ELEVEN YEARS TO SAY GOODBYE

When you’re young, you don’t spend much time thinking about getting old. You know it’ll happen, but it feels so far away that it can’t compete with all the other things vying for your youthful attention. There are those of us that just don’t want to think of it at all, at any age: death, and years preceding it. There are many depressing considerations and it’s not how we want to spend our time.

But, if you fail to plan for your own decline, the people who suffer the most will be your loved ones, typically your spouse or kids. They will carry the burden you could not: adapting to your physical limitations, emotional needs, and sometimes financial burden. They’ll do it while coping with their own emotions and newfound stressors. They’ll be caregivers and decisionmakers for those who didn’t used to require that kind of help.

It’s easy to let these concepts be academic and not look too deeply at the reality of declining health in old age. So, we put a story to the concept. After all, stories stick with us far longer than banal advice, even if its accurate.

It’s time to meet Paul the first. Technically, Paul Sr., but I like the former, it sounds regal. If you’re familiar with our firm, you’ll know his son, Paul, Jr., resident charismatic Cajun, partner, advisor, and long-time advocate of end-of-life planning. His zeal for such issues stems from his firsthand experience watching his dad, the elder Paul, live eleven years in a state of cognitive and physical decline, and the toll that took on his mom, siblings, and Paul himself.

Paul Sr. was born in 1929 in Baton Rouge, LA., to a poor family. He was the son a of a sheet metal worker and one of four children. He would see his father die of throat cancer in his sixties. His mother would live on into her nineties, and he cared for her until her passing.

He went on to LSU where he studied law and became an attorney. He moved to Lake Charles to clerk for a federal judge right out of law school and eventually joined a firm in the area. That’s where he would raise his family.

He became a partner a big law firm that started small, eventually being promoted to Managing Partner, a role he didn’t like. Paul Jr. thinks it’s because it took him away from people, his clients and it was very stressful. He remedied this by moving to smaller firm later on. Paul Sr. specialized in probate work in estate planning and real estate and had a habit of making friends out of clients. Sounds familiar.

Paul Jr. describes his father firstly as a family man, a person deeply in love with his wife and five kids. He was kind, compassionate and involved with his community through Rotary Club, community gardening, and church activities.

He loved to read, do his own yard work (and subsequently brag about it), play solitaire, watch boxing, and eat Blue Bell ice cream, only Homemade Vanilla.

He became an avid bird hunter and fisherman alongside his children, taking them to what Paul Jr. calls “those cool old Cajun camps” where the kids had to be in bed at 8pm and the adults stayed up drinking and playing cards. Paul Jr. said the kids were always too excited to sleep.

The family of seven was also known to take long road trips in their Ford Country Squire station wagon or Oldsmobile 98. Mom, Dad, and one lucky kid occupied the front row. The remaining kids occupied the final two rows of bench seats, using each other’s shoulders for pillows as they trekked along. Kid placement was of less concern that ensuring the ice chest made it to a prominent position in the trunk.   

On a particularly long drive from Lake Charles to California, Paul Sr. was pulled over for speeding near Ft. Stockton, Texas. If you’re not familiar, they had almost made it out of the state. Paul Jr. prefaces this story by saying that the officer probably felt bad for his dad, seeing the distance traveled and the number of kids in the car.

All five kids were peeping over the backseat when Paul Sr. produced a credit card in lieu of “license and registration”; it looked like a lame attempt at a bribe, which of course it wasn’t. He, like all parents on long road trips, was exceptionally exhausted. The officer ended up laughing and letting him off with a warning.

Paul Sr. did not throw things away. In that same station wagon, a hole rusted through the floor, so much that you could see the road moving as you looked down. When the hole became dangerously large, he had someone weld in a metal plate to cover it. He drove his old pickup that leaked fluid until the wheels fell off. In a nod to this hallmark of his personality, he was even buried in his 30ish years old Brogan boots that he refused to give up despite obvious wear and tear.

The earliest signs of dementia came in 1991. The symptoms were mild, things I’ve frankly done myself at 39 years old: poor recall, loss of concentration, small-scale forgetfulness. His law partners informed the family and by 1993, he could no longer practice law.

Medical tests were long and cumbersome. “There’s no blood test for Alzheimer’s”, says Paul Jr, so it took a while to get a confirmed diagnosis. But it was indeed confirmed and caring for Paul Sr. became a huge concern for the entire family.

In the following months, Paul Sr.’s condition deteriorated. He became disoriented and combative, even trying to hurt his wife, Lonnie. This was interspersed with emotionally charged moments where he would cry and repeat “you just don’t understand”. It was around this time that the family had to “take the keys” from him; he could no longer drive.

At first, Lonnie cared for him in their home. When that became untenable, he was taken to Baylor for a clinical trial. The drug provided caused Paul Sr. to lose sleep, be constantly moving, shifting. It made matters worse for all involved. He was evaluated by a geriatric psychiatrist and placed for a short while in a mental health facility in Houston, where some of his kids and grandkids now lived. After that, he moved into a memory care facility in the area.

Lonnie struggled to make the drive from Lake Charles to Houston which necessitated a move back to Louisiana. He was placed in a nursing home. When that didn’t pan out as expected, Paul Jr. notes that they can’t “love your family like you do”, they rented a house in Lake Charles and began in home care.

In order to keep her sanity, Lonnie lived in their old home while Paul Sr. received full time care in the rented house, though she visited daily and often brought him home-cooked food. They eventually purchased the home due to frequent rent increases.

Paul Sr. had now become physically unstable and couldn’t walk without tripping. He lost recognition of his kids and grandkids, something Paul Jr. laments to this day, his children never knowing their grandfather as he was before Alzheimer’s took over. While the caregivers were generally good, there was one instance where the person on duty left and forgot to lock the door. Paul Sr. got out and “cruised the neighborhood” on foot and was clipped by a car in the process.

In 2002, Paul Sr. fell and broke his hip, which often spells doom for the elderly. He had a hip replacement and in a stroke of truly terrible luck, fell again and broke the same hip. Now, he was totally immobile, and a hospital bed was brought in to accommodate his needs. Extra care was taken to make sure he ate, drank, didn’t get bed sores, and diapers were changed regularly.

18 months passed in this condition. He lost a lot of weight, falling to the 90-pound mark. When the caregivers called to say his breathing was becoming very labored, they knew the end was close. The family surrounded his bed in Lake Charles as he took his final breath. That was 2004, eleven years of suffering.

What followed thereafter was less chaotic than it could have been. Thanks to the forethought of Paul Jr. and his family, the proper medical documents and funeral arrangements were made in advance, taking the need to make large decisions off the table for the family. It was time to deal with their grief.

Lonnie carried tremendous guilt during Paul Sr.’s illness, being unable to care for him properly in their home. Paul Jr. spent hours in person and over the phone reassuring his mom that she had done the right thing, and was doing all that was possible for Paul Sr.

Paul Jr. coped with his father’s illness and death through prayer. He was able to accept it and deal with it because he knew, as the oldest son, his mother and siblings needed him to be strong. He knew, upon diagnosis, that his dad’s condition would only worsen. Still, seeing him at the end was painful; his father a shadow of what he used to be. “You’re looking at the person”, he says, “they’re a picture of themselves you can’t relate to anymore”.

Paul’s understanding of the subset of financial planning that we call “legacy planning” helped him steer the family and make good decisions for all involved. He spared the family what he could.  Now, he takes that experience and expertise into every client relationship, helping people consider their own sunset years and how it may impact their loved ones.  

Paul Jr. wants you to know that Medicare doesn’t cover long term care facilities. Lots of people think it does, and don’t look any further into it. The options on the table to cover the cost of care for most families are self-insurance, to the tune of $80-$100k annually, or getting long-term care insurance. Paul Sr. was lucky enough to have assets to use for his care, but it did make a dent in the funds left to his wife after his passing.

Statistics don’t matter to the individual; but they help with probability. It’s true that the average stay in a nursing home or other care facility is only 3 years. It’s true that women tend to stay in homes longer than men.  Many people feel they can self-insure for those 3 years and save the ever-rising premiums for long term care insurance, or perhaps only get a policy for a female spouse.

Consider what happens if you fall outside the average. Paul Sr. needed care for eleven years, and Paul Jr.’s mother-in-law needed it for thirteen years. We don’t advise waiting until you discover you need the coverage to buy it. By then you likely won’t pass the underwriting. The best time to buy coverage, assuming a real need and good health, is in your 50s.

Still, this isn’t a push for coverage for everyone in all circumstances; it’s a push for a real analysis for everyone through holistic financial planning that accounts for these possibilities.

A few weeks ago, Paul Jr. became a grandfather for the fourth time. He and his wife, Heather, welcomed a grandson, Fischer, to his trio of little girls. His grandpa name is “Gampy”, an homage to Paul Sr. who was called the same by his grandchildren.  Our Paul is a family man, too.