Probate: Our Experience continued

Today I will write a little more about Probate from my own experience.  I want to emphasize that I am not a lawyer.  There are many good books on Probate and you might want to check some out of your local library when you need some information.

It is not necessary to have a lawyer if you are an executor for a simple estate and/or if you don’t have anyone who might make the process difficult for you.  On the other hand, if there is property to sell and perhaps complicated financial issues, it is probably a good idea to have a lawyer.  Also since the executor is legally responsible for the decisions made during probate, I think you might want to at least consult a lawyer during the process even if you are doing most of the work yourself.

Legal Fees

In my state, the fees for the lawyer are set by state law and vary by the value of the estate.  For my lawyer, the fee setup was like this:

  • 5% of the first $100,000
  • 4% of the next $200,000
  • 3% of the next $700,000
  • 2 ½% of the next 4,000,000
  • 2% for sums over $5,000,000

Needless to say, for dad’s estate we didn’t get to the higher levels!

They said the average estate is administered in 16 months, but could be as short as 8 months.  It took 20 months to complete dad’s estate.  It felt like a hundred years!

There are advantages and disadvantages to such a fixed rate.  First of all, you know exactly what it will cost and you have no reason to fear that the lawyer will drag things out to increase his fee.  On the other hand, there is a disincentive for the lawyer to put in more hours on a complicated estate.  And there is nothing to push him to get to this case when others are going to be more lucrative.   I did feel that our estate lawyer let some things just sit while he worked on more interesting or more profitable cases.

Now you might also be thinking about “avoiding probate” as I have seen and read many articles and talks about doing so.  Again since I am not a lawyer, I won’t go into why you might want to do that.  I will just say that I did NOT want to avoid probate.  This is so because I believed (and still believe) that I would never get my brother out of my parent’s house if we did not have to sell it to complete probate.

Again I will say that there are times when probate is not necessary.  If the decedent had very few assets, probate would probably not be necessary.  If the decedent has a house or other property, this makes it more likely that probate will be necessary.  In fact, one of the reasons I wanted to sell the house when dad was in assisted living was so that probate would not be necessary.  Also, I knew we would reach the point where dad’s cash would run out and then I would have to either sell the house or apply for Medicaid.  This would be especially true if he needed to go into a nursing home.

One thing I always kept in mind was that in our area a person needed to show they could access at least $100,000 in order to get into a good nursing home as a private pay resident.  If you had less, you would need to apply for Medicaid or sign papers stating that the nursing home could take and sell your home or other property in order to pay the debt after the resident reached the point where they could not pay the monthly rent.

I have been told by people who specialize in elder care that the better quality nursing homes take mainly private pay residents.  Once you are on Medicaid, it is hard to get into your first choice nursing home in an area like this.  They say that even when patients start as private pay and then spend all their money they can often stay as a Medicaid resident.  However in general, the Medicaid clients are given the lower quality rooms or the least desirable locations like near the elevator, laundry room, etc.

The most desirable nursing homes often won’t take Medicaid clients at all or limit the number of Medicaid clients they will take.

Therefore, I didn’t want dad to go on Medicaid as long as he could pay his own way.  Also if anyone were to sell my parents home, I wanted to do it ourselves so that the nursing home or government agency wouldn’t take a share of the value of the house just for administration of the sale.  I felt sure we could do it better and less expensively ourselves.

I was unsuccessful in convincing my brother to vacate the house while my father was alive.  My brother believed as long as he dug his heels in, he would be able to stay there forever.  This, in spite of the fact that he owned his own home in another state that was bigger and nicer than the one he was living in.  Basically he wanted access to both houses for as many years as it took to move his belongings from dad’s home to his own home.

Here I will state that my brother is a hoarder.  His belongings would take multiple 18-wheelers to move from one house to the next.  He had little motivation to do the hard work of packing and moving so long as he was able to keep his access to both houses.


Posted in Caregiving, Eldercare, Estate Probate, Hoarders, Hoarding, Medicaid | 10 Comments

Life After Death: or How My Life Progressed After Dad’s Death

I know I haven’t written regularly since before dad passed away.  I have been overwhelmed with the process of probating his will and settling his estate.  It is not the legal probate process that is so onerous.  Instead it is the emotional turmoil and the family controversy that goes along with settling an estate.

Although I knew that at age 97, dad did not have long to live, even before his sudden heart attack.  Nevertheless, I was overcome with grief and the inability to focus.  I knew I was to be the executor and that there was a lot of work ahead of me.

However it was the dead of winter and the “polar vortex” was down and around us.  I couldn’t even contemplate doing the things that needed to be done.

I had returned to my home community to be with dad during his last illness.  My children were with me at the hospital and hospice until dad passed.  They went with me as I went to make funeral arrangements and to start the legal process with the estate lawyer.

I don’t deal with winter very well and don’t drive on snow or in the dark.  I told the lawyer and the funeral director that I had to finish everything by the end of the week so I could return to my vacation rental.  I would take care of most matters upon my return, and what couldn’t wait would be done by telephone, mail or overnight couriers.

My neighbor brought in my mail for me and my son forwarded it to me once a week.  From my southern retreat I dealt with the issues that couldn’t wait.

One of the first tasks was to write an obituary for dad and determine where it would run.  When mom passed, we chose two newspapers, one in their home town and one in their winter community.  But by now, dad hadn’t been in the winter community for 4 years and many of their friends had passed on.  Instead I ran the obituary only in their home community, where friends and relatives remained.  I sent a note to the senior community where mom and dad had spent winters for several decades and asked that it be posted on their bulletin board.

The obituary that we published also had an online component and some friends from the south also wrote condolences there.  I received many cards that were forwarded to me, and my brother, who lived in dad’s house, also received cards.  I sent personal notes to everyone who had written their condolences.

The other pressing issue was dad’s final checks from both Social Security and his work pension.  I had to be sure those were returned.  It is easier with Social Security to have the bank return the deposit or Social Security recoup it because all dad’s checking accounts had to be closed immediately upon his death.

I couldn’t make any checks from the estate for months — until the letters of testamentary were issued by the court.  I did get a letter from Social Security and called dad’s bank to please send the funds back.  I thought it would add too much confusion if I sent a personal check and the bank told me that as a rule, Social Security does just take the funds back.  That worked out well for me.

Because bills were coming every day, and I was anxious to begin paying them, I called the lawyer asking about opening an estate account.  He reminded me that I was not the executor until the surrogate court declared me to be the executor.  That meant that the will naming me executor had to be accepted by the surrogate court and the court had to issue letters of testamentary stating that I was the executor and giving a tax number so the estate could open bank accounts.

In the end it took 2 months to get the letters of testamentary because my brother refused to sign the papers he had received.  Signing the papers would mean he accepted me as the executor.  My sister signed quickly as she wanted the estate to be settled.  However, my brother wanted to delay at every step.

I have stated before that my brother was a hoarder and he lived with my parents.  He didn’t want to vacate the house and was using every method he could come up with to delay the entire process.

Finally I asked my lawyer what we could do to make him sign the papers.  I knew my brother did NOT want to be the executor.  We were both present when my parents wrote and signed their wills in their lawyer’s office.  He knew they wanted me to be executor.  The estate lawyer called my brother’s lawyer and I think his lawyer told him he has to sign or the court will order him to.  Anyway after a delay he signed and the court issued the letters of testamentary.

With the letters of testamentary I was able to open an estate checking account and finally begin paying dad’s medical and other bills.

I won’t write any more today but I did think I would continue to spell out a bit more about how the whole estate settlement process can take so much time and cause so much stress.  If siblings get along the whole thing can be settled quickly and easily.  But if one heir wants to slow down the process, there are many ways he can do so.

Posted in After Death, Caregiving, death and dying, Eldercare, Estate Probate | 7 Comments

End of the Year Wrap Up

I know I am way overdue for a posting especially now that the year is drawing to a close.  This will be my first Christmas without dad, and he would have had another birthday by now too.  I miss dad very much, and even after 5 years, I miss mom incredibly too.

This is the first year I can plan to travel without arranging for companions to watch over dad.  It lifts a heavy weight off my shoulders, but still leaves a large empty spot!

Most of the tasks I had to do after dad’s passing have been done.  But the estate probate still must be settled.  This is complicated by sibling disputes and may not happen for quite awhile.  In the meantime I try to put it out of my mind.  The lawyer is supposed to be handling that so there isn’t much I can do other than stress about it!

Even with dad gone, I still encounter elder issues on a regular basis.  I live in a community of seniors and many have had serious illnesses this year.  In fact, 2 nearby neighbors have passed in the last month and several others are seriously ill at this time.  When I can, I help my neighbors determine what resources are available for them since I spent so many years studying about those issues.

I continue to keep up with some of the blogs that I have been reading for years.  But I have dropped many of the others as I try to pick up other activities in my life.  Now I am able to attend seminars or travel out-of- state more easily and I have done so several times. I haven’t even looked at this, my blog, in months because of family and other obligations.  I had hoped that once I wrap up probate I could blog about the process.  But with this being so involved right now, I have decided to stay away from the details.  I will just say that I don’t feel that I have totally dealt with mom’s and dad’s passing because there are still so many issues up in the air.

Grief is a strange thing too.  For one day I will think that I am totally OK and the next day I will get a sudden urge to call mom (gone 5 years now) or go visit dad.  They were such an intricate part of my life for so long, it is hard to internalize the fact that I can’t just go see them now.

As we approach the holidays, I am thankful to have most of my children and grandchildren nearby.  My focus is on preparing for the holidays and family gatherings that will be happening in the next month.  I hope to feel a fresh start in 2016 and to be able to move on.

I will always miss mom and dad, but now I need to focus on the future and the things I can do with the younger generations.  It is odd to be the oldest generation now — the orphan who can’t turn to mom and dad with questions as I always have.

And for you, my readers, I hope the past few years of blogging has been a help in your eldercare responsibilities.  I am not sure how much I will post in the future, but for now I will keep up what I posted in the past.

I had always envisioned this blog moving on to other family issues.  Perhaps after the disputes are settled, I will feel more ready to do so.

In the meantime, I wish you all a Happy Holiday Season, whether for Hanukkah or Christmas or New Years or any of the other holidays people celebrate during this time of the year.

Posted in After Death, Caregiving, Eldercare, Probate and Estate Settlement, relationships | 10 Comments

Back to my Blog — At least For Today!

I spend a fair amount of time thinking about this blog, but never seem to get the time to sit down and write. So much has been happening, and only a few of these things were anticipated.

I did finally manage to give away almost all of the donations I had stacked in my living room, dining room and garage from cleaning out dad’s assisted living apartment. Other items had been in my closets and garage as dad’s room was too small for all season clothing.

I had several large bags of adult diapers which I learned Catholic Charities could really use for some of the clients that they serve. Then I donated dad’s walker to them also. They have been so helpful. My transportation driver comes from Catholic Charities so that was how I made that connection.

Additionally, I donated all of dad’s clothing from summer shirts to winter jackets and much more to various charities. I took bags and bags to Goodwill. Others called about having a “truck on my block” in the next week and I said yes to 3 of them. Now my garage is nearly cleaned up and I have just one open box to donate next week.

While cleaning out dad’s things, I have begun to make bags of my own clothing and other items. It is easy to build up too much stuff, especially when living in a very small apartment. I have only just begun with my own stuff though. I ran out of time and energy before I ran out of things to do.

I am trying diligently to move dad’s estate settlement forward. After an almost 3 month wait I finally got the letters of testamentary which were needed to move probate forward. I met with the lawyer and his assistants several times so far. We have some complications that are also holding things up. Other things are moving as planned, just more slowly than I had hoped.

In order to take my mind off all the “work” of probate, I signed up for some community classes. I enjoy these immensely and don’t like to miss a class. Thus I schedule doctors, hair dresser and other appointments for the non-class days.

Soon I will be doing some traveling. I refrained from much travel all the years I was caring for mom and dad (over 5 years) because I didn’t want to be too far away in case of emergency. Basically I stayed in the same time zone and not too far from an airport. Now I will be traveling further as I go to the other coast to visit my daughter and her family. It will be a short reprieve from the long list of tasks I am working through.

I feel like my life has been on hold ever since my retirement over 6 years ago because I was so focused on caring for mom and dad. Now that they are gone, I want to move on to the things I had always planned to do “when I retire”. Slowly I am beginning some of those, but most remain as ideas for the future.

Posted in After Death, Caregiving, Probate and Estate Settlement | Tagged , , | 6 Comments

Settling Dad’s Estate

I haven’t posted for awhile so it is time for me to get back on track. I returned home from my Southern vacation three weeks ago. Unfortunately, I caught a bug while flying I think and ended up with a serious cold with bronchitis and more. I am still taking antibiotics to get rid of the remainder of this bug.

I had a long list of tasks to accomplish when I got home. Few have been done because I was so knocked out by my illness. Finally last week I was ready to begin to do some of the things that needed to be done.

First I arranged for one charity to pick up four boxes of dad’s belongings and then a week later I took 7 more bags to the drop-off center for another charity. Since the estate lawyer wants me to document everything that I give away, this is not an easy task. I photograph and list all the items and retain those with the receipts from the charities.

This week was finally warm enough at the same time that I felt well enough and I began to clean out my garage. I found more boxes of dad’s summer clothing, several jackets and other boxes of his belongings all of which did not fit into his Assisted Living apartment. I knew I was storing items at my home, but thought I had already donated most of them. Now I have more boxes and bags to drop off when I get some time and energy to do so.

Another task on my to-do list is taking dad’s televisions to be recycled.  His computer also needs to be recycled, but my son will take care of that.  Dad hadn’t used that computer in 4 years but he refused to let me take it away.

This week I expect to finally get the required papers from the court and then I will be able to open a bank account for dad’s estate. At last I will be able to deposit the refund checks he got from his rent, utilities and other places. And I will be able to pay his medical bills that are all filed in a folder waiting for me to be able to make out a check.

This whole process is taking much longer than it should. But I have no options other than to take things day by day. In one sense I was too busy while I was away and then sick when I got home so it wouldn’t have mattered if I got the proper papers sooner or not. With luck by the end of this week I should be starting the process of settling dad’s probate.

Also earlier this month I had to work on my federal and state taxes and on dad’s federal and state taxes. Since I couldn’t make checks from the estate yet, I had to use my own personal check to pay dad’s taxes. Later I will be reimbursed by the estate.

In the meantime I just learned that the mother of a friend will be moving into the same Assisted Living Facility that dad had been living in. Like so many people, she was adamantly opposed to move into assisted living, even though she was having a lot of difficulty living alone. Her son finally just packed up her belongings and arranged for the move. They are hoping she won’t try to wonder home as she knows the area so well. I hope she finds the companionship makes her feel happier and more comfortable than the loneliness of her own home.

So even as I wind things up for dad, I am an observer of others in the same situation. I feel like I have been too busy to even take the time to grieve for dad. It will hit me in little bits as I am doing other things. I haven’t been back yet to the places where I used to take dad to lunch, or even to his assisted living facility.

Day by day, I am beginning to normalize my life. But I feel that it will take time for me to get used to the idea that I don’t have to be ready to jump and run when the phone rings. Dad is in a better place. Soon I will not have to keep reminding myself that I can really make plans for my own activities now.

Posted in death and dying, Eldercare | Tagged , , , | 14 Comments

Memory Books Contribute to Personalized Care in Hospice

When dad was in the hospital I felt he was not seen as a total person – just a patient. I wanted to bring in pictures of him but there wasn’t any place to put them. In the hospice there was a nice piece of furniture that held not only his clothing, a small refrigerator and a television, but also had many shelves for personal items.

I brought in many of dad’s favorite pictures. I had pictures of mom and dad together, pictures of dad with his brothers in their military uniforms from World War II, etc. In addition, I brought in many of the memory books I had made for mom and dad over the years.

I set the memory books on the shelves, open to pictures of dad also. I also had calendars with pictures of mom and dad that were set up on those shelves. I had them there to make the room feel like home to dad and to us as well.

Soon I realized that all of dad’s caregivers – his doctor, his nurses, his nurses’ aides, etc. had sat down in dad’s room and read his books. Even the social worker knew about dad’s life from reading his memory books.

The doctor told me he thought it was wonderful how they were all able to get to know dad better through the pictures and especially the memory books. The social worker realized that dad was proud to be a US Marine (“once a Marine, always a Marine”). When the Vietnam Veteran called to say he was coming to bring dad a quilt, she told him dad was a Marine, and the veteran volunteer brought dad a quilt specifically made for a Marine.

The wonderful thing about hospice is that all of the caregivers were dedicated to just a few patients. The same caregivers saw dad each day and they got to know him and our family. I believe these memory books were a significant help in allowing dad’s caregivers to get to know him as a person. Even though dad was unable to speak by the time he arrived in hospice, the caregivers all talked to him and talked about the life he had lived and his family as they saw it in the memory books.

So, even though I have written about the importance of memory books before, I want to reiterate how they contributed to dad’s personalized care during his last illness. Now those same books are ours to review and remember the ones who was so important in our lives.

Posted in Caregiving, death and dying, Elder Care, Eldercare, Family, Hospice, Memory Books | Tagged , , , , | 14 Comments

After Dad’s Passing: Part 2

I did not mention a funeral service in my last post about the things I had to do after dad passed. In fact, I had dad cremated and picked up the “cremains” the same day I picked up the death certificates. Again this was much faster and easier than with mom’s passing. Within 3 days I had his death certificates and cremains at my home.

Because most of dad’s friends and all his contemporary cousins, siblings, etc. had pre-deceased him, I wasn’t sure if or where to have a service. I had asked a priest to come to the hospital to see dad within days after his heart attack. The priest gave dad the “last rites” which is now just called the anointing I guess. I am not a Catholic but knew this was important to dad.

I didn’t see any point in having a funeral service locally as dad had spent most of his life in other communities. He only knew our family and the people at his assisted living facility in our town. Everyone else was hundreds or thousands of miles away.

Dad will be interred in the national cemetery with mom. Since this is hundreds of miles from my home I planned to have a memorial service instead of a funeral service. I haven’t yet determined if the memorial service will be in my community so my children can all attend or whether to try to have something near dad’s house hundreds of miles away. We still have many relatives in that area and some of dad’s younger work friends have asked to be notified if there is a service. But travel and arrangements would be much more difficult for me there. Therefore, dad’s memorial service is one more thing I have deferred until later in the spring when I have more energy to deal with it.

You may also notice that I haven’t mentioned my siblings. Neither my sister nor my brother came to see dad before he passed. I am doing all of the paperwork, etc. as well. I get frustrated with the lack of support from them, but this is not new so I am not surprised.

While dad was in the hospital and then hospice, my son’s wife’s grandfather was also very ill. He was expected to live at least 3 more months but instead he passed away just 2 days before dad. So while my son was sitting vigil with me at the hospice, his wife was dealing with her own grief and loss of her grandfather.

Her grandfather’s wake was the day after dad died and his interment was the next day. The only advantage of all this grief at once was that they were able to take 3 days bereavement for each death. My son was late for his wife’s grandfather’s wake because he had been with me at the lawyer’s office. He went with his wife and her family to the funeral service later that evening and the interment the next morning.

As I mentioned last time, I was able to leave my northern home less than a week after dad passed.  I was anxious to flee the cold and snowy weather.  However there were tasks I had to complete before I left.

One of the things I wanted to complete before I left home was dad’s obituary.  I emailed my children for digital pictures as I was too unfocused to find what I wanted. My daughters came through as usual and I had a nice one chosen to send to the newspaper. I decided not to place an obituary locally since dad knew so few people in our community. Instead I had it placed in the newspaper in the community where he lived most of his life. I sent a copy of it also to his assisted living facility and to the mobile home community where he and mom used to spend their winters.

Many relatives and some of dad’s friends saw the obituary in the newspaper and contacted us to ask to be notified if there is a service.

I also still have not finished with dad’s belongings from his apartment at his assisted living facility. When we cleaned out his apartment, I sent all of his furniture to my sister on a moving van. My son and daughter helped me bring home everything else – mostly clothing and personal items. I have them all sitting and waiting in my home. When I get home in the spring I will sort items for donation, etc. I hope to give some of the better items to the organizations that help the homeless and other such charities. Dad had so many warm shirts I am sure they will appreciate them.

Also now I have heard from the legal team that I am supposed to be making an “inventory” of all dad’s belongings at the time of his death. Thank goodness my daughter obtained receipts for the bags of clothing she dropped off at the charity store. I will record the rest of his things (or photograph them for later recording) when I get home.

Although I am physically many miles from my home, my mind still goes back there most days as I contemplate other unfinished business.  I would like to hit the ground running when I return from this respite from the winter weather.

Posted in death and dying | Tagged , , , , | 6 Comments

After Dad’s Passing

Dad passed away in his hospice on a Sunday evening. My children and I went back one last time to see dad and pack up his belongings about 8:30 that evening. After we left, hospice personnel called the undertaker who came and picked up the body.

Less than an hour after I got home that Sunday evening, the telephone rang. It was the undertaker. He said he had just picked up dad’s body and did I want to come in right then to sign the paperwork? I had already met with him in the past and gave him information about dad, his parents, his military experience, etc. I was tired and sad. I said no, I did not want to go in so late on a Sunday evening.

I agreed to meet with him at 9 AM on Monday morning. I called my son and asked him to go with me so that I wouldn’t get emotional and forget the answers to the many questions that might come up. My son and daughter (and dad) had been with me when I made arrangements with mom’s undertaker, over 4 years ago, so he knew what to expect.

It was cold and icy and I also needed my son just to help me walk through the parking lot! The undertaker had all the paperwork carefully prepared and we got right down to business. He must have had 20 forms for me to sign. Most were government forms following federal or state laws that stated that I was not told I was required to purchase an urn, a lined coffin, embalmment, etc. I couldn’t believe how many things they had to show I was not required to purchase.

Now I remember years ago when these laws were passed because funeral homes used to insist that things like embalmment or lined coffins were required by law (and sometimes they were). Then came the era when people wanted to make their own coffins or purchase them cheaper elsewhere and funeral homes balked at that. Now it is clear that the buyer has more rights and thus these forms are used to show we weren’t intimidated into buying more than we wanted.

The next questions had to do with the death certificates and how many did I want. He suggested at least 4 I think, though I got a few more. When mom passed away it seemed like everyone wanted proof of death including banks and insurance companies.

After we were done, my son dropped me off at home but agreed to pick me up after lunch as we were scheduled to meet with the lawyer. I knew the legal process was going to be long and complicated because dad still owned his house hundreds of miles from my community. This meant the estate would have to go through probate.

In addition, I still planned to return to the south and flee the terrible northern weather. I was so overwhelmed with the cold and icy roads and just total sadness. I wanted to do as much as I could quickly and then leave the rest of the process until I returned home in better weather.

As we talked with the lawyer and his legal assistants, I could see this was going to be a lengthy and confusing process. I was very thankful that my son was with me, though he was working with a deadline – as he had to be somewhere else. It took us about 2 ½ hours for the legal team to explain all the steps that had to be taken in order to begin the probate process.

While the will said that I was to be appointed executor, that wasn’t an automatic process. The lawyer had to prepare papers and take them to the court to appoint me as executor. And before that could happen, he had to send a copy of the will to everyone named in the will. And he had to send papers for them to sign saying they do not object to me being named executor. I don’t know what will happen if they don’t sign, but I can’t imagine they want the job!

After those papers come back, the lawyer will file the petition to the court to name me executor. In the meantime, he prepared the petition and had me sign it anyway as if the papers were returned. That way I would be able to leave and return to my winter vacation without waiting for this process to play out.

If anything happens while I am gone, my son will be able to meet with the lawyer in my place to pick up or deliver necessary papers, etc.

Another thing I am supposed to do is to open an estate bank account by closing my father’s other accounts unless they are joint accounts or payable on death. I will also add any money that comes back as refunds for prepaid items like his telephone and cable bills. However, I can’t open the estate bank account until after I am named the executor by the court.

In the meantime, I can’t use the estate bank account to pay any of dad’s bills – like his medical bills. I am uncomfortable waiting to pay all bills, but so far that is what I am doing. The lawyer said I could pay from my own funds and keep good records and have the estate repay me if I need to, but it is better to wait for the estate account to be opened.

One of the things I was worried about was the death certificates. When mom died, a series of errors delayed the death certificates for over a month. The undertaker had put the wrong date of death on the certificate and the doctor did not catch the error. It was in the weeks between Thanksgiving and Christmas and it seemed impossible to get anyone to move with reasonable speed. It took about 3 to 4 weeks to get the certificates with the error on them and another 3 weeks to get the amended certificates. In the meantime I couldn’t collect insurance or do much else.

I was pleasantly surprised when the undertaker called me two days after we had met. The death certificates had already arrived. I drove over and picked up all the copies. What a relief! One more anticipated problem was avoided!

I called the law office to see if the petitions I was to sign were ready yet. I reminded them that I wanted to leave town as soon as possible to get to a warmer climate. They worked hard to accommodate me and by late Thursday they had the petitions ready to sign.

I had purchased airplane tickets for Friday with little faith that I would actually get out that quickly. However, it seems that just by setting a deadline, I made things move along faster and it all worked out. My son drove me to the airport on Friday.

Less than a week after dad passed away I had gotten away from the winter weather and resumed my aborted vacation in the south! I could hardly believe it, even as I disembarked from the airplane. My next door neighbor told me I got out just in time as there was over a foot of snow the next day and the airport had been totally closed down!

I still have a lot to do in terms of settling dad’s estate. However, for the time being I am taking a much needed break. I have friends here in this southern community and they are all very supportive of my loss. In addition, many friends from home have also sent me notes and cards.

I know I will have a lot of work waiting for me when I return home, but in the meantime I am avoiding this winter of unending snow and extreme cold.

Posted in Caregiving, death and dying, Elder Care, Eldercare | Tagged , , , , , , | 24 Comments

Dad’s Last Days in Hospice

Last time I wrote about dad’s hospice. As I mentioned, he slept through most of his first day there. The next few days he was awake and aware of his surroundings more, though he didn’t speak at all. He did indicate with his hands and facial gestures when he was thirsty.

Each day the palliative care physician came in the room to talk to me. He told me what was happening according to his morning assessment. By the third day dad seemed to be doing so much better than the first. I asked the physician if he still expected dad to have about 3 months left. He said no. At this point, dad was not eating anything and not drinking anything except tiny amounts of water from a syringe or sponge.

“I think you can count the remaining time left in days, not weeks.” He said. I was surprised. He looked so good. His color was good and he didn’t seem to be in any pain, though he was getting medication on a regular schedule to prevent pain. Doctor A said that dad would probably experience a big change the following weekend – 5 or 6 days away. He said that without food and water, dad would be slowly declining unless he had another heart attack.

It was just hard to imagine that dad would be gone. I knew he had two heart attacks and that his heart was badly damaged. I knew his kidneys didn’t appear to be functioning right, as indicated by the dark color of his urine. Still, thankfully, dad did not appear to be in distress.

As the week progressed, I could see that dad was losing his ability to swallow. In addition, his eyes didn’t seem to follow us anymore. He kept his eyes half open all the time, but I wasn’t sure if he could see anything at all those last 3 or 4 days.

I spent every afternoon with dad. I could see he interacted well with all the staff. The low patient-staff ratio meant that all the nurses and aides knew dad and they all seemed to really care about him. My son or daughter spent time with me in dad’s room at the end of every day.

In addition, a volunteer came in every day and spent some time with each patient and his family in the patient’s room. She just talked about anything and was there to give suggestions and help people feel they were not alone.  This woman came in every day — 7 days a week — for several hours to visit with the hospice patients.

One day a different volunteer came to visit dad. He was a Vietnam Veteran and he brought dad a handmade quilt with US Marines fabric, a certificate of appreciation for dad’s service as a Marine, and an American Flag pin. By that time, dad was not very aware of his surroundings. I felt sad that dad was unable to see since it was beautiful quilt and dad was so proud of his Marine service. The nurses put it on dad’s bed each day after that. This veteran didn’t just volunteer at hospice. Instead, he visited veterans whether they were in the VA medical center, a local hospital or nursing home. In addition, he volunteered to pick me up the next day to visit dad as I didn’t have a ride yet. The bad weather kept me looking for rides each day.

The nurses had suggested that I talk to dad even when he was non-responsive. I had heard that before and did it with mom. I tried to tell dad that I would be all right when he passed away. I would be sad and I would miss him, but I would be all right. However, every time I tried to say that, I started to cry, so I wasn’t too sure I was being very effective! I am sitting here with tears running down my face right now as I write this.

As the doctor had predicted, dad’s condition changed markedly from Friday to Saturday. By Saturday he was completely non-responsive. He didn’t move his head to my voice or open his eyes. The nurses continued to try to put moisture cream on his lips, to readjust his position every 2 hours and to give him pain medication.

He appeared to be in distress more often now also. The doctor changed his orders to increase the amount of pain medication given regularly as well as to add the other medication for anxiety more frequently. I don’t think the medication alone was enough to completely knock dad out, but combined with his declining condition; he was asleep most of the time.

Over the weekend, my son, daughter and I continued our vigil at dad’s bedside. We left only to get something to eat. The doctor thought dad would pass on Saturday but still he held on. We returned Sunday and again spent the entire day at dad’s bedside. I tried again to tell dad I would be OK when he passed away, and was more successful at talking without crying. Dad didn’t give any indication that he heard me.

He seemed to be holding on by sheer willpower. He had not eaten nor had anything to drink for over a week and was totally unresponsive. But still he hung on. His breathing changed a few times over the weekend. The first time I called the nurse and she said it could be any time but there was no way to tell for sure.

Late Sunday afternoon when the volunteer was there, she suggested that dad might be holding on just because we were there. We might have to leave for awhile before he would pass. A few hours later, one of the nurses said the same thing. We left around 6 but I asked that the hospice call me if dad passed or if anything indicated it was imminent.

My son drove me home and I had some dinner.   Just after 8 PM, I got the call from hospice. Dad had just passed. I called my son and daughter and asked if they wanted to go in with me. Both did. We went to see dad one last time. The staff had begun to pack up some of dad’s belongings but had not changed anything for dad in his bed. We said goodbye and talked quietly among ourselves.  I packed up the quilt and all of the snacks I had brought in during the week.

We were glad dad was finally at peace, but disappointed to have been absent when he passed. I can only accept that if he had the ability to choose the time, then that was how he wanted it. He knew we were with him all that time and I think that gave him comfort.

I am thankful for all the help and care that we got from such a wonderful hospice. It is difficult to lose a parent. But compared to mom’s last hospitalization, this was far less stressful for both the patient and the family.

Posted in Caregiving, death and dying, Elder Care, Eldercare, Family, Hospice | Tagged , , , , , | 17 Comments

Dad at the Inpatient Hospice Facility

Last week I wrote about dad’s experience with hospice in the hospital. Just over a week after his heart attack in the emergency room, we were fortunate in being able to get dad an inpatient hospice bed for dad as I wrote about in my last post.

During dad’s last Friday in the hospital he was still able to talk and ask for a drink of water or to use the commode. He asked to be repositioned for comfort, and drank just a little cola with his lunch. I was told the ambulance would come at 5 PM to pick dad up and take him to his hospice which was nearby. I rode in the ambulance also, but in the front with the driver.

I went to the hospital cafeteria around 4:30 to grab an early dinner since I thought I might miss out on a chance to eat while the move was taking place. Dad’s dinner tray arrived just before 5 but as usual he wasn’t hungry. The ambulance was delayed for almost 2 hours due to heavy demand at that time of day. In fact, we didn’t get dad into his room at the Hospice facility until 7 PM.

Immediately after we arrived, the staff made sure dad was comfortable in his bed. I put his clothing in the closet and prepared to go home. It had been a long day and immediately I could see dad would get the personal attention he needed. I didn’t have to worry about being there or having someone else there to advocate for him.

I want to tell you some of the wonderful features of this hospice. First, and foremost, the people were all angels. They were always friendly and smiling and ready to do anything to help us. If we pressed the call button, they responded within just a few minutes and a nurse or aide would come to dad’s room to make him comfortable or to answer our questions.

The hospice building was built within the past few years and was designed specifically for that purpose. There were 11 private patient beds – 5 in one “wing” and 6 in the other. There was also a huge “great room” which had a kitchen and living room. There was a pot of hot soup available for families and patients every day for lunch and supper. The type of soup changed for each meal except on weekends when they had the same type for lunch and dinner. There was also always a pot of coffee ready for families. The kitchen cabinets also contained many condiments and extras such as jam, sugar, crackers, tea bags, etc. I made myself tea each day since I am not a coffee drinker.

Some of the patients’ families sat around the dining table in the great room to eat or talk. The kitchen was well equipped with all the appliances and pots and pans anyone could want to cook a family meal (but I did not cook). I usually prepared myself a cup of soup or tea and took it to dad’s room since I wanted to spend as much time as possible with him.

The other end of the great room was a living room with a large screen television, sofas and chairs and a huge aquarium. Along one wall was a gas fireplace with a stone ledge where one could sit. There were cabinets containing puzzles and toys for families to spend the day there or to take to the patient’s room.

In addition, there was a small “quiet room” in each wing and a laundry room with a washing machine and a dryer and vending machines for snacks plus an ice/water machine. Everything was convenient and easy to use.

Each patient’s room had a large screen television and CD/DVD player. There was also a loveseat that turned into a bed so family members could spend the night if they wished. A shower was available to family members who slept there also.

Now, I will tell you about the staff. There was a full time doctor on staff Monday through Friday. Two individuals shared this position. Dr. A would be there for 1 ½ weeks and then Dr. B would be there. On their alternate weeks, the doctors worked in the palliative care department at the hospital. On weekends, one of the two doctors was on call.

In addition, there were registered nurses on duty 24 hours a day. I think there were 4 during the daytime hours and 2 in the overnight hours, but am not positive on that. In addition to the nurses, they had probably 4 nurses’ aides who came in to make the patient comfortable and respond to requests from the family. They worked in teams of 2 to turn the patient, etc.

Other staff included the social worker, the receptionist and the cleaning person. For only 11 patients, the staff to patient ratio was wonderful.

The morning after dad arrived, I telephoned to see how he had spent the night. They said he was comfortable. When I got there to visit, I found dad asleep. In fact, he slept all that day with few waking periods. Somehow the move from the hospital to the hospice had worn him out. Or perhaps he was just finally comfortable enough to sleep through for hours at a time.

At hospice they did not insist on making him sit up in bed or move to a chair. He stayed in the bed all the time. Nurses or aides came to turn him or change his position at least every 2 hours to prevent bed sores, etc. They positioned him with pillows on both sides. The doctor explained that they did not need to make him sit because he was not being prepared to be discharged to home or rehab. Now they could do whatever made them most comfortable, whether sitting or laying down.

In addition, he was now getting liquid oral medicine (morphine) for pain every 4 hours. Also the doctor or nurse checked him periodically to ascertain that he was not uncomfortable or in pain. Another medication was on orders if he needed it for anxiety.

The doctor came to dad’s room each morning to assess his condition and determine if any changes in standing orders were needed. Later he would explain to me what was happening based on this assessment.

Once in hospice, dad never talked again. He appeared comfortable and was able to shake his head to indicate yes or no. He didn’t like to be repositioned and moaned audibly when he was moved even a little. He liked to get some water from a syringe or small sponge on a stick. His mouth was drying out as he was mouth breathing all the time now.

I put my hand near dad’s hand on his bed when I arrived and periodically through the day. Most of the time those first few days, he reached out and grabbed my hand and squeezed it tight. That was how we communicated most. I talked to dad and waited for him to shake his head or squeeze my hand.

Each day I arrived around noon and late in the afternoon my son and or my daughter would arrive. We would then all visit for awhile. My daughter was great about going straight to dad. We weren’t sure if he could see the last few days, but she would go right up to him and speak loudly. “Hi Grandpa. It is your granddaughter (she gave her name). Give me a kiss!” Then he would pucker up his lips for a kiss. Until the last 2 days, she was still able to get him to pucker up and squeeze her hand.

My second daughter came from her home which was several hours away to spend the weekend and say goodbye to her grandfather. She was also able to take me places in the morning on the snowy icy roads as I had errands I needed to run. We also stopped at a deli each morning to pick up sandwiches before we went to visit dad. Over the weekend, my children and I spent most of each day with dad.

All the patient’s meals and the soups were sent over from the hospital which was just around the corner. Dad wasn’t hungry at all and never ate a meal, but most days I had soup at midday.

To be continued…


Posted in Caregiving, death and dying, Elder Care, Eldercare, Hospice | Tagged , , , , , | 13 Comments