Mom is back in the hospital

cargiverburnoutWhen the primary caregiver fails, it’s really hard to quickly pick up the pieces. In this case, Mom has been caring for Dad with Alzheimer’s, but now Mom has health issues that landed her in the hospital.

If the caregiver ends up in the hospital, the mad scramble from Plan B begins.  Most families are totally unprepared and it surprises me how often this happens given all the data available to educate us on how important it is to have a plan in place.

According to the Family Caregiver Alliance nearly three quarters (72%) of caregivers reported that they had not gone to the doctor as often as they should, and more than half (55%) had missed doctors appointments.

More alarming is that elderly spousal caregivers (aged 66-96) have a 63% higher mortality rate than non-caregivers of the same age.

If you have a parent who is filling this role, it’s time to sit down and have a real conversation about how to create a Plan B should something happen to them. Is there some way to help them now before a crisis? What can you do now to be prepared to easily step in if they are unable to fill the day-to-day role of caregiver?

Maybe over dinner or a cup of tea, could you ask:

  • Tell me about your average day. How often and how are you helping mom/dad?
  • If you fell and ended up in the hospital, what could I do to help mom/dad?
  • Have you found any local support groups?

Spousal support groups can really help since many will discuss how to set up Plan B as well as how to minimize the stress of caregiving. In fact, I heard these stats from a support group leader.

The best way to help is to start from a place to help the caregiver be successful. Most of the pushback I see is when the family wants to take over. Start by asking for a job you could do to help them both.

Trying to put plans into place from the hospital or from another state just creates more stress for everyone. I hope you will have an opportunity to discuss this before you may ever need to use what you learn.

If you need to get some immediate help to navigate medical issues, I hope you will look into finding a local Aging Life Care Manager. You can learn more or search for one in your area at www.aginglifecare.org.

If you want a guide to start having a conversation around what you need to step in and help, you can use this list of key documents and information you would need to help manage the finances and maintain the household.

The reality is we should all have a Plan B in place. I hope this guide will help get started. Shared.

49% of Americans Retiring Earlier Than Planned

The latest U.S. Census reports that there are 44.7 million over the age of 65 in the United States. According to the Department of Health & Human Services, seven out of ten of them will need three or more years of long-term care before they die. Unfortunately, most families are not prepared when they need to step in and help mom, dad in the face of a crisis or medical issue, and the consequences of being unprepared can be severe amongst families – causing chaos, confusion, and loss of money.

What’s more, a 2014 survey by the Employee Benefit Research Institute found that 49 percent of retirees surveyed had retired earlier than they had planned. The survey found that many Americans find themselves retiring unexpectedly, and many retirees cited negative reasons for leaving the workforce, including 61 percent who cited health problems or disability.

Conversation Starters

The earlier you start talking about this the better. If you are having the discussion with a parent, always go in respecting the parent/child dynamic even through you may be 60. Consider this a conversation where you are trying to understand how a good friend, and someone you love is planning on spending the rest of their life. Some ways to do this include:

  • Ask mom and dad how they plan on spending their 60s, 70s, and 80s. Where do they want to live and how do they want to spend their time?
  • Request recommendations on how to approach estate planning. When did they do theirs and how did they decide who should be their advocate if one of them is unable to speak for the other?
  • Share a story of a friend or colleague who faced a difficult family health issue and talk about how your family might have handled the situation differently.

Unfortunately, you may have to wait for a pivotal event to happen before mom or dad are ready to have this discussion with you. Let me know if you have some additional suggestions on how to get this conversation started and I hope you will share which ideas helped your family.

For a free guide on how to organize your documents, accounts, and assets so that you can easily find them, or share them with a loved one should they ever need to help you, visit MemoryBanc.com/save.

How will I not become my mom?

wheelchairI vividly remember my husband once accusing me of being just like my Mom when we were in a disagreement. He knew quickly afterward that it was one of the meanest things he could say to me and has never repeated it in a derogatory manner. I think every daughter has some of this baggage. My Mom did a million wonderful things, but for some deep psychological reason, when used as a slight, there are some things about our Mom that we vowed we wouldn’t become I suppose.

I know my Mom never wanted to be in this place, in a wheelchair, with little memory, and an inability to do most things for herself. As a caregiver, I wonder how to avoid the fate of my parents.

I was encouraged by Dr. Oz when I appeared on the show, and have read many articles that equate dementia more to lifestyle than to heredity. One of the coolest things about the show was meeting Dr. Cynthia Greene who was the expert during my segment. She founded Total Brain Health that offers brain fitness toolkits for senior care, healthcare and fitness settings. She also is the author of Your Best Brain Ever that was named a “2013 Top Guide to Life After 50” by The Wall Street Journal. She, along with Dr. Oz encourage fish oil supplements, which I was doing before, but has now become a daily habit.

The major things I have done to help my loved ones if any illness or disability strikes is to complete my estate plans, written down my answers to The Conversation Project questionnaire, and continue to use MemoryBanc to organize our documents, accounts, and assets. Together, these will give my loved ones a treasure map on how to manage and follow my wishes should they need to step in and help me.

I’m excited to share that a new version MemoryBanc:Your Wookbook for Organizing Life is hitting bookstores this March for just $17.95. To pre-order at a discount, check out any of these popular retailers:

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Excited. 

The documents you need when a crisis strikes

I was the adult child named on the Durable Power of Attorney (DPOA) that needed to step in and use it. It was VERY difficult to use in several cases. For a more detailed look at my history, you can visit the blog I’ve been writing for three years on caring for two parents. One way to ensure that the individual you have named with this power can help you is to create a roadmap of the documents, accounts, and assets they may need to manage until you are back on your feet, or inevitably, to settle your estate.

My parents did everything that was recommended by their estate lawyer, financial planner and life insurance provider. However, they prepared most of the information to be delivered to me after they were gone. When they were too ill to manage on their own, I needed to know about their medical history, banking accounts, online services, household warranties … the list was daunting.

If you are named, or have named someone as your DPOA in your estate planning, you should sit down with them to review the location of important documents and instructions. After 40, nearly half of all American’s are expected to have a disability event lasting 90 days. It doesn’t need to be gloomy–as I reported on how I  shared my plans with the individual who I would expect to help me as well as with my children who are only 12 and 17 years old.

3DcoverFor an easy to use workbook that will guide you through the collection of your documents, accounts, and assets so that you can easily find the information when it’s needed, or could share it in a crisis, you can order MemoryBanc: Your Workbook for Organizing Life from any of these popular retailers at a pre-release discount today.

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Sharing MY DPOA & Estate Plan Wishes

This past weekend, I sat down with my brother and my kids and walked them through the estate plan my husband and I recently had updated. It wasn’t doomy or gloomy since we are in good health. It just resulted in peace of mind for my kids to know our plans and we made sure that everyone knows where they can find our completed MemoryBanc Register, and the original copies of all of our important documents.

I wanted to share this as a follow-up to last weeks post discussing the importance of having a Durable Power of Attorney (DPOA).

If you don’t already know this, the U.S. Department of Health and Human Services reports that 7 out of 10 of us will need long-term care assistance for at least 3 years. The difficulty a loved one faces when you don’t have a DPOA can be expensive, undignified and lengthy.

I hope you will consider speaking with a lawyer dedicated to the practice of estate law in your area. You should be able to get one for just a few hundred dollars.

Life Preparedness 101

mbicons1.jpgWe all know that we should plan for future life-changing events, but it’s one of the first things we put on the back burner. We have a million excuses, and have learned that procrastination does not work, but there are some things we just never make time to complete.

When it comes to organizing your personal information, doing it later is often too late. The statistics are alarming—some 43 percent of all people age 40 now will have a long-term disability event prior to reaching age 65. And seven out of ten people who turn 65 today will need some type of long-term care services and support lasting three or more years. Could a loved one act as your medical advocate and provide your medical history or list of medications if you were unable to? Could someone else access your bill-paying account to cover basic expenses while you recovered?

Having a system that documents your passcodes, inventories your assets and provides a health biography will not only provide you with quick access to information when you need it, but also can provide a roadmap to the individual that would step in and help you—even if only temporarily—should you need it.

In 70 percent of all households, Consumer Reports found that both spouses were unaware of the major details about family finances and where to find account information. If your partner was suddenly incapacitated, would you be able to step in and manage what your partner was doing? And if you live on your own, it’s doubtful that friends or family would know the details of your life and your wishes if they wanted to help you.

For all these reasons, documenting your life details and putting them in a format that makes it easier for you to retrieve and that someone else can access is important. It matters the most to those people around you whom you love and would be negatively impacted by your failure to simply document basic details.

Click here for a checklist of all of the important documents and details you should have organized. 

The financial costs of aging in place … are you sure?

retirementfundsAs I face the reality of the high costs of my Mom’s care, I’m working on creating my ideal aging story line. What I realized as I have watched my parents was that while most of us bought into the traditional concept of “retirement” with open schedules and the pursuit of hobbies, that model undermines healthy aging. We all want to live a life with purpose and that doesn’t stop in retirement. The idea of free days conflicts with staying engaged, accountable and productive. I decided I needed to change my life so that my pursuit of purpose didn’t feel like work. I found it when I launched MemoryBanc.

To help me plan better for the rest of my life, I’ve been reading up on as well as attended an event recently hosted by AARP on what to consider if you want to “age in place.” The real number is much more complex than just adding up the changes you may need to make your home more livable. As I recently mentioned, my Mom is living in a Continuing Care Retirement Community (CCRC) that involved a very large sum of money that was used as a down payment and considered “pre-payment” toward needed services. Even with that she’s paying a base fee of around $7,500 a month to be in Assisted Living. As I recently shared, some months have been closer to $12,500 as we have had to hire extra assistance since typically Assisted Living is not designed for individuals with cognitive loss.

If you want to stay in your home, you should consider how it might suit you should you develop mobility issues. However, my parents only temporarily faced that issue when my Dad broke his hip and needed a place to rehabilitate. Thankfully, one of the benefits of the CCRC agreement was that my Dad could move into their skilled nursing until he was able to manage on his own. My Dad was able to recuperate and as soon as he could manage stairs, they were back in their 3-level town home.

I believe there are other factors more important to consider than the cost of adapting your home for your aging lifestyle. In our case, both my parents developed memory issues (Vascular Dementia and Alzheimer’s). They were unable to recognize their inability to manage. Had they not been in a CCRC, my siblings and I would have had to petition the court for conservator and guardianship of my parents. If you know someone with dementia, you know that while they might not remember if they just ate dinner, they will know that their child has taken them to a public court proceeding and is charging that they are unable to manage their own affairs. None of us could have foreseen this scenario, but we were days from filing the petition when their CCRC acted and helped us manage a move into Assisted Living. Even with estate plans in place, we were faced with this difficult choice.

I haven’t gotten very far but do know that now, there are no perfect answers. What I hold true is that having your family members involved and having these discussions early are the key to making the most of the rest of your life.Studied. 

 

Related stories.

The Financial Costs of Aging in Place

Did you know we have a date for Dad’s burial?

dateAs I entered a holiday celebration at a girlfriends house, my phone is ringing. My Mom is calling me at 7:30 p.m. She hasn’t called me “late night” in over a month.

Kay: “Hey Mom. How are you?”

Mom: “Kay, Did you know we have a date for Dad’s burial? He’s gonna be buried next month.”

Kay: “Yeah.”  I’m a little dumb-founded. I hesitate to say anything and I don’t have to wait for my Mom to continue.

Mom: “We need to get all the other plans finalized. He doesn’t want a funeral, just a few people around his grave and a burial.”

Kay: “Okay Mom, E’s (my brother) is coming in town in ten days and he has offered to help with all of the planning for Dad.”

Mom: “What do you mean, I’ve planned it all. There is just going to be the burial. I already arranged it with Arlington National Cemetery. His plot has been picked out. What does your brother have to do with any of this?”

My Mom has not had any conversations with the funeral home, Arlington or the minister. We have continued to provide her with details when she was interested and taken her our driving tours of the cemetery.

This is the part where the record screeches (Internet connection is lost) and I struggle with the perfect way to manage this call. While my Mom can’t remember what she just did, she does keep some elements of memory. Most importantly, I recognize her need to do this final act for my father — at least be involved in the process.

Since my 20’s, my parents had written instructions for their funeral plans. They never changed, until about a year ago when my Mom started telling me they wanted burials, not funerals. I never really understood why and it wasn’t a discussion my Mom would engage. However, I felt the inner turmoil growing as I sensed this was going to be a problem. My only response was often that “a funeral isn’t really for the person that died, it’s for the people who are left behind.”

We are in the final stages of working out the funeral program, we will have at least 40 people just from the family in town, in additional to dozens of colleagues who have expressed interest in coming to the funeral. I hesitate to let the idea that Dad will just have a grave site burial settle into my Mom’s brain. Instead of lying, or trying to explain what’s been planned, I usually just stop talking about the topic and change the subject.

Thankfully, my Dad wrote up his plans years before the Alzheimer’s started to cloud his thinking. My mother-in-law reminded me, than even with well made plans — you may have to improvise. Her mother had picked out an outfit for her burial that she and her sister’s changed. It turned out that she would be buried in the middle of winter in North Dakota and the dress she choose just made her look cold. The story still makes me giggle.

We all need this event.

Personally, I need a funeral. I need to witness the full honors service he will get for his years of service to our country. I need to hear the preacher share the prayers, songs and remembrances at the funeral. I need to say a final good-bye. Desired.

If you have had good success in handling a situation like this, I’d love to hear from you. 

Seventy percent of American’s over 65 will need long-term care

70%Wow. Ignoring the facts won’t make them go away. They seem unbelievable.

The National Clearinghouse for Long-Term Care Information reported that about 70% of Americans who live to age 65 will need long-term care at some time in their lives, over 40 percent in a nursing home. Learn more by visiting their website and to learn more about how you can plan.

The same report cited the averages: Those who are 65 today will need long-term care services for three years. Women need care for longer (on average 3.7 years) than do men (on average 2.2 years). While about one-third of today’s 65-year-olds may never need long-term care services, 20 percent of them will need care for more than five years.

The most important thing you can do today (at ANY age) is set up a Durable Power-of-Attorney. There may be situations in which even your spouse needs this document. Check with a local estate attorney.

Having your estate planning and financial plan in order is important, but more important is making sure your accounts, access codes and personal papers can be easily found by those who may need to step in and help you. Until our late 80s, we are more likely to suffer a temporary incapacity than we are to die. CNNMoney reported than more than $58 billion in unclaimed money and assets is sitting with state and federal treasurers — it’s the stuff that got lost in the shuffle of a move, personal crisis as well as death.

Here is a link to the full list of papers so you can do it yourself. If you want to be prompted through the process in a workbook format, you can order a MemoryBanc Register. Use the term “Reader” for a 10% discount on your order. Alerted.

44 Million Caregivers in the U.S

replyhazyOne of the most striking realizations for me lately is how many of us are out there helping an aging loved one. In November 2012, the Alzheimer’s Association reported that 43.5 million care for someone 50+ years of age and 14.9 million care for someone with Alzheimer’s disease or other dementia. 

Our system doesn’t work. I know my story is unusual because I had two parents with similar stages of dementia, but I just had to learn faster. Our problems were magnified. My parents either couldn’t recognize or wouldn’t admit their lives needed to change. It meant less freedom and they were unwilling to accept any assistance.The dementia crept in and eventually, they were unable to comprehend the situation.

My parent’s fully believed that selecting a Continuing Care Retirement Community (CCRC) would mean they would “never be a burden to their children.” You can wade through over 300 stories I have shared in the past two years on how difficult this journey has been. I imagine most children have a love/hate relationship with the place their parents are staying.

My parent’s were happy with their choice, and the day they were moved into Assisted Living removed a huge weight from my shoulders. I’m very appreciative of the way my parents CCRC handled the situation.

However, I’m not satisfied that we have found the right options. I spend 20 – 30 hours supporting and visiting my Mom many weeks of the year. I know that isn’t what they intended, but I’m duty-bound to provide.

How can we change this dynamic so we don’t keep making the same mistakes? Queried.

Please share in the comments section how you are approaching or have decided what to do for your most senior years. 

 

It takes all four of us to manage the move

fourkids (2)The past year has made me regret not having more than two children. Since I grew up with four kids in my family, I always believed I would have four children myself. That was until I had the first one! He was a tough baby, or possibly, I was an ill-prepared mom.

I started late, having my first at 33, so that by the time I was ready and actually did get pregnant, my second arrived to a 38-year-old mother. Given all the high-risk discussions and the additional needs just a second child brought, my husband and I felt for us, it was too late to have more. I am lucky to have two healthy kids.

On the day of the move with my parent’s, we can barely manage my mom between the four of us. Our game plan was that two of us would give our parents a specific task to keep them busy while the other two would manage the move and movers. My mom always behaved nicer when there were two children in front of her — she would often bully you if you showed up alone.

When the movers arrived we have them start with the bedroom. While they are loading up the furniture, we task our parents to decide which sofa set they want in the new apartment. My sister and I invite my dad to go to the new apartment.  My mom is furiously trying to redirect the movers. My dad invites my mom along and she comes with us to the new apartment. Our job is to kill time so the movers can move.

After we linger in the apartment, we suggest getting lunch. On our way to the dining room, my mom sees their furniture being moved down the hall and takes off for their old apartment. My dad decides to follow me into the lunch room. My sister takes off to the old apartment after my mom.

My dad and I order lunch and try to find a topic to discuss. It’s only been two hours since breakfast so I’m unable to really eat anything. I know if I don’t eat, my dad won’t eat so I try to at least fill up my plate with a salad and some fruit and move it around on my plate.

My dad is ready for this move and does not want to fight it. My mom is making him very uncomfortable. I ask if he will come with me to the grocery store and we can pick up some of his favorites snacks for the new apartment. He agrees.

My mom and sister make their way to lunch and we tell them of our plans. We invite my mom along with us. She is not interested.

We all go back to the apartment and my mom is very upset. She keeps trying to tell the movers to put the furniture back and runs to the office of the Executive Director. I leave my mom to my siblings to manage and take my dad out to shop. Wandered.