PLEASE be prepared...

I am 61 and my mother is 83. I presume that most people in this forum are at least middle-aged to be dealing with aging parents with health/cognition issues. My dad died four years ago. My mom has diabetes, congestive heart failure, and stage 4 renal failure. Another 5 point decline in GFR and she will need dialysis. She falls a lot and in the past year, has spent more time in hospitals and rehab centers than at home. After harping at her for the past two years, I finally “stole” her car a couple months ago. Two days later, she passed out in the car while my sister was driving her home from a doctor appointment. Had I not taken her car and she been driving at that time, who knows if she would have killed herself and perhaps someone else on the freeway. Four weeks ago, I put her into a group home against her will. That decision was hard enough, let alone the paperwork and drama that followed.

Mom does not have serious dementia and is fully aware of what is happening around her. Yet she refuses to admit her declining health and the fact that she cannot safely live on her own anymore. Our conversations have been reduced to: “Why are you doing this to me?” “I want to go home.” “Why can’t I go home?” Why are you so mean to me?” “Why do I have to stay here?” After multiple “come to Jesus” discussions, she finally signed a medical and durable POA yesterday, allowing me to access her bank accounts so I can pay her bills and group home costs as well as file paperwork for state and VA benefits. This whole thing is very complicated, time-consuming and emotionally draining – especially since this whole thing has been a fight from day one.

I am not writing this to complain, but to add a perspective to the conversation here. I have become acutely aware of the importance of having one’s affairs in order BEFORE it becomes acutely necessary.

PLEASE… While you are healthy and clear-headed, make arrangements to save your children from being forced into an untenable position. We all think about having a will and advance directives for health issues and final disposition. We don’t think about preparing for many of the other details. For example:

Driving – Do you have a document assigning someone to make the decision about when you become unsafe to drive, and agreeing that their decision will be final?

Guns – Many people are passionate about their weapons. I heard a story on NPR a year ago about an elderly father in the early throws of Alzheimer’s who locked himself in his bedroom with all his guns. The family was terrified. Do you have a document giving someone the authority to take your guns away from you when they feel you are no longer safe with them?

Medical POA – More than a simple DNR form, a medical POA gives someone the authority to make medical decisions for you when you cannot make them for yourself. Who decides when that time comes? Give them that authority now.

Independent living – Perhaps the most important document is a Springing Durable Power of Attorney which gives someone the authority to take over your affairs and make decisions on your behalf when certain conditions are met – usually physical or mental incapacitation. The most important part of this document should be how the determination as to your incapacity should be reached. Perhaps a consensus of doctors and family members would be good. If you do not articulate this detail, it will fall to the courts to determine competence. This process is VERY arduous, expensive, and pits you against your loved ones as enemies. Why would you do that to your kids?

Most of us believe that as we age, we will be reasonable in making decisions. Even though a person may not have serious dementia, sound reasoning tends to wane with advanced age. You do not have to be wealthy or have a complicated estate. These are simple issues to deal with now but will become more complicated when you start getting up there in age.