Tag: caregiving (Page 1 of 2)

Daughter-in-law uses the “D Word” with Mom.

December 3, 2024 / David Russell

I am 81 years old and I live with my son and daughter-in-law. My husband died two years ago and my son insisted I move in with he and his wife. The problem is, my daughter-in-law thinks I have dementia, and uses hurtful comments like, 'well, that's just your dementia talking' or 'you must have Alzheimer's because you're so forgetful.' I hate being a burden on them, but I am most upset that my husband and I did not have a plan for this time in our life. I'd rather be living in my own home, but I don't see a way out. I feel trapped.

Margaret T.

I want you to know that your feelings of frustration and being trapped are valid, and it takes immense courage to share your thoughts. The transition into a new living arrangement at this stage in life, especially after the loss of your husband, can be incredibly challenging. You deserve to feel respected, valued, and autonomous even if you aren’t in your own home.

It’s important to recognize that both you and your daughter-in-law may be feeling overwhelmed. Caregiving can be exhausting, and sometimes stress can lead to comments that hurt more than help. Acknowledging that both sides may be struggling can create a foundation for better communication.

Open Communication is Key

I encourage you to have a heart-to-heart conversation with your son and daughter-in-law. Consider proposing a family meeting where everyone can express their feelings in a safe space. It may be beneficial to prepare what you want to say beforehand, so you feel more confident in expressing your thoughts clearly.

Express how hurtful comments about your cognitive state make you feel. You have the right to set boundaries around how you wish to be spoken to, and doing so can help foster a more respectful and supportive atmosphere at home.

Exploring Options for Independence

If living independently is something you desire, this could be a good time to explore options:

Discuss Alternative Living Arrangements: You could gently approach the idea of looking into independent living or assisted living facilities that might provide the support you need while allowing you to have your own space.
Maintain Your Social Life: It’s critical that you are able to maintain your social life. If there are friends that you connected with before, take measures to reconnect with them through activities, outings, or personal visits. If this isn’t possible, then using technology to connect with these friends in a personal way should be explored. This will help with feelings of isolation.
Consider Home Care Services: If it feels right, suggest the possibility of hiring a part-time caregiver. This could alleviate some of the burden on your son and daughter-in-law while allowing you to maintain privacy and independence.
Leverage Technology: If forgetfulness is concerning, devices that offer reminders for daily tasks can help manage that worry and allow you to maintain autonomy.

Dealing with Regrets

It’s clear that you are grappling with significant emotions, including regret about not having made plans for this phase of life with your husband. It’s common for many couples to focus on the present rather than anticipating future changes, which can sometimes lead to feelings of uncertainty and helplessness. Recognizing this regret is painful, but it can also offer a valuable lesson to others who may find themselves in similar situations.

The truth is that life can be unpredictable; having a plan, even a loose one, can provide a sense of security and options when challenges arise. As difficult as it is to navigate these circumstances now, your experience serves as an important reminder for others: it’s never too late to start planning for the future, regardless of age. Engaging in discussions about potential care needs, living arrangements, and preferences, even when everything seems fine, can pave the way for smoother transitions later.

Prioritizing Your Wellbeing

As you navigate these challenges, don’t forget to prioritize your mental health. Setting aside time for hobbies, reading, or simply relaxing can help you rediscover joy in daily life. If you feel comfortable, talking to a counselor or joining a support group for seniors can also provide a valuable outlet.

Consider keeping a gratitude journal to focus on the positives in your life, which can be empowering and uplifting as you work through this transition.

Moving Forward

Remember that though it may feel difficult, there are paths to reclaim your agency and independence. Your feelings matter, and advocating for your own needs is both important and appropriate. Life transitions can indeed be daunting, but with open communication and proactive steps, you can guide your situation toward greater respect and fulfillment.

I hope these suggestions resonate with you, and I wish you all the best as you move forward. You are not alone in this journey, and there is hope for a fulfilling future.

Politics isn’t the only subject to avoid at Thanksgiving!

November 25, 2024 / David Russell

My siblings and I will be gathering at our parents' home for Thanksgiving this year. It's the first time we've all been together in over five years. Our parents are in their early 80's and while they are independent now, my siblings and I have wondered whether they have a plan for advanced age or long term care. Since we are not all together often, would this be a good time to ask our parents what their plans are? My sister says yes, but my brother says it will only ruin Thanksgiving.

Belinda J.

Thanksgiving is meant to be a time of joy, gratitude, and family togetherness. But when important questions, such as aging and long-term care, linger in the background, it can pose a significant dilemma or create unwanted drama at the dinner table if broached without caution.

While the intent is certainly rooted in love and concern, many professionals suggest that Thanksgiving may not be the ideal time for such sensitive discussions. To best address your question, let’s look at several reasons why it may be better to postpone this important conversation and offer guidance on how to plan for a more appropriate time to delve into these discussions later.

Reasons Why Thanksgiving May Not Be the Ideal Time

Emotional Atmosphere: Thanksgiving can be an emotionally charged time for many families. The holiday brings together various sentiments—nostalgia, joy, and sometimes even stress—that may not create a conducive environment for serious discussions about aging. Introducing a heavy topic could unintentionally dampen the festive spirit.
Distractions and Busyness: During Thanksgiving, families often find themselves caught up in preparations, cooking, and entertaining. These distractions can make it hard to focus on a deep, meaningful conversation. An environment filled with noise and activity may prevent the thoughtful dialogue that these conversations require.
Fear of Conflict: Sensitive subjects about aging can sometimes lead to disagreements among family members. Introductions of differing opinions or concerns could escalate into tension, overshadowing the positive interactions that Thanksgiving aims for.
Lack of Preparation: Both parents and adult children might not be mentally or emotionally prepared to engage in discussions about long-term care during a holiday focused on gratitude and celebration. It’s essential to choose a time when everyone can reflect on the topic without distraction or stress.

Planning for an Intentional Conversation

Given these factors, it might be wise to plan for a more suitable discussion about long-term care and aging when the atmosphere is more relaxed and conducive to open dialogue. Here are some steps to help facilitate this:

Identify an Appropriate Time: Choose another family gathering—perhaps a holiday meal in the coming months or a family barbecue in the summer—as a priority for these crucial discussions. Setting a specific date allows family members to mentally prepare and ensures they’re ready to engage in constructive dialogue.
Create a Comforting Environment: Once you have a date in mind, plan the environment thoughtfully. A comfortable, quiet setting can enhance communication, allowing for open discussions where everyone feels heard and respected.
Build the Foundation Early: In the lead-up to your planned discussion, consider mentioning the importance of discussing aging and long-term care in a less formal setting. A casual conversation in passing can help normalize the subject. For example, during a family call or chat, you might say something like, “I’ve been reading a lot about aging and care planning; it’s something we should consider as a family.”
Engage Gently During Thanksgiving: Use the Thanksgiving gathering to plant the seed without forcing the conversation. You could bring up related topics, such as discussions about recent medical advancements or friends’ experiences in caring for aging parents. This can pave the way for future conversations without putting anyone on the spot.
Reassure Your Parents: If you know your parents have some thoughts about their future care plans, encouraging an ongoing dialogue can make them feel involved in the decision-making process. For instance, you can express appreciation for their independence and state, “I admire how well you both are managing, and I think it would be comforting for all of us to have a plan in place moving forward.”

Fostering Ongoing Conversations

Once you’ve planted the seed and the initial discussion takes place, continue to foster the conversation. This topic doesn’t need to be resolved in one sitting. Encourage check-ins that keep it open, ensuring that everyone feels comfortable discussing changes or updates in the future.

By creating a culture of transparent communication around aging, your family can approach the subject in a way that feels natural rather than forced.

Prioritize Connection Over Timing

While Thanksgiving offers a wonderful opportunity to bond as a family, it may not be the best moment to tackle serious discussions about aging and long-term care. By postponing this conversation to a more suitable setting, families can ensure that everyone is willing and able to engage thoughtfully. Planning intentional discussions and subtly introducing the topic can pave the way for a supportive dialogue, ensuring that family members feel connected and prepared for the future care of their loved ones. By prioritizing the right time and environment, families can foster an atmosphere of love and understanding while addressing the realities of aging head-on.

Dad has become “a Monster”

October 31, 2024 / David Russell

I know I'm supposed to keep a good attitude with my aging father. He moved in with us about six months ago after Mom died, but he has become a monster! He is demanding and expects me to wait on him hand and foot. He belittles me and is inconsiderate to my husband. He's even become suspicious of my handling his finances, which he is unable to do on his own due to his cognitive decline. I have two other siblings who live far away and they have no idea how difficult this is. I promised Mom I wouldn't put him in a nursing home, but this has become more difficult than I imagined.

Margaret A.

Ah, the joys of caregiving—where the role of dutiful child transforms into an unexpected stint as a live-in ghostbuster. Take a moment to appreciate the ghastly twist your life has taken since your father moved in after your mother’s passing. What started as an extension of your compassion and hospitality has somehow morphed into a full-blown horror show. Six months in, he’s become a monster! It sounds like you’re living in a haunted house, filled with demands that would make even the most patient caretaker break out in a cold sweat.

As the days turn into a series of eerie encounters, navigating your father’s new demands must feel like you are a character in an Edgar Allen Poe short story. From expecting to be waited on hand and foot to belittling comments, the challenges of caregiving can resemble a horror movie gone awry. It’s natural to feel frustrated and overwhelmed when the person you’re trying to support appears possessed by something other than common courtesy.

Reader asks, “What’s the difference between ‘assisted living’ and ‘nursing home care?

October 1, 2024 / David Russell

My father is 89 and seems to be forgetting things like taking his medications and practicing good hygiene. Last week, while visiting him at his home, it was clear he hadn't bathed for several days and he looked unkempt. I've been looking into nursing homes in the area where I live, but a friend suggested I look into an assisted living facility instead. What are the differences and is one generally more expensive than another?

Stan B.

It’s understandable to feel apprehensive when you notice changes in a loved one’s well-being, especially in their later years. Aging brings a myriad of challenges, and your attentiveness to these issues is commendable.

Your father’s situation—forgetting about medications and neglecting personal hygiene—is not uncommon among seniors. It can be difficult for them to maintain independence while also ensuring their needs are met adequately. Given these circumstances, exploring options like nursing homes and assisted living facilities is a wise move.

Dad has Alzheimer’s. Mom asked me to take over the finances. Where do I start?

September 17, 2024 / David Russell

I just found out my dad has been diagnosed with Alzheimer's disease. My mom called me and through tears asked if I would take over their financial affairs while she tends to Dad's care. I have no idea where to start, what they have, or where to find anything. I think they are fairly well off. They live comfortably and own a vacation property in Idaho that we all use occasionally. I have an older brother, so I'm not sure if I have the authority to do anything. She did say they have Wills in a safe deposit box, but I don't know how to access it. What should I do now?

Shelly T.

Receiving news about a loved one’s Alzheimer’s diagnosis is undoubtedly a heavy burden. It’s challenging to process the emotional ramifications, and on top of that, your mother is reaching out for help regarding their financial affairs. It’s natural to feel overwhelmed and unsure of where to start, but you’re not alone in this.

While this will be a profoundly personal journey, here are a few tips to begin the process of taking over financial decisions.

Mom leaves more to one child than another: what could go wrong?

September 10, 2024 / David Russell

Three years ago, my mother moved in with me and I became her full time caregiver. Last year she changed her will to leave more to me than my sister who hasn't done anything for her care. In fact, she hasn't spoken to mom since she moved in with me. I don't get paid for providing care, but I do use her social security check to help pay for household bills and groceries. Aside from that, mom has a sizeable stock account that she inherited from our dad. I'm worried my sister may cause trouble when mom dies and learns she doesn't get as much as I do. Should I ask her to change her will to be more equal?

Esther B.

I can sense the unease in your voice. As caregiver for your mother, it makes sense that she might favor you in her will, especially if your sister isn’t interested in a relationship with your mom. While your question is more about what happens after your mother dies, my hope is that there will be opportunities to communicate with your sister before that happens, resolve the rift between her and your mother, and avoid the potential conflicts that may arise. Ultimately the decision to accept the provisions of your mother’s will is hers.

That said, let’s discuss some practical issues to address your concerns, minimize legal complications, and discourage potential disputes with your sister when it comes to your mother’s will.

Understanding the Legal Framework

First, it’s important to ensure that the change your mother made to her will is legally sound. The will must have been updated at a time when your mother was fully competent and free from undue influence. Consulting an estate attorney can ensure all legal protocols were followed, thus making it less vulnerable to future challenges.
Was the change made with the assistance of an attorney? Although it’s not a requirement, using an attorney to execute legal documents like wills can avoid the mistakes people make when doing it themselves. Often, people will write a will in their own handwriting (called a holographic will). While these may be valid, these types of wills are easily disputed and may not have followed the procedures for valid will executions in the state where the person resides.
Assuming your mother did use a lawyer, and at the time did possess the capacity to execute a new will, who was present in the room with your mother’s lawyer when she changed her will? Just your mother? You with your mother? Only you? Ideally, it was only your mother. If you were present, did the lawyer directly address your mother or direct questions to you? The less your involvement in the meeting, the less likely you could be open to accusations of undue influence.

Guarding Against Will Contests

If your sister decides to contest the will, she could potentially claim undue influence or argue that your mother lacked the mental capacity to make such a change. To prepare for such scenarios, work with her attorney to maintain thorough records of the discussions and motivations behind the will’s adjustments. This documentation reinforces that the decision was made independently and with full awareness.
Did your mother include a no-contest clause to her will? Known as an in terrorem clause, this can discourage your sister from contesting the will, as she risks forfeiting her inheritance if she loses the challenge. While this is not enforceable in every jurisdiction, where applicable, it serves as a strong preventive measure.
A letter of intent can also be included, detailing your mother’s reasoning behind her decisions. This document, although not legally binding, provides context that could be useful in defending the will against disputes. Sometimes, these are prepared by the person creating the will, but the attorney may also provide this service.
Keeping detailed records of your caregiving responsibilities and related expenses is crucial. Not only does it validate the more substantial inheritance in compensation for your caregiving role, but it also provides a clear, factual basis for the distribution decision should your sister challenge it.

Proactive Communication and Mediation

Facilitating open communication with your mother and sister could be beneficial. If your mother is comfortable, hosting a family discussion where she shares her reasons for the will’s changes may help your sister understand the context and reduce tension. Transparency often alleviates suspicions and pre-empts conflicts.

If direct communication seems difficult, consider bringing in a professional mediator. A neutral third party can help facilitate productive discussions and address any underlying concerns or grievances. This proactive step can prevent more heated disputes down the line.

Engaging a Professional Team

Engaging the right team is critical. Not only can a team of professionals provide advice and counsel, but their presence and involvement demonstrate that you are not acting alone in managing your mom’s affairs. If her lawyer does not specialize in estate planning or elder law, you can look for one near you by visiting the National Academy of Elder Law Attorneys. Other team members might include a geriatric care manager, financial planner, or family counselor.

By addressing these issues now—through open communication, legal safeguards, thorough documentation, and professional advice—you can reduce the likelihood of disputes and honor your mother’s wishes effectively. While it’s a challenging situation, approaching it with preparation and empathy can help maintain family harmony and respect for everyone involved.

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Can Mom’s New Boyfriend Replace Me as Power of Attorney?

September 4, 2024 / David Russell

I hold power of attorney for my mother. She's 89 years old and for the last two years, she has had a close companionship with "Stanley," a widower in the retirement community she lives in. Lately when we've discussed her future care needs, Stanley has been present and has bristled at the idea of Mom moving into assisted living or skilled care, even suggesting she move in with him. I'm concened that Stanley could talk her into removing me as power of attorney and naming himself. If so, what can I do to protect her?

Sarah T

First, your mother’s happiness is undoubtedly important, but so too is ensuring that her interests are protected as she navigates this vulnerable time in her life.

So, take a deep breath. This is a common concern that many family members face, and you’re not alone in dealing with these situations that involve both touchy and practical issues.

Reader is Confused: “Doesn’t Medicare Pay for Long-Term Care?”

August 27, 2024 / David Russell

I'm confused. My 78 year old dad recently had heart surgery and was released to a long term care facility for several weeks of rehab. He has Medicare and has a Medigap policy as well, but a long term care expert recently told me that Medicare won't pay for long term care. We've yet to get a bill from the facility, but now I'm concerned he's going to have to pay for this out of his pocket. Can you clarify this please?

Jeff P.

Sorting through health insurance details can sometimes feel like navigating a maze, especially when it comes to your dad’s recovery after heart surgery. If you’ve recently been told that Medicare won’t cover long-term care while he’s in a facility for rehabilitation, you’re certainly not alone in your confusion.

Medicare and Rehab Services

First off, let’s tackle the terminology. When we talk about long-term care, we often think of assistance provided in a nursing facility over an extended period. However, after a hospital stay, what your dad is receiving at that facility is actually classified as rehabilitation services – not long-term care —and that’s where Medicare comes into play.

To qualify for Medicare coverage in a skilled nursing facility (SNF), your dad needs to meet a few key requirements:

Hospital Stay: He must have a qualifying hospital stay of at least three consecutive days. Two days just won’t cut it, nor does admittance “for observation.” It must be an actual admittance for treatment in a hospital for at least three consecutive days!
Timely Admission: He needs to be admitted to a Medicare-certified skilled nursing facility within 30 days of being discharged from the hospital.
Type of Care: The services provided must primarily be skilled nursing care or rehabilitation therapy (think physical or occupational therapy).

Coverage Duration

Now that we’ve established that Medicare does indeed help with rehabilitation in a long-term care facility, let’s cover the specifics of what’s included:

Days 1-20: Medicare Part A kicks in and covers 100% of the costs in a Medicare-qualified rehab facility. It just so happens that many of these facilities are also nursing homes.
Days 21-100: From day 21 onward, there’s typically a daily copayment involved. For 2024, this amount is expected to be around $200 per day. Definitely something to factor into your budgeting.
Days 101 and Beyond: After the first 100 days, Medicare steps back and does not cover any costs. It’s all out-of-pocket!

Out-of-Pocket Costs and Medigap Magic

With the basics in mind, let’s get to the crucial part: out-of-pocket expenses. This is where your dad’s Medigap policy can really come to the rescue.

What is Medigap?
A Medigap policy is basically supplemental insurance that covers some of the costs that traditional Medicare doesn’t. Most Medigap plans help cover the daily copayment that starts after day 20.

Plan F: Offers full coverage of those copayments after the 20th day.
Plan G: Generally covers the copayments but requires that annual Part B deductible to be paid first.
Plan N: This one can require some copayments for certain services, but it still provides significant coverage for the days beyond 20.

Taking a closer look at your dad’s specific Medigap plan will give you the clarity needed to manage these potential costs.

Tips for Managing Long-Term Care Costs

Communicate with the Facility: When that first bill rolls in, don’t hesitate to reach out for clarification. Ask them questions about what Medicare is covering to understand your father’s financial responsibilities better.
Review the Medigap Policy: Make sure you’re familiar with the details of your dad’s Medigap plan. Each plan can have different coverage options, so understanding what’s included can help avoid surprises down the line.
Explore Other Aid: If costs start feeling overwhelming, consider looking into additional resources, like Medicaid or veterans’ benefits, which may help cover expenses once Medicare and Medigap benefits have been exhausted.
Get Professional Guidance: If you find yourself feeling lost in the financial fog, consulting with a financial advisor who specializes in elder care can provide direction and peace of mind.

While it’s easy to mix up the terminology surrounding Medicare, particularly when dealing with rehabilitation services in a long-term care facility, the key takeaway is this: If your dad is eligible and receiving rehab services, Medicare can help cover those costs—at least for a while! Understanding how Medicare and Medigap work together will empower you to make informed decisions about your father’s care and manage any potential financial burden.

Remember, you’re not alone as you navigate this. It may feel complicated now, but with a bit of persistence and the right information, you’ll find your way through!

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Ten Ways Technology Can Help with Remote Caregiving

August 20, 2024 / David Russell

I live far away from my older parents and I have no siblings. They insist on staying in their home as they age and I am concerned about their being alone. I work in the tech industry and would like to know what new technologies are useful to help families care for their aging loved ones?

Mark W.

This is such a common situation nowadays. As our parents grow older, their desire to remain in the comfort and familiarity of their own homes is completely understandable. For those of us living far away without siblings to share in the responsibility, ensuring their safety and well-being can be challenging. Fortunately, advancements in technology, alongside traditional forms of support, offer innovative solutions to make caring for aging loved ones manageable from afar. As someone working in the tech industry, you’ll find these developments particularly meaningful as they offer peace of mind while fostering closer connections despite physical distance

Smart Home Devices

Smart home technology has become indispensable for seniors wishing to age in place independently. Devices like smart speakers with voice-activated assistants (such as Amazon Echo or Google Home) enable seniors to set medication reminders, manage schedules, and control home appliances effortlessly. Additionally, smart security systems, like Ring doorbells, allow older adults to monitor visitors at their doorstep without having to physically open the door, enhancing both safety and convenience.

Personal Emergency Response Systems (PERS)

PERS have advanced beyond simple panic buttons. Current systems offer features like fall detection, GPS tracking, and two-way communication. Products such as MobileHelp and Philips Lifeline ensure that seniors can summon help at any moment, providing reassurance to both them and their distant caregivers.

Telehealth and Remote Monitoring

Innovations in healthcare technology have transformed access to medical care for seniors. Telehealth platforms facilitate virtual doctor visits, significantly reducing the need for travel. Additionally, remote monitoring tools track vital signs, including heart rate and blood pressure, sharing real-time health data with medical professionals to ensure timely care and intervention.

Robotics and AI

The rise of robotics and artificial intelligence in elder care is an exciting development. Companion robots like ElliQ by Intuition Robotics and Pepper by Softbank Robotics are designed to engage with seniors, offering companionship, reminders, and health monitoring. Furthermore, AI-driven tools can analyze behavioral patterns, identifying changes that may signal health concerns before they become serious issues.

Why Banks Might Refuse a POA

August 13, 2024 / David Russell

I hold a valid power of attorney for my mother, but when I tried to use it at her bank, the bank refused to recognize it. Why would the bank refuse to honor a valid legal document?

Nancy s.

As a holder of a power of attorney (POA) for a loved one, it can be incredibly frustrating when a bank refuses to recognize this legal document. You may believe that you have the authority to act on your mother’s behalf, but banks sometimes take a cautious approach when it comes to powers of attorney. Let’s explore some common reasons banks might refuse to honor a valid POA and what you can do if you find yourself in this situation.