Trigger events

When trigger events strike, you are left with a horrendous burden and having to scramble for answers and loose ends in the dark. For example, you could be preparing dinner for your family in New Jersey when you get a phone call from a hospital in Delaware telling you that your mother has been admitted with a stroke. She’s only 76, and she never previously had any heart issues, and yet there she was in an ICU in some hospital.

But your mind wanders to your father. He is older and has second stage Alzheimer’s. He cannot be left unattended, and yet his wife who had been his caregiver is now fighting for her own life. The voice on the phone doesn’t know where he is, and when you hang up, an icy draft invades you and lodges in your gut. Anguished, sudden realizations start filtering in. In essence, your old normal has been shattered and your life turned upside down. From that moment on, you have to start adjusting to new givens, a whole bunch at a time.

The “double whammy” that boomers are caught in

It’s not as though boomers don’t have enough on their plate being in the classic grip of having to deal with college-age kids as well as elderly parents. Alzheimer’s though can be the straw that broke the camel’s back. Unless of course the family is well organized and there is a BIG PLAN in place.

People who are 80 or over have a 50% probability of having Alzheimer’s (according to Malaz Boustani, a research scientist with the Regenstrief Institute and the Indiana University Center for Aging Research), and the odds get worse if Alzheimer’s already exists in the family, say in parents, uncles, aunts, and other. Even younger parents can show early onset of AD, and yet, amazingly, trigger events still catch many families by surprise. If it’s not a stroke, it can be a broken hip, or a pneumonia that incapacitates one parent and leaves the other AD-impaired parent isolated and at risk.

The 5-step Boomer Plan for long term sanity

And yet, we know for a fact that many of us don’t think about transitions, including end-of-life transitions, until they hit us on the head with the subtlety of a sledge hammer.  Not being prepared means being torn apart by having to take impromptu stands on a multitude of fronts. Here is a 5-step master plan that every boomer should consider.

1. Who’s in charge?

You should have a meeting at least twice a year with everyone who has an interest in your parents’ wellbeing –siblings, spouses, uncles, etc.-to assign responsibilities. It is so helpful to walk into a sudden crisis knowing exactly how others will be helping you out rather than to have to seek people’s assistance while you’re in the middle of the storm.

2. Long Term Care (LTC) insurance:

You can buy this type of coverage from any one of hundreds of insurance companies. It covers each parent for receiving care at home or in any long term facility and up to any amount you choose. For example, you can get insurance for up to $120 a day, with a time limit (5 years or more) or with a dollar cap (up to $10,000 or other amount). You would thus have access to paid long term care once your doctor prescribes it. As for the costs, you may purchase 5 years of $100/day at age 50 for a monthly premium of, for example, $195/month. If you add years of coverage or daily amounts to your coverage, or you start at an older age, your premium would go up.

3. Legal documents:

  • Get your parents to sign HIPAA documents authorizing doctors and medical facilities to share information and charts with you.
  • Get your parents to sign a “health care proxy”, allowing you to make medical decisions on their behalf if they are unable to do so themselves
  • And finally, get them to sign over an “advanced health care directive” (a.k.a. a living will). This will state to all concerned how the individuals want for after they stop breathing (resuscitation, artificial life support, and tube feeding).

4. Housing:

  • If the plan is for them to remain at home for the long haul, then the house needs to be rendered appropriate for aging individuals (wider doors for wheelchair access and several other features).
  • If on the other hand there is consensus in favor of an assisted living facility, it would be useful to have the parents move into a likely facility on a trial basis for a short while. At the very least, a facility should be earmarked, toured, and kept on file for a quick admission when events warrant.
  • If a facility is indeed the preferred option, then a real estate broker should be given the task of selling the house (which might take months or longer to sell). In that scenario, you might wish to start upgrading the house to “showing” condition.

5. Finances:

Aging parent(s) may still be carrying old 401(k)s or other stock accounts that no one has looked into for years. Get the type of financial consultant who is on a fixed retainer paid by you and who does not stand to gain on your buying or selling of assets. It may sound harsh, but the guiding assumption in managing assets for the aging is that they are going to pass away in the near future. Thus all stock and real estate assets should be liquidated and converted to cash or near-cash (Treasuries and money market accounts). The proper powers of attorney should be signed, giving you full rights over those accounts. Finally, you should take your parent(s) to their bank(s) and have the bank managers officiate over their giving signatory powers over those accounts as well.

Next time you get a call from a hospital ICU, you won’t get cold sweat trickling down your spine. You’ll hopefully be better prepared for awkward transitions.

About Mike Takieddine, the author:

Mine has been a privileged life, first for having traveled all over as son of a diplomatic family, then for having had the opportunity to study at Oxford, and finally for a gratifying career in geriatric home care where I had the opportunity to restore sanity and optimism to many family caregivers. I look forward to using this wonderful medium to discuss the various ailments that afflict the elderly.