Thursday, July 30, 2020

The Final Stage of Life, Part II (Ironic, right?)

Dear Friends,

How are you in these difficult times?

I have one last post on the topic of Terry and some lessons learned.

Money

Not everyone can save and invest as Terry could. She could have stretched her budget and lived in more upscale places, done a lot of shopping and travel but she grew up during the Depression and learned a lot about saving pennies, budgeting and investing. None of her investments were risky and she kept them for a long time, riding out the ups and downs of the American economy. She had money to enjoy retirement and money to use in those last years when she needed help. Continuous care residences are expensive and insurance doesn’t cover them.

Medical

She had great insurance. This is not a political statement - it’s a reality of life that treatment is expensive and we don’t all have access. Get the best insurance you can and go to the doctor early before your condition gets worse. 

Take the medicine you need and follow the instructions. Antibiotics don’t work if you take 1/10 of the recommended dose and then stop. Keep a list including your prescriptions, vitamins and over-the-counter medicine. If your list is getting complicated, long, and you are afraid you might forget, keep a copy of the list with your medicine and use pillboxes. Bring the list to each doctor’s appointment. They all ask for this information and if you are unwell, you might miss something.

If you’re concerned about hearing the doctor properly and adequately giving them information, if you are ill and unsure you'll remember instructions, someone else should be in the room with you. 

Start to research where you would go if you think it’s time or listen to feedback from others who know you. Let your feelings be known and document if you can.

Think about who would make decisions for your finances and health and complete the proper paperwork. Terry had a completed Power of Attorney form and that was helpful for banking. 

The Mayo Clinic has a great post about Living Wills and Advanced Directives to help you learn about these issues and processes. Have a frank discussion with your doctor and loved ones about what the options mean and which ones you have selected. The more paperwork and decisions in place, the easier it is for your loved ones to carry out your wishes. Different states have different laws and requirements, so if you move, find out if you have to make changes.

Make death plans. Some may donate bodies to medical science, others will choose burial or cremation. There are additional options such as headstone or plaque, ground or columbarium, scattered ashes or remaining in a container on a mantle. If you choose cremation, having a specified place to put cremains is a wise idea. If you want to be on a mantle, when your survivor dies, someone else has to decide what to do with your cremains. It’s burdensome.

Do you want a traditional funeral? Celebration of life? Obituary? These choices are to provide documentation and comfort for family and friends. You can present your wishes in advance in writing. One of the most interesting obituaries I saw was composed by the deceased who reflected on his life during a long illness. His humor, his proudest moments among is family and friends were noted. He expressed who he was in the years between the “dash” in his life, the dash being the mark between birth and death on the tombstone.

Whatever you decide, make those plans in advance. Loved ones will have enough emotion and details to tend to without sitting in offices reviewing options and do not need to guess about your wishes.

I have attended the funerals of my parents and both of my sisters. The stories I heard from their friends and other family members were a great way to celebrate their lives and hear what they meant to others. It is both comforting and inspiring to learn from others in a formal situation one last time.

Your Stuff

I have seen and experienced this: no one wants your stuff. Furniture is one thing, but I want to talk for a minute about other stuff.

Mama didn’t have much paperwork. She regularly discarded paid bills once the checks cleared and didn’t keep things longer than necessary by law. My sisters had a lot of papers from work and home and sorting through all of that was very demanding for their adult children. I moved toward autopay and paperless billing several years ago and the convenience and the idea of not drowning in paperwork is great for me and my (very far in the future, I hope) survivors.

Emotions and Grief

I went to an Alzheimers Support Group and the leader mentioned “grief and relief” when someone dies of a disease that has tortured the mind and/or the body. I don't know what others feel but I experienced this with loved ones who had lingering illness. 

Sudden loss is very different and in these COVID-19 times, survivors may not have those public services in person and may not have the comforting touch or hug. It's hard for mourners. Online services are helpful but no substitute for our needs as people.

I found it helpful to identify online forums for certain illness and life situations and the information and support I felt (and gave) was priceless.

The heart has no clock and we can be triggered into loss, dismay and mourning when hearing a song, a joke you want to share, seeing old letters and photos or even some movies. If you experience this loss and mourning even years after loss, it's normal. It's also normal to remember your loved ones with smiles and even jokes.

There are times when you should get help from a support group or professional if you find you cannot climb out of your sorrow, if you're depressed. Seeking help is a good thing.

My friends, I've explored this unexpected topic of aging, accommodating, seeking help and ultimately mourning and it is quite a bit different from my original intentions of identifying resources for considering retirement.

I hope these posts have been helpful and I will return to the other topic next time. I am eager to share our experiences of retirement (or not!) and a move to an active senior (age 55+) community.

Take care,

Marcia

Friday, June 19, 2020

That Final Stage of Life

Dear Friends,

I hope you're well in these challenging and difficult times.

This was going to be one long post but there is a lot to say so I am posting a section now and the next one when I can. This is a personal story along with some lessons.

I previously mentioned our elderly family member, ”Terry.” I chose a name not gender-specific so as to protect privacy. For this post, since Terry has died, I will use the pronoun “she” to make writing a little easier.

My husband has said that one of the last lessons we learn from our elders is how to live toward the end of life and how to die. I’ve thought about that a lot and this is why I decided to write about Terry and our lessons learned.

Terry was a professional. She started working right out of school and took time off when she had a child. She rose through the ranks due to her skills and ability to work with top executives and organize their work-lives. She was an avid reader with an extensive vocabulary and amazing memory for stories, names and places, and she knew how people and events shaped history. She loved to travel and did so for as long as she could.

Prior to a terrible diagnosis, I saw some signs of change. We took a long ride together as we went for her hearing aids and for the first time Terry was searching for words, sometimes sounding close to her intention but not quite there. Her house and clothes were neat and clean and there were no stacks of papers.

Yet something was wrong.

I was not sure what was happening and I had not been around many people in their late 80’s. There were some other signs showing me she needed to live nearby and have more assistance. We started researching places to live near us as we have limited space and stairs leading to the bedrooms and full bath. I read a lot during this time and could see certain needs might arise for which we would be unprepared if we scrambled at the last moment.

She had a health emergency and the decision was made for us. 

We researched several facilities and together we looked at them, discussing pros and cons, reading reviews and helping her make decisions. Terry had a beautiful house and a lot of furniture doesn’t fit into those smaller places. {Related post about “stuff.”

Through the National Association of Move Managers, we found a great service and they helped sort through possessions without the emotional component and managed reminiscing respectfully. With a new floor plan, together they decided the layout in advance and the professional packed, moved, unpacked and placed items in the right places.

There was a lot of resistance and heartbreak over letting go of a life of independence and decision-making without needing input from others. I can sympathize and cannot imagine how difficult this is for anyone making these decision.

Terry moved near us, and it’s a good thing we selected a local community. I learned immediately she needed help in a new environment and I made appointments for her and went to them, sitting in the room and reminding staff and doctors to speak a little louder and I provided information Terry did not share. With a vision problem and another condition making it difficult, I started managing the checkbook and would point to the line for Terry to sign. Good thing I’m honest!

Terry had good jobs and saved and invested covering the expenses of living in the facility. She had retired with a package supplementing Medicare and, having seen the bills pre-and-post insurance payments, it was a relief to know she had good coverage.

We saw Terry through many emergency room visits, hospitalizations, a care-worker in her home and finally memory care. I learned not to walk over to see Terry but take the car as I never knew what kind of condition she would be in. There were several times we thought “this is it” and then she rallied.

Her geriatrician had started a home visit program as many patients found it difficult to go to the office. That final doctor’s visit, I arrived early and Terry had not eaten much so we talked and I used the fork and started feeding her and she took a few more bites. I searched for conversation to have and knew she had visited Florida. I asked if they’d ever gone and do you remember the trip. There was a flood of memories with places and sights they had seen along the way and the most coherent conversation we’d had in some time. Before I left I stroked her hair, kissed her forehead several times, told her I loved her. She was looking at me and I felt she went from fully present to maybe being half here, half slipping into haziness. I wondered did she still know this was me or did she think I might be her mom as I was doing motherly things: feeding, kissing, stroking her cheek and hair. 

She died a few days later. We waited for the Neptune Society while in her room with her and talked about her life, her experiences, our great times together and all of her accomplishments. We were there about 4 hours. It gave us time to just sit together, take this in, celebrate her life and mourn her passing. We had selected a spot for the ashes in advance so we did not have those decisions to make.

Next time I will write about planning for this stage of life and later I’ll talk about the emotional part.

Take care, 

Marcia