Are You Ready? Durable Power of Attorney

Cri-sis a time of intense difficulty, trouble

a time when a difficult or important decision must be made

At some point we are going to be faced with a crisis situation. I'm not talking about a midlife crisis. I'm talking about a sudden life event when decisions must be made without hesitation for the welfare of a loved one. A healthcare crisis.

My latest crisis involved my older sister, Peggy.

Peggy is 73 years old without children and a husband who has Alzheimer. My sister and I are a three-hour plane ride from each other.

Her health was relatively good until four years ago when she had to place her husband in a memory care facility. Stress causes a lot of health issues, especially when you become a caregiver. I have read where roughly 30% of caregivers die before the person they are caring for. I think the percentage is higher.

Caregivers are so consumed with giving care they neglect their own health. As time passes, they don't even realize the toll it's taking on them until it's too late.

Enter my sister's life.

She spent 7 days a week going to the memory care facility to visit and help care for her husband. At first, he walked and could feed himself, but his physical and mental health quickly declined. He can no longer walk, feed himself, communicate, and is incontinent. Peggy had been feeding him every day. Twice a day.

During the four years of caring for her husband my sister gained a lot of weight. She developed Type 2 diabetes, high-blood pressure and has arteriovenous malformations (AVMs) which, in her case, are an important vascular cause of gastrointestinal bleeding. She would get so anemic she had to have iron infusions. Even after an infusion she would try to go by and see her husband even though she needed to go home and rest.

She had way too much on her plate. I saw what was happening and would always encourage her to take care of herself. I reminded her that her health and well-being were number one. She would agree but would never follow through.

Not long ago I went and helped her sell a place they had on Lake Lanier. She needed to simplify her responsibilities. She started to get rid of a few things like his car and things they had collected for over fifty years of marriage. It was progress. I was optimistic she would make a lifestyle change.

She set up a Revocable Trust and updated her Last Will and Testament. Also, very importantly she had an Advance Directive for Health Care making me her health care agent. She made me her Durable Power of Attorney (DPOA). I got the papers in the mail and put them in my safe. We both felt good she was prepared for an event where she might need my help.

She called me almost daily. Most of the conversation was about the frustration with the memory care facility and how they failed to take care of her husband despite the high cost. Peggy would mention being tired and fearing her iron level was low. Perhaps she needed another infusion. After her gallbladder was removed, her stomach was always upset. She tried to figure out what foods might be causing it. Her shoulder and back hurt. She thought she might have pulled a muscle lifting something heavy.

The call.

Peggy informed me her cardiologist wanted her to have a cardiac catheterization (heart cath). The stress test administered earlier didn't look good. The cardiologist said she'd probably need a stent, maybe two. I wanted to be there, but she assured me her friend would be with her and stents were not that big a deal. I got out Peggy's DPOA papers she sent me and thumbed through them for the first time. They were draft copies without signatures. I called and told my sister. She brushed me off and said not to worry, she'd take care of it when she got home from having her stents. Later she called and said she found her copies and told me where to locate them.

Another call.

The heart cath revealed blockage so severe they transferred her by ambulance to another hospital which happened to only be across the street. She needed open heart surgery. This time I got on a plane and flew to be with her.

More bad news.

Peggy's gastroenterologist, in a matter of fact voice, told us the surgeon won't do open heart surgery because she's a high-risk bleeder due to the AVMs and there was a good probability she would bleed out during surgery and die. (Not the doctor's exact words but pretty close.) My daughter and I were in the room with Peggy when we heard this. My mouth fell open. We asked what her options were if they won't do surgery. The doctor, in her same flat voice, said Peggy would be sent home and given medication that would extend her life. We're in shock.

Next morning. When it rains, it pours.

The surgeon informed us that my sister's blockage was too severe for medication to work. He doesn't want to do the bypass surgery because of the high potential for bleeding. He does recommend a stent specialist. Stents? Isn't that what they wouldn't do at the other hospital? During this time my sister and I have a conversation on what she wanted me to do if she didn't make it.

Back to square one.

The stent specialist met with us and told us her blockage is at the junction of several arteries and it would be tricky putting them in. Also, if stents were done then she would be on blood thinners for up to a year with a high risk of them causing her to bleed. He said he thought her best option was by-pass surgery. He would talk to the surgeon and try to get him onboard. If the surgeon wouldn't do the by-pass surgery, then the stent specialist would do the stents. None of us are feeling good about this situation.

Stay tuned for part 2.

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