You have just read a blog post written by Jason McIntosh.
Thank you kindly for your time and attention today.
Since relaunching this blog as a regularly updated enterprise late last year, I have several times linked to my post from July 2013 on securing power of attorney for one’s aging parents. Sometimes the context matches that post’s title; sometimes I instead wish to make a reference to that year’s personal ordeals. But in any case, the post has this whole time ended with a promise that I’d link to followup telling the rest of the story, and I never have. So, let’s take care of that now. If the moral of the earlier post was secure the services of elder-law attorney, then this post’s shall be please do not ignore their unexpected advice.
First of all: everything’s fine. The dreadful period from which I wrote the power-of-attorney essay, which began when my partner and I discovered my parents barely alive and unable to care for themselves in their rural Maine cottage, ended six months later when I found an appropriate home for my (by this time widowed) mother. Though her Alzheimer’s had lingered for years undiagnosed and untreated — as it still remained, when I wrote that post midway through that period — proper treatment from a geriatric-medicine specialist at Acadia Hospital has changed her violent, fearful spiral into a controlled descent. More importantly, she has since late 2013 lived in Woodlands of Brewer, a “memory care” facility that does very well at balancing the treatment of its residents as autonomous adults deserving dignity while also guiding them away from potential harm wrought by neurodegenerate confusion. First and foremost, this means a secure building, proofed against its inhabitants’ freely wandering outside and down the street.
You can find a summary of the remainder of my 2013 in a LiveJournal post I wrote last year. (The post ends with an unfortunately tangential veer regarding my shift in attention towards the assistance of my next-older brother, who at the time found himself rapidly sinking into profound problems of his own. He has managed to find more qualified help and stabilize his situation a great deal since then. Another story entirely, that.)
My friends tell me that I seemed to comport myself well enough over this whole period, much of which I did share in real time on LJ and Twitter. The kindest and most lasting compliment came from a film-studies maven who compared me offhandedly to the character Holly Martins from The Third Man, stumbling by chance into a completely dreadful situation and just sort of shruggingly winging through it until reaching the end, at which point, maybe a little heartbroken but otherwise whole, he quietly smokes a cigarette while the zither plays him off. (I’ll take a black coffee instead, but otherwise that sounds pretty nice.)
The LJ post compresses time and simplifies details a great deal, but for the purposes of today I wish to highlight its admission that it took me months to accept the lawyer’s advice — first delivered at the very beginning of all this — to get my mother on Medicaid, the half-century-old American system of begrudgingly socialized medicine for the provably poor. It has proven such a blessing, most obviously in reducing her monthly expenses (which, she having no money, I had to front) from nearly $10,000 to approximately $0, that it seems completely bizarre today that I dragged my feet for as long as I did.
In the earliest weeks of the crisis, at least, I simply lacked attention as a resource. An unavoidable focus on finding a safe place for my mother to live constrained long-term planning of any sort. As she failed over from living alone at home to living in a conventional retirement home to living in an assisted-living (but not memory-care) facility, each step alternated between the scramble of moving and a refactory period where I could plan what to do next before the situation again became untenable and required another move. (These breaks became increasingly long, at least, proportional to each location’s higher-than-the-last level of in-home care.)
All these moves also exposed me to a great deal of garden paths to wander down, promising solutions that seemed more appropriate, somehow, than Medicaid. I remember the head of admissions staff at the first retirement home beaming when she heard that my dad had served in the Air Force during the Korean War. She immediately produced a pamphlet promising well-deserved retirement riches for all American veterans or their widows, published by a local law office. It looked like the first pointer towards a solution that anyone had so far provided me, and I embraced it.
I can’t remember if I tried contacting that lawyer, but I did ask my mother’s lawyer about it, and he disapproved of the idea. We could apply for veterans’ benefits if I really wanted, he said, but he didn’t recommend it. He felt strongly that Medicaid would suit my mother’s situation much better. I asked him to proceed with the veteran’s benefits application anyway.
Why did I do that? I suspect, in retrospect, that the solution seemed more elegant to me, somehow. The fact of my father’s military service, which my whole life I had never paid much mind to (as neither did he, leaving it behind in the 1950s) took on an intriguing and hopeful new aspect. Applying it to my mother’s predicament felt like solving a puzzle in a video game with a unique key, found through good fortune and circumstance, rather than brute-forcing the lock with Medicaid. Perhaps I also felt influenced by romantic notions of my helping my father to continue providing for his wife and family after death, by way of a nation grateful for his service. How much more attractive that did that feel at the time, versus getting mom hooked up with a medical program for poor folks (e.g. herself, another truth I may not have wished to comprehend plainly).
In late August I had a long-awaited meeting with a kindly contact I had made in the Veterans’ Administration, and here I learned that, of course, my mother’s attorney had the right idea all along; not only was my mother’s qualification for veterans’ benefits far from assured, but even if she did qualify, the amount of the award would cover a bare fraction of her enormous expenses.
By this time, I had wandered down another romantic-notion path, this time one of noble self-sacrifice: I would throw my freelance career away, yoking myself instead to some full-time senior-level software job, making just enough money to cover all my mother’s bills myself. I interviewed at half a dozen places, and found the experience quite souring. On the four-hour Bangor-to-Boston bus home after meeting with the VA guy, dizzy with doubt and disappointment, I made a mind map that helped me conclude that no future existed where I both paid all my mother’s bills and also contributed to a financially, emotionally, or socially stable life for myself or anyone else in my family.
I’ll spare you the details of the map, but here’s what it looked like, zoomed out:
The next day I called the lawyer and said I was ready for Plan A. Boy, did he sound cranky with me. He wasted no time in assigning me a pitbull of a paralegal who (in exchange for the remainder of my mother’s checking account) moved mountains to obtain my mother’s entry into Medicaid, making possible her life-restoring access to both Acadia and Woodlands. But he also made plain his disgust at my months of knowing-better obstruction in allowing him to see to his client’s best interests, no matter how well-intentioned I felt.
He would remain cranky in all our interactions since that summer. He would stay kind of cranky with me as his office assisted with the sale of my mother’s crummy little cottage in late 2014, and he still sounded a little bit cranky earlier this summer as we reviewed our options regarding the car that remains my mother’s legal possession. I like to think he’s lightened up after I’ve failed to make any further bad decisions regarding his client’s welfare and against his own advice. I can’t say I didn’t have it coming, in any event.
In June of this year I visited my mother and her new partner — another Woodlands resident, whom my brothers have taken to calling “Papa Bill” — and though her weakened and diminished body now relies on a wheelchair much of the time, her mind has reasserted itself into this world that you and I inhabit. She recognized me as her youngest son, something she couldn’t quite manage a couple of years ago. She asked how old I was, and I told her, and she cried “What? Oh no!” and laughed and laughed. What else can you do?
And that’s the end of this story for now. My earlier advice has not changed: if you have elderly parents, and you all live in the United States (or a state sufficiently like the U.S. for this advice to apply), please hire an elder-law attorney as soon as you can, even if your parents still enjoy youthful health. And once you do, please take the lawyer’s advice to heart, even when it runs counter to your own romantic notions of late-life care.
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