Lack of communication by the Assisted Living Center - what a PAIN

For each week that Mom's in this assisted living facility (ALF) I find another reason that I want to move her. Some times it's based on Mom's comments or complaint, some time's it's because they just don't seem organized. Some times they do something that makes me wonder just how well they take care of my Mom.

Today it was a miss communication about a doctor's visit and now I'm ticked off. She had an appointment with the doctor at 2:45pm. The van was supposed to drive her there and my brother was all set to meet her. He planned to take her for coffee and pie afterward then return her to the ALF. So, I called the ALF about 1pm to remind them that she needs lots of notice to get ready, then I called Mom to remind her and she'd ALREADY BEEN THERE! She said the van driver took her in, waited and then drove around for about 30 minutes before taking her back. She was thrilled to get out and enjoy the sunshine. While I was happy that things went smoothly and that she enjoyed the ride, I was upset because my brother made arrangements to meet her there. He changed his schedule to be there and he also planned take her out. No one told us that the appointment was changed!

The doctor's office worked with the ALF to change the appointment from the afternoon to morning but the ALF didn't tell the family. The doctor's office left a reminder message on my NEPHEW's phone - he's not even on the contact list. He passed on the message but we didn't talk about the TIME. The ALF didn't call us even though they're supposed to tell us EACH time she has an appointment.

The bottom line for the ALF is that they just have WAY, WAY too many people to care for and not enough staff to tend to these details. It leaves me wondering about the other details that slip through the cracks. Or worse - WHO - slips through the cracks.

Feeling bad and Mom acts like "mom" to make me feel better

After my pity party yesterday, Mom did her motherly best and made me feel much better about everything. I did not tell her that I was frustrated, hurt, angry - all of that emotion I felt yesterday. I called her to discuss a doctor appointment and we chatted about some clothes that I sent last week. She thanked me and then got choked up and said, "I looked around yesterday and counted up all the things you've done to meet all my needs and make me comfortable. Have I said 'thank you?' You know I appreciate all of it and I hope you'll let me reimburse you."

That was all I needed to completely turn around my state of mind. Next week I might feel bad again, but her simple recognition today will last a long, long time. Of course, I won't take her money - unless it's for something big like a wheelchair or walker - those are beyond my budget. For a few clothes, some goodies, type writer ribbon - I can't take her money. I got some love today and that's enough!

Loss of logic and reason are hardest to handle

This morning I've hit a milestone. I'm fighting hot flashes, I have a migraine and I have not slept. I am so frustrated and upset that I'm ready to tell Mom to find someone else to handle her affairs. I feel that way right this second but it will pass. Stupidly, I never expected my logical, rational and sensible Mom to loose her ability to understand her situation. Here's what set this off:

Last night my cousin called to play a voice mail message that Mom left on his home phone more than a week ago. She requested his advice because she "doesn't like the way things are going here." Her voice sounded strong; there was her normal hint of stubborness she gets when she's feeling determined. My cousin understands that she's okay and her affairs are being handled well. He knows that I am not squandering her money. I, on the other hand, spent a sleepless night. Each time I began to drift off, I'd dream that I was arguing with Mom. I'd show her receipts, canceled checks for rent, prescriptions, shoes and such all to no effect.

Intellectually I know that she is dealing with a loss of control. Her body is failing, someone else is driving her routine, her funds are dwindling and she misses her own home. I guess I expect her to be at least a little grateful that I try to do so much for her. When I'm there with her and we talk about these things she gets it. She agrees that she can't be home, that her savings must be used for rent, that she needs things like new shoes. I leave feeling like things are okay then she makes a call to my brother, a friend or she gives me hell a week later.

I knew that dealing with my elderly Mom would be difficult but I just didn't expect to feel so drained by it all. I've always been a strong person, able to get a lot done and be practical and logical. There is no logic in her actions now and that's hard. I feel hurt - I know it's not Mom's intent, she can't help herself. The main reason my parents asked me to be their PoA and handle things is because I would NOT take such behavior personally and give up. But, the mom-child relationship is probably the MOST personal relationship we have - it's nearly impossible to separate the emotion from this relationship and respond to Mom's irrational thinking without hostile emotion. I need to respond with love and it's hard to do when she runs me down to others, when I have the same conversations about her needs and abilities over and over and over.

I remember my Mom sitting at the kitchen table crying in frustration and hurt after visits with her mother, Bertha. Bertha was in a nursing home, her short and mid- range memory long gone. She believed she was hospitalized after an appendectomy and expected to be released soon to go home to her husband and kids. She wondered to my Mom about the man that visited her.  She claimed he sold all of her nice glass ware and spent her money. The "man" was her eldest son; my favorite uncle and a good and honest man, who'd NEVER take advantage of her. For years she accused him of selling off her belongings -often things she never had at all. He finally stopped visiting. He was too hurt and felt that his mom was long gone. My Mom kept visiting out of a sense of duty, even after it was clear that Grandma didn't recognizer her as the daughter she longed to see at home.

I must admit to feeling better after venting here. I hoped to avoid venting on this blog but my feelings are honest and being honest is freeing. Things are coming full circle - I watched my Grandma help her elderly parents. I helped my Mom deal with Grandma, now I'm going through the same thing with her. I must remind myself that Mom is changed. Like my uncle, I feel my Mom is long gone. Because I love "that" woman, I will continue to help this one and hope that some portion of the logical and rational part of her comes through now and then.

Take Power of Attorney seriously or don't do it at all

I just read about a couple of jerks in Portland, Oregon that abused their Power of Attorney (PoA) for an elderly aunt and I am TICKED OFF at these two dolts! After what they've done they should go to jail! When I learned about this terrible situation, I was pleased to learn they'd been arrested. I'll try to keep up with it and report back on their punishment.

To make a long story short: An 83 year old woman (I'll call her Elderly Aunt) was due for surgery, shortly before the surgery her age 60-something cousin and niece pressered her into signing a complete PoA. After signing it, Elderly Aunt was hospitalized in bad shape and her doctor told Jerk-Cousin and Evil-Niece she would likely die any time. In no time at all these evil creeps cleaned out the woman's accounts, her home, sold anything they did not want and then sold the house and car. The proceeds were distributed by Jerk-Cousin and Evil-Niece to their families. Well....Elderly Aunt recovered and was absolutely crushed to learn that she had nothing left but the anniversary ring on her finger. Jerk-Cousin and Evil-Niece claim an attorney told them to "spend it all" to avoid probate - that is absolute BULL-OOOOH-NEE! These two committed FELONIES; they abused this elderly Aunt at the most vulnerable point of her life. They are thieves. There is no way around it.

I feel so sorry for this Elderly Aunt, mainly because she is heart sick to loose all of the special sentimental things within her home and because a FAMILY MEMBER is responsible for this callous outrage. "Family" should be those people that we can trust to help us remain safe, loved and to live with dignity. A PoA should do the same - family or not! This scenario raises all kinds of issues and questions:

• Elderly Aunt worked long and hard all her life and now faces a sparse existence during her final years. She might have been quite comfortable if someone who truly respected her acted as PoA and would work to ensure her comfort.
• These creeps pressed her to sign when she was facing surgery and not thinking clearly. Why didn't she have a PoA before it was easy to take advantage?
  
• Elderly Aunt must now rely on the paultry state stipend for personal needs like underwear and socks! After paying rent at a nursing home it's generally something like $50 per month, depending on the state of residence. This is terrible and just so unfair.
  
• Does Elderly Aunt have grown kids? Where were they? Why didn't they step in to help?
• Elderly Aunt might have a will that left things to family or charities. Did Jerk-niece and Evil-Cousin even consider this?
  
• Elderly Aunt might have bills, debt or other commitments like tax liens that should be met before distribution of any assets. After Elderly Aunt's medical state, this should be the foremost concern of a PoA.
  

A Power of Attorney should not be taken lightly; these can be very powerful tools and give people a lot of control if not done properly. Before I write another word, I must include a disclaimer:

I am not an attorney. This blog is in no way intended to provide legal advice. You should consult an attorney in your local city or county if you have questions about granting a PoA or becoming a PoA.

Let's discuss PoA's and their purpose: PoAs are generally done so that one person can act on behalf of another. PoA's can be broad or specific. In my experience I've held both complete ( or durable) and limited PoAs. For instance, my husband went on a military deployment to the Persian Gulf and before he left we completed a PoA that gave me permission to make medical decisions on his behalf if he were incapacitated. This is called a Medical Power of Attorney and outlined his wishes for end of life care, life support and such. It was important to him that I be spared tough decisions in a poor emotional state. We also did a limited PoA for property management that enabled me to collect rents, pay property taxes, change utilities and such for rental properties that he owned. This limited PoA also listed the things that he did NOT want me to do such as the ability to sell or trade the property. The limited PoA also had an expiration date of 12 months from the date of his departure. We did not consult and attorney for either document but used templates we found on line and had them notarized at our credit union. Thankfully, I did not have to exercise the Medical Power of Attorney but I did use the Limited PoA to make changes to some insurance coverage and hook up some utilities. In those cases, both parties asked for copies of the notarized PoA and I was able to get things done with no issues.

For my Mom I hold a Durable Power of Attorney - within the State of Idaho - it's the most powerful PoA. She and my father completed these years ago, long before anyone would question their judgement at naming me their PoA. This PoA and means that I could invoke it to to do anything on their behalf at any time. They felt this was necessary because my father had a history of heart disease and my Mom's family had a history of alzheimers. ( Thankfully she has no symptoms of that ailment!) I could walk into their bank with my notarized copy and take all of their funds; I could sell their cars, clothes and property. However, I have used it rarely and only with their permission or after discussing things with them. I realize that I could cause serious problems for them so I take it quite seriously. It's my job to look out for Mom's best interests and I use her PoA ONLY for that purpose.

If you are considering naming a PoA, think about these things:

• Identify someone who you are sure will act in your best interests, not theirs.
• Identify someone who will work to do WHAT YOU WANT, if it's possible.
• Identify someone who will work to ensure your physical and emotional well being and your dignity when making decisions for you.
  
• Tell your PoA what you want done and put it in writing.
• Ask him/her if they are willing to do it -often it means that someone will be mad at the PoA. S/he needs to be tough enough to handle it.
  
• Complete a living will or medical PoA so the person doesn't have to make tough decisions about proloning your life or suffering with artificial means or needless - and often costly = medical treatments.
• If you don't have a trustworthy family member, consider your attorney, a paralegal or contact your local Area Agency on Aging about volunteers who might do this on your behalf.
• Selecting a PoA that lives nearby or someone who can readily reach you in emergency situation might be a good idea. If decisions must be made quickly, you want to avoid delays due to travel.
  
• Remember that most PoA's end upon a death so having a will and naming an executor is important.
  
• Before completing a PoA contact an attorney in your state of residence for their advice. Each state has specific laws concerning PoAs, living wills and such.
  
• Understand if the PoA must live in the same state of your residence.
  
• A credible PoA, and one that will hold up in court, should be notarized at the very least.
  
• The laws that hold a PoA accountable for malfeasance differ from state to state so it's important to understand what you can do if a PoA is misused.
  

If someone asks you to be a PoA:

• Take it seriously and do it ONLY if you are willing to make tough decisions for that person. It's not likely to happen but it's possible. I almost invoked my PoA to move my Mom and it would have been UGLY. I knew that going in and know that my parents asked me to be their PoA because I'm strong enough to do the hard things on their behalf.
• Remember that you can be prosecuted for mis-management of funds, theft or fraud if the person's funds are not used to pay for their care and debts.
• If someone asks for your assistance to "avoid probate" take them to an attorney. Don't wing it; it's way too complicated and differs from state to state.
  
• If someone asks for your help to meet criteria for state aid (generally called medicaide) also see an attorney. Each state has a "look back" period, often 3, 5 or 7 years. Distribution of assets during that time can disqualify an Elder from receiving assistance for months and even years at a time.
  
• Remember that being a PoA DOES NOT make you an "heir". You do not havce the right to inherit anything and it does not mean you will be the executor of their will or estate. PoA's usually end upon the death of the requestor.
• Talk with the Elder or requestor to understand what they want and how they want to live out their years.
  
• Be prepared to work with them a lot, you must talk things over if it's possible and get their inputs.
• Be prepared to be tactful and unbiased and to do research on insurance, medicines, treatements - all kinds of things that come up.
  
• Be prepared to help create solutions for the individual - they might need new walkers, subscriptions to magazines, goodies in their apartment; help interviewing and selecting home health care workers - a wide variety of things.
  
• Seek out advise and help from social workers, pharmacists, doctors and local aging specialists.
  
• If you can't devote the time to be a good, responsible PoA, don't do it. The Elder or requestor is asking for your devotion, assistance and concern - so don't do it if you can't give these without resentment or great inconvenience to yourself.
  
• Be prepared to give out notarized copies of your PoA documents. I've had to provide them to Mom's bank, insurance company, doctor's office, Assisted living facility and to the local DMV to renew auto licenses.
  

If your parent or family member DOES NOT ask you to be their PoA, don't be insulted. They have their reasons. They may want an unbiased third party to reduce the risk of family in-fighting or claims of favoritism. If you ARE a PoA, be prepared to be the bad guy. You can hope it doesn't come to that but be warned: if more than one person is involved, someone is bound to be unhappy with something at some point. It's just human nature and humans being what they are - self-interested - is the reason a PoA is so important and can be vital to the safe, secure and dignified final years of an elder.