Walking Them Home

Death. The only guarantee in life is death. As our parents age, that guarantee becomes obvious, real. We plan for life; we get an education; we strategize for jobs; we develop our close relationships; we map out vacations; we plan life. Few people, plan for their old age and the effects of their death. With the promise of death for all of us, why is this topic taboo? Instead, we can accept it and plan for it.

Eight years ago, I moved from Orlando and a fun job at Walk Disney World to live near my aging parents. I believe it would not have been beneficial to suggest my parents move to Florida; I had seen other elderly parents move to live near their children and they went down mentally and physically very quickly and died not long after moving away from their ‘natural environment.’ While some adult children cannot do this for their parents, I know it was the right decision to be there to walk my parents home.

Here some strategies and tactics to manage the journey:

1. Ask your parents if they have the following: wills, end of life wishes documented, living will, resuscitate or no-resuscitate orders, power of attorney. If they do not, locate an attorney who specializes in elder issues. Then, approach your parents to set up an appointment to take legal care of these important documents. Tell them that once they’ve completed the legal documents, they can go on with life knowing they will not leave their children and grandchildren with legal problems, probate issues, succession problems, no access to bank accounts/investments/pensions/other resources, and without knowing their parent’s wishes. A great elder care lawyer will be able to advise your parents and you on how to keep their home and still go into assisted or nursing care facilities.

2. Your parents will need to put their executor, and perhaps you and other siblings - the children they trust to do the right thing, on their bank accounts, financial accounts, investment accounts, safety deposit boxes - get another key for the box(es), etc.

3. Discuss assisted living, in-home care, long-term care, nursing home options and how to pay for it if the time comes. Visit care facilities and put your parents’ names on waiting lists for the facilities they prefer or that you select as a good fit for your parents. Find out if your parents have long-term care insurance or have a savings account specifically earmarked for these expenses.

4. Know what medications and supplements your parents take. Have the specific lists on your smartphone so it’s handy if you need to show it at doctors’ appointments and at hospitals. Know what therapies your parents participate in: physical, occupational, counseling, exercise. Get the names, phone numbers, and addresses of their doctors and other care providers; get the name and contact information of their pharmacy or organization that mails their prescription meds to them. Keep this information in your smartphone.

5. Find out debts your parents still have. Discuss their insurance: homeowners, auto, Medicare, etc. Help them fill in any gaps in coverage with supplemental insurance. Locate copies of mortgage papers, car titles, etc. Gather all of the important papers in one place and be sure the executor and the children/grandchildren your parents trust have copies. Make copies of their insurance/Medicare cards front and back, of their driver’s license, of their passport identification pages, and of any other important papers.

6. Encourage your parents to minimize their belongs now, to ask family and friends if there is anything special they want; either mark it with their names on it or give it to them now. This is a delicate topic and is highly emotional for your parents, so go slowly if you can. See my blog post on “They Don’t Want Your Stuff.” Gently share with them that it is kinder for them to work through minimizing now rather than passing on and leaving their children and grandchildren a nightmare to go through while they are already dealing with their grief over missing their loved ones.

7. Access their abilities to do yard work, pay bills, to hear and see adequately, to do household chores consistently. Asses their mobility and suggest a cane or walker or wheelchair if needed. And, here is the biggie: assess their ability to drive safely. Be prepared for lots of angry or passive aggressive pushback on the issue of no longer driving. If you can, go slowly on the ‘no more driving’ edict. Losing the ability to drive represents, to oldsters, one of the final acts of independence they used to enjoy. If they are no longer driving, search for and set up transportation to doctors’ appointments, going to church, shopping, etc. for your parents if you cannot do the driving for them.

8. Discuss preferences for the ‘send off’: donating body to local medical school for scientific and educational study - this must be done well before end-of-life is imminent, cremation and the accessories associated with it, burial, style of funeral/memorial service/wake/graveside events. Funeral home and cemetery preferences? Talk about and document what music, flowers, venue, programs, lifeline slideshow, photos to display that your parents want for their ‘send off.’ Ask your parents who, among their friends and family, needs to be notified at end of life. Get phone numbers and mailing addresses for the list of people your folks want notified.

9. Arrange caregiver support for yourself. Walking parents home is exhausting, mentally and emotionally draining; support for you is critical.

10. Encourage your parents to tell you their stories. Listen and learn. Encourage siblings and grandchildren to call and to come visit often.

11. Together with your parents if they are self-aware and if they are capable of effective mental functioning, make a list of markers that indicate it’s time for full-time nursing home care or care at their home. Here is the list for my parents: 1. Mobility - if they cannot walk using a cane or walker, it is time for constant care. 2. Not taking the medications as prescribed 3. Cannot get into and out of the bathtub or shower on their own 4. Cannot dress themselves 5. Cannot control their bodily functions - while some of you may be able to change their pads and ‘diapers’ and clean them, I know my boundaries - I cannot do that type of task for my parents. 6. Dangerous, unsafe behaviors - parents wandering down the street, leaving the oven or stovetop on, etc.

12. Help them filter out scams they get over the phone or through the mail or through email and text.

13. Encourage them, if they are mobile, to get up at least once an hour to walk in the house or outside. Encourage them to get some sort of exercise.

14. Check their refrigerator, freezer, and cupboards for expired foods.

15. Look for signs of hoarding odd things such as saving bits of aluminum foil, small amount of string, plastic lids that don’t go on their jars. This is an strange time in their lives and clinging to things is a form of attempting to stay in control and to be independent.

16. Discuss the need for safety in their home. Set up a Ring (https://ring.com) or SimpliSafe (https://simplisafe.com) type system and motion detection safety lights outside. I do not suggest an old fashioned alarm system because they will likely set it off often and the police don’t have time to respond to lots of false alarms. Encourage your parents to look at the security camera at their front door and not to open the door to anyone they don’t know.

17. Monitor their bank and credit card accounts. As you know, elderly people are targets of “poor me, can you give me/loan me/donate money to me.” Oldsters may be toontrusting and could easily be taken advantage of.

18. Assess their home as you would for toddlers: use non-slip rugs, plug up electrical outlets not being used; install handrails in the washroom and long hallways; install bedrails, etc.

19. Be aware that when parents age, lots of your childhood traumas, anger, disappointments, blame, shame, and guilt can emerge. Get counseling to help you deal with these issues.

20. Yes, your roles have reversed and you are parenting your parents; if you or your siblings cannot be there for them, don’t allow yourself to feel guilty. Employ caregivers and care places for your parents.

I hope these ideas help you as you walk with your parents to their final destination.