Carve out Time at Thanksgiving to Talk with Family and Friends

carveouttimeThe fact that 9 out of 10 American’s will need someone to speak on their behalf before the end of their life was documented in a joint study done by the National Institutes of Health and Veteran’s Affairs.

Do yourself and your loved ones a favor by having a discussion about this FACT before you are faced with the reality. Those that step in to help will face a lifetime of guilt and doubt if you have not been clear about end-of-life wishes.

For those of us who have cared for someone with dementia, what we know is that there are years of choices to be made well before end-of-life that can be just as challenging. Telling someone I want to “die in my home” is probably not always practical, so offering some more guidance on ways you would like to spend your time if you have limited mobility or cognitive impairment.

What we know now is that isolation is a very real health issue. What is your social network and how will you be able to stay active if you can no longer drive yourself? What I have seen is that when many of my clients reach their 80s, they are finding that they no longer have local friends who can give them rides if they are still in the area. It get’s hard to make new friends when you aren’t getting out and trying new things.

This Thanksgiving, I hope you will carve out some time to start the conversation with your loved ones on how you plan to live the rest of your life. I’ve included three great resources below, and hope you might start by sharing with friends and family your ideas about how you will spend your time in your 60s and 70s; where you plan to be living and how you will be spending your time.

I am lucky my parents shared their thoughts with me. It made a difficult journey a little easier knowing that we did or are doing what we can to honor their individual wishes.

Hopefully, by reading one of these books you will get some ideas on how to best engage in a positive conversation with your loved ones this Thanksgiving. Wished.  

ADDITIONAL RESOURCES 

Being Mortal: Medicine and What Matters in the End (B&N $8.93) by Atul Gawande

It’s $11.00 at Amazon and free shipping for Prime members. 
In Being Mortal, bestselling author Atul Gawande tackles the hardest challenge of his profession: how medicine can not only improve life but also the process of its ending. Medicine has triumphed in modern times, transforming birth, injury, and infectious disease from harrowing to manageable. But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit.

AARP Roadmap for the Rest of Your Life: Smart Choices About Money, Health, Work, Lifestyle … and Pursuing Your Dreams by Bart Astor
Life after 50 isn’t what it used to be. The rules have changed. No more guaranteed pensions, retiree health plans, or extensive leisure and travel. It’s time to forge new paths and create innovative models. That’s where the AARP Roadmap for the Rest of Your Life comes in. Bart Astor, author of more than a dozen books, offers a comprehensive guide for making lifestyle decisions, growing your nest egg, and realizing your goals. It’s a positive read I highly recommend.

The Conversation Starter Kit
If you want to be the expert on your wishes and those of your loved ones, not the doctors, nurses, or end-of-life experts, check out this free resource (donations accepted) that includes easy discussion starters for the coming holiday. This doesn’t have to be a gloomy conversation. I was lucky my parents shared their wishes with me.

Three things you can do to protect yourself from fraud.

fraudprotectioniconThe number of institutions that have our data and that been hacked is only growing. The reality is that a lot of our personal information has probably been sold or can be found on the “dark web” used by these crooks.

We have the ability to defend our selves — the fact is that most people don’t do the basics to help themselves. In my role as a Daily Money Manager, I have stop being shocked by the number of auto-debits from subscription services my clients aren’t using and often don’t even know about that are on their credit card statements. To make bill-paying easy they set up auto-payments to make sure the bill got paid. However, that using results in the habit of ignoring the monthly review of your statement.

I also don’t recommend that you set up auto-debits from your checking account either. Instead of giving what amounts to a limited “power of attorney” to come into your account and take out the money you owe, set up automated payments you PUSH OUT from the account using the bill pay portal. While these direct from your checking account systems work well for many American’s, I was behind a man at the bank who had set this up for his mortgage. The payments kept being pulled after he sold his home and now he couldn’t pay his new mortgage. He was told that they only way to stop it was to close down his bank account. What a headache.

I had a similar issue with a charity pulling money from a clients’ account and thankfully, we were able to have them voluntarily terminate the automated transfer. It took MANY phone calls and follow-ups, but finally they stopped. It was a reputable charity, but they have little incentive to respond to requests to terminate donations.

Three things you can do to make sure you don’t become a victim of fraud is:

  1. Religiously review your credit card statements and address issues immediately.
  2. Monitor your checking account and balance your checkbook. I’ve recently seen a check for $2,000 debited for $3,000.
  3. Check your credit reports at least once a year and report any inaccuracies. If you aren’t at a point in your life to need credit, I would consider freezing or locking your credit. To learn more about that you can view this article.

A final step to protect yourself is to make sure you are not using your DEBIT card for any online purchases. Only use a Credit Card that offers the fraud protections should your card number be compromised.

You have the power to protect yourself, but it requires your attention.

Three things you can do to protect yourself from fraud.

fraudprotectioniconThe number of institutions that have our data and that been hacked is only growing. The reality is that a lot of our personal information has probably been sold or can be found on the “dark web” used by these crooks.

We have the ability to defend our selves — the fact is that most people don’t do the basics to help themselves. In my role as a Daily Money Manager, I have stop being shocked by the number of auto-debits from subscription services my clients aren’t using and often don’t even know about that are on their credit card statements. To make it easy they, or a loved one, set up auto-payments to make sure the bill got paid. However, that means that NO ONE is looking at the statements in most cases.

I also don’t recommend that you set up auto-debits from your checking account. Instead of giving what amounts to a limited “power of attorney” to come into your account and take out the money you owe, set up automated payments you PUSH OUT from the account using the bill pay portal. While these direct from your checking account systems work well for many American’s, I was behind a man at the bank who had set this up for his mortgage. The payments kept being pulled after he sold his home and now he couldn’t pay his new mortgage. He was told that they only way to stop it was to close down his bank account. I have recently had a similar issue with a charity pulling money from a clients’ account and thankfully, we were able to have them voluntarily terminate the automated transfer. It took MANY phone calls and follow-ups, but finally they stopped. It was a reputable charity, but they have little incentive to respond to requests to terminate donations.

Three things you can do to make sure you don’t become a victim of fraud is:

  1. Religiously review your credit card statements and address issues immediately.
  2. Monitor your checking account and balance your checkbook. I’ve seen a check for $2,000 debited for $3,000.
  3. Check your credit reports at least once a year and report any inaccuracies. If you aren’t at a point in your life to need credit, I would consider freezing or locking your credit. To learn more about that you can view this article.

A final step to protect yourself is to make sure you are not using your DEBIT card for any online purchases. Only use a Credit Card that offers the fraud protections should your card number be compromised.

You have the power to protect yourself and your loved ones. Recommended. 

Take Control of Your Credit Now.

CreditfraudfreezeGiven the number of breeches, especially for a loved one that doesn’t need to open a line of credit, it’s time to either put a FRAUD ALERT or a SECURITY (Credit) FREEZE in place.

Fraud Alert tells creditors they need to take reasonable extra-steps to confirm that it is you asking for credit. It lasts for 90 days and includes a free credit report.

Security Freeze locks your credit and requires action (and for now $10 to lift the freeze or re-freeze it) on your part to access credit. It took me about 30 minutes to do it online for all three. Be forewarned, you will have to be able to bring up past credit history and addresses — which is why I am an advocate of having one place for writing it all down. A great tool (it’s my book) can be found on Amazon.

I choose to use a Security Freeze for myself since I don’t foresee many situations in which I will be applying for credit in the coming years. Here are some links to each of three big bureaus:

Equifax Link to Freeze your credit: https://www.freeze.equifax.com

Experian Security Freeze: https://www.freeze.equifax.com ($10.00 fee)

Transunion Security Freeze: https://www.transunion.com/ ($10.00 fee)

Watch out for the upsell. Many of the sites will try to get you to buy their monitoring services. I don’t recommend those because I have found they just make you more concerned and the truth is that you have the ability to put the protections in place for free or a minimal cost.

To view the story on the report from Consumer Reports, click here.

Please let me know what you chose and what you found if you initiated one of these services. Protected. 

It’s time to lock our credit.

CreditfraudfreezeIf our lives as caregivers weren’t busy enough, there is one additional step to consider if you are caring for a loved one. Given the number of breeches, especially for a loved one that doesn’t need to open a line of credit, it’s time to either put a FRAUD ALERT or a SECURITY (Credit) FREEZE in place.

Fraud Alert tells creditors they need to take reasonable extra-steps to confirm that it is you asking for credit. It lasts for 90 days and includes a free credit report.

Security Freeze locks your credit and requires action (and for now $10 to lift the freeze or re-freeze it) on your part to access credit. It took me about 30 minutes to do it online for all three. Be forewarned, you will have to be able to bring up past credit history and addresses — which is why I am an advocate of having one place for writing it all down. A great tool (it’s my book) can be found on Amazon.

I choose to use a Security Freeze for myself since I don’t foresee many situations in which I will be applying for credit in the coming years. Here are some links to each of three big bureaus:

Equifax Link to Freeze your credit: https://www.freeze.equifax.com

Experian Security Freeze: https://www.freeze.equifax.com ($10.00 fee)

Transunion Security Freeze: https://www.transunion.com/ ($10.00 fee)

Watch out for the upsell. Many of the sites will try to get you to buy their monitoring services. I don’t recommend those because I have found they just make you more concerned and the truth is that you have the ability to put the protections in place for free or a minimal cost.

To view the story on the report from Consumer Reports, click here.

Please let me know what you chose and what you found if you initiated one of these services for you or a loved one. Protected. 

Honesty and Dementia

honestyI work with a client who has some cognitive impairment and an Alzheimer’s diagnosis. After we work on bill payments and review his accounts, I take the mail to the post office. Well, I took two birthday cards for his daughter, promised to put stamps on them, and mailed then without stamps!

I called him and told him what I had done and suggested a solution. I would pick him up to go get new cards, then fed-ex them to they arrived on time. He chuckled at me and and told me not to worry about it.

I gotta say, I was sick about it. I didn’t want his daughter to be disappointed or think he forgot her birthday. Watching a loved one change is so difficult, and I didn’t want her to think he didn’t remember her birthday, or was to a point that he couldn’t get off a card.

It’s the small things that sustain us and make a difference. I needed to let him, and his daughter know it was my failing.

But, there are some issues when honesty hurts. When my parent’s were fighting me and my siblings because they felt like they were doing fine, I thought getting different doctor’s to confirm their diagnosis might help. I sat with them through three different doctor’s telling them they had vascular dementia (mom), and Alzheimer’s (dad). I finally realized it didn’t matter what the diagnosis was, I needed to figure out how to help them and the truth of the matter was inconsequential.

The journey to care for a loved one is tough and will challenge you in ways you never imagined. I hope you will take the time to be kind to yourself and know that you will make the best decision you can with the information you have when it needs to be made. When will what you know or honesty hurt and when will it help is a lesson I still keep trying to master. Confessed. 

Sense of Purpose Equals Happier Seniors

BeingMortalEventPicI’m involved in the local village for my town. We hosted an event with Dr. Atul Gawande, the best-selling author of Being Mortal. Over 300 residents joined us to watch Dr. Gawande talk and discuss how we can prepare my home town of McLean, VA for the rest of our lives. There is no simple answer.

Every adult should read his book. Not only does it frame the issues we face as caregivers, it gives us the facts about how to better plan for the rest of our lives.

Story after story discussed how simple things like caring for a pet, a plant, being able to make bad choices for yourself, all enhance the lives of those that need help with the activities of daily living. Just because someone needs help getting dressed, or reminders to help them navigate their day, doesn’t mean they no longer have the need to be needed.

The book delves into how many communities focus on safety, which is what the kids/loved one might want in a community. However, the person that is moving wants autonomy. And often, those interests conflict.

Several papers have recently run the story by Judith Graham “Retirees with a sense of purpose seem to do better health-wise as they age”. Apparently, dozens of studies have shown that seniors with a sense of purpose in life are less likely to develop Alzheimer’s disease, mild cognitive impairment, disabilities, heat attacks or strokes, and more likely to live longer than people without an underlying motivation to “give purpose to their life.” The article goes on to discuss that most often what is lost is the opportunity to contribute meaningfully, rather than the interest to do so.

For those of us caring for loved ones, are their ways we can incorporate more responsibility into their lives? If mom gives up her car keys — can you make sure she can still volunteer at church? If you move dad from his home, can he take his dog and still care for him? Instead of doing it all for them because it’s quicker, are there things you can give them to tackle? Sorting socks, folding towels, watering plants?

For most American’s, “independence will become impossible” (Being Mortal). Unless we have an instant death, someone is going to have to speak for us and the statistics say 9 out of 10 Americans will need someone to speak on their behalf before they die (Veteran’s Administration & NIH Study.) Are we even ready for the rest of our lives?

It’s time we reconsider how to have a good life all the way to the end. Is there a way you can help make this difference in someone’s life now?  Challenged.

** If you are looking for resources to help you, check to see if there is a local village in your area. They not only have social opportunities, and vetted resources, but also might be able to offer some ways to volunteer back into your own neighborhood. You can visit this page to see if there is a village near you. 

Elder Fraud: The Silent Epidemic

elderfraudstoryFinancial fraud is stealing $36 billion from our elders every year. So often, they don’t recognize it or they are too ashamed to tell family members for fear of repercussions. The Equifax breach is just one more in a long line of complications. One of the things you might do for yourself and your loved ones is to put a lock on your credit. When you need it, you can unlock it, so it will require an extra step … but that is GOOD!

To learn more about getting a free credit report and how to put a lock on your credit, visit this site hosted by the U.S. Federal Trade Commission. 

For those worried about loved one, I found doing things for myself first and talking about it or asking advice was one way to have a discussion with my parent’s about what might be an uncomfortable topic. When we needed to redo the Durable Power of Attorney for my parents, I first talked about who I listed and why. Even with a diagnosis of dementia, both of my parent’s were deemed to have decisional capacity by a doctor. And we could and did have a conversation about the issue and it resulted in making changes that they understood and were comfortable with.

It might be a good time to bring this up with a parent you are concerned about. After you go through the process yourself, you could suggest it for mom and/or dad, and let them know how easy it was.

The first step is to take a look at your credit report. As I recently shared, I found that accounts of my deceased mother were listed on my credit report. You never know what you might find! The next step is to consider putting a lock on your credit. It won’t protect your or your loved ones from exploitation, but anything you can do to minimize yours, and your loved ones risk, is a good thing.

To learn more about some of the scams you can watch this CNBC report. Shared. 

 

When an Independent Living Community isn’t always the Right Solution

choiceThe choices you are faced with when you are stepping in to help are many and varied. One adult child was telling me how she just got her dad to move into an independent living community and dad was still driving. She shared that he was diagnosed with Alzheimer’s so they wanted to get him somewhere and he seemed to be doing pretty well. I understand the hope to at least get them into a place that is more attuned to help, and that offers other levels of care when needed.

However, what most people don’t truly understand, or interview the community about, is how the community will be able to support the resident. The daughter was thinking “phew, we got him into the community,” but Independent Living is just that — there is no safety net. The dad was probably forgetful at home, and that won’t change, but will most likely increase after the move. Are there options to hire support for this while he is living Independently? Will he accept it?

Is it safe for him to continue driving? You would hope that his doctor would help with this issue, but in many cases, the doctor doesn’t have time to discuss it. Dad is going to need to go get groceries, will he be able to find his way safely from the new location?

When and how does the community help make sure the Dad is in the right environment.? Some communities offer day programs for people with memory loss, while others will force a move into Assisted Living.

My parents were in Assisted Living. After my dad passed away, my mom was very isolated because most of the other residents didn’t want to sit with the lady who couldn’t remember their name or that she had already ordered lunch. We ended up moving mom into a Memory Care community outside of the community she lived in because in her community most of the memory care residents were at the end stage of the disease. My mom wanted to walk and be active, but she needed cues and help getting dressed, and some one to make sure she ate.

The reality is that when there is cognitive decline, making changes earlier gives your loved one a better chance at adapting to the new environment.  You just want to make sure that it will also be the right place after the move in.

However, please recognize that you also have the option to help them stay in their home with assistance, and then find an Assisted Living or Memory Care community that is best for them as they are moving into a later stage of their disease.

Life Care communities (or Continue Care Retirement Communities) usually require a large down-payment. Will they really be able to live out there years in that community?

If you are at this juncture, I recommend finding a local Aging Life Care Manager who can help discuss the options in your area. It will save you hours of time, could save you hundreds of thousands of dollars, and help ensure you find the right community for your loved one and be prepared for the changes that will come. Experienced.

 

Some related blogs include:

We were forced by the community to move my parents.  My parents refused to move from their apartment until the community threatened to evict them from their apartment.

Making the transition to Assisted Living when your parents refuse. The process we went through to move my parents when they refused.

 

 

 

 

My deceased mom’s accounts were listed on my credit report.

creditreportexpIn the wake of the Equifax breach … which joins a long line of security breaks … I suggest you take a look at your own credit report now.

I often talk about how to help mom and dad and manage through being the adult family caregiver, and often one of the best things you can do is to lead by example.

You can get a free copy from the three major bureaus once a year, and it’s worth doing. When I recently ran my own reports, I found that my mom was listed along with some of her credit history. My mom passed away almost two years ago.

To get your report, visit: AnnualCreditReport.com 

You should not have to pay ANYTHING, so if you are being prompted to pay, you are on the wrong site. If you are just doing a check up, I would request all three. When I did this for myself recently, on the first one from Equifax, everything appeared to be in order. When I got to Experian, it provided more details and showed some accounts from my mom, who is now deceased. It also had several misspellings and listed former work addresses as former residences. It took around 45 minutes to get through the customer service system to the person that could help me. I found the same errors on the TransUnion report. They were very helpful in getting the issues corrected.

The good news is that corrections get shared with the other credit bureaus, and Experian is going to send me a note when the updates have been made and shared with the other bureaus.

In the wake of the breach, you might also consider putting a lock on your credit and recommending that to mom or dad as well. It won’t prevent the exploitation that is rampant and costs seniors $17 Billion a year, but at least it’s a start to having a positive discussion with your loved one. Hoped. 

 

What can you do when your help is not wanted?

lifesaverIn the course of a few days, I talked with two different adult children who are trying to help loved ones but being told their help is not needed. This stage is the worst in my opinion for many reasons. The first is that it is the time when changes can be made to extend the life the individual or couple wants. Cognitive issues don’t go away by ignoring them, and early action offers the most opportunities to make choices and find good solutions for continuing to enjoy life. Unfortunately, you may have to wait until there is a critical failure before you can step into help.

In both cases, the husband is caring for a wife that clearly has some form of dementia. To the husband, I believe they are trying to maintain the life they have been leading and not recognizing how much the quality of life for the spouse, or for them, has changed. First, see if you can step into the spouse’s shoes. What is it that they are afraid will change if they try to get the care their spouse will need? This is the time when they fight hardest to maintain their lives.

Please recognize that the individual with cognitive issues often don’t recognize they have a problem. It’s a medical condition called Anosognosia and what you might not be privy too is how much the husband tried to point out these issues only to create a fight with his wife. He might feel like he is keeping the peace and protecting his spouse.

If there are other adult children, can you get all them together to present a united front? Do the have good friends who might join you or neighbors they trust that have reached out with concerns? My siblings and I did this twice. Our parent’s politely declined our suggestions both times. My siblings all followed up these visits (they flew in from different parts of the country) with letters. Both my parents had cognitive issues and no short term memory, so they truly believed we were making up the issues we cited.

If you have siblings that won’t help, or encouraging your parent to ignore the feedback from the other kids, you most likely have to wait for the critical failure.

I realized that my frequent visits to stop-gap the issues my parents were having (turning back on the water, showing up to get dad off the floor on a regular basis, meeting the police when they broke into their home and called them to report a burglary) was enabling them to continue leading their lives. The decision to not show up one night and my suggestion that my mom call “911” resulted in my dad ending up in the hospital and helped us implement some better solutions for their health and safety for the time being.

If you feel they are neglecting their loved one, you might consider calling in Adult Protective Services. I would at least call them to see if they have some suggestions. Typically they are unable to help unless there is imminent danger.

The reality is most likely that the spouse feels terribly alone and has no one to talk to. They want to protect their privacy and often won’t bring this to the attention of their physicians. Most doctor’s don’t have the time to even help someone navigate a what it means to have mild cognitive impairment or dementia.

So what can you do?

  1. Listen, suggest, offer. But back off if you get no.
  2. Wait for the failure, and be ready to help when you are invited in.

I wish I had more suggestions, but sometimes you can make someone else do what you believe is right, they have to be ready. Witnessed. 

 

For some other articles related to this topic:

Sometimes you just have to be sneaky: After meeting with my parents, this is what the retirement community psychologist suggested when my parents refused to accept the help they obviously needed.

Someone broke into your house? What happened the night my parent’s call the police to report a break-in.