This past month I once again experienced life as prelude to practice. It started with an email two weeks ago from a hospice caregiver at my father's request with words every child dreads: "Your Dad has asked me to write and tell you he thinks the end is near. He says you'll know what to do." What had been planned as a birthday celebration in Florida within 48 hours ended as a death vigil for my father. My immediate family members were gathered at my parent's home to say goodbye. Dad died quickly and peacefully after struggling for years with chronic pulmonary dysfunction. Two of us were on either side of him holding his hands while he was sitting up on the couch, and we noticed that he stopped breathing.
The following days were busy with funeral arrangements. Fortunately, my Dad had written out detailed instructions for his obituary, the funeral home, and church program, including specific hymns and names of those to deliver eulogies. He had purchased a "burial package" from a local funeral home including the rental of a casket for visitation and funeral, followed by cremation, all of which was so helpful to minimize our decision-making at such an unsettling time.
What About Mom?
After the funeral, our first concern was for our mother and how her needs would be met in our family's "new normal." Dad had always been the planner and decision-maker. How could six brothers and sisters reach consensus to move forward and avoid the #1 problem encountered in the distribution of estate assets, money? We'd never been particularly close but now was the time to bond for Mom's good. Mom is physically healthy, and we hope will live for many more years. However, she has some dementia and is unable to walk, requiring 24/7 skilled nursing care. Fortunately, my youngest sister and husband volunteered the spare bedroom in their home for Mom's care. Mom was visibly pleased with this decision.
Next, came the preparation for my sister's home to be fitted for Mom's needs.
Three of us sat down with care-givers and proposed an annual budget for Mom's continued care. This included in-home nursing care (the largest expense item, approximately 2/3 of total budget), personal items, compensation for my sister's time, privacy and lost wages, and items needed to make her home handicap-friendly - including a light-weight wheel chair to fit through door frames, a hospital bed, shower stool and handle bars.
My siblings then advertised and interviewed qualified caregivers and gave them an in-home "test" to make sure each was a good fit not only for Mom's needs but also with my sister's family. My sister called references provided by each applicant.
Mom moved in last week to her new home. Her name is on the waiting list of a nearby assisted living facility in the event care provided in my sister's home is not sufficient for her physical needs.
Finally, we've all agreed on a conservative, relatively low-risk annual average financial goal for the investment return on Mom's assets to cover her on-going expenses.
- Conduct a family meeting with all concerned parties before death or, if not possible, with the nominated executors and trustees, to review wishes in writing well in advance of need.
- Review estate documents and assets as soon as possible in order to assess how much is available for survivor's needs.
- Plan an annual budget for lifetime living expenses of surviving spouse and agree so there are "no surprises" when estate proceeds are reviewed.
- Consider purchasing long-term care insurance to offset cost of healthcare needs. The cost of in-home healthcare is expected to be one of the greatest living expenses in retirement until end of life and can significantly deplete family inheritance.
- Make time to grieve. Consider enrolling in a grief counseling program. I've found the "Grief Share" (www.griefshare.org) program in local churches to be effective for those who have suffered significant loss.