Fidelity Viewpoint – Managing Cognitive Decline

This is a helpful reminder for those who are helping family members with cognitive challenges and for those of us who might start to struggle at some point in the future. I am thankful that my wife’s mother recognized that she needed help and then accepted help. Her financial “advisors” were not doing a good job and they were charging her for the work they were doing. We made changes together while she was still able to make decisions regarding her future. Now she is no longer able to do that. She was wise to act when she could and set in place the right legal documents with her attorney’s help.

Read this article for more helpful information:

Managing cognitive decline

Legal Matters Matter

Wayne and I recently checked one more thing off of Momma’s to-do list mentioned in the following story posted on Facebook in 2016. We met with our local funeral director and pre-paid Mom’s funeral. It’s nice to have that one out of the way. There are so many financial planning and legal matters to attend to when it comes to caring for a loved one who can no longer care for themselves. I hope by sharing this information, light is shed on someone else’s journey.

Facebook journal entry – February 4, 2016

As far back as I can remember, Momma was always a list maker; life just rolled better once her thoughts and plans were written down on paper. I know the feeling. I enjoy the physical act of checking things off of my to-do lists too. Some may think me crazy, but, when I accomplish an unexpected task, I add the job to my to-do list just so I can experience the euphoric mini-rush of being able to check it off as “DONE!”
Two summers ago, Momma’s memory loss was beginning to advance. I had been noticing changes since 2010, but Mom had been able to disguise her forgetfulness and few people knew she was struggling. In the summer of 2014, she was still having more good memory days than bad, but her memory loss was making its ugly presence known – and others were noticing the changes too. Her friends at church would patiently listen to her tell the same story several times in a conversation or ask the same question repeatedly.
That summer Wayne and I began to make more frequent trips to see Mom. While Wayne would help her with household handyman projects and matters related to finances, I would work with Mom puttering in her garden or working indoors with her on various decluttering projects.
As we spent more time with Mom, I believe that God helped us see that stress – real or perceived – adversely affected Momma’s memory. I began spending more time at Mom’s house helping her tackle the paperwork that was threatening to overwhelm her. The bed in my old bedroom was hard to find beneath the sea of junk mail, bank statements, file folders, binders and clipboards. Scattered throughout this paper jungle were various legal pads, notebooks and miscellaneous pads of papers where mom was obviously trying to jot down tasks on her to-do lists. Mom had boxes and boxes of files, but didn’t have a system for filing that was working for her. I started taking home a box at a time and, with Wayne’s help, weeded out the stuff she didn’t need to keep, condensed the duplicate files, and then created a much smaller A-Z file system for her. Our son Matt got involved in this project too, helping create a more streamlined household filing system for her.
That summer, Wayne and I chose to spend time reading her various lists and couldn’t help but notice one theme showing up quite often: Momma wanted to take care of end-of-life legal and financial matters. We decided that this needed to be a stress-relieving priority, given the relative clarity of thought she was having now versus the unknown path her thought process might take in the future.
Gathering up her legal documents and financial statements, Wayne and I started to wade through and organize them making our own lists of things that needed to be updated, questions that needed to be asked, and people we needed to meet. Then, with mom’s blessing, our first stop was to meet with Mom’s lawyer. Now that Dad had gone to his heavenly home, Mom wanted to make sure that everything was updated. We made an appointment and were so glad we did. We worked with Mom’s lawyer to update her will and, while we were at it, updated both her financial and healthcare power of attorney (POA) legal documents (Power of Attorney for Healthcare and Durable Power of Attorney). This step alone came in handy for many of the tasks we would want to accomplish over the next few months.
Wayne’s review of Mom’s retirement accounts caused him to raise his eyebrows. The funds were being managed by two different advisors; one doing a respectable job, the other – not so much. Numerous unreasonable fees were eating away at any gains her accounts were making. Together with Mom, we decided to move one of her two accounts into a Fidelity account and allow Wayne to oversee and manage them. With her Durable Power of Attorney paperwork in hand, we were able to handle these financial decisions and changes on mom’s behalf. Receiving all of the investment related documents in the mail was very confusing for Mom, so we changed the mailing address to our own. Wayne then condenses the information into a single page summary document listing her current balances in her various financial and investment accounts.
The next stop on our “Momma’s to-do-list journey” was to take her to the cemetery where Dad is buried. Several years ago, Mom and Dad had purchased two plots from a friend who had a few plots she had inherited that she wanted to sell. Based upon the paperwork I had in hand and a few phone calls I had made, I was confident that everything was in order. Mom just wanted to double-check that everything was pre-paid and in order for her own future interment. We stopped at the cemetery’s office to speak with the attendant and were assured that all of the necessary prepayment was in order.
We then drove to the section where Dad was buried and set out to find Dad’s grave marker. As we slowly moved through row upon row of tombstones and markers, I was reminded that there is more to getting ready for the inevitableness of death than taking care of financial matters. I whispered a prayer of thanksgiving that both of my parents had taken care of the most important thing. Well, actually, Christ had taken care of that on the cross for them…Mom and Dad just accepted His gift of salvation by faith.
We found the marker. As Momma and I stood arm in arm reading the grave marker together, it seemed odd seeing her name on the marker too. Glancing at Momma to see how she was doing, I saw a peaceful smile.
Over lunch following our visit to the cemetery, we talked with Mom about what her wishes were concerning her future burial plans. An incredibly tough discussion, but I am quite sure her concerns over the future were visibly replaced by a gentle peace of mind.
At the end of our summer of checking many things off mom’s to-do lists, I created a special binder to house all of the important documents related to end-of-life matters. This binder includes:
  • Power of attorney documents
  • Original copy of her will (along with a copy)
  • Cemetery and burial plot titles and documentation
  • Mom’s wishes related to her funeral service – including the hymns and scriptures she would like to include
  • A list of people mom would like me to notify concerning her home-going
  • A list of legal tasks I will need to complete.

Admittedly, this reference binder is more for me, than for mom. When God chooses to call my mother home to heaven, my job of honoring her final wishes will be much easier. On this side of Glory, we will enjoy our time with mom and rejoice in knowing our summer of checking things off her to-do lists brought her great peace of mind.

Meet My Brother

I’ve mentioned my brother a few times on my blog now, so thought I should reach back in time to almost a year ago where I introduce him on Facebook. I’m Brad’s health care power of attorney but, more importantly, his sister. So, I got involved in my brother’s business when it became very apparent to me that there was more than laziness keeping my brother living as a recluse in my mom’s spare bedroom. No work for 6 years (he’ll admit being lazy at first about finding work after losing a good job). No income and no ability to handle his own financial affairs. Diabetic, but doing nothing about it. No time spent with friends. Just sleeping, eating, smoking cigarettes in the garage, and watching TV. One day in April of 2015 I announced to Brad that I was taking him to the VA to see if we could get him some help for some very obvious (to me) health problems. He was so sick and very willing to go. That began a year of uncovering and treating several significant health problems – including cancer – multiple cancers, one of which had already traveled to lymphnodes.

With the help of some pretty amazing doctors at the VA Hospital, Brad fought his cancers and won. But the fight was hard on his already frail body. It soon became clear he could not go “home” again. Brad has since settled in nicely in a skilled nursing facility near my home. Visits with the doctors at the Madison VA are not quite as frequent. We continue to routinely screen for skin cancer, treating when necessary.  Because Brad is not a good candidate for another round of chemo and radiation, we are no longer actively screening for the return of colorectal cancer via invasive tests and medical imaging. We’re doing what’s referred to as “watchful waiting” – waiting for symptoms of cancer to return and planning to provide comfort care should his cancer return.

Facebook Journal Entry – May 2, 2016

Meet my younger brother, Brad. I would describe him as a generally laid back, genuinely nice guy. Single. Never married. Former trucker. His happy place in life is sitting around a campfire with a few good friends after a day of hunting or fishing. It has been a few years since he has felt well enough to be in his “happy place,” or anywhere besides his bed.

Lately I’ve been accompanying my brother to the VA hospital once or twice a week, sometimes spending an entire day there, depending on how many doctors he needs to see. My heart is filled with compassion for my brother. It has truly been a rough year for Brad. So many ailments and serious health concerns previously identified by the Milwaukee VA (Zablocki) have been addressed. Now, as we transition his care over to the Madison VA, -Brad’s new care teams have been getting to know him – one clinic at a time: Retina Clinic, Geriatric Clinic, Dermatology, Oncology, Urology, Podiatry, and Neurology. Brad and I are very grateful for the fine care he continues to receive as a military veteran.

Profoundly grateful.

Today’s appointment was with his new neurologist; a straight-shooter who does not mince words. Nothing was sugar coated. Sometimes I would steal a glance at Brad to see how he was taking the brutally honest information. There was very little in the way of encouraging news today. I had mixed feelings; part of me wanted to cry, the other wanted to hug this doctor for his forthrightness and practical advice.

Brad has battled cancer courageously and without complaint. In this regard, except for some skin cancer yet to be excised, he is doing well. The sad news is that he will never regain the use of his legs. Diabetes and chemo and radiation therapy have taken their toll. No amount of physical therapy will help him regain the lost muscle mass. The wheelchair is, and will continue to be, his everyday companion.

It pains me to see my younger brother living in a nursing home. I want him to live with me and I want to help take care of him, but my house will not accommodate his mobility needs. Due to mom’s physical problems and her declining mental acuity, living with mom is not an option either. Thus, Oregon Manor is his new home

Mom misses Brad too. Each and every day she hopes he is coming home to live with her. The mom in her wants to take care of her boy. Today, after Brad’s appointment, I brought him to Mom’s apartment for a little visit. Wayne prepared dinner and we sat down to eat together as a family. This meal together brought mom joy and gave Brad a different sort of dining experience than he has in the nursing home. Time with family. Precious.

After dinner and a brief visit, it was time to get Brad back to his abode. Together, we’re getting the hang of this transportation thing. I’m even learning to wrestle his wheelchair in and out of the trunk…not with the greatest finesse, but it’s getting easier.
Our ride “home” was quiet. There was a lot for both of us to absorb following today’s visit. With Brad situated comfortably in his room, I left to go spend a little more time with mom. Once in the car, however, the enormity of the doctor’s words today registered in my heart and hot tears began to flow. It was another one of those moments in life where I knew I needed to pray, but the words would not come. But God knew what was on my heart and He heard my unspoken prayer.

The Comforter is here and He gives peace.