OT: Moved the thread about senior care

[nailshooter41]

Not the best thing to be thinking about, but do they both have advanced

> directives with do not resuscitate orders? If they don't, it might be nice > for someone on the staff of the care home to discuss it with them.

Out of respect for basilisk's thread about his loss, I moved my off topic thoughts to a new thread.

I think it is pertinent information for most of us middle aged guys to be thinking of, so here is my response to LDosser's question. I would highly advise anyone that will be stuck with sorting out the legal details of their parents or loved ones (or maybe not so loved....) to have a talk with them to make sure these documents are in place.

My parents "fibbed" to me about having all of this done, and only had in their hands exactly what I had completed for them before. Doing all of this with old, tired and sick people makes this task a thousand times harder (and much more expensive) than it needs to be.

They still have to sign all the documents, and affidavits, so the big difference is that they have to understand all the details and ramifications of their affairs between illnesses, "down days", doctor's appts., physical and mental therapy, etc. All of it has to be done with brains that have been affected by cancer and chemo, strokes, diabetes, and the onset of dementia.

And now they have to pay to have the documents transported to them by the attorney for reviews ($$$) and witnessed by a non family member. I think the only ones sicker of this whole process than me is them.

Some of these documents go out of usefulness since their is new, preferred legal language. Some need to be replaced, some docs need to be updated. > A state approved, federally approved, or a form from Quickbooks Will Maker probably won't do it.

For example: The hospital that my folks like has a lot of seniors, so in turn have a lot of senior care doctors. BUT, having been sued by their patients enough times, they have their very own set of medical directives. These must be signed and witnessed before every procedure (in addition to the normal hospital disclaimers), and will be on file for 6 months. After that, new docs must be signed, as the hospital told me they aren't in the document archiving business. Additionally, their legal staffs update the forms on a routine basis so they want THEIR newest forms on file along with the state promulgated forms.

Another example is their nursing facility. They are part of a larger state sized chain, and they have their own documents that allow or disallow treatment. They DO NOT want either of them to die there on premises for any reason; with that in mind they have their own forms that are a rider to ours as long as they are on the premises. They cannot "pull the plug" or order any advanced medical treatment, but if either of my folks are ill they can call for transport and move them to a hospital immediately. And without specifying the hospital they want, they take a person to the one they want, even if they have never treated them and have no records there. They get them out as fast as they can to reduce liability.

****************************

They have now have the following either executed or in process, and I would certainly recommend these to everyone that is "of age", whatever that might be, or to have these docs done on behalf of yourself:

- Do not resuscitate orders

- Medical directives to comply with state and local laws to allow for their care and assignment of ability to enact the DNR if they become comatose

- Medical Power of Attorney directives that allow commitment to permanent procedures on a treatment as well as monetary payment level

- Legal Power of Attorney assignment for certain aspects of their personal lives

- Durable Power of Attorney for everything else

- All monetary accounts now have a sibling on as cosigners for access

- A new/updated will (last one was 5 years old) that spells out their wishes

- Most importantly (at least from my standpoint) is a solid, written budget with a financial plan

Medicaid used to have a 3 year "lookback" to see about your eligibility for their services. It is now a whopping FIVE years, and if you don't plan well, it will bite you hard. My parents should have started planning years ago, but didn't. Now they live in fear that if they really need heavy medical care, it may not be available. Essentially, we must time the life of their assets to make sure they can continue to get care, but not too much or they won't be Medicaid eligible.

Now try to plan the medical future of a 84 year old man and woman. Make it more interesting by throwing in years of poor health.

So my folks are now starting their financial planning (something other than "saving money") now at the ages of 84 for him and 80 for her. Good job!

My Dad is now stuck trying to understand all the complicated information when he would rather be watching Matlock reruns. Worse, he now has to depend on others to make sure he gets what he wants, and he can't believe they charge for it. And he can't accept the fact that if the attorney changes a document or adds a codicil, there are additional charges incurred.

All in all, pretty miserable for everyone involved.

So again... if I could encourage any of you to get this done now for YOU and YOURS, I certainly will.

Robert

[basilisk]

I feel for you. I see this in my future, Dad is 77, Mom 70, and the excuse I hear is "We'll take care of it when the time comes". It's just never quite the right time.

basilisk

[Robatoy]

I have already seen this in my future. We're lucky that we have a family friend who is a lawyer, and actually one of the decent ones. We drafted up all the documents about 8 years ago when both my mom and dad were on the ball enough to know what it was we were trying to do for them. They gave me 100% power of attorney on all matters with their wishes outlined in terms of DNR etc. We had a bit of a party afterwards as they were obviously relieved of any grief they so badly wanted to avoid for us after they were gone. My sister getting hurt didn't change a thing. They're both 88. My mom is a crumpled little thing at 98 pounds, the osteoporosis has eaten a lot of her away. She once was a 5' 10" Dutch woman. But her mind is tough as nails. My dad, not so much. Physically healthy as a bear, his mind has mostly wandered off without him. He asked me my name. I told him it was Rob. He said: "Heyyy...I have a son named Rob." He's happy, well fed, a funnier than ever. He pretends to pull-start his walker, like a lawn mower and does this every morning. Then walks to the nurses station and want to pay his hotel bill and reserve a limo to the airport. Everybody loves him there. We know _that_ day is coming. I will never be ready for that. . . Thanks Robert for the good advice. I know it is good advice, I hope some others will pay attention to it.

[keithw86]

For the last ten years, or more, of my mother's life she had a DNR notice posted on her refrigerator. When I first saw it I was rather taken aback (we didn't live in the area and my brother took care of her financial and medical details). It didn't take too long for me to get over the thought, though. She died at 95 in December of '08. Turns out that since she died in my brother's home (he'd pulled her out of the senior home nine months before) the DNR solved all sorts of other possible legal problems, as well as the obvious.

When my father died, 45ish years ago, there were all sorts of issues, including my own mother needing to "adopt" me. Her bank accounts were frozen as well as any saftey deposig boxes. It was a mess for a while, and she had no (access to) money in the interim. My brother made sure that all of these details were taken care of (no ugly probate, no legal hassles of any kind, nothing). For that, I am grateful for both of them.

[LDosser]

Amen to a lot of very good advice. I saved the post.

Thanks, LD

[Han]

"LDosser" wrote in news:hj2m3v$uhp$ [e-mail]- september.org:

22g2000yqr.googlegroups.com...

Please note: It is never too early to leave a will, living will, DNR desires, for you yourself. Once you get (semi)incapacitated it will be much more difficult. What would you do if had a car accident or your planned elective surgery goes wrong, and you become a vegetable?

Do not put off until tomorrow what you can do today. And make your living will/DNR instructions part of your medical record!!

[LDosser]

I have an advanced directive and happen to be having some surgery in about 8 hours!

[nailshooter41]

Very true.

We did a lot of this a few years ago (about 5 - 6 ) but the needs of the hospitals and treatment centers have changed so much we still had to rework every agreement.

I have a friend of mine doing this for my folks, and he said it is important to have all docs reviewed and rewritten as needed every three to five years. Not so much wills, but in particular the ones that deal with medical issues.

If there was one thing that I regret about whole affair, it is not really pressing them hard to get their affairs in order before now. I asked them, talked to them about it, even set them up with an attorney to get it done. They would never do anything other than the most rudimentary documents, and never took care of all the ancillary docs that make life easier for all.

I kept DNRs and Medical POAs in larger red folders in their house hanging near doorways that said: FOR EMS ATTENDANTS in large letters. The EMS guys loved it.

I thought we were all on the same page of keeping the info updated and taking care of finances, etc., but one day it all stopped, and they folks were no longer interested.

I should have kept after them and done all I could to get them to take care of this stuff earlier.

And as has been pointed out, when you really need these docs, it can be too late. I am not sure what my father was waiting for, maybe some kind of signal, but even at 80 he wouldn't go and sit with the attorney to get his legal and financial affairs in order.

I thought he might be thinking he was facing death, and he assured me that wasn't it. He just wasn't going to do it, and that was that.

I should never have let up the pressure. The other side of that coin was that I never, ever, thought it would be me taking care of these matters. Never.

But due to bad attitudes, foul language, raised voices, accusations or near abuse, and a healthy dose of game playing by my folks, both sisters pulled out of the project.

For me, that doesn't make this project much different than running a construction job. And I must say, neither of my parents have seen the foul tempered, nasty disposition of a job site foreman side of my personality in person. I don't think they really like it much at all. But at this stage, all of this has proven too much for my sisters, so it all falls to me.

And every time we "come to it" all I can think about it how unnecessary doing all of this now is for both camps.

Once again, I would never have let this go if I though >> I

[Han]

"LDosser" wrote in news:hj3nds$poo$ [e-mail]:

Good luck!!

[Han]

" [e-mail]" wrote in news: [e-mail]:

I do feel your pain, Robert. I was lucky in that my sister was receptive and (as a real estate broker-type) knowledgeable of legal issues in general. Although, she being in France, me in the US, and our parents in Holland, it was a phone relay most of the time. I also was lucky in that my parents did have the DNR-type stuff documented.

[Leon]

I am going through this right now. Both of my parents are 87. My mother was diagnosed with stage 4 cancer on their 60th wedding anneversary in December. She haa gone a round of chemo and 1 week later, Saturday night, went in to the hospital with complications. Not sure if she will come out again to go home. They both have will's and I talked to them about a living will as did the doctor. So far they have not made one. Basically they do not want to think about that at all but there is going to come a time that they will wish that they had.

Once they reach a certain age you have to initiate and follow through with every action for and with them it seems.

[RonB]

Very true stuff. My mother and father-in-law were the first to start decline. My mother suffered several minor strokes and was finally diagnosed with Alzheimer's when she was about 80. Her doctor said it might be the degenerative effects of strokes but the Alzheimer diagnoses put her in a better care mode with nursing care facilities. By the time the social folks started talking about durable power of attorney she was probably beyond the point of reasoning but they, basically, turned their heads when she signed the directives. Pretty much similar story with the father-in-law but he only lingered about a year. Mom went four years in and out of care facilities. We made sure all of the decisions were laid out and documented with the other two parents; and after watching their spouses degenerate they were very supportive....well mostly.

Getting your act together is among the best things you can do for your offspring. When things are going to hell in a hand-basket is the wrong time to have to suffer through end-of-life planning and directives. Some people seem to think that a DNR is a death sentence for a loved one. Not true. Health care workers are run by lawyers too. They will not let a person pass just because they have a DNR order. During my father-in-law's last few months, my wife had to iterated the family's DNR expectation to nursing home personnel no less than three separate occasions; and he recovered briefly from two of the episodes. Not fun for the caregiver but the point is, health workers aren't going to let someone die from a hangnail because of DNR.

Depending on state laws, nursing care financing should be thought out too. I am not a big supporter of long-term-care insurance because most people do not outlive the premium they put into a plan. My mother-in-law would have because she was in independent or nursing care for six years. My father and father-in-law a combined 1-1/2 years. My point is; before the problems start, take time to understand costs, your parents assets and how long one of them can afford to pay for nursing care. Most states allow division of assets (essentially a financial divorce); and you should have a game plan in mind regarding the $-point when you visit the SRS folks to get division started. BTW, in Kansas it took several months, and checks were being written during the process. Also, regarding long-term care insurance the insurance companies play scare games that not fully supportable (We were getting good nursing care for parents for about $30K/year, not the $60-70K cited by insurance carriers).

Again, getting your health act together can be the best things you do for your offspring or caregivers.

[RonB]

Also too true to be comfortable for us. During the fifteen or so years of doctors, hospitals, nursing facilities, lawyers, hospice, etc.; occasionally it emotionally came down to being a job. We were managing "stuff". From time-to-time we had to reset our thinker to realize we were dealing with mom or dad's welfare.

During the fifteen years we also developed a rather offbeat and irreverent sense of humor regarding the situation. I think it was a defense mechanism but it got a few odd stares from folks who haven't dealt with it yet. One one occasion my wife told my daughter "When I start acting like grandma, just shove me off of a curb in front of the bus."

Daughter wasn't amused.

[Larry Jaques]

On Mon, 18 Jan 2010 14:12:09 -0600, the infamous "basilisk" scrawled the following:

Absolutely. After seeing how funds can get tied up in probate for years, sucking up 20%

Not too many people want to face the fact that they're getting older, getting more frail, and that they may soon be sick or senile. Look at the flap about the pamphlet _Your Life, Your Choices_ which O wanted to give to seniors. It was nicknamed the Death Panel book by critics.

I was going to give you a link for it but it is now offline. I found my copy and will email it to anyone wishing a copy. 378KB, 53 pages. I feel that it's a neutral, informative document on a subject which should be considered IN ADVANCE of any family member having problems, if at all possible.

Read it yourself, and give it to your folks to read. Then talk, relating to them some horror stories about NOT having made wills or durable healthcare directives, then see about getting them 'em into a Living Will (this term has now been taken over by healthcare folks to mean advanced healthcare directives, but I mean it in the originas sense.) This keeps their hard earned cash out of the government's hands, too, if they care. Most folks want their legacy to go to their children, not some spendthrift govvy arsebite. I've heard recently of people whose bank accounts have been taken over by the gov't when the elderly family member got sick, but this is unsubstantiated.

[Larry Jaques]

On Mon, 18 Jan 2010 23:52:28 -0800 (PST), the infamous " [e-mail]" scrawled the following:

I hear ya.

Do that now. Get yours in order and take it to your folks' house to show them that you, too, need to have them and you have done so now, before it's too late. It makes a big impression on people to see that in print because it's scary stuff, reviewing our humanity, our frailties.

[Jim in Milwaukee]

Would appreciate it if you would send me a copy. e-mail addy: lujinatsbcglobal.net

Thanks much,

Jim in Milwaukee

Larry Jaques wrote:

[Han]

"Leon" wrote in news:evOdnVQFLe9hK8jWnZ2dnUVZ [e-mail]:

My parents had already expressed the wish not to have their lives extended at the cost of only more suffering. My sister and I had to discuss this for my father's case when I thought the time had come. It wasn't nice, and I am still wondering at times. I am sure I/we made the right decision, but there is always that nagging doubt of what if.

[basilisk]

complicated

reruns. Worse,

he wants, and

the fact

codicil, there are

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probate for

getting older,

senile. Look at

O wanted

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offline.

378KB, 53

a subject

having

talk,

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'em into a

healthcare folks to

originas

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go to their

recently of

gov't when the

unsubstantiated.

Send me a copy as well, bill at welshpembrokecorgis.com Thanks basilisk

[nailshooter41]

I'm very sorry to hear that, Leon. I hope for he best outcome for her, no matter what that might be. Just no suffering....

And by then, the mole hill has become a mountain. With all the litigation going on these days, some attorneys want competency statements and for docs to be notarized in their presence after they review them with their clients. Imagine what it costs to get your attorney to spend an hour or two plus travel time to the nursing home. Ouch!

I agree. And as a special bonus, my father thinks that when you want him to do something, you are pushing him around because he is old. This includes things like reminding him to take his medicine, get ready for physical therapy, etc. He is sure that at this time in his life he is victimized and taken advantage of because of his age. He sees it everywhere.

They haven't lived this comfortably, securely, had less personal responsibility or eaten this well in YEARS. Almost every aspect of their lives is being handled now, and they still feel cheated.

After I went to a caregiver's workshop, I realized how normal this all is for seniors. Now I don't listen that much, and try to focus on keeping them organized, their bills paid, and their 10,000 doctor's appts. in order.

Why it was just the other day I told my old white haired pappy (after

30 minutes of solid bitching - my normal personal makeup only tolerates about two minutes or so then collapses) if he didn't shut up I was going to tie him in his wheelchair and roll him out into traffic.

I felt much better.

Robert

[Leon]

Han, your heart felt decision was the correct one at the time, that is all that matters. Don't dwell on the past, it does you no good.