Eventually It Gets Personal!

In keeping with the fact that November is National Hospice Awareness month, as well as our focus on caring for our aging parents, I decided to go personal with this blog and share my own experiences in each area.

Two years ago, my brother, sister and mother and I had to confront the reality that our 81 year old father/husband was terminally ill. He had liver damage from fatty liver disease and both his liver and kidneys were starting to shut down. The only treatment option would have been a liver transplant and at 81 that’s truly not an option.

Initially, we had to deal with the issue of whether or not Dad was a DNR (Do Not Resuscitate). Now, Dad was a really smart and incredibly practical man, so I was pretty certain that if his heart gave out at any point, he wouldn’t want to be brought back. But he was going in and out of consciousness due to drug interactions that a failing liver couldn’t process.  Therefore, my Mom was in charge. After 56 years of marriage, when the hospital asked us about a DNR, Mom’s only answer was that they needed to do whatever and go to any lengths to keep Dad alive. It took a lot of family meetings and then using moments of Dad’s lucidity to convince Mom that he was in fact by choice a DNR. This is a really tough conversation to have when someone is already ill. I urge you to have this conversation as a family far in advance of the potential need.

For the next two months, Dad would go into the hospital for a week, and then be too weak to go home, so he’d go to a rehab center for a week or two. Another drug interaction and then we’d repeat the process. After 8 weeks, I said to my family, “is this really how Dad wants to spend whatever time he has left or how we want to spend our time with him, going from hospital to rehab and back?” So we decided it was time to bring him home and call in hospice.

Hospice was incredible! They showed up in advance with a bed and everything we would need to take care of Dad at home. They took over medication dispensing, provided counseling and nursing assistance. They had 24 hour help available if we need to call someone. I was amazed at their service and even more so at their hearts. These people were incredible at helping the dying transition to the afterlife and help the living cope with the reality of their loved ones’ death.

The most amazing gift a hospice nurse gave to me was when I had been with my parents out of state for a week, missing the holidays with my husband and kids and really felt like I needed to go home. But Dad had been hanging in there and I didn’t know what to do. The hospice nurse told me to go home and be with my family, but make sure and say goodbye as if it was my final chance to speak with my Dad. I thought long and hard about what I would say to him. When I was about to leave, I asked for a moment alone and I told my Dad what he meant to me and what wonderful parts of me I felt like I inherited from him. What a blessing to have that chance! I went home and when he died a week later, I was totally at peace having said that final goodbye.

Fast forward one year… to early 2012, just one year after Dad died. I get the call from my sister, who lives near my parents, that my mom was having a stroke. It was a big one, but mainly affected her cognitive skills. She woke up not remembering that Dad had died, what year it was or much more than the names of her children and grandchildren. She also lost her ability to read. Immediately my mother lost her independence and we were looking at having to get her live in help so she could stay in her home. Over this year, many of Mom’s long term memories have come back, but the short term recall is shot. Her heart and blood work look great and she could continue to live a long time, but will always require care.

My sister and I started doing our research and called a variety of different care giving services that were recommended by the rehabilitation center. Interestingly, Medicare was done paying for Mom’s rehab after 2 weeks, and she was basically being kicked out. We were shocked to find out that the cost of care was $220 a day, which equals $80,300 a year (Holy crap!).  Now Mom and Dad had scrimped and saved their whole life so they could afford to pay for that for a while, but that’s a lot of cash! Gratefully, I had begged my parents around 12 years prior to buy Long Term Care insurance. The benefit I had sold them was only $100 a day, but with the cost of living adjustment, the daily benefit was now $165 a day, covering $60,226 of that $80,000 a year bill. Needless to say we breathed a big sigh of relief!

The total cost of the premiums they paid for that coverage over the 11 years was around $55,000. We have already recouped that cost. But the reality of insurance is you hope you waste those premium dollars! Who wants to have a car wreck, a house burn down, die prematurely or lose their independence in old age? Obviously no one, but the question is can you afford the cost if any of those things happen to you? If the answer is “No”, then insurance is the answer. If your parents can’t afford LTC insurance, consider paying for coverage on your own or with your siblings.

Next week kicks off the holiday season of Thanksgiving through New Year’s. This is a great opportunity to discuss all of these issues with your aging parents. Most people haven’t asked their parents these sensitive subjects. Don’t blow the chance to talk to them about their final wishes while they are healthy and can give you their input. You won’t regret it!

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