Fabulous Friday Find: ?Saying Goodbye: How families can find ...

This new book can help caregivers reduce stress and find renewal even as they come to the end of their caregiving journey.

Editor?s note: Perhaps the most stressful time for caregivers comes at the end, at that time when we know our loved one is dying. While it may not be possible to feel joyful during this period, it definitely is possible to reduce some of the related stressors. Today, guest blogger Barbara Okun, PhD, offers advice about getting the finances in order well before the stress of terminal disease kicks in. We?re excited to be giving away a copy of Saying Goodbye: How families can find renewal through loss to one lucky reader! Just post a comment to be eligible.

Several of the interviewees quoted in my recent book, ?Saying Goodbye: How Families Can Find Renewal Through Loss,? reported that they wished they had paid more attention to financial and legal issues prior to their loved one?s death. Two widows, in particular, were shocked to learn that they inherited a lot of debt, and they had to sell their houses immediately in order to survive. One husband had lost everything in bad investments, and the other had hidden his failing business. You can imagine the rage they felt at this betrayal by their spouses.

Others did not realize that they should have had cash reserves on hand to tide them over after their husbands? deaths and the cessation of income. Though they were embarrassed, they had to borrow from friends and family. One woman was pressured by her dying mother to leave her family and business to come take care of her mother in her home. She did so for three months, having been assured by her mother that she would be compensated for her loss of income, but when her mother died, there was no stipulation for this in her will.

The point of these examples is to emphasize how important it is for caretakers to initiate discussions with the patient about financial matters at the beginning of a terminal illness. The caretaker and adult family members need to make sure that the patient has prepared a will, power of attorney, health care proxy, advanced healthcare directives, and disposition of valuables, and that all this information has been updated. If the patient was the major provider and financial manager of the family, members need to learn how to take over these responsibilities and functions if and when it becomes necessary.

Mental health literature notes that the topic of ?money? is more difficult for people to discuss than the topic of ?sex.? People feel a great deal of anxiety and ambivalence about these discussions due to cultural and generational variables. As a result, most families are not aware of the salaries, assets, and debts of the oldest generation. It should also be acknowledged that the patient may change his or her mind about designees or estate plans during the course of a final illness. As long as the patient is cognitively intact, he or she must be involved in all decisions and problem solving regarding these matters.

Another concern for caregivers is the increasing costs of health care and caregiving. Patients are discharged from hospitals earlier than in the past and may require home health services that may or may not be covered by insurance. So, family caregivers need to share the responsibility of locating appropriate community resources and entitlements and of advocating with insurance companies. For example, some communities provide free transportation to medical facilities. Caregiver burnout is less likely to occur if the caregiver delegates and shares responsibilities. Caregivers require self-care, and some respite, in order to provide effective care.

In ?Saying Goodbye,? my co-author, Joseph Nowinski, PhD, and I recommend that the family and patient prepare a ?Just in Case? manual at the time of diagnosis. It is actually optimal to prepare this long before illness occurs; many people begin this manual upon retirement and update it annually. At the very least, it should include: power of attorney, health care proxy, health care directives, all insurance policies, bank accounts, names of physicians, lists of medications, names of lawyers, clergy, accountants, passwords, military papers, real estate deeds, birth and marriage certificates, where the will is located, the names of guardians for the children, lists of people who should be notified, wishes about funeral and burial arrangements, and a letter of intent about disposition of valuables and any other wishes of the patient. One of the most difficult issues for caretakers and their families, is having to make decisions without knowing what the patient would have wanted.

Open communication and financial preparation relieve the caretaker of unnecessary worry during the patient?s life and facilitate healing and renewal after the death. When there are no surprises, the family is better able to reorganize and stay connected in supportive ways.

Barbara Okun, PhD is a professor of counseling psychology at Northeastern University and a clinical instructor at Harvard Medical School. She is the author of ?Saying Goodbye: How Families Can Find Renewal Through Loss? (Penguin, 2011) with Joseph Nowinski, PhD. Their website is www.NewGrief.com.

Tagged as: caregiver burnout, caregiver stress, coping, costs of caregiving, costs of health care, delegation, financial planning, financial stress, grief, planning, respite, self-care

Source: http://cheerfulcaregiver.com/coping/fabulous-friday-find-saying-goodbye-how-families-can-find-renewal-through-loss

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