your relationship with your parents about money is not an easy task. With the right tools, though, you can do it. You will be able to discuss issues and topics that were previously off-limits and figure out ways to work in tandem with your parents to improve, modify, or change their financial circumstances. You will have a new sense of freedom in your communication with each other and no longer fear the forbidden topics of money and death.

But to get to this place, you will have to take a series of well-planned steps that require your patience and persistence. The first step is to plan out a Family Meeting to sit down with your parents, review their finances, and help them make plans for their future. This family meeting is an integral part of your new relationship and has a number of different pieces that need to be put in place before the meeting occurs. If these pieces are not prepared properly, the Family Meeting can become a disaster; resulting in hurt feelings, anger, and possibly the breakdown of all financial communication.

The Family Meeting should be planned well in advance to avoid any such nasty surprises. One of the most important things to do first is to identify who amongst the children is most appropriate to coordinate and lead the meeting. This is the child that parents can easily communicate with, the child that they are comfortable discussing their personal affairs with, and the child that has no fear in asking them important questions.

The second person you want to involve in the Family Meeting is one of your parents’ trusted advisors. In your own case, your most trusted advisor might be your financial planner or your accountant. But that might not be true for your parents. In their generation, they might not have had much contact with a financial planner. They may never have used an accountant to prepare their taxes. Take a look at their situation. Who did they turn to when they had a family crisis? Who have they sought out when they had financial questions? That is the person you want. It may be a family lawyer, a local bank executive, or even a minister, rabbi, or priest. The important thing is that your parents are comfortable with them and trust their advice.

The trusted advisor’s role will be to present the idea of the family meeting to your parents and convince them (if necessary) that it is a good idea and will benefit the family. He or she will also share with them a list of topics to be discussed at the meeting.

In Part Two we will discuss the Agenda of the Family Meeting.

Are You The Alpha Child?

Who is the “Alpha Child”?

The Allianz Life Insurance Company conducted a study they defined as “The American Legacies Study”. They gathered information by conducting over 2000 interviews with Baby Boomers and their parents. One of the findings their study revealed was the existence of the “Alpha Child.”  This is the child that keeps the family connected, who is always the first to make sure that family gatherings occur on a consistent basis, and communicates often with his siblings and parents. He or she is the child who the parents are most comfortable discussing money issues with. This is the person we want to organize and co-facilitate the Family Meeting.

The Alpha Child in your family may be you. Examine your relationship with your parents. If the above listed characteristics describe you, then it is most likely that you are that person. But don’t let your ego get in the way. Be objective in your evaluation of your relationship with your parents and your siblings’ relationship with them. If you are married, discuss it with your spouse and ask for his or her feedback.

Obviously if you are the only child, you may think that you don’t have a choice. But in some cases if you are the only child, your spouse may act in the capacity as the Alpha Child. Your parents may have more confidence in talking over issues with him or her than they do with you. After all you are their child and they may never give your opinions the same weight as your spouse or another person outside the family. Your husband/wife might be brilliant in your parents’ eyes. There is no reason why you shouldn’t take advantage of this situation.

I am an only child and I have acted as my mom’s financial advisor since my dad passed away almost 10 years ago. But every time I give her an investment recommendation and it works out, she seems to remember that it was an idea my wife came up with. So whenever we need to discuss an important financial issue with her I discuss it with my wife first and she will often propose it to Mom. It has a much better chance of getting adopted than if I brought it up.

Caregiver = Angel

Approximately one year ago I learned what it was really like to be a caregiver and the receiver of care. In December of 2007 I had ankle surgery and was told by the Doctor that I couldn’t put weight on the ankle for six weeks. As a result I was confined to a wheelchair and a walker ( I had a terrible time using crutches) I needed help taking a shower, getting into the bathroom, couldn’t negotiate stairs and generally had a difficult time taking care of myself.

I was home and away from work for over a month. During that period of time my wife had the primary responsibility of taking care of me.  I learned how frustrating it was to be relatively helpless. But more important than that I realized the pressure I put on my wife to take care of me. Every time I needed something I expected her to be immediately available to get it for me. I often found myself calling out her name ( sometimes yelling it) and waiting for her to arrive to fulfill my request. One time when she was in the basement washing clothes I yelled her name for a good twenty minutes. I thought she had left the house and gone somewhere,  I panicked.  I found that I often became irritable and grumpy when it took her more than a few minutes to respond.

Our caregiving experience only lasted about 30 days. I  imagined what it would be like if Mary had needed to take care of me for months and even years. Then I thought of some of my client families with one spouse debilitated by a stroke, Parkinson’s Disease or dementia.  And of course you know who the caregiver is 90% of the time. It is a wife, daughter or daughter in law. How many of us men would have the stamina and patience to take care of a spouse or our parents?

These women are angels. They take better care of their parents and husbands than themselves. But unfortunately this takes a toll. They often have to leave the workplace to take care of a family member. As a result they often lose income, retirement benefits and seniority inside their company. But worse than that they often suffer physically from being a caregiver. Stress and physical exhaustion takes it’s toll, often making them sicker than those they take care of.

We must take care of these angels, our wives, daughters and daughters in law. Because we know that they would take care of us.

Young@Heart

Last night I had the privilege of watching a movie entitled Young@Heart. It is a documentary showing a group of older people (average age 80) who get together with a chorus director (Bob Cilman) and form a chorus which sings such contemporary hits such as “Every Breath You Take”, “Yes I can,can” ‘I got you” and many others. The  movie is absolutely heart warming as it shows these elderly folks rehearsing two to three times a week to prepare for a concert, some leaving their hospital beds  to get to rehearsal.

While crying, laughing and dancing as I watched the DVD, I realized something very important was being shown to us. When old people have a purpose, a passion, they live longer, more satisfying lives. Steve Martin, one of the chorus members (not the comedian) said it well. “If you stop moving you will become a target”. During preparation for the concert two members of the group died, but the chorus continued on, dedicating their efforts to their fallen friends. And even those who passed on, up to their dying day, were trying to make it back to rehearsals and sing.

This is a strong lesson for us and our parents. What are your parents’ passions? Encourage them to stay involved in the activities they love and even find new ones to explore. Hopefully they will happen upon an angel like Bob Cilman, the chorus director of Young@Heart who nurtered the members along the way to enjoy and expand themselves. It’s not such bad advice for each of us, no matter what our age. Follow your passion. Stay involved and grow a little every day.

I encourage you to watch Young@Heart. Better yet, watch it with your parents. You will all be inspired.

Protect your parents from fraud

I didn’t realize how much elderly people were prayed upon by scam artists until I met with one of my elderly clients recently. He is a retired physician who was a very bright, savvy individual but is now beginning to lose some of his mental sharpness. I met with him and his wife at their home. His wife informed me that he had been receiving 8-10 calls a day from various scammers claiming that he had just won the lottery. They told him that all he needed to do was pass on his bank account information to them and the award would be transferred to his account. More than once his wife encountered him reading his bank account information over the phone to a total stranger.

When I met with my mom at her retirement community (she’s 88) I just happened to take a peek at her mail. 4 out of 5 pieces she received were from organizations requesting money for one reason or another. One was an organization claiming that she was part of the group that had been short changed by social security. They were raising money to approach congress and change the laws to get her money back. It included a very official looking certificate sent by a very  reputable sounding senior’s organization.

I recently read a very good book entitled “The Boomer Burden” by Julie Hall, The Estate Lady (www.theestatelady.com). Her job is to help adult children clean out the homes of their parents when they pass away or move into a retirement community. She cited many shocking incidents of children, friends and family members taking advantage of elderly people. She stated that 50 percent of elderly Americans are victims of financial exploitation. The average age of a victim of financial exploitation is 78!

Julie makes specific recommendations in her book to help adult children protect their parents from fraud.

1. Register your parents telephone numbers with the National do Not Call Registry (www.donotcall.gov/)

2. Discuss with them the list of common frauds ( described in her book) and ask them to contact you if they suspect that anyone is trying to defraud them.

3. Ask your parents to contact you if anyone offers to buy their possessions.

4. Make sure a family member personally visits your parents on a weekly basis.

5. Reduce your parents junk mail for a small fee by going to either of these websites; www.stopthejunkmail.com or www.greendimes.com

Julie points out that an excellent source of information on the many financial scams that your parents may face is the National Center on Elder Abuse. (www.elderabusecenter.org)

Probably the single best piece of advise I can provide is for you to stay in touch with your parents. Be available when they get calls from doubtful people and visits from scam artists who want to do home repairs or claim to be a bank examiner. Communicate with them and know what’s going on in their lives.