We have all heard the saying, “It takes a village to raise a child.” I am quickly learning that it also takes a village to help care for a dependent parent or spouse. When a tragedy occurs, you really find out who your real friends are and who you can count on to be there for you.
Over the last couple of weeks, I have been preparing, conducting, and cleaning up from a Life Event Sale at my mom’s home. It has been an overwhelming task for me and I could not have accomplished it without the help of some really great people. Friends of mine and my mom’s from ages long ago have reached out and spent countless hours helping me sort, set up, sell, tear down, pack, haul, and whatever else was needed to get the job done. People that I have not seen for decades stopped by to visit and shop. They sent their friends to do the same. I heard about stories of long ago and appreciation from these people for what my parents meant to them. It was very heartwarming.
I also have to thank my sister for spending several days of her first week of summer vacation helping watch over Mom while I was away. She was a great help and it allowed me the opportunity to devote my time and energy toward this sale. She expressed that the experience helped her better understand the challenges of being a caregiver for a live in loved one. Just having that extra support and sharing is crucial for my sanity sometimes.
I also found that just asking for help from people most are more than willing to do so, if they are aware of how they can be helpful. I received help from some people whom I had not met before. Almost everyone can relate to this type of situation and understand the challenges.
I will forever be grateful to everyone who stepped up. You all will be true friends in my book and hope that I can return the favor when a need arises.
Deciding to have a loved one move in often is often full of mixed emotions. You want to do what is best for the person who needs to relocate, but how will this change impact your home and you personally? The advice that I received from others was mostly supportive of the idea, but the opinion of one of my most valued role models, Dr. Laura Schlessinger, was against it. I will argue both sides and you can be the judge.
The positives of having your loved one at home is that you have more control over their care. You can manage their medications, activities, meals, and social life. They generally are happier being among family over strangers. The cost is less – even with in-home caregivers. You can spend more time with the loved one and create many more new memories.
The negatives are the added responsibility of managing that loved one’s care. If you try to be their primary caregiver without the help of professionals, you can easily exhaust yourself on a daily basis tending to the loved one’s needs. Your own personal time or time with other family members will be minimized. You also have to give up space in your home for this person to stay that will often involve incorporating their belongings with yours. In some cases, that may mean that other family members are inconvenienced in order to find the extra room.
Dr. Laura argues that one should give priority to their immediate family, spouse, and themselves. A caregiver’s responsibility should not involve sacrificing time and attention from spouses and children. She suggests that the caregiver’s responsibility is to find a proper place or caregiver service for the loved one to make sure their needs are being met. If the loved one cannot afford these places or services, they need to find the resources to help pay for it – even if that means the entire family of the loved one pitching in to help fund their care.
If you have read my previous blogs, you understand the reasons why I made the decision to move my mother in with me. I can understand and appreciate both sides of this argument. Mother has been in my home for a week and a half. The first week was a challenge and I started doubting my decision right off the bat. I had lived alone for most of my adult life, so adding anyone new to my household would require adjustment on my part. When you complicate that situation with a completely dependent housemate, I will not lie that I had to check my attitude a few times.
Even with 9.5 hours a day of help from an in-home caregiver service, I was finding most of my day being spent helping them with my Mom. Cooking, cleaning, shopping, doctors appointments, dressing, bedtime, medications, and an ongoing list of to do’s would occupy my day. I had very little time to do anything for myself. Mother had to adjust, as well. She had to realize that not every urge and want of hers needed to be performed by someone else right then and now. She needed to learn patience. She had to get used to the caregivers spending most of the day with her and understanding the necessity of their purpose. A routine needed to be established.
I am happy to say that once the first week was over, things have settled down substantially. I am able to let the caregivers do their thing with her and go off and do my work. Hence, a blog today!
Next week, is the big Life Event Sale at Mother’s home. I will be busy working that sale. If you are in the East Texas area, come check it out June 1-3.
For the last two weeks, I have spent 12-16 hours a day packing and moving two houses into one. I have finished unpacking and decorating the new house that will combine the household of both my mother and myself. Even though I donated two carloads of household items and clothes to Goodwill, I still managed to have things for which I cannot find a good spot in the new house.
At the same time I have been unpacking, the handyman has been working on modifications to the home for Mom. He is building a ramp in the garage that will accommodate her wheelchair and allow her easy access to enter the home. The next project is her room and bathroom, which requires new flooring and fixtures. We hope to have most of it finished by end of week. I have planned to move Mother in Friday evening. The cost to make this home handicapped accessible is going to be close to $8000.
I am now interviewing in-home care givers, as well. This industry appears to be quite competitive since there were many choices to call in the area. I scheduled appointments with two companies that seem to offer the type of flexible service that Mother will require. The representatives appear to be very eager to help and their follow up has been excellent. The decision of which to choose is ultimately which company offers the service and care that best fits the needs of Mother.
The costs I have been quoted float around $21/hour with a 4 hour minimum. They will provide care givers for multiple shifts and 7 days a week, if needed. Doing the math, if one required 8 hours a day for 7 days a week, that runs $1176/week. On a 4 week month, that is $4704/mo. You will pay time and a half for holidays or overtime. A working family may need more than an 8 hour day. I expect to have a caregiver at least 9-10 hours a day, so that will push the numbers up to about $5500/mo. I know it sounds high, but considering that the assisted living situation costs almost $2000/mo. more and we had to pay a $4000 reservation fee, living at home will be a savings to Mom and a better quality of life.
In-home care assistance is just as much a need for the family caregiver as it is for the loved one that requires the care. The responsibility to help with a ill, handicapped, or memory-impaired person is huge. It can easily consume your life. Some people are able to handle the task on their own and do it well. For most, including me, it can be exhausting and time consuming. Occasional days of this work is doable, but every day would not enable one to have a life of their own, offer time to work, and add a tremendous amount of stress. It is important to enjoy your time with your loved one and keep your sanity.
For many, adjusting to life with a caregiver in the home will take some time. In the next coming blogs, I will write about the experience of this process.
How do you go about tackling downsizing a home? It is an overwhelming task in many cases. The best place to start is in the areas that are visible. Look at counter tops, shelving, furniture, and corners of a room. Do you have things piled there? After you declutter those areas, tackle the not so visible areas: pantries, closets, cabinets, storage bins, garages, attics, storage rooms, and furniture with storage areas.
Don’t complicate things by giving yourself unreasonable deadlines on getting the entire house cleared out. Do one or two areas each week. Get friends and family to help you.
Below is a printable list of suggestions on the process of downsizing. I hope you find it helpful.
If you would like professional help, please contact me at Seasoned Life Transitions. The email is seasonedlifetransitions@gmail.com . The toll free number is 866-653-9669.
Those sales after a holiday, such as Christmas, Halloween, and Easter, offer up irresistible deals. Up to 75% off! How can you pass up that cute Santa or that new goblin yard decoration? They are so cute!!! You buy a few sacks full of things and take them home. Since the holiday is over, you stuff them (still in the sack) in a closet for next year. This routine happens after every holiday, year after year. Before you know it, your closets are stuffed in every crook and crevice with these bargains.
This past weekend, my sister and I sorted through 2.5 closets and a few cabinets of Mom’s. We had a pile of shopping bags that was 8 feet wide and 3 feet tall. Mom oohed and aahed over almost every item, but she made the hard choice to let go of 90% of those purchases. After about 3 hours of this sorting process, it began to hit her how out of control her buying had been. She had never pulled it all out and looked at the quantity of items. The amount of money that she had spent was also starting to hit her. $20 here and $50 there. It adds up to a great deal of money. Money that she can use now for her expensive long term care.
My sister and I spent two solid days pulling out things from these 3 closets, two china cabinets, shelving in laundry room, and the shop. I filled up the back of the pickup truck twice with trash. All of these purchases, many of which are still brand new with the price tags still attached, will be sold in a Seasoned Life Event Sale in June. They filled up the counter spaces in the shop. It truly looks like a retail store! The hard thing to grasp is that all these items were new purchases. We haven’t even started on her storeroom that contains bins after bins of the Christmas decorations she used year after year! These will be the things of which she has the most emotional attachment. She has to reduce “the keep” holiday items to 5 bins.
The next hard thing to grasp is that these are just holiday items. We have not even started on household items, such as china, glassware, decorative pieces, and clothing. I have so far spent over 40 hours sorting and cleaning out spaces in her home. Most of this has been the most cluttered areas, such as the closets and shop. I am guessing that it will take over 100 more hours to finish clearing out the house completely. Some of that time will require professional movers and other family members to pitch in. My body is aching and bruised, but I will keep going. It has to be done.
Hopefully, all of this information will set off a light bulb or warning light to other seasoned life people who need to downsize. Do not put this type of burden on your loved ones! I do this for a living. They do not. The task is too overwhelming and time consuming for the average person. They will tend to take the easier downsizing path, which includes, hauling it off to the junkyard, donating it, or selling it off for cheap in a garage or estate sale. Future blogs will take you through the Seasoned Life Transitions process and show you what we do and the results.
After almost 35 years in the adhesive tape industry, today is my last active day at work. Everyone says that they wonder where the time went. In some cases, I feel the same way. I remember the beginning of my career very well and it does seem like it was just a short time ago.
My career was split into two phases. The first phase was as a salesperson for Plustar, Inc. The second phase was the owner of Tape Solutions, Inc. Running my own business was definitely challenging at times, but far more rewarding.
I could not have been successful in either phase without the support of customers, vendors, employees, and co-workers. There are hundreds of people who were loyal to me for many years. I have to thank a few.
Byron Barlow and George Marvin, the founders of Plustar; June Finlay and David Mahon, co-workers at Plustar; multiple customers, including Bill Birch, Eric Hoover, Casey Gonzales, Darryle Woods, Anthony Flores, Bruce Mansfield, Ralph Rodriguez, Angie Aragon, Pete Moreno, Les Miller, David Hall, and so many more; former employees, Jeff Heath, Rosalinda Talkmitt, Elizabeth L. Melvin, Walter Colson, and Kevin West; and vendors, Shurtape; Packsys; ATP; Electro Tape; Decker Tape; Cantech; and many more were all key components to my success. Thank you all from the bottom of my heart.
I look forward to the new venture, Seasoned Life Transitions. I hope to help many people and believe this is now my life’s purpose.
When a few weeks were left prior to the 100 day mark of Mother’s skilled nursing stay, a care meeting was called to discuss her future plans. It was during this meeting that I learned the real truth about the financial end of long term care.
In a previous blog, I discussed average costs of long term care. (average in the State of Texas for the rate to be $140/day + extras) I was told that for her to stay in this facility, she would go on self-pay after 100 days at a rate of $165/day + extras. For a 30 day month, that comes to $4950 + extras. I was a bit relieved to hear that number, because I had seen the statements from the insurance company and the figures they were charged were immensely higher. Below is the actual amounts from the statements:
May 2016 – Medicare was billed $26,706.15 by the skilled nursing facility. That is the amount they paid, less a deductible from Mom’s secondary insurance (about $4400). During the month of May, Medicare was also charged for a doctor’s visit from three different doctors for $280-$336/ea. Medicare paid a very reduced amount in the range of $160 to each doctor. Medicare was also charge for 9 visits by a nurse practitioner for $270/ea, of which they would actually pay about $116/ea.
June 2016 – Medicare was billed $24,998.29 by the facility and they paid that less a smaller deductible from the secondary insurance. The doctor charged for 2 visits this month, 11 visits by the nurse practitioner, and 4 other services/doctors billed Medicare for the same numbers of the previous month per visit.
July 1-19 – Medicare was billed $15,606.06 by the facility. There were no doctors visits, but 7 charges by the nurse practitioner. Two additional charges by other services.
When I asked the administrator of the skilled nursing facility why the rates were over $800/day previously, she was stunned that I knew this information. She replied, “We charge the maximum amount that Medicare will pay.” You are probably asking, “What difference in care do you get for $165/day versus $800?” If you haven’t read my blogs from day 3 and 4, I will tell in brief – not much!
I have probably looked at those reports 4-5 times in the last few months and I get just as angry every time! Mom was not getting proper care in numerous ways during that time and had to eventually be hospitalized to recover from her ailments. She supposedly was visited and treated by a doctor and nurse practitioner several times each month and she was not getting better. I did meet the doctor one day when Mother was so ill and asked her if she had actually examined Mother. She told me, “No.” She had just observed her progress during a therapy session. I asked her to please physically examine Mother and she said she would. She told me to ask the nurse’s desk a few days later for doctor’s notes on her findings. I did and the nurse told me that there were no doctor’s notes of an exam – just orders that Mother needed to be changed every 4 hours.
I also tried to call the nurse practitioner from the phone number listed on the insurance documents. It was not a working number. I tried googling her name and could not find any office for her. I asked the nurses about this nurse practitioner and was told she comes in really early (before her office hours) to visit patients. Often before 7 a.m. I found that odd, since there was no office that I could find for her. I asked them for her phone number and was told that they don’t give out that information, but they would give her a message to call me. I never once received a phone call from this woman who was charging Medicare and insurance for 10 visits a month!
I am not suggesting that all skilled nursing facilities are bad. Many are not though and that is the truth of the matter. If you plan on putting a loved one into a place like this (or yourself), it is crucial that you have good insurance and a trusted family member who can look out for your best interest. Ask the hard questions and be persistent. There are agencies that can help, if you have problems. DADS with the State of Texas is one. There are also ombudsmen with the city in which your facility is located that can help mediate.
Family heirlooms, furniture pieces passed down from previous generations, sentimental gifts, purchases during a special vacation, or just a collection of items that have a special appeal can accumulate over a lifetime. One can also find his or her closets, storage rooms, garages, attics, and even rented spaces are overflowing with stuff. It is easier to justify keeping all of it than to deal with the overwhelming task of sorting through all of it and making decisions about keep, sell, trash, or donate.
For many of us, there exists an emotional attachment to many of these things. We have a fondness for the memories that are associated with the item or how it was acquired. Many of our parents and grandparents lived during the Depression or other times of hardship. They began accumulating things because they hated going without or being poor. Many of these people look at having things as comforting and sign of status and accomplishment.
There are some extremes of people who get an adrenaline rush from the thrill of buying something and cannot control the urge. Many of them also have difficulty throwing things away. This behavior can be extremely problematic and lead to hoarding. In those extreme cases, a trained psychologist would be necessary to help these people understand they have a problem and get the counselling necessary to get control over the situation.
The younger generations have not typically gotten as attached to things as us “seasoned life” people . The millennials and Generation X group have a minimalist attitude. They desire freedom and seek the thrills in the here and now. Being tied down by stuff is not desirable. If it doesn’t fit in a backpack or compact car, it isn’t their cup of tea. They enjoy a more spontaneous lifestyle. If the seasoned life generations think that our kids and grandchildren want all of our stuff, we are grossly mistaken.
Don’t assume that those cherished items you have collected all these years will be loved and appreciated by other family members. If you think it is overwhelming to sort through and make decisions about your things, try to imagine what it must be like for someone else to be put in the situation to do it for you. Divorce, illness, accidents, or death can occur to anyone anytime. These events can shift the burden of responsibility to a loved one.
If you have been reading my series of blogs, you know that this is my situation. It actually goes back even before Mother’s stroke. My father had varied interests and hobbies, which resulted in a large collection of items. When he became ill, Mom and I both tried to convince him he should take control of selling off his collection while he still could. No one knew the value and history as well as he – nor had the connections. He refused to let them go. When he passed away, my mom was now left in the position to take care of it. It took a while, but with the help of my brother and some of his knowledgeable friends, she was able to sell almost all of his collection.
You would think that from this experience, my mom would be more agreeable in downsizing some of her things. Not the case! I tried for years to get her to cut back on continuing to acquire more of the things for which she had a weakness. It didn’t happen. She would laugh it off and say that I can get rid of them after she is gone. Every closet, cabinet, storage room, and nook in her home was crammed with this collection.
Now that she has made the decision to move into my new home, the amount of stuff she can bring will be limited. Due to her physical condition, the work of sorting, packing, moving, selling, and discarding her things will be left to me and my siblings. Of course, Mom will be involved in much of the process, but I know it will not be easy for her to decide. The downsizing process begins this weekend.
In the first blog I mentioned that even before Mom suffered
her stroke, I had developed an exit strategy from my business. I also had a concept for a new business venture that I was keenly interested in pursuing. A big step in this plan was listing my business for sale with a Mergers and Acquisitions firm. My adhesive tape business had received a good deal of interest right away and I received three different letters of intent in the first few months. Due to a variety of reasons, the interested buyers pulled out before the negotiations even started. It was not until a couple of months after Mom’s illness, did the next letter of intent come through.
This interested buyer came in for a visit in August and we came to an agreement on price in September. The due diligence process was excruciatingly slow. It is during this process that many deals fall apart. Much of the delay was due to the buyer’s loan process. Over three months went by before an actual closing date was set.
During this time, I had many discussions with Mother about our options after the business was sold. I knew she would be happier nearer to her friends and I, too, had friends in the Dallas area. I had lived there for 17 years prior to moving to Austin. Mother was aware that she was not likely to ever be able to live on her own again. She was quite happy to move to Dallas. She would just say, “I want to go wherever you are going.” When I asked her if she would rather find another assisted living facility near where I bought a home or live in the new home with me with the assistance of in-home caregivers. She said, “I need the think about it.”
While all this was going on, I started my business plan for the new company. There was much research to do and I was having great difficulty deciding on a name. I also wanted credentials, so I enrolled in an on-line course to become a certified antique appraiser. I was doing my best to lay the ground work for the next few months.
About a month before the closing on the sale of my business, Mother told me that she had made a decision. She wanted to try living at home. She wanted to have more freedom and feel more independent in her daily activities. She wanted to be proactive with her therapy in hopes that she could still improve her speech and movement. She was tired of doing the same thing every day. She was bored in the assisted living facility and needed more variety. She missed socializing with her friends and hoped she could resume playing in some of her bridge clubs. It was up to me to make it happen.
The business closing went through in the middle of February. I had agreed to a 3 month consulting agreement to help with the transition of the business ownership. That gave me a few months to finish my plan and start building a network of professionals to help me in the overwhelming process of downsizing and consolidating two homes, listing the homes for sale and coordinating the timing of all of it. It should be a snap, right? After all, that is a big part of what I am going to be asking people to hire me to do.
The next blog will start explaining the process of downsizing….
Getting used to an assisted living situation does require an adjustment – not only for the resident but the family members, too. It is not unusual for the resident to be angry in the beginning. This is especially true for those loved ones that suffer from memory issues. They will often feel very confused and lost. The caregivers and nurses at a memory care facility are trained to handle an upset resident. These tactics usually involve some type of diversion.
I found it especially helpful to attend a family support group the first couple of months that Mother was in assisted living. The responsibility and guilt that family members go through can be overwhelming. It was interesting to hear about everyone’s story and experience. Although everyone was different, much of the issues were the same: a spouse that feels so guilty about leaving their loved one behind, the stress of being yelled and cussed at for putting them in this place, and the financial responsibility of paying for two different residences.
Mother understood where she was and why she was there. She had to warm up to participating in activities. I encouraged the social directors and caregivers to make sure she was involved in the various activities. It was important that she develop a routine of getting out of bed every morning, getting dressed with full makeup and jewelry, eating meals in the dining room, and socializing. Attempting to get her life as normal as possible, I felt, was of great importance in Mom’s recovery. One small thing that meant a great deal to her was to get her hair done in the salon every week.
She also began another 6 weeks of therapy. It was a goal to keep the momentum of improvement she had started at the acute care rehab.
Scooting across a bed or bench, standing up and maintaining her balance for 10 minutes, keeping her paralyzed right arm and hand flexible, working her brain in order to improve her speech, and improving her ability to read and write were important in her recovery. After that round of therapy, she had shown great improvement.
As the holidays approached, decisions needed to made in regards to how we could celebrate them with Mother. We requested and were approved to get a couple more weeks of therapy to train myself and one of Mother’s granddaughters on transfers. We wanted to be able to take Mom out and that meant learning how to move her from wheelchair to car and back. We also had to learn how to get her in and out of bed and in and out of the bathroom.
After about three weeks of twice-a-week training, I took Mom out to lunch in a restaurant. She was so excited and was waiting at the door when I arrived! We had a nice afternoon of shopping and lunch. The next big event was to bring her home for an overnight stay. We did that on Thanksgiving night. I will not say that it was easy. There were definite challenges and it is a lot of work. I took me two hours to get her up, showered, dressed, and hair done. Due to all this, the family decided to hire an in-home caregiver at Christmas. (In a later blog, I will discuss in-home caregivers.)
As the next few months go by, Mother’s verbal improvements were great. She was happier and we were able to reduce her medications in half. This was very important to Mom. She was put on an anti-depressant medication within a couple of weeks of admission in the skilled nursing facility. She complained that it was making her “foggy” and she objected to taking it from the very beginning. I refused it at first, but the nurses and therapists insisted that it was necessary. The ability for Mom to get out and do normal things also helped her improve. Her verbal accuracy was over 80% at the 8th month mark.
The cons of the living situation for Mom was that she was getting extremely bored with the mundane and repetitive routine day after day. She would often cry and express her desire to spend more time away with me. She missed her friends and her social life. When her physical therapy ended, her exercise was reduced to almost nothing. She began to lose some of her strength. Also, once Mother was up and dressed, she could move about on her own with little assistance within the facility. Due to this fact, the caregivers would mostly ignore her much of the day. More dependent residents got their attention. If Mother didn’t want to wear her brace or put her armrest on her chair, which was important to maintain her flexibility, the caregivers didn’t insist. The result was a slight regress in her condition.
All of this help lead me to the conclusion that talking to Mother about living at home with me, with the assistance of in-home caregivers, might be in her best interest. Stay tuned on her reaction and what happened next ……