Logistics of Aging & Dying – From an Organizing Perspective

in Organizing
Logistics of Aging & Dying – From an Organizing Perspective

This month’s blog post is taking a different turn as my mother passed away recently and I wanted to write about some things I have learned from an organizational perspective during this time. Forgive me for not mentioned the emotional journey, nor any legal aspects. This is more about the logistical aspect of losing a parent and what to do before they pass, and also before it’s your turn. 

As a former Professional Organizer, keeping records and paperwork in order is something I do. What if those you care for do not abide by that philosophy? That is what I was confronted with the past few years of my mother, and her husband’s declining health. One thing I did was gather their paperwork well in advance, so if I had questions they might still be ‘with it’ enough to answer. Since they both developed dementia, many things became incomprehensible to them over time. I started by creating well-labelled files for all the paperwork I was finding and keeping most of it with me. 

Here are some of the roadblocks I encountered and what to know so you don’t run up against them too:

  1. Roadblock #1: Needing to have POA (Power of Attorney) for both of them in order to even ask the necessary questions regarding anything in their lives. Having this in place for my mother early on was super helpful. Once they became incapable of managing finances this document was crucial. It allowed me to speak for them when they no longer were able. Once dementia sets in, it is too late. (Then doctors need to get involved, etc.).
  2. Roadblock #2: Getting Power of Attorney for my mother’s husband. Since he didn’t want anyone to touch anything of his, this took longer. Once he realized that he could no longer handle anything as he always relied on my mother, and she could not even write a check and mail payments for bills anymore, he agreed. They both needed me now 100%. This all should have happened years earlier than it did which could have prevented the massive stress that I went through for not having the knowledge of their situation sooner. 
  3. Roadblock #3: Insurance policies. Determine what policies are still in effect and which have been cancelled. Those I uncovered had no documentation which resulted in my having to call multiple companies to find out if the policy existed and what was valid. IN order to actually get this information I needed to prove I have Power of Attorney. 
  4. Roadblock #4: Secrecy. My mother’s husband, and therefore my mother, didn’t share anything about their financial situation nor their plans for their end of life with any of their 3 adult children. Me, being the oldest of the three, became the person in charge. Eventually I needed to reason with them before the dementia to explain that someone needed to have copies of their records or nothing could be done properly – if at all. They finally acquiesced.  
  5. Roadblock #5: Getting services in place. I had no idea what Medicare and MediCal/MediCaid were all about and had to learn super-fast. It turned out that since both had only their Social Security checks as income, they each qualified for MediCal (California’s version of MediCaid) which helped cover all medical expenses. Later I could apply for an Assisted Living Waiver (ALW) which helps pay for Assisted Living & Care using Social Security Checks as payment in full. 
  6. Roadblock #6:  Getting an ALW can take upwards of a YEAR to acquire! Had I known about this document and its value and time frame, I would have applied to this for them years ago. Learn as much as you can as fast as you can! I also learned of an organization called PACE (https://www.dhcs.ca.gov/provgovpart/Pages/PACE.aspx) which assists to help find housing and care for the elderly who have no assets. Very kind. Very helpful. 
  7. Roadblock #7:  Speaking with the Social Security office on their behalf --- Even with the POA, I wasn’t permitted to do so. So, by becoming a Rep-Payee – which took a few weeks to acquire - made it much easier to receive guidance and services afterward. This didn’t take place for me until both had full-on dementia. A dedicated bank account for each person’s social security payment to go into is required, so get that set up right away which has your name on the account as well. Then you can also pay bills for them when they can no longer do so. 

More Tips:

Watch the money! See where money is being spent. I learned late in the game that my mom had been paying for medical insurance for years that she shouldn’t have. Money was already taken from her Social Security check to cover a Medicare Insurance policy. Over $300 a month was being spent on premiums she should not have been paying. Once I discovered that issue, I was able to change her insurance to a much better policy and there were no additional premiums. No one tells you this unless you ask! 

Get Assistance! Contact the local APS (Adult Protective Services) office and ask for guidance. Prior, I wasted time and money trying to get help from Elder Attorneys. There are services – but you need to find them and ask everyone along the way for help. Put everything in order and in motion as soon as possible. This helped greatly when they both passed within 5 days of one another. At the end, they both had MediCal and Hospice in place and everything was figured out including what was to be done with their bodies. Hospice, by-the-way, is AMAZING. They are so helpful and guided me along the way before and after my mom and her husband passed. 

There are SO many logistical tasks that have to be done when a person dies, that it is hard to even ‘feel’ the loss if you are the person handling all these logistics. Being proactive about all aspects of a loved one’s life sooner versus later will be such a relief. I wish I had known more sooner. I ended up setting a lot of wheels in motion at the 11th hour. The facility my mother died in knew what to do and they really took care of a lot. 

I was able to order death certificates promptly through the company who took care of my mother’s body. These are required in order to cancel or close various accounts. While in the past many copies were necessary, some places were fine having a copy emailed – so I could simply scan one in and send it to those agencies that required it. Telling an agency that a person has died isn’t enough – you must prove it. Same for filing a claim to collect on an insurance policy. 

This is a long post – but hopefully a useful one. There are several other tips I learned that should be mentioned… 

  1. Have a Will and make sure you note if you want a DNR (Do Not Resuscitate). My mom had that, so the nursing staff knew what to do in those final minutes. Her husband did not have either of these in place, which led to confusion for those caring for him in the final minutes. 
  2. Have an Advanced Health Care Directive - but do NOT make your Health Care Directive agent be your same-aged spouse. Ask, or at least alert, the person(s) you are planning to put in charge. This is not something a person is required to accept just because they have been named. My mother and her husband named one another and when they both became incapacitated, I learned that I was named as ‘second agent’ to make all medical decisions for both of them. I did not know that I was named for my mother’s husband until very late in the game. Just ask!
  3. Make sure those who will be caring for you and making decisions for you receive a copy of those papers indicating such. By the time that person’s help is needed, it could be too late to look for the paperwork as to what the dying person’s wishes are. 
  4. Get rid of stuff that is no longer serving you. I have helped many people deal with a dead relative’s belongings. We keep so much worthless and useless stuff far too long. Start disposing or selling things you don’t need or use any more. Give things you want others to have as soon as you are no longer using them. They get to use and enjoy the item longer, and you get to enjoy seeing them own what you give them. 

Bottom line – don’t wait until the last minute to take care of these things. As you age, sit down and share with someone who you want to be ‘in charge’ of your world – called the executor – the details you have written out. No one really likes to discuss end of life situations, but like it or not, that time will come. Don’t leave a mess for someone else to clean up after you’re gone. Is that the lasting memory you want to leave them with?