Tough Conversations

Solutions Through Compassionate Communication.

Your Power of Attorney: Sword or Shield?

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A man I’ll call George hired my friend, a social worker, to visit his “Uncle Milt.” George hoped my friend would persuade Milt, 96, to move from the home he loved on the East Coast to a nursing home in Nebraska near George. Uncle Milt, however, was firmly planted and said so loud and clear.

The social worker found Milt alert and engaging. She gave him a “mini-mental” test that showed minor memory loss but no dementia. Milt’s two long-time health-care aides were present. They kept him clean and well-fed and took him on outings. A neighbor looked in on Milt every evening. Clearly they all shared a deep affection for Milt. He seemed happy.

My friend informed George that Milt could safely remain in his home and recommended he be allowed to do so.

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Is Lack of Transparency the Same as Lying?

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What if we neglect to tell a family member something that we feel is unimportant or even trivial, but they think IS important and not trivial? Is that lying? Or behaving falsely?

For example……

What if a family member, a care-giving sibling (CGS), uses her parents’ money to purchase a first-alert device or a home security system so she knows whether the parent has been in an accident or has a medical emergency? The other siblings live a several hundred miles away. Why bother? They’re not involved, right?

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Who’d Have Thought?

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As elder and adult family mediators, we keep learning about (not-so-new) legislation, court settlements, and resources that may pleasantly surprise Whp'd Have Thought by Sig Cohenmany elders and their family members. Here are three that may benefit you, a loved one, or someone you support.

  1. Medicaid is Not a Single Program

    2.  
    Many, including myself, thought that Medicaid covers only nursing home care for low- and no-income individuals who financially qualify for the benefit. Not so. [Read more…]

Stuck in the Information Gap?

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Dear Reader,

Please take a minute to answer these four questions:

1. Have you thought about the possibility that you may need senior care as you grow older?

2. If yes, are you aware of the various senior care options that you may need and that are available to you?

3. If yes again, have you begun planning for your and your family members’ senior care?

4. Do you know what these options may cost you (and your older adult parents) as you both get older and, hopefully not, become infirm?

If you answered YES to just one of these questions, consider yourself in a minority.
According to a 2009 study carried out by the Boomer Project* for Home Instead** a majority of the respondentsqueried queried (a whopping 73 per cent of the adult children, i.e., Baby Boomers)  said they have neither thought about nor planned for the kinds of the care they may need as they grow older.

More disturbing: 50% of the seniors surveyed indicated that they have neither thought about nor planned for their own future care needs.

The survey revealed that most respondents:
• Knew little about the care options available to them,
• Were ‘misguided’ about the cost of these options, and
• Were ‘poorly informed’ about how they will pay foror how much these options will cost them.

Most believe that their social security and Medicare benefits will be sufficient to cover these expenses. Only 18 per cent of the adult children cited long-term care insurance as a possible source for financing their future care needs. And only 21 per cent of the seniors surveyed could name long-term care as a potential financial resource.

These findings were so alarming (to us, at least) that we plan to devote the next two blog posts to information that emerged from this survey. Stay tuned.

Sig Cohen

* The Boomer Project provides market research and strategic consulting to corporations, industry associations, civic and non-profit organizations.

** Home Instead Senior Care is a U.S. based international franchise network that provides high quality non-medical senior home care. It consists of more than 875 locally owned and operated offices that help seniors and their families through the home care stage of aging.

Over 40 With a Living Parent? Some Questions to Consider

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Last week we described our recent workshop and named some questions we posed to older parents and their surprising answers. This week we look at the questions and answers for their kids:

1. What is your greatest concern about your parents’ aging process?
[Driving safety was a huge concern. Some didn’t want their children to ride with the parent. But adult kids are torn. They are sensitive to the loss of freedom if parents can’t go when and where they want. Some expressed an obligation to offer alternative transportation and thought about how that would complicate their own lives.]

2. What do you want to know about your parents’ future plans that you hesitate to ask?
[Many said they don’t know whether parents want to be cremated, what kind of service they would want, or where they want to be buried. They hesitate to raise the topic of a parent’s death, regardless of how near or far in the future that seems. They suspect the parents themselves may not have thought it through.]
[But a few said parents had actually written out the details of their own funerals: hymns, who will speak for them, and even a liturgy.]

3. How satisfied are you with your knowledge of your parents’ finances?
[If their parents had not volunteered the information, most children did not want to ask directly, for fear of sounding greedy or eager for the parent to pass. They agreed they might be able to ask for a list of bank accounts and insurance policies, etc. Many children had knowledge; others had none. Sometimes one sibling did know and was willing to share the information.]

4. How much do you want to be involved in helping your parents make health care decisions?
[Even if a child or siblings did have a power of attorney for health care, they hoped the parent would also prepare a “living will” or a Five Wishes document, so that all the siblings would be on the same page. That way, if a hard decision has to be made, all will know what the parent wants. One man told me that his brother, who had the POA, extended their mother’s suffering for two years because she left no instructions and he could not bring himself to let her go. The siblings are still not speaking to him.]

5. Where do you imagine your parents will be living later in their lives?
[Most expect the parents to live in their own homes as long as possible, then go into some assisted living near the child. If parents live in another state, they anticipate some resistance from the parent. Some are worried about the cost of assisted living.]

6. What’s your deepest hope for your parents as they age?
[That they can be lucid, peaceful and pain-free and feel loved.]

What questions would you like to ask your parents? Please share your thoughts by writing a comment.

Carolyn

Six Questions for Older Adults (And Answers Their Kids Need to Know)

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Sig and I recently led a communications workshop for 40 families on the topic “Necessary Conversations at Midlife and Beyond.” We divided the group into people with living parents and those whose parents had passed on. Each group was assigned questions to discuss among themselves, in order to prepare for a conversation with their own families. Here are the questions we gave the older adults, and in parenthesis the sometimes surprising answers that emerged:

1. What is your greatest concern about aging?
[The majority said dependency, helplessness, and consequential loss of freedom. This is why it’s so hard to give up driving. The second most common answer was fear of abandonment.]

2. What information do you want your children to know, but you’re afraid to mention?
[Most denied there was any such topic – I now think the word “afraid” was too strong. But some secrets came to light. For instance, one parent added a child to all his financial accounts but has not told the other children. Note: Please talk to your lawyer about the possible legal effects of this before you do it. There are better ways to allow a child to take care of your bills.

Other “secrets”: A parent wants to leave more money to a child with greater needs, but hasn’t mentioned it to the other kids. Or parents worry about leaving money to a child whose spouse they don’t trust. One secret might be a parent’s desire to marry again.]

3. How do you feel about discussing your finances with your children?
[Again, some answered “No problem” or “They already know.” But see above. Some don’t want to reveal how little they have, for fear the children will feel burdened. Wealthier parents don’t want to reveal how much, because they may want to give a large amount to charity and don’t want the kids to feel entitled. If you’re uncomfortable sharing specifics, we recommend you at least put a list of all the information your kids will need – life insurance policies, safe deposit box number and key, bank account numbers, stock broker info, etc., in an easily found place.]

4. How much do you want your children involved in making your health care decisions?
[I suspect this was the toughest question for folks to think about, because it does imply helplessness. All three small groups put it off to last and never got to it. About half did have health care powers of attorneys and/or living wills. See Five Questions. ]

5. Where would you expect to be living later in your life?
[We were surprised that nobody said “With my child.” Most said they want to stay where they are. Some are in their own homes, others had moved to a senior community like Leisure World, still others are in independent living in a continuing care facility, which they like. Perhaps unrealistically, no one expects to be in a nursing home.]

6. What’s your deepest hope for the future?
[Most common answer: “That I keep my mind intact.” One woman touched us when she said, “If I become helpless, I hope I can accept that with grace. I hope I can find meaning in it.”]

Can you think of other questions? Write a comment and let us know.
A coming blog will share the questions and answered of the adults with living parents.

Carolyn Parr