Aging With Dignity

Have your parents told you want kind of care they want at the end of life? What if they can’t communicate with you when the time comes? They need to have a document called a Living will to make their wishes known. This document is also called an advance directive.
Doctors and lawyers have been urging Americans to fill out advance directives for decades! Yet, according to the Wall Street Journal, less than a third of American adults and less than half of nursing home patients have done so. Many people don’t want to face the fact they they may become sick and not able to communicate with their family how they want to be taken care of.

Your parent might say “If I get to that point I don’t care what happens to me.” You might respond,”Maybe you don’t care, but we do!” Without specific instructions, family members may have to decide whether your parents want to be kept alive artificially, what level of disability they are willing to live with and how to let them die if they had no hope of recovery.

If family members aren’t available, Doctors generally can make the decision whether or not to discontinue medical care if future steps are futile. But many refuse to do that, largely for legal reasons. Without other instructions, in most cases, Doctors will attempt to keep a person alive at all costs.

But studies have shown, most people would not want life sustaining care if they were in an irreversible coma. On the other hand, some patients  might want to be kept alive at all costs and some religions require it.

Advance Directives are not just about ending life, however. Aging With Dignity ( www.agingwithdignity.org) is a not for profit organization that has developed a form which covers five different important areas that should be addressed. These include:

The person I want to make health care decisions for me when I can’t make them myself. (health care proxy)
My wish for the kind of medical treatment I want or don’t want.
My wish for how comfortable I want to be.
My wish for how I want people to treat me.
My wish for what I want my loved ones to know.

This form is legal in 40 states. It is not only a Living Will but It also identifies a health care proxy, an equally important advance directive. The health care proxy is a person who is responsible to carry out you wishes and make medical decisions for you if you cannot. This person must be at least 18 years of age and should not be your health care provider or an employee of your health care provider.

You can receive the Five Wishes Form through the Aging With Dignity Website ( www.agingwithdignity.org) or call them at 1-888-594-7437.

Caring Connections, a program offered by the National Hospice and Palliative Care Organization will provide you with directions on the process of end of life planning. It specifically focuses on the naming of a health care proxy to act in your behalf. You can download the forms to name your health care proxy specifically approved in your state at: www.caringinfo.org

Advance directives do not have to be filed officially. They go into effect automatically as soon as they are signed and witnessed; some states may also require notarization. It’s important to give your family members and doctors copies, or at least instructions on how to access them. Some states have electronic registries that store advance directives online. Google Health has started a similar free online service. See www.google.com/intl/en/health/advance-directive.html

And by the way if you haven’t already figured it out, advance directives are not just for your elderly parents. You need to complete them as well! Because in reality, its not just old people who get sick or have accidents.

Are you your parent’s parent?

Recently I have been giving a number of talks at Assisted Living Communities about the ideas in my book. “Can We Talk? A Financial Guide For Babyboomers Assisting Their Elderly Parents” I make a point of talking to a number of attendees before each meeting. Many of them are the adult children of elderly parents who are beginning to struggle with maintaining their own homes and leading an independent life.  I can see the turmoil their children are going through. I went through it myself.

When you see your parents making every effort to maintain control of their lives but at the same time watch that control slip away it is a very sad thing. When my mom kept getting lost making the trip from her apartment to the dining hall at her independent living community, I knew we had a problem. But I tried everything I could not to disrupt her life and keep her in an environment where she was comfortable. I didn’t want to upset her. We hired round the clock aides to assist her but after a month we realized it wasn’t working.  She became even more confused when the aides kept changing every 8 hours.

Finally my wife presented me with the cold, hard facts that I had been trying to ignore. My mother could no longer live in her lovely two bedroom apartment. We had to move her to an assisted living community that specialized in serving memory impaired residents. I was shocked and upset but I knew my wife was right.

My wife found a wonderful facility close to where we live that had only 50 residents and was known for its Alzheimer’s care. The day finally arrived when we were going to move her. I was a nervous wreck. What if she refuses to go or gets very upset? I slipped into my role as her child, not willing to become the strong parent that I needed to be. But my wife rose to the occasion.  She told my mother that we were going to a place where they would help her get back on track and start to feel better.

The first few nights were ok, but she kept asking me on the phone, “When am I going to go back home?” My wife assured her that she would stay there until she was doing better. After a few calls to the director stating that I thought this was a bad decision and my mom was ready to go back home, the director suggested I not call my mom for several days. She was absolutely right. My calls were the trigger that made her think back to her previous life and kept disrupting her adjustment.  I held off on my calls and she began to adjust.

After a week my wife stated, “we’ve got to move her furniture up to her new room and store what she doesn’t need.” Again, I became my mother’s child.  I was concerned that she would be unhappy with me or disapprove of what I was doing.  I responded with, “What if in a few weeks she demands to go home and says she doesn’t want to be there. What do we do then?” My wife replied, “ If she says that, do you really want to move her back to a place where she’ll be lost and confused? Do you think that is the right thing to do?” I knew we were making the right decision, but it seemed so hard at the time.

My mom has been at her new home for a year and a half now and she is very happy. We know that we took the right steps to change her environment and put her in a community that offered her the care she needed. I am sure that there are many other adult children facing the same decisions I had to make. Fortunately I had a courageous wife who would not let me ignore the reality before me. I learned that it is very difficult to become your parent’s parent but it is often the only thing you can do.