Friday, March 12, 2010

When The Bottom Falls Out Mind Map ™

Here is the When The Bottom Falls Out Mind Map ™ that I created for a family where the aging parents told their adult children they were going to wait until they “needed to plan” (Double-click on the image to enlarge it).

The goal was to provide the adult children with a way to visually show their parents the type of decisions that would have to made if the bottom falls out. They simply told their parents they would “do their best” when things fell apart and gave them a copy of the mind map. These are the things we are going to have to decide with or without you they said. No scolding. No lecturing.

A few weeks later their parents brought up the mind map. They has some questions. It was a start.

We are all visual people. Check lists, brochures, and passionate pleas may fall on deaf ears. But a mind map lays out the interconnecting parts, a global view of the complexity that lies ahead. In essence, the When The Bottom Falls Out Mind Map ™ is the current marching orders until further notice. One way or another, it helps settle what really is going to happen…

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8 Comments

  1. Comments  John Kalb   |  Wednesday, 14 January 2009 at 10:59 am

    Thanks for posting the map. It’s very clear and useful. A nice conversational tool.

  2. Comments  jdearing   |  Thursday, 15 January 2009 at 3:16 am

    I can’t wait to print this out as a resource. Unfortunatley it’s too late to use with my little mother as she is past reasoning,moderate Alzheimers or some type of dememtia. Thanks for your post.

  3. Comments  Mary Gergen   |  Friday, 16 January 2009 at 1:35 pm

    The “When the Bottom Falls Out Mind Map” .. (trademarked, I see), is tinged with the negativity that so many people use when thinking about others.. THe OLD… Your piece today gives no credit to the older people and places all the power with the children. Why should they insist on this conversation with their elders? And what is so bad about waiting til the bottom falls out? I think you should give the people directly involved more credit.

  4. Comments  David Solie   |  Friday, 16 January 2009 at 2:27 pm

    I see this as a control issue where older adults are electing to stay put until ?something happens.? There is nothing wrong with this choice, but it is not without consequences. There are a multitude of unanswered questions that will have to be eventually addressed when something does happens. I think its only fair to disclose these questions and their impact of future control issues in the spirit of informed consent. I think it helps older adults gain additional perspective on their choices while at the same time helping adult children accept their parent?s decisions.

  5. Comments  Edie Dykeman   |  Monday, 26 January 2009 at 5:43 pm

    What a wonderful tool you have created. Too many families wait until the bottom falls out to deal with the myriad problems that arise. This tool gives parents the opportunity to let their children know their wishes, the adult children know what their parents desires are, and everyone can plan ahead for possible family emergencies. This tool allows families to know if they are on the same page or not, and if not, come to some kind of understanding regarding concerns for the future. I see this as a win-win proposition.

  6. Comments  Elna Tymes   |  Friday, 27 March 2009 at 3:20 pm

    What a great tool! I’ll be using it (with your permission and appropriate attribution) in a presentation I’ll be giving in July at a national convention. I talk about dealing with elderly parents a lot, and I find that not only is it difficult to get the older folks to address these issues, but it’s equally difficult for their kids to bring up some of these issues. Unfortunately, putting it off till later usually means that these decisions will be made in a time of crisis, when cool heads are harder to find.

  7. Comments  Laura Bramly   |  Tuesday, 14 July 2009 at 8:37 pm

    Mary, I’ve seen what happens when the bottom falls out as it happened to my family. Fortunately they had the financial resources and, living in Canada, the government support and health care, so that we didn’t have to deal with many of the issues on David’s chart. However, my stepfather had exactly one week to find a nursing home to take my paralyzed mother with dementia. This was from a short list, dictated to him by the local government, of homes that had availability. If they had addressed the “what if’s” so clearly illustrated on David’s chart, they might have had their name on the waiting list for the home they had REALLY wanted to go to, and had talked about for years, but had never done anything about. Also, my mother refused to get a real diagnosis for her memory loss. We didn’t know she was losing her memory due to strokes. Her staunch avoidance of the issue (and wow, your comments sure remind me of her!), in retrospect, led directly to the demise of a lovely, smart woman, my mother. As a result, I’ve become an advocate for dementia and a militant supporter of early diagnosis, and recommend all families (and yes, this has to come from the kids sometimes) do something I call an “Aging Will.” The Aging Will addresses what David has outlined in his chart. Similar to a Living Will, it lays out the wishes of the parents so that when the bottom falls out and everyone is running around in a panic, they can refer to their Aging Will and remember what they had decided back in calmer times.

    David, with your permission, I’d like to “print” your chart in my blog, http://eldercaretalk.blogspot.com/

    Thanks for your great work.

  8. Comments  Stormy Knight   |  Wednesday, 27 January 2010 at 11:15 am

    What a great tool to get focus where it belongs instead of playing games. Thanks!

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No Money: No Comment

I was recently asked what to do about aging parents who had little or no savings but refused to discuss any aspect of their “money issue.” It reminded me that our role as adult children is not necessarily about problem solving; it is about compassionate containment. So many of the issues we feel compelled to “fix” have no clear answers. The best we can do is sort out what to accept from what we can actually change. Here was the advice I offered:

The issue of money, like so many other issues in the last phase of life, is about control. The best way to approach it is to reframe money as means of maintaining control. Lack of money takes away control. This link http://www.dsolie.com/articles/reframing.html will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this.

You may also want to consider three strategies that will help you “hedge” your parent’s financial risk:

1. Buy a long term care policy with a two years home care/two years nursing home benefit. This assumes they will cooperative with the process (i.e. signing the applications and answering questions).

2. Start funding a dedicated “side fund” for expenses that a long term care policy will not cover.

3. If you parents own their home, become familiar with how “reverse mortgages work and when they make sense.

Lastly, you need to began discussions with local area agencies on aging to determine what, if any, community resources can assist your parents if they run out of money.

This is a tough end-game, especially if you parents don’t want to talk about. The article will help you frame your conversations. Be patient but persistent in your discussions about control and your desire to help them maintain it.