A New Vision for Aging
David Tillman December 19, 2011
Class: Ministry with Older Adults – United Theological Seminary, MN
Session four: Aging Grace-Fully Planning Toolkit
Thesis: As we age it is important to understand health care issues, living options, financial and legal issues, and how we talk to others, as this can enhance our process of aging grace-fully and for those we love.
Scripture: “We plan the way we want to live, but only God makes us able to live it.” (Proverbs 16:9).
Quotation: “All the rest of life has been for the sake of coming to this time in it. Everything else has been pure practice for this time, simply gestures of what it is to live fully.”[xxxiii]
I would like to talk about some practice things and considerations as our parent’s age and as we age, then do a case study in small groups to talk about some of the issues we or others we know may face in our lives. When is the right time to speak to your family about the issues of aging? This can be a challenge for older adults who have been very independent.
There are some practical items to be aware of that can make it easier for parents and their families during the aging process. Do you, your parents or children have a will? “A will: a legal document written to have control over what happens to one’s property and assets when one dies. A will generally does not involve health care decisions. A Power of Attorney:A legal document in which one person gives another the authority to make specific financial decisions. Unless specifically written to do so, a Power of Attorney document will not cover health care.” [xxxiv]
Regarding one’s health care, “A Health Care Directiveis a tool which allows you to: appoint another person (called an agent) to make health care decisions for you if you become unable to make or communicate decisions for yourself (Part I), or leave written instructions so that others can make decisions based on your wishes and preferences (Part II), or do both—appoint a health care agent and leave instructions.”[xxxv] These also can be called a “living will” and “durable power of attorney for health care.” A “Health care agent: (is)one or more persons legally authorized to make health care decisions for another who is not able to communicate.”[xxxvi]
Let’s talk about living arrangements for older adults. My understanding is Medicare pays nothing for long term care. If a person runs out of money, there is government assistance that will pay for a nursing home if needed. Living in one’s home, apartment, or senior home is an option only if one is able to take care of themselves or they are living with a caregiver. As one’s health slips a person may need to be cared for in an assisted living or nursing home. At the end of life, hospice care is available, usually if death is imminent.
As one ages it is helpful to talk to your children and family to discuss what your wishes are for living arrangements, sooner than later. If possible, talk about end of life issues with your parents that include completing the health care directive, power of Attorney for health care, funeral arrangements and liturgy, burial plans and overall wishes for their family when they die.
Case Study: This case will give us the opportunity to talk about end of life issues which one family was faced to deal with after their parents were in a car accident. Pass out the case study, explain to group to have one person in group read the case study and one person to take notes while the group answers the questions and then report back a summary to the larger group when we reconvene in 20 minutes from now. When we reconvene have each group spokesperson recap their questions and open up the discussion to the larger group.
Case study worksheet: John (age 72) and Maria (age 73) have been married for forty-five years. They both worked and retired at age sixty-five. They raised three children, Mike, Cheryl and Dan, and have six grandchildren. Mike, the oldest child, and Dan, along with their families, live in the same city as their parents. Cheryl and her family lives 1,000 miles away. Due to an argument five years ago, Mike has not talked to his parents, Cheryl or Dan for over five years.
Six months ago John and Maria were driving, on an icy winter day, and were hit by a truck that ran a red light. John was killed immediately and Maria was in critical condition with a severe head injury in the intensive care unit at the local hospital. Maria’s condition was getting worse and a decision was going to need to be made soon about continuing life support through a ventilator which who keep her alive, however, due to the head injury it was determined that she had lost most of her brain functioning. Three years ago, Maria had told Cheryl and Dan that if something like this every happened to her she would want to be allowed to die than to be kept alive with a life support system. Unfortunately John and Maria had never written a will, health care directive or power of attorney for health care, stating their wishes in writing.
At the hospital Mike, Cheryl and Dan met with the doctor to discuss what to do. Cheryl and Dan told Mike about what their mother had each told them about not putting her on a life support system. This was the first time Mike he had heard anything about this. Mike’s faith tradition believed that they should do anything possible to keep his mother alive. Cheryl and Dan argued that they would like to honor their mother’s wishes. A decision was made that day to keep Maria on a life support system as Mike would not agree to take her off the system. Cheryl and Dan had felt that all three of them needed to agree before they would allow the life support system to be removed from their mother.
Two months later, Maria died at the hospital, with a medical cost of $850,000. The family had a funeral, yet tensions were high amongst the Mike, Cheryl and Dan. These two months had put a lot of strain on the whole family. Without a will Mike, Cheryl and Dan began to argue about their parent’s estate. Cheryl and Dan felt that since Mike had distanced himself from his parents that he should not get his equal share. Cheryl and Dan also felt frustrated that had they followed their mother’s wishes to discontinue life support, the bills for the extended hospital stay would have saved the estate $100,000. With no will it took one year to settle the estate and $120,000 of legal costs for all three children.
Case Study Questions (on worksheet): 1) What are main the issues among Mike, Cheryl and Dan regarding their mother’s condition? 2) Looking back at this, what do you think Cheryl and Dan could have suggested when their mother told them about their end of life wishes regarding the use of a life support system? This is followed by case study discussion in larger group.
Conclusion: I hope our time talking about Aging Grace-Fully with some practical knowledge has been valuable to you. Pass out course evaluations as before. After each session, the Adult Education Committee will review the evaluations and make course updates as needed.
For those who attend the “Aging Grace-Fully – A New Vision of Aging” course it will bring to them a renewed awareness and understanding to help in their own aging process and also how they can love and support their parents, family members and friends as they Age Grace-Fully.
[xxxiii] Joan Chittister, The Gift of Years, 202.
[xxxiv] Minnesota Board on Aging, University of MN Extension Service, http://www.mnaging.org/advisor/directive.htm (accessed December 16, 2011).
xxxv] Minnesota Board on Aging, University of MN Extension Service, http://www.mnaging.org/advisor/directive.htm (accessed December 16, 2011).
xxxvi] Minnesota Board on Aging, University of MN Extension Service, http://www.mnaging.org/advisor/directive.htm (accessed December 16, 2011).
© 2011, revised September 2020, by David Tillman, All Rights Reserved, www.lifesjourney.us