LESSON FOUR: Make sure your parents have a person appointed to make financial decisions and health-care decisions for them should they be required. Make sure that they appoint the right person for the right task. A son who is an MD would be good for health-care decisions, but is he too busy to sit by their bedside? Pick someone else who has the time to sit. They can always call Dr. Son who can advise them by phone. With a widow or widower, making plans or changing estate plans is crucial. Make certain that your mom or dad's plans have been updated to reflect the loss of a spouse. And do it quickly. Some spouses don't last too long after they have lost a loved one.

Joe made the decision the day after Jane's death to give away all of Jane's belongings. My wife said that he was angry that she had died and abandoned him and this was his way of showing his anger. In any case, all of her clothes, even her bed, were in the pile to be given away. Joe's daughter was there, and she and my wife went through everything to either keep or give away. They got along well, but not every family is so lucky.

LESSON FIVE: A situation like this could have led to disaster if there was any hostility between the step kids. Ask your parents if they want to cause trouble. If they want to cause friction and drive a wedge between you and your step-parent, all they have to do is nothing. Chances are that upon the first death, the kids and step kids will fight over trivial things and end up hating each other. On the other hand, if your parents want to smooth over issues that could cause problems, deal with their stuff while they still can. Who for example should get the jewelry and the clothes and the shoes and the books and other items of sentimental value? It doesn't have to be in a will, but it does need to be written down.

(From Elder Law Alabama)

LESSON TWO: DNRs should be honored no matter where a patient might end up. If you have one or if your loved one has one, make certain that the document's existence is acknowledged by the staff of the facility where your loved one is residing. Sometimes a simple "DNR on file" note of the chart is sufficient to tip off EMTs that they should ask questions first. And do not confuse a DNR with a Living Will! If confused, ask a lawyer.

Joe had called us when Jane was first admitted to ICU. He was a basket-case and we couldn't get a straight answer from him, partly because of his condition and partly because he didn't know. His generation worships doctors and think they "shouldn't be bothered with questions" or some such nonsense. He was lost metaphorically, and like many guys, wouldn't ask for directions.

LESSON THREE: When in doubt, take charge. My wife and I drove to NC and she took over. Joe was hesitant to call the MDs. My wife got their numbers and called them all to get answers. Joe was hesitant to call his priest. My wife got the priest on the phone and he was there in 15 minutes. Joe was hesitant to ask about the results of tests. My wife got the nurses to chase down the doctors and get answers. So the lesson is this- a grieving spouse is not equipped to handle these matters. He or she needs help but is possibly hesitant to ask for help. Better to ask forgiveness than permission. Take charge but be kind to the spouse and be willing to defer when the situation changes.

Read Bill’s final lessons in our next post...

Local attorney-at-law who specializes in the elderly, Bill Nolan, recently learned some hard lessons. He shared these lessons in his own blog, Elder Law Alabama, and allowed us to share them with you…

When a loved one dies...

My 80 year-old mother-in-law died last week. She died fairly suddenly so no one in the family, my wife particularly, was prepared. My wife and I drove to NC to be with her mother in the hospital and my wife was the person who was given the decision to remove life support. We were in her room as she died.

I learned a few things about the process of dying, of leaving things unsaid and undone and of trying to cope with the loss of a loved one. It is one thing to read about something and know it professionally and academically. It is quite another to actually be a part of something as it is happening.

Both my mother-in-law (let's call her Jane) and her husband Joe were self-sufficient. No one had been helping them with any of the daily chores we all deal with -- paying bills, balancing checkbooks, monitoring retirement accounts and so on. After Jane's death, I sat down with Joe to talk to him about their finances. Joe was at a loss as to where they were. Jane had been in charge of all their finances! He wasn't even sure how many accounts they had or how they were titled, and he was not familiar with the nature or amount of their retirement accounts. In addition, he was in shock over his wife's death. He wasn't thinking clearly. He was exhibiting grief, depression, sadness, anger and an odd nonchalance about the whole process that was out of character. We were not sure whether he was actually showing symptoms of dementia or not. Had Jane been covering for him lately? Or was Joe just partially deaf and in shock?

LESSON ONE: Make sure that your parents understand that if one of them should die, the other might need help with financial matters. While most seniors are not willing to share this personal information with even their adult children, make them understand that the one who dies first might be the financial wizard, leaving the other spouse to fend for themselves. If they won't let you in on their specifics, at least ask them to organize their finances somewhere so that, if and when the time comes, you could step in and reconstruct everything without too much work.

Jane had been suffering from a lung disorder that would have eventually killed her but that was not the cause of her death. She had a "Do Not Resuscitate" order with her nonetheless, because of her condition. She had been in the hospital earlier in the week for back pain and had just been released to an assisted living center for rehab prior to returning home. The assisted living people found her unresponsive one morning and called the EMTs, who got her heart beating again. Yes, despite having a DNR, the Assisted living people took the action they took. Jane was in ICU for two days on every machine known to man, and during that time, there was never any brain activity. She had really died at the ALF but because they called in help, she was kept alive, against her wishes, for two more days.

Read more of Bill’s lessons in our next post...

The term long-term care (or LTC) encompasses a wide range of assistance, support, and care provided over an extended period. It is designed to meet the medical, personal, and social needs of those who cannot fully support themselves. The primary goal of long-term care is to maintain a patient’s independence.

Long-term care can take place in many settings including an individual’s home, sites in the community (grocery stores, post offices, etc.), assisted living facilities, and nursing homes. Continuing a “normal” routine with LTC assistance allows the patient to retain dignity and can be a beneficial relationship for many years. The use of LTC services takes the strain off family members while giving patients the best care possible.

The term long-term care (or LTC) encompasses a wide range of assistance, support, and care provided over an extended period. It is designed to meet the medical, personal, and social needs of those who cannot fully support themselves. The primary goal of long-term care is to maintain a patient’s independence. 

Long-term care can take place in many settings including an individual’s home, sites in the community (grocery stores, post offices, etc.), assisted living facilities, and nursing homes. Continuing a “normal” routine with LTC assistance allows the patient to retain dignity and can be a beneficial relationship for many years. The use of LTC services takes the strain off family members while giving patients the best care possible.

As we pressed for Leslie’s return to her apartment, she became more and more stressed as we were met with objections. She collapsed and was rushed to the hospital. They treated her for dehydration, intestinal bleeding, and congestive heart failure. I was able to find a new assisted living facility while she recovered. Soon after, Leslie moved and began settling in. She now has only two or three physicians’ visits a month.

Leslie believed she was put on Earth to care and nurture for others and to have those positions reversed is unsettling. “Jeanne and Ellen of MARCA Care pulled me back from the edge,” Leslie said. “For over a year, they walked me through hospitals, nursing homes, doctors’ offices, and into assisted living. Now at 91 years old, I enjoy a good quality of life. My only son and his wife could not possibly have handled all of these crisis situations, so we were all blessed to have these caring ladies for ‘family.’ They have been amazing.”

With photos and keepsakes surrounding her, Leslie can continue her road to recovery. She has kept her lively sense of humor and keen grasp of the world and its issues. Leslie has finally found a place of contentment.