Cathy Cress

Expert in Aging Life and Geriatric Care Management

How Can a Care Manager Help Elder Die Without a Will , as Aretha Franklin Just Did?

Aretha Frankin Died without a will last week. Most of us have heard this. According to her lawyer, she was aware she needed to take care of this but ” never got around to it”. This leaves her estate liable for potentially millions of dollars of taxes and attorneys fees and a drawn-out timeline for her 4 sons to inherit the proceeds from her estate.

Could a really good care manager have convinced Ms. Frankilin to ” get around to it” . She was, as many have said, ” a force of nature” and a woman who would be hard to sway. But care managers specialize in working with VIP clients and the rich and famous, who are often highly difficult to work with, so she might have convinced that she needed to work with her attorney to this to protect her family and her estate.

But we will never know.

However, care managers can specialize in End of Life care and one of their jobs is to make sure their client has all their legal documents

Once the terminal diagnosis is known with an elderly client, the care manager who has added “end of life services” to their agency, is often the one who will initiate and guide advance care planning discussions. As difficult as these discussions may be, the burden on the family is significantly lessened if decisions about advance care planning are made before the client’s condition worsens.

Hopefully, this has already been done but many people put it off for fear of death. A recent study found that less than 50% of severely or terminally ill patients had an advance directive in their medical record.

Advance directives are legal documents that allow clients to make decisions about their health care and finances in advance of when they are not mentally or physically able to do so. These documents which must be signed, dated and witnessed naming another person to make decisions for you.

Your job as a care manager is the make sure the dying client has these documents:

 

If the client does not have these legal documents and wishes to create them, the Geriatric Care Manager will suggest that the documents be put in place with the oversight and consultation of an elder law attorney

Care Managers play a big role in end of life issues. They are their navigators through all five stages of dying, many times long before palliative care or hospice are called. Often GCM’s can help the family and client to bring in hospice or palliative care.

 The final passage through life can emotionally charged.  If the family is following a long labyrinth to the end, the blind alleys may be blocked by cultural, religious, and moral beliefs. Care managers can find an opening through this maze.  Money, family dynamics, and fear of dying can all explode a fraught crisis of care in dying. When the important end of life decisions need to be made, like Ms. Franklin’s will, the stress of the responsibility and the seriousness of the situation can break a wave of distress fear and anxiety over the “ whole family system” the dying elder. The geriatric care manager specializes in this whole family system.

 Proactive discussions and legal planning can help to reduce some of the potential pitfalls. Good legal guidance can also help clients like Aretha Franklin make better decisions, like making a will or a trust, and saving her family from adding to the burden of her death.

Consider getting this product with my GCM Operations Manual 

The Nearly Normal Aging Family When John Wayne Falls

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Why is the nearly normal family shocked by their aging parent’s crisis- even after all their friends complain about it? After a lifetime of seeing their parents as the indomitable during their often indulged, 50’s and 60’s childhoods, baby boomer children, are stunned and dazed when their now aging parents are no longer that John Wayne father figure who can root out every bad guy depending only on his gun and horse.

When Dad or Mom need to ask for support following the loss of health in old age, their adult children are thrown into a crisis. This crisis has been labeled a filial crisis by pioneering social worker Margaret Blenkner. She was a breaker of new ground in the social sciences was the first director of the Benjamin Rose Institute in Cleveland and introduced the concept of the filial crisis. This crisis, she theorized, happened when the adult child realized that their parents were not invulnerable. Like the Twin towers crumbing after America ‘s 911, these adult children saw their impregnable parents start to disintegrate and with it the supportive bulwarks of financial, economic and emotional support, even in their children mid-life.

This filial crisis is, in essence, a new developmental phase in life, the loss of your parent’s independence and their dependence on you. However, Blenkner’s research and ideas are little known outside the field of aging or even within it. Unlike other major developmental chapters in life like becoming a mother or father, parenting a teenager or marrying, the developmental phase of beginning to take responsibility for your parent is not part of the wider popular culture.

What To Expect When You ‘re Expecting. flies off the shelves and is a joy to readers. A Bittersweet Season, Caring for Our Parents and Ourselves- is not greeted with joy- it is just what it says about parent care- bittersweet.

If you are a geriatric care manager want to find out more read the chapter, “Loss, Filial Maturity and Homeostasis in the Aging Family “in my book, Care Managers Working With the Aging Family  written by brilliant, long time care manager Leonie Nowitz.

 

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