By Attorney, Philip Kavesh
A Difficult and Costly Decision
But the Best I Ever Made
Given Mom’s dementia diagnosis, the doctor and I decided that she required 24-hour care. I consulted with a Geriatric Care Manager, referred by UCLA, who works with families to find the proper housing and level of care for loved ones. She helped make the process painless, well almost.
While searching for a care facility for my Mom, I am not going to lie, I was pretty shocked by their greatly different quality of care - - and cost. The “base” fees were about what I had expected, but when all of the “extras” were added in….WOW! Given my background in estate planning, I was well aware that it was expensive for any kind of senior living or nursing care, but I was not quite prepared for how expensive it turned out to be. Thankfully, with the help of my Mom’s financial advisor from Pence Wealth Management and some Long-Term Care Insurance that we had in place for Mom, we were able to cover all these costs and place Mom in a great facility near me, without having to eat much into her investment principal (a big concern because her sister was already 99!).
Then the day came to move Mom into the chosen facility. This is the stuff that not a lot of people talk about. How difficult it is to see your parents get older and age, and then have to deal with it. Even though, in the back of my mind, I knew that this day would come, it still did not quite prepare me for the reality when it arrived. “Putting Mom into a facility” was something I never wanted to do, but she clearly needed 24-hour care that none of her children were in a position to provide. I will never forget pulling out the checkbook on the day she was admitted to write that first month’s payment. My writing hand was shaking so badly that I had to use my other hand to hold it so I could sign the check! I was filled with a mix of emotions, ranging from guilt and anxiety, to uncertainty and fear.
But, I have to say, it turned out to be one of the best decisions I have ever made.
Mom Is Fine Now
There may not yet be a cure for dementia or Alzheimer’s. However, with the proper care, it can be significantly slowed down. Between the medications prescribed to my Mom and the dementia care program she attends daily, my Mom’s quality of life, and time with us, has most certainly been extended. Mom’s memory has continued to decline to the point she rarely remembers who I am when I visit, but she is always happy to see me. She raves about her new residence (in fact, she relishes giving her visitors a full tour, as if it really were her own house!). And she never worries about, or even asks about money or her jewelry anymore. I’ve been able to easily and fully take over her affairs as the Successor Trustee of her Living Trust plan.
The beautiful thing is that the facility, Belmont Village, keeps Mom in the NOW. She doesn’t have to be concerned with or saddened by her lack of memory of the past. She’s constantly moving around and interacting with others. Mom enjoys all sorts of activities, from dancing, singing, movie night, jigsaw puzzles, and dinners with her friends, to walks around the grounds. Simple things in life give her pleasure, including watching the birds in the trees outside her window and the rabbits hopping in and out of the bushes surrounding her place, and in particular her after-dinner ice cream treat! Mom also enjoys our regular outings, when I drive her around the Palos Verdes peninsula. She loves the scenic views and we often stop to take a short walk or frequent a local café for a coffee and a sweet treat (or two!).
Every day for Mom is a brand new lovely experience (although it may appear to others as the same as the day before). She’s healthy and happy. Who could ask for more at her age? On September 9, Mom will celebrate her 97th Birthday!
Takeaways From My Experience
That May Help You or a Loved One
If you or your parent are over age 70, you’ll definitely want to read on.
First, I've learned from various studies that, although dementia or Alzheimer’s may not be totally preventable, their onset may be significantly slowed down. Amazingly, my Mom’s condition did not appear until into her 90’s! That’s because, in great part, she maintained a number of healthy habits throughout most of her life:
- Healthy body weight (she was very lean)
- Avoided drinking alcohol (almost never)
- Never smoked
- Exercise (she has done stretches every day that I can't even do!)
- Plenty of rest and sleep (regularly sleeps 8 hours each night and gets in an afternoon nap)
- Eating mostly fruits and vegetables, little red meat
- Engaging in mind challenging activity, like her daily Sudoku puzzle
- Maintaining good hearing and vision (after her cataract surgery and lens replacement, she sees better than me!)
So, careful living (and I suppose good genes and karma, too) can pay off!
My second takeaway is the need to be aware of the early signs of not only memory loss but erratic behavior which could be symptoms of dementia or Alzheimer’s disease. (Check out this article, “10 Early Signs and Symptoms of Alzheimer's” from the Alzheimer’s Foundation.) Don’t assume a person is okay just because they seem that way during short visits or zoom calls. Take enough time to evaluate the person around the clock and fully observe their condition. The sooner that you can identify the scope of any problem and come up with a care plan that makes sense for your loved one and your family, the better.
Third, realize in advance that the care or housing (or both) is expensive and plan for it. There are options for Long-Term Care Insurance and other financial planning and saving strategies that you can start to put in place to help off-set some of the costs down the line. In our seminars we talk all the time about how it’s not a matter of “if” you’re ever (or your parent is) going to be disabled or too ill to take care of yourself. It’s a matter of when. I’ve seen the statistics that, once you’re over age 70, there’s better than a 70% chance you will require some form of long-term care, potentially for many years.
Fourth, there are also some estate planning actions you can take early, like being named as immediate agent for your parent under a Power of Attorney and as Co-Trustee under his or her Living Trust. And, when the point of incapacity is reached, quickly transition in as sole Successor Trustee with two doctor letters. Plus, do Medicaid benefits planning to help cover the cost of long-term nursing care. All of these things are why we stress the importance of a well-built and properly maintained Living Trust-centered estate plan.
Last, but not least, I know that people have differences of opinion about placing an elderly loved one into a care facility. I certainly respect everyone’s individual stance on this and what feels best for their own family. But I will say that having a Geriatric Care Manager who was able to meet with me, understand our family’s budget and evaluate my Mom’s needs before any decision was made was truly a blessing. Not everyone is in a position to take on the care of a loved one and to do so in a way that may give that loved one the time, personal and medical attention, and memory care that they really need. Every time I visit with my Mom, I am reminded of how happy and reconfirm that we made the right decision for her and the quality of her life.
