Losing a loved one to death is exactly what happened to me in 2015. My Father died at the age of 89. I felt unsettled and incomplete when he died. My experience had been fraught with unnecessary suffering for all involved. This took me to research and soul searching, which inspired my latest book entitled, A Chance to Say Goodbye: Reflections on Losing a Parent. Money and big emotions all surface when losing a loved one to death.
My hope is to support others who face losing a parent or loved one or who have already lost one. Death includes the financial and heartfelt parts of losing a loved one, and there are things that you can do to travel through this path.
Perceptions About Money Change As You Age
Through my experience, my perception of money changed as I lived life as a 50+ baby boomer with aging and dying parents. My Father’s health slowly diminished after a stroke he suffered when he was 85 and from that point onward there was a cascade of decline. His body was failing and he fought that fact.
My visits to my dad increased, as he needed more and more assistance, support and management. I became his medical decision maker officially when he fell in his kitchen breaking his hip in July of 2015. He was never able to return to his home again. He had a surgical repair and then was admitted to a rehabilitation facility, where he later died.
Anesthesia from surgery escalated what had been previously recognized as mild dementia. The doctor at the rehab facility then claimed he had severe dementia and as a result of his reduced cognitive clarity, I would be making all his decisions.
Before my dad’s hip fracture, I had been in a bubble of denial that his end was approaching. After his hospitalization, I was slapped in the face with the reality of his impending death.
Medicare would only cover three months in rehab. As my dad approached that mark, it was clear he could not go home and would need skilled nursing care. I had selected his rehab facility, which included a skilled nursing wing, knowing the probability of his return home was remote. He had become so weak prior to his fall that he could not live independently again. His home was not disability friendly with stairs to get in the house and to get to his bedroom. Bathroom doorways were too narrow to accommodate a wheelchair.
Cost of Long Term Care Can Be Sobering
So I found myself looking at the costs of a nursing home with no further Medicare reimbursement. The shock of the figures of daily care was hard to swallow. My dad saved money and still had some left, but with the costs of long-term care, those funds would rapidly evaporate.
As is often the case with elderly hip fractures, this event is often the beginning of the end. My dad developed other ailments, namely gall bladder issues. He then had to have another surgery within three months of his initial hip repair. His body was in a weakened state and as a result, there were complications of the gall bladder surgery, He developed a mysterious infection, pneumonia and seemed to lose all his energy.
He died a few weeks after his gall bladder was removed. His heart stopped and no one was in the room. There were no goodbyes.
Although sad, his suffering was over. And because he died just before his Medicare benefits expired, his life savings were not completely depleted. But what about the baby boomers who have parents who reside in assisted living facilities for years? How does one prepare financially for the possibility of your own health decline in advanced age?
I’m concerned that we discuss the financial aspects of end of life care and the emotional impact as well. This is what I’ve covered in my new book, A Chance to Say Goodbye: Reflections on Losing a Parent. Other writers have also shed light on this time of life.
Karen Wyatt is the author of the book What Really Matters: 7 Lessons for Living from the Stories of the Dying. She mentions the financial and emotional side of our current healthcare system. “Approximately 25% of the annual Medicare budget is spent on aggressive, life-sustaining care during the final month of life, much of which is futile and may actually prolong suffering rather than enhance life.”, she says.
Sometimes It Should be Quality Of Life Over Quantity
My experience with my dad was one of him resisting death. Because of that mindset, he didn’t question costs-financial or emotional-at the end of his life. He kept doing all the tests and all the procedures and took all the pills suggested. I don’t blame a person for giving their full focus on living a long life. I do encourage a focus on quality over quantity at a certain point.
Sometimes it is okay to say enough is enough and let the body take its natural course. The fact is that our bodies do wear out and at some point, spending all our financial resources at prolonging it may be misguided.
Kathy Kalina, author of Midwife For Souls: Spiritual Care For The Dying said, “I’m still haunted by memories of tying patients down to keep them from pulling out tubes, repeatedly sticking IVs into worn-out arms, and assisting with heroic resuscitative measures that we called the ‘million dollar send-off.’” I was able to avoid that high price tag at death’s door by saying no to hospitalization at the end of my dad’s life. I chose comfort care for him. I knew his heart did not have enough strength to keep beating much longer. I elected to allow it to stop when it did and not order resuscitation. These are questions that you may find yourself faced with as well as you care for a loved one through the end of life.
Kathy Kalina also says, “Doctors have a tendency to think of death as a personal enemy, and that’s usually good. If I have an illness that can be cured, I want my doctor to wage all-out war against it. But once it becomes evident that treatment is not going to be successful, I want to spend my last days in comfort and peace.”
Losing a Loved One & The Million Dollar Send Off
Philosophies on how to live and how to die vary due to the multitude of personalities on this planet. There is no right or wrong way. But there are costs of our choices. A ‘million dollar send-off’ may not come out of your parent’s pocket or your pocket in full, but we all pay the bill in reality. Health care and insurance costs are high and in some cases unaffordable. Our choices do affect the bigger picture of the health care whether we realize it or not.
In the United States, life expectancy at the time of this writing is approximately seventy-nine years, and depending on whether you are a male or female, it can be slightly more or less. At a certain point, will you elect to do every regular exam and test that you routinely did in your prime? Is there a point when you can spread out or eliminate tests like colonoscopies, mammograms, and dental x-rays? Are you investing in prevention with a good diet, exercise, and wellness treatments to promote health, balance, and healing?
Often we are reactionary only making efforts to repair health when a problem crops up suddenly. Those issues were probably building for years and years before symptoms presented themselves. It might be optimal to shift our spending towards preventative treatments as we age to avoid a crisis later. I call it priority spending. I love to invest in feeling good each day, week, month and year. So I budget for wellness treatments such as massage, acupuncture, chiropractic, yoga and other health-oriented measures.
The responsibilities of caregiving and decision making for my dad took an emotional and physical toll on me. I had to double my efforts to stay well during his decline and during times he had a health crisis. I also had to recover after things settled down and after his death. Caregiving in the United States; National Alliance for Caregiving in collaboration with AARP; November 2009 reported “23% of family caregivers caring for loved ones for 5 years or more report their health is fair or poor.”
Drs. Janice-Kiecolt Glaser and Ronald Glaser state, “Stress of family caregiving for persons with dementia has been shown to impact a person’s immune system for up to three years after their caregiving ends thus increasing their chances of developing a chronic illness themselves.” (“Chronic stress and age-related increases in the proinflammatory cytokine IL-6.”Proceedings of the National Academy of Sciences, June 30, 2003.) So it behooves one to understand these findings and take care of oneself if you involved with care-giving responsibilities.
Pay Close Attention To Caregiver Expenses
Furthermore, if you find yourself in a caregiving position, you may not be able to work or generate your own income. From Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving; National Alliance for Caregiving and Evercare, March 2009 shows “47% of working caregivers indicate an increase in caregiving expenses has caused them to use up ALL or MOST of their savings.” This sort of income loss may not be in your financial plan!
If you have an elderly loved one, it behooves you to have conversations for possible scenarios if their health should change. Clarifying wishes and discussing options for care early while the parent or loved one is of clear mind and relatively good health will provide a roadmap for when disability or dementia occur later. Aging is difficult but with thoughtful preparation, the stresses of it can be decreased for both the elderly person and you.
Research into facilities and agencies that support those who need assistance as they age will give each family member a starting point. Waiting to look into care options until there is a sudden hospitalization only doubles the stress of the crisis. Denial and avoidance that someone you love is approaching fragility are all too frequent. One moment your father or mother might be walking, and then next moment, they have fallen and broken a hip.
Talk Openly About End of Life Care
My advice is to have conversations with your family, doctors and financial planners on a regular basis. Tour care facilities near elderly loved ones. Look into agencies that provide home health care services. Encourage engagement in physical therapy and wellness measures to maintain strength and quality of life. Create a network of support and care professionals to lessen the burden of care from one person alone.
Living to a ripe old age can be a blessing and a curse. Our society is facing a large population of aging baby boomers. If you have not yet lost your parents, you soon will do so. And then you need to prepare of your own senior years. Fear can be lessened with education and preparation. Acknowledging your own mortality can be liberating. Reflect on your priorities. Grab chances to do those things you have always dreamed of doing. Savor special moments. Connect deeply with others. Forgive others and yourself. Express love and compassion. Make this day, this year your best yet!
If these challenges are familiar to you and you want to read more about them please check out my book on Amazon
Feature image via CNN