Imagine my surprise as I started watching The Sopranos and discovered – dang, this sounds like my life!!!!
I’m a little late to “The Sopranos.” It first aired in 1999, and I’m just getting around to watching it. I just started Season 2, but have been surprised that one of the pervasive conflicts of the show is the drama between Tony Soprano and his elderly mother, Livia. The big conflict being — what to do with mom when she can no longer take care of herself at home, but thinks she is managing just fine. This is a classic elder law conflict that we regularly deal with in our office.
Livia is a widow living alone in the house where she raised her children. She is an unpleasant complainer who was never a good mother. Tony looks in on his mother and determines because of her cognitive decline and loneliness, she should no longer be living alone. He finds a nice retirement community for her. Livia resists moving, referring to the place as a nursing home. However, after Livia sets her kitchen on fire by accident, Tony hires a live-in companion. Livia is so difficult to deal with, the companion soon quits. Livia then hits a friend with her car, and her destiny is set. Tony moves her into the retirement community.
I started watching The Sopranos because I discovered I like James Gandolfini. I can’t express how surprised I was at finding so many themes in a mob show that were relatable and familiar in my life! For example, Tony has power of attorney, but does that mean he can make Livia move against her will? (not in real life). Tony finds a lovely retirement community, but Livia only sees it as a dreary nursing home. Livia is having memory lapses and cognition issues that are putting her safety at risk (eg. starts a fire on her stove), but doesn’t think she needs help. Tony arranges a live-in companion, but Livia doesn’t want anyone in her house and runs the caregiver off.
Shew! I’ve heard all these stories several times over from my clients. And while hopefully our clients’ parents are not as difficult as Livia, even the sweetest, kindest parents can suffer a decline in cognition, and resist all efforts of their children to help them. It’s for this reason almost every day I go home after work and say a little prayer that goes like this: “Please please please when I get old with dementia, let me cooperate with the people who are trying to help me!!!!”
What can The Sopranos teach you about your aging parents? Admittedly, even people who have been lovely parents and done excellent planning ahead can become difficult to deal with. We cannot control what age and disease might do to our minds. The only thing we can do is plan as best as we can and hope for the best.
On the planning side, make sure your parents have done estate planning documents. A power of attorney and advance medical directive are critical tools in helping your parents with decision-making during their lifetimes. Have a frank conversation with your parents about finances and what kind of care they would be able to afford should they need it. If parents say “don’t ever put me in a nursing home,” children should ask their parents what their plan is if they can’t take care of themselves anymore? If they want in-home care, how are they going to pay for it? Who will provide the care? Is there money to pay it? Can they afford long term care insurance? Should they look at estate planning tools such as trusts for asset protection in the event they need nursing home care?
We also suggest you explore local retirement communities, assisted living facilities and nursing homes. Visit those facilities with your parents to know which places they would prefer if facility care becomes necessary. Talk to home companion services. Talk to friends who have had to put loved ones in facilities and ask them if they would recommend a particular facility. Imagine the stress on adult children when parents become suddenly disabled due to a health event, and the children must suddenly pick a facility with no frame of reference, and no documents in place giving them authority to make decisions on their parents’ behalf. Avoid the stress by planning ahead.
There’s no doubt that this moment in time where the roles switch and the child is suddenly in charge is difficult. Tony and Livia are proof of this. (Although not usually difficult enough that mom takes a hit out on son — oops, spoiler alert!!!)
Planning and communication between parent and child early on, before the need for care arises, is your best chance in shepherding your parent into the stage of life when they can no longer live independently.