End of life decisions.

[leebee]

We've just learned that my BIL has lung cancer with bone metastases- stage IV. Five year survival is about 1%; in reality, we are talking 6-9 months. My SIL is devastated, of course, as are we all. She keeps going between horror- what am I going to do- and being drunk- understandable, I am not passing judgement on this. However, she's said she doesn't know what to do financially, where to turn, what's available, etc. I don't know what kind of questions to ask her, or what to suggest when she asks. Is there someplace/one to turn to for help and advice in this kind of situation? They are both in their 60s, he's retired railroad and a veteran. She's on disability from a car accident 20 years ago. No will, no life insurance, nothing substantial in the savings. They own their house, but she's not sure if her name is on it or not. What kinds of things should they be preparing? I can think of some things- file a will, get onto the bank accounts and house, cars, etc., but what other things should she deal with now, so when he passes away her financial life will go as smoothly and be as secure as possible? Right now we are all just reeling with this news; I know there're things she should consider, but my thoughts aren't exactly straight right now, either. TIA.

(For the record, YES, she has asked me these questions and for help, and NO, there's not a lot of money/worth being discussed.)

 

[cijay]

She's got at least 6 precious months that a lot of people don't have the luxury of. If he can sign a paper - start now to be sure the house is in her name and get it done if it's not. When you say 'no will' - you mean 'will and testament' or you mean 'no will to do anything'? Because there's time to draw up a will and testament but get it done pronto. She has the advantage that she can find someone to answer these questions, the bank etc. Is there a senior's help line? Call them.

When my mother died, my father was as 'useless' as someone perpetually drunk (he wasn't but wasn't willing to do a single thing to find these things out) and it was a burden on everyone because so many things couldn't be released to anyone but him - and he wouldn't go anywhere, answer the phone etc. Spending your time drunk is NOT understandable (unless she's alcoholic in which case I have no experience with the illness) because things have to get completed. Unless your brother in law appoints another person, SHE is going to have to do/be there for a lot of it and she has no time to spare. When my dad was failing, it was a lot of running around, signing things etc but we were already appointed POA and directors, the house was already ours, my brother had authority to sell his truck and camper, sell anything out of the house (and we did, the only thing we have left are sentimentals) and make any financial decisions. MUCH smoother. If they have kids, I highly recommend it.

Final word of advice. He NEEDS to write down/record his wishes for his remains. Burial, cremation, burying the cremains or scattering, where to scatter etc. It won't help if he tells 1000 people and one person who has authority (this would be his wife) decides she wants it done differently. It's not like you will have any 'legal' standing but at least you can show it to her.

 

[dotfurio]

What about some end of life counseling? I know there are therapists who deal with this. If nothing else maybe counseling with their clergy. It might help them both face what's coming and maybe find some peace in the time the have left together. She may regret wasting those last few months with him being drunk.

ETA - will she be getting a pension from the RR or his veteran status?

 

[mjkacmom]

Meet with a lawyer. My mom had all of her ducks in a row when she passed in November, and I just got a tax ID number for her trust. Her wake (one viewing), and funeral costs $10,000 (she was cremated, buried in a family plot). That didn't include the repast, we had no limos.

If he has his own bank account, transfer the money (my mom still has $10,000 in hers that my dad can't access, but that might because of having to set up a trust - he has Alzheimer's, so everything is in my hands).

Get in touch with hospice now, even if he's going for treatment. Then you will know what they are entitled to later, if they choose to go that route. My mom had a bad diagnosis, but wouldn't give up hope (4 months from diagnosis to death). Therefore, she wouldn't discuss her last wishes (she was in amazing shape before the cancer, and was planning on living to 100, and ate clean, excercised daily).

My 12 year old told me she wanted to be cremated, her caregiver said she wanted to be nearby, so that was that. Her best friend picked out her outfit.

I'm sorry for your family. I suggest setting up an online care page, to give updates. My mom wouldn't let us, because she felt like that was for dying people, so we fielded so many calls. Do set up help, in the form of meals, errands, yard work, to make things easier.

 

[QueenIsabella]

It may be a little soon, but contact hospice. I don't know if they help out on the financial end of things, but they could probably refer your BIL/SIL to someone who could help them with end-of-life finances. The time to deal with that is now, unfortunately--even if he thinks he has 6-9 months, he could have 2 months or 4 years, who knows. But, organizing the finances will give him some peace of mind in his last months.

P.S. I can't say enough good things about hospice for end-of-life care. The most common "complaint" is, people wish they'd called sooner.

 

[TheDisneyDoll]

I don't mean for this to sound morbid please forgive me if it does, but talk with them about donating his body to science after he's passed. That can really lighten the expense and it can do a lot of good! The family can host a memorial in celebration of his life rather than a full blown funeral and that is a much better way to control the expenses.
Absolutely avoid going in to debt as much as possible, loans and things can feel like a good idea when you're pressured to get money but later on they cause their own issues and even health problems from stress and anxiety.

i'm so sorry your family has to experience this, there's no easy or right way to do it but I hope you're able to find one that is best for your family.

 

[sunshinehighway]

I'm so sorry you guys are dealing with this.
Besides the big, obvious stuff ( getting her name on major accounts, end of life wishes...) changing house hold accounts to her name, making sure she knows login ins and passwords to accounts.
Having to deal with things that seem little now, like putting bills in her name, might feel overwhelming later.

Also meeting with a financial planner might help them both. If she has a solid plan, it might help them both. He's probably also worried about what will happen to her. If they both know she'll be ok then its one less thing on their minds,

 

[leebee]

By "will" I meant the legal document- sorry- but he doesn't have much will either. He's not going to treat this, at least as of right now. I respect his decision- he wants palliative care only. This is a loveless marriage, so neither of them will get comfort or support from the other. The rest of us are trying to be there for each/both of them. I most worry about their adult son, an only child, who has been "in the middle" of mom and dad all his life. I know that my SIL won't keep drinking, she's just trying to adjust to all this in her own way, and is scared of contemplating a future without the financial support she now has- to say nothing of the fact that my BIL is 100% responsible for the physical upkeep of their home. My SIL has never mowed a lawn, much less re-slated the roof or re-pointed the brickwork. He has always done that. Obviously these services can be hired, but it costs. She is pretty much frantic about being able to keep the house in shape. I think that's a bridge to cross went he time comes. Right now, we're hoping to guide her in the direction that will ensure her financial stability... just not sure where to start. I'll suggest she start by talking to their bank; they should be able guide her about accounts, getting things into her name too, etc. I just can't believe that they never thought of their future beyond knowing that he'd have railroad retirement... or that any of this is actually happening.

 

[srferson]

If they own their house and she's worried about upkeep, it may be wise to plan to sell when the time comes. She can downsize, move to a condo or apartment where she is not responsible for as much maintenance, and get a chunk of change from the sale that, depending on the value of the house and financial planning, could help for a long time.

 

[hereyago]

First: I am very sorry this has happened.

Second: Many people dont plan, they its too morbid.

Third: They need to find out if she will get railroad retirement benefits after he is gone.
Did he retire 20 years from military? if so, she will get survivors benefits.
As far as cars: are they paid off? if so, and her name isnt on them: go get her name.on titles
and have it worded his name or survivor then her name.
Same as house: she needs her name on that deed.
get wills for them both now.
get DURABLE POA. Health care proxy.
Living wills.


She has to know his info, passwords, ss# account # .

No life insurance means she will have to pay oop for funeral.
I second TheDisneyDoll about donating body to science,
Also lastly, you are a good person for helping.

And after he passes, she will need support and help, paperwork .

 

[Poohforyou]

If your BIL is getting a pension from the railroad they should check whether it'll continue after he's passed. I know with my dh we were given that option but had to decide when his pension began.

I'm so sorry you all have to deal with this. I would also check with the social worker at your local hospital they would likely be,a good resource. Also hospice should be able to assist with the practical side of this situation.

 

[Lynne M]

I'm so sorry; I hope his remaining time can be as comfortable and peaceful as possible.

As morbid as it may sound, there's an upside in having time to plan. We recently lost a family member suddenly, and though they and their spouse planned well for each other's financial well-being, there's still a backbreaking amount of....stuff....that has to be figured out.

We found that an hour with a lawyer helped immeasurably. They help people deal with the financial/practical side of someone's passing all the time, and ours had a wealth of information and tips. It would be wise for your BIL and SIL to sit down with a lawyer and make a will. That will save pain, aggravation and money later. We were available to avoid probate altogether because there was a will that clearly provided for all of the assets.

If he has property that he owns by himself - house, cars, boats, etc - he may want to get other names on the deed. Particularly the house. If he wants the house to go to his wife, get her on the deed now.

I understand the panic about taking care of the house, but there's an easy answer for that one. An apartment or condo. It will likely be less costly than a house, and you just don't have to worry about snow plowing and trash pickup and what to do if the toilet overflows.

 

[ronandannette]

We've just learned that my BIL has lung cancer with bone metastases- stage IV. Five year survival is about 1%; in reality, we are talking 6-9 months. My SIL is devastated, of course, as are we all. She keeps going between horror- what am I going to do- and being drunk- understandable, I am not passing judgement on this. However, she's said she doesn't know what to do financially, where to turn, what's available, etc. I don't know what kind of questions to ask her, or what to suggest when she asks. Is there someplace/one to turn to for help and advice in this kind of situation? They are both in their 60s, he's retired railroad and a veteran. She's on disability from a car accident 20 years ago. No will, no life insurance, nothing substantial in the savings. They own their house, but she's not sure if her name is on it or not. What kinds of things should they be preparing? I can think of some things- file a will, get onto the bank accounts and house, cars, etc., but what other things should she deal with now, so when he passes away her financial life will go as smoothly and be as secure as possible? Right now we are all just reeling with this news; I know there're things she should consider, but my thoughts aren't exactly straight right now, either. TIA.

(For the record, YES, she has asked me these questions and for help, and NO, there's not a lot of money/worth being discussed.)

I want to offer you a little insight into the "other" end of things; not so much the business aspects. Our brother died almost a year ago; same age and exact same diagnosis and prognosis as your BIL. He also chose no active treatment - comfort measures only. He actually ended up having a little bit more time than they originally thought and it was GOOD TIME! There was very little physical deterioration or acceleration in symptoms for almost a year. Then the metastases gradually began to cause bone/joint pain, which was fairly easily handled with prescription meds. Mobility then began to decline fairly rapidly and his appetite went - that's what finally sent him to hospital (acute care for 5 days) and then into hospice for 14, where his demise was relatively quick and merciful - they did an EXCELLENT job of pain management and comfort as well as supporting us.

What I'm trying to say is that while it is normal for everyone to be panicking right now - just step back and breathe. There will be enough time for your heads to clear and to begin taking steps to get things sorted. BIL will have many more days to ponder his own wishes and how he will take the best interests of his family into account. Please urge his wife to try and respect that the decisions are still his and that he also needs consideration in his grief and fear. FWIW - we are blessedly grateful that our brother did not spend his last year in an agonizing battle with rounds of chemo and radiation. The treatments, as you know from your BIL's prognosis, are not likely to avail much and in themselves cause much suffering. God bless you all.

 

[Mizzoufan]

 

[Meshell2002]

Youve gotten a lot of good advice. My father passed away last summer from the same thing. Get all legal stuff done/ signed asap. Check with his pension about spouse/ survivors benefits. If vehicles are not being used and theres a payment on them id sell and pay off the loan. Check on any life insurance or short term disability policies he may have had. Definately contact palliative care....they can help before hospice is needed and only with what you need in your specific situation...including home health care if your SIL is unable to physically help as he gets weaker. Try to get counseling for both of them....these conversations about wrapping things up are hard to have but harder if not discussed....I believe there will be some good days ahead but those come when affairs are set straight asap. If he has spreading to the brain the last few months he may not be able to remember details of policies and such. My heart aches for your family.

 

[Pea-n-Me]

I agree with a social worker, perhaps one associated with his medical group or hospital. They help people deal with these issues quickly all the time. They can point you in the right direction.

The American Cancer Society offers a lot of helpful programs and services.

As a pp mentioned, check with the local senior center.

Their town probably has a veteran's affairs official who can help with veteran's issues. And of course, the VA. But the veteran's officer might be a little more personalized.

I think a notebook with user ids and passwords is a great idea.

Checking into railroad benefits and what about social security benefits?

And biggest issue, they need to do either living wills or health care proxies, not sure what your state calls them. Appointing someone to make decisions for him if and when he can't himself. It doesn't necessarily have to be his wife if there are trust issues. And he can also list a back up person, but read the wording carefully.

And obviously a will will cover the legal issues. (Health care proxies can be part of a will, but they can do one in absence of a will, also.)

I agree with her looking toward selling the house and moving into a condo or apartment, if possible, if she doesn't want to deal with upkeep on the house. Maybe look into senior housing?

She should also make sure HER advance planning documents are in place for her SON. Relatively easy to do both at once.

Thanks for being there for her. This can be such an overwhelming task when someone dies. Some people just aren't up to the task. I had to do it when I was in my 20s for my mother when my father died suddenly.

Everyone really needs a will.

 

[Kitty 34]

I'm so sorry, Leebee, your family is going thru this.

 

[leebee]

Thank you all for your advice and support; I was so afraid to post my questions and be told to "MYOB" and be chastised for sharing over the internet with a bunch of strangers. I have a good list going for when my SIL calls! I fully support my BIL's wishes to not treat this aggressively. Unfortunately, I think he's pretty far along in the disease process; he's been having thigh muscle wasting and bone pain since September, and when he finished the 2nd course of PT his home-town doc prescribed, in pain and unable to walk, my SIL got him an appointment at Cleveland Clinic, where they diagnosed the cancer and have already put rods in his femur to stabilize it agains breakage. Anyhow. I am hoping that, whatever time he has left, he can have as much quality of life as possible, and that we (siblings and spouses, nieces and nephews) can help support both my BIL and my SIL.

I laughed, though, reading about senior services and senior centers. It never crossed my mind, but of course we are all in that category now. My SIL is 60, my BIL 69, I'll be 60 this summer… just seems odd to associate those numbers with myself and my siblings!

 

[tvguy]

Meet with a lawyer. .

I second this. Meet with an attorney and do estate planning. For for every ADULT reading this, even if you are only 25 years old, do this, and do it now.
My dad had cancer and had a year to get his affairs in order. I was 9 when he died. His planning was so helpful to my mom. As a teen she always kept me informed on what her wishes were if something were to happen. When I was 18, she redid her estate plan to reflect I was now an adult and included me in the plan. She was diagnosed with cancer 4 years ago, then 2 days later had a stroke. Even with an estate plan in place, it was pretty overwhelming to deal with the care decisions, things like which rehab center to move her to, and where to move her for long term care. She had everything set up so that I could continue to keep up with her bills, her house, her car. She purchased long term care insurance which covered all but about $300 a month of her long term care costs. She passed away 13 months later.
The only very small hitch came when I sold her house, the Title Officer balked at her trust, because it was done nearly 40 years ago, and because it was so simple, just 2 pages. The Title company's lawyers looked it over, and that hitch was overcome in a few hours. It met all the legal requirements. One of the old time lawyers recognized the form she used. It was the one the County Recorders' office used to hand out for people to set up trusts for their houses. They stopped handing those out because lawyers objected because it allowed people to not use a lawyer to set up a trust. So instead of $1,000 in legal fees, people were setting up trust for just the $15 Recording fee!

 

[Pea-n-Me]

Just something medically to note, in case it comes up, Leebee. If he was a smoker there can be a lot of "shame" associated with a lung cancer diagnosis, and a lot of "I told you so's" from people. It's just one more thing people have to deal with that can escalate the emotions of already-overwhelmed people. Just something to think about. You might look to the American Lung Association's website, or the American Cancer Society, to see how to help them respond to that - I'll take a peek around for you.

Here's one article: https://www.lungcancerfoundation.or...he-bias-the-stigma-the-shame-blame-and-guilt/

And another: http://www.lungcanceralliance.org/assets/docs/publications/Final Stigma Brochure 4 color 9_18_12.pdf

In an roundabout way, these may be especially helpful to this man's son.