I recently had to assist my 78 and
82 year old aunt and uncle, respectively, who were
dealing with some pretty typical issues Ė fear of losing
independence, an awkward reliance on family members and
their changing status in their own community. As a
professional fiduciary, I do this for a living and
thought I would be able to jump right in and give them
the benefit of my experience.
My aunt and uncle have no children,
but do have community support from friends. In my
conversations with my aunt, she shared that my uncle,
not her, was getting more forgetful. These conversations
went on for about six months.
When I actually visited them, I
discovered that they were not coping as well as they had
said. For example, my uncle is a Methodist minister and
still had a small congregation in a neighboring town. I
discovered that he would get up to preach and halfway
through the sermon forget what he was discussing and end
up preaching on three or four subjects. Because he had
been a stable and positive influence within his
community for over 50 years, people overlooked his
ramblings. Ironically, his congregation continued to
grow during this period.
The most revealing incident that
showed me the extent of his lapse of short-term memory
occurred at a local restaurant when he introduced me to
a resident. In the course of the conversation, he asked
how her mother was doing. The woman was a little taken
back since my uncle had conducted her funeral the
If one individual is having physical
or memory problems, usually a spouse will fulfill the
role of caregiver in order to maintain some semblance of
their previous life style. But what happens if that
individual is having problems as well?
In my infinite wisdom, I
contacted the aging services within their county
to see if there were support services available.
What I found was one caseworker for the entire
county. Because my aunt and uncle had some
assets, they were not eligible for help. I went
to Plan B and contacted the Oklahoma Chapter of
the National Association of Social Workers to
obtain names of qualified individuals to provide
case management. I located an individual 50
miles away and had her begin the process of
getting my aunt and uncle on the right track. I
thought I had it all under control.
When individuals have the
right to determine their own destinies, they
sometimes will not cooperate. My aunt and uncle
decided they were quite capable of taking care
of themselves. Something I had learned several
years ago is that individuals have to experience
a crisis before they accept help. The crisis
came about six months later.
My aunt contacted an uncle in
Oklahoma, saying she was having a nervous breakdown and
asking him to immediately come to help. When he arrived,
she was unable to cope any longer with my uncle or
herself. Arrangements were made for admittance to a
geriatric unit at a local hospital for a full
evaluation. What we found was a person with severe
depression and anxiety. This crisis started a process
that would not have been carried through unless a plan
had been created earlier outlining their wishes.
How can we help our elderly family
members with medical and financial decisions? Where do
we begin? First, sit down and ask who they trust to make
medical and financial decisions.
Second, visit an attorney to assist
with documents that will answer these questions. If cost
is an issue, there are a lot of free services available
through Legal Aid and senior centers. Their attorney
will discuss living wills, durable powers of attorney,
and durable power of attorney for health care.
Third, make sure that you know the
answers to the following questions in the event that you
have to step in to make decisions on their behalf:
The personís current
Level of trust with
doctors? Is the person comfortable with
their doctor making the final decision
concerning any treatment needed?
What makes the person
laugh or cry?
What is their attitude
What are the wishes on
the use of life sustaining measures for
If the person could not
care for himself any longer, how would
living arrangements change?
What is the level of
worry concerning the amount of money
required for care?
arrangements been made? What are the wishes
for funeral, burial, or cremation?
Who can be trusted to
make medical or financial decisions if the
person were unable to?
These are tough questions to answer.
I have friends who have ended up in therapy after trying
to answer them, but they need to be asked. Luckily, I
had conducted the exercise with my aunt and uncle and
executed the necessary documents to ensure their desires
and needs would be met.
Individual self worth and dignity
are important factors as we age. We need to allow the
individual the dignity and privacy we all want through
this process. If the individual does not want to discuss
the specific issues, honor that. The old saying, ďall
things work out in the endĒ really is true. It might not
end as you envisioned, but when an individual reaches a
crisis state, situations tend to resolve themselves.
One last piece of advice that I
hear over and over for older individuals is to live life
to the fullest each day, doing what you want now. Their
biggest regret is not what they have done, but what they
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