“The” Conversation

 

My sister Nancy, two brothers Bruce and Carl, and I had a conversation with my 91-year-old Mother at the end of a great family reunion.  There were only the five of us and one grandchild who were there.  As it turned out, my siblings’ spouses were not there.  My mother has been so fortunate to have neighbors who deliver hot food to her every day and help with housework.  My mother has lived in this home on 20 acres in rural Arizona, ten miles from Sonoita, AZ, for the last 45 years.  She loves this home.  My step-father built this home after they moved to Santa Cruz County, AZ, from Maricopa County.  We all want her to live there as long as possible.  My brother Bruce is a retired neurologist who has treated patients grappling with end-of-life issues over his career, and then in his own life when his wife’s mother needed to move into a nursing home.  Bruce started the conversation.

“Mom, this is what I think may happen sooner or later.  There will come a time when you will not be able to stand up on your own.  At that point, you will need to call 911 for the paramedics.  They will take you to the hospital.”  Pause.  “From there, you will live with Nancy [in Tucson] for a month.  Then you will live in Flagstaff for two months with Gary and me.  Likely you will be living in Gary’s home because my home has two stories, while I will be taking you to the Aquaplex daily and caring for you because Gary is still working.  Then, you will move to Oregon to live with Carl for a month.  In the meanwhile, we will need to sell your home.  We will then continue to alternate having you live with the four of us.”

We were all in agreement.  I had just read a remarkable book about the end of life called Being Mortal: Medicine and What Happens in the End by Atul Gawande.  I was struck by how living with extended family was so much better for the elderly.

Bruce explained more.  He said that it was important that Nancy know that this would not all land on her as she was living nearby in Tucson and was the only girl.  (He mentioned that he had seen situations where the first child who had mom, would not be able to reach the other siblings, who would be suddenly not be answering their phones.)  We talked about what to do about Mom’s stocks.  We agreed that Carl would go to his investment advisor at Edward R. Jones, to consolidate her assets.  I volunteered to find out with lawyers about how to transfer the home now, so we would not have to file a conservatorship.  I said that my house was not set up for a wheelchair.  Bruce said, “Well, you will have a month to get that taken care of.”

My mother spoke up.  “Gary has been providing me with $500.00 every time he visits.  I want him paid back first.”  Everybody agreed.  We talked about her will which was created in 2000 after my step-father died.  Bruce said that he didn’t need any money.  (His net worth is probably several times more than the combined net worth of his three siblings.)  My mother’s original idea was to split her assets and to give half to her children and half to her 10 grandchildren.

Bruce suggested that we keep it simple and simply divide her assets three ways between Nancy, Carl, and me, and he would take care of his three children.  I suggested that I should receive only 20% of the assets as I did not have any children, and Nancy and Carl should each receive 40%.  Nancy and Carl disagreed, “No Gary, you get a third.”  Pause.  “Plus, when you pass, our children will likely inherit from you.”  Me:  “Well, that’s probably true.”

My nephew just listened to all of us with amazement.

I am the oldest of six children.  I was born in 1952, Bruce in 1954, Suzie in 1957, Nancy in 1960, Carl in 1966, and Liz in 1970.  We lived in Scottsdale in Maricopa County.  I went off to The University of Arizona in Tucson in September in 1970, so all eight of us were together for only a half year between Liz’s birth and me going off to college.  My parents divorced around 1974.  My mother remarried a year later.  Liz died in 1982 at the age of 12 when she was thrown from a horse.  My step-father died in 2000 at the age of 75.  Suzie died at age 49 in 2006 due to the impact of smoking earlier in her life.  My father died in 2016 at the age of 90.  There are only the four siblings and my mother left.

When my sister Suzie died in 2006, she died intestate, meaning that she did not have a will.  So, her assets would be divided between my parents where there was a great deal of animosity.  However, Suzie had a life insurance policy where Nancy and Carl were the two beneficiaries.  Nancy and Carl were looking at sending their children to college.  We concluded that this would be what Suzie would want, as Bruce could afford to send his kids to college.  As the family lawyer, I had a quick solution to this.  Both of my parents, Bruce and I would each individually “disclaim” our interests in Suzie’s estate.  By the process of elimination, that would lead only Nancy and Carl to inherit.  I wrote up four disclaimers which we all signed and witnessed.  Boom, it was done!

Just as I had used my expertise in 2006, Bruce used his expertise in 2022.

Nancy is a labor and delivery nurse who works one day a week and is on call.  Bruce and his wife are both retired.  Carl’s wife is retired.  We’ve got this covered.  My mother will be well cared for no matter what.

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  1. Gary Robbins Member
    Gary Robbins
    @GaryRobbins

    Here is my review of “Being Mortal: Medicine and What Happens in the End” by Atul Gawande:   https://ricochet.com/1302401/book-review-being-mortal-by-atul-gawande/.  I wrote:

    If you are beginning to confront “end of life” issues, I recommend it very, very highly.  (Sooner or later, you will likely be confronting “end of life” issues, so why wait to buy it?)

    • #1
  2. Jim McConnell Member
    Jim McConnell
    @JimMcConnell

    You have a great family, Gary. It’s great to see how you have all handled what are often difficult situations.

    • #2
  3. Juliana Member
    Juliana
    @Juliana

    Fortunately you were able to have that blunt of a conversation with your mother while she can be a participant. Also, that you are all agreeable.

    Unfortunately, this seems to be an ideal situation, not always available to others. My husband’s aunt, who recently passed unexpectedly (she was still lucid, mobile, and in her own home – covid took care of that) at the age of 100 refused to accept that at some point she may die. My mother-in-law, who was deteriorating physically and mentally refused to leave her home and relied on her husband, who was also deteriorating physically and mentally, to care for her. She eventually went kicking and screaming to an assisted living facility with him. She died in less than a year. He is happy being taken care of at the facility, where he has been for six years. The adult children do not get along well – shouldn’t really say that. Let’s say there is an interfering spouse who makes all conversations and decisions difficult. Not looking forward to the brouhaha which will ensue once my father-in-law dies – of which I will definitely steer clear.

    You are blessed by your circumstances. I hope the travelling does not weary your mom and she has many more happy years to spend with her children and grandchildren.

    • #3
  4. BDB Coolidge
    BDB
    @BDB

    Greetings, and well met.  I agree with previous comments.

    Just one issue, and you all probably already discussed this.  My guess is that serial relocations will not only be difficult for your mother, but stressful and perhaps harmful as well.

    In my HIGHLY limited experience, with elders, one thing does not go on its own.  Either several things go at once, or else the degradation of one faculty exposes existing erosion of others.  When things get difficult, they will get difficult across the board.

    Still, it sounds like you and your kin are way ahead of the game, and it’s heart-warming to hear.

    • #4
  5. The Cynthonian Member
    The Cynthonian
    @TheCynthonian

    Gary, I’m glad you and your family are in agreement about how to handle your mother’s remaining years on earth.  I completely agree with you (for once!) that elderly people do best when loved ones are nearby and are the primary caregivers, until/unless it gets to the stage where they are no longer able to do so.

    My 95-year-old mother lives next door to me.  My sister (the youngest) and her family are on the other side.  One of our brothers is 2 miles away.   All of us see and talk to Mom often, usually daily.  I am her primary driver since I retired and moved back to AZ.  Mom frequently mentions that she knows she is very fortunate to still be living pretty autonomously, and that she knows it wouldn’t be possible without having us all around her, providing practical support and taking care of physical tasks that she can no longer do herself.

    One thing I’m curious about……it sounds like your mother’s 4 remaining adult children made the decisions, and presented it to her as a fait accompli.  What was her reaction?   Did she balk or disagree at all?

    • #5
  6. Bunsen Coolidge
    Bunsen
    @Bunsen

    Gary- my heart is with you and your siblings and most of all Mom.  I pray for good outcomes for all.

    As an Advisor of Edward Jones, I can tell you, without even knowing who your brother works with, that your family will be well taken care of.  I would recommend, if possible (make it so), all of you kids get on a Zoom with mom and the advisor to continue being on the same page.  One of you should help mom with the financial decisions but all should be in the loop as much as you want to be.  Also she will need to have a “permanent” address for registration purposes.  But I know the Financial Advisor will get that all settled for your family.

    I have already ordered a copy of Being Mortal – more for my professional self than personal but did so on your recommendation, thank you.

     

    • #6
  7. Gary Robbins Member
    Gary Robbins
    @GaryRobbins

    The Cynthonian (View Comment):

    Gary, I’m glad you and your family are in agreement about how to handle your mother’s remaining years on earth. I completely agree with you (for once!) that elderly people do best when loved ones are nearby and are the primary caregivers, until/unless it gets to the stage where they are no longer able to do so.

    My 95-year-old mother lives next door to me. My sister (the youngest) and her family are on the other side. One of our brothers is 2 miles away. All of us see and talk to Mom often, usually daily. I am her primary driver since I retired and moved back to AZ. Mom frequently mentions that she knows she is very fortunate to still be living pretty autonomously, and that she knows it wouldn’t be possible without having us all around her, providing practical support and taking care of physical tasks that she can no longer do herself.

    One thing I’m curious about……it sounds like your mother’s 4 remaining adult children made the decisions, and presented it to her as a fait accompli. What was her reaction? Did she balk or disagree at all?

    Bruce actually presented it to us as a fait accompli.  All of us were grateful to him.  And I don’t have any problem with us getting someone to stay with my mother to get her out of bed and in and out of the bathroom.  My mother was relieved with Bruce taking the lead, as he is the physician.  My mom is a nurse, so she has accepted death.  She believes strongly in an afterlife and she has three large pictures of my step-father, Liz and Suzie facing her in the living room.  She has told all of us that when it is her time, she is ready to go.  She has a “DNR” (Do not resuscitate) sign on the fridge.

    I love spending a week with my mother every 6th or 7th week.  

    • #7
  8. Doug Watt Moderator
    Doug Watt
    @DougWatt

    Great post Gary. As painful as it might be to have “The Conversation” the time not to do it is when medical issues reach a crisis. It reduces the stress level, bitter feelings among the survivors, and bitter debates concerning medical care.

    • #8
  9. Gary Robbins Member
    Gary Robbins
    @GaryRobbins

    Bunsen (View Comment):

    Gary- my heart is with you and your siblings and most of all Mom. I pray for good outcomes for all.

    As an Advisor of Edward Jones, I can tell you, without even knowing who your brother works with, that your family will be well taken care of. I would recommend, if possible (make it so), all of you kids get on a Zoom with mom and the advisor to continue being on the same page. One of you should help mom with the financial decisions but all should be in the loop as much as you want to be. Also she will need to have a “permanent” address for registration purposes. But I know the Financial Advisor will get that all settled for your family.

    I have already ordered a copy of Being Mortal – more for my professional self than personal but did so on your recommendation, thank you.

    Carl lives in Redmond, Oregon, a bedroom community of Bend, Oregon.  We were talking about Vanguard and so forth, but he really loves and trusts his advisor in Bend.

    • #9
  10. Gary Robbins Member
    Gary Robbins
    @GaryRobbins

    Doug Watt (View Comment):

    Great post Gary. As painful as it might be to have “The Conversation” the time not to do it is when medical issues reach a crisis. It reduces the stress level, bitter feelings among the survivors, and bitter debates concerning medical care.

    We all get together every couple of years, what was different here was that we had no spouses present.  I had no idea the conversation was coming; Bruce decided that it was time, so he launched it on us.  Nancy was really relieved that as the one daughter, and the child living the closest to my Mother, she would not have Mom dumped on her.  I am already looking at movies to watch with my mother.  Carl has suggested with the distance between Oregon and Arizona that he have two months together.  We will all work it out.

    I hesitated before posting this.  I emailed it to my mother to ask permission.  She is having trouble with her email, so she suggested that I simply send it out to my siblings to see if anyone objected.  No one did.  

    • #10
  11. OldPhil Coolidge
    OldPhil
    @OldPhil

    Our neighbor is one of 11 kids, and they all take turns going to Iowa to stay with Mom for 2 or 3 weeks at a time. Mom lives with one of the kids, but the rest do it to give him a break. Our neighbor just got back after 2 weeks there. 

    This is how it used to be (aging parents moving in with the kids), but rarely happens these days. My parents had two children, despite coming from families with 8 and 9 siblings. My wife and I had one. 

    But hey, our son has two, so maybe there’s hope.

    • #11
  12. Gary Robbins Member
    Gary Robbins
    @GaryRobbins

    OldPhil (View Comment):

    Our neighbor is one of 11 kids, and they all take turns going to Iowa to stay with Mom for 2 or 3 weeks at a time. Mom lives with one of the kids, but the rest do it to give him a break. Our neighbor just got back after 2 weeks there.

    This is how it used to be (aging parents moving in with the kids), but rarely happens these days. My parents had two children, despite coming from families with 8 and 9 siblings. My wife and I had one.

    But hey, our son has two, so maybe there’s hope.

    Wow.  I could do that also.  I am doing essentially 1/6 or 1/7 right now.

    • #12
  13. Full Size Tabby Member
    Full Size Tabby
    @FullSizeTabby

    As illustrated here, each family has its own dynamics.

    In my case, my late mother’s health had deteriorated gradually over many years, and she had discussed her desires with both my brother and me (the only two siblings). When she had the stroke that we knew started the final decline, my brother and I together were able to give clear instructions to the medical staff. The medical care coordinator said she wished more families could do that, as she had witnessed too many intra-family fights over what care should or should not be provided. 

    In my wife’s case, her parents were adamant to live in their house to the end. Fortunately there were financial resources to pay for the live-in care they needed (which interestingly where they lived was cheaper than putting them in a nursing home would have been) and for maintenance and repair of the house itself. Many people outside the family criticized our decision to “let” mom and dad live in the house – it wasn’t “safe,” as a fall was probable, and the house was a long distance from medical care. My wife kept pointing out that they were both 95+ years old. She’d rather they be content with where they were for their last months/years than be theoretically “safe” in a place with better medical care but they didn’t enjoy living in. They did both died contentedly at that house within a few months of each other (which made for an interesting disclosure when we sold the house a few months later – yes, two people have died in this house). Shortly before they both died, they were both hospitalized simultaneously. They were on the same floor of the hospital, but because it was the peak of Covid restrictions, they couldn’t see each other, nor could any family visit them. So they both decided they wanted to go home. The medical staff were aghast. But again, they were over 95 year old. Even if it shortened their lives by some amount, they would rather be comfortable together in their home than separated in a hospital. 

    Both my mother and my wife’s parents had thoughtfully put their financial assets into forms that made it easy for my brother (in my mother’s case) and my wife (in her parents’ case) to manage and then distribute to the heirs. My wife’s parents did disinherit one of my wife’s siblings from the primary financial assets, but did provide her with personal items, and that sibling did not raise any objections to the asset distribution. 

    • #13
  14. TheRightNurse, radiant figure of feminine kindness Member
    TheRightNurse, radiant figure of feminine kindness
    @TheRightNurse

    Wow.  This is… very oddly specific and very much like a blog post in it’s in depth nature of your family, their earnings, locations and such.  I wonder how your siblings would feel about it?

    Anyway…

    I agree with @BDB that shifting homes frequently is not good for the elderly, though shifting caregivers is.  What is usually best is to have a centrally located home where caregivers take turns staying in the home and doing the care.

    I wish your family the best in all of this, it is intensely difficult.

    • #14
  15. Gary Robbins Member
    Gary Robbins
    @GaryRobbins

    TheRightNurse, radiant figure … (View Comment):

    Wow. This is… very oddly specific and very much like a blog post in it’s in depth nature of your family, their earnings, locations and such. I wonder how your siblings would feel about it?

    Anyway…

    I checked it out with them, and gave any of them the right to veto it.  They didn’t.

    I agree with @ BDB that shifting homes frequently is not good for the elderly, though shifting caregivers is. What is usually best is to have a centrally located home where caregivers take turns staying in the home and doing the care.

    I wish your family the best in all of this, it is intensely difficult.

    Thank you so much.  I am quite open to living with my mother every fourth week.

    • #15
  16. TBA Coolidge
    TBA
    @RobtGilsdorf

    May comity continue to bless your family. 

    • #16
  17. TheRightNurse, radiant figure of feminine kindness Member
    TheRightNurse, radiant figure of feminine kindness
    @TheRightNurse

    Gary Robbins (View Comment):

    TheRightNurse, radiant figure … (View Comment):

    Wow. This is… very oddly specific and very much like a blog post in it’s in depth nature of your family, their earnings, locations and such. I wonder how your siblings would feel about it?

    Anyway…

    I checked it out with them, and gave any of them the right to veto it. They didn’t.

    I agree with @ BDB that shifting homes frequently is not good for the elderly, though shifting caregivers is. What is usually best is to have a centrally located home where caregivers take turns staying in the home and doing the care.

    I wish your family the best in all of this, it is intensely difficult.

    Thank you so much. I am quite open to living with my mother every fourth week.

    Okay.  Phew.  I know my family would not love that,  but to each their own internet footprint.

    Good luck on the arrangements. 

    • #17
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