Originally posted @allaboutestates.ca

I had the pleasure last week of being a panelist as part of the Canadian Association of Gift Planner’s mentoring & education breakfast, on the topic of Ethics. When I had previously thought of ‘Gift Planning’ I was only considering the Will component, the gift left to a particular charity, once the person had died. I had not fully appreciated all of the challenges that might be experienced when working with the older person while they are still alive. There was much discussion in relation to the donor’s capacity, and the challenges posed when large amounts of money are being gifted and bequeathed to a charity especially when the donor might exclude family from their will. Ethical practices and how to do the ‘right thing’ are certainly critical considerations for gift planners.

My contribution as a panelist was in regards to the vulnerability of many seniors and those that find themselves alone in their later years. Their vulnerability isn’t necessarily in direct relation to their capacity but rather their need for friendship and assistance when the cost for this interaction might be naming this ‘friend’ in their will as a beneficiary. I had previously blogged about this thorny topic in ‘Sharing the Caring’.

I understand that it is very hard to be and feel old and to find oneself alone. The exchange of ‘I will assist you now and you don’t have to pay me BUT you do have to leave me your house…. or your money’ does not seem fair. It is an equation that we may see in family but it is also an equation we may see between the older person and their neighbours and/or their caregivers. In some cases, it might be a reasonable exchange when there is capacity and genuine care and concern; but it can also be highly suspect and smell of elder abuse. Perhaps the best scenario would be if there is a separate bone fide attorney for property (either a person or a trust company) who has been named who can work to ensure the older person’s money is being appropriately spent- on them- the older person but even so, the issue and need to have someone trustworthy appointed as attorney for personal care is clear.

Originally posted @allaboutestates.ca

What does this mean exactly? Does it mean a greater discount at Shopper’s or at Timmy’s. I don’t think so……

It is actually a reminder to all of us to acknowledge the great contribution made by seniors every day. As boomers reach this milestone, a senior is officially defined as someone over the age of 65, but this definition in practice may vary between the ages of 55- 60 and 60- 65 years plus. This official definition may include access to provincial and and other monetary benefits( and yes Shoppers Drug Mart does offer a 20% Senior’s Day discount on the last Thursday of every month).

Our Federal government is working hard to develop strategies and policies to support ‘seniors’ to remain living as well and healthily as possible. We now have the beginnings of a Dementia Strategy-actually we have a Ministerial Advisory Board on Dementia who will advise the Minister of Health on dementia care and key issues that need to be addressed. As we know the greatest risk of developing dementia is getting older… so we have to be prepared for our ‘golden years’. With the average life span for Canadians aged 65 and above at 87 for men and 89 for women we hopefully have many years ahead.
There are a number of tools now available on the Federal website offering tips and information on aging in place and ways to balance work and caregiving- a favorite theme of mine.

So take this day to thank a senior in your life. Visit or call family members. Spend some time together, go for a meal, go for a walk together or just pick up the phone and say hello…….

Originally posted @allaboutestates.ca

In my opinion, dementia is our greatest health crisis. It is a disease that is not based on culture, gender, ethnicity, or social economic background although there is some current research that there may be some modifiable factors. Alzheimers is the most common form of dementia and one that impacts more women than men. The Canadian Alzheimer’s Society shares that women represent 72% of all Canadians living with Alzheimer’s disease, likely because women live longer than men.

Dementia is as a general term describing symptoms which include a decline in mental ability, loss of memory and judgement severe enough to interfere with daily life. Older age is the greatest contributing factor for developing dementia. Every 3 seconds someone in the world develops dementia and we don’t yet have a cure. The cost of supporting someone living with dementia is extremely high both financially and emotionally. I have written extensively on its impact on family caregivers and on employed carers, which are 35% of working Canadians. The impact on our health care, social structure and resources are also significant.

Financial planning takes on a different meaning when considering the 24 hour cost of care that is required.

Countries around the world are developing dementia strategies to address this growing health crisis. Canada’s national strategy, Bill C-233 is still in its infancy but there is now an advisory board working with the Minister of Health and presumably the Minister of Seniors to develop this strategy.

Awareness is the starting point. More and more of us know and/or are living and loving someone with dementia. For more information please visit alzeimers.ca

Originally published @allaboutestates.ca

Last week, I had the pleasure of celebrating my oldest client’s birthday. She turned 99. We share the same name and she is often inspiration in my day to day work. She and her 94 year old sister live together, have never married and have no other family, other than each other and their community of 24 hour caregivers and me I suppose as I feel like family to them as well.

These two special ladies were referred by their trust officer who is also like family to them. The bank holds their attorney for property and they have been working together for many years. A few years ago the younger sister fell and broke her hip. It was at that time that I was asked to meet them and assist with their care needs. Until that time, they were completely independent, living on their own in the same two bedroom apartment where they have lived for over 60 years. They did their own shopping, cooking, laundry and cleaning. Every day Audrey would take the bus to Baycrest to visit her sister who was in rehabilitation post hip surgery. One day Audrey did not show up and I received a call from her worried younger sister. Long story short, finally at 9:00 pm at night after many calls to the police and various hospitals, we located Audrey at the emergency department. She had fallen when exiting her apartment building on her way to visit her sister, some 6 hours earlier. The ER department was about to send her home after giving her 30 stitches to repair a major laceration across her scalp and forehead. That same evening was the beginning of their accepting care in the home. It has been 2 ½ years now since that fateful day. They both remain mentally sharp and continue to make their own care decisions. They joke with me and ask me with a twinkling eye ‘if they still have their marbles’, which they do….

They are both doing well and are well looked after and are enjoying life.
Last week I joined them for birthday cake, they both share the same favorite, which is a black forest cake. This is the only dessert that they eat and only on their birthdays. Audrey’s words of advice to me was ‘eat well and take care of yourself’.

Excellent advice but I don’t think I can live with only eating dessert twice a year!

Ask yourself: Are your clients living as well as they could/should be?

 

Originally posted @allaboutestates.ca

Last Monday was Labour Day which signifies back to school and end of summer. It is a time of new beginnings, setting goals and starting new projects.

Today is the first day of the Jewish New Year, another fresh start for those who celebrate. For many who may not attend synagogue, it may still be recognized and celebrated with family sitting down together for a festive dinner. Traditions continue and are past down from generation to generation. For some it is a favorite recipe that has been shared. For those with dementia, familiar food, song and stories can bring calm and happiness.

In my day to day work with families, I see love and care but I also see hurt and even hatred. For feuding families I wonder if this might be a good time to put aside differences and recognize how important family is.
Holidays can also be a difficult time, especially when there has been a death of a loved one over the previous year. It is during the holidays when I believe their absence is felt stronger than ever. An empty chair at the table can be felt very strongly.

I have always looked forward to September as I too start new projects and set new goals. Thanks for the opportunity of sharing a few thoughts of gratitude on this Monday morning. Happy New Year/Shana Tova

 

 

Originally posted @allaboutestates.ca

I had previously blogged on the state of loneliness and the efforts being made in the UK with the creation of a Minister of Loneliness. We know that this is also a huge problem in own backyard and one that we continue to need to be aware of. My colleague recently shared a new campaign originating in the UK called the “End Loneliness” with a conference in October 2018 touted as the ‘world’s largest conference dedicated to tackling loneliness’. This wonderful video reminds us ‘when making friends was child’s play’.

The campaign was launched in 2011 and is a “network of national, regional organisations and people working together through community action, good practice, research and policy. We want to ensure that loneliness is acted upon as a public health priority at national and local levels.” It is designed to inspire thousands of organizations and people to do more to tackle loneliness in older age. Stats from the UK found that 5% of adults in England report feeling lonely “often” or “always” with younger adults (those 16-24) more likely to experience loneliness than those in older age groups. I found this interesting yet it comes as no surprise given most everyone I see on the TTC is looking at their phone.

Modeled from this campaign my colleague’s idea is to have the video play in local coffee shops so that the type of connection highlighted, if only just for a minute, would connect with the many who live in their world with loneliness. Consider in addition to ‘roll up the rim to win’ that we have ‘make a new friend for a minute’.

Originally posted @allaboutestates.ca

Over the last few months I have attended two 90th birthday parties. Both had a common theme for me, which was how good it is to have family and friends around. Both of these 90 year old gentleman are still sharp, engaging and while less active than they once were, they maintained the same sparkle in their eyes that I had known for some time. They both said that while they did feel their age, they were very glad to experience every day ‘this side of the grass’.  When discussing aging with others, a very common refrain is “I don’t feel my age” and “I feel exactly as I did 20, 30, 40 years ago”. So which is it? Perhaps the distinction is how one is physically and what ailments they may be living with at that particular time.

I too recently celebrated a milestone bday (let’s just say the 90 year olds have a few years on me) and the sentiment of not feeling one’s age holds true for me too. While I may not feel any older, my morning aches and pains tell me that I am. I am grateful to have gained a lifetime of experience and knowledge and have learnt so much from those around me, with whom I live, love and work.  I celebrate birthdays and am glad to have another day on ‘this side of the grass’.

Perhaps we have two speeds, the one we feel emotionally and spiritually (high?) and the one we feel physically (low?).  It is important to honor both in our daily interactions with each other.

A Feel Good Story

by Audrey Miller on August 13, 2018

in Articles & Blogs by Audrey, Dementia, Elder Care

Originally posted @allaboutestates.ca

I am one of the lucky ones. I like what I do and I enjoy my work very much. The counsellors who work with me say the same thing and while we do deal with much sadness, we always try and find the positive in our daily work. This is one such story.

Mark is a 90 plus year old gentleman who was a very accomplished executive. We met Mark recently; he was living on a secure memory floor in a retirement residence. His history of how things came to be, are still unknown to us; but what we do know was that he had not been managing well in the community and had been subsequently placed there by the Office of the Public Guardian and Trustee. The referral came to us from his trust officer who recently became involved when Mark’s paperwork and their appointment as his Attorney for Property became known. Our counsellor met with Mark who was withdrawn, quiet and distrustful. She also met with the resident care team to understand his needs and status. He had severe memory issues but was relatively well physically. His room was stark without any personal belongings. We were told that his condo had just been sold and that a moving company was going to clear out the unit in the next few weeks.

Our past experience told us that we needed to get to the unit quickly and identify and choose some personal items, such as photographs, family pictures, artwork and furniture that could decorate his new setting. We know that having familiar items around us can assist with memory recall and comfort and we felt that this would be important for Mark. Fast forward to this past week when my colleague went to visit him and found him in his room sitting in his favorite leather chair with a huge smile on his face. He invited her to sit down and have a cup of tea with him.

Mark was alone yet he wasn’t. He had the foresight to assign an attorney for property who was a pro active advisor. His attorney wanted to ensure his client was managing well and as such we were invited to make a difference in his life, which provided great satisfaction for all of us. This small step is just the beginning in getting to know Mark and working together to ensure he is living as well as he can with the appropriate resources and supports available to him.

 

I Didn’t Want To Wake You

by Audrey Miller on July 30, 2018

in Uncategorized

Originally posted @allaboutestates.ca

A story I heard…..

Last week Zoey had the pleasure of visiting her aunt and uncle (in celebration of a 90th bday) who live in the States.  Zoey and her husband accompanied her mother who took the train in (by herself) from Montreal so that we could fly together.  Zoey’s mom used a wheelchair  transport for the airport, which greatly accelerated their wait in security, customs and boarding the plane (tip # 1: book a wheelchair and only take carry on luggage).  Fortunately the travel and trip went well.

Their return flight home was delayed; they arrived home in the very early hours in the morning (tip # 2: pre book transportation).     Zoey walked her mother to the guest room and said goodnight.  The next morning Zoey went into her mother’s room to find her sitting in bed holding a bloody tissue to her forehead, with blood on her, her bedding and clothing.  When asked what happened, she replied that when getting into bed, she tripped, fell and hit her head on the wall. She had spent the entire night sleeping fitfully, with a gash on her forehead that was still bleeding.  When asked why she did not call out for assistance, she simply said: ‘ I did not want to wake you’.

Now as you can appreciate Zoey was not thrilled with her response  and told her so,  and professionally I will share that  her response is more common than one would think (tip # 3: make sure the night lights are ON).

Upon assessment, Zoey and her mom agreed that the situation did not require a trip to the emergency room but Zoey did want to have her checked out by a physician.  The steps taken included:

  • Checking internet for closest urgent care centre: she was not able to enter her postal code to determine proximity,
  • Calling the closest family health team office: office closed, message connected to telehealth Ontario, left message with the return cell phone number,
  • Looking up walk in medical clinics and eureka, she was able to enter her postal code, she called the closest clinic, they were open and  had parking available,
  • They attended the clinic, had a short wait to meet the doctor who assessed her mom and applied sterri strips to the forehead wound and cleared her to continue her return trip home scheduled for later in the day,
  • Zoey received a return call from telehealth (abount 1.5 hours after leaving a message).

Zoey’s  mom was lucky.  Tip # 4: Consider yourselves fortunate. Zoey had a complete list of her mom’s medications and medical history as she had a  Wellness Binder (although it needed to be updated) and  was grateful that the fall was not more serious than it was.    For her mom the fall was not a big deal but for Zoey, it was……

 

 

 

 

Originally posted @allaboutestates.ca

This past week I met with two new clients who were both single women in their mid- 70’s. They both lived alone in their own condos and had retired from well-paying jobs. There were reaching out to EC to help guide them in thinking about and planning for a time when they would be less capable (both mentally and physically) of managing their own day to day needs. Thankfully, they are both planners and were being proactive.

Neither of these women had children nor close blood relatives on whom they could rely. Our conversation soon focused on the important paperwork particularly the need for powers of attorney for both property and personal care. My particular interest of course is in relation to the attorney for personal care and the importance of identifying a key individual (or individuals) who could make decision on their behalf when they were no longer capable of doing so for themselves.
This was problematic for both and neither felt that there was anyone who stood out, who could or would assume this role. There were concerned that their friends were the same age and many were struggling with their own health challenges and they did not want to add to their load.

Over the last many years, we have worked with many older single women and like these two ladies, the issue of who to name as their attorney for personal care had been of concern. Fortunately a trust company can be named for property and this can alleviate a lot of worry and apprehension. However, for personal care, this is not an option. In several cases the older individual contracted with a neighbor to fill the role as attorney for personal care with the understanding that the neighbor would be named in their will as a major beneficiary. This had not worked out well for them. Other times, there was no one named and the Office of the Public Guardian and Trustee had to step in. This did not always work out well either.

Other times I have seen several friends appointed who could share the responsibility and I think that ‘sharing the caring’ among friends may be the route more frequently chosen. EC is often asked to work with the attorney (attorneys) and be their eyes and legs. Knowledgeable and professional care managers are doing the groundwork, navigating the health care systems, identifying resources and helping the attorneys to make an informed choice once they know the options available. I believe this is of great assistance and through continued education we are seeing more and more proactive individuals getting their important paperwork in place and feeling confident about their futures.