The Price

Every now and then I am reminded about what is essential in our elder law practice.  I so often get lost in the technicalities of legal work that I sometimes forget what may be my most important role.  That role I believe is to share my experiences with our clients about what other families have done when faced with the decline in health of a family member.  What I often discuss with caregivers is that their problems are not unique to them but are universal.   Many new clients come to me with a sense that their story is unusual or unique and that it may be too difficult to even address.   A story in this months’ issue of Time magazine was incredibly powerful and a reminder to me that I, as an elder law attorney, have a unique role when brought in to assist a family in transition. The times story concerned the author’s failed attempts to assist her sibling in caring for a ailing parent.  The story reminded me of my own family and of the families that I see daily. See So who helps mom?
Just this week I talked with a daughter who felt the need to tell me that her elderly mother’s loss of weight was not the fault of her or of her sister.   She explained that she lived in another state, a thousand miles away but kept in constant contact.  Her sister, who had nine (9) children of her own, not only took care of her kids but looked after her mother.  Her mother lived alone but they not only helped her themselves but chose what they felt was a good aide.  They never touched mom’s money unless it was for mom.  Despite their good intentions, mom had the invariable problems that illness and aging bring.  There were minor injuries and a few ambulance calls.   A “helpful” friend thought that the aide was not providing good care and, rather than talking to the daughters, reported the case to the Area Agency on Aging.  The Agency visited and found nothing wrong.  They asked for an application to be signed so that the family could get “help.”  The aide, who was quickly losing the ability and skill to keep up with mom’s condition was let go.   Mom was admitted to a respite facility to enable the daughters to find another caregiver.

Mom never wanted to go to a nursing home.  Her daughters promised her that she wouldn’t.  They were doing their best to keep their promise.  Mom’s attorney and friend couldn’t intervene due to his own age and retirement.  The respite social worker was asking questions.  How did this happen?   Did you supervise the caretaker?   Your mom is too thin?  Your mother shouldn’t go home.  She should be in a nursing home.  If you don’t cooperate, you could be liable.  They called me in desperation.   What can we do?  We have a Power of Attorney.  Can we take her home?   Are we in trouble?  Can we really be held liable for this?

I gave them the advice that I often give – “believe it or not this all is pretty normal and we see it all the time.”    They were aware that what they were doing was not an easy task but they were not aware of how common their problems were.   The care of an aging parent is difficult if not impossible.   There are plenty of people who will be there to second guess if something goes wrong.  I tell people that the kids or caregivers who come to my office always have good intentions.  Every one of them feels the need to explain that they don’t care about money.  They care about their parent.  They all are conflicted about intervening.  They want mom to have her dignity and her independence.  In many cases, they themselves are hampered and cannot see the reality of the situation.  They do not want to lose mom or dad or their family.  There is often a caregiver child living with mom or dad or near their home and there are often kids who move away.   I tell them about my own mother and my own sister and how difficult it was not to be nearby and the price I still pay for not being there.  I still have conflicts about it.

When I was in college we watched the play “The Price” by Arthur Miller in Family Psychology class.   The play had a significant impact on me since my own father had recently died.   The play is about two brothers coming together to clean up their father’s home after his death.  One brother was a caretaker who stayed at home.  He was a policeman and struggled financially.  He cared for his father but felt he had missed some opportunities that he might have taken if not for his commitment to his father.  The other brother left home early, attended medical school and became a successful doctor and owner of several nursing homes.  One lost the opportunity to be in his father’s life.   The other lost his independence and the ability to claim his professional and financial goals.   Both paid a price for their choices and both were conflicted about it.

I tell this story to my caretaker clients to help them to try and unite and work together for the care of a loved one.   Whether you stay or go, you are to a certain extent, built and ultimately perhaps, limited by your particular role in your family.  I remind our caretakers that this may be the most difficult family event they will ever face.  I tell them that it is faced by almost all families.  If I am speaking to the one who stayed, I tell them not to assume that a sibling who is far away does not care.   I tell them about our experiences with caretakers who are far from home.  We see conflict and guilt and therefore a certain level of defensiveness about discussions about care.   A casual question from an interviewer from Department of Aging becomes an accusation.   An innocent application becomes an admission of failure.   I tell them that this is normal, it happens all the time.  And money, this is the most volatile of topics.  I sometimes joke that I am going to hang a sign in my office that says “I know you are not doing it for the money.”  That is how “normal” it is to have these conflicts.  I told my new client with the thin mother that what she and her sister were doing was not only appropriate but bordering on heroic.  It is easy to focus on the failings and ignore the accomplishments.  It is hard to intervene in a parent’s life without feeling that you are imposing.   And most time the parent fights intervention because they themselves are afraid of admitting defeat.  Although, once they do they usually relax greatly and do better because they don’t have to “fake-it” anymore.

There is no road map, but the children who take the time to seek our counsel are showing that they are working to understand what is needed and what is proper.  The kids who abuse their parents and run off with their money never come to our office.   We have seen hundreds of families.  We have seen many in tough circumstances and look to help them with perspective by telling them what other families have done.  We often know when a course of action will actually hurt rather than help a situation.  I often tell our new clients that they can relax.  That is what I told the sisters.  You are doing the right thing.   It is not easy.  Don’t be too defensive.  Work together.  Keep communication open.   Let everyone know what is happening.  Surprises are not good.  There will be problems. You will be questioned.  You know your mom and you are trying to do what is best for her.   It’s normal, relax.   It’s the price we pay for being in a family.