Tag Archives: Home Health Care

Getting Your Paperwork in Order, Part I

As we make this journey with our parents into their late elder years, it often emphasizes the difference in generations. When I was growing up, we did not discuss finances or other “adult” topics.  Finally when dad approached retirement, mom and dad gave me a copy of their will so I would have it in case it was needed.  When they had the will prepared, their lawyer prepared a durable POA for them also.  The POA was very basic and just gave POA to each other, as expected and normal for that time.   Besides the will and the POA, I had no idea really of the state of mom and dad’s finances.  If I asked a direct question, mom would answer me, but I always felt that it was a topic that we never discussed.   More to come on POA’s in a future post.

During the initial discovery of dad’s Alzheimer’s, I learned that dad had been struggling for a while with keeping the checkbook and finances straight.   My parents kept every piece of paper that came into that house since 1955.  They had turned the middle bedroom into a mini office. There was a file for everything.  At one time, it was orderly, but just the amount of records was overwhelming.  They did nothing online, so everything was a hard copy.  When dad started experiencing problems, he inadvertently moved things around, refiled things and filed things randomly.  Tax time was a nightmare.  So, mom took over the checkbook, but with everything that was going on she was quickly overwhelmed and confused.  She called me and said that she could not do it anymore.  I took over their finances about 5 years ago.   I converted everything to online accounts and changed the address on everything so that it came to my house and ultimately phased out most of the paper mail.  Mom and dad had a small nest egg.  They never had a lot of money, but dad had meticulously planned for their retirement and future.  He had paid off the house and cars before retirement.  He gets social security and a retirement check from the state.  He was always frugal – mom, not so much.

So, our roles began to change.  The transition of me taking over the finances was never openly discussed with dad, it just happened.  Having the bills come through my hands emphasized mom’s love of shopping and a need to curtail that.  All of a sudden I was having to make decisions for them.  This is probably one of the hardest areas to navigate with your adult parents.  Dad readily accepted my help and never questioned me.  This is not the case usually.  Most adults of mom and dad’s era are private about their resources.  They will not readily relinquish control.  Speaking with other children of aging parents, I see their struggle to get into a position where they can help.  Most often the man was the primary financial manager and sometimes the wife has never actually had to take on that responsibility.  I see so much difference in my generation, that will make it easier for us to manage.  Both my husband and myself can manage our finances.   We have discussed finances over the years with our children.  The conversations are much more open and accepted.

I have learned so much that I am already implementing to make sure that I don’t leave a mess for our kids.  I know that some people think that this is morbid to think about and discuss.  It is realistic.  I do not plan on leaving this earth any time soon, but the one thing that I have learned is that tomorrow is not promised.  I am not obsessed with this topic.  I use the things that I have learned to make my life more uncluttered and simpler to live everyday.   I used the opportunity when we moved last May to purge everything that I had kept over the years that was of no value to anyone but me.  I am pretty sure that 20 to 30 years from now that Hunter is not going to be interested in every paper that he brought home in kindergarten.

My biggest concern is figuring out how to leave access to any online accounts that I have.  I am not necessarily talking about bank accounts, but more the emails, the google doc accounts, the real estate related websites that I pay for automatically every month.  I think that will be our challenge in the future.

So, I have transitioned into that period in life where I am my parents’ parent and my childrens’ parent.  I have no doubt that I will be difficult when I have to transition that role to my children.  For that, I apologize ahead of time.  For the time being, I will continue to save for the future and my retirement.  I will continue to simplify my belongings.  Being mom and dad’s advocate and manager is an ongoing learning process.  I will do my best to allow them to live with respect and dignity throughout a time that is not very dignified at all.

 

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Caregiver Issues

At this point in time, we rely on my mom to be my dad’s primary caregiver.  Up to this point, dad has needed guidance and patience.  He often can not remember how to get dressed, but he does not need physical help, just someone to tell him to put his socks on before he puts his shoes on. And yes, I do understand that it is a supreme challenge to always be there for someone, but at least we have not had to look at round the clock care yet.

If you have ever researched the cost of an Alzheimers facility, the cost can range from $5000/ month upwards.  And it is not only a cost factor.  Dad does not want to leave home — ever.  Yes, we know that the day will come, but I can not obsess about that now; there are too many daily worries to overcome.  We are very lucky that we have found a wonderful, caring, experienced person to come to their house 4 days a week to help them out.  Katy is wonderful because she provides moral support to both of them and they have very different needs, believe me!  Sometime in the near future, we will have to increase that time to 5, 6 and then 7 days a week.  It will get more expensive, but still will be less expensive than a facility and dad will remain happier.

Our biggest challenge right now is the fact that mom is also exhibiting signs of dementia.  We understand that as you get older you will experience more memory issues, but we are seeing more drastic changes in her.  We feel that a large part of her recent decline is because of increased medication that she is taking.  She depends on doctors and medication and I think that she takes way too much to the detriment of her health instead of the other way around.  So, now we are posed with another problem. Our caregiver needs a caregiver.   Our first plan is to meet with mom’s doctors, all 10 or 15 of them, and see what medications we can wean her off of.  Her world revolves around her doctor visits and she is validated when they prescribe a new medication.  It will not be an easy process and it will have to be monitored all of the time, but she can not continue the way that she is going right now!  I do place some blame on her doctors.  You have an 87 year old woman and you constantly prescribe anti psychotics and narcotics.  Wish us luck as we attempt this huge undertaking.  It will not be an easy task.

All Home Health is Not The Same

A couple of months ago we had to seriously reconsider the assistance that we were using to help mom and dad.  We have seen a definite decline in mom’s mental ability over the last six months and she basically does not want the responsibility of making decisions any more.  We have had several home health assistants over the last couple of years and the main problem that we have experienced is the lack of caring on their part.  The job is not highly compensated and the requirements are not very stringent either.

We are always walking that fine line of providing what mom and dad need and conserving their money.  They are definitely on a limited budget and that makes the decisions harder sometimes.  I got recommendations from friends and then I spoke with several new agencies.  We knew that to get what we needed that we needed to increase our budget and we were prepared to do that.  When we made a decision, I spoke with the current home health agency that we were using.  They were very adamant that they could provide what we needed with one particular aide.  Of course, my thoughts were “why did it take a threat of leaving to have them take us seriously” but I listened to what they had to offer and I told them that we would try one more time.  Mom and dad do not  adjust to change very well, so we need to minimize the turnover of help.

The main thing that I was looking for in assistance for them was more help in planning.  Forgetting to buy things at the grocery store and lack of meal planning were concerns.  Treating dad with respect and helping him get out of the house and moving again was another big concern.

It turns out that we have been fortunate to have found an absolute angel.  Katie has made the biggest change in mom and dad’s life (particularly dad’s).  She oversees so much of their daily schedules.  She plans and cooks meals for them.  She has dad exercising and getting out of the house.  They both love her to pieces.  The house is cleaner and their attitudes are better.  And dad has an advocate in his corner and he realizes that.  He talks with her about his concerns and fears in a way that he can not with the rest of us.  He finally has someone that has no unreasonable expectations from him and will listen unconditionally.  That is what I want for him.  I don’t want him to worry and be scared.  I can’t stand the thought of that.

We have a long, hard road ahead of us, but it will be so much easier with Katie by our side. I am ever so grateful that she came into our lives.