Modern Family Matters

How to Talk About End-of-Life Care with Your Parents

December 20, 2022 with Janice Goldmintz Season 1 Episode 75
Modern Family Matters
How to Talk About End-of-Life Care with Your Parents
Show Notes Transcript

We sit down with Aging Advisor, Janice Goldmintz, to discuss how adult children can approach the conversation of end-of-life care with their aging parents. In this interview, Janice covers the following:

  • Key conversations and considerations to have early on as a family 
  • Important documents that are needed to ease aging and end of life concerns.
  • The reason behind families avoiding these important conversations 
  • How a health directive explaining preferences for end-of-life care is a gift, not a burden, to children.
  • Tools and resources for you to navigate your aging and the aging of your loved ones.
  • Finding professional help to facilitate family meetings and create plans for long term needs.
  • Where to find information on aging concerns.
  • …and much more!


If you would like to speak with one of our family law attorneys, please call our office at (503) 227-0200, or visit our website at https://www.pacificcascadelegal.com/

If you're interested in getting in touch with Janice, you can do so by visiting her website: https://www.talkaboutaging.com/

Disclaimer: Nothing in this communication is intended to provide legal advice nor does it constitute a client-attorney relationship, therefore you should not interpret the contents as such.

Intro:
Welcome to Modern Family Matters, a podcast devoted to exploring family law topics that matter most to you. Covering a wide range of legal, personal, and family law matters, with expert analysis from skilled attorneys and professional guests, we hope that our podcast provides answers, clarity, and guidance towards a better tomorrow for you and your family. Here's your host, Steve Altishin.

Steve Altishin  0:32  
Hi, everyone. I'm Steve Altishin, Director of Client Partnerships here at Pacific Cascade Legal, and today, we have Aging Advisor, Janice Goldmintz, to talk about how adult children can approach the conversation of end of life care with their aging parents. Hey, Janice, how you doing?

Janice Goldmintz  0:51  
I'm great. How are you, Steve?

Steve Altishin  0:53  
I'm doing well today. Before we start, can you just kind of talk a little bit about yourself,  and how you got to be doing this stuff? 

Janice Goldmintz  1:01  
Sure. So my background is in gerontology. I have a Master's of Science in gerontology, which is just the Study of Aging. And I think that I got probably just as much information from being the adult child of aging parents, and that practical journey that I was on with my mom, and now am on with my dad. So I bring academic and personal experience to it. And I came to it because I remember my grandmother, who was just about my age, which is kind of scary to think about this, was already in a nursing home. And this nursing home environment was so not nice. The only way I can put it, these people were warehouse, they were sitting in their wheelchairs around a nurse's desk. And I thought I don't want my parents to ever go through that. So I think that was always in the back of my mind that there was something that I wanted to be able to do. And I was brought to this path. And, you know, I really love advocating for our older adults.

Steve Altishin  2:07  
I love it. And, you know, I would like to say, Oh, this is gonna be fun, but maybe not necessarily. Because like you said, this can be a tough conversation. I have to let you know that last night, I was talking to my wife about doing this topic. And you know, we kind of looked at each other and went, Well, we're dreading this for us. So you know, I can really understand the reluctance. But can you give us some insight, just a little furthermore, as to why these family discussions don't happen?

Janice Goldmintz  2:41  
Well, there are a couple of things, if you look at it on on the side of the children, they're watching their parents who have been their parents all their life, that may be experiencing challenges. And that's hard to watch. You know, we think our parents are gonna live forever, and they're invincible. And then this kind of reality starts to set in, and you have to start looking and going, Wow, I see things happening. What is that going to mean to them? What is it going to mean to me? So I think on the kids side, that that is the beginnings of the hesitation, oh, I don't want to acknowledge it, or no, they're okay, they're okay. Or however that pans out. And then on the parents side, they have the opposite. Well, I've been the parent all these years, I have to continue on in my parental role, I don't want to ask for help from my kids. I don't want to acknowledge that that rule may reverse or change. And I don't want to burden my children with, you know, anything that might be happening. So it's like, neither one wants to burden the other or talk about it, because people think if you talk about it, it's going to make it more real. And you know, we know that's not the truth of it. 

Steve Altishin  3:55  
Yeah. But there are challenges, aren't there, just like, for the children, you know, the one I just think of off the top of my head is where the parent is and where the kid is, they may not even be in the same city. And there has got to be various challenges that they have to kind of figure through.

Janice Goldmintz  4:16  
Yeah, so that definitely is one of them. You know, you may have two or three children, one lives in the same location as the parents and the other ones don't. So how do you navigate who does what? Because you don't want the child that is in the same vicinity to feel like, oh, I have all of the burden. And my siblings are, you know, almost lucky, they don't have to do this. Or you have the ones that live out of town that feel guilty that they're not there to help. So there's all of that dynamic. Then if you're the only child, you may feel like it's all on you. Or if you have siblings and one sibling says, well, mum and dad, you know should live with one of us. No, no, no, I think they should go to a retirement residence. No, no, no, we'll bring help in, or we'll do this or that or the other. So getting family accord for what you want to have planned for the future can be also very challenging if you have many different opinions about what to do.

Steve Altishin  5:18  
Oh, yeah, I know, we had some friends who were sort of thinking they were being forced into this situation, and they had kids. And it was like, I'm kind of in the middle now of raising my own kids, and now I've got my parents, and that can be a struggle.

Janice Goldmintz  5:36  
Yeah. And if you think about the age that people are having children, if you had your children in your late 30s, it's likely that your kids may be high school age, maybe university age, and then you've got aging parents. You're still in their lives, you're still part of what of what's going on with your kids, you want to have hands on. But now you've got this other element of your parents needing you and where do you go first? And who do you take care of first? And it's going to become more challenging, because people did have kids later, and people are living longer. So that sandwich generation is going to definitely be part of your experience.

Steve Altishin  6:19  
It could be cultural. 

Janice Goldmintz  6:20  
I mean, there could be that for sure. 

Steve Altishin  6:22  
Yeah, absolutely. So when to talk? You know, I was kind of talking, we were talking before, you know, well I'm in my 60s. I mean, I don't have to do it, do I? And so it's like, you know, when is it time? When do you start wanting to bring it up?

Janice Goldmintz  6:43  
I think, you know, 60s is a really good age, because for most of us, we're, and I'm in my 60s, healthy. And I think that when we're healthy is the time to have to say, hey, you know what, everything's great now, but just if something should happen, I want you to be aware, I want to have my powers of attorney selected so that I can do that and ask around. Is that okay? Would you like to do that? You know, is that okay with you? That gives you lots of time to do that. It gives you lots of time to think about what you might want for yourself, when you're older, it might be time to think about, Hey, these are the investments I have, this is the insurances I have, or I don't have these, this is how I would like you to take my resources and use them. Because I think you can have those conversations in a sort of non threatening kind of a format because everything's good. And you can get everything on paper, have a file or whatever it is that you need. And as long as people know where that is, it gives a chance for siblings to sit down with each other if they want, aside from their parents who say, wow, you know, this is what I'm capable of doing today. We can look at it again in five years and another five years, but at least we have a plan in place for today. Because who knows, nobody knows. So I think that there's no perfect time. But I think when people are healthy is the best time to start. Because then it also gives an opening for when things are not maybe you know, things are starting to happen, challenges. You've already got a background and format and you go, okay, yeah, I know, you know, if something happens drastic and I need to know when my parent wants resuscitation and ventilation. Oh, I know. Here it is. Here's the Living Will, here's the power of attorney. I've got it. We're good to go. So I think this is a good age.

Steve Altishin  8:49  
That makes total sense. It's like, you know, you don't plan for your kids college education as you're taking them to college. And so we've always told our kids to, you know, plan ahead,  look for all your stuff, make sure you've got your phone and your ID at your desk before you go to the airport. So you've sort of got to pre-plan. But, do you need everyone there?

Janice Goldmintz  9:23  
Do you need everyone now? I would say that the more people who are the key players, the better. And it doesn't necessarily have to only be your children. It can be your grandchildren. It can be friends of the family. It can be, you know, what if you don't have children, and you want to have somebody who might be involved in your care? It could be friends, it could be anybody who you think you would want to depend on in the case where you can't speak for yourself. So you know, if you have a child that doesn't want to be part of the conversation, you have to honor that too, you know? You can't force somebody to the table because you're not going to get the answers that you want. But I do believe that the more key players that you get that are hearing it together, that are strategizing together, that are putting in their thoughts, the better the plan that's going to be and the easier for it to be executed.

Steve Altishin  10:25  
If I were to come to you and say something like, you know, I want to start this conversation, either with my parents or I come to you, and I say, want to start this conversation with my kids. I mean, how does that happen? I mean, you know, other other kind of ways you can start that discussion from either side?

Janice Goldmintz  10:44  
I think so I think that it's if your goal, which should be no matter who you are, your goal is the highest quality of life for everybody. So it's not just the kids saying, Well, I'm going to tell you what to do. And that's what we're going to do, or the parents saying, This is what we're going to do, it's an opportunity to sit down as a family, I'm just going to call it a family at this point, to say, hey, you know what, I've been thinking about this. And I know and acknowledging in the beginning, I know this isn't going to be the most comfortable or uplifting of conversations. But let's do it. Now let's do it. When we all are on the same page, we all can have an input. And this doesn't have to be a one and done, we can take little chunks, however you're comfortable, and do it that way. But I think let's start this conversation and see where we're at. Because that's the starting point is to say, here's where we are today. I'm healthy, I'm good. You know, everything's great. I've got, you know, my life is is going along great and swimmingly. But who knows what's gonna happen tomorrow? So let's have a plan.

Steve Altishin  11:54  
Yep. Yeah. So that kind of leads into, you know, what do we talk about? There's so many. There's financial stuff, there's health stuff, they're just sort of living arrangements of there's so many things you can talk about? Or what do we talk about in this country? What do we mean by preparing aging and end of life care.

Janice Goldmintz  12:18  
So I would say that the first thing is to have a file setup for the parents that has the lawyers, and it's, again, it's the present day, that can change over time, but at least you have today's the lawyer, the accountant, the banking information, the investments, the safety deposit boxes, where's my will, whatever you have, properties that you have deeds to, just so that everything is centralized, and everybody knows that if something should happen, I can go and grab this file, or this stick or whatever. And I'm going to actually say it should be a file, because technology is changing. So if you had something on a floppy disk, you wouldn't be able to use it right? Or on a hard disk, or even on a CD, very few computers anymore have CDs. So we have these little flash drives. You know what? That could be replaced. But when you have physical paper, it doesn't. It doesn't disintegrate. 

Steve Altishin  13:18  
That's true. I was just gonna say, you know, passwords change. Every month and a half I get something from, you know, the bank saying hey change your passwords. I mean, yeah, just stuff like that. You need to know, it seems like,.

Janice Goldmintz  13:32  
Yes. So I think you know, what people would call "old school" works the best in this situation, have a physical copy? If you want to have it on a flash drive, or whatever, as well, great. But look at that every few years to say, okay, is this still the right technology to have this thing on? So I think that that's the beginning. Let's start with with the easy stuff, because that's easy, then you can start to talk about, well, if I was, you know, incapacitated, or I had mobility issues, where would I want to live? What would I want? And again, that's today, in five years from now, 10 years from now, 15 years from now, you may change your mind, because now you're living it. And you might have thought you would want one thing and in fact, you want something else. The number of people who have said to me, they'll take me out of my house in a pine box, who ended up in retirement residences. There's a lot of them, because when they said they'll take me out in a pine box, their health was good. They didn't realize the challenges they were facing. And as they saw that, you know what, really, this is not the best. Oh, I've got stairs. I can't get up and down my stairs. Oh, if I stay in my home, I'm socially isolated. I don't want that. So going through that situation may change and having an open mind and open plan is also going to be helpful. But getting it down for today. It's you know, Better, better, you know, greater than perfect.

Steve Altishin  15:03  
So you have something as the parent, and maybe I guess the shake, you know, too little hold it, I want to tell you about my values, you know, what I what I think is important,  philosophically or just in general, is that a relevant conversation to have?

Janice Goldmintz  15:25  
100%, because the truth is, as a child, I may want something from my parent. You know, I may want them to live forever. But as the parent, they may say, Look, I know if I'm in this situation where I would be on a ventilator, and that was the only way I could survive, I wouldn't want and I would want you to disconnect, you have to go with the value of the person who is going to be receiving the care. And the opposite way to, you know, if somebody feels like, you know, due to their beliefs, their religious beliefs, or whatever, you know, I don't want to discontinue any kind of treatment, I want everything you can give me because when God is ready for me, God will take me and yet the child is thinking, I don't want to see my parents suffer, what if they're suffering? Can I let them suffer? Because that's what they want. It is a hard distinction. But really, you have to go by what the person whose care, it's going to, you know, who's going to be receiving the care, you have to go by their values. And I think that that's also another reason why this is important. Because you don't want to be faced with a situation of an emergency. And you think, Oh, I don't know, I we've never had this conversation. Would they want to be on a ventilator? Would they want to DNR? I don't know, what do you think, what do you think, this way you can say here, I don't even have to make the decision. Here's the decision that that person already made. It's not for me to make, there you go. It takes that that pressure off of whoever is the one who has to make those decisions if the decision is already made? 

Steve Altishin  17:01  
Yeah, yeah. We there's an attorney in our office. So I was talking to her about what we were doing. And she was in that situation with her mom, she said, and you know, that they're, they're actually making that decision. And I did AdvanceTrac to them telling what they want, you know, turned out to be a gift. You know, because it wasn't, you know, oh, God, I have to decide whether to do this. I've, I'm following what they really wanted to do. Yeah, makes it a lot easier. What about the sort of support network around the parents? I imagine, especially as you get older, you get more? Do they get involved in this? Or do the children talk to them? Or, you know, do they fit into this conversation.

Janice Goldmintz  17:47  
So I think that health professionals really can be very instrumental. Because sometimes people will listen to their health professional more than their child. And, you know, they're the expert. So sometimes engaging a health professional, like, let's say, you think that your parents shouldn't be driving anymore. For you to say, Mom or Dad, I don't think you should be driving as one thing. When a doctor or a nurse practitioner says you shouldn't be driving, they'll listen or the or, you know, the Department of Transportation or whoever it is that they see as the expert would be alive. Not that it would be easier for them not to drive, but to take that on, as opposed to a child saying you shouldn't be driving. Also, in terms of the health issues, if you're not well versed in some of them, bringing in a health provider can give you answers to what is this going to look like? How is this going to play out? How is this going to affect my parent? How is it going to affect our life as a family? Sometimes having that information can also help you make better decisions? Now, certain things like dementia, in every single person, it's different. So you can't there's no, there's no script. But at least if you have resources, you can go to the Alzheimer's Society and they'll give you a lot of information if that's what it is, Heart and Stroke will give you a lot of information. diabeetus will give you a lot of information so that you feel like you have what you need to make informed decisions. That you're not just Googling Google said but you know, again, I think that bringing people in in terms of the legalities for sure go to your lawyer, find out what do you need to have for a power of attorney a Living Will your your you know your your will or whatever else it is that you need? get legal advice. If you have questions about your financial situation, your investments, whatever, go to your financial advisor, get all of the the people who are supporting you To, you know, to live the life that you're living, to have it all together so that when you're sitting down and saying, Well, no, I think in five years, when I'm retired, I'm going to have this pension. So I will have this money coming in, or I'll have this investment income, or I'm going to lose this income. If you're not 100% sure of what that is, gather that information, and then have it. You know, at a meeting, as I said, it doesn't have to be one and done. You could have a number of different segments to that meeting.

Steve Altishin  20:34  
Yeah, yeah. Oh, that's what I was thinking, as you're talking this is, this is probably not a single conversation. Ongoing one? And is, is it common? Do you see or? Or that? Or should it be, I don't know that that one of the children sort of becomes the point person, because you talk about all these things to have and to know, and they change, and it can be too many cooks spoil the pot of all the kids are trying to do it?

Janice Goldmintz  21:09  
Yes. So one of the things that I think is important is for the siblings, if there's more than one child to sit down and say, What do you feel most comfortable? Are you more comfortable with the healthcare? Are you more comfortable with the property side? Are you comfortable making appointments and going to appointment? Are you comfortable, looking at the finances, whatever, whatever that is. And if you can come to an agreement, that's the best scenario to say, this is what I'm going to do this I'm going to do and everybody's comfortable. And that the person that is doing the hands on care will say, has the ability to say to the other siblings, you know what, I need a break, now I've been doing it, I need a break, I need one to do to step in. So I can go on vacation, or I can do whatever it is. So again, it's asking for what you need. And having everybody realize that, again, this is today's plan, I may need help, I may have to switch, I may need to do something else. The other thing is in terms of health care, a lot of places only want one point of contact, they don't want to have to wait for three people. So that's one thing that I learned in terms of power of attorney is that you have a choice of saying, Joe and Mary, or Joe or Mary. And it's really important to have that distinction. If you want to have everybody's input, then use the words and but if it's okay, if you trust each other, and let's say somebody is living out of town, and and you have the one child that's living in town, and you trust that child to make those decisions, and if you have or than any, any one person can make those decisions. And I think that's an important thing to speak about within your family. 

Steve Altishin  23:04  
Yeah, it reminds me I used to do some stuff with with healthcare and the one of the things that that people don't know is that HIPAA does not just allow doctors are insurance companies to talk to the kid just because they're the kid and they need to get it they need to get a in writing that they're allowed to even know what the insurance covers. Right? Yeah. So that kind of leads to you. As as an aging advisor, how do you get involved if I can do it? I say, Okay, here's the problem, my sister doing them, but brothers, don't let my mom and dad run on that. And we just can't seem to get going here or we started and now we don't know how to finish it. And where do you come in?

Janice Goldmintz  23:53  
So what I can help with is facilitation. Because again, when you have an objective third party who has I have no agenda, I don't, I'm not going to tell you your plan is good. Your plan is bad. If it's your plan, and it works. So the idea is to have a third person or an objective party come in and say all right, what do you think? What do you think? What do you think? With no filter and just get everything down? Get everything on paper? And find out? What is it that you agree on? What is it that you don't agree on? And a lot of times it is the parents saying I'm good. I don't need this. And the kids saying, Oh yeah, well, you know, you leave the stove on or you don't have food in the fridge or your meals on Open. Or the opposite. The parents are saying we need help. And the kids are like, no, no, no, you're good. You're good. You're good. So sometimes you need somebody who can say all right, let's look at the situation from all sides. It's really bad don't want to say referee, I'm gonna say a coach. I'm gonna say it's a coach to say this is this is the structure and and to bring structure to it, because what you don't want is bickering and fighting, and then nobody wants to sit down at the table together, you want somebody to make sure that everybody is listened to and respected. And that you can come away at the end of it with that tangible plan. And sometimes you need a third person for that.

Steve Altishin  25:26  
Well, in your case, you know, where the where the stuff is hidden, you know, how, you know, you could tell someone, well, this is how you can find someone's prescriptions. This is how you can find these things, their Medicare, a lot of people just as much as not wanting to it, it's, I have no idea where to go to get this information.

Janice Goldmintz  25:49  
And that is, and that's the truth, too, is that there's resources out there, as I was saying that can help you to put that plan together that you may not even realize are out there. There's government programs, there's private programs, there's tons of information, but if you don't know where to look for it, it can be very challenging. 

Steve Altishin  26:16  
Yeah. Oh, yeah, Wow. Well, we shot through 30 minutes. That was quick, this was really good. This is really, really important stuff and stuff that it's easy to turn your head away and say, well, we'll do that next year. But they don't know what's going to happen next year, for next year. So I really, really think this is important. And before we go, I want to make sure that you can give everyone listening your contact information if they have more questions. And if we missed a point, you've been saying, Steve, I wanted to say this, and you didn't... well, do that now.

Janice Goldmintz  26:47  
Sure. So I have a website. It's www.talkaboutaging.com. Because that's what we need to do. And I am more than happy to direct you to resources help you out, answer questions. And it's just Janice@talkaboutaging.com.

Steve Altishin  27:07  
Thank you, thank you so much. Again, you just for sitting down to talk with us. You know, you're making important issues really understandable. And that's, that's a skill.

Janice Goldmintz  27:19  
And it's important, it is important. And I as I said to you earlier, I thank you for bringing this out into the open because it's not it's not a subject that people generally think, hey, I need to sit down with my family and figure out what to do if I've challenges occur.

Steve Altishin  27:36  
Yep, exactly. So thanks again. Thanks very much. Thank you, and everyone else. Thank you for joining us again. If anyone has further questions, today's topic, obviously you can get a hold of Janice, as she has told you or you can post it here and we can help you get connected with Janice. So until next time, stay safe, stay happy and be well.

Outro:
This has been Modern Family Matters, a legal podcast focusing on providing real answers and direction for individuals and families. Our podcast is sponsored by Landerholm Family Law and Pacific Cascade Family Law, serving families in Oregon and Washington. If you are in need of legal counsel or have additional questions about a family law matter important to you, please visit our websites at landerholmlaw.com or pacificcascadefamilylaw.com. You can also call our headquarters at (503) 227-0200 to schedule a case evaluation with one of our seasoned attorneys. Modern Family Matters, advocating for your better tomorrow and offering legal solutions important to the modern family.