An End-of-Life Conversation at 29


by Janet Simpson Benvenuti

2020 was supposed to be a banner year. My son was getting married at the end of May; the logistics of planning a destination wedding in Sedona, Arizona had been an all-consuming adventure for his fiance and their friends. As the mother of the groom, I had little to do, and yet he found ways for just the two of us to share this journey together. First, came a call 18 months ago and two trips in secret to our favorite jewelers to pick out a diamond so he could surprise her with a proposal and an engagement party at their favorite restaurant. More recently, he arranged a meetup to select material for the custom suit in which he’ll be married. By February, the planning was finished, with celebrations ahead in three states with his large extended family.

Then, the coronavirus struck. Plans were cancelled, celebrations postponed and, one Sunday, I found myself having a conversation with him that would have been unthinkable a few months ago.

The topic? My end-of-life game plan.

Five years ago, my husband and I updated our estate plan and, more recently, we shifted the responsibilities for handling our finances and health care decisions, if we both are incapacitated, to our two children. It seemed the right time to make the change; they’re in their twenties and we’re about 25-35 years away from our statistical expiration dates.

As viral infections spread, I allowed myself to consider what would happen if both my husband and I were ill, intubated in the hospital, unable to communicate our healthcare wishes or pay our bills. I then did three things:

1. Find Health Care Proxy, HIPAA Authorization and Durable Power of Attorney. I printed copies of our medical and financial powers of attorney and inserted them into a plastic sleeve, like one finds at Staples. I transferred copies of those documents onto a flash drive.
2. Provide Explicit Guidance for the Healthcare Agent and Financial Power of Attorney. I wrote a one page cover letter with specific instructions on how to manage our healthcare issues that included the cell numbers of physicians in the family and contacts at the hospital where we’ll likely be situated. I included how to pay our bills along with the names and contact information for our financial advisor, tax accountant and attorney, and the password to access my computer.
3. Cue up Relevant Advisors to Handle the Situation. I called our financial advisor (who knows all about our financial matters) and gave him our children’s emails and cell information along with specific instructions (in writing) to proactively reach out to them should we become ill.

Then, I invited my son and his fiance over for dinner. Over dessert and coffee, I pulled out a manila file folder. “Although this is unlikely to happen,” I began, I handed him the folder that contained the instructions, our healthy care proxies, HIPAA authorization forms and financial powers of attorney. His fiance sat silently at the table as I talked, later acknowledging that she recently had had a similar conversation with her parents.

After dinner, as my son prepared to leave, manila folder and flash drive in hand, we stood alone in the garage waiting for his dog to run her final laps before their car ride home. “Thanks for having our backs,” I said quietly, out of earshot of his father and fiance. “No problem,” he replied. I nodded and continued, “By the way, there’s a second plastic sleeve in that folder that holds your healthcare proxy. If you go to the hospital, just grab it. I’m your healthcare agent and the admitting physicians will want to see that. I’ll handle your bills, too. Don’t worry.” He nodded silently and reached out to gently rub my back.

The unthinkable is not that his father or I might become infected with the coronavirus and die, although we have no known underlying health conditions that put us at risk. The unthinkable is that he might, too, and in a year that was supposed to be one of joy and a new beginning, this was the last conversation I expected to be having with him.

We’re in the midst of a pandemic, not the flu. Don’t live in denial. Play the “what if” scenarios and tell your family what they need to know.

Since that evening, I’ve slept well, knowing that I’ve done all I can to anticipate the future, whatever may happen. My family and I can now just focus on helping others navigate this challenging time and get back to planning a wedding.

Keep well.

Circle of Life Partners, LLC. All rights reserved.

If You Are Hospitalized During the State of Emergency

by Janet Simpson Benvenuti

The COVID-19 virus has upended all of our lives, none more so than infected family members who need hospitalization. Recently, I asked attorney Alexis Levitt if I could circulate her advice to clients about being hospitalized during this state of emergency. As you know, visitors are not allowed to accompany patients into hospital settings.

Here are her suggestions in how to prepare for that possibility. I’ve added a couple of notations in italics and wrote a separate post about how I prepared my family. As we know, it’s not sufficient to follow this advice; we also need to talk with our family, especially our healthcare agent and financial power of attorney.

From Attorney Levitt,

I hope you are all staying home (unless you are an essential worker). I want to share some important points to keep in mind if you are hospitalized during the state of emergency. These apply whether you are hospitalized for COVID-19 specifically, or for any other reason.

1. Keep your Health Care Proxy, HIPAA Statement, and Medication List at your fingertips.

(a) If you are a client of ours, then we enrolled you in DocuBank. Take five minutes now to update your medication list. (Really. Five minutes. I updated mine recently, it was very easy.) If you do not use DocuBank, print out hard copies and put them into a plastic sleeve or envelope.

(b) Keep copies on your phone. You can save the documents to your Google Drive, you can simply keep them attached to an email, whatever you like, so long as they are accessible to you on your phone.

(c) Keep copies on the back of your front door or on your refrigerator. Many first responders will look in these places for emergency medical papers.

2. Advocate to be coded as “inpatient” rather than “under observation.” If you are in the hospital and then transferred to a rehab, how you were coded at the hospital will make a big difference in payment source for the rehab stay.

3. If you are transferred to rehab and told that you will be paying privately, call us (your attorney). Under the State of Emergency, some of the usual coverage triggers for payment for rehab have changed. Nursing home billing offices could be – quite understandably – overwhelmed and perhaps not updated on the temporary changes. We can help.

4. Call us (your attorney) if you need a guardianship or conservatorship. For anyone who has not signed a health care proxy or a power of attorney, the hospital (or rehab) may tell you that you need a guardian or conservator. This is a court proceeding handled by an attorney.

(a) It’s possible that the hospital or rehab attorney will handle the guardianship and/or conservatorship for you, for free. If that is the case, be sure to check in with them as to who they are naming to act as the guardian or conservator, and, if you are not happy with their choice, advocate for naming someone you prefer.

(b) If the hospital or rehab tells you that you need to find your own attorney (or if you are not comfortable using their attorney), then please call our office. This is something that we can handle for you.

Reprinted with permission.

Phone Scams: Social Security, Grandchildren & Donations

by Janet Simpson Benvenuti

While we’re all distracted by the coronavirus, here’s a gentle warning to remind your now housebound parents and grandparents about telephone scams. Recently the National Council on Aging reported the top three telephone scams for elders:

Social Security Spoofing Calls. In this scam, the caller may spoof the SSI hotline so caller ID looks legitimate, and then either threaten the listener or ask for help activating a suspended social security number. During the pandemic, Social Security is continuing to issue checks despite scammers indicating otherwise. Here’s the link from the SSI and guidance from Consumer Reports about what to do if you receive one of these calls.

The Grandparent Scam. In this scam, the caller indicates they’re a grandchild in an accident or legal trouble and ask for cash or gift cards.

Donations following Natural Disasters. This scam takes advantage of donations that follow a natural disaster – or a pandemic – with the caller impersonating charities asking for money or, if the listener is in the area impacted, offering help.

If your family wants to donate to organizations during this time of crisis, use a site like Charity Navigator to check on their validity.

Another scam reported recently is one offering a free coronavirus test kit for Tricare and Medicare beneficiaries. Concerned families should check with their physician for testing.

Many elders already avoid answering their telephones from unknown callers. I asked a class full of tech-savvy business leaders for guidance on how best to block access from telemarketers and spammers. Two companies were mentioned: Ooma, a home phone service that provides multiple ways to block spam calls and Nomorobo although online reviews have been mixed. I’ve attached a useful video from The Verge about robocalls and how to stop them.

Share what works for you and your family.

Family Caregiver Resources Regarding the Coronavirus

by Janet Simpson Benvenuti

The recent outbreak of the coronavirus reminds us how interconnected we are globally and the importance of protecting our most vulnerable family members and friends. We encourage you to follow the guidance of the Centers for Disease Control about hand washing and preventative actions and listen to the news for updates in your local community.

If you are able, reach out to your older neighbors and offer to grocery shop for them. Many elders do not use delivery services like Instacart and may be uncomfortable risking exposure to the virus by shopping.

For updates about the coronavirus globally, healthcare and other professionals find the Johns Hopkins Center for Health Security trustworthy. You can register for their daily updates here.

Listen to geriatrician Dr. Leslie Kernisan’s podcast about the coronavirus and how best to protect our aging parents and ourselves.

Read the AARP’s guidance about limiting access to assisted living and skilled nursing homes.

Join the private Facebook group Working Daughter where you’ll find emotional support from thousands of women and men who are supporting their aging parents.

Together, we’ll navigate this journey. You’re not alone.

The Guide to Long-Term Care Insurance

by Tobe Gerard, CLTC, MBA, MLS, LIA

We believe that the best all around consumer guide for long-term care insurance that is not state specific is A Shopper’s Guide to Long-Term Care Insurance. Unfortunately, it is not updated every year so we are extremely excited that it has just been updated for 2019 and is now available. This consumer-friendly guide was written and published by the National Association of Insurance Commissioners. We hope that you will find it valuable. Use it as a starting point for the conversation about long-term care and long-term care insurance with your financial planner or insurance agent.

For context, a study of 200,000 claims by PricewaterhouseCoopers found the current average cost of long-term care services is $172,000 for a person who needs assistance with at least two activities of daily living or has some cognitive impairment.

Since 2000, Tobe has committed her professional life to helping people manage the risk of needing long-term care.

Reprinted with permission.

Are you a Working Daughter?


by Janet Simpson Benvenuti

Recently I met for lunch with Liz O’Donnell to discuss her latest book entitled Working Daughter, A Guide to Caring for Your Aging Parents While Making a Living. Liz is a marketing executive who suddenly found herself caring for two parents who were diagnosed with terminal illnesses on the same day. Juggling the demands of a full time job and two young children, Liz turned her experience into a poignant story full of humor, encouragement and practical guidance. Intent to help the readers overcome “insomnia-induced, middle-of-the-night Google searches,” Liz weaves her personal story with clear advice that will help working daughters and sons navigate the practical challenges of supporting aging parents while acknowledging the emotional, and potentially negative, impact on relationships, health, and careers. Among the pages you’ll discover,
1. How to identify the warning signs that there is a problem;
2. Fifty things family caregivers can do to practice self care;
3. Strategies for setting boundaries & communicating with parents, siblings & spouses;
4. Senior living options and how to transition parents to a new home;
5. The Working Daughter Bill of Rights.

To better support women balancing eldercare and career, Liz founded WorkingDaughter.com and oversees a private Facebook group of women and men supporting their aging parents. Order the book and if you, or anyone you know, is juggling work and parents, invite them to join the Facebook group; it’s like being online with 2,500 non-judgmental sisters. You’ll laugh, cry, vent, and get advice on topics ranging from the best underwear for incontinence to how to find decent home care or assisted living communities. You may also enjoy the Working Daughter podcasts.

Author Virginia Morris sums up Working Daughter best. “Women might be able to shoulder both work and motherhood, but throw an elderly parent’s care into the mix, and these mighty women can collapse into a heap of wine, cheese dip, and tissues. Liz gives them guidance on how to accept their fates, manage the mess, and find some joy in the moment.”

Enjoy. And thanks, Liz, for enabling us all to learn from your experience.

Advice from an Experienced Family Caregiver

by Janet Simpson Benvenuti

Recently, I spoke with Elizabeth Barge, Norfolk, VA, to glean her insights about caring for aging parents. Elizabeth has spent the last five years supporting the needs of five elders – her parents, step-father and in-laws – in a family of nine siblings in a blended family of adults, a situation that would overwhelm most of us.

Here are her five insights.

First, focus on doing THE NEXT RIGHT THING. This will keep you from being overwhelmed; doing the next right thing will always result in forward progress.

Second, start laying the foundation BEFORE you have to act on it. For example, she called and asked the director of the assisted living facility where her parents were living if she needed to start looking for Memory Care. The director answered an emphatic YES, so she started looking for Memory Care centers close to her home in May. When her parents needed to move from the assisted living facility in September, she was ready.

Third, be conciliatory toward siblings and step-siblings. Sometimes they just want to know someone heard and maybe considered their point of view.

Fourth, accept that you can only work with what you have, therefore NO GUILT. If parents are too private about their affairs and not willing to allow adult children in as confidants, then when the mind goes, said adult children can only do the best they can with the information they DO have. When you do the best you can with what you have, there is NO GUILT.

Finally, the opinion of the guy/gal who does the hands on care for parents gets the MOST weight. Period. In her case, the other eight siblings and the spouses accepted that and thanked her at her step-father’s funeral for taking such good care of him. “In baseball vernacular,” she said, “I was the closer.”

Elizabeth is what I often call the ‘designated child’, the one who does most of the hands-on care for parents. If you’re that adult child in your family, remember that you’re not alone. I hope that you find Elizabeth’s words of wisdom helpful, that you focus on the next thing, without guilt, and that, in the end, your relationships with your family, spouses, partners and siblings deepen knowing that you did the best you could.

Thank you, Elizabeth, for sharing your insights with us.

Where do I find help for Aging Parents?

by Janet Simpson Benvenuti

The scenarios are all too common. A worried daughter lives in Chicago; her aging parents reside in Florida. A son works on the west coast while his widowed mom lives in Virginia. How do adult children find support for their aging parents when they need assistance? Many families elect to find a local professional care manager to help them and their parents navigate the elder care system.

How do you find a competent professional care manager? In five simple steps.

Step 1. Check with your employee benefits group to see if your Employee Assistance program provides help from professional care managers.

Step 2. Get names from the professionals in your parents’ lives. Specifically, ask their physician, attorney and financial advisor for names of local care managers. For example, many elder law attorneys have relationships with professional care managers.

Step 3. Reach out to your parents’ local Council on Aging. Speak with the director or the nurse or social worker on staff. Ask them to recommend a local professional care manager.

Step 4. Search for professionals using one of three national organizations: the Aging Life Care Association, the National Association of Healthcare Advocacy Consultants and the Alliance of Professional Health Advocates.

Step 5. Interview prospective care managers. Email info@colpartners.com for a copy of our interview guide.

The chemistry between your parents and the person whom you’ve entrusted to support them is key to a successful journey together.

Finding the right care manager can take time, but the benefit is having a professional who can provide care advice and information about available community resources over the duration of time your parents need support.

Post any thoughts or questions below.

Food for Healthy Aging

by Janet Simpson Benvenuti

Earlier this summer, leaders in the food service industry met for their Menus of Change annual summit at the Culinary Institute of America’s Hyde Park campus.

Among their initiatives are to show that “changing menus is a powerful, and previously underappreciated, way to drive improvements in our health” and to make “plant-forward” dining mainstream. Plant-forward is a style of cooking and eating “that emphasizes and celebrates…plant-based foods including fruits and vegetables; whole grains; beans, legumes and soy foods; nuts and seeds; plant oils; and herbs and spices.”

These diets are not only good for our health but also for the health of the planet. So, your mother was right, eat your vegetables and get at least some of your protein from beans and legumes instead of meat. Here is an infographic that makes it easy to create a plant-forward diet Principles for Healthy Meals along with a recipe for lentil soup you may enjoy.

$10 LifeTime Pass to U.S. National Parks

Buy a Pass before August 28, 2017
$10 LifeTime Pass to National Parks

Do you know that anyone 62 and older can get a Life Time Pass to all U.S. National Parks for just $10?

If you, your parents or grand parents love to travel and enjoy the beauty of our National Parks, order a pass before August 28, 2017 when the fee increases to $80.

Here’s a complete list of all American National Parks and Forests.

A Few More Details:
Annual and lifetime Senior Passes provide access to more than 2,000 recreation sites. The passes cover entrance and standard amenity (day-use) recreation fees and provide discounts on some expanded amenity recreation fees. Traveling companions can also enter for free. The Senior Passes admit pass owner/s and up to three adult passengers in a noncommercial vehicle. Children under 16 are always admitted free. Also, at many sites, the Senior Passes provide the pass owner (only) a discount on Expanded Amenity Fees such as camping, swimming, boat launching, and guided tours.

How can I purchase a Senior Pass?
Senior Passes can be purchased at any federal recreation site, including national parks, that charges an entrance or standard amenity (day-use) fee. Proof of age and residency is required. Passes can also be purchased online or through the mail from USGS; an additional $10 processing fee will be added to the price.

Happy Trails!