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The things we should have discussed ahead of time
March 13, 2014 5:08 PM   Subscribe

My 72-year-old mother has been in the ICU for a week, and it's 50-50 on whether she'll pull through or die. I'm struggling to be a responsible adult about the whole thing.

Special snowflake details: She has a chronic lung disease, then caught H1N1 on top of it. That developed into pneumonia. She's currently on a ventilator; she crashed when the paramedics were taking her to the hospital a week ago. The ventilator was removed a few days later, but then re-introduced when she began to crash again. Right now, it's a matter of seeing if she's going to manage without it. If she can't, she's made her wishes quite clear in the past and we'll be abiding by them.

Meanwhile, I have a severe anxiety disorder, an overload of credits in my final year of undergrad, and no idea what I'm supposed to do now.

We'd covered the medical stuff in the past, as well as the post-mortem scenarios. When you hit 70, I guess it's just expected. But no one has ever explained to me the other parts. Should I be paying bills? I don't have any money, and no written permission to access her accounts (though I have the PIN for her debit card). I've debated calling and just saying I'm her, as I have all the necessary information, but "is that the right thing to do" and "does it even freaking matter" are eating at me.

I'm 23 and I used to live alone, so that part isn't an issue. I recently had my anxiety medication doubled as well, so I'm half-zombie most of the time. But it's midterms week, the dog cries all day and all night looking for her in the house, and there's a pile of things that I'm sure I should be taking care of but I don't know how.

Posting to the green for an impartial look/varity of opinions.
posted by iarerach to Human Relations (22 answers total) 4 users marked this as a favorite
 
Don't be afraid to ask for help from those around you.

There are a couple options w.r.t school:

1.) Do your best, and apply for a hardship withdrawal if your best isn't good enough
2.) Just apply for a hardship withdrawal now.

In medicine the idea of 'triage' means you have to make choices about how to allocate resources, because you can't do it all. You need to triage. Decide what is most important, and of that what you can expect to handle. Then only take care of that, and deal with the rest later.

I suggest school needs to be put on hold. They will understand. From there perhaps find a family friend to take care of the dog -- one less issue to worry about. Then look for a counselor at school (some/most schools even have student legal services), and work on making a list of what is required to get your affairs in order.


Throughout all of this it is normal to feel despaired, depressed, overwhelmed, and scared. You can't avoid that, and it would be strange if you didn't feel that way. But life won't stop either, so just do your best.

I'm so sorry to hear about your situation. I'm sure others can give more specific advice.
posted by jjmoney at 5:17 PM on March 13 [3 favorites]


Oy, this is really hard.

First off, next time you're visiting, ask the nurse if you can talk to your mom's social worker - I think at most hospitals there'd be one assigned. That person can give you some bare bones guidance about what you need to think about in terms of decision making for your mom and can offer referals in the community.

Second, who can you call on here? Are there any family members who can work on this stuff with you? Close friends?

Is your mom of sound mind at this time? If so, you can get a financial power of attorney and then have access to her bank accounts etc. this gives a basic explanation of what I"m talking about.

But to triage the situation right now, I'd actually call the bill companies and defer paying anything for now. If you have to lie and pretend you're her to do so, it seems worthwhile if you can call and say, "I am having a medical crisis, I cannot pay this bill right now, I should be able to pay something on (date one month from now?)" to just put this aside for the moment, but I'm curious to hear the advice of others here.

Please take 1/2 an hour every day (at least) to take care of yourself. Take a hot bath, or meditate, or watch a funny TV show, or whatever you do to take care of yourself. You still have a long haul ahead of you and you need to pace yourself and get support.

Best to you.
posted by latkes at 5:19 PM on March 13


First, I'm so sorry to hear that you're going through this.

The hospital (most likely) has a social worker on staff. Ask to speak with that person. They should be able to sit down with you sometime this week or next week. They can talk to you about how you're handling school responsibilities, what assistance might be available to you for the financial stuff (both how to handle it and how to figure out where you mother might have other accounts/insurance/etc.). Support groups for people in similar situations.

They can also help you with so many other things that you haven't even thought of yet.
posted by bilabial at 5:21 PM on March 13


If she does pull through (and I hope she does!) you need power of attorney. On preview, what latkes said. And she needs a will. See a lawyer!
posted by treehorn+bunny at 5:22 PM on March 13 [1 favorite]


1. Dog goes to a boarding place for 1-2 weeks. This is not mean, it is compassionate - s/he will be getting more attention and affection without you and since it will be a total disruption of their routine, it may not be so upsetting to have his person not in the home.

2. Talk to your college. Tell them what is going on. They can arrange for you to have extra slack in classes as necessary, and possibly either withdraw from some courses or possibly have professors allow you to take the tests later, at home, whatever. Ask for help.

3. Go to YOUR doctor. If you need help sleeping this is the time for pharmaceutical aids. If not s/he can tell you if there is something else you can tweak to help you through this tough time.

4. It has been a week, unless bills are on the verge of going to collections, simply ignore them for now.

5. Ask for help. Ask everyone in sight. Ask the nurses for help so you can go get some rest, ask your friends to bring by food or come pick you up so you don't have to drive home, ask for help. In this kind of situation many people don't want to impose but DO want to help.

6. Thirding finding a lawyer. Call free legal aid. The hospital can help.
posted by arnicae at 5:32 PM on March 13 [6 favorites]


About your college: call the Dean of Students office. (It might be called Office of Student Affairs or something similar.) Tell them you are having a crisis and need advice and help. Then they can guide you as far as talking to your professors. I would strongly consider taking a leave or withdrawal for this semester, because it sounds like you will not be in a position to concentrate on school for quite some time. This is ok. Give yourself the breathing room you need to deal with your mom's affairs, if you are the person in charge. School will still be there when you get back.
posted by LobsterMitten at 5:40 PM on March 13 [6 favorites]


Re: the bills, you may be able to call and explain the situation so she doesn't get whomped with late fees.

Does your mother have a DNR and POLST form on file? Is that what you mean by "medical wishes declared"? A living will and health care proxy are other documents you may need to produce. Since your mom has serious health issues, she should (in better health, of course) appoint you as her Power of Attorney and Health Care Proxy. These documents will allow you to do many of the things you cannot right now.

Deep breathing, as often as you think of it, as many times in a row as you can manage. Good luck, and keep us posted.
posted by Riverine at 5:51 PM on March 13


Does you mother have a lawyer? Can you get power of attorney during this? Does she have a will?
posted by Ideefixe at 6:01 PM on March 13


Right now? Take enough cash out to survive. Ask the hospital staff to contact the social worker. If you need to fill out any paperwork, they will help you do so.
posted by Marie Mon Dieu at 6:11 PM on March 13 [1 favorite]


I am sorry, this sucks. My father died quite suddenly and I was the executor and I developed a pretty good routine for handling his affairs before I was actually officially able to handle his affairs. First off, I'm sorry, this is super stressful. Taking care of yourself should get way up on the To Do list. I know it's tough but take time to read, walk, bathe, eat, the other things you need to be doing, and don't feel guilty.

I agree with other folks in the thread, I would, if I were you

- lean on other family/friends for immediate support either with dog walking, decision making, meals, whatever
- if now is not a good time for school a hardship withdrawal should be something you can do
- talk to a hospital social worker
- if necessary, get medicine for sleeping

For bills I would basically look at it like this

- big bills that could snowball, I'd try to pay. This is mortgage, credit cards, car payment. I'd pay them with your mom's money and I would not even blink about it
- other bills I would put it a pile so they don't get lost and I'd wait until there was a better time to deal with them

Right now you have a lot of tense waiting to do. I hope things turn out okay. Take care of yourself so that you can step up to do whatever needs to happen. Try not to get too hung up on the small stuff (which is what most bills are, in the immediate short term) which is a classic thing that anxious people (I am one!) do when there's a crisis. I am sorry you are going through this, MeMail me if I can give you other help.
posted by jessamyn at 6:12 PM on March 13 [4 favorites]


I went through something very similar. In terms of bills, the most important ones are the mortgage, if there is one, and the utilities. Deal with those - call them and explain. This has happened many, many times with many people. Life happens. If you talk to someone and they can't/won't help you, ask to speak to their manager. Be sure to write down names and/or ID badge numbers and the date and time of your calls. Document what they say.

Your mom's house will need heat, light, and phone service.

Then - what others have said about talking with a social worker. When I went through something similar, it was the hospital social worker who explained what to do and how to do it. They can be a real lifesaver.

And do not worry about spending your mom's money. You are taking care of her. That includes taking care of yourself.
posted by clarkstonian at 6:17 PM on March 13


I'm so sorry, I know that's so hard. My dad had a very big stroke while I was in grad school, was in a coma for a couple of weeks and in hospital and rehab for months, and I know just what you mean about the bills and account access. I wished twelve million times I'd either had him sign a power of attorney or at least had my signature on file at the bank. Couldn't be helped.

Latkes is right, definitely talk to the social worker - if there's not one assigned, you can ask for one.

I wasn't able to impersonate my dad, and I didn't have his PIN. So I talked to his bank, I talked to his creditors (including the rental agency) and I borrowed money from my in-laws for what I absolutely couldn't delay paying. If they hadn't had it, or hadn't been willing to lend me some money, I'd have gone to the bank. There are short-term loans available, and although the terms are awful, I was just borrowing until my father could pay me back and then I could reimburse them completely, I figured.

You probably don't want to do your term or year over again, but if you need to, take a hardship withdrawal. (I did. Three times, for sickness or death of parent. I did finish my PhD, though, and in the same timeframe as most of my peers, thanks to the support and help of my school.) Talk to your favorite professor or to the person who manages your undergrad program and get them to help you access what the school can help you with. You are, unfortunately, probably not the first student who's come up against this.

Again, I'm so sorry. I'm pulling for you. You're doing an awesome job, although it probably doesn't feel like it, and you're going to get through this, although ditto.

For future reference: the power of attorney expires when the person it covers passes away, so the two of you need to talk to a lawyer about a will and about planning what to do to cover what would be shared expenses while the estate's waiting for administration or probate. Often, early consultations with a lawyer are gratis, with fees for investigating tricky problems or writing the will itself, so don't let the prospect of the expense scare you off - lawyers know their skills are expensive and understand that's a challenge for many clients.
posted by gingerest at 6:18 PM on March 13 [2 favorites]


Nthing the medical social worker! That's their job, cases like yours and your mom's. You can also ask about counselling - the hospital often has a counsellor who will talk you through the emotional side too.

Asking people for help is hard when you are so overwhelmed. Get a coffee and sit down somewhere quiet with a pad of paper and write a long rambling list of everything that needs to be done, small to big. Then rewrite it by groups on several pieces of paper. Post on your facebook that you need help and when people call, you will have a list you can actually give them to help with. If your mom has a facebook, post there too. Or go through her address book and call the friends you recognize and ask them for help too. Does she belong to a church or temple?

Don't hide how much help you need - people really really want to be helpful during a crisis like this. People who don't simply won't offer, but the people who ask, they genuinely feel better about helping you. You're not imposing on them, you're giving them an opportunity to show caring for you and your mom and to feel good about themselves.

I hope your mom gets better, and that you have more time with her. Be kind to yourself - this is one of the hardest roads you'll travel in your life, so set down whatever you can and keep only what will help you get through this time.
posted by viggorlijah at 11:06 PM on March 13 [1 favorite]


Riverine has good advice. If your mom is conscious, have her sign a power of attorney naming you. It must be witnessed. Then you tell her bank that - or give them a copy - and you can write checks to pay her bills. She should also give you a health care power so that you can control her care if she should lose consciousness.
posted by Cranberry at 12:22 AM on March 14


If your Mom wasn't in the hospital, she'd be paying her regular bills and, if you can, I think you should pay her mortgage payment and utility bills out of her account and anything else that's something she'd take care of if she were home. By all means, keep the utilities on and the house payment up to date - you don't want the utilities to be shut off and everything in the refrigerator spoil - that would add way more misery to your life than what you have already.

If she gets to come home again, she'll appreciate the fact that you kept her in good standing financially - she doesn't need that hassle, either. If she doesn't get to come home, it will still make things much easier on you.

And I hope very, very much that she'll come home again and be well.

There's very good advice here - most importantly, take care of yourself. I just wanted to add the note about the utilities because many years ago I had to spend several months out of town taking care of my own mother and when I came home I found that the person who was supposed to be keeping my utilities paid had dropped the ball, the electricity had been turned off and the refrigerator had to be hauled - full - to the dump. Even the water had been turned off and all my plants were dead. So keep that utility bill paid up - you'll be glad you did.

Again, my best to you and your Mom.
posted by aryma at 12:41 AM on March 14


I am so sorry this is happening.

Please speak to your dean of students office. They should be more than willing to write a note to your faculty that you are experiencing a family crisis and that your faculty should consider giving reasonable leeway on assignments for the next few weeks.

This letter will go further than if you just reached out to your professors because it can make your life easier if you do end up needing to take incompletes at the end of the semester. I don't think you need to withdraw. You should have opportunities you can look at before that and proceed in stages with school (letter of accommodation for the next few weeks --> possible incompletes if necessary ---> completing incompletes over the summer or accommodations for the next few weeks ----> leave of absence as things progress ---> starting back again in summer or fall). I really don't think you want to withdraw entirely from school.
posted by zizzle at 4:22 AM on March 14


I'm so sorry. Your Mom wants you to be okay, and you know what her wishes are so that's great.

1. Call all the utilities, the mortgage company, etc, and explain that your mother is having a health crisis and that she's in the hospital fighting for her life. If you can, deligate it to a family friend or a cousin or something. If you want, memail me and I'll do it for you.

OR

2. Write the checks and/or pay online. It's not that big a deal. Checks are processed by machines.

3. The dog is upset, but he'll be okay. If he's upsetting you, can he go to a family friend until things stabilize in your life?

4. Get in touch with your professors. Let them know what's going on. In most cases, you can take an Incomplete or you can arrange to catch up the work during the summer. Your professors want to help you, let them.

5. Put out the call for help. Ask people for specific favors. "Can you take the dog?" "Can you feed me dinner?" "Can you arrange to have Mom's place cleaned?" "Can you water my plants?" ASK! Your friends and family need to know what you need so they can help you through this trying time.

Take care of yourself. It's not going to get easier, but you will survive this.
posted by Ruthless Bunny at 6:00 AM on March 14


Put out the call for help. Ask people for specific favors. "Can you take the dog?" "Can you feed me dinner?" "Can you arrange to have Mom's place cleaned?" "Can you water my plants?" ASK! Your friends and family need to know what you need so they can help you through this trying time.

This times a million. Use all your social networks. If you are in Milwaukee I will come walk the dog and water your plants. People really want to help.
posted by desjardins at 11:06 AM on March 14


I'm sorry this is happening!

My father in law passed away last year, and my wife was his executor. It was not as stressful a situation as you are in.

Since there is so much good advice here for the situation as it exists now, I would like to give you some advice for when (and I hate to say it, if) your mother pulls through this, and that is to have your mother put you on her bank accounts as a co-signer. My wife was on her dad's accounts (he was widowed) and my mother has me on hers. She had no physical access to the checkbook, etc. until he died, but in Washington at least, while he was alive and after his death she had every right he did to use that money. It came in very handy in the weeks after her dad's passing, and in the days while he was incapacitated before his death.

And of course, if she pulls through, celebrate a little, then take this as a wakeup call to get her affairs in order for when the inevitable happens.

Good luck!
posted by lhauser at 9:58 PM on March 14


It's probably a bad sign that I don't actually remember writing or posting this, but I'm glad I did, and I'm going to blame the memory lapse on stress/the flu I inevitably caught too, since I live with her. As always, turning to the green was a good idea. Many thanks for the advice and the kind words.

Answers to common questions: What little family we're not estranged from is on the other side of the country, unfortunately. There is a health proxy form, but no DNR on file; I'm working off of the conversations we've had in the past, when she was in sound mind, and I'm extremely confident in that aspect. Getting paperwork things figured out has been on the to-do list for a long time, and didn’t happen due to a messy divorce. Thankfully, things could be a lot worse; I live with her in an apartment, so there's only one home/set of bills to worry about.

I've spoken to my professors and am putting off any decisions on whether to withdraw off until after spring break -- which started this afternoon. So I have nine days to catch up on sleep and figure out the other issues. I'll take stock before we head back and see if it's something I can do, or withdrawal is necessary.

Thank you all for the recs about the hospital staff. I wasn't sure if there was any sort of legal help available, but I will definitely ask when I go in tomorrow. As well as moving cash from her accounts to mine so I can write checks. I don't know why that didn't occur to me sooner.

A hundred thousand thanks for the reminders to take care of myself. I'm bad at it at the best of times, and the guilt that goes along with all of this is one of the hardest things I've ever had to deal with -- even if it isn't necessary.
posted by iarerach at 12:55 AM on March 15 [1 favorite]


I'm so glad things are settling a bit for you. One more piece of advice, since you mention estranged relatives.... If you think there is any chance people will come after you and accuse you of any wrongdoing related to your mother's money, you could squash that issue right now if you just keep a notebook and make a written ledger of all transactions that you handle. Keep copies of the bills you pay, write down dates and amounts, etc. Later, if there is any issue, then you are completely covered and can show due diligence.

Best of luck, and let us know if there is anything we can do, either over the internet or locally.
posted by CathyG at 11:12 AM on March 15 [1 favorite]


It sounds like you're already planning to meet with the social worker, which I was going to recommend and saw that multiple other people did as well. So yes, social worker- it's their job to help you sort through the logistical stuff and connect you to the right resources, and they've helped people through your exact situation countless times.

In terms of your emotional coping, next time you're at the hospital for a while I'd highly recommend asking whether a chaplain is available to meet with you. Even though technically a chaplain is a religiously-affiliated person, in my experience they only talk about the spiritual stuff if that's what you want. If it is what you want they will say prayers with you or whatever you need. If it's not what you want, they will still talk to you about your situation, your feelings and your coping. Like the social workers, they have seen people in your exact situation countless times and are specifically trained about offering support in tough situations like these. And because their role is one of emotional support, they're not going to be running out of the room in a big hurry because they have a patient crashing in another room (like your doctor might.) They can take time out for you and I think that really helps people especially in the chaos of a hospital. In four years of medical education I have to say the group of people I was most consistently impressed with in the hospital were the chaplains. They are so incredibly sensitive, smart and well-trained. A lot of my medical ethics type lectures were taught by the chaplains, and they were also heavily involved in an end-of-life care course I took. This is what they do and in my experience they were universally awesome at it.
posted by GastrocNemesis at 3:17 PM on March 15


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