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Tuesday, November 29, 2005

The Belle of the Brawl*

This is a totally political post.  While it began in the Clinton years, it was Newt who had power.  The current admin leaves society issues to the family unless it's to keep some people alive.  Well it takes a village.  And our society is aging but we have no social policies in place.  So most families do the best they can do. 

I got a Masters in Social Work with a concentration in clinical geriatrics while this was happening in the naive belief that the problems of the middle class, non Medicaid eligible would be addressed.  You have to be very rich or poor to get decent help in this country.  And if you have any assets and you're older with family you love, get a trust.  I took the link from the government.  They recommend it.

While I would love to take credit for the title; it's the name of Moxie and my friend, Sar's new blog.

This is the most personal post I have ever written. It's also the saddest; it's about things that I have been trying to talk about for fourteen years.

Yes Bring it on! is a political blog. But politics should primarily be about issues. Here it is aging, single adult daughters, taxes, health insurance, Medicare and Medicaid in one post.

My dad died suddenly when I had been working at Social Security for two months. I took three days off and on the fourth day the managers asked which of two offices I would want to work in. Frankly they both were in horrible neighborhoods, in places I wasn't too familiar with.

I was in the first External, not promoted from within SSI Claims Rep training class in eight years. Have always found it ironic that Bush 1 tried to put back together what Reagen tried to dismantle. I had applied for positions in San Diego and Miami, and the transfers came through. I had been in a semi-relationship with a character actor who had moved to LA; he had many male straight friends; it was perfect.

But my mom had macular degeneration. She was of the first generation of people to outlive their body parts through diet, good health care, and all the rest.

My mom's macular had begun when my parents were in a photo safari in Kenya; she thought it was her new eyeglasses. Maybe something could have been done then. We'll never know. Ultimately she lost all her eyesight except for a shadow here; a shadow there. She wasn't demented and yet many people treated her as if she were.

New York was falling apart in 1991; we were still feeling the effects of the 10/17/87 stock market fall and ensuing recession. I lived in the richest zip code in America, 10021, and would count the Old English Ale bottles I passed on the way to the subway. In the morning I would wake up bag people sleeping in both the vestibule and the first floor hall. There were three apartments on the first floor; the first was unoccupied; the second was mine; the third was occupied by girls my super thought were prostitutes; and I thought were drug dealers because people would come and go every five minutes at night. When I had overnight guests they would stay up and count; I had become impervious to it.

Oh I was so ready for a change. I made it all the way to Riverdale, The Bronx. If there is one place that I will never write nicely about it's Riverdale; my time there was hell.

I don't drive; the world's safer that way. It would take me about three hours to get to her house on Long Island. Keeping my mother independent took two daughters, a major part of my sanity, and almost my sister's and my relationship.

Estate planners often use a lifetime trust in place of a will. Like a will, a lifetime trust can be used to provide for the disposition of assets and has the advantage of avoiding probate. An advantage that a lifetime trust has over a will is that it also can be used to manage assets during a person's lifetime. For example a lifetime trust can be a useful planning tool for incapacity because it can be established and controlled by a competent person and later continue in operation under a successor trustee if the person establishing the trust becomes unable to manage his or her affairs.

My sister paid her bills and managed her portfolio; I took care of her doctor's appointments and what I later would learn were "psycho social" needs. My mom didn't want to have a trust though my dad was a CPA and my mom knew very well that she could control it. Since she couldn't do her own paperwork the only control left to her was not having a trust. I knew I should have urged her to do it, but she was my mom. My sister and I jointly consulted our mother on all financial decisions.

I had the brilliant idea to leave Social Security and get a Masters in Social Work with a concentration in clinical geriatrics. I took a year off to try out school and be even more available for my mother. I had left home at eighteen; 20 years later, there I was again. I didn't go out every day or even every week, but I spoke to my mom, five times a day. And whenever she would need me I would be there. I became expert at speaking to doctors and forcing them to speak to my mother. I became expert in old age, but I wasn't.

My parents had raised my sister and I to be independent. It was easier for my sister; she married, and several years later bought my mother's house when my mom moved to a large apartment complex that was a NORC; Naturally Occurring Retirement Community. It has an eighteen hole golf course, a country club, an arcade which looks like a movie set of a beautiful city, and activity rooms. My mom loved book clubs, discussions, museums, anything cultural really.

She wasn't very good at being dependent. She wasn't very good at becoming blind in her 70's and 80's

She was good at meeting people; but my always sociable mother became shy and insecure. She thought that most people treated her as if she were demented and as her own sisters refused to visit, I would have to agree with her. I no longer really speak to most of my mom's family. We had once been very close.

Newt Gingrich was elected shortly after I began school. For all of you who think it was a good thing; I'm not going to get into "changing welfare as we knew it." It affected my life incredibly.

I expected to be able to discuss these things at school but my top rated grad school of social work, didn't have one Masters Degree level course on aging from 94-96; they had before and after. I could have taken a PHD level course but was advised against the courses as I already knew the content from my field placement and research classes. The larger school had a center on aging but it was distinct from the social work school which made no sense at all. I did an Independent Study on Abuse because I had become good at recognizing it. And sometimes I wasn't sure if I was becoming an abusive daughter or not. Elder abuse can be hard to recognize; it's not only physical but neglect, fraud and other things. It's not mandated reporting.

My mom couldn't go to activities by herself as she couldn't navigate the hallway to the elevator and the arcade. She wanted me to fix this problem and I couldn't unless I moved in with her, brought her down and back up. Many other daughters might have done this. I couldn't.

I couldn't fix any of my mother's problems. Though I passed the state licensing exam while still in school, had been given my own hall in the nursing home I did my field placement in at the beginning of my second year, had a 3.84 cum, and an outstanding field placement evaluation, I felt like a failure.

My mom had been my best friend since I was a kid. I know that sounds strange, but we had a closeness and a friendship that's more typical in this generation of parents and children. I was slowly losing both my mom and my best friend. Oh yeah, I was adopted, for the record. I forget.

I stayed at the nursing home, though I had been offered some great field placements because it was familiar and I couldn't handle change that year. It was exciting the second year; I worked with two psychiatrists, both female, who had started geriatric mental health clinics. By the time I graduated the clinics had disbanded; victims of the Newt cuts.

Social work salaries were the only salaries to go down in 1996. When I found myself almost fighting for a $28,000 year a job I knew it was time to get real. It was a damn insult. If I didn't find a coop in Manhattan by the summer of 1997, I was going to be priced out of the market. I'm good at trends; it was kind of obvious to me. If I didn't find a coop in Manhattan I was going to lose my mind. Worked at the nursing home; went home to another or a building that felt like one.

I will spare you the rest. I bought a coop; my mom consented to get an aide five days a week, four hours a day. She wasn't Medicaid eligible; something I could have made her in a day, and I heard a lot about how stupid I was for not making her go on Medicaid as earlier I had heard about how I shouldn't have let her eat by herself. These were PHD's in Social Work who provided such incredible solace. They were experts in capability; they knew that the reasonable man standard no longer applied. A person could be capable in one area but not another, yet judged well enough to live alone.

My mom remembered every phone number; she could take five medications a day by herself. She was bright but blind and scared. Something happened to her after 9/11. It took the life out of her; she sounded different; at times I thought she had suddenly become demented. But two weeks after it, she said that there was a question she could only ask me:

"Do you think it's repercussion for everything we have done?"

I was shocked as I was in full patriotic mode. Fortunately I could speak in my normal voice and say:

"Some people think so. I don't."

She told me that sometimes she couldn't find her way around her apartment. I was the only person who knew this and I did nothing. May G-d or whoever forgive me. I knew that my mom wanted to die in her apartment and I knew that something wasn't right.

She fell in her bathroom and died fifteen minutes later. It is only this year that I have begun to lose the guilt and the extreme mourning. I'm me again for the first time in a decade.

But her death was only the beginning. Though we wouldn't have had to pay estate taxes this year, we had to pay full taxes for 2001. We live in New York City and thus had to pay city and state taxes. The highest.

This isn't going to make me real popular. My sister and I had never asked our mother for a cent. She would give me a hundred dollars many times when I saw her, but I would put out money for things for her and never asked for it back. My sister did the equivalent of a full time bookkeeper/accountant; I was my mom's private fully trained and accredited social worker. Even when I was working or in school. Both my sister and I stopped going far away. Neither of us would be more than three hours or so away from home.

I spent so much time at doctors offices with my mom, I neglected my own visits; I neglected many things because my entire psychic energy was tied up with my mom's. I don't know how else to explain it. I'm paying for all that now.

I am glad that my mom never went on Medicaid. I met so many people who were so much richer on Medicaid. I can understand it, but I don't think it's ethical or good. Yet damn, the Medigap was so complicated. Now sometimes I'm glad my mom's dead just so we don't have to look at the new insurance policies.

If my mom had a trust we wouldn't have given the government a huge chunk of money. Yes there would have still been the costs of probate, but...our mother didn't pay us. I didn't get any social security credits for the time I wasn't officially working or in school though I ran a hall and took the place of a part time social worker. My sister didn't get any during the ten year period. We deserved the money that went to the government.

No CPA, broker or lawyer could believe that she didn't have a trust. She was our mother; it was her wish to retain control if only in name. I feel badly about the money; I really believe that we earned it. But first we were daughters.

I can't believe that it took The New York Times until last Friday to discover this growing problem. I hope that people begin discussing it now.

I read in a blog today that The Times article could stop girls from becoming brain surgeons. Not at all; no 22 year old is going to stop a career because of something that could possibly happen when she's 50--I was adopted so my parents were older and my sister and I were younger. No, I was going through a mid career change, and my sister had just begun to work for my dad as she had an MBA.

I had a friend who finally moved out of her parents home when she was 38, a Senior VP at a Fortune 100 company, bought her own home, and her mother became severely demented and had to move in with her.

My mom and I would joke about my living with her. We figured that we would last two days before we began to want to kill each other. We wanted to anyway. Yet my mom remained my idol. It's so hard to explain, and at each aging symposium I would go to, I would expect to discuss similar situations to mine. But everybody either had pat solutions or no solution at all.

For fourteen years I have been trying to get a dialogue going on the problems of aging in America, very specifically the aging parent issue. Next very selfishly I want a dialogue on "who is going to be there for me", because while I was immersed in my mom's life I stopped my life. I looked like I had a life, but I was going through the motions.

I had never known what it was like to be depressed before. I know now. I knew how to be an independent adult; I didn't know how to be whatever this was.

The Times calls it "The daughter track," I call it the train to nowhere

Posted by Pia Savage at 12:01 AM in Current Affairs, Economics, Politics, Science, Weblogs | Permalink


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It’s very hard to deal with all the problems related to aging with no substantive help from the government. I'm one of those people who think besides maintaining the infrastructure; our government should be there to lend a hand once in a while. I am very concerned personally about aging. I have no family safety net – friends, yes – but no one to do for me what you and your sister did for your Mother, and there are times when that scare’s the piss out of me. Who’s going to help me through that ever increasing maze of paperwork? I’m afraid by the time I’m in my 70’s, my husband and I are going to have to rely on what finances we have managed to squirrel away. And that is a truly frightening thought, what with medication and treatment fees skyrocketing.

As for what happened to your Mom – give yourself a break, Pia; you were there for her - really. Her fall was an accident no one could have prevented. I do understand the responsibility part, though. I always take everything on my shoulders as well. It’s so hard sometimes to realize we are not, after all, God. Be at peace, my dear.

Posted by: The Fat Lady Sings | Nov 29, 2005 2:21:41 AM


I went through that a few years back. Taking care of an elderly parent is extremely hard both monatarily and mentaly. It happens to more people than you think and it is happening more and more.

I would hate to politicize this but the GOP's plan is that you should have known better!!! Planned better!!!! Thunk better!!! Easy for them to say when they are rich.....

The GOP is nowhere near the party of the people.

What happened to you has happened to many the conservative media would not like to report on but it happens a lot.

Life is what you make of it and people are what make your life, so thank your Mom for the strengths she instilled in you and move on.

I know I thank my Mom for it every day.

Posted by: The Bastard | Nov 29, 2005 7:19:21 AM

Pia, the thing that all policymakers need to see is how policy interacts with people's lives. That's why this is a great post. Whatever programs we have need to accomodate the lives they're meant to secure.

Posted by: Doug | Nov 29, 2005 9:48:15 AM


My sister went through a similar situation with my mom. My sister was going through a horrible divorce at the time and attempted to commit suicide. My sister was put in a mental institution for one month. When she was let out, my mother, who was 90 at the time took a cab from Riverdale to White Plains, where my sister lived, and she and my sister slept in the same bed in the same one bedroom apartment for three months. My sister and I were lucky enough to have a mother, who at 90, was still able to feel and care for others.

My mother loaned my sister some money and she was able to buy a condo in New Rochelle, on Weaver St., across the street from Scarsdale. My mother lived alone, and my sister brought her food once a week, and every weekend my sister would pick her up and spend the weekend with my mother at her new home.

Since I lived in LA and was working 24/7 as a practicing trial and appellate lawyer, I could only visit my mom and sister a few times a year. I would take my mother on long drive through the Westchester and Connecticut countryside which she loved and adored. Both mom and I loved beauty. I still do.

Two years before my Mom died, she discovered her birth certificate. That certificate reflected that she and I were both born on the same day, March 15th. That discovery brought my mother and I closer together as I now could understand the similarity in interests. When Clinton was going through the impeachment trial, my mother, who was 91 at the time, commented: "he is a man isn't he. Men do what men do. It did not affect his ability to run the country." She was a legal secretary at age 15, and worked as such until I was born.

Then suddenly, I received a telephone call from my sister who told me that my mother had fallen in her apartment in Riverdale, broke her hip, and was taken to the hospital. I got on the next plane, but arrive in NYC two hours after she passed on. I did not get the chance to say goodbye.

I delivered the eulogy at her funeral, and I was proud to be my mother's son to have the ability and the courage to deliver my heartfelt, long repressed, thoughts and feelings.

Pia. Sometimes life sucks and throws you a curve ball. My mother was expected to live to 100 and I was overjoyed at that thought. I live my life trying to straighten out life's wrongs. Sometimes I succeed, and sometimes I fail, but I try to do my best. We are stuck for another 3 years with the worst President that America ever had. You and I both know that, and most everyone who reads this blog knows that. Bush is an ignorant, uncaring, unfeeling, fratboy, who thinks of nothing except himself and his monied supporters. His religion is his crutch. What else does he have to turn to, drink and smack. Wouldn't you love to do some social work with him and socialize him to fit into humanity?

Lastly, as you know I am a lawyer. Even lawyers do not take care of their own personal situations, as they are so busy taking care of others. Finally, at my wife's urging, we employed an Estate Lawyer to do an estate plan and set up a series of trusts, to avoid the situation that you described. I still do legal work for my friends and myself, sometimes I get paid and sometimes I do not. However, if I save someone from a lot of grief, I feel good about it. It is not about money. It is about life. I can only wish the Bush Administration and everyone in it, a very short one.

Posted by: Martin Friedlander | Nov 29, 2005 2:04:41 PM

Again you bare your soul for all to see. Thank you for your courage to share. At some point, the government will have to deal with the insurance, medical, and elder care industries with brass knuckles. But unfortunately, it may take a disaster the size of Katrina to force it.

I rememnber back to the days when Hillary Clinton was tarnished becuase she was working on some of these very issues. Let's hope that with the next administration has the courage to address these concerns.

The W, Rove and Co is supremely distracted and distracting.

Blog on Sister, blog on.

Posted by: windspike | Nov 29, 2005 2:08:13 PM

Pia, thanks for the nod. I'm impressed with the way were able to interweave your personal experience into this post.

Posted by: Sar | Nov 29, 2005 2:25:58 PM

Thanks all
This wasn't meant as a whine; or for me to rant, though as everybody knows I love to do both

I'm over the guilt; though when I was researching this, the government site about trusts was very easy to find

when I continually looked for government sites about trusts while my mom was still alive; couldn't find it, and I always look for the most primary sources avaliable. While my mom might not have liked the government she respected laws, and had I been able to find it and read it to her, I know she would have changed her mind

But it's really not about the money; but time spent that can never be gotten back, even my career choice was based on my need to understand what was happening and to find people that I could discuss this with.

I found two types of people: "get her Medicaid," get her into an assisted living facility," or "get a damn trust."

There are ironies to this: she didn't want Medicaid and I can't blame her. She would have killed herself before moving into a situation she couldn't have controlled.

My dad used to have us have death drills, but he never had disablity ones; disablity wasn't in our vocabulary.

Then back to money. Much of the money was made in the 1990's. Who made it? My sister and I; so in reality we paid over and over again for making sure that our mother would never have to rely on government assistance.

We paid the damn taxes in 2003 before the war was announced. We actually pretended that the money was going to go to good purposes--our country.

I left out the parts about how difficult everything was in New York after 9/11; and how doing the most simple things were complicated by anthrax--no mail for six weeks; and by the attitude of clerks etc who were overwhelmed by tragedy and couldn't deal with normal death

Honestly I wouldn't care about any of this if my mom hadn't died alone and concious. I, the geriatric social worker, had been with "strangers" when they died, but I wasn't there for my own mother. I'm over that now

But I want people to understand that keeping one older person independent takes a family, much much time and yes money

And I hate the thought of my mom's money going to support a war she would have detested

Posted by: pia | Nov 29, 2005 2:37:52 PM

Obviously I am neither old enough nor do I possess enough knowledge to address this issue. I do hear some of this or have heard it in the past as I have several physicians on my family and one of them is a geriatric practitioner in Florida as a matter of fact. Policies are not made in regard to human beings who have to actually live a life ...that is all I heard that and take care fo your finances , make sure your assets are allocated and protected a long time before you become incompetent or unable to distribute them yourself.

So we spend billions on a inane war and this...is how we treat and or address our aging population?

Nicely woven essay and thank you for sharing it.

Posted by: cooper | Nov 29, 2005 6:52:41 PM

In 2002, my grandparents thought they had enough money saved for a very comfortable retirement. They both had pensions and Social Security, not to mention hundreds of thousands in additional cash tucked away in a variety of IRAs, bonds and annuities.

Within two years, though, the cost of health care, medications, in-home nursing care for my grandfather (his choice - he lived with my parents for a while but they were like oil and water) and end-of-life hospice care for my grandmother had completely wiped out their life savings.

The state took possession of the family home and sold it off. My grandfather, a depression-era penny-pincher who had scrimped and saved for his entire lifetime, is now reduced to a $20 per month allowance and a bed in a state-funded nursing home.

Quite an ironic end for a staunch Republican, and I don't mean that mockingly.

Something has to give. Whether it's tort reform, an overhaul of the pharmaceutical industry, health insurance reform, a national healthcare system or some combination of all of the above, we really need to figure out some sustainable form of affordable healthcare, and quickly.

In the next decade or so, a sizeable portion of the US population is going to start hitting the age where healthcare costs start to escalate. When that happens, it's not going to be pretty.

Posted by: Joe Snitty | Nov 29, 2005 9:28:03 PM

lack of help is nothing new. reinventing the wheel is what they do. LOOKOUT or you'll be charred by the system

Posted by: charred by the system | Dec 4, 2005 2:28:17 PM

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