retirement

    Are You Listening?

    As our parents get older, we often relate to them as if they were our children and we listen to them in that way. My mother suffered from Alzheimer’s and her conversations would revolve around a few topics: her need for a phone, an eye doctor appointment and another box of tissues. But occasionally she would say something quite profound, and if I weren’t listening to her carefully, I would miss it.

    Being a good listener is a real art. Several years ago I took an excellent training course in Elder Mediation offered by Elder Decisions in Boston.  Sharon, an attorney from Maryland, who was in the course with me,  introduced me to some of the books written by members of the Harvard Negotiation Project.  She shared a book with me written by Douglas Stone, Bruce Patton and Sheila Heen entitled, Difficult Conversations, How to Discuss What Matters Most. In this book, the authors describe the key skills to become a good listener.  I think we would all benefit from applying these skills to our conversations with our elderly parents.

    The authors state that truly listening to another person transforms your relationship with them.  They suggest learning to listen “from the inside out.” In other words, listen with curiosity. Ask questions. Paraphrase what your parent says so s/he understands that you understand him/her. Listen for the feelings behind what is being said and acknowledge those when you hear them.

    But don’t let your conversation become an exercise in listening correctly. The heart of good listening is listening with authenticity. People will sense what’s going on inside you if you are not genuine. If your intentions are good, the words you use are not that important.

    The authors remind us that each of us has an internal voice, the voice inside our head that reports what we are thinking, not what we are saying. This internal voice is constantly evaluating everything that is going on, including our words and actions and what the other person is saying. If we are not aware of this voice, it can create havoc with our attempts to listen to others authentically.

    Listen to that internal voice in your head. What is it saying now? (What, me? I don’t have any internal voice.) Don’t turn off the voice, but listen to it carefully.  How is it evaluating what the other person is saying? Get to know the kinds of things your internal voice is transmitting to you so they don’t interfere with your conversation.

    Stay focused on curiosity in your conversation with your parent. Remember that most people, especially elders, rarely perceive that anyone is actually  listening to them. And when they sense that you are authentically paying attention, it will open up their heart.

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    What will you do with all your stuff?

    One of the greatest concerns I have noted among older couples is, “What will happen to all our stuff when we are gone?” I can remember having a family meeting with a couple in their 70s and their four adult children and noticed that mom was getting very anxious. At first I thought her anxiety was due to the fact that she was preparing to discuss her end of life planning with her children.

    But when I asked her what her concern was, she responded, “I don’t know what I am going to do with all my stuff! I have several beautiful collections and I don’t want my children fighting over the objects right after my funeral or just putting them out in the yard for a giant garage sale!”

    She admitted to me that she hadn’t slept for several nights thinking about this terrible possibility. She confided in me that her husband still wasn’t talking to his sister after 20 years because she had raided the house when their parents died and taken everything of value before he had even arrived. “I don’t want that happening in my family!” she proclaimed.

    So what did we do? I asked her to describe her valuable collections to her children at the family meeting. She then created a list of all the items and asked each child to review them. If they wanted an item they were asked to put their name next to it. If more than one wanted something, they both listed their names next to it and mom would decide who got it.

    Mom collected the lists after the family meeting, reviewed them over the next few weeks and then reported to her children who would get what. No one disputed her decisions. After all, the collections were hers and she could give them to charity if she chose. The next time I talked to her I noticed her anxiety level was significantly less. She told me that for the first time in a long time she was sleeping very soundly.

    If you are a parent, don’t do your children a disservice. Don’t leave it up to them to decide what to do with your stuff after you are gone. The loveliest relationships are often spoiled by siblings fighting over the silver forks. Meet with your children and tell them what you intend to do. If you are an adult child, strongly suggest to your parents that they follow the procedure my client did. It will save much grief and anxiety for the whole family.

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    Is A Hospice Program Right For Your Mom Or Dad?

    When the medical director of my mother’s assisted living residence called me I was curious to know what she wanted to talk to me about. After informing me how much everyone at the facility loved my mom she then made a statement that took me by surprise. “I think you mom would benefit greatly by going into a hospice program.”

    My thoughts immediately jumped to “Oh my God, she’s about to die. The end is very near.” The next day a hospice nurse visited me and explained to me what hospice was and whom it could benefit. She did state that in order to qualify for hospice an individual is expected to die in 6 months or less. But she added that some patients have been in hospice for a year or more. And in some cases they have improved so much they are taken off of the program.

    I learned that Medicare would pay for an upgrade to her wheelchair that would make her much more comfortable and provide for any other medical equipment she needed. A nurse would be assigned to her who would monitor her condition weekly, review her medications and report back to us if any changes in her condition occurred. In addition a home health aid would visit her three to four times a week to bathe her or provide any other personal care that would benefit her.

    She would be assigned a social worker that could assist her and our family with any emotional support that was needed. An experienced physician would participate in the development of her care plan and oversee her medical regimen. And all of these services would be fully covered by Medicare.

    Within two days the nurse had visited her, made specific recommendations to changes in her meds and brought in a new mattress and a more comfortable wheelchair for her. I was amazed at how quickly she went into action and how knowledgeable she was about the aging process.

    I had noticed for a few months that my mother had deteriorated significantly but I wasn’t sure how to deal with this and who to talk to. The hospice nurse made it clear to me she was available 24 hours a day, seven days a week if I had any questions or concerns. I immediately felt much more comfortable knowing that someone was watching her situation closely and would be available whenever we needed her.

    If you have a family member who is beginning to show signs of slipping away I would recommend strongly that you find out more about the hospice program and have a hospice nurse visit you to answer your questions. In most cases she will do an evaluation of your loved one at no cost. The website for the National Hospice and Palliative Care Organization will help you find a hospice organization in your area.

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    Thank You, Hospice!

    In my last post I mentioned a conversation the medical director of my mom’s assisted living residence had with me. She suggested we enter mom into the hospice program. With some trepidation I agreed and met with the hospice nurse who very gently described to me the program that would follow.

    She informed me that a hospice aide would visit with my mom several days a week to help her in any way needed. She, as the assigned hospice nurse, would check in with mom weekly and give me an update. In addition Medicare would provide her with a much more comfortable wheelchair and mattress for her hospital bed.

    I stopped in to see my mother one day when the hospice aide was with her. The aide had gently combed her hair, put cream on her dry skin and dressed her in a lovely dress with matching scarf and earrings. She looked beautiful. The aide commented on what a lovely woman she was.

    After a number of visits in the following three weeks,I could see that my mother was failing. She had a hard time speaking a full sentence, was asleep most of the day and was becoming increasing unresponsive.

    On Sunday morning, November 30th I received a call from the residence that mom was totally unresponsive and was taking rapid short breaths. I called the hospice nurse, picked up my daughter, who was visiting with us, ( my wife was away at a conference) and rushed to the residence.

    The hospice nurse on call arrived before we did. He had given mom medication to ease her pain and make her more comfortable. He assured me that he would be available all day to help in any way needed. It was clear to me that the end was near.

    My daughter and I spent my mom’s last hours with her. She passed away in comfort, in her own bed, holding my hand. I could not have asked for better circumstances for my mother to leave this life.

    A few days later, I though about what would have happened if mom was not in hospice. She would have been transported to the emergency room in an ambulance. A number of nurses and doctors would probably go into action trying to keep her alive. She would die in strange circumstances amidst all the noise and activity of the emergency room, with my daughter and I witnessing her demise from the background.

    Thank you, Broad Reach Hospice for making the end of my mother’s life, gentle, loving and peaceful.

    Preserving Your Legacy

    The last six months of my father’s life, I visited him every week in his rehab facility. He was desperately trying to get well enough to return home. Because of his Parkinson’s disease he could no longer swallow and as a result couldn’t eat normally. But he could talk. And we would talk for hours every time I visited him.

    But most of our conversations were about insignificant things like sports teams, my job or the weather. We very rarely got into a real conversation. On one occasion I asked him what it was like growing up as the son of a minister. He told me that he had never gone to a department store to buy clothes. All his new clothes came from the barrel, where members of the congregation would toss clothes they didn’t want.

    He shared that in the first eighteen years of his life, he had moved eleven times as my grandfather was transferred from church to church. But we never talked about his childhood again. And I never asked him about his experience as an Army engineer, landing at Omaha Beach on D Day.

    Six months after my father passed away, my mother asked me a question. “Did you ever look at Dad’s scrapbook?” And she handed me a leather bound scrapbook filled with pictures, maps, newspaper stories, insignia and a letter signed by General Dwight D. Eisenhower. I was shocked. I had never known that this scrapbook existed.

    For the last fifteen years I have leafed through that scrapbook hundreds of times, wishing that I had the opportunity to learn from him what his experience was like. But I will never get the chance. I share this with you because I want to emphasize the importance of sharing your stories and experiences with your children.

    How did you and your spouse meet? What was it like growing up? What were your parents like? Where did you go to school? What was it like? Our children want to hear about these things. And we need to share them.

    There are several ways to share your experiences and your life with your family. You can create an audio or video recording for them. You can write your personal biography. There is a national organization that can help you with this project. It is the Association of Personal Historians. Through them you can find a professional in your area to help you. They will create a professional audio, video recording or book of your life with your input.

    In addition, Storycorps has created a smartphone app. which provides you with a series of questions to create an interview. A family member can ask you the questions and the answers will be recorded on your smart phone. If you desire this recording can be saved to a national archive at the Library of Congress. Storycorps started interviewing individuals in 2003. It was created to provide all Americans with the opportunity to record, share and preserve the stories of their lives. Over 40,000 people have conducted recorded interviews at their kiosks around the country. These are now saved to the Library of Congress.

    The Legacy Letter

    But let’s assume you are not ready to go to those lengths yet to record your life. The best way to start is to write a Legacy Letter. It is as simple as answering a series of questions in a letter format.

    In her very informative book, The Wealth of Your Life, A Step-By-Step Guide for Creating Your Ethical Will, Susan Turnbull suggests that creating the Legacy Letter is a five-step process. Here are her suggested steps:

    • Identify whom you want to send the letter to. Do you want to send an intimate letter to just family or a more public document to be read by many people?
    • Consider your intentions and opening lines. Start the letter with the brief statement of why you want to write the letter. “I am hoping to share many more wonderful years with you but I wanted to make sure that you know…..”
    • Reflect and make notes. What is your theme? Is it an opportunity to express your love to those close to you? Do you want to share the values that have been important to you that you want to be remembered for? Do you want to pass on the wisdom that your experience has taught you? Do you want to pass on the family history to the next generation? Jot down your thoughts. You may choose to include some or all of these themes in your letter.
    • Create an outline to structure the order in which you wish to make your points. Keep in mind your audience, your goals and the most important things you want to say.
    • Create your letter (or record it). I strongly suggest that you create a video of your words as well as a written document. In the video your words will come to life if you share them with enthusiasm and conviction. In this era of smartphones and sophisticated technology it will be very simple to create a video record. You can even post it on Youtube or Facebook if you so desire.

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    PERMISSION TO REPRINT:
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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.