Wednesday, February 23, 2011

Time Perspectives for Long Distance Caregivers

We all tend to have a love-hate relationship with time which is only magnified while caregiving. Add miles to the equation and heartache often results.

Time doesn't change... nor does its
challenge to caregivers...
In talking to a young woman who recently lost her father, she noted one particular issue that caught my attention– the effect of the time factor for long distance caregivers during a crisis.

This woman's father had been diagnosed with pancreatic cancer.A month earlier, he’d had a full checkup, receiving a clean bill of health given his age and previous health challenges. The new diagnosis surprised everyone. The disease was moving swiftly. After all his doctors consulted, they advised the man’s wife to call the children. This was only days after he woke up ‘not feeling quite right.’The daughter lived nearby but the son lived hours away. The family gathered and the news was shared. 

With the doctors giving him perhaps only days to live, his family felt they had literally one business day to get his affairs in order. The dying man was able to give his family direction in how he wanted things handled, including what casket he’d like, and what details needed to be in his will. Trudging through their shock and grief they did it all – in one day. The son stayed on, waiting. He stayed, and stayed, and stayed. Eventually he was put into a situation no one wants to deal with. He had to return to work and his life hours down the highway, knowing he might not see his father again.

Miles add to caregiver stress.
This is an awful issue that many caregivers face. There seems to be no right course of action. I’ve talked to many who have provided care for loved ones at a distance who have shared the pain of guilt magnifies every emotion involved. Here are a few steps to take to help relieve some of the pressure:

1. Talk it out: When life is ending or health challenges make you feel that you might miss your chance to say something important, don’t wait. Say what needs to be said. Leaving issues unresolved increases stress and makes grieving more difficult. If you are fearful that bringing up a sensitive topic might upset your loved one, realize that it might be on his/her mind too. Or, once you’ve cleared the air, you can tell them how much it meant to you to be able to do that. That in turn, gives them a valuable sense of peace. 

2. Admit it: Admit to your self that it hurts to be in this position. Sometimes admitting the pain that you feel as a caregiver relieves pressure. Too often, caregivers paste that smile of “all is fine” over their inner turmoil and push their feelings aside. Those feelings only fester – let them out.

3. Stay connected: When you have to leave your loved one, make sure you feel as comfortable as you can about your ability to stay in the information loop. Talk to the others involved in care to set up your lines of communication. Perhaps now is time to add that texting or email plan to your cell service so you can get updates more regularly than you’d have time to otherwise. You can always cancel it later if needed, but the extra money spent in the short term may buy you a sense of security that will help you cope.

4. Create your safety net: Long distance caregivers need a support system too. You need your boss and friends to know what you’re going through and be ready to help when time comes. Knowing that key people in your life are on alert to support you when you get “the call” brings peace of mind.Whether it is setting up a work-from-the-road or a leave time flexibility plan with your boss, or backups for your carpool duty, give yourself the support you need to be the caregiver you want to be. 

We can’t change time, and in crisis situations we can’t do much about the miles between us and our loved ones, but relief from pressure, guilt, and anxiety can be part of your plan as a long distance caregiver.

Friday, February 18, 2011

Determining Your Own Climate of Care

After posting for several weeks on legal issues, let's take a look at just our basic thought processes related to caregiving. I recently read the following:

There are only four types of people:

Those who have been caregivers.
Those who are caregivers.
Those who will be caregivers.
Those who will need caregivers.

When many people first begin to realize the truth of this concept, their minds often cloud with fear. But taking some time to let your mind wander through the clouds empowers you to determine the climate you'll face in the future. 

Spending some time in the clouds helps you choose
your own climate of care.
Former Caregivers:  Sometimes caregivers push aside the memory of the challenges they've faced and forget to use what we've learned to prepare for their own future or to help others. When you share your experiences with others, you encourage them in their journey. When you take the knowledge you've gained while being a caregiver and apply it to your own life and planning for the future, you gain a valuable sense of security.  I've been through caregiving and I know I'll go through it again. That's another nugget for you. Been there, done that, doesn't mean you won't go there again!

In YOUR Future:  I'm always thrilled when fully independent seniors pick up When Your Aging Parent Needs Care for the purpose of reading it and sharing the the topics in the book with their adult children. They're being proactive. They realize the truth that one day they will need support. Is it always easy to come to that conclusion?  No. The idea that "growing old ain't for sissies" is true. But understanding that aging is not something that can be avoided, and planning accordingly, is smart.
     It doesn't matter if you're 20, 50, or 80. You know how you want to be treated and how, if you ever need help, you'd want that help to be offered. Let someone know. If you see your grandparents facing safety issues in the home and wondering why they don't move to a smaller place or a retirement community, mentioning that to your husband might bring up a discussion of facility care you might need one day. Then the discussion about long-term care insurance might. If you decide that might be your best option, knowing that rates for long-term care insurance are much lower the younger you sign up might save you a bundle in the long run.

Current Caregivers:  If you are a caregiver, don't forget to pat yourself on the back. No human being, let alone any caregiver, is perfect. Along the road you're traveling, you'll face doubt, fear, and insecurity. Are you making the best decisions possible? Questioning oneself is normal, but requires perspective. At any point of decision making, gather the information you can and once a decision is made, give yourself credit for having made the best decision you can based on all the information available to you at the time. The old adage "hindsight is 20/20" often haunts caregivers who refuse to give themselves credit for doing the best they can. Take heart, doing the best you can is all you have, and it is enough.

Future Caregivers:  What if it suddenly dawns on you that caregiving duties will be yours one day?  In contrast to proactive seniors, I often hear from people in their 30's, 40's, and 50's who say "Oh, my parents are just fine. I'm glad we don't have to deal with that." But ask yourself.... What will your role be if you get a call in the middle of the night that Mom or Dad has had a stroke?  Are you, your siblings, your spouse(s) prepared? A few conversations held in non-crisis moments bring peace of mind to all who may one day take a primary or supporting role as caregivers.

Take the lessons you've learned through the tough times, facing the fears, and clouds of doubt.  Remix them into a picture of a care climate you can live with peacefully. When you do, there may be many days of sunshine ahead, even when crises do arise.

Tuesday, February 15, 2011

The Will: Part 6 - The final chapter – when seasons change!

If posting six times on the topic of legalities doesn’t drive home the point that these issues are important for everyone, please reread the posts!

Winter will turn into Spring
- change is constant
photo by David Loudon
For those of you who have addressed these issues in your lives and the lives of those you care for, here’s a final nugget for you. Change happens. Isn’t change one of the true constants in our lives? When dealing with legal issues, many seniors and/or their caregivers want to have the conversations, handle the legalities, and tuck those documents away never to see again until the unfortunate day of need. However, be aware that change does happen. When the seasons in our lives change, it's important to check to see if our legal documents need updating. If a person has been named executor of a will but discovers that work will take them out of the country for several years, you may need to make an adjustment. Or, what if an adult child’s life situation changes and he or she is not in the position to handle your affairs the way you’d like them to? In many cases, attorneys will guide their clients to have a primary person named as their legal voice (whether for powers of attorney or wills) and then have a second person named in case the first is unable to fulfill the duties.If that’s the case, remember that everyone involved should know that they’re involved, even if on the ‘second string’ of players, and know the details of how and when the players step onto the playing field.

A person’s wishes for bequests may change. If a separate list of bequests is made, it can be updated. If those bequests are specifically stated in the will, they cannot be changed unless the will is updated.  

Remember that change affects even our legalities but by planning ahead, the effects of change on our comfort and security level should be minimal. 

Friday, February 11, 2011

The WILL - Part 5: Are you de-valuing your greatest asset?

The average person de-values their
 greatest asset ...
 One of the biggest misconceptions about handling legalities, particularly when it comes  to wills, is our perception of ourselves and our assets. As mentioned in Part 1 of this series, changing perspective can make a difference. 

I spoke with a delightful woman yesterday who said, yes, she'd heard everyone needs a will, but she never felt she had anything of value that needed the kind of protection a will offered. Though I was saddened by her response, I realized she needed that change in perspective. So I asked a few questions: 

Did she own a home? No.
Did she own a car?  One that wasn't paid for. 
Did she have personal items that she would like to know someone would one cherish as a memory of her when she was gone? Yes, she might, but they weren't worth much.

In her mind, 'worth' was measured in dollars and cents. But the reality is that her will, and the act of giving authority to someone to handle things like closing out the payments on that car, is an asset worth protecting. 
Might she like someone in her family to have the option to take over payments on that car? 
Did she have any personal items that she wanted to share with her loved ones?
Who would make sure that happened?

As we spoke, she realized that her "life treasure" was not any one item or her perception of wealth, but the ability to control what she did have.
I asked her if there was someone in her life who would appreciated the honor of being asked to be the person to settle her affairs, to make sure those personal items found their new homes.  
Immediately she started nodding her head. 
One child would want that.
Even though this woman did not feel she had things of value, she began to change her perspective. Someone would need to handle her personal belongings when she was gone. Giving that control to someone is an asset worth protecting and a gift to the person who receives it. It says, I respect you and trust you with what I have.  Thank you for being that person to me. 
So who will you give that gift to?  It's your priceless life treasure - worth protecting by having a will. 

Tuesday, February 8, 2011

The Will, Part 4: What to do when there are no family members to support your legal wishes.

Trust is the key element when
 deciding who should handle your
legal affairs.

It’s sad but true that there are many people who have no one who is a significant part of their lives to take care of legal issues. But that doesn’t mean that assets and the power to make decisions should just be left to the doctor in charge, a court officer, or the fine print in the bank’s policy. There may be friends or extended family willing to lend a hand with legalities.

If you’re having trouble determining the right person to help you, ask yourself these questions:
  1. Who would visit me, or who would I want to visit me, if I were ever hospitalized?
  2. If I had an emergency in my home, who would I call?
  3. If I needed to get a ride somewhere, who would I call?
Next, see if the people who come to mind, whether related by blood or not, are those you really trust to make decisions for your best interests, and if they are in a position to be of help if a need arises. A relative with shady business dealings is unlikely to be the best choice. An adult child with substance abuse issues may not be the best choice. A relative living a distance away without the means to travel in case of an emergency would not be the best choice either. An older relative with their own serious health issues may also not be the best choice.

Friends or church members/staff can fill these needs when there is no spouse, significant other, or family around, or when the family dynamics are such that there is no family member in a position to fill the need. You may find you need more than one person – one to handle your financial affairs, another your healthcare issues. 

How to approach another person to handle your legal affairs?

Simply ask. 
  • Explain the need and your desire to make sure your wishes are honored. 
  • Explain what your wishes are in specific circumstances.
  • For financial issues: make sure that person knows that if they agree to be your financial back-up, that you’ll review with them where the account information, checkbooks, and your wallet are generally kept. 
  • For healthcare issues: The Five Wishes program at www.agingwithdignity is one that is great for reviewing potential end-of-life decision making situations and helps guide a person with this process. Let the person you have chosen know who your primary care doctors are or where you keep this information listed. Hospitals may not be able to find records they need to help with emergency care if they do not know the name of the doctors to contact for records. Your healthcare representative can help with information flow in a time of need.
  • Explain what legalities are involved.
  • Explain any unusual or uncomfortable family dynamics that may be involved.
  • Give the person time to think and consider. 
  • Once a decision is made, take care of the legalities. If you can, have that person come with you to handle things legally so they know where you handle your business and where you’ll be storing your documents. (See The Will – Part 3)
Make sure that those people you are close to, but who may not have been selected as the legal representative, do know who will have your legal authority if a crisis occurs. Make sure to let church staff and your primary care physician know who you’ve designated as your legal representative in time of need, too. 

Lastly, relax. Once you have own support team in place, regardless of their blood relationship to you, you know that your wishes will be supported even if you can’t tell others what they are. That’s peace of mind.

Friday, February 4, 2011

The Will - Part 3 - Storing Legal Documents

A Will, Heathcare Power of Attorney (Proxy), and (Durable) Power of Attorney do no good if they can’t be found at the time of need. Even caregivers who have been handling their loved ones affairs for some time may not remember where these important documents are because they generally are not referred to unless there is a crisis - out of sight, out of mind.

Attorneys will retain copies of client’s files for many years, but check with yours and your state regulations to find out for sure. But what if that attorney dies, or moves, or closes his or her business? What if the caregiver doesn’t even know the attorney’s name their parent used decades ago in another city or state?

Keeping up with legal documents is important whether they are your own, or belong to someone you care for. Knowing they are in a file ‘somewhere’ doesn’t get the job done either.

The bank safety deposit boxes have regulations about who has access to a box and when. In some states, at time of death, a safety deposit becomes part of an estate and cannot be opened until ownership or legal rights of access to the box can be proven. If the box is co-rented, the other renter would likely have access, but only during banking hours. What if you need that healthcare power of attorney when there’s been an accident and it’s the middle of the night?

Consider the following:

  1. Having a fire proof safety box for storage in the home is a good resource. Still put documents in a plastic bag to protect from water damage. These come in various sizes, from small suitcase style boxes to large safes. Determine what works for you and keep it safely stored.
  2. Have all legal documents in one place and tell the people who need to know where the key is kept.
  3. Have copies made of the Healthcare Power of Attorney (Proxy) and have them notarized. 
·   Give a copy to family members who are authorized by the HPOA to make decisions. 
·   Take a copy with you when traveling.  *
·   Have a copy in the glove box of your car. *

*it is not a good idea to do this with your (Durable) Power of Attorney which authorizes control over financial issues.

Specifically for the Caregiver:  While you’re supporting someone else’s will for their life and legal affairs, take time to do it for yourself! Handle these matters before a need arises and you’ll have peace of mind.

Tuesday, February 1, 2011

The WILL - Part 2: Preparation Saves Headaches and Heartaches

You walk into an elegant room and sit down. A tall graceful gentleman approaches the podium in front of the gathered group of people. “I hereby begin the reading of the Last Will and Testament of….”

Folks, that’s a movie scene. It isn’t real life. When death occurs, one person, the executor, has to handle property distribution. The probate court in the county must be notified of a death and the existence of a will within a specific amount of time. Unless you’ve dealt with this before, and most of us haven’t, it’s a logistical nightmare at a time when grief impacts everyday activities.  

Talk to your loved ones about the wishes for their personal property before the need arises. Save headaches and heartaches. Some things can be handled before a death occurs, thus saving estate taxes and other expenses. If Grandma wants her cabin to go to Uncle Joe, transferring the title to him now, or putting both their names on it, may save Uncle Joe some hassles down the road and help Grandma feel that all is taken care of. You may discover that an attorney will be needed to help handle things.

But what if there isn’t a lot of property? A list is still helpful, even if there isn’t much to put on it. Think of wedding rings and jewelry, family photos, furniture, and other items that will need a new home one day- it may even be the family cat. 

A list of ‘bequests’ helps both of you. It is proof, when it is time to distribute property, that it isn't not your decision but your deceased loved one’s decision about who gets what. Probate officers may need to see that list and may have paperwork for the executor to make sure those assets are distributed. A list is most helpful when there are difficult family dynamics. Lists can be changed, but someone should know where the most updated one is located, even if they are not told what is on the list.   

One family would occasionally take out a permanent marker during family gatherings. The parents would think of an item that would one day need to be passed on and together they would decide who wrote their name on the object. When those parents moved to a new home, one daughter asked if she could write her name on the wall. It was a joke, but when the parents pass, there will be no question of where the family items are to go and all are aware.

Now that you’re thinking, start doing: if you’re a primary caregiver and know you are the executor of your loved one’s estate, go ahead and check out the current probate rules for the county in which your loved lives, or ask them to check into it. By knowing what your loved one wants, and taking steps to ensure that those goals can be met, you’re providing peace of mind for both of you.