Posts Tagged ‘Aging Parents’

Hospice, Funerals, Cremation and Saying Goodbye

My Godmother, Dad, Uncle George (poet) us kid in Italy 1960

My Godmother, Dad, Uncle George (poet) us kid in Italy 1960

My mother was diagnosed with Dementia in May 2006 while my step-father was dying of lung cancer.  Hospice was our saving grace.  I had no idea how wonderful their support and advise would be during Dad’s last few months of death.  He died on my birthday, October 24, 2006.

My mother lived at Sunrise Assisted Living and enjoyed her life very much.  In fact, I just received a copy of the last letter her friend, Norio, of Japan received from her.  Here is a quote from her note, “I don’t have much to say since I don’t do anything except play cards anymore.  I hope you are enjoying every day of life.  I sure am.”

On December 8th, 2009, Hospice was called in to help my mother since her health had deteriated so bad. I knew the routine and went through mourning on my way home from her place that day.  Between Hospice and Sunrise her last month was very pleasant and I enjoyed every moment with her.  She passed away peacefully on Thursday, January 14th.  I had a traditional funeral with a cremation immediately following the service.  I was told that 50% of families are now choosing cremation.

Since my mom’s name is Rose, I am planting a gorgeous Rose Garden with her ashes this spring right in the middle of our circular brick paver drive. There is a huge stone there already, so I will have it inscribed with her name.

After the service, my loved ones and I had the pleasure of going through the dozens of photo albums, scrapbooks, and letters she and my father exchanged when he first went into the army.  I also came across a stack of poems written by my godmother’s husband, George Richardson, a distinquished poet and one of her best friends since high school.  I would like to share it with you now…I promise you will read it twice and it will bring tears to your eyes…

My dear I lay awake last nightTill you were by my side –
The lights were out, the dog was gone
My God I almost cried
I heard your voice as you came in
The first time late for bed –
I thought at first it may bave been
Just something I had said
Twas then I made my mind up dear
I’d be a better mate –
And rid myself of all the doubt
The years of jealous hate
And as you stood beside my love
The scent, it filled the room –
So like the smell that meant so much
When we first bride and groom
The song you picked to play that night
My eyes I kept them shut –
How wrong I’d been through all these years
Within my stubborn rut
I tried to raise my hand to you
With ring that we had wed-
But that’s when you apologized
For all that you had said
I guess that’s when I first felt good
Our friends were all around –
I knew I couldn’t reach you now
And Where that I was bound
The kiss you placed upon my lips
AS though it dealt by fate –
Within my coffin I did lay
Your kiss was two days late

~George Richardson

About the author:  Katana helps women ages 43-60 create lives of abundance, joy and financial freedom while following their passions.  She is a Certified Financial Planner and Caregiving Expert.  You can contact her at katana@katanaabbott.com

Hospice offers a helping hand: Saying Goodbye to Mom

Mom's art show at Sunrise Assisted Living

Mom's art show at Sunrise Assisted Living

My mother has been in Hospice since the first of December.  She suffers from Dementia which is a brain disease.  I just got off the phone with a relative, and he couldn’t understand why Dementia is causing her decline since is seems like a simple brain or memory loss issue.  It’s not though.  Since she was diagnosed, she has slowly been declining in all areas of her life.

I remember taking her to Fitness 19 to work with a trainer last year, and she told me that mom’s muscles were no longer firing…and she just could not seem to get the rhythm of the treadmill together.

Last summer, she was still taking long walks with me and working in the garden and even playing pool with my husband when she began to experience a serious decline.  It may have been the change in her medications after her last visit to the neurologist…I have racked my brain over this.  It doesn’t matter now though, because I and everyone else did our best. 

In most cases, caregivers are giving 100% and it’s just part of the process and there is nothing we can do about it when the decline begins.  My mom went into the hospital in August, came home was back in a month later, came home, and them moved to the dementia section of Sunrise Assisted Living.

If there is anything I can recommend to someone reading this post, it is to go to the higher level of care earlier in the game. My mother stayed in assisted living for 30 days longer than she should have and had several falls.  Once she moved to the higher level of care, she was so well cared for, that she thrived at first.  But in the end, there was nothing anyone could do.  No heroics could save her.  She was on her path to transition to the other side, and I could not stop it.

Maybe she just wants to go visit everyone.  All her loved ones have already left this world.  Tonight, as I sat next to her side, she was unconscious for the first time.  I told her I loved her, I said The Lord’s Prayer for her and I told her it was okay to look for her loved ones.

I hope it’s wonderful on the other side.  I hope she is happy when she gets there.

Hospice has made this process so much easier. If you are not familiar with Hospice, don’t be afraid when the doctor recommends it.  They are the most caring and loving people.  They have mad this entire experience so peaceful for her and for us.  Feel free to share you experiences with me.  I would love to hear from you.

Caregivers and When to Bring in Hospice?

Thanksgiving with mom

Thanksgiving with mom

What do you do when the doctor recommends calling Hospice for your loved one?  After visiting my mom on Thanksgiving and watching her finish her entire dinner, it was shocking to visit her just a week later to find her on oxygen.  My daughters were in tears as we played a couple hands of rummy with her while I held her cards and played for her.  Just weeks ago, she had been able to play independently…plus she actually beat me at a few hands.  How does this happen so quickly?  I called her doctor, and he recommended that we contact Hospice for a consultation.

I am very familiar with Hospice.  My step-father was diagnosed with lung cancer at 86 in October 2005.  We managed to keep dad healthy and enjoying life (beating all odd, the doctor said) and finally called in Hospice in June.  Hospice was our saving grace until he died on October 24, 2006 on my birthday.  I love Hospice.  I’ll share that story with you one day…now back to mom.

Yesterday, I surprised mom on her birthday.  She is just 76 and suffering from dementia and a series of unexpected falls that have caused this sudden change in health.  She was very excited to see me with her gift and cards in hand.  She was just finishing up with her last therapy session that was related to her hospital stay and subsequent rehab stay at Fox Run.  It gets complicated, doesn’t it?

I have been crying on and off every day and feeling this pit inside my stomach since I realized that my mom really is declining.  I have been asking myself did we do all that we could have, did I choose the right doctors, what chould I have done differently?  It’s funny how we do this to ourselves.  I am sure I am not alone with these types of feelings, right?

When I look into my mom’s eyes now she seems to be telling me all is fine and she is ready to go and be with Dale (my step father), and her mom, dad, bothers, and Aunt Madge.  She smiles all the time and is just happy to be with me and grateful for the moments of time we have together right now.

I am calling Hospice tomorrow as her doctor has recommended.  It seems so final, but I know it’s the right thing to do.  What are your feelings about Hospice?  Thank you for your support right now…and I send my love to all of those who are going through this same process right now.  Feel free to share your thoughts…

Caregiving and Gratitude

Yesterday I visited my mother at Sunrise Assisted Living.  She had just moved over to their Reminiscence – dementia section.  At first I was worried that she would not like it, but after visiting, I found that the homey setting which resembles a very large open kitchen, dinning and living area was perfect for individuals at this level of need.

About six weeks ago, my mom had a short stay in the hospital and than spent three weeks in rehab at Fox Run, an Ericson Facility, my mother spent her days in bed, often in a hospital gown.  Although their nurses and care was excellent, my mom was bored and sleep most of the time.  At Sunrise, she is up and dressed, her hair and nails are done every Thursday.  They even gave her a pedicure.

I visited mom yesterday, and she looked beautiful…she could not get the smile off her face.  She loves her new room and we even played a game of cards.  It’s amazing how lucid she was after my experience last week when she barely recognized me.

Today while I was preparing turkey dinner, my brother ran over to see mom and had a Thanksgiving lunch with her.  I even received a call from her nurse giving me an update on her condition.  She said mom would not be able to travel to our home today, but she was doing much better after the “house call” from the Sunrise physician.

My heart goes out to all these wonderful caregivers.  Thankyou for giving your lives in the service of others so our loved ones can maintain their dignity and quality of life.

Reminiscence

Caregiving Dilemma: dehydration, over medication or what?

As a caregiver to my mom, I am forced with a huge dilemma right now.  A week ago, I went to visit my mom at Sunrises Assisted Living.  She was still in bed at 10 am.  Recently, she has been wanting to sleep.  She was excited to see me when I woke her up, so I helped her with her shower, and then helped her get dressed.  I was shocked to see how much she deteriorated in her abilities to manage on her own and it puzzled me.

Mom and Dad

Mom and Dad

 

How could my mom be experiencing such huge changes in her physcial and mental abilities so quickly and what could I do about it.  I decided to spend a few hours with her to see how she was managing her daily activities.

I took her to the dinning room and asked the chef to prepare scrambled eggs, toast, OJ and coffee.  When it came out, not only was it delicious, but I was thrilled too see my mom devour every last bite.  She had no problem managing her breakfast independently and we had a great time together.

Next, I invited her to play rummy and she was thrilled.  We started playing in the bistro, and soon we had a full table of other players.  Mom played quite well.  The only issue was that I had to remind here when it was her turn.

One week later, last Saturday evening, I stopped over to say goodnight and to my horror, my mother was in here wheel chair, looking off into space with a dazed look.  She did not recognize me, and could not speak or move her legs.  What was going on?  I pulled out one of her photo albums, and began to show her pictures asking her who these people were.  When I showed her a picture of herself, she replied, “Mum-ma”, like a talking doll.  When I asked her to identify her recently deceased husband — my stepfather –she  replied, “Pa-pa”.

I called the attendants in to help my mom to bed…and left in tears.  What was going on?  One thing I noticed is that my mother seemed very dehydrated, so I called the nurse and requested that they monitor her food andn water intake and make sure she is given water regularly with a straw as if she was in a hospital.

I noticed that she even had a problem swallowing the water and pills that night…and I was told that she has lost interest in eating.

What does a daughter do at this point?  What do you do when a loved one is unable or unwilling to feed themselves and begins to refuses food?

Please share your stories and experiences with me for my upcoming book with co-author and Legacy Expert, Meredith Bromfield called, The Designated Daughter:  Caregiving and Legacy Planning.   Thank you.

Selecting a Long Term Care Facility with Long Term Care Insurance

My mother, Rose, painting with Dementia

My mother, Rose, painting with Dementia

My mom is back at Sunrise Assisted Living and is thrilled to be back home. The only problem she has been facing currently, is that she is now what they call, “a fall risk”. In fact, since she returned home from rehab at Fox Run, she has fallen four times. This means that her level of care is going up and so will her monthly costs. I have a dilemma to deal with. Since my mother has a long term care policy that pays $90/day for an assisted living facility and $150/day for a skilled care facilitity, my question is: Should I move mom to a skilled facility and collect the extra $60/day benefit or $1800/month for her, or do I use her savings to make up the difference in rent?

Sunrise is not considered a Skilled Care Facility, so the most my mother can receive from her policy is 60% of her monthly $150/day benefit. If she were to move to a Skilled Care Facility like Fox Run (owned by Erikson), for example, she could receive the $150/day. Another issue: Fox Run also requires a $100,000 deposit to move in. Not all facilities do this, however, the deposit is returned to the resident when they leave, OR to their estate when they died. Plus there is an added benefit. The resident will never be forced to leave because they run out of money. Once the deposit is used up, the facility takes care of their expenses.

There is a lot to consider, right? My mom spent three weeks at Fox Run in rehabilitation and what I found is they are an excellent medical model facility. The care, however, is totally different than where she currently lives. Fox Run provides a “Medical Model” of care and Sunrise follows a “Social Model”. While my mom was at Fox Run, she was bored and spent all her time in her bed sleeping. Now that I have brought her home to Sunrise, she has spent her days dressed, socializing and very active. We both like the model so much better.

Be sure to consider this when you are looking for a long term care facility for your loved one. It’s amazing not only how many choices there are, but also how the type of facility you select can affect your long term care policy. Let me explain.

When my step father was diagnosed with lung cancer and my mother with Dementia in the fall of 2005, they moved from their private home to an “Independent Retirement Community”. Here they had a two bedroom apartment and even though they had a kitchen in their apartment, lunch and dinners were provided in a beautiful formal dining room with the other residents. When my father became very ill, the facility actually managed the medications and helped with custodial care for an additional fee. He paid for his expenses out of pocket, and then applied to his long term care policy for some small “home care benefits” that the policy provided.

While they were living in an “Independent Living Facility”, my mother was diagnosed with Dementia and qualified for benefits under her long term care policy. The problem we found out was that Independence Village was neither an Assisted Living Facility or Skilled Care Facility even though they had full time nursing staff. It actually had something to do with the construction of the building!

At this point, although my step-father qualified for his long term care benefits, we would have had to move him a new facility to collect his long term care policy benefits. We decided that peace of mind (staying in place) was more important that collecting insurance benefits during his final nine months of life. Had we known about this issue in advance, we would have selected another facility that offered multiple levels of care. This is a good thing to consider before selecting a facility when you own a long term care policy.

So when my step-father passed away, I moved mom to my house temporarily and began to look for a long term care facility that would work best for her situation. This is when we chose Sunrise. The West Bloomfield Facility was just 10 minutes away and she woudl have a wonderful studio apartment, three meals a day and lots of social activities. Her policy would pay 60% of her long term care policy daily benefit which was $150/day.

So this is where mom stands today: She is moving to another wing of Sunrise where they offer a much higher level of care AND she will not be in a nursing home envirnoment. Instead, she will remain very active and spend her days with the other residents in a “home style” area and just go to her room to nap or sleep at night.

Her rent, however will jump from $4800/month to $6330/month. Again, I can collect another $1800/month for her by moving to a Skilled Nursing Facility, but she would be back to the Medical Model. I have decided to run a financial time line to compare the difference between moving and staying to see how long her money will last both ways. And I have also put her on a list to move to the first semi private room when it becomes available. This will save her around $1200/month.

So the question is would you rather be in a Medical Model Skilled Cafe Facility collecting $150/day benefit (probably still in a shared room), or would you rather be in a very large “studio apartment” style shared room in a Social Model Facility for $600 more per month? My choice is the social model. We will start out paying around $6000/month initially for a private room, and then around $5000/month as soon as a semi private room is available. This sounds like a reasonable solution.

My mother is very fortunate. Because she and my step-father came to me for financial planning right after they were married 20 years ago, they were able to do a financial and estate plan when many options were available and insurance costs wereaffordable.

My mother’s long term care policy premium at age 58 (20 years ago) was under $100/month for a lifetime benefit period, and with an inflation rider (so her policy benefit would increase every year by 4%). If she had waited until she was 70 to purchase the policy, it would have been too expensive and she would have been uninsurable.

The secret is starting to plan as early as possible…beginning with our own planning….and realizing that no matter what your situtuation is today, there is always an appropriate plan of action. The key is finding a caring and knowledgeable advisor to help you through the process.

I would like to hear your experiences. Feel free to share them with us. If you are interested in help with these types of questions and situations, email me at katana@designateddaughter.com or call me at 248-366-0137. Either I or one of our Contributing Experts will be able to help you with your situation. Also, be sure to sign up for my Caregiver’s Manual right here on the website. It’s a great tool for helping you prepare for this entire process.

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