Elder care for dummies – what we did right

I’m now 5 months into unexpected elder care.  Many people have urged me to list some tips for others who might be going through this process. So here’s a candid assessment of what I think my family did right. 

The background:  my 85-year-old mother was still living by herself in the New England home that she and my father purchased in the early 60s. She was diagnosed with colon cancer a couple of years ago, and was undergoing biweekly chemotherapy treatments. Despite urging from her family friends and neighbors, she resisted any effort to even contemplate moving from the house into independent living, let alone take action.   To make matters worse, she grew up during the Depression and hoarded everything.

Last August, I flew out to visit her and found her holed up in her bedroom with severe stomach pains and not having eaten in several days. I called an ambulance, and after several tests in the emergency room, it was determined that she had a hernia. She subsequently underwent surgery, then went to rehab for four weeks, and after that point her oncologist stated that it would be impossible for her to return to independent living in her house.   He also was halting chemotherapy for good because he did not feel her fragile condition could withstand it.

• Almost 15 years ago, we proactively put all of the kids’ names as co-signature authority on mom’s bank account.   This enabled us to quickly assess her financial affairs when the crisis occurred.
• Just this past March, we used the services of one of my high school friends, who practices family law, to update mom’s will, power of attorney, and health care power of attorney.
• My mom let us know where in the house she kept most of her important papers.
• 10 years ago, and then five years ago as an update, I sent her a questionnaire to fill out. In it, I asked as many questions as I could think of to ensure that when “the time” came, we would honor her wishes as closely as possible, including what music she wanted played at her funeral, whom she wanted notified, and where her plot was.   Many families may find this gruesome – to me, the most gruesome thing is trying to figure out what your loved one would have wanted with nothing to guide you. Better to research this years ahead.
• In the years since my father passed away in the early 80s, we removed as many items from the house as mom would let us (which wasn’t much) in an effort to stay on top of the clutter.
• Just a few years ago, I took her through the house and asked her to identify some of the antiques and glassware. As she told me about each one, I wrote the information down and taped to the underside of the furniture or put a small piece of paper inside the glass.
• When she was moved to rehab, we only had a couple of hours to decide where she would be taken. (Warning – it is typical for hospitals to only give you this little notice before your parent is discharged). We chose a rehab center that was close to the hospital, in the event that she might have to go back on ER trip. As it turned out, she did have one incident during rehab and fortunately the hospital was only two minutes away.
• We met with an eldercare lawyer early on to ensure that we understood all the estate tax ramifications.
• Although it was in a rush, we researched all the assisted living and nursing home options in the area, and chose one that was extremely clean, close to all her friends and neighbors, and most important of all, had the best meals.  We ate several meals at the facility unannounced.
• We went through all of her bills and eliminated all the unnecessary ones to save money.
• We divided the house contents into categories:   pure recyling, paper with addresses/personal info that needed to be shredded, items to donate, items to be appraised, items to be sold.
• We hired Shred-It to come to the house to pick up and destroy all of the paper to prevent identity theft. 
• We trusted our instincts. Something told us to hold off starting hospice right away, even though we were urged to do so by rehab, and as it turns out, according to some state laws, if you have already started hospice you are therefore not eligible for assisted living.  Had we jumped right into hospice while she was in rehab, we would have had no option but to put her in a nursing home after rehab. She is much happier in assisted living.

We’re still learning as we go along.    If I could change one thing, it would be that we had addressed the “elephant in the living room” more directly – i.e. her inability to make decisions – and forced her hand.  If your elderly parent lives close to you, it isn’t such a challenge.   Mine lives a 5-hour plane trip away, so the tasks at hand are a little more daunting, even in this 2.0 age.