Need Care – ?

Centers for Medicare and Medicaid Services (Me...

Centers for Medicare and Medicaid Services (Medicaid administrator) logo (Photo credit: Wikipedia)

My widowed mother became legally blind in her late 60s. She was sharp as a tack, but blind as a bat, and needed help at home. That was her reward after she had given a lot of years to my father, who had been bed-ridden by rheumatoid arthritis, Guillain-Barré Syndrome and other degenerative factors. I was at home as a care-giver for part of that experience. I now want to share some thoughts and resources to help anyone, who needs or is giving care right now.


  1. We’re all getting older. Either our bodies will work tolerably well into old age or something will break down along the way. It only takes two of six essential skills for a person to officially require care.
  2. Despite our best efforts, we can not predict what will happen in the future. Although most of my school chums and I are reasonably healthy and well, I have lost friends and family to brain cancer, ALS, degenerative diseases, and suicide.
  3. You can never assume that “help is around the corner,” or “my kids will take care of me.” Although volunteers (including family) may be willing to help, they have lives as well…and changing your diapers, cooking three squares per day, and helping you find your remote 24/7 may not be possible for them for an extended period.

Where to begin? Try these points to start:

Relationships –  A recent article in The Ensign magazine entitled “When One Needs Care, 2 Need Help” by Nancy Madsen-Wilkerson describes the challenges faced by family caregivers. The author experienced the trials of providing care to family members, and spent a week herself in the hospital recovering from complete exhaustion. The article touches on several vital points:

  • Preparation – like any hazard, forewarned is forearmed.
  • Advance Directive – your written, legal decision about your care, used when you are no longer able to say how you want it.
  • Durable Power of Attorney – you name the person(s) you trust to make decisions when you are no longer able to do so.
  • Coordinated care – plans for who can help, when, and under what conditions.

The article is a good read and will plant some seeds of preparation in your own mind and spark discussion in your family.

Insurance and Professional Help – If you have assets and want to preserve them for your survivors, consult your planner about Long Term Care (LTC) insurance. LTC insurance is designed to do two things: 1) pay a professional to take care of you  in your home or a facility of choice (you pay pennies on the dollar for care-related fees when needed), and 2) preserve your assets. If you die on Medicaid, most states require that your estates pays back the expenses after you die (the government LTC site explains this). The pool of care money created by LTC insurance alters that equation.

Admittedly, there are many considerations to discuss in this very personal decision, it is essential for you to consult an expert in the field. AND – this is a BIG AND –  don’t wait until you need it to buy it. You must be physically and financially healthy in order to purchase LTC insurance.

Choosing Care – Visit facilities in your area. Good ones should be forthcoming about the services they offer, including pricing, levels of care, etc. They are businesses, and are in competition for your trade. It will pay you in the long run to understand when you or your loved one can say at home and when it is time to move.

My Experience – My mother was very aware of the importance of planning. When I moved back home to take care of her, she was very specific. “Jim,” she said, “Here is my will. Here is the key to my safety deposit box. You’ll find all of my documents, my life insurance and everything else you’ll need. And here is the attorney that you will consult when I go.” When she passed, every instruction was as good as gold. I was spared the burden of guessing. I cannot tell you how tremendous her last gift was to me and what a difference it made when it was time to exercise it.

If there is a moral to this story it’s this: if you think planning is tough, imagine life without it. Then get to work.


White House Conference on Aging

Administration for Community Living

Alzheimer’s Association

Long Term Care (info)

Chutes ‘n’ Ladders — Life Transitions

If your life situation (working or otherwise) is about to change, read on:

Nice Day to Jump Out Of an Airplane.

“Great day to jump!” Image by Striking Photography by Bo via Flickr

There are several things you must do to transition:

  1. Assess your resources. These may include family, friends, savings, skills, reputation, belongings and other assets. Become clear about the people and things in your life that you can rely on.
  2. Take care of yourself. This is a daily task and includes your physical, mental and spiritual health. Turn off the tv, brush your teeth, get dressed, exercise, read something inspirational or motivational and make plans.
  3. Make yourself accountable to someone, preferably someone who cares about you and doesn’t accept excuses.
  4. Follow through on your plans.
  5. Practice gratitude daily for everything you have.
  6. Write something about your day to complete it and set out some goals for the next day.
  7. Sleep well and long enough. This is much easier to do when you know you’ve done everything you can for that day to accomplish your goal.

    Let’s unpack these practices:

  1. Take time to write down everything you’ve got. If you need money, sell off extra stuff in the local Free Trader, on Amazon Marketplace, Ebay, Craig’s List or some other marketplace. You’ve got shelter and food, so you have a base. Phones can be cheap and good (My Net10 works great!). Start your search for business, support and assistance. When you have savings or passive income (such as rental properties, royalties or business income), you have time.  You have skills, reputation and friends; call on them fearlessly. If you lack any of these resources, get busy and create them.
  2. Personal care is fundamental. Do we need to say more? Eat well, sleep enough, and stay engaged in life.
  3. Find an Accountability Partner. Being accountable substantially increases the odds of your doing what you say you will do. Most of us won’t keep promises to ourselves, but we will do everything possible to keep our word to someone else. There are a lot of ways to handle this piece, but you can start with a friend who will listen for your accomplishment and not buy into any excuses you make up. A side benefit of having a relationship like this is that your level of integrity goes way up, and there is a real material benefit to having that happen for you.
  4. There is power in doing what you say you will do. You already know where good intentions lead by themselves. Put your focus on doing the thing and acting as if you cannot fail. You will be amazed at what comes of it.
  5. Express sincere gratitude. That habit creates great feelings, both for yourself and for the person to whom you express gratitude. If you’re not in the habit, start. It will take work, but it gets easier and more delicious the more you do it. There is real power in actually doing this thing daily.
  6. Remember that every time you review your accomplishments you alter your current thinking. Writing multiplies the effect. The brain lives for feeling good. Accept no substitutes.
  7. Appropriate daily rest is fundamental. It’s part of our natural cycle of things. Just as your car needs service, your body and mind need time to regroup, repair, and heal. Although we are called upon to tax ourselves beyond sanity from time to time, this should never become habit. Your car doesn’t operate well on fumes and neither should you.

When you focus on simple acts of care, improve your support structure, and maintain your integrity, then you have a real basis to change the world around you.