Tag Archive | death

New Book: “You Oughta Know: Recognizing, Acknowledging, and Responding to the Steps in the Journey Through Dementias and Alzheimer’s Disease”

I’ve just written and published my newest book, You Oughta Know: Recognizing, Acknowledging, and Responding to the Steps in the Journey Through Dementias and Alzheimer’s Disease.

It is available in both paperback and Kindle versions.

I’ll include the short summary from Amazon I wrote for the book:

You Oughta Know: Recognizing, Acknowledging, and Responding to the Steps in the Journey Through Dementias and Alzheimer's Disease“This book looks comprehensively at all the steps that occur in dementias and Alzheimer’s Disease.

In my own experience with this and in counseling, supporting, and working with others who are going through these steps, I realized there is a basic lack of comprehension about the big picture of how these neurological diseases progress.

I know that because the same questions get asked and answered over and over again.

My purpose is to ask those questions and answer them in a way that, first, makes sense, and, second, works for everybody involved.

I know. I’ve been on the caregiving side of the equation personally. There were no books like this when I did it, so I had to learn on my own and figure out what worked and what didn’t. I made mistakes. You’ll make mistakes.

But, in the end, my mom and whoever you love and are caring for, got the best we have to give and we can learn some pretty incredible and good life lessons along the way.

If you don’t read another book on this subject, you should read this one. I don’t have all the answers, but the answers I have learned are the ones that probably matter most.

Not just now, but for the rest of our lives.” 

This book also includes the last step that we take alone without our loved ones: grief. I’ve been there and I’ve done that and although I will never not feel the grief on some level, I’ve learned some lessons that I know will help each of you.

If You Needed Help, Does Anyone Have What They Need From You to Step Up to the Plate?

Kay Bransford and I seem to be on the same page a lot these days, but I see that we seem to be the only ones willing to tackle these subjects, so I guess we will keep sounding the drums that all of us need to be preparing in advance for the possibility that something – whether it’s Alzheimer’s Disease, dementias, other life-threatening illnesses, or simply time and chance – could suddenly and dramatically or slowly and insidiously render us incapable of taking care of our own affairs.

It seems to me that the very thing we try most to avoid thinking about, talking about, planning for is the very thing that will eventually happen to us all. And that is death.

Denial is, in my opinion, stronger and more pervasive in this area of life than in any other. “If I don’t think about it, then it isn’t real” seems to be the underlying thinking of this denial. I’m here to tell you that all the denial in the world won’t take away its inevitability of happening.

None of us, except those who chose to usurp God’s will and end their own lives, know how or when we’re going to die.

I believe most of us assume it will be quick and instantaneously, but the reality is that, in all likelihood, most of us will probably have a period of decline in which we will need help handling our financial, legal, and medical affairs before we take our last breaths.

And, after we take our last breaths, someone will have to take care of getting us buried and ending our financial, legal, and medical status among the living.

Who would that be for you? Yes, you, the one who is reading this post. Do you know? Does that person know? If that person knows, have you made this as easy as possible for him or her by doing your part and making sure he or she has everything he or she needs to do what needs to be done?

Or, because you don’t want to think about it or talk about, will that person have the burdensome responsibility of trying to figure it out all on his or her own?

We say we don’t want to be burdens to our loved ones. By taking care of this, you and I – we – have taken a big step toward easing the magnitude of that burden that, if we live long enough, will be shouldered by our loved ones.

I did my first will and living will shortly after I turned 21. I had just graduated from college, but not before having a very serious car accident (one that I miraculously survived with some significant injuries, but nothing like what I should have suffered) just before I graduated.

I’d never been that close to being face-to-face with death before, but it made me realize that I needed to make sure that my affairs – and they were paltry in those days but even then I had life insurance – were in order for the ones I’d leave behind.

From that point on, I have been meticulous about keeping my will up-to-date, the beneficiaries on my insurance policies up-to-date, and all the information my executor will need to take care of things up-to-date. I added a DNR to my medical wishes about 20 years ago, I got my cemetery plot 15 years ago, and I wrote out my funeral service and burial wishes about 10 years ago. 

Additionally, my executor has updated access and account information to everything online and offline to finish up my earthly affairs when I’m gone.

preparation-death-alzheimer's-disease-dementias-age-related-illnessesThis, in my opinion, is the last act of kindness I can do in this physical life. It is also one of the greatest.

Mama used to worry that something would happen to me (i.e., that I would die before she did) and then about what would happen to her. There were times in our lives together that could have been a possibility, but I always reassured her that I’d be there with her to the end. And I was by the grace of God.

Of my parents, Daddy was a paradox when it came to this subject. On the one hand, he had life insurance that would take care of Mama after his death and he insisted, in the year before his death, that Mama get her own checking and savings accounts and get credit cards in her name only.

On the other hand, there were other areas in which he had great difficulty facing his mortality. I remember Mama suggesting that they start getting rid of clothes and other things they weren’t wearing or using anymore and Daddy’s response: “the girls can take care of that.”

The will that Daddy had in effect, until shortly before his death, was the one that he had drawn up just after he and Mama adopted us. None of the information was pertinent or relevant anymore.

After much and extended (I’m talking a couple of years) discussion between Mama and him, they finally went to a lawyer, about six weeks before he died, to have a current will drawn up.

Mama was just the opposite. Somehow, I think all the deaths of close and beloved relatives in her early years made the inevitability of death more real to her. She, primarily, during our growing up years, talked on a regular basis about what would happen to us if she and Daddy died and how we needed to take care of each other and be good kids so the road without them would be easier for us.

Not long after Daddy died, she and I sat down together (I was now checking in daily and helping her navigate through some of the things that Daddy had done and offering advice and assistance as she needed it) and she told me what she wanted – and didn’t want – as far as end-of-life wishes.

We went to an attorney together and she did a will (which she later changed to a revocable living trust), living will, and all the POA paperwork. I had copies, she had copies, and she put copies in a safety deposit box at the bank.

At that time, I didn’t need or want knowledge or access to her financial accounts, but as time went on, she needed more of my help in dealing with them, so she gave me access to get into the accounts and help her (we always sat down and did this together until she wasn’t able to anymore) keep up with bills and what she had. 

By doing this with me, Mama made things much easier for me when the time came that I had to step in because she couldn’t do it.

I can’t thank Mama enough for her foresight with this gift. Instead of having to focus on everything brand new coming at me at once, I could focus on what was most important, and that was Mama: loving her, caring for her, being there for her.

The last couple of months Mama was alive, we’d be sitting close, holding hands, and talking and suddenly she’d say “I don’t want be a burden on you,” with tears rolling down her cheeks. I’d squeeze her hands and pull her closer in a hug, kissing the tears away from her cheeks, saying, “Mama, you’re not a burden to me. I love you unconditionally. I wouldn’t be anywhere else doing anything else but right here doing this with you.”

Mama would relax in my embrace and I would hold her tighter as I said these words because they were true and we both recognized that they were true, but most of all, I recognized how easy Mama had made things for me by equipping me with what I needed to step in easily and take care of the routine things so that I could save my energy, my focus, and my love for taking care of her.

Making Sure We Have the Personal Information We Need to Help Our Loved Ones with Alzheimer’s Disease and Dementia

Author’s note: I originally posted this in 2013, but like medical advocacy, this is important enough that I will be reposting it monthly to remind us all that we need to have all our physical affairs – medical, legal, end-of-life, and digital – in order now.

Tomorrow is promised to no one. It’s hard enough to deal with loss (in the case of dementias and Alzheimer’s Disease, there are two losses to deal with) without having the process made as easy as possible by those we’ve lost.

This is one of the kindest acts we can do for those we leave behind who have to wrap up our physical lives in the face of grief and loss. Not doing this just makes things harder than they need to be.

Final wishes - digital and documentsI urge everyone today to stop and take care of these things (be sure to update them as things change) as an act of love and kindness.

This post by Kay Bransford, on her Dealing With Dementia blog, is important enough that I want to share it here, as well as the reminder she wrote today (January 21, 2014) for all of us who are – or may be in the future – caregivers for loved ones with Alzheimer’s Disease and Dementias.

We live in a digital age and we work very hard to protect ourselves online from things like identity theft and access to our financial and personal data.

However, it is important to make sure that we give access to our POA’s in case something happens to us and it is important that we have this information for our loved ones with Alzheimer’s Disease and dementia whom we are caring for and, if not already, will be entrusted to handle their legal, medical, and financial affairs for them.

So, Kay’s advice is timely for all of us.

Fight, Flight, or Meltdown?

I read Ann’s post and it was if her words were coming out of my mouth. The journey through dementias and Alzheimer’s Disease with our loved ones is unique, challenging, long, and, at times, extremely difficult.

So, too, is the journey through the grieving process after they’re gone.

Ann Napoletan's avatarThe Long and Winding Road...

caregiver-burnoutI probably composed a 2,000-word post in my head earlier this evening as I drove home in tears – and now I’m having a hard time putting together a sentence! My eyes are burning, I’m exhausted, nauseous, and I wish I could run off to a deserted island until February.

It was this time last year that really marked the final decline for Mom. We’d hit a low point in September, but then she came back just a bit – enough to give us some hope. That, however, didn’t last long.

Detour Ahead – or Not

Over the past couple of months, I’ve tried so hard not to get weighed down with sad memories and heartache. Now that November is here I think it’s catching up with me. Each day, I find my thoughts wandering to last year at this time, and to be honest, I’m not sure that…

View original post 515 more words

“Life and Death in Assisted Living” – PBS Frontline Documentary

I watched Life and Death in Assisted Living on PBS’s Frontline program earlier this week, and I highly recommend this for all family members with parents with dementia and Alzheimer’s Disease in assisted living facilities with “memory care” units or who are considering placing their loved ones in this kind of facility.

Let me say at the outset that they’re not all awful. However, let me also say that they will never take care of our loved ones as well as we can and would. I understand that some people, because of distance or a myriad of other reasons, believe they have no other option. If that’s the case, it is our responsibility to be (or designate a family member who is there to be) all over that facility and our loved ones 24/7.

Sadly, the mistreatment, the mistakes, the lack of care shown in this series are more likely to occur. Again, I’m not trying to make generalizations here, but I’ve seen some of this firsthand with people whose family members were absent most of the time or couldn’t be bothered even when serious matters arise.

These elderly people tend to get treated differently – worse – by some staff members when family and loved ones are not involved. My first-hand observation of this – and my Mom’s when she was an ombudsman at a facility in northeast Tennessee after my dad’s death – made me (and my mom) want to lower the hammer, rescue the elders, and shake some sense, compassion, and love into their families and loved ones.

We have a responsibility to our parents and our elderly folks to ensure that they have the best care possible as they end life. We cannot do that if we’re not involved day in and day out, even if we can’t care for them at home, with assisted living or nursing home care.

The more we are present – and I mean every day, different times of the day, for chunks of time each day – the less likely our loved ones and parents will suffer the mistakes, negligence, and deaths because of lack of care or failure to do the job that this series talks about.

Mom was in an assisted living facility with a memory care unit until I knew she was as stabilized mentally as she could be. It was not the first choice she and I had made, but the first choice turned out to be a “let’s-get-you-in-bind, put-the-screws-to-you, then-make-you-hand-every-bit-of-cash-you-(or-your-children)-have-over-to-us-up-front.”

And that’s not uncommon, based on what I’ve found in my research since then. I can’t think of too many times in my life when I’ve been angrier than I was when this materialized, but I discovered that this company was fairly representative of how assisted living and nursing home facilities, especially those that offer memory care, work.

As appalled as I was to discover this, I was even more appalled to discover that this is business as usual for most of these places. 

Fortunately, the place that I found for Mom wasn’t like this, but it had its own unique set of issues. The reality is that nobody else is ever going to, or in fact can, care for our parents and loved ones the way we will and are able to.

The bottom line for us is whether we’re willing (and able, because some people are not) to make the sacrifice to do for our parents and our loved ones what they were willing to do for us when we were babies, helpless, and completely dependent on them. 

assisted living memory care dementia Alzheimer's diseaseFor the last several weeks she was her assisted living facility, I was living there because she’d fallen and had a bad ankle sprain and I needed to be there. Within a short time,we made the decision that she would move back in with me and we’d be together at home until the end.

And I’m grateful we had that time together, although I know at times it was hard for my mom and at times it was hard for me. In the end, that didn’t matter, because I knew…and Mom knew…that we were both doing the best we could and there was unconditional love and care behind that.