Is Your Parent Afraid of Running Out of Money in Retirement? Part 1

My Dad was a victim of Bag-Lady syndrome.

It took me a long time to understand what was going on. I finally found the name for my father’s terrible fear of losing his money in an article in MSN Money of all places!

Bag-Lady syndrome is the fear, often found in women at all economic levels, that financial security could vanish overnight. The spectre of being penniless and homeless haunts some women’s dreams.

Olivia Mellan, a Washington, D.C. therapist who specializes in money psychology, comments, “One of the ways that it impacts women’s lives is it makes them afraid to take risks with their money. That’s why a lot of women have lots of money sitting in a checking or savings account doing nothing. They’re afraid they might need it if they end up on the street.”

That’s it! But, how did my father end up with Bag-Lady syndrome?

According to Mellan, men don’t usually have this type of fear. “They have fears that are more rational and related to their provider burden: being injured, dying young, being laid off, things like that. Whereas bag-lady syndrome is more global, a magical, nameless thing like free-floating anxiety.”

At age 83, my father had already been retired for 18 years. His health had deteriorated so much that we joked about his quarterly “vacations” at the local hospital. Even with Medicare and supplemental insurance coverage picking up most of the bill, those vacations were shrinking his retirement savings.

If he needed to earn more money today, who would hire someone who was hard of hearing, walked haltingly with a cane and was flummoxed by high tech equipment?

All of my attempts to chart his retirement assets and show him graphs about how long his retirement money would last, were useless. It didn’t matter how much money he had. His fear had to do with not knowing how he could make more money if he needed it.

As his health and fear worsened, Dad just refused to spend any money. No geriatric care manager ( see previous post Is In Home Care The Answer?.) No in home care. No meals in the retirement community dining room.

In hindsight, I could have helped my father deal with his fear by dragging it out into the daylight and brainstorming ways for Dad to take action. Helping him find a job? Well maybe not a job, but some way to actively make even just small amounts of money.

Taking action, it turns out, is the key to licking Bag-Lady syndrome. (more in next post)

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Is In Home Care The Answer?

In my last post Will An “Elder Monitor” Keep Mom At Home Longer?, I mentioned that my Dad chose to move to senior independent living rather than stay in the home he owned. Still mentally alert and generally capable of taking care of himself, he was having difficulty climbing the stairs to the second floor of the house.

But that was only part of the reason to move. It was the ongoing maintenance of a modest three bedroom Cape Cod that he wanted to eliminate. He had never been a supervisor in his career. Managing the gardener was not something he liked doing.

Those traits that made Dad outstanding as an aircraft quality control representative, paying attention to tiny details and holding fast to specific procedures to complete a job, made for immense frustration with a “mow and blow” gardener.  The gardener was trying to accomodate this 82 year old man while juggling the demands of other customers. There was only so much time allocated to each house.

The gardener understood very well that “Time is Money.” If my father didn’t get to the door rapidly (which was hard for him)  when the gardener ran the bell, the gardener would take off for the next house.

Dad and I discussed getting more help in the home for him. He just didn’t want to manage more people. “They all try to cut corners,” he emphatically told me.

As a long distance caregiver, I was at a serious disadvantage.  Some people management issues can be resolved by phone, but most of the time, face to face talks are the best way to get things done. “Let me show you exactly which weeds didn’t get pulled.”

Dad was clear that he didn’t want to manage workers. I was too far away. We didn’t have a local family member who could act as “manager” of the service providers.  More service providers, like house cleaners and in home care providers, would make his life more complicated rather than easier. So, moving to retirement community where all of the maintenance was handled seemed like the perfect solution.

The concept of living in a secure, resort-like community with meals, house cleaning, and laundry services like a four star hotel had captured Dad’s imagination. Free local transportation, regular pinochle games, planned activities (Miko the Magician!) and weekly excursions added to the allure.

His cute little house, which had no sentimental value, was in a nice middle class suburban community where the overwhelming majority of residents worked during the day. His grey striped tabby and the newscasters on CNN  were his only companions.

Shops and senior services (lunch at the community center was just $1.25!) were only short drives from the house, but I could already see that his driving days were numbered. Diabetes had taken its toll on the circulation in his legs. He tried to compensate for his slower reaction time when he drove which was becoming less and less frequently. So when a a vacancy came up (after 3 months on the waiting list) in the lowest cost retirement community in the area, he made the move.

Other family members have made different choices. I have two aunts who chose to stay in the homes they have each lived in for half a century. In each case, one of their children moved in to manage care for the parent. One has daily in home care so that her son can work during the day.

My cousin tells me that he has fired more in home providers than anyone else he knows. He shrugs , “I’m tough to work for. She’s my mom and I want her treated right.” He has tried agencies; he has hired directly. One woman has cared for my aunt for seven years. Other have lasted just weeks or months. Because she need around the clock care, several providers are needed.

Still, in home care has been the right choice for my aunt. She had gotten very personalized care in familiar, comfortable surroundings. Nursing homes just can’t provide that. But in home care hasn’t been inexpensive. The largest cost has been my cousin’s time to hire and manage the care providers and take care of my aunt in the evenings.  He has put his own life on temporary hold.

For those families who can’t provide this type of caregiving, there are geriatric care managers who help elders and their families find the right solution and even manage providers. A geriatric care manager typically has a nursing or social work background and is very familiar with all of the services available in a local area. Some companies are even offering these services as part of employee benefits.

When I first became a long distance caregiver, I had the help of a free service provided by a local hospital where I lived. The care manager was a tremendous help in finding information I needed.

Unfortunately, the assistance the care manager could provide was limited by distance. She lived in California. My father lived in New Jersey. I tried to discuss the idea of hiring a local care manager to help him when I couldn’t be there. Dad rejected the idea of hiring anyone. Loudly!

Much later, I would discover the hidden reason why. (to be continued in next post)

Will An “Elder Monitor” Keep Mom At Home Longer?

In an open letter to our Presidential Candidates in a recent issue of Fortune Magazine, Andy Grove, former Chairman of Intel, proposes that Medicare can help seniors stay in their homes longer by specifying and paying for monitoring devices for them. The devices would alert a human to help a senior when medication has been missed, for example.

Ignoring the self-serving aspect of his idea for the moment, his suggestion is not unreasonable. It can be a way to provide peace of mind for family, especially for long distance caregivers.  In Japan, families can rent an “i-pot” for a senior living alone.  

The electric tea kettle boils water, records the time when the pot was turned on and dispenses the water, and emails the information to a neighbor or family member. If the elder doesn’t boil water at the usual time of day, someone can check to make sure everything is alright.

But, will an internet teapot or other kind of “elder monitor” reduce costs? Andy Grove suggests that technology can reduce the costs of assisted living and nursing home care. Which costs does he mean? Medicare? The elder’s family?

Medicare does not pay for assisted living or nursing home care. Medicare pays for doctors visits, hospitalization and the skilled nursing services required for recovery.  Ambulance rides are only covered if the person has to be brought in on a stretcher.

Today, seniors are living longer but in poorer health, which sends them to the hospital frequently. Even just a few days in a hospital bed can cause frail patients to lose strength and mobility. This neccesitates the stay in a skilled nursing facility for “rehab” so the elders can function safely once they return home. Preventing hospital stays would make a significant impact on Medicare costs.

An “elder monitor” that allows the doctor to monitor and communicate with a patient about medications and self care could help.  Doctors at Georgetown University Medical Center did just that with a pilot project for Type 1 diabetics.  Patients transmitted their data to the doctors using their home PCs. The doctors reviewed the patient data weekly and made suggestions on diet, exercise and insulin dose. The researchers found that closer monitoring and feedback by doctors helped to avoid ER visits and hospital stays. (I’ll save the discussion of HIPAA’s privacy requirements for another post.)

But, this would not have helped my dad who stubbornly resisted adopting any technology beyond the TV remote and the an alarm clock that set itself using the US Atomic Clock. He might have used an internet teapot if he received it as a gift. 

So, Andy, it’s a great suggestion but adoption may take a long time. I gained a first hand understanding of the term “digital divide” when I flew from Silicon Valley to help my Dad in NJ.

My father’s decision to move to a retirement community centered on getting away from the ongoing upkeep of a house.  Managing gardeners, painters and cleaners had become a burden. I was too far away to coordinate effectively with all of them. No one had email!

It seemed to make sense for Dad to move to a smaller place to call home that took care of the maintenance, offered meals, transportation to appointments ,and fun events and outings. The allure of nursing staff available round the clock at the push of a button was hard to resist.

He would be safer, have convenience and enjoy life in the company of other active seniors. And, it worked . . . for one year. (More in my next post.)

Work vs Caregiving: Balancing Conflicting Roles

She was a quiet, diligent bookkeeper who at one time dreamed of being a nurse. Other family members’ needs always seemed to take priority over her own.  Ever the practical soul, my mom quit her job to stay home full time when my younger sister was born in the late 1950’s.

First, it was her children who needed her — the requisite home keeping, trips to schools and doctors, and coordinating the annual PTA spaghetti dinner in the basement auditorium of the school. She worked to balance errands, banking and housework alone as her husband (my Dad) traveled out of town on business for days at a time.

 A decade later, she was needed to help with ailing parents on both sides of the family. She struggled to balance the difficult decisions of who should get her time on any given day. Then, as my dad neared retirement, his medical conditions demanded her attention. She tended to ignore her own needs most of the time. It resulted in her death.

The tightrope I’m walking is a bit different. I’ve continued pursue my business dreams while having a family. Owning my own business had made it easier for me to flex between the two worlds of work and family with the added help of daycare, schools, cleaning staff and an adaptable spouse. 

That is . . .  until a parent 3000 miles away became seriously ill again. There are some things that just can’t be done by phone and email. My presence was required.

Long days at the hospital left me with little energy to work remotely from my laptop late in the evening in my motel room.  I determinedly worked on the most pressing items. “Just good enough” became my motto. My efforts were limited to just getting the absolute minimum done at work.

After two weeks, I was able to go home and resume a more normal life.  My spouse and teenaged children had managed to successfully hold business and home together while I was gone. I had lost momentum at work, but I could regain it with extra hours of concentrated effort. I lucked out.

But what happens if you need more time for caregiving than you have paid vacation time? If you work for a company with 50 or more employees, the Family and Medical Leave Act (FMLA) requires your employer to grant you 12 workweeks of unpaid leave during any 12 month period to care for an immediate family member who has a serious health condition. 

Certainly this can be a help in an emergency situation, but it doesn’t begin to address the needs for caregiving for a chronic condition like dementia. A good friend (male) was asked to take early retirement when it became clear to his bosses that the demands of caring for his mother had priority over overtime. Ironically, this company was named one of the 2006 Working Mother 100 Best Companies.

It turns out that taking the early retirement offer turned out to be the perfect solution for that moment. He was able to focus on being a caregiver (with the help of in-home nursing staff). And, he was eventually able to consult for the company on a more flexible schedule than he had before.

So, everyday I count my blessings and look for the opportunity present every time an issue arises. I don’t make plans too far ahead. My motto today is “Be here now.”