elderly Parents

    4 Steps to Protect Your Parent with Alzheimer’s

    Once your parent has been diagnosed with Alzheimer’s disease, you must make certain that a plan is in place to protect her and your family. You cannot delay. In order to sign legal documents, your parent must have the mental capacity to know and understand the act which she is engaging in and have a desire to engage in that transaction. Once your parent contracts Alzheimer’s disease, her mental capacity may still be sufficient to sign the documents necessary to create a plan but action must be taken while she still has that capacity.

    You should make sure the following 4 steps are taken to protect your parent and your family.

    1.  The parent must have a Durable Power of Attorney. With this power, she names a representative/agent to make decisions on her behalf. A Financial Power of Attorney allows the representative to make financial decisions for her. The Medical Power of Attorney gives the representative the authority to make medical decisions. In some states, the Medical Power is identified as a Health Care Proxy. Since these powers are specified as “Durable,” they will still be valid if the individual is no longer mentally competent to make these decisions.

    It is important that the parent select someone to have this power that he or she can trust and is easily accessible to help with financial and healthcare decisions. It may be one of the children, a close friend or adviser. A successor should also be named to take over the responsibility if the first person is no longer available.

    2. Each parent should also have a will drafted specifying who should get their property at their death.  Again, they must have the mental capacity to approve such a document. That means they must know who their family members are, what assets they have and to whom they want them passed. If they do not have a will, the state they live in will determine how their assets are to be split up.

    3. Your parent should also have Advance Directives in place. Advance Directives are documents that tell the Alzheimer’s patient’s  family members, caregivers, and doctors what their end-of life-choices are and what health care they want to receive. The family and healthcare professionals are expected to act in accordance with these wishes. Advanced Directives include a Living Will. The Living Will is a document that a person uses to control their medical care if they become mentally incapacitated and can’t make end-of-life health care decisions.

    The Living Will should include a statement that if the person is mentally incapacitated, certain instructions should be followed to provide medical treatment to them. It should also state when life-sustaining treatment should be terminated. If a patient contracts Alzheimer’s disease after completing a Living Will and is in the late stages of the disease, there is a question if medical treatment can be denied in accordance with the document. But although Alzheimer’s is an irreversible disease, it is not defined as a terminal illness. When a person dies, they do not die as a direct result of Alzheimer’s but as a result of another complication such as pneumonia.

    4. Your parent must also have A DNR or do not resuscitate order on file with her care providers. A DNR must be signed by her physician. It is an order from that physician to hospital staff and emergency medical services professionals stating under what circumstances that they do not perform medical intervention if your parent is dying. At any point, if your parent is still “competent,” your parent or his or her representative can revoke a DNR. The verbal wishes of a competent patient always supersede a DNR.

    If an Alzheimer’s patient does not have a Durable Power Attorney named or does not have a Living Will, it will often fall on the courts to determine who has the ability to make medical or financial decisions for that person. This is often a very time-consuming process that can cause excessive delay in making important decisions. It is very important that family members make certain that Alzheimer’s patients put these documents in place while they still have the mental capacity to do so.

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

    Four Steps to help a Dying Parent

    Few of us know what to do or what to say to our parents and loved ones who are close to death. We often try to avoid all discussions about the topic and take the easy way out, falsely reassuring them that they are doing well and will get better. Recently I read a book entitled Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying by Maggie Callanan and Patricia Kelley which has given me new insights into the process of dying, what to listen for, what to say and what to expect from our parents who are about to die.

    Callanan and Kelley have tended to the terminally ill for more than a decade as hospice nurses. In their book, they relate many touching stories of their experiences with patients at the end of life. Through these stories, I began to appreciate the many ways that the dying communicate their needs, reveal their feelings and even choreograph their final moments.

    The authors pose a very important question: “ Is it possible to find anything positive in this devastating event?  Can this remaining time be used to share treasured moments of living, while coping with the many losses death brings?”  Here are four recommendations they make that will help you:

    1. Dying people often share messages through symbols or suggestions that we often misinterpret as “hallucinations” or “confusion.” These messages fall into two categories: attempts to describe what they are experiencing while dying or a request for something they need for a peaceful death. Pay attention to everything they say. There may be an important message in any communication however vague or garbled.

    2. Your parent should get as much information as she wants about the changes taking place in her body and the likely scenarios of her death. She should be given the opportunity to maintain some control over her life by making decisions about medication, treatments and even the site of her death.

    3. In the last days of her life, your parent will probably go through five stages of dying, denial, anger, bargaining, depression, and acceptance. Don’t try to give advice or solutions. Just listen and accept.

    4. Don’t be afraid to talk about death with your parent. Avoiding the subject may be interpreted as not caring. Don’t force the topic if they’re not ready to talk about it. But don’t shy away from it either. You might open with a question like, “Can you tell me what’s happening?” Don’t worry about saying the wrong thing. Remember, what is often harder to forgive is the failure to do or say anything.

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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.

    Senior Investment Fraud

    There have been an increasing number of financial advisors who call themselves “Senior Specialists.” Often these titles don’t require any specific study or experience. Seniors are a very attractive audience for these “specialists.” They often have a large portion of their investment assets in cash and CDs. As rates have continued to come down, seniors are looking for attractive alternatives with higher yields. Many financial advisors have used “free meal” seminars to attract seniors and sell them a number of CD alternative products. The Securities and Exchange Commission did a study in 2007 noting the deceptive practices used in these seminars.

    If you or your parents attend one of these investment seminars, be very careful. Do not sign an application at the seminar. Be critical of the promises made at the meeting regarding guaranteed returns and safety of principal. Often if statements sound too good to be true, they often are. If your parents have attended one of these seminars or have signed an application and given the specialist a check, do some research on the product they purchased. There is usually a grace period allowed to return your parents’ funds if they change their mind.

    The SEC provides important information for senior investors including explanations of different products, asset allocation, and risk. You can also get information on affinity fraud, “senior specialists” and investment advisers and what to look for to identify and steer clear of potential frauds on their Senior Investors page.

    FINRA provides important information for senior investors. Its website has such items as Broker Check that gives you the ability to look up the history of your investment professional to see if they have prior complaints or problems. Their website also includes including Investor Alerts that provide timely information on steering clear of investment scams and problems instead of just dealing with their aftermath. Subjects of recent alerts include Look Before You Leave: Don’t Be Misled By Early Retirement Investment Pitches That Promise Too Much; Annuities and Senior Citizens: Senior Citizens Should Be Aware of Deceptive Sales Practices When Purchasing Annuities,” and Seniors Beware: What You Should Know About Life Settlements.

    The North American Securities Administrators Association (NASAA) also has helpful information available for seniors on its website, ServeOurSeniors.org, developed this to provide resources for senior investors, family caregivers, the securities industry, and policy makers. Resources include: a quick checklist of questions to ask before you invest, 10 tips to protect your nest egg and guidance on where to turn for help.

    Regulators have warned that seniors may be confused by designations that imply some expertise in helping seniors. Information regarding professional designations is available through NASAA’s Investor Alerts. There is also SEC information on professional designations and FINR’s Professional Designation Database.

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

    Alzheimer’s Children

    I used to visit my mom at least twice a week. She had been diagnosed with Alzheimer’s disease and used to live in an assisted living community dedicated to memory-impaired residents before she passed away. When I would see her, she often commented that everything was mixed up, that she couldn’t remember anything and that she was very frustrated. I would sit opposite her and acknowledge her frustration but couldn’t really say that I understood what she was going through because I didn’t.

    When I was with her, I would try to put myself in her place. What if I tried to remember my spouse’s death but couldn’t remember when it was, if I was at the funeral or what the cause of death was? What if I searched my memory and couldn’t remember if I had one or two children and didn’t know where they were born? Imagining this situation would make me very anxious.  I would ask myself the question, “If I no longer have a past, do I have an identity? Would I become a non-entity?”

    Certainly my mother didn’t disappear during this time. She was a warm, loving presence in her community. Everyone who knew who she was commented on her friendly disposition and her sense of humor. It is interesting to note that once she began to lose her memory, she became a warmer, more caring person. She was very thankful for any show of kindness by anyone in her community and was so happy when I would come to see her.

    Perhaps there is a valuable lesson here. Doesn’t our memory often define who we are? When we are faced with a decision, don’t we usually look back in our past and see how we handled it before? Or, when we are in a challenging situation, don’t we often determine what we will do based on our success or failure in similar situations in the past?

    Isn’t this approach to life very much like driving on the road  looking in the rear view mirror? How much of our experience is actually new and fresh? Or is it mostly a rehash of what we’ve done before? With this perspective, I have begun to look at memory in a new way. If I had no memory, wouldn’t each experience be interesting and unique? Wouldn’t it be very much like a young child facing life for the first time?

    Perhaps we should begin to look at Alzheimer’s patients as those who live life totally in the present. When is it that they begin to accept their inability to recall events and live life totally now? And when they are able to do that, doesn’t life become a never-ending new experience with no barriers or limitations?

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    Don’t Darken the Twilight Years of Your Parents’ Lives

    Some people refer to old age as the “winter” of one’s life. But that doesn’t mean our elderly parents’ lives have to be dark, cold and lonely. There’s so much we can do to keep the sparkle in their lives, but we must cover all the angles.

    There are a number of problems that adult children might come across when trying to help their elderly parents. First and foremost, parents will always view their children as just that – children. It is very difficult for them to imagine a scenario where they become dependent on their offspring. This can make them defensive and difficult to deal with. Another issue is that elderly parents, for one reason or another, are not always fully open about medical, financial and other important issues. This can lead to great strain on the family later, when action needs to be taken but the children are unaware of vital details.

    In their old age, parents might have increasing trouble with everything from medical and financial needs, through to everyday tasks like shopping, laundry, cooking and cleaning. And if children are in full-time work themselves, with families of their own, care for their parents might just be the final straw that breaks their backs. But there are ways children can help their parents without being impacted so much. First, one needs to know all the details of their parents’ habits, needs and lifestyle. Look for tell-tale signs that they are struggling; are they keeping enough food in? Are there household tasks being left undone? What medications are they taking? What are their effects? Details such as these will help in deciding the best course of action.

    Nursing homes are often the first thing people jump to when care for their parents is needed. However, the fact is, many elderly people do not need nursing homes. Retirement villages are alternatives to nursing and care homes and give the elderly all the living assistance they need, while allowing them to maintain privacy and independence. They can improve their health with exercise, good diet and a generally more positive outlook. Such communities allow them to be surrounded by friends, have professional assistance on hand when they need it, and not feel like they are a burden on their children

    For many parents, being looked after by their children is unnatural and undesirable. Communicate with your parents and you will understand how to both please and help them.

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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.