The Dreaded Dementia

Of all the perils that might befall an elder orphan, dementia is surely the most frightening.

Dementia describes a variety of diseases that are detrimental to the function of the brain. We often think of Alzheimer’s disease which marks the majority of all dementia cases, however, brain damage caused by a stroke or an injury, impairment from Huntington’s disease, are some of the other causes.

This insidious disease slowly embraces its victims and leads them into a fog from which at least in the present day they will never return.  We are often teased with news of advances in the fight against dementia.  Sometimes it feels like a race to cure Alzheimer’s disease or at least inhibit its advances against the time that we have before it envelops us.  There are plenty of on-line resources that describe the symptoms of dementia and the progress that research is making to deal with it.

Fortunate are those of us who have not witnessed the effects and progression of dementia among our family members and acquaintances and the struggle and challenges that their care-givers face and we are aware of the suffering that is inflicted on them.  We learn of the drastic steps that those care-givers take to deal with the condition.

As I write this, the legislators in the Province of Quebec are dealing with the debate.  Under Quebec’s 2015 law, euthanasia for the demented is specifically excluded arguing that a person who makes a request for medical assistance in dying must be capable of consent.  They now want to open a public debate on legalizing euthanasia for persons unable to give that informed consent and allowing people to make advance requests for assisted suicide, giving people with dementia access to the medical procedure.

Those opposing the idea contend that demented patients need to be protected and the wishes that they expressed years ago may not reflect what they would want today.

Quebec is also asking the courts to clarify a section of the federal assisted-suicide law that says the procedure should only be available to those whose deaths are reasonably foreseeable.

The issues came to the forefront as a result of a recent case of a man who is facing second-degree murder charges in the death of his 60-year-old wife, who had Alzheimer’s disease but was refused a doctor-assisted death but whom according to family members was refused help.

Now the question that surfaces is while we remain of sound mind whether we should be off to our lawyers to prepare a document that will deliver the authority to our loved ones and care givers to end our lives when we have lost our mental capacity to make that decision ourselves.  There is a great deal more to explore on this matter including how to prepare legally,  financially, and otherwise for the possibility that we might succumb to this terrifying disease.

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The Stages of elderorphanism (Is that really a word?)

When we arrive on the planet, and probably for the next few decades, the thought of becoming an elderorphan likely never enters our minds.  We have parents, aunts, uncles and other relatives not to mention plenty of friends who we know that we could depend on if we needed them.  The majority of us possibly embrace the idea of parenthood at some day in the distant future.

Then come the middle years.  Perhaps our future elderorphans  enjoyed a lifestyle unrestrained by children and just kept putting it off.  Perhaps Mother Nature played a cruel joke on them and adoption would be their only path to a family, and perhaps they simply decided that they were not the parenting kind.  And life continued on as they enjoyed their time with their spouses, family and friends.

At some point though it may have begun to dawn on them that it might be a good idea to undertake some planning in case they managed to outlive those who were close to them and that they had designated if only in their minds as the people they could turn to for help and support if required someday.  But that time was still a long way off, and who could predict the changes that will confront them?  No need to hurry.  Things always sort themselves out!

As time marches on, the pressure slowly increases towards at thinking about the future.  The future elder orphans begin to study their wills.  Who will survive to be their executors?  Who will be the beneficiary of their estate?  But more importantly, who can they designate as their Power of Attorney for financial and other matters and for personal care?  Reflecting on their own acquaintances over the years, it becomes obvious that there were a few elder orphan friends, neighbours and relatives who navigated through this potential dilemma.   Some were happy and successful outcomes.  Some were sad and lonely.

Some elder orphans simply accept that the future is out of their hands and that there is little that they can do to influence the outcome.  Others decide to investigate some steps to ensure that they have the best chance of enjoying a happy ending.  The planners are probably still reading this.  Perhaps they will discover some ideas here that facilitate their quest for that goal.

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How Many elder orphans are there?

Opinions vary widely on how many elder orphans there are in our population but it seems that anywhere from 15% to 25% of people over the age of 65 either are elder orphans or likely will become one, and the numbers are trending upwards.

It is reported that U.S. Census data from 2012 showed that about one-third of Americans aged 45 to 63 are single, a 50% increase from 1980; nearly 19% of women aged 40 to 44 have no children, as compared to 10% in 1980. Today, one in three Baby Boomers is unmarried.

Several factors are contributing to the rise including historic low marriage rates. A large number of young people lack the economic security to consider marriage and it is reported that 40% of them are still living with their parents. In mid to lower income groups there are fewer desirable partners and a lot of people believe that marriage is obsolete. These and other factors contribute to the inclination to delay marriage and consequently narrow the window to rear a family.

Statistics suggest that half of all marriages result in divorce and it has been this way for the last forty years when no-fault divorce made it a great deal less complicated including elimination of the requirement for a long separation. People who get divorced and remarried are more likely to divorce again and further narrow the window of opportunity to raise children.

Especially among professional women with careers in law, medicine, finance, education and technology, many women are putting advancement in their career ahead if the desire for a family. With a strong financial foundation of income and savings these women may be less willing to sacrifice their lifestyle by compromising on a less than perfect mate.

Thanks to advances in modern medicine we are simply living longer and so providing an increased chance that we may become an elder orphan.

Whatever the number, it is clear that there are a lot of us. Let’s just assume that it is a very low estimate of 10%. With a combined population of Canada (35 million) and the U.S.A. (320 million) that would translate into a population of elder orphans the size of all of Canada or slightly less than the population of California. Unless they are elder orphans, most people would not be aware of any of the issues that confront us.

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