I’ve been reading through the Bible chronologically the past couple of years to better understand the actual flow of events recorded therein. It’s slow going—about a chapter a day—but it’s much easier to understand events when doing it this way, rather than how the Bible has been assembled. Though this post isn’t about what I’ve learned, I will say that I continue to be amazed by the bare humanity (and lack of glossiness) of people in the Old Testament. It’s about as real as you could get when chronicling the history of people.

One such story is that of Absalom, a son of David, who attempts to overthrow David as King, and nearly succeeds. While doing research on this event, I came across the 1936 book Absalom, Absalom! by William Faulkner, which takes its name from Absalom of the Old Testament, because of the main character’s ambition and family conflict. Faulkner’s story is set around the American Civil War and deals with themes of ambition, pride, and slavery through multiple perspectives.

I have never read a Faulker novel, and boy was I in for a surprise. Faulker has an amazing way with words, but this novel in particular is a challenging read. Not only is the storyline complex and non-linear, but the sentences are long, flowing, and poetic. One sentence in particular is 1,288 words long.

It’s this sentence that I decided to diagram to better understand the nested words and phrases. I didn’t go into the same level of depth that I did for my analysis of Lincoln’s Gettysburg Address, but I still found value in the effort.

First, here’s the longest sentence (in italics) and its preceding paragraph and as written. Below that, you’ll find the diagrammed sentence.

As Written:

“Yes,” Quentin said. He sounds just like father he thought, glancing (his face quiet, reposed, curiously almost sullen) for a moment at Shreve leaning forward into the lamp, his naked torso pink-gleaming and baby-smooth, cherubic, almost hairless, the twin moons of his spectacles glinting against his moonlike rubicund face, smelling (Quentin) the cigar and the wistaria, seeing the fireflies blowing and winking in the September dusk.

Just exactly like father if father had known as much about it the night before I went out there as he did the day after I came back thinking Mad impotent old man who realized at last that there must be some limit even to the capabilities of a demon for doing harm, who must have seen his situation as that of the show girl, the pony, who realizes that the principle tune she prances comes not from horn and fiddle and drum but from a clock and calendar, must have seen himself as the old wornout cannon which realizes that it can deliver just one more fierce shot and crumble to dust in its own furious blast and recoil, who looked about upon the scene which was still within his scope and compass and saw son gone, vanished, more insuperable to him now than if the son were dead since now (if the son still lived) his name would be different and those to call him by it strangers, and whatever dragon’s outcropping of Sutpen blood the son might sow on the body of whatever strange woman would therefore carry on the tradition, accomplish the hereditary evil and harm under another name and upon and among people who will never have heard the right one; daughter doomed to spinsterhood who had chosen spinsterhood already before there was anyone named Charles Bon since the aunt who came to succor her in bereavement and sorrow found neither but instead that calm absolutely impenetrable face between a homespun dress and sunbonnet seen before a closed door and again in a cloudy swirl of chickens while Jones was building the coffin and which she wore during the next year while the aunt lived there and the three women wove their own garments and raised their own food and cut the wood they cooked it with (excusing what help they had from Jones who lived with his granddaughter in the abandoned fishing camp with its collapsing roof and rotting porch against which the rusty scythe which Sutpen was to lend him, make him borrow to cut away the weeds from the door—and at last forced him to use though not to cut weeds, at least not vegetable weeds—would lean for two years) and wore still after the aunt’s indignation had swept her back to town to live on stolen garden truck and out of anonymous baskets left on her front steps at night, the three of them, the two daughters negro and white and the aunt twelve miles away watching from her distance as the two daughters watched from theirs the old demon, the ancient varicose and despairing Faustus fling his final main now with the Creditor’s hand already on his shoulder, running his little country store now for his bread and meat, haggling tediously over nickels and dimes with rapacious and poverty-stricken whites and negroes, who at one time could have galloped for ten miles in any direction without crossing his own boundary, using out of his meager stock the cheap ribbons and beads and the stale violently-colored candy with which even an old man can seduce a fifteen-year-old country girl, to ruin the granddaughter of his partner, this Jones—this gangling malaria-ridden white man whom he had given permission fourteen years ago to squat in the abandoned fishing camp with the year old grandchild—Jones, partner porter and clerk who at the demon’s command removed with his own hand (and maybe delivered too) from the showcase the candy beads and ribbons, measured the very cloth from which Judith (who had not been bereaved and did not mourn) helped the granddaughter to fashion a dress to walk past the lounging men in, the side-looking and the tongues, until her increasing belly taught her embarrassment—or perhaps fear—Jones who before ’61 had not even been allowed to approach the front of the house and who during the next four years got no nearer than the kitchen door and that only when he brought the game and fish and vegetables on which the seducer-to-be’s wife and daughter (and Clytie too, the one remaining servant, negro, the one who would forbid him to pass the kitchen door with what he brought) depended on to keep life in them, but who now entered the house itself on the (quite frequent now) afternoons when the demon would suddenly curse the store empty of customers and lock the door and repair to the rear and in the same tone in which he used to address his orderly or even his house servants when he had them (and in which he doubtless ordered Jones to fetch from the showcase the ribbons and beads and candy) direct Jones to fetch the jug, the two of them (and Jones even sitting now who in the old days, the old dead Sunday afternoons of monotonous peace which they spent beneath the scuppernong arbor in the back yard, the demon lying in the hammock while Jones squatted against a post, rising from time to time to pour for the demon from the demijohn and the bucket of spring water which he had fetched from the spring more than a mile away then squatting again, chortling and chuckling and saying ‘Sho, Mister Tawm’ each time the demon paused)—the two of them drinking turn and turn about from the jug and the demon not lying down now nor even sitting but reaching after the third or second drink that old man’s state of impotent and furious undefeat in which he would rise, swaying and plunging and shouting for his horse and pistols to ride singlehanded into Washington and shoot Lincoln (a year or so too late here) and Sherman both, shouting, ‘Kill them! Shoot them down like the dogs they are!’ and Jones: ‘Sho, Kernel; sho now’ and catching him as he fell and commandeering the first passing wagon to take him to the house and carry him up the front steps and through the paintless formal door beneath its fanlight imported pane by pane from Europe which Judith held open for him to enter with no change, no alteration in that calm frozen face which she had worn for four years now, and on up the stairs and into the bedroom and put him to bed like a baby and then lie down himself on the floor beside the bed though not to sleep since before dawn the man on the bed would stir and groan and Jones would say, ‘Hyer I am, Kernel. Hit’s all right. They aint whupped us yit, air they?’—this Jones who after the demon rode away with the regiment when the granddaughter was only eight years old would tell people that he ‘was lookin after Major’s place and niggers’ even before they had time to ask him why he was not with the troops and perhaps in time came to believe the lie himself, who was among the first to greet the demon when he returned, to meet him at the gate and say, ‘Well, Kernel, they kilt us but they aint whupped us yit, air they?’ who even worked, labored, sweat at the demon’s behest during that first furious period while the demon believed he could restore by sheer indomitable willing the Sutpen’s Hundred which he remembered and had lost, labored with no hope of pay or reward who must have seen long before the demon did (or would admit it) that the task was hopeless—blind Jones who apparently saw still in that furious lecherous wreck the old fine figure of the man who once galloped on the black thoroughbred about that domain two boundaries of which the eye could not see from any point.

Diagrammed:

Unfortunately, there’s no easy way to diagram or show diagrammed sentences on Substack, so I’ve done it in outline form in a document. To any English teachers out there reading this: I know I haven’t done this correctly—it’s really just an organization and nesting of phrases to make it all a little more understandable. Please forgive me.

Diagrammed William Faulkner

161KB ∙ PDF file

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Anyhow, it was a fun exercise for me, and probably means nothing to you. But, who knows, maybe it’ll encourage you to pick up a book and do some reading…might I recommend Absalom, Absalom! by Faulkner? 😬

Or, maybe start with something easier.

I also just recently read Dungeon Crawler Carl, which is a science fantasy series by Matt Dinniman about Carl, a Coast Guard veteran, and Princess Donut, his ex-girlfriend’s talking cat, who survive an alien corporation’s destruction of Earth and must compete in an 18-level dungeon crawl (think Dungeons and Dragons role playing game) reality show for survival and Earth’s reclamation. If you can’t tell from that last sentence, it’s a much easier and funner read than Absalom, Absalom!, though not quite as fulfilling to work through.

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• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

Before I cover Mom’s final hours, I want to talk briefly about Hospice. Though we didn’t use Hospice, because the end came so quickly, I do think it’s important you know about it and what options are out there.

Hospice

Hospice is a form of end-of-life care focused on comfort rather than extending life. It is generally intended for someone with a terminal condition who is believed to be approaching the final months, or even hours, of life. It’s for when the goal shifts from trying to prolong life at all costs to managing pain and other symptoms, preserving dignity, and making the person as comfortable as possible. Hospice can be provided in a person’s home, assisted living facility, nursing facility, hospice center, or sometimes a hospital. It also provides emotional and spiritual support for both the patient and the family.

In many cases, hospice is a team that comes to wherever the person is living. That team may include nurses, doctors, social workers, chaplains, aides, and other professionals who help manage symptoms and guide the family through what to expect. Hospice also does not mean that everyone expects the person to die that day or even that week. Under Medicare, hospice eligibility generally begins when physicians certify that a person is expected to have about six months or less to live if the illness follows its normal course. A person can remain on hospice longer if they continue to meet the eligibility requirements.

Traditional medical treatment often seeks to extend life, no the matter the quality (as you’ll read in my experience below), while Hospice instead seeks to make the time that remains as comfortable and meaningful as possible. There may come a point when comfort, dignity, and time with family may become a higher priority than additional treatments. This is what Hospice is for.

Like I said, things with my mom progressed too quickly for us to even consider Hospice. So, let me tell you about her final hours.

The Fall

Mom had mobility issues and was prone to falls. If she fell in assisted living, they would usually have to call the paramedics to help lift her up because she was overweight and was generally unable to do much to help others lift her. So, when assisted living called me to say that she had fallen again and was taken to the emergence room, I thought this would be like the other times, except this time they added that she had vomited and that there was blood in her vomit.

I went to the ER, where she was in bed and talkative, and reported to me that nothing was broken. She said that she was scheduled to have an endoscopy so they could figure out where the blood in her vomit was coming from. I had an event that I had committed to attend, and Mom said she’d be fine without me, so I said that I’d return once the event was over. Then, at the event, I saw I missed a phone call from the hospital; they left a voicemail saying the endoscopy was finished and that Mom was in the ICU.

That’s strange, I thought. ICU? Why would she need to be in the ICU after an endoscopy? Details were sketchy, but the gist was that they found an ulcer and that Mom was losing blood internally somewhere. Her white blood cell count and blood pressure were both low.

I went to the hospital to be with her, and over the next nine hours she ended up having three “episodes,” where the pain she was feeling would cause her to become nauseous, which, combined with her low blood pressure and white blood cell count would lead to her losing consciousness.

First Episode

During the first episode, as I stood next to her hospital bed, I held her hand as she struggled from the pain, then she turned her head to me, stopped moving, and immediately turned pale. I’ve never seen someone go so pale so fast.

Nurses immediately rushed in, put an oxygen mask on her and went into triage mode. I stepped back to let them do their thing and looked around the room. Five people were in there.

At one point, a person in scrubs, who I assumed was a nurse, stood next to me to watch as well.

Then, out of the blue, he leans over and says to me, “Does she have a DNR?”

I immediately turned to him and asked, “I’m sorry, what?”

The nurse repeated, “Does she have a DNR? A do not resuscitate?”

I said, “What? Wait, what are you saying? Yes, she has a DNR. Why are you asking me?”

The nurse replied, “I’m sorry, give me a second, I need to help them.”

I stood there contemplating what he just asked me, why he would’ve asked me, and what I should do with that information.

The nurse returned and said, “Sorry about that.”

I continued our conversation, “Listen, I need to understand what’s going on right now. Why did you ask me about a DNR?”

The nurse said, “I just want to make sure we’re prepared.”

Quite tersely I said, “Prepared for what? I didn’t realize this was that serious. We’ve been in the hospital many times over the last couple of years. What’s going on now that’s different?”

The nurse replied, “She is downtrending.”

Again, tersely I said, “Downtrending? What exactly does that mean? I need you to be very clear with me right now, so I understand what’s going on.”

The nurse said, “The primary nurse has more experience with this kind of thing. He’s been doing this for 30 years. Maybe you should speak to him.” Then he walked out of the room. I never saw him again that night.

I’m not one for cussing. But that was definitely a “What the *#@!” moment.

Around that time, the other nurses brought Mom back into consciousness. I went over to her and held her hand.

She looked up at me and said, “I don’t know how much more of this I can take.” I then went and talked with the main nurse and got a better understanding of how much blood she had lost, what the issues were, and how concerned they were.

Second Episode

The second episode was similar to the first and was due, primarily, to the internal bleeding and pain Mom was having. Unfortunately, due to her low blood pressure and low white blood cell count, the staff didn’t feel it was safe to give her pain medication.

The staff was also struggling to get a needle well-established in her vein. She desperately needed more blood, but the staff simply couldn’t get a needle in. Mom was notoriously difficult to stick with a needle due to her thinner skin and fragile veins.

The nursing staff had requested a peripherally inserted central catheter (PICC) be put in, but the doctor who could administer it was not at the hospital and was doing rounds among other hospitals—she would be there later.

They tried one last-ditch effort to get a needle into Mom’s arm, and this time they were successful. Had they not been, the only other option they presented to me was for them to drill directly into her leg bone and administer blood through there. This required some googling on my part to understand what exactly that involved—needless to say, I was very glad we didn’t have to go that route.

I should note, as an aside here, that throughout the night, though there were multiple nurses were around, most of my interactions with actual doctors was over the telephone or through a small video teleconference screen in the ICU. The same was true for the interactions between the nurses and the doctors. I don’t know if it was because of low staffing on a Thanksgiving weekend, or if this is a new standard. Though I don’t think this affected the quality of care my mom received, it was not what I was expecting. During Mom’s final episode, a couple of doctors were in the room.

Final Episode

After finally getting three bags of blood through her IV, Mom was able to start getting some sleep. I pulled up a chair and sat next to her hospital bed, drifting in and out of sleep myself as the machines beeped and whirred.

Then, abruptly, she had a third, more violent episode and vomited blood. I yelled for the nurses. As people poured in, I backed up and out of the way again.

At one point, I counted 15 people in the room, plus two police officers outside. I don’t know why the police were there, maybe they thought I might get upset or something.

I continually prayed for wisdom that night. I prayed that God would help me to ask the right questions and make the right decisions. I asked that He would make it abundantly clear to me when I would need to make a decision and what that decision would be.

Then, a nurse jumped up on Mom’s bed and began doing chest compressions on her. Reality slowed down. I remembered Mom’s words from earlier in the week of how tired she was of being in pain and how she couldn’t wait to be in Heaven. I remembered how earlier that night she said she wasn’t sure how much more of all this she could take. And, I knew she had a DNR, and that if they were doing chest compressions, it meant her heart had stopped.

I turned to the nurse next to me and said, “Stop.”

He asked, almost incredulously, “You want us to stop?”

“Yes,” I said, emphatically, “Stop doing chest compressions.”

In a commanding voice, he said to all in room, “The family would like you to stop doing chest compressions.”

Fifteen pairs of eyeballs turned toward me. There was utter silence in the room. A nurse sat astride Mom, paused mid-pump, staring at me.

To this day, that image is burned into my mind.

“Yes, stop doing chest compressions.” I repeated.

Then, from somewhere near one of the machines, a voice said, “Oh, her heart started again.” I was incredulous.

Amidst the chaos and crowd of people in the room, a breathing tube had been inserted, and that was the only thing keeping her alive. She was not conscious and was not on pain relievers—this latter piece of information I had to get confirmed, because I was first told that she was on pain relievers, which didn’t make sense.

The staff offered to keep Mom alive long enough that my brother could fly into town to say goodbye. As much as I respect our medical system, I have also found that it is built to keep a body alive as long as there is a way to do so. We have machines that can replicate just about every bodily function and perform the function for you. But there comes a point for some people when more intervention isn’t helpful, it’s just prolongs things—but to what end and for who’s good? I called my brother, who was out of state, multiple times throughout the night to let him know what was going on and to talk through things with him. Thankfully, we were on the same page with how to proceed.

So, once again, I told the staff to cease life support.

The End

A civilian chaplain came in to be there with me and my wife while final arrangements were being made to give Mom morphine, take her off the breathing tube, and let her pass.

The chaplain was nice, but then it got a little awkward as the chaplain encouraged me to talk with Mom and let her know how I felt about her. She said that Mom could still hear me and would want to hear my voice. While I appreciate all of this, it was weird having her in there suggesting I do this.

In hindsight, I wish I would’ve told the chaplain that I appreciated her being there, but that she was free to go. And, I also wish I would’ve talked with Mom more than I did. It was just weird having a stranger in there during the final moments. I don’t blame the chaplain; I should’ve just said something.

While Mom lay there, her heart rate slowing and eventually stopping, I continually ran my hands through her hair—something I thought she would’ve liked.

The scene was not pretty. She was not pretty. Her open eyes were glazed over and she was unresponsive, there was still blood on her face from where she had vomited it up, her arms had numerous needle tracks and bruises, and her hospital gown was open, revealing one of her breasts. I guessed that it had become exposed when they started doing compressions. I covered it up.

This was not the first time I had seen parts of my mother naked. After a shoulder replacement a few years ago, she was unable to fully clean herself in the shower, and she asked for help. Later, as her mobility further decreased, I would help her get on and off the toilet. Can you imagine the humility required from her to have her son help her like that?

This, my friends, is what we will all face when we get older. It’s also why we need people in our life.

She was not a perfect mom, wife, or friend, but she tried. She could frustrate the heck out of me. She could be very self-centered at times. She could dominate conversations. But, none of us are perfect. I have my own faults. Many of them, in fact. And who knows how I’m going to act when I get older.

When she was passionate about a cause or issue, it was because she was deeply concerned about people. As I stroked her hair, all I could think about was how much I loved this woman who had lived in this world and cared so much for people.

Even as I rewind the tape of the last couple of decades, there is so much more that I wish I could’ve done, so much more I wish I would’ve done. There’s absolutely no doubt I could’ve done more for her. But I could’ve also done less.

To a degree, the end came abruptly. No one was expecting it. I was mentally prepared for many more years of declining health, more support, and more time together. Yet this was the end of it. What at times were inconvenient tasks or errands for her now became moments I would never have again to help and to be with her.

Whenever leaving after visiting her in assisted living, I would always bend over, give her a big hug and kiss her on the cheek. She would embrace me tightly as if I were still a young child. Then, as I’d go to walk out the door, I’d turn back, look at her, and tell her again that I loved her. She would always say, “I love you too!” with a giant smile and a cute goodbye wave.

One of the most difficult times afterward was packing up her furniture and personal items from her assisted living apartment. After we were done, I stood at the door and looked back into the empty room, thinking of all the times I had looked back at her to see her smile and wave. Only this time, there was no one to respond when I said, “I love you, Mom.”

In an ironic twist, as my wife and I were just about to walk out the door of her assisted living apartment for the last time, my wife said, “Wait, what’s that?” and then reached into the darkness of a small horizontal gap above the mini-fridge. She pulled out a paper plate with some of Mom’s jewelry. Mom had apparently put it there to hide it from staff (not that they ever took anything). In what was previously a solemn and sad moment, we had to laugh. To the end, Mom had found ways to hide and hold on to things. She loved her jewelry and her dresses, and so it was fitting that this is what we found. When I finally walked out the door, all I could do was shake my head and laugh as I pictured my mom childishly smirking at our find.

But that was not the end of decision making. Many more decisions would need to be made.

Advice

• Get a DNR if that reflects your wishes, and make sure your loved ones know exactly what it means for you and where to find a copy of it.

• Ask doctors and nurses to explain things plainly. Also, don’t be afraid to ask for a second opinion or for someone else to confirm information (in our case, one nurse told me that mom was on pain relievers, while another told me she was not—I’m glad I got confirmation of which one was true).

• Keep asking questions until you understand the issues and your options to address them.

• If you want privacy in final moments, it is okay to ask people to step out.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge

• Chapter 9 - Finding a Place for Puppy

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

Share

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

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Reflections on Caring for an Aging Parent:

Chapter 10 - Life in Assisted Living

As I mentioned, I don’t think we could’ve found a better assisted living facility for Mom. Now that it’s changed management and ownership, I don’t know if that’s the same case. But at least for our time there, it was great. Here are some key things that stood out:

Food

Though the assisted living location was great, it wasn’t perfect, and Mom would let us know when she wasn’t happy. The complaints mirrored those I’ve heard from other people at other places and were primarily focused on the food—either the taste, the portions, or the selection available. In all fairness to Mom, there were times that she received paltry portions (she’d send me photos from her phone) and she would have to ask for more food and I’d have to talk to the staff. However, most of the times she received small portions was when she showed up toward the end of the meal period. During those times, she could still get always-available snack food, like chips and fruit. Lesson learned there—show up early to meal time to get the best selection of food that’s been prepared.

Despite the complaints on quality or quantity of food provided by the assisted living staff, it’s still provided, by others, so you don’t have to worry about going to the grocery store or cooking meals yourself. If you do want to prepare your own food, independent living facilities usually all have a stove and oven in the room. And while assisted living facilities do not usually have these, they do have microwaves and mini-fridges, so you can have your own food in your room. This, Mom took full advantage of when she’d sleep in past breakfast hours or had the desire for late-night munchies. H-E-B delivery (yes, they deliver to assisted living) was her go-to for keeping her personal pantry stocked between times that we’d pick up food for her.

Activities

In addition to prepared meals, assisted living facilities offer a variety of activities. This can include movie nights, arts and crafts, church services by visiting clergy, exercise sessions, choir, Thirsty Thursday events where alcohol (yes, actual alcohol) is served to the residents by staff, trips to the grocery store and to restaurants, and just about anything else the staff can come up with, or is recommended by the residents. Each month an activity schedule would be emailed out and posted that showed the activities that would be occurring. We, as family, were welcome to join in any of them, and would usually join in the monthly themed dinners like the Hawaiian Luau, Cinco de Mayo, western night, and others. We enjoyed going, hearing the karaoke singer, seeing Santa make the rounds, and talking with other residents and staff. Many times, this is when we were able to meet the family members of friends that mom made, which was nice. And, most of all, Mom really enjoyed us being there—it gave her something to look forward to, and I think she liked to show off her family to her friends (which, hey, it’s always great to be loved by your mom so much that she’s proud of you and wants to show you off!)

Transportation

Depending on your ability, and the assisted living location you choose, you could still have a car and use it if you wanted. We kept Mom’s car there, but she never used it—a fact I’m grateful for because I’m not sure it would’ve been safe for her to do so. But it was very handy for when I needed to take her to appointments. It was a minivan, which was much easier for her to get in and out of, and there was room for her wheelchair in the back.

Transportation to medical appointments was available, though we only tried that once when my schedule wouldn’t allow for me to take Mom myself. As you might expect, when you depend on assisted living for transportation, you are on their schedule—both for drop-off and pick-up, so early coordination and patience are required. Mom had to be ready early for pick-up, then had to wait for a while after her appointment was over for the driver to come back and pick her up.

Medical Support

The assisted living facility always had at least one nurse onsite who could provide basic care, if needed, and provide medication to residents who weren’t able to administer their own meds. However, they really only provided basic care; if a patient fell or was injured, the medical staff would call an ambulance for the resident to be taken to the hospital.

Also, you should know that having the nursing staff provide medication will be more expensive, primarily because the medications are tightly controlled and closely monitored. Mom was able to self-medicate, but she was required to keep her meds locked up in a drawer that only she had access to.

We were grateful that the facility also had on-site physical therapists who could help Mom to try and stay active, at least when she was willing. Being onsite meant one less trip that had to be coordinated. And, the physical therapy staff was great at gently encouraging, helping, and pushing her to be active and increase her mobility. She made considerable improvement when she consistently attended her appointments and did her exercises.

Staying Active

Though there’s no one dictating when you can come and go from assisted living, if you are no longer able to drive and are dependent on other people or services to get you places outside the facility, I could see how it might feel like a prison. In this regard, it could feel as though someone has taken away your freedom. And much like prison, the things you have to look forward to are meals, appointments, and things that break up the monotony. And that’s also why it’s important to do those things. They break you out of a rut, they give you things to look forward to.

So, my recommendation is to go to activities, even if mundane, just to have things to keep you active and engaged. In life, the more active you are, the healthier you’ll be. Be it mental, physical, or social, we need engagement and activity. We don’t do well when were static. A body at rest will stay at rest, as Newton would say. It feels good to sleep in, sit on the couch, watch TV, scroll your phone or surf on your computer. But what you really need to do is get out there and do things, with people.

Advice

• Choose a facility carefully and continue reevaluating. A facility’s quality can change with new ownership, management, or staffing.

• Expect some complaints, especially about food. Take concerns seriously, but recognize that dissatisfaction with taste, portions, and selection is common.

• Review the activity calendar and participate regularly. Even simple activities provide structure, reduce boredom, and support mental, physical, and social health.

• Embrace the opportunities to do new things and meet new people.

• For family, join events when possible. Holiday meals, themed dinners, and other gatherings help residents stay connected and allow families to meet staff and other residents.

• Evaluate transportation and driving honestly. Keeping a car may be convenient, but safety should come first. Facility transportation also requires advance planning and patience.

• Understand the limits and costs of medical support. Onsite nurses generally provide basic care, while emergencies require hospital services. Medication management will also involve additional fees.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge

• Chapter 9 - Finding a Place for Puppy

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

Share

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

Reflections on Caring for an Aging Parent:

Chapter 9 - Finding a Place for Pup

Let me start this chapter by saying, I am a dog lover. For 14 years my family had a Goldendoodle, and he was awesome. He was the best dog a family could ask for. He was smart, loving, sneaky at times, and (almost) always obedient. We had to put him down a couple of years ago, and that decision and his absence still hurt. I share this because the following may not sound like I’m a dog lover.

This whole time that Mom was in rehab, we also had to board her dog, a mini poodle that she had rescued from a previous aging homeowner who was no longer able to care for it. Mom loved her dog, yet also didn’t always care for it the way it needed—another sign of being overwhelmed by life’s requirements.

After an earlier surgery, Mom and her dog both stayed with us while she was recovering. Every time I approached Mom to help her with something, the dog would yap at me like I was going to hurt her. A day or two into the stay, I was at my wit’s end—here I am trying to help Mom, and this dog was getting in the way. The dog was also not disciplined—it would freely pee and poop where it wanted.

For these reasons, we were adamant that the dog could not stay with us again.

So, when Mom went to rehab, the dog went to a kennel. And, let me tell you, a kennel is not cheap. Thankfully, after a few weeks, we found someone who could care for the dog in their home for cheaper than what the kennel was charging.

Once Mom moved into assisted living, she immediately asked when she could have her dog with her. “Well,” I said, “as soon as you’re able to walk from your room to the outside dog park, we’ll talk about that, because the dog can’t go to the bathroom in your room.” To a degree, this was a delay tactic on my part, because I wasn’t ready to deal with another difficult conversation—in her current condition, I knew there was no way she’d be able to have the dog in assisted living, she simply couldn’t make the walk to the outside dog park. The comment was also intended to provide motivation for my mom to do physical therapy and work on her movement, in hopes that one day she might be able to walk to the dog park.

Though she never admitted it to me, I think she knew that she wouldn’t be able to care for the dog properly there in assisted living, but she couldn’t stand the idea of turning her back on a dog that she herself had rescued. I get that, and I think that provides yet another glimpse into the heart of Mom.

I, on the other hand, though not heartless, had a clearer picture of the situation and knew that my love for Mom meant that I’d have to be bad cop here and be the one to blame for saying the dog could not come to assisted living.

Though it is possible to have pets in assisted living, I do not recommend it, and neither do the staff. Be them a noise issue, tripping hazard, hygiene concern, or just general added responsibility for the residents, pets can add further complications in an already complicated situation.

Eventually, we had multiple difficult conversations, and Mom finally acknowledged that she could not care for the dog there in assisted living. However, for months afterward, she would continue to say that I was the one who wouldn’t let her have her dog with her. I knew she was hurt that she couldn’t have her dog with her, and I was the outlet of her sadness and hurt.

After some research, we found a wonderful adoption agency and dropped the dog off with them. Mom wanted to see her dog before we dropped her off, but we did not think that was a good idea. We told her that it the dog would not understand why she was being reunited only to then be separated again after a few minutes. The reunion would only really be for Mom’s sake, and that was not fair to the dog.

The day we dropped off the dog at the adoption agency was yet another hurdle that we previously had no idea how to get over. Early in all of this, the issue of where her dog would live if she moved to assisted living was a looming issue that we knew we’d have to solve at a future time.

In many ways, this is how the past two years went. If someone were to tell me in the beginning all that we would go through and the many decisions we would need to make, I wouldn’t have believed them nor wanted to go through it. Thank goodness we don’t know the future; I’m afraid it would be overwhelming for us if we were all knowing. It’s best to just take each day at a time, each decision at a time.

The list of major hurdles I tallied included:

1. Understand Mom’s finances.

2. Get Mom to agree to go to assisted living.

3. Find a good assisted living location.

4. Get Mom moved into assisted living.

5. Go through Mom’s stuff in the house.

6. Get rid of stuff in the house.

7. Decide what to do with the dog.

8. Renovate the house.

9. Sell the house.

10. Get an updated will.

11. Get bank accounts updated.

12. Get money put into funds that would sustain her as long as possible in assisted living.

Even with these big tasks, there were numerous small ones that popped up each week—picking up medication, trips to medical appointments, assembling things she’d buy online (yes, that was still happening, just not as much).

But, all of these tasks, be them big or small, gave me opportunities to be with her. And for that, I’m grateful. Had she not agreed to change, her situation would’ve only deteriorated faster. Though, had she agree to change earlier, not just with the move, but with other habits, she likely would’ve lived a longer more enjoyable life, and we would’ve had even more time together.

Advice

• If an aging parent has a pet, plan for that pet early.

• Loving an animal and being able to care for it are not the same thing.

• Be realistic about mobility, toileting, grooming, feeding, and vet needs.

• Boarding costs adds up quickly.

• Assisted living may technically allow pets, but that does not mean it is wise in your specific case.

• Rehoming a pet can be loving if it leads to better care.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

Share

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

  ---

  Reflections: on Caring for an Aging Parent:

  Chapter 8 - The Purge (Managing the Mess)

Reflections on Caring for an Aging Parent:

Chapter 8 - The Purge (Managing the Mess)

With an assisted living location picked out for Mom, we took measurements of furniture pieces from her home we thought would fit, took pictures of the furniture, and even did a little mock-up of Mom’s room on grid paper so she could get a feel for what her new place would look like with the furniture in it. Not surprisingly, given her hoarding, she wanted more of her furniture in there than we could fit, so we had to say “no” to some items going in there.

While Mom was still in rehab in Austin, we had to do a Zoom call so the nurse at the assisted living facility in San Antonio could assess her mobility and ability to care for herself, versus what support the staff would need to provide for her. This assessment helps the assisted living facility staff establish her Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), as discussed in Chapter 5.

After that, friends from our church helped us get the furniture moved into her assisted living facility. As an aside, I want to say how grateful I’ve been for our church community—they are wonderful people who have been servants, givers of wisdom, and providers of spiritual and emotional support when we needed it most.

My wife spruced up Mom’s assisted living space, which we now referred to as her “apartment.” We hung pictures, and got everything ready to make it as welcoming and home-like as possible. The big day came, and we moved Mom in. She took it all well—not overly pessimistic, but not overly optimistic either. The staff were all welcoming to her and numerous residents stopped by to say “hi” as well. I was grateful for the warm welcome they provided to her.

With Mom settled in assisted living, we then went about cleaning her house.

Over the course of a few days, my wife’s brother, my brother, my brother’s wife, my sons, and my wife and I went through the house sorting, organizing, and trashing items. Even without Mom there to bless every decision, it took us adults three full days to go through everything.

We rented a 6-foot-tall, 22-foot-long roll-off dumpster and had it delivered and parked in the driveway. Obvious “trash” items went in the dumpster, “keep” items were sorted into piles of like items, and items people were unsure about came to me for a decision. By the end of the process, we had everything sorted, stacked, and neatly visible. And we had filled the 22-foot dumpster to the top.

Our early hope was that we could hire an estate sale company to come in and sell everything for us, the proceeds of which we would use to help pay for assisted living.

We had two companies come out to the house to survey everything. Within a few minutes of each coming out, I could tell they weren’t interested. Representatives from both companies were very kind and honest with us. They said there really wasn’t anything of significant value among her many items. Both companies instead recommended that we donate everything and take the tax write-off to reduce her tax bill from selling the house. Mom had a hard time accepting this; to her there were many valuable items in her home that someone would want to buy. They say, “one man’s trash is another man’s treasure,” apparently, one man’s treasure is also another man’s trash.

If you’re not familiar with it, there’s something called the Endowment Effect, where individuals place a higher value on items they own than on similar items they do not own. You generally experience this when you go to sell something and the price you want is higher than someone is willing to pay. Your emotional attachment to the item causes you to overvalue it.

When I showed the estate sale reps a box of vinyl records (something I thought would be valuable), they looked through them and shrugged their shoulders—nothing really of value here. The same was true for multiple bookcases of books. My quick search on eBay confirmed this.

The estate sale reps were also kind about telling us which items we might want to try and sell on our own—the items were not the things I expected. It was the odd little things, like a Santa mug and one or two other seemingly innocuous items, that the estate sale folks pointed out as potentially valuable. But even those, when I looked them up on eBay, weren’t worth a whole lot—only tens of dollars. There definitely weren’t any awesome collectibles worth thousands of dollars.

There were items that I thought someone in the family, or a friend, might want, so I gathered those and had them available during the celebration of life event we had for Mom later. Friends and family were free to take whatever they wanted—either to use, remember Mom by, or both.

But most people don’t really want other people’s stuff, which I understand. When an extended family member passed away a few years ago, the executor of her estate invited us to go through her home to see if there was anything we would like. The family member had great taste. I loved her furniture and decorating style. But in the end, we simply didn’t want, need, or have room for more stuff in our own home. And this, I think, tends to be the case for most people’s stuff. Again, reference the Endowment Effect: just because you value your stuff doesn’t mean other people will, or at least not to the degree that you do.

Even when I did find things that I thought people might like, I ended up having issues. I found a set of plates from the 1970s that I thought a friend might like. The friend did like the plates and gladly accepted them. Then, a month later, the friend told me that they had done research online and found that the plates had harmful amounts of lead in them. The plates had to be thrown away.

Once we had everything sorted and stacked, I walked into the living room and was struck by the fact that I hadn’t seen the house this organized in well over a decade, if not longer. I had flashbacks to the years that I had lived there during high school. It was both nostalgic and sad.

With the house organized, and the estate sale representatives telling us there weren’t enough items of value to have an estate sale, even on our own, we had to figure out what to do with everything.

We coordinated with the Society of Saint Vincent de Paul in Austin to pick up the big furniture items. The rest of the items we loaded into a large U-Haul and dropped it all off at Goodwill. Needless to say, the staff at Goodwill were quite surprised by the large donation. Before we dropped it all off, I took pictures of everything so I could log it all for the donation deduction on taxes.

But, not everything was donated or with Mom in her new place.

Mom loved to sew, and she was good at it. She even had her own sewing business for many years. This hobby, turned business, also turned into another hoarding problem. And because she had emotional attachment to all of her fabrics and sewing supplies, she did not want us donating them or giving them away. So, we rented a 10x10 storage unit to keep it all in. We had bins of sewing fabric, thread, sewing machines, and other accoutrements stacked in large plastic bins five feet high. For a year and a half we paid for the storage unit just to store the sewing supplies. After Mom passed, we donated it all to Community First, an organization that provides support to homeless in Austin and helps them get back up on their feet by proving housing and workforce training. Given Mom’s giving nature, we think she would’ve appreciated it all going to an organization that helped others.

After getting the house cleaned out, we then moved forward with renovations. I won’t go into much detail on the renovation piece, other than to say that this too was a major lift. We met with several contractors, chose one, then set about meeting with them to discuss and choose which items were worth renovating, which were not, and to what degree we should improve something for the greatest payoff at minimal cost. It was the standard updates and improvements you normally see—bathrooms, kitchen, paint, flooring, landscaping, and new fencing.

Our weekly trips up to Austin continued so we could meet with the contractor to check on progress and coordinate details, and do work that they would not be doing.

Three months later, we finally finished with renovations. Then, we took Mom to see the renovated house.

I wasn’t sure how she’d react to the changes. I fully expected lots of crying since it no longer looked like “her house.” But she didn’t cry. She went around the house, looked in each room, inspected different items, commented on the renovation work, and that was about it. She visited with her neighbors, then we got back in the car and drove back to San Antonio. I think the house had changed so much that it no longer really looked like “her house” to her. Or, maybe she just knew it was time to move on.

A few months later, as we sold the house, I did one last walk-through. And that’s when the tears hit. I thought of all the memories of living at the home during high school, of holiday meals with extended family, of returning with my family to visit Mom, and of Mom’s declining health and struggle to stay on top of things over the last few years. I realized I would never see the inside of this home again. It was difficult to leave.

But, as I took all of this in, I also couldn’t help but see the home in its newly renovated condition and think about how new memories would be made by a new family. In many ways, this was a reset for many people.

Advice

• Take photos before, during, and after the purge. It helps you see progress and helps if you need to create a log for donations.

• Create categories: keep, donate, trash, storage, and decide later.

• Expect the process to take longer than you think.

• Do not overestimate the resale value of ordinary household items. And, don’t assume an estate sale company will want the contents of the house. Most stuff is worth less than people think.

• Sentimental value does not equal market value.

• If there are truly sentimental items that others may want, identify them intentionally and put them aside.

• Accept that some of your things will need to be discarded.

• Rent a dumpster if needed.

• Bring help.

• Do not turn one person’s hoarding problem into your own garage or guest room problem.

• Purge your own stuff regularly so others don’t have to deal with it.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

Share

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

Reflections: on Caring for an Aging Parent:

Chapter 7 - Managing Tasks and People

A growing percentage of adult life seems to consist of what I call “life-maintenance activities”: submitting and resubmitting paperwork; waiting on hold, scheduling and rescheduling and going to appointments, fixing house and car problems, chasing administrative loose ends, and so on.

“I’m just going to do X” turns into “I had to do A through W just to get to X, and then I had to do Y and Z because something else broke.”

I’ve realized a key component of wisdom is understanding just how much margin you need to add into your activities and actions to be realistic about what you can accomplish in a day. Experienced craftsmen know that home repair projects and car maintenance will likely take 50% longer than you anticipate—oh, and far longer than the edited YouTube video conveys. This is the way it is with other items in life as well.

That was certainly true while helping Mom.

Checklists and notes are about the only way I can keep track of all that life throws at me. But simply tracking all the to-dos in life is the bare minimum; it’s acting on them—moving the ball down the field—that really counts. Capturing all you need to do, prioritizing it, finding time to do it, then actually doing it, that’s where the rubber hits the road.

For much of the past couple of years, we kept up with Mom’s medical conditions, appointments, and important information through shared documents. I took notes at medical appointments and recorded them in a shared document. I did this mainly so I could remember what happened from one appointment to another, but also so family members could see what I saw and heard.

Mom liked to add things to my to-do list, so it was a constant balance between getting her what she wanted versus what she needed, while also trying to balance my own time between work and family. When she couldn’t properly prioritize the wants from the needs, I did so for her, sometimes to her disappointment, but always for her good. Alas, this is what it is to make decisions for someone you love.

This entire time, my brother and I spoke nearly weekly. I would explain to him what I saw and what we went through. He lived in Albuquerque and was working full time, so he did not have the proximity to Mom or the time that I did. I am most grateful for him listening and being a sounding board on decisions, while also not dictating how he might want things done differently. I have friends whose relatives do question them…while also not providing any support themselves. That would be incredibly frustrating.

I acknowledge that my brother and I have a great relationship. It wasn’t always this way—I was a jerk older brother when we were growing up. As adults, we have grown much closer, and I cherish our relationship. When it comes to executing Mom’s estate, we pretty much see eye-to-eye on things. Plus, we’re both pretty chill people in general.

I also acknowledge the right of family members to ask questions about how a loved one is being cared for and provided for. It’s only fair, and it does allow for better decision-making. However, that dynamic takes maturity on everyone’s part. Debate and conflict in marriage are difficult enough; conflict across extended family can be even harder.

I’d like to think I was very open with my brother the entire time. From providing spreadsheets showing Mom’s finances, to using shared documents showing medical information, to regular phone call updates, I did not want the hint of impropriety. Just as I wanted Mom’s trust, I wanted his as well. This, I believe, brought me “freedom of movement on the battlefield” to accomplish all the tasks that needed to be done. Even as I continue to work through the estate and closing of accounts, I’m completely open with him on how much money is in which account, what the insurance policies look like, and I seek his input on things where decisions need to be made.

All in all, I’m grateful for his trust, it has made the process easier. I can’t imagine how much more stressful all of this would be if we disagreed strongly, fought over things, or had to go to court to resolve differences. We have become closer through this, not farther apart.

A Word About Family

While I was in middle school, my parents divorced, and I made the decision to live with Dad. He and I were getting along better than Mom and I were at the time because she represented many of the things I was pushing back against as a teenager. As shameful as it is to admit this, at the time of the divorce I thought, “This is cool, now Dad and I will get to hang out more.” Teenagers. Sheesh.

While I lived with Dad, my brother went to live with Mom back in Texas. I have tremendous respect for my brother and what he went through moving to a new place and supporting Mom. The same year that my parents divorced, Mom’s mother died. It was, as she would say, the hardest year of her life. Throughout all of that, my brother was there with her and for her. And while he couldn’t be with her at the very end of her life, he served her and sacrificed for her in other ways and at other times. Over the years, he and his wife made numerous trips to Texas to help with Mom.

I think part of Mom’s hoarding came about because my brother and I did not live near her, so we weren’t always able to help her with things. There were many times that I felt bad about what neighbors did for Mom because I felt like they were doing things I should’ve been doing. Alas, it’s difficult to manage your own family and career and life and figure out how to balance it all on top of broader family needs and responsibilities. As I mentioned, I have a lot of respect for people who can have extended family live with them. Yet I also know it’s not for everyone—either due to space, personalities, or other factors.

And also, I know there were things Mom could’ve let go of in order for us to help her more. She made choices that contributed to the situation. Ultimately, we are responsible for ourselves and our own actions, but we also need other people in life. People need people, yet people are also difficult. All these things can be true.

I loved Mom. She was a great mom. Yes, she had her faults, but don’t we all.

Advice

• The more organized you are, the easier it is to find things when needed. This doesn’t make the obstacles stop coming; it just makes you more prepared for them when they do.

• Use shared documents to keep track of important information and to keep friends and family on the same page.

• Over-communication is usually better than under-communication.

• The person doing the hands-on work needs trust and room to operate, but that person also needs to be open with others who have a say in the situation/outcome.

• If you cannot help much physically, help administratively, emotionally, or financially.

• Be careful how much you criticize from a distance unless you are also willing to carry some of the load.

• I know every family dynamic is different. To the extent possible: be supportive, be open, be chill, be helpful, be fair, don’t be greedy.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

Share

Reflections: on Caring for an Aging Parent:

Chapter 6 - Managing Finances

Mom had a savings and a checking account, a state pension, Social Security, and—most importantly, as it turned out—a paid-off home. However, other than monitoring her bank account balance, Mom didn’t really have a budget or track her spending. On the bright side, despite all the online shopping, Mom at least bought mostly cheap stuff and did not spend extravagantly in other ways.

To understand what type of assisted living she could afford, we needed a consolidated picture of her finances. That meant identifying all her accounts, downloading bank and credit card statements, studying spending patterns, and building a spreadsheet showing income, expenses, and projected future costs.

Account Access

My brother was essentially Mom’s on-call IT department. He could remotely access her computer, knew the systems, and could troubleshoot issues as they arose--which they did frequently. Even after he’d put safeguards and firewalls in place, she would accidentally find ways to disable them or download some new app. Many times, he’d call me to tell me that he had absolutely no idea how she had accidentally managed get around the electronic safeguards he put up. I was incredibly grateful that he was able to help with all the computer support. I know it was, at times, frustrating for him.

Another benefit of my brother’s remote access to Mom’s computer was that he helped her manage all of the usernames and passwords for her accounts. He had set her up with a Norton password vault that kept usernames and passwords all in a safe place. Through this, I was able to access all her accounts while she was in the hospital recovering.

I know this level of access to usernames and passwords isn’t an option for everyone, some people may not keep this information on their computer, and others may not feel comfortable providing all this information and access to someone else. But it’s at least worth considering and having a conversation with loved ones about. This access was critical to all the behind-the-scenes support we provided to Mom the past couple of years. Consider the fact that you likely know how to get into all your accounts, but would your loved ones know if you weren’t there to tell them or show them?

A complicating piece to all of this is two-factor authentication (2FA). It is nearly ubiquitous now when you try to log into an account. It’s not enough to simply have a username and password; instead, you will also be sent an email or a text to your cell phone for you to log in. At first, to log into an account, I had to either be with Mom (and her phone) or call her and have her tell me the code that was texted to her. After a while, I was able to add my cell phone number as an additional option. Once she passed, I kept her cell phone plan active because it would still receive 2FA codes for accounts that I needed to log into on her behalf.

The Financial Picture

After downloading her account statements, I was able to review all her income and expenses for the past few years and then build a spreadsheet to capture the important pieces. Using that, I then built a future budget that took into account which items would increase in cost, which ones would decrease, and which would remain the same.

After calculating the estimated cost of assisted living, we could then do the math to determine how many years of assisted living Mom could afford based on her income and other expenses. It was clear that her pension and Social Security would not cover the monthly expenses, so each month she would be drawing out of her savings to make up the difference.

This led to a rather sober conclusion—that her savings wouldn’t last long. To extend the length of time she could pay for assisted living, we would have to sell her house. Even with that, her money would not last forever.

I showed her the spreadsheets and graphs, specifically the graph estimating how many years she would be able to afford to be in assisted living. I tried to be as realist as possible with my projections, taking into account inflation and increasing prices due to increasing help needed with acts of daily living that I talked about in the previous chapter. These were not comfortable conversations or truths, but I wanted to be transparent about it all. My brother and I then also assured Mom that if her money ran out, we would continue to support her.

After she agreed to sell her home, we then considered whether we should sell it as-is (it was not in great condition) or renovate it to try to get more money out of it. My wife is a realtor, so she was familiar with the Austin housing market. She also has a good eye for renovations and what changes add the most value. So, we had a couple of renovation companies come out to give us quotes, then, after crunching the numbers, we concluded that it would be worth renovating—the expected payoff would be more than the money spent.

Spending thousands of dollars on renovations was, understandably, scary for Mom. She would be spending money in hopes of getting it all back, and then some, when the house sold. We discussed it at length, showed her the math, and looked at comparable home sales. In the end, she trusted us and agreed to do the renovations. I’m grateful for that trust, and she was better off for it.

Because Mom bought her house at a cheaper price than what she would be selling it for, she would have to pay taxes on the profit from her home.

(First, a quick note: the following section only covers federal taxes; I won’t discuss state taxes here, since each state has different laws, but know that you may have to pay state taxes as well.)

For a single person, if you’ve owned and lived in your home for at least two of the last five years, you can exclude up to $250,000 of profit from federal taxes (this is current as of 2026). That “profit” part is calculated by subtracting the price you purchased the home for from the price you sold it for. You are also able to subtract certain improvements you make to your home as well.

For example, if you bought your home for $50,000, then lived in it for 40 years and sold it for $350,000, your profit would be $300,000. As mentioned above, you can exclude $250,000 from that, which leaves $50,000 that you will owe federal taxes on.

But let’s say you put in new kitchen countertops and renovate the bathrooms at a cost of $20,000; then that $50,000 would be further reduced to $30,000 of profit that you would have to pay tax on.

I won’t go into the details of the home renovation, other than to say it took months to complete and required my wife and me to go up to Austin weekly to check on the status, meet with the contractor, and continue to make decisions on paint color, cabinet styles, flooring, and a thousand other things.

I’ve written before about decisiveness and momentum and the need to just keep moving forward on tasks in life. This was never more true than in the past couple of years. Decisions had to be made and forward progress was required…every, single, day. If there were days that we fell behind in making decisions or taking action, it would result in snowballing tasks and regret on my part. My wife has a saying: “Do what you can when you can.” This served us well. Got 15 minutes between events in your day? Then you better make that phone call, send that email, or do research on that thing. Your later self will thank you. Your later self will not thank you for scrolling social media when you could’ve been doing something productive.

After we sold the renovated home, I was able to put the proceeds into a high-yield money market account. From there, each month I started putting portions of that money into Certificates of Deposit (CDs) that matured over different periods of time. These had higher interest rates than the money market account. This “laddering” of CDs would require monthly tracking and management on my part, but it also meant Mom would earn higher interest while also having access to the money she would need.

Bank Accounts

But before I could establish the CDs, we had to open an account at a bank in San Antonio because her bank in Austin didn’t have any branches here. This, too, involved more phone calls, paperwork, money transfers, and switching numerous bills that had been set to autopay from her previous bank. Most of this could be done online, but other times it involved our coordination due to two-factor authentication on her phone or her signature being needed on forms. Ultimately, I think it took about three months for me to finally get all the autopay accounts fully switched over, and that was with me working hard to stay on top of it all.

With regard to bank accounts, you might consider either establishing a trust and have the bank accounts in the name of the trust, creating a joint account with the person or people you want to have access to the money upon your death, or creating your account with rights of survivorship to the person or people you want to have access to your money upon your death. The primary benefit to these, depending on what state you live in, is that you can generally avoid the accounts going to probate to access the money. I’ll talk more about probate in Chapter 11—just know that it can take weeks, if not months or years, to complete. During that time, the deceased’s bills (like mortgage, car payments, etc.) still must be paid by someone (usually the executor of the estate) with funds from somewhere (not the deceased’s frozen accounts).

Because of the complexity of readers’ finances and situations, I won’t cover the full pros and cons for a trust, joint account, or rights of survivorship. At bare minimum, though, I recommend naming beneficiaries on your accounts. No matter what, talk with an attorney and/or financial advisor to see what would be best for you.

Recently, my wife and I realized we needed to update our will and other documents. We met with an attorney (depending on what you need, this will likely cost over $1,000; if you do it online, it may be cheaper) and she recommended that we look through all of our accounts to ensure we had rights of survivorship between each other and that our children were listed as beneficiaries. I was very surprised to find out that I had never listed our children as beneficiaries on our primary checking and savings accounts. If my wife and I had died together, say in a car crash, that money would’ve likely had to go through probate.

Fraudsters and Donations

When my mom transitioned into assisted living, she also started allowing me to handle more of her day-to-day finances. As I’ve said about other things, I’m grateful for the trust. In the end, it saved her time and stress and ensured bills were paid on time (which wasn’t always happening when she managed them) and erroneous charges were corrected.

Once I began managing Mom’s accounts, I could see recurring donation patterns and small automatic charges everywhere. Mom had a generous heart, and many organizations knew exactly how to exploit that. They knew how to pull on her heartstrings, whether through mailers showing downtrodden people or animals, or through alarming emails declaring that she must “ACT NOW!” to prevent politicians from doing something that was going to threaten the future of humanity.

For some of the automatic donations, I had to go through a maze of online menus to turn them off. Some of the organizations didn’t even have phone numbers on their websites. The only way to contact them was via a form on their website. Even some of the political action committees (PACs) have sub-organizations with their own websites and donation portals. It was frustrating and confusing for me; I can’t imagine what it would be like to try to turn those off if you were elderly. And even then, there were donations that I could not figure out how to turn off. Eventually, the donations only stopped when we closed the credit cards. What a scam.

Speaking of scams, I have a friend whose aging father received a telephone call from someone saying that the father’s son (my friend) was in jail and that to get the son out of jail, the father needed to send money. The son was not, in fact, in jail.

The father drove to the bank, withdrew $9,990 ($10 short of triggering federal reporting requirements), then went to a Coinstar kiosk and sent the money via cryptocurrency to the perpetrator. The fraudster kept the father on the phone, instructing him what to do each step of the way. The bank teller even asked the father what he wanted to withdraw that much money for, but the fraudster, who was still on the phone with the father, told him not to tell them, so the father simply told the teller that he was on the phone and couldn’t talk to her.

After sending the money to the fraudster, the father called his son and asked if he got released from jail.

“What are you talking about, Dad? I’m not in jail,” my friend said.

After the father explained everything, my friend asked why he didn’t just call him to begin with. It was an elaborate scheme, even to the point that the fraudsters had someone pretend to be the son on the phone. According to them, the son had been “hit in the face” and lost some teeth, so he was mumbling and that’s why he sounded different. Because the money was sent via cryptocurrency, there was no way for the police to track it, and the father was out nearly $10,000.

Just this last week, while I was at the bank, sill handling finances for my mom’s estate, I saw a sign on the counter listing things to do if you think you are being scammed. I told the bank teller the story above and she said that this is scam is increasing in frequency. So, beware. From the bank, there are three common fraudster tactics: credibility, urgency, and authority.

Thankfully, for Mom there wasn’t anything so egregious as this, but the many other smaller donation transactions did add up. I explained to Mom that at this point in her life she needed the money more than these organizations did, and for the most part she agreed, and we turned those automatic donations off.

More Day-to-Day Management

The last couple of years, Mom really fell behind on keeping up with the mail. This happens when you’re a hoarder and you feel the need to read every catalog, magazine, advertisement, bill, and package that comes to you, but can’t get through it all. Bills would get buried under stacks of junk mail and wouldn’t get paid on time. I did my best to manage her mail, to include trashing all the junk mail, but she would still squirrel some of it away and would’ve tried to review every single piece that came in had I not gone through it first.

Regarding junk mail, I’ve found that it, and frequent donations to organizations that send pleas via junk mail, cause the junk mail to increase at an exponential rate. We had a lull of incoming junk mail when Mom moved into assisted living, but once the address change kicked in, so did all the junk mail from companies that were still sending mail to her previous home. After she passed, we changed her official address to my home so I could receive any important items that would arrive in the mail. Now, when I go to my mailbox, 75% of our household mail we receive is for her, and nearly all of it is junk. If an organization provides a postage-paid envelope for a donation, I return the donation slip in their envelope with the words “Nancy Rendell is no longer alive. Stop sending these!” It seems to be working. At minimum, I’m using up their prepaid postage envelope and costing them something for their greediness.

Toward the end, I managed all of Mom’s finances. She still had access to credit cards (which she continued to use to buy stuff online), but I could monitor it all and ensure bills were paid on time. Like I said before, I’m grateful for that trust. And, ultimately, she was better off for it too.

Advice

#1 – Make sure your will is up to date.

Online access

• Digital access is now part of estate planning. Access to usernames and passwords can become essential—do not wait until hospitalization to start figuring out how your executor (or loved ones) can find your logins and passwords.

• Keep the decedent’s phone active for a while after death if 2FA codes are still needed.

Finances

• Don’t assume fixed income will cover assisted living; do the math on income and expenses and build a realistic care budget.

• Simplify accounts where possible.

• Review bank and credit card statements for patterns.

• Get professional tax help if tax returns are behind.

• Watch for scams, donation traps, and predatory fundraising.

• Keep a list of recurring subscriptions and autopays. Last year I created a spreadsheet of my own subscriptions, to include cost, renewal date, and a history of past costs…it was a real eye opener.

• Depending on what your situation is, and what an attorney or CPA tells you, you may want to:

  • Ensure your accounts are set up as joint with rights of survivorship between you and your spouse.

  • Determine what status would be best for those you want to have access to your money when you pass: a trust, a joint account, rights of survivorship, or simply beneficiaries.

Home

• Selling a longtime home can create tax consequences, so do your research.

• Keep records of major home improvements in case you need proof for tax write-offs.

  ---

  Links to each chapter:

  • Introduction - Why I Wrote This

  • Chapter 1 - The Buildup

  • Chapter 2 - The Tipping Point

  • Chapter 3 - Aging and Medical Care

  • Chapter 4 - Important Documents

  • Chapter 5 - Finding a Place to Live

  • Chapter 6 - Managing Finances

  • Chapter 7 - Managing Tasks and People

  • Chapter 8 - The Purge (Managing the Mess)

  • Chapter 9 - Finding a Place for Pup

  • Chapter 10 - Life in Assisted Living

  • Chapter 11 - Her Final Hours

  • Chapter 12 - Afterwards

  • Final Reflections

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This Saturday, July 4, 2026, marks 250 years of independence from our British overlords.

Or does it?

The day we’re commemorating is July 4, 1776, when delegates at the Second Continental Congress voted for independence from Britain. Declaring independence in this way is the equivalent of telling your bank that you no longer want to pay your mortgage (albeit a mortgage that keeps increasing) while still living in the house. You don’t actually own the house just because you told your bank you’re no longer making payments. When you stop making payments, the bank will demand compliance or send someone to evict you. And for seven years, this is what the British tried to do.

The last major battle of the American Revolutionary War was the Battle of Yorktown, which ended in October 1781, when American and French forces defeated the British. However, other smaller battles, both on land and at sea, continued into 1783. It was only when the Treaty of Paris was signed on September 3, 1783, that the war for American independence officially ended.

I’m quite certain that those American Patriots didn’t exactly feel the yearned-for “Safety and Happiness” of independence while attempting to row across the icy Delaware River on Christmas night in 1776, or while enduring years of battle with meager pay, scarce food, tattered clothing, and little ammunition. As you celebrate this Fourth, consider that the day marks 250 years since our declaration of independence; it’s been 243 years since we officially earned independence with the Treaty of Paris. We can celebrate 250 years of actual independence in 2033.

So, I say, Happy 243^rd Birthday, America!

Whether you celebrate 250 years or 243 years, it’s important to understand the history of our independence and how long it took to earn it. And more than time, what it took in terms of lives, money, effort, determination, and alliances. Declaring that you’re independent and being independent are two different things, and maintaining your independence is something else altogether. We didn’t just have to earn independence; we’ve had to keep it.

As you’re singing along to “The Star-Spangled Banner” and watching fireworks—the rockets’ red glare, the bombs bursting in air—keep in mind that our national anthem was written during the War of 1812, another war we fought against Great Britain on our home turf in North America. It lasted nearly three years. And 46 years after the War of 1812, our nation divided in a Civil War. More than 600,000 people died, all Americans. At Gettysburg alone, there were more than 50,000 casualties. After four years, the brutal Civil War came to a close in 1865, and President Lincoln was assassinated. In the next 160 years, three more U.S. presidents were assassinated and others survived assassination attempts, the country endured the Great Depression and multiple recessions, two World Wars and many other wars and battles, and countless other challenges to our unity and independence.

There are many reasons why our country has maintained its independence for so long. We are blessed with tangible qualities like abundant natural resources, borders with only two countries, and the buffer of two oceans. But just as important are our intangible qualities, like representative democracy, real and intellectual property rights, personal rights, and an entrepreneurial spirit. Americans are generally optimistic, inventive, risk-taking, and hardworking.

But I sense that we’re slipping.

Though we haven’t come under oppression by a foreign power, we are coming under oppression by a different type of ruler, one to whom we are voluntarily surrendering our independence. It’s eroding us from within, not from without. We invited it into our lives and our homes, and now we are paying it an ever-increasing mortgage, one that will never result in ownership.

We created the internet, smartphones, social media, and streaming to make the world more open, connected, and smarter. And though we’re more digitally connected, it has come at the cost of human connection and cognition. We’ve become more divided and disconnected and dumber.

We assumed endless news, entertainment, and content would provide fulfillment and enlightenment. Yet people are more confused, anxious, stressed, depressed, and suicidal. We wanted to be omniscient, yet we are overwhelmed by all we see in the world. We wanted to be omnipotent, but we’re overwhelmed by all there is to do when we’re told to do it all.

It’s made people want to hunker down, isolate, curl up, and scroll for answers and solace in the same place that created so much confusion in the first place. We’re constantly busy, constantly plugged in, constantly seeking satisfaction and distraction to avoid having to think about it all.

It’s time to stage a rebellion against our rulers! It’s time to reclaim independence from our digital devices and addiction.

How, you ask?

Imagine, if you will, a world in which computers, cell phones, and ceaseless streaming didn’t exist. How would you spend your free time? What would you do with your evenings and weekends?

My guess is you’d do what people did 50 years ago. You’d spend more time with your family, friends, and neighbors. You’d join clubs. You’d go to church. You’d go to the bar. You’d go on walks around the neighborhood and hikes in nature. You’d tell your kids to play outside after school and all day on Saturday. You’d listen to live music. You’d listen to music at home as a family, without headphones. You’d learn to play music. You’d have more in-person conversations, more phone conversations by voice instead of text, and write more letters. You’d enjoy peace from distraction, enough peace to do nothing but think about things and create things, and then do it again because there was that much time to do so. You’d get bored, and it would be okay.

You’d take up arms! Or rather, take up into your arms a book and arm your brain with knowledge and resolve. You’d slog through it, spending time in the trenches—in the tough prose, the tedious paragraphs, and the twisting story line. You’d do it for America! You’d do it for yourself. You’d do it with friends and family members.

If it took seven days, seven weeks, seven months, or even seven years to form or reform the habit and earn our independence, it’d be worth it. You would be better for it. Our nation would be better if we all did it. Changing habits in life is hard, especially when you’re fighting against the digital dopamine dispensers surrounding us, so expect your brain to push back.

Our digital devices encourage immediacy, ease, passivity, and isolation, yet the best things in life usually require time, effort, determination, and alliances—just remember what it took for those early American Patriots to earn their independence.

Footnote

If you’re looking for more information, resources, or tools, I recommend the following books. I’ve included the published date of each work to show how long others have been sounding an alarm on this topic. They’re all great reads.

• Amusing Ourselves to Death: Public Discourse in the Age of Show Business by Neil Postman (1985).

• Bowling Alone: The Collapse and Revival of American Community by Robert Putnam (2000).

• The Shallows: What the Internet is Doing to our Brains by Nicholas Carr (2010).

• Irresistible: The Rise of Addictive Technology and the Business Keeping Us Hooked by Adam Alter (2017).

• How to Break Up with Your Phone: The 30-Day Plan to Take Back Your Life by Catherine Price (2018).

• Digital Minimalism: Choosing a Focused Life in a Noisy World by Cal Newport (2019).

• The Anxious Generation: How the Great Rewiring of Childhood is Causing an Epidemic of Mental Illness by Jonathan Haidt (2024).

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Reflections: on Caring for an Aging Parent:

Chapter 5 - Finding a Place to Live

I loved Mom, but we knew, for everyone’s sake, that living with me and my wife wasn’t really an option. During shorter recovery stays with us she ignored some of our basic house rules and acts of common courtesy, which was frustrating. Given our personality, political, and lifestyle differences, having her live with us indefinitely would have been a recipe for conflict. But more than that, I didn’t think my wife and I could provide the physical support and medical care that Mom regularly needed.

I have a great deal of respect for families who can make multi-generational living work. It is not for everyone. If you are an older person wondering why your adult children may hesitate to have you move in, it may be because living with others requires adaptation from everyone. Growing older does not give you a free pass. This is especially true if you’ve been living by yourself for years and doing things you like to do when you like to do them. Living with people is difficult—all parties must be willing to adjust. No one has “earned the right” to be stubborn or stuck in their ways, nor, frankly, is it healthy.

As we sorted through Mom’s house, we were also beginning deeper conversations about independent living and assisted living. She did not want to leave her house, lose her freedom, or pay thousands of dollars per month for care. However, she agreed to visit one independent living place in Austin a few weeks before the urinary tract infection incident. At the time of that visit, she did not want to move out of Austin because all her doctors were there (she had quite a few), and she did not want to find new ones. After the urinary tract infection and rehab, she was open to moving closer to us in San Antonio.

Types of Places to Live In

Here are some of the options we learned about:

Independent living is essentially an apartment complex for older adults who can still do most things on their own. These facilities usually have a dining area and provide activities for residents. Many times, they may also have a doctor or nurses available in the facility. They may also have a full kitchen, to include oven and cooktop, in the apartment.

Assisted living is for those who need help with Activities of Daily Living (ADLs) or Instrumental Activities of Daily Living (IADLs). ADLs are the basic functions of daily life—things like bathing, dressing, toileting, eating, moving around, and getting in and out of bed. IADLs are the broader tasks that allow a person to live independently, such as managing medications, shopping, preparing meals, handling money, keeping track of appointments, using transportation, and dealing with household tasks. Normally, assisted living will have nurses in the facility, and may have a doctor as well. For safety reasons, assisted living rooms do not normally have ovens or cooktops.

What I learned is that many older adults can hold on to a sense of independence longer than they can actually hold on to the practical abilities that independence requires. A person may say, “I can still live on my own,” and what they mean is, “I do not want to surrender control.” But if they are missing medications, falling, unable to manage paperwork, living in filth, or unable to prepare food safely, then the issue is not whether they feel independent. The issue is whether they are safely independent.

Your price for assisted living will usually be based on a base rate (typically determined by the type, size, and location of the room you want) as well as how much help you need from the staff. The more ADLs you can handle on your own, the lower the price. There are usually ADL “levels of care,” or tiers, each with its own price. Some facilities use a four-tier system, some use a five-tier system, and I’m sure there are even six-tiered systems out there. The more help you require with ADLs, the higher your level/tier will be, and the more you will pay on top of the base rate. Unfortunately, it is not always clear what type of ADL care falls into each tier; instead, the tier you fall into it is often based on a holistic assessment and determination by a nurse.

Your ADL tier can also change. It could go up after a major surgery, when you need someone to help you get dressed until your arm gets better, and then it could go back down once you recover. Generally, though, as you age, your ADL needs will increase, which means your price will likely increase as well. Regardless of whether your ADL requirements and costs go up, the overall cost of assisted living, independent living, or memory care will also likely increase annually with inflation.

A nursing home, also referred to as a skilled nursing facility, is focused on intensive, 24/7 skilled nursing care. This is full support with multiple medical staff and orderlies. Though Mom had numerous medical issues, she did not need to go into skilled nursing.

The higher the level of care a facility, like a nursing home, provides, the more efficient the facility must be with their staffing and layout, which usually translates to more communal and open areas where staff can keep an eye on multiple people and rooms at the same time.

A memory care facility is specifically focused on individuals with Alzheimer’s or dementia. Sometimes, these residents may be in fairly good physical condition but still cannot safely live on their own, or sometimes even with others, because of risks to their own safety or the safety of others.

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When we started discussions with my mom about independent living and assisted living, we led with independent living, but we knew that she likely didn’t have the physical autonomy to be able to be there. Once she began to see that, we were able to transition our discussion more toward the support that assisted living could provide her.

One of the hardest parts of this process is that to an aging parent, assisted living can feel like surrender—of privacy, freedom, money, routine, and identity. To the adult child, it can feel like a plainly necessary step. Those two perspectives usually collide. We learned that the conversation went better when we framed assisted living in terms of support rather than loss. Meals. Medication help. Fewer risks if she fell. People nearby. More safety.

With my mom agreeing to explore locations to live in around San Antonio, we went on various websites that rated assisted living places, talked to family members who had walked this road before, and did a ton of research. Ultimately, we ended up narrowing it down to three locations near our home, and we visited each.

Each location did their best to “sell” us on their location. The more they put their sales hat on, the more I was turned off. The more genuine they were, the more I listened. If they were disorganized or late for our appointment, I was unimpressed and wondered if it was a sign of larger mismanagement.

If you’ve never been in an independent living or assisted living facility before, it can be depressing. People sit in wheelchairs, some staring off into the distance, a few doing older-people activities like arm circles and leg raises from their chairs. Very few people look happy. They generally stare at you as you walk by. I’m sure they are wondering if you’re someone’s child or if you’re about to “commit” your loved one to this facility. I should note, though, not all places are like this. In some, the residents would greet us and talk with us about things there—this was encouraging sign.

In the end, we narrowed it down to a place that we were pleased with and that had an immediate opening. In hindsight, we chose the best place possible. The staff were great, the residents were outgoing, and the location was 15 minutes away from our home, far closer than the two-hour drive to Austin.

But even in the past few months, the facility underwent new ownership, then new management.

And this is the trouble with assisted living and independent living facilities--there’s a lot of churn in ownership and management, so today’s best place may not be tomorrow’s best place. It’s hard to figure it all out. The best you can do is stay engaged and communicative with the staff so they know you’re paying attention to what they’re doing and how they’re treating your loved one. You can always move to another facility, as most are on a month-to-month lease, but that means doing more research, visiting other locations, and moving.

After Mom passed, I revisited her assisted living facility to pick up some mail. I thanked some of the staff there who had a positive impact on Mom and told them how grateful I was for their kindness and support. We talked about how hard it is to find a good facility, and I asked one of the staff members what they would do if they had to choose a facility for their loved one.

“I had to put my dad in a facility,” he said, “and despite being in this industry, I ended up having to move him because I realized we made a poor choice initially. My biggest advice is to go visit the facility numerous times and at different times of the day. If the staff have good attitudes and you see them around at all times, day and night, that’s a good sign.”

How to pay for It

Aside from the overall change of moving out of her house and losing some of her freedom, Mom’s biggest concern about moving to assisted living was the cost. The average cost in the U.S. for AL is about $5,500 per month, or $66,000 per year, though prices vary widely. It is expensive. And that’s just for base-level care. Depending on the additional ADLs you need help with the price will go up hundreds of dollars per month. The figure also varies based on location and quality of care.

When it comes to independent living, assisted living, or memory care, do not depend on the government to pay for this. Know this: Medicare does not cover assisted living.

Medicaid, however, might cover assisted living costs. Like most things regarding insurance, it’s complicated how and what they’ll pay for. Every circumstance is different. As I understand it, there are income limits and asset limits for Medicaid to be able to pay for assisted living. Your income must be at or below the poverty level, and you cannot have more than $2,000 in assets—this includes your home and bank accounts.

There are ways to prepare for this, but it’s not simply as easy as transferring your loved one’s assets to another family member, because Medicaid and the IRS pay attention to this. You should definitely talk with a financial professional to see what options are available to you.

To see what Mom could afford, I would need to understand what finances looked like. We’ll cover that in Chapter 6.

Advice

When it comes to choosing an independent living or assisted living location:

• Visit many locations.

• Visit at different times of day.

• Ask about staffing turnover.

• Understand the pricing structure and how care levels affect cost.

• Ask what happens if care needs increase.

• Ask how often rates increase.

• Do not let a polished lobby fool you.

• See what activities they offer.

• See what the dining area looks like and what food options are available (and what the actual food looks like!).

• Watch how staff interact with residents when they don’t think they are being evaluated.

Proximity matters more than you think—being close enough to visit often is a real advantage.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

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The Introduction was a brief background on the passing of my mom and why I’m writing this series.

In Chapter 1, we covered my mom’s growing hoarding problem and our attempts to help her out of that hole.

Chapter 2 told the story of when Mom’s urinary tract infection made her delirious and how I called the police to check in on her.

Chapter 3 discussed aging and medical care.

Now we dive into some things I learned while helping her through medical issues.

Reflections: on Caring for an Aging Parent:

Chapter 4 - Important Documents

Once we started going through Mom’s office paperwork, we realized she had not updated her will in years. Worse, the person named as executor of the will didn’t even know she was the executor.

Sadly, a similar situation happened when my aunt passed away a few years ago. No one knew where her will was located. After searching through the house, it was finally found, and that’s when my aunt’s friend discovered that she was named as the executor. That friend had asked my aunt years before to have her taken off as executor because she didn’t think she could adequately handle my aunt’s estate; my aunt said she would choose a different executor, but never did.

As a comparison, just think of your neighbor and what would happen if they passed away and had designated you as executor, without you knowing. You likely have no idea where their accounts are, what bills have to be paid, or whether you are mentally, physically, or practically prepared to administer an estate without any advance notice. That’s not a fair thing to leave someone with, especially unexpectedly. Naming someone as executor for your estate is not a casual thing. That person needs to know your wishes, where your documents are, and what they are walking into.

So, we met with an attorney and updated a number of Mom’s legal documents.

Though I took her to the appointment and was with her, I made it very clear that I was happy to step out if the attorney needed to discuss anything confidential with her. Honestly, I did not care about her possessions. I cared that the documents were in order for the day when we would have to act on her behalf.

The documents we updated included:

• General Power of Attorney – For me to make broad decisions on her behalf.

• Medical Power of Attorney – For me to make healthcare decisions on her behalf if she was unable to do so.

• Directive to Physicians - Otherwise known as an Advanced Directive. This document designates the conditions under which you want life-sustaining treatment provided. This includes things like a ventilator (for breathing), dialysis (for kidney function), a feeding tube (for eating), or other treatments.

• Will - to designate who would handle her estate upon her passing (otherwise known as the executor) and where her money and possessions would go.

A very important note here: Some people think that they can use a Power of Attorney to handle someone’s affairs after that person passes away, but this is incorrect. A Power of Attorney becomes invalid when the person dies.

I never had to use the General POA because we created a joint bank account while she was alive and because other situations did not arise that would require it. But it was useful to have it in reserve.

The Medical POA and Directive to Physicians proved much more important. The documents gave me legal authority to act, but more than that, they guided me toward what she would have wanted.

People sometimes ask me what I’ve learned from Mom’s passing and whether I’ve made any changes. I tell them that one of the very first things I did was put together a document listing all of my immediate family’s assets (checking, savings, investments, home, cars) and the associated banks and bank account numbers.

• I listed car, home, and life insurance policies—the companies they were held with and the account numbers.

• I discussed our mortgage and property taxes.

• I listed the location of important documents, how to find usernames and passwords, and how to access files on my computer.

• With my wife I discussed how income and pensions would change when I died, what insurance policies would kick in, and some future planning considerations with regard to Social Security.

• And I also discussed my funeral. Though, honestly, I know I won’t be around for it, so I’m pretty much leaving that up to whatever the family wants.

• I now update the document every six months, print off a copy for safekeeping, and also provide an electronic version to my immediate family members.

If that sounds like a lot of work, it was, at first. But once the structure was in place, updating it takes very little time. The peace of mind is worth the work.

I recognize that conversations about death with loved ones is not always easy. Sometimes the conversations are hampered by bad relations, other times it’s a sense of privacy (“We don’t talk about those types of things where I’m from.”), and sometimes it’s from embarrassment about debt or lack of income.

With regard to finances, not talking about them isn’t going to make it easier for your loved ones. If you are in debt and paying those debts will be the responsibility of someone else upon your death (either the executor of your estate or a co-signer), one of the most loving things you can do is have a conversation about it before you pass away. There may be things your loved ones can do to help you while you’re still alive, if you let them.

Advice

A bit of a repeat: have the difficult conversations with your family.

• Most importantly: you should have a will, and it should be up to date.

• Just as important, have a discussion with the person or people you are designating as executor (or co-executors) so they are aware of what you want.

• And, if you want to be even nicer to your loved ones, you’ll create a document that lists important things, like: bank accounts, financials, insurance policies, important logins, and document locations.

• Review beneficiary designations regularly.

• Update documents after marriage, divorce, deaths, births, moves, or major financial changes.

• Do not assume your loved ones know your wishes just because you have mentioned them casually.

Other things to consider:

• A life insurance policy—especially if your family depends on your income to pay bills.

• Advance directives are not just for old people.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

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The Introduction was a brief background on the passing of my mom and why I’m writing this series.

In Chapter 1, we covered my mom’s growing hoarding problem and our attempts to help her out of that hole.

Chapter 2 told the story of when Mom’s urinary tract infection made her delirious and how I called the police to check in on her.

Now we dive into some things I learned while helping her through medical issues.

Chapter 3 - Aging and Medical Care

A few years ago, I had a nagging hip problem. Despite seeing multiple specialists, the issue would not go away. When I finally came full circle back to my primary care doctor, he said, “It just looks like you’re getting older. These kinds of things happen when we age.” It was depressing to think that I might simply live the rest of my life with pain and limitation. In that respect, I could understand some of what my mom was facing. It is depressing when there is no clear hope of getting better.

Whenever I would get frustrated with my mom, I tried to remind myself of that experience. I do not know what it was like to live in her body and feel the pain she felt. I only know that I have had injuries that felt insurmountable, and I know how depressing it can be. I recovered and my mental state improved, so I’m not sure how I would act if the ailments didn’t go away but instead grew and compounded.

For Mom, the hoarding wasn’t just about wanting stuff, her physical inability to keep up with life also contributed to the problem. Because of her medical issues, from autoimmune problems to limited mobility, every day was physically and mentally taxing. That compounded the hoarding in two ways: she could not keep up with cleaning, sorting, and throwing things away, and she also bought more things to try to make life easier.

She was resourceful and crafty in her ways to get by or around limitations. She had more grabber reacher tools than I could count, scissors in every room, and pens in every room. She had neighbors pick up her mail when she could no longer do it herself. She learned that if she called 911 to send a policeman over to pick her up after a fall she might get a bill, but if she called the fire department she would not be billed. And, as she liked to tell me, “Those firemen are stronger and more handsome than the policemen.” I would roll my eyes and tell her I did not approve.

For the last year and a half of her life I went to most of her medical appointments with her. That helped me understand what the doctors were saying and advocate for her when necessary.

The week before she passed, we were seeing a new specialist for a new diagnosis. As is typical with a new doctor, there was a mountain of intake paperwork to provide medical history, insurance information, medications, surgeries, hospitalizations, and allergies. It was time-consuming and frustrating for both of us. I could also see signs of Mom’s memory slipping because she couldn’t remember certain information for the forms. Her handwriting was deteriorating and her hearing was also getting worse. I cannot imagine her handling all of that paperwork alone.

One thing I wish I had done much earlier was create one master document with all of her medical conditions, medications, and personal information. That idea only dawned on me after that appointment. That day, after the appointment, I went home and created it, determined never again to rebuild her medical history from scratch in a waiting room. My plan was simple, the next time we saw a new doctor, I would write “see attached” and hand them the packet. Unfortunately, I only got to use it once, a week later at the hospital where she died.

Below is a blank version of that document in case you’d like to use it. I’m sure there are others available online, so don’t consider this all-inclusive. My intent was not to create the perfect packet of information, but to spare myself from having to reconstruct her entire medical life in the middle of each crisis or waiting room.

Personal & Medical Information

128KB ∙ PDF file

Download

Download

Key topics include:

• Full name, date of birth, Social Security number, and insurance information

• Emergency contacts

• Primary care doctor and all specialists, including phone numbers

• Diagnoses and major medical history

• Surgeries and approximate dates

• Current medications, dosages, and prescribing doctors

• Allergies and reactions

• Preferred pharmacy

• Copies of medical power of attorney, advance directive, and DNR, if applicable

Interestingly, at that same appointment, after answering the many questions about her surgeries and diagnoses, Mom sighed and said, “I can’t wait to be in Heaven, so I don’t have to deal with all of this anymore.” She was serious. Those words came back to me in the ICU a few days later when I had to make very difficult decisions.

Multiple times Mom had to go into rehab, usually following major surgery, because it was not safe for her to return home until she had regained mobility. Getting into rehab meant insurance had to approve it based on what the hospital and therapists documented. That usually meant working with a discharge planner, filling out paperwork, and scrambling to understand which facilities had openings and what would actually be approved by insurance.

As a hospital decides it is time to discharge a patient (a decision often driven by medical stability and insurance) they usually want to know where that person is going next. That is not a small question. You are not just deciding where someone will sleep, you are deciding what level of care they need and who will provide it, what insurance will cover, what location is realistic, and whether they can function safely there.

Rehab is generally short-term with the goal being improvement. You go there because there is hope that therapy and support will restore some function and allow the person either to return home or move to a lower level of care.

Skilled nursing is different. It is less about short-term recovery and more about ongoing support for people who cannot safely care for themselves. Rehab has a finish line in mind. Skilled nursing often does not.

One complicating factor is that the same facility may offer both. Unless you are paying close attention, it can be easy to misunderstand whether your loved one is in a temporary recovery environment or sliding toward a longer-term level of support. This is an important distinction because it affects not only cost and logistics, but also expectations. One of the questions every family has to ask is, “Is this a temporary setback, or is this the new baseline?”

In our case, every rehab stay felt like warning. Hospitalization, rehab, discharge, repeat. Over time, I begin to realize that medical events in old age do not always come and go. Sometimes they ratchet life downward one click at a time.

I will warn you now, skilled nursing facilities can be a shock. Depending on what your insurance covers, you may be in a shared room with space for only two single beds, two nightstands, and a thin curtain to separate you from your roommate. You likely both have TVs mounted on the opposite wall that loudly battle with one another for your attention. Nurses and orderlies come in at various times, sometimes unscheduled in the middle of the night, sometimes long after you’ve pushed your button requesting them. Generally speaking, they are not happy places. I speak from experience.

After Mom had her shoulder replaced, she had to go into a skilled nursing facility. This was really the only option my mom had—I could not provide the attention, care and rehab at home that she could receive there.

The month that my mother was in a skilled nursing facility was torture for her. I had to meet with staff to advocate for her when they wouldn’t listen, would mess up her medications, or would treat her roughly. She had to request room changes due to a roommate who coughed incessantly. I’d visit her nearly every day after work, not just to check up on her, but to show the staff that there was someone watching them and keeping them accountable. One time, I walked into the room and immediately smelled the overwhelming odor of urine. I asked Mom about it, and she said her roommate had pushed the attendant call button more than 30 minutes ago for help to get out of bed to go to the bathroom, but no one had come. I went out, tracked someone down, and was able to get the problem resolved. To some degree, it wasn’t the staff’s fault; they were undermanned and overworked.

Just know this—you can and should do your homework when selecting a rehab or skilled nursing facility. There are websites that provide reviews that you should read through. Then, most importantly, make sure the staff know that you care about your loved one and are actively aware of and engaged with how they are doing.

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One thing that turned into a blessing, though it initially felt like a burden, was taking Mom to appointments. It disrupted my work schedule and required patience with the fact that she was never ready on time. I wish I could say I always relished those opportunities to serve her—brushing her hair, helping her with shoes, rubbing medicine on her shoulder—but that would not be true. There were times I saw it as service. There were many other times it was simply frustrating. Alas, welcome to the true me.

I took encouragement from my mother-in-law, who has cared for more people than I can count. She has cared for aging aunts, disabled cousins, and still cares for her own ninety-eight-year-old mother. People like her remind me that it is possible to show up day after day for people who are frail, messy, dependent, and not always easy to care for.

For me, it was a year and a half with my mom. There are people who do this for much, much longer. God bless them.

Advice

Planning for aging and end of life all starts with a conversation, which can be hard to do. Some families do not want to talk about health decline or death. That is unfortunate, because both will happen whether we talk about them or not.

Ideally, you should talk openly with loved ones about:

• Current and past health issues.

• Wishes regarding resuscitation.

• Wishes regarding your body after death—organ donation, cremation, burial.

• Funeral or memorial preferences.

Additional advice:

• Go to appointments with your loved one when you can.

• Build extra time into medical days. Everything takes longer than you think.

• Bring a notebook or use an app to take notes at every appointment.

• Keep one master medical document and update it regularly.

• Ask doctors to explain things in plain English so you understand what they’re saying.

• Do not assume “rehab” means full recovery. Ask directly whether rehab is expected to restore prior functioning.

• Ask who is making discharge decisions—the doctor, the therapist, the facility, or insurance—and what the discharge decision will be based on.

• Ask what specific abilities your loved one will need in order to return home safely.

• If you are told, “They’re not safe to go home,” take that seriously.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

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Chapter 2 - The Tipping Point

It was a Thursday when we finished going through her office. On Saturday I called to check on her, but the call went to voicemail, which was not unusual. Then on Sunday one of her neighbors texted to say she had not heard from Mom. Again, not always unusual. So I texted and called her again and got no response.

A reasonable option would have been to ask one of her neighbors to go check on her. But they had already done that so many times over the years that I no longer felt right putting that burden on them. Quite frankly, they were burned out. It had begun to scare them, either because the house was disgusting or because they feared that one day they would find her dead. I do not blame them. My mom leaned on her neighbors far more than she should have, and I remain grateful for the help they gave her over the years while my brother and I lived elsewhere. In some ways, that is what neighbors are for. But there are limits.

So instead of asking a neighbor, I called the police and requested a welfare check. The responding officer called me when he arrived. I gave him the code to the garage keypad (something I was glad to have) and talked him through the layout of the house. Sure enough, he found her laying on the floor of her bedroom. She was awake and talking, but she was not making sense.

They took her to the emergency room, and I drove up to Austin to see her. That is when I learned how profoundly a urinary tract infection (UTI) can affect the mind of an older person.

When I asked Mom what had happened, she told me a fantastical story about camping in the woods, being chased, and many other outlandish things. She provided elaborate details about her adventures, each more bizarre than the previous. To her, the story was entirely real.

When she finished, I said, “No, Mom, that’s not what happened. I called the police because we hadn’t heard from you. They found you on the floor of your bedroom. You had been down there at least a day or so.”

“No,” she said, while wagging her finger at me. “That’s not what happened. You think you know what happened, but I really know what happened.”

I knew enough not to argue with someone whose mind was not functioning clearly, so I dropped it. What I did do, though, was ask her to tell me the story again, and I recorded it on my phone.

Over the next few days, the antibiotics began clearing the infection, and as they did, her mental clarity returned. At one point she asked, “What was it you said happened to me?” I told her, and she shook her head because it conflicted with the fading memories in her own mind.

I pulled out my phone and said, “Mom, I want to play you something. This is you explaining what happened.” We listened to the earlier recording. When it was over, I asked, “Which version makes more sense to you—what you said then, or what I am telling you now?”

When she realized her version of reality did not make sense, and that mine did, she became scared. And understandably so. It would be frightening for anyone to realize that their own brain had deceived them about reality.

She cried. I comforted her and told her we would work through it together.

That was the beginning of the whirlwind effort by my wife and me to find a place where she could be better cared for.

But first, in the next chapter, we’ll talk about medical issues in older age.

Advice

• If an older loved one is suddenly confused or delirious, consider a urinary tract infection and get it checked immediately.

• If something feels “off,” don’t brush it off too quickly.

• Make sure you have a way to access the home in an emergency.

• Know how to request a welfare check and don’t feel guilty for using that option when needed.

• If an older loved one lives alone, prolonged silence can be a warning sign.

• Keep a list of neighbors, friends, or nearby contacts who know the person’s routines.

When someone is delirious, don’t waste energy arguing with them. Focus on getting them treated and safe. Once they are clear-minded again, gently explain what happened so they understand the seriousness of it.

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

  ---

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Let’s get the ugly part out of the way first.

Mom was a hoarder. As is likely true for most people in that situation, holding on to things started small and then snowballed. I cannot tell you exactly when it started for her. I only know that over the years, whenever I visited her house, I began to notice things piling up in certain places—things that needed to be put away, organized, read, recycled, or thrown away. Over time, the piles grew.

It wasn’t just the hoarding that became a problem, it was the general uncleanliness too. Stains were left untreated. Dishes piled up in the sink. Basic housekeeping seemed almost nonexistent.

There was a point about four years ago when things became unhealthy and unsanitary. I will spare you the details, but it was atrocious. My brother and his wife flew in, and they, along with my wife and me, sat down with Mom to express our concern. We were logical and emotional in our plea to her to be willing to change. As I later learned, interventions rarely work. And neither did ours. She made promises, but nothing came of them. I consulted friends and professionals, and unfortunately there was not much we could do unless she was willing to accept help.

When we offered to come in and help clean, she generally refused. One reason was that when we helped early on, we moved too quickly for her to supervise every item being sorted and discarded. It wasn’t intentional; we were all working full-time jobs and could only come in on weekends, so we attacked the problem with efficiency and purpose. For Mom, it was overwhelming.

Sometimes other family members had a little more success getting her to allow them in. But despite their best efforts, they were mostly rearranging deck chairs on the Titanic. Her stubbornness and talkativeness would eventually wear them down.

In the summer of 2023, Mom fell and had to go to the hospital with a urinary tract infection, and then on to rehab. During that time, my family and I were out of the country. Her neighbors confided in me that the home had gotten worse and that something needed to be done.

While out of the country, I coordinated with Letty and Lee Inabinet from Visiting Angels in San Antonio to go into her home and at least get the kitchen and bedroom back into livable shape. But I knew we needed Mom’s permission first, so they went and met with her at rehab. She expressed concern about other people going through her things. I had worked with Letty while I was in the Air Force, and I trusted both her and Lee completely. I told Mom that. Letty was wonderful with her, assuring her that they would only clean and organize. Mom agreed. The Visiting Angels team deep-cleaned the main rooms, then returned to rehab to show her photos and reassure her. I remain deeply grateful to the Letty and Lee. If you are in the San Antonio area and need help of that kind, they are the kind of people you want.

Unfortunately, once Mom returned home, she reverted to old habits.

Eventually, after I retired from the military, I realized the only thing I could do was come alongside her and help on a weekly basis, in accordance with her wishes. Thankfully, my military pension gave me the flexibility to scale back and work part-time in my new job at UT San Antonio. I am grateful for the flexibility the folks at UT San Antonio gave me while I was helping my mom. I have no idea how I, or anyone working full-time, could handle something like this.

So from January through May of 2024, just about every week, my wife and I drove to Austin one day a week to go through things in her house with her.

My wife and I are very Type A people. I retired as a Colonel, and my wife has managed her job as a realtor while also managing our family and home through my many military absences over the years. I say all that not to brag, but to say that if there are two people in the world who know how to organize things and get things done, it’s us.

And yet the process of going through Mom’s house almost broke me. Not because we did not know what to do, but because nearly every decision required her approval.

We started in the kitchen. There was stuff everywhere. I did not know where to begin. I opened one drawer, then another, then another. I decided to gather like items, starting with spatulas. I found twelve of them, held them up to Mom, and asked which one she wanted to keep.

She analyzed every spatula. After fifteen minutes, we had negotiated her down to keeping three. But she did not want anything leaving the house, so we had to make two separate piles: one for things that might be given away and one for things that might be thrown away. After spatulas came whisks. After whisks came wooden spoons. And on, and on.

After a few weeks of trips, we finally got the kitchen somewhat organized and cleaned. If organizing was difficult, cleaning was even worse. There were cockroach droppings on every shelf, on dishes, and in cups. We went through gallons of dish soap and cleanser. The pantry contained food that was more than fifteen years old, yet even throwing that away required negotiation.

After the kitchen, we moved to the dining room, which we needed as a staging area for things we had sorted but that she still had not decided whether to donate, recycle, or trash. As we left each week, we gave her assignments, like going through one stack of sorted items and deciding what to throw away. Rarely did she complete them.

From the dining room we moved to her bedroom. By the time we finished going through her clothes, we had filled more than ten moving boxes with dresses, many still in original packaging from an online store.

We had small victories along the way: decluttering a cabinet, seeing the floor in places, and clearing a path wider than a foot. Some things became a game: counting the number of each like item we found to see which there were more of (scissors actually outnumbered spatulas), and seeing what the oldest item in the pantry might be (I found a bottle of alcohol at the back of the top shelf that was from the 1980s).

When Mom was not looking, my wife and I would quietly take things outside and put them into trash bags that we brought back to our house. Why back to our house? Because she would check her outdoor trash can after we left to see what we had thrown away. Call me dishonest if you want, but it was for her good. It was stuff any other person would have called trash.

There were even times when she remembered something that had been in the house but that we had thrown away behind her back weeks prior. She would ask us about it, and depending on what we thought her response would be—or our own frustration level—we would feign ignorance or tell her we had thrown it away. We could not do that too often, or she would lose trust in us. Again, call me dishonest if you want, but she simply was not keeping up with life in a way that ensured her health and safety.

It is difficult to do the right thing for someone when they do not see it as right. It is even harder when they get upset with you. In many ways, over the past few years, the parent-child relationship flipped. I found myself caring for her in ways she once did for me.

This kind of thing is not in the manual of life. Grow up, go to school, get a job, get married, have kids, retire. That is the arc of life as people tend to imagine it. No one really tells you about the stretch where you may need to care for your parents, many times while also continuing to shepherd your own children through life. This is what they call the “sandwich generation.”

Please do not misunderstand me. I am not bitter. I have no regrets about the time I spent with Mom. I am grateful she let us help her, and grateful we had the chance to do it. I am simply saying that the world does not usually explain that this too may be part of life, just as it does not tell you that marriage will involve struggles or that loved ones may have serious health issues. But that is reality.

I will also say that after raising me for nearly 20 years, I feel that the least I can do for my parents is help care for them for whatever period, and in whatever way, they need (and will allow). As difficult as it may be, it seems selfish to do otherwise.

By May, after four months of weekly trips, we finally reached her home office, where all of her important paperwork was “filed”—in stacks, spread around the room. Some piles had collapsed into others. There was a thick layer of dust on everything.

If there was one upside to Mom’s hoarding, it was that she had kept a lot of important paperwork along with the junk. I initially tried to go through each paper there in the house, deciding whether it was important and where it belonged. But she wanted to see each piece of paper too.

Eventually, I just threw the papers into boxes and bags and brought them back to our house. I spent evenings and weekends going through everything page by page. In the end, I was able to figure out where she had bank accounts, credit cards, and other essential information. The downside was that our living room began to smell like her house, which neither my wife nor I liked.

As tedious and lengthy as that process of going through paperwork was, if I had waited until after she passed to do it, it would have been a million times harder. Because I was finding things while she was still alive, I could ask her about them. I also had the luxury of time. If she had died before I had gotten through all the paperwork, I would have been trying to identify all of that information while simultaneously handling every other part of the estate.

Then, the same week we finished going through her office, I had to call the police to check on her.

Advice

To Hoarders

My guess is most hoarders fall into one of two categories: 1) you do not see yourself as a hoarder, or 2) you understand you have a hoarding problem but you don’t know how to break out of it.

If you find yourself in the first category—that is, you do not think you are a hoarder—but there are people in your life telling you that you are, then you likely are a hoarder. Quite often, others see our faults and shortcomings before we do.

Please understand: this is a problem. It is not normal to hold on to things to the degree that you do, especially if it is impacting your health and safety. If people closest to you are expressing concern, please listen.

If you know you are a hoarder but do not know how to get out of it, seek counseling. It is an addiction. Recovery takes time and effort. Maybe you keep things because you do not think your situation can improve, or maybe you do it because of finances, health, or the sheer size of the problem. There are people and organizations who can help, if you let them.

Additional advice:

• The goal is not perfection, it’s health, safety, and dignity.

• If the whole house feels overwhelming, start with one drawer, one counter, or one corner. Progress over perfection.

• Let someone you trust help you make decisions and help you go through things.

To family and friends of a hoarder

I am sorry. I wish I had an easy solution, but I don’t.

Even when my wife and I showed up every week, Mom was rarely willing to let much go, and even after she moved into assisted living she never truly changed the hoarder behavior. As we learned, interventions rarely work. Like most things in life, lasting change has to come from within.

Additional advice:

• Document what you are seeing. Photos and notes help you track changes over time.

• Don’t assume one difficult conversation will solve anything.

• Pace yourself. Protect your own sanity. Burnout is real.

• Get outside counsel when needed—social workers, counselors, doctors, or elder-care professionals.

• Focus first on health and safety hazards, not aesthetics.

• Accept that “better” may be more realistic than “fixed.”

Links to each chapter:

• Introduction - Why I Wrote This

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge (Managing the Mess)

• Chapter 9 - Finding a Place for Pup

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

  ---

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She had been to the ER many times in the previous couple of years, whether for falls, pain, or other complications. Each time, her problems were diagnosed, care was provided, and a path forward was prescribed. So when I showed up at the hospital on Saturday, November 30, I assumed this visit would be like the others.

Just a few hours later, when a nurse leaned over and asked me, “Does she have a DNR?” I realized this visit was different. (A DNR is a do-not-resuscitate order; it is a document that allows a person to choose not to receive life-saving measures in certain situations.)

Then, a few hours after that, when a nurse began doing chest compressions while straddled over Mom, I had to make the decision to cease further medical intervention.

Three times that night she experienced episodes, each more difficult than the last, that tested my wisdom, maturity, and love. I tell people that I feel like it took me 50 years to have the wisdom to make the decisions I made that night. I am not sure I would have been wise enough to ask the right questions or make the right decisions 30 years earlier.

My brother and I loved Mom, and I know she deeply loved us. She cared for us like only a mother could. I miss her, and I miss that she wanted to be around us. As moms go, you really could not ask for much more. My brother and I put together an obituary for her. I hope it did a decent job of conveying how much we loved her.

This is a series of reflections on the years leading up to her passing, the final hours of her life, and the things I learned while caring for an aging parent.

It started as a therapeutic exercise—simply writing down what her final hours entailed. Then it expanded into the last couple of months, then the last couple of years. Along the way, I realized there were lessons throughout that might help others who are going through, or will one day go through, similar situations. Eventually, it became an twelve-chapter document.

Why I wrote this

I’ve titled this series Reflections on Caring for an Aging Parent. Most of us have lost or will lose a parent sooner or later. Sometimes it’s unexpected and fast; other times it stretches for years and requires incredible sacrifice to care for a sick or elderly family member. Both are difficult in their own ways. In this vein, my purpose in these posts is to share lessons learned from our experience. The topics include hoarding (what to do if you are a hoarder, and what to do if you have a family member who is one), aging and medical care, important documents, finding a place to live, finances, dealing with someone else’s stuff, re-homing a pet, and a good deal of personal reflection on the passing of Mom.

I understand that there are differences in every life and death. You may have had a different experience or learned a different lesson. If you feel like sharing that in the comments section for others, feel free to do so. If you don’t, that’s fine too. I know how personal and private those experiences can feel.

Years ago, a pregnancy book was published with the title What to Expect When You’re Expecting. If I were to come up with another title for this series, it might be something similar, but from the other end of the bookshelf: What to Expect When You’re Expecting…to Die. I am not trying to be glib here. I have simply found that a little levity is necessary during hard times. In the way that the original What to Expect book was informative, I hope this writing is as well, because this writing isn’t just about caring for a loved one, it’s also about what we each need to be doing to prepare for our own death. And, let’s face it, each of us is going to die, so we should be prepared for it.

Thus, I think of the audience for these reflections through two overlapping lenses: time and relationship.

Time

• Some readers are not in this season yet. I hope you tuck a few of these lessons away for future use.

• Some readers are in the middle of this right now. I hope something here helps you navigate the road you’re walking.

• Some readers have already walked this road. My hope for you is shared solace. You are not the only one. It was hard. Thank you for what you did.

Audience

• Those dealing with aging parents.

• Hoarders, or family and friends of a hoarder.

• Those dealing with medical, housing, or financial challenges related to aging.

• Those serving as caregiver, power of attorney, or executor.

• Those facing end-of-life decisions for a loved one.

• Those wanting to prepare now for the practical realities of aging, decline, and death.

I hope you find some useful nuggets in here, whether for now or later. I also hope the narrative keeps you engaged. If it doesn’t, feel free to skip ahead to the “Advice” section in each chapter.

Credit for much of this content, either directly or indirectly, also goes to friends and family who have volunteered in hospice and cared for aging relatives. Throughout the many decisions we had to make, people were there to serve as sounding boards and offer advice. We are grateful for their wisdom.

Caveats

Let me make a few caveats up front.

First, I am not an estate planner, certified financial planner, attorney, doctor, nurse, or therapist, so the lessons I offer here come simply from experience in my situation with my Mom. I strongly recommend meeting with appropriate professionals to discuss your own situation.

Second, I am going to air some dirty laundry about Mom. I do this not to disparage her; my brother and I loved Mom deeply. I do this to connect with those of you facing similar circumstances. We are all adults here. We can acknowledge that people have faults and still have virtues. We can be lovable at times and a pain in the rear at times.

If you are in any doubt about how I felt about Mom, know this: she had shortcomings, but our family loved her deeply. That is how love works. People are not always easy to be with (my wife tells me this). Love means working through difficulty. We would not have done the things we did to help her if we had not loved her.

Third, you may read some of this and think that we should have done certain things differently. You are probably right. You may have had experience or insight we did not have. We were simply trying to make the best decisions we could, one step at a time. We sought counsel from friends, family, and professionals, and then we moved forward.

Below is what we’ll be covering over the next few months. I’ll post one new chapter each week. Chapter 1 is available now; to read it, click the link below.

• Chapter 1 - The Buildup

• Chapter 2 - The Tipping Point

• Chapter 3 - Aging and Medical Care

• Chapter 4 - Important Documents

• Chapter 5 - Finding a Place to Live

• Chapter 6 - Managing Finances

• Chapter 7 - Managing Tasks and People

• Chapter 8 - The Purge

• Chapter 9 - Finding a Place for Puppy

• Chapter 10 - Life in Assisted Living

• Chapter 11 - Her Final Hours

• Chapter 12 - Afterwards

• Final Reflections

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Andrew Lloyd Webber wrote a musical about her—Evita. In 1996, the musical was turned into a movie starring Madonna as Eva. The titular song of the musical was Don’t Cry for Me Argentina, which you can watch Madonna sing here:

The song speaks to the complexities of her rise from poverty to power, as she reassures the people that, through her transformation, she is still there to support them. It’s a plea to the Argentinian people to show understanding for all she’s been through, and ultimately, not mourn her death.

I’m reminded of the song as I watch what Javier Milei, the current Argentinian president, is attempting to do.

Eva Perón became one of the defining faces of Peronism by championing the working class and turning the state into an instrument of social protection and mass loyalty. She helped create the emotional and political style of Peronism itself—direct appeals to “the people,” strong symbolism, organized labor as a pillar of power, and a government expected to care for ordinary Argentines.

The current President, Javier Milei, by contrast, has taken a different path. Since taking office in December 2023, he has pushed a libertarian, pro-market agenda centered on cutting state spending, deregulation, labor reform, and weakening the old Peronist model of unions, subsidies, and state-led economic management.

His policies have led to a strong GDP rebound and reduced inflation. For now, he has achieved meaningful stabilization.

But he has plenty of critics, and some believe that Milei has abandoned the people. Public backlash over austerity measures, along with corruption allegations and stagnant incomes, has eroded his approval ratings.

And so, the lyrics of Don’t Cry for Me Argentina echo in my mind.

It won’t be easy, you’ll think it strange
When I try to explain how I feel
That I still need your love after all that I’ve done

….

Don’t cry for me, Argentina
The truth is I never left you
All through my wild days
My mad existence
I kept my promise, don’t keep your distance

In Eva Perón’s pleas to the Argentinian people, I can’t help but wonder if, reimagined, the lyrics could serve as a plea from Milei—that he has not forgotten the people and that his austerity measures are in their long-term best interest, if they’d only trust him and have patience.

No doubt there are many who see Milei’s approach as “mad”—it’s hard not to when you see images like this:

But keep in mind that the inflation rate in Argentina was nearly 300% in 2024, so perhaps a mad approach was required. Even now, at a more “normal” rate, inflation in Argentina sits around 32%. And you thought our U.S. inflation rate was bad at 3.3%.

Time will tell if Milei’s approach works—whether he “kept his promise”—and whether the people have the patience to see it through or instead “keep their distance.”

If not, there’s always the potential for a second, or third, chance.

In a bit of a political twist, Eva’s husband, Juan Peron, was overthrown as President of Argentina in a coup in 1955. Then, almost 20 years later, in 1973, he was elected president again. By that time, he had remarried, and his new wife, Isabel, became vice president alongside him1. When Juan Peron died in 1973, Isabel became president but was later overthrown in another military coup in 1976.

So, when it comes to Latin American politics, the people can be fickle, cycles happen, and anything’s possible.

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Twelve years ago, my family and I experienced one of the most unique stage shows that we had ever seen, or that we’ve seen since. It was called The Intergalactic Nemesis.

In The Intergalactic Nemesis, comic book images are shown on the screen while actors on stage speak the lines you’d normally read in the comic panels; meanwhile, sound effects are played by someone else on stage. Think of a 1930s radio drama, along with still images, played out in front of you.

It is quite an engaging storytelling experience.

Originally performed and recorded as a radio drama in 1996 in an Austin coffeehouse, the show eventually grew to broadcast quality, and they ended up going on the road as a live stage play. They were even on Conan O’Brien’s show and NPR’s All Things Considered. Kansas State even put together a study guide for the show, providing background on the creator and the genre. We saw the show in 2014—almost 20 years later—as they toured the country. We loved the show.

To me, this is another story of something that started small, then grew after continued work and time, into something people might think happened overnight. Sadly, though the show is no longer being performed in person, you can watch episodes here. And, you can get their graphic novels (comic books) here.

But wait, there’s more!

In a surprise twist, while researching the creator, Jason Neulander, I found out that he’s put together a new show, this one based on Treasure Island, called Jane Hawkins and the Pirate’s Gold! It looks like they’ll be touring this fall and it’s a family-friendly show.

The Austin Chronicle describes it as, “The live version of Treasure Island Reimagined will do something very similar [to The Intergalactic Nemesis], bringing to…life the exploits of young Jane Hawkins, a 12-year-old working in a sleepy seaside inn on the coast of Scotland in 1754. Her world is turned upside down when a mysterious stranger washes up at the inn, sending her on a journey of peril and plunder.”

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Then I wondered how hard it would be to make my own site that would do the same thing as Series Graph.

What I found was that it was both easier and harder than I thought it would be. Here’s what my site, Episode Graph, looks like:

If you just want to go to my site and don’t care at all how I made it, go here and skip the rest of this post.

But, I’ll tell you up front that there are some issues with my site, so don’t plan to use it as a substitute for Series Graph. Here are the limitations of my site:

• My site has trouble getting information for certain TV episodes, so some ratings will be missing. This could be rectified if I paid money for a proper API feed (more on that later).

• The “dark mode” colors aren’t right, making that mode difficult to read. To change it to “light mode,” click on the asterisk/moon icon to the right of the search bar.

• My site may stop working. I actually wrote this post weeks ago, but I had used up all my “credit” from my free Netlify account (read more about how I use Netlify here) and had to wait until a new billing cycle kicked off for the site to become active again. My free account came with 300 credits, the next level up costs $9 per month and gives you 1,000 credits per month. I want to try to keep all of this at the free level, so I didn’t upgrade. I’ll be honest, I didn’t know how many credits I was eating up each time I uploaded a change to my site, though I do know that it took quite a few iterations to get the site I have now. Either way, when I exceed my free credits, all sites I’ve created on Netlify (to include my Olympics spinner and geography game) stop working until the next month, as you can see below.

How I made my site

I went to Claude’s Codex and typed in this prompt:

ok, i want you to make an html site that allows me to look up tv series or movies and see the imdb ratings of each episode (or movie) in graphic form similar to the Series Graph app/website. can you do that?

Codex said it could do this, but that I’d need to get access to an API and would need to upload files to Github.

I vaguely knew what these two things were, so after some back-and-forth with Codex, I was given background and instructions.

APIs

API stands for Application Programming Interface. In plain English, it is a set of rules that says: 1) what you can ask a system to do, 2) how to ask it, and 3) what kind of answer you will get back.

From Claude:

Websites use APIs by sending requests to external services and receiving data back in a structured format (usually JSON), which they then display to users.

For example, when a website shows weather, maps, or login options, it sends a request like “get current weather for this location” to another service’s API, receives the data, and uses it to update the page in real time.

Think of an API as a request for data from another organization that stores that data. For instance, if you wanted the latest stock prices, you’d sign up for an API to get stock prices from an organization that track them, like Bloomberg. If you wanted hotel pricing and availability data, you might sign up for an API from Expedia. Or, if you wanted to get weather data, you might sign up for an API from Weather.com.

You get the idea—basically anyone out there who has information on the web will likely offer you the ability to sign up for an API to get their data. Some agencies offer their data for free, like the government, and others require you to pay for the data—IMDB falls into this latter category, charging $150,000 per year. Obviously movie data is a big business!

I did not have an extra $150K lying around, so I asked Codex what other options were available, and we settled on The Open Movie Database (OMDb) API, which was free for a limited number of queries.

Unfortunately, I quickly used up my allotted queries in building my site and playing with it, so for now I pay $1 per month to get unlimited queries but limited data (as I later learned).

GitHub

GitHub is a website and platform for storing, managing and collaborating on code. Codex originally wanted me to have the code stored on my computer, which would mean every time someone accessed my Episode Graph website it would go to my computer to run the code. My previous two projects, Your Vibe Code Guide to the Olympics and Your Vibe Code Guide to World Geography, both had static data, so no outside information was required. This project, however, would require going and looking at data that would constantly be updated (new TV episodes and movies come out every day).

I am not a fan of running a website from my computer, so Codex told me that Github is a good alternative. And, that it is—especially since it offers a free option for my limited use. There are also paid options depending on your needs:

So, with that background, off I went. I had never used APIs or Github before, so I asked Codex to walk me through every step of signing up, and uploading code.

Though this all may sound complicated, it actually wasn’t. I did this all one night sitting on the couch watching another episode of The Lincoln Lawyer—which, as an aside, is a great series, both as TV and in book form (and so is the semi-related Bosch series)!

Within a couple of hours, I had a fully functioning site.

It started out with a basic line graph:

But I wanted the option for boxes, so I went back into Codex, told it what I wanted (along with an image from the Series Graph website), and within a couple of minutes it gave me new files to upload to Github.

Once that loaded, I wasn’t happy with the large size of the boxes, so I asked it to make a slider tool enabling the user to make the box sizes as large or small as they wanted:

Note that you can choose between boxes or a line graph—it kept both options. From there, I asked Codex to provide “average” lines on the line graph. It wrote new code to show linear average, moving average, or no trend line at all, then I uploaded the new code to Github.

You might also notice that when you type a movie or TV show title in the search bar that the left panel of the site shows a list of all possible movies or shows with that title that you can choose from. I did not choose this option, Codex put it there in the initial version.

The information at the top and the sortable list at the bottom of the page were all created on the first iteration of the site by Codex as well…I didn’t even have to ask for them either.

However, this is where things started to get hard.

I wanted a button to toggle between light mode and dark mode, so Codex built that functionality in via a moon/asterisk button to the right of the search bar.

But, dark mode is horrendous:

I played around with Codex for quite a while trying to fix this issue, but eventually gave up because it was taking too long.

Also, it was around this time that I realized that some episode ratings were missing and I couldn’t figure out why.

I queried numerous other TV series in my new app and inevitably certain episode ratings would be missing from those also. For the next few nights, I worked for hours with Codex to try and diagnose and fix the problem. Ultimately, what I narrowed it down to (I think) is that the $1/month OMDb API does not give me all TV and movie information; if I want all TV and movie information, I’d have to pay $150K per year to IMDB for their API.

So, there my imperfect site sits.

I think what strikes me as most interesting about these projects is how easy they are to code with no coding experience. Some of these websites or apps, like Series Graph, are popular because of how they’ve coded their site to display information or be interactive. If I, as a novice, can take a screenshot of cleverly done website and just ask Codex to make it for me, then where does the competitive advantage lie? Are site designs considered Intellectual Property? If all the information on the internet is available for vacuuming up and repackaging, where’s the limit?

As a coda to this post, while doing some research for a Global Hot Spots (areas of conflict in the world) course that I’m developing, I came across a site that looks very much like it was developed with the help of AI—World Factbook Archive—which is designed to be a replacement for the now-defunct CIA Factbook. The website, though glitchy at times, has suspiciously similar components to some of the coding projects I’ve had Claude do for me. I’ll admit, though, the website is well done with lots of great graphics and interactive tools. The interesting part of it is that all of the past CIA Factbook data was uploaded to GitHub, and since it’s static and no longer being updated, anyone could create a similar website without using an API.

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I’d like to tell you about Aspen—he was the best dog you could ever ask for. He was smart, playful, loving, ornery, and we miss him. We got him in late 2009, when he was still a pup, and had to put him down in 2023—it was one of the hardest things we’ve had to do as a family and was especially hard on my wife.

We named him Aspen because he was white, like the bark on Aspen trees, and because we enjoy Colorado, which has a town named Aspen. He was a Goldendoodle, which was a fairly newish breed in the mid-2000s, but now you see them everywhere. I wanted a German Shepherd, but I was overruled by other family members. I’m glad they won out.

As the dog of a military family, Aspen saw so much transition and change that anytime we packed our bags, even for a weekend trip, he’d get nervous and lay next to the piled up bags. He’d lay completely still and flat—except for his eyes, which would dart left and right to track the movements of the family as they walked back and forth. When we’d open the door to walk out of the house with our bags, he’d be the first out the door, as if to say, “I’m going too!”

Six months after we got him, we took a road trip from Florida to Alaska, driving across the southern U.S., then up the West Coast into Canada. He traveled with us in our minivan, his area taking up as much space as our two sons combined.

Along the way, we stopped at the Grand Canyon to stretch our legs, see the view, and take Aspen for a walk. I kid you not, a bunch of Japanese tourists with cameras saw this giant white puffball on a leash and immediately started snapping photos. Aspen responded with a toothy, open-mouthed, tongue-sticking-out smile and soaked in all the attention. He could be a bit of a showboat at times. In fact, once, he was even on the front page of the newspaper for a Fourth of July parade. Aspen made the newspaper picture; my son, however, was cropped out.

After the Grand Canyon, he got to see Yosemite. Then, in Canada, we got on a ferry where he had to stay below deck in the car in his crate. For the next couple of days, whenever we hit a port—whether noon or midnight or anytime in between—we’d let him out to go potty, then usher him back to his crate. Then we all got back into the car to drive through the Yukon and into Alaska.

In Alaska, he loved the snow in the winter and the grass fields in the summer. His best friend was our neighbor’s dog, Nalia, a large Alaskan Malamute. The two of them loved to wrestle, and it wasn’t uncommon for it to end with blood stains after one or both of them had played a little too rough and bitten the other around the nape of the neck a little too hard. They were never angry at one another; it was always playful.

He was an incredibly smart dog. Early on, he learned to tap a bell hanging from the handle on our back door to signify that he needed to go outside to go to the bathroom. Because his urine would kill the grass, I installed pebbles in an area on the side of the house—his “doggy litter” area, if you will. At first, it worked great.

Then he became too smart for his own good. He trained us to open the back door anytime we heard the bell ring, even if it was just because he wanted to wander around the backyard to smell things. And since he didn’t like the feeling of the gravel on his paws, he’d walk toward that area of the yard when we let him out; then, as soon as we closed the door, he’d sprint away to the grassy area to go to the bathroom.

To say he was the best dog is not to say he was a perfect dog.

Once, in Alaska, we had to take him in for emergency surgery after realizing that a wool sock he had eaten had gotten stuck in his intestines. I’m not sure I could’ve choked down (pun intended) the $1,000+ vet bill had I not loved that dog. And that’s nothing to say of how I later had to manually pull the other sock out of the exiting hole of his digestive system (I’ll spare you the details on that one). The things you do for the ones you love.

He was a bit of a Houdini at times. Though he never ran away, sometimes he would escape from our backyard, only for us to find out he’d gone when he pawed at our front door from outside. We’d open the door, and he’d be like, “Hi folks, I’m back.” and would trot back inside. To which we’d respond, “We didn’t even know you were gone!” I’m reminded of Billy in The Family Circus comic strip:

I imagined that, like Billy, Aspen had wandered the neighborhood, checked out some things, then decided he was ready to come home, so he did.

From the beginning, we had a rule that he was not allowed on our couch.

But something changed along the way, and it just started happening. He was not a lap dog. With a dog his size, it was like an elephant coming to sit on the couch—the process of getting on was cumbersome, followed by circling before sitting and then constant stretching and maneuvering to claim more couch real estate. If my wife or I ever got up from the couch to grab something from the kitchen, we’d return to find our place filled with whatever part of his body was not taking up the other 90% of the couch.

Couches, beanbags, beds… he had an elevated sense of self. The floor simply wasn’t good enough for this dog.

Sometimes he had a rough night partying and didn’t quite make it fully into bed. We can all relate.

And sometimes he had a rough day at the office:

I thought this picture of him waiting for Santa was nice too; he heard there were openings on the sleigh team and wanted to interview.

He loved going on walks, but he was terrible at going on runs. He wanted to smell every single blade of grass, which doesn’t really make running feasible.

Walks also meant us humans carrying poop bags and picking up his poop. And poop he did. Nope, he couldn’t go in our backyard; instead, he had to wait until we were 100 yards from home and make us humans carry his filled poop bags back for him like royal servants. I’m still not sure who trained whom. We carried innumerable bags of poop home from walks around the neighborhood over the years. It was embarrassing for us humans, and I think he was proud of that.

He had a particular gait that made him look like he was just kind of loping or bebopping along. Thus became one of his nicknames—Bebop.

Eventually, his list of nicknames grew so long that we only called him Aspen when he was in trouble or we needed him for something. His nicknames included:

• Bebop – which, of course, led to other nicknames, like:

• Beeeeeeeebops Las Vegas - said like “Vivaaaaaa Las Vegas!”.

• Bipity Bops – Inspired by the song from the Cinderella cartoon with the lyrics “Bipity Bopity Boo”.

• Bibity – A shortening of the above.

• Polywoggers – Along with his gait, his tail had its own personality, wagging in numerous directions… thus poly, meaning “many.” We’d usually call him this after his tail knocked something over, as in, “Polywoggers, watch your tail!”

• Poop eater – Self-explanatory.

• Dogger breath – Also self-explanatory and usually preceded by “poop eater.”

• Monkey dog - When he did something goofy. As in, “You monkey dog, stop rolling in the dirt! We just gave you bath.”

• Squirrel chaser – Squirrels are, well, squirrely. And though he liked to chase them, they were simply too fast to catch. But the most annoying part to him was when they’d cackle at him once they got up in the tree. “Squirrel chaser,” I’d say, “you’ll never win, they can climb trees.”

• Deer harasser – We have a lot of deer in our neighborhood. And while we were busy picking up his poop on walks, this giant white fluffy 70 pound dog would attempt to slowly sneak up on the deer. I have no idea what he thought he’d do when he got them, but then again, I don’t think he ever really intended to catch them. He would only half-heartedly jump at them when he got close. Then, as they’d bound away from the “great white killer,” he’d turn back to us and smirk, then continue bebopping along on his walk.

For everyone in our family, though, his most enduring trait was that of stress sponge. He was so docile that you could just lay next to him on the floor, petting his soft fur, letting him soak up the stress of the day. There were many days that I felt God put him into our lives to do just that. He would lay there as long as we would. I miss the feel of his fur.

He was also the neighborhood’s friendliest dog. Though he’d bark at other dogs in passing, it was not aggressive. It was as if he was saying, “Hey, what’s up, dude!” If they didn’t respond back with a bark or friendly wag of the tail, he’d pause and look at me as if asking, “What’s wrong with that guy?”

When we were in Alaska, we had a giant field behind our home. We’d go out to the field and throw a ball for him to fetch. He’d run to get it a couple of times, but after that, we’d end up having to go get the ball we threw.

When he was younger, he was very fast. In that same Alaskan field, the boys and I would play a game with him where we’d have him sit in place, then we’d start walking away, and, after we’d gotten a certain distance from him, we’d start running. As soon as we started running, he’d come chasing after us.

He’d always catch me—and catching usually meant swiping at my legs, causing me to trip and land face-first on the ground. I’d laugh and he’d come over and lick my face. He loved the thrill of the chase and the taste of victory.

As he grew older, he became slower, weaker, and increasingly in pain. There was less walking and more lying around. What he really loved was just sitting outside, watching passersby like an old man.

Alas, his compounding health issues just became too much, and we had to put him down. It was one of the toughest days for our family. There are harder things to bear in life, no doubt, but the loss of a pet is difficult—especially when that pet was Aspen.

To make matters worse, one of my sons and I were out of town and had to watch virtually as he passed. But it was harder on my wife, who held him as he took his last breath and felt his heart beat for the last time.

Undoubtedly, he was the best dog a family could’ve asked for.

So, Aspen, you big fluff ball, in your honor, we raise a bag of poop to you. We miss you, Bebop, you poop-eating dogger-breath polywogger monkey dog. Know that the squirrels still cackle, the deer continue to invade, and you’ll forever have a place in our hearts.

Aspen, the best dog a family could ask for.

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But this post isn’t about land invasions or airborne assaults on foreign soil.

Instead, since I’ve been seeing a growing number of stories about the Strait of Hormuz, global shipping chokepoints, and the Taiwan Strait, I thought I’d tie them all together. I hope you find this helpful.

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For years, it was easy to assume that globalization, digital networks, and advanced technology had reduced the importance of physical geography. But recent events are showing the opposite. Even in an era of AI-enabled warfare and precision strikes, narrow waterways and physical supply routes still determine outcomes. Roughly 20% of the world’s oil supply flows through the Strait of Hormuz, and even limited disruption there has already caused sharp spikes in energy prices.

History shows the danger of trying to solve these disruptions militarily—misjudging second- and third-order effects has led to costly failures in the past.

The Gallipoli Lesson

The Gallipoli campaign during World War I is a case in point, as Niall Ferguson points out in this great piece. The Allied powers attempted to seize control of the Dardanelles Strait to reopen a vital supply route and gain a strategic advantage. What followed was a costly failure—poor planning, underestimated resistance, difficult terrain, and logistical breakdowns led to a prolonged stalemate and eventual withdrawal.

The campaign didn’t just fail militarily; it produced unintended economic and political consequences as well, and those consequences were both immediate and far-reaching. Economically, the failure to reopen the Dardanelles meant that grain shipments from Russia remained blocked, contributing to price volatility and fears of food shortages in Europe. Britain had to intervene heavily in markets—subsidizing shipping, restricting exports, and even attempting to influence commodity prices—measures that distorted normal economic activity and reflected how quickly wartime pressures can override market systems.

Politically, the fallout was just as significant. The failed campaign weakened the British government, forcing Prime Minister H. H. Asquith to form a coalition government and contributing to a loss of confidence in leadership. Winston Churchill, who had championed the operation, was removed from his post and saw his reputation severely damaged (though it was salvaged in WWII). Beyond Britain, the campaign failed to stabilize Russia, which remained economically strained and politically fragile. These were conditions that ultimately contributed to the Russian Revolution. In short, what began as a strategic effort to solve a military and economic problem ended up weakening alliances, destabilizing governments, and compounding the very risks it was meant to resolve.

Chokepoints, it turns out, are complex multi-armed systems that can quickly tighten into a chokehold. Intervening under pressure rarely unfolds as planned, and often produces outcomes far different from what decision-makers expect.

Global shipping chokepoints

Global trade—worth more than $11.5 trillion annually by sea—depends on a handful of maritime chokepoints. About 80% of global trade by volume and 55% by value moves across oceans, concentrating risk in narrow corridors like Hormuz, Suez, and key Asian straits.

Not all chokepoints carry equal risk. As seen in the image below, Closing Hormuz blocks energy flows with few alternatives, but affects about 6% of global maritime trade. By contrast, disruptions in the Taiwan Strait (~13%), the Suez Canal (~16%), or South China Sea (~24%) would impact a far larger share of global commerce. The most severe scenario, blocking Southeast Asian routes, could affect up to 26% of global trade, forcing massive detours and cascading delays.

Even when rerouting is possible, it comes at a cost: longer routes, higher insurance, and slower delivery times that ripple through supply chains and consumer prices.

The impact of just-in-time logistics

Even limited disruption, such as a quarantine, would force ships to reroute, sometimes adding up to 1,000 miles to journeys, which would raise costs, delay deliveries, and cut off access to key ports. This is especially problematic in a just-in-time (JIT) logistics system, where companies keep minimal inventory on hand and rely on precisely timed deliveries to keep production moving. Designed for efficiency and cost reduction, JIT leaves little room for delay. When shipments arrive late, production lines can halt, downstream deliveries are disrupted, and shortages ripple outward. What begins as a routing adjustment at sea can quickly translate into factory slowdowns, empty shelves, and rising prices. In a more severe scenario, these compounding delays can cause entire supply chains to seize up across industries ranging from electronics to energy, exposing how efficiency-driven systems often sacrifice resilience in the face of disruption.

Rare earths and microchips

Control over rare earths is becoming just as strategically important as control over energy and trade routes. These minerals, essential for everything from EV motors and wind turbines to advanced electronics and military systems, are heavily concentrated in one place: China, which dominates global production and processing. That concentration is now driving a coordinated push to diversify supply chains. Japan and France, for example, recently agreed to deepen cooperation on rare earth sourcing and refining, including a new facility expected to supply a significant share of Japan’s future demand for key materials like dysprosium and terbium. These efforts reflect a broader shift, as countries invest in alternative suppliers, recycling, and joint ventures to reduce reliance on China, which has already demonstrated its willingness to restrict exports for strategic or political leverage. The result is a growing recognition that rare earths are not just industrial inputs, but are also geopolitical tools that are increasingly central to economic security and global power competition.

The Taiwan Strait

The Taiwan Strait has emerged as economically consequential chokepoint. Approximately $2.45 trillion in goods—more than 20% of global maritime trade—passes through it each year. It is also the center of the global semiconductor industry, with Taiwan producing over 90% of the world’s most advanced chips, including 99% of those used for cutting-edge AI systems.

The broader trade exposure is enormous. Taiwan’s ports handle hundreds of billions in goods, while China alone moves roughly $1.3–$1.4 trillion in trade through the strait. U.S. allies are heavily dependent as well: about 32% of Japan’s imports and 30% of South Korea’s imports transit the strait, much of it energy and high-tech components.

China is increasing pressure on Taiwan through military activity, economic leverage, and “gray zone” tactics that fall short of full invasion. These include potential blockades or restrictions on shipping that could disrupt trade without triggering immediate war.

One advantage of the Taiwan Strait is that alternative routes are available, unlike the Strait of Hormuz. This Economist article does a great job of modeling and mapping potential impacts.

However, if conflict and blockade expanded throughout the South China Sea, the consequences would be far worse.

At the same time, uncertainty in U.S. policy and competing global commitments are creating openings for China. Subtle changes in diplomacy or priorities could weaken deterrence, raising the risk of miscalculation. The situation is further complicated by the fact that major powers cannot fully concentrate on multiple theaters at once, increasing the chance that one crisis creates opportunities in another.

In conclusion

The global economy is highly efficient, but also highly concentrated and fragile. A small number of chokepoints carry a disproportionate share of trade, energy, and critical inputs. Disruptions in any one location can cascade quickly across regions, industries, and financial systems.

Countries are responding by stockpiling resources, diversifying supply chains, and investing in domestic production, but these adjustments take time and raise costs. In the near term, the system remains exposed. The question is not whether chokepoints matter, but which one becomes the next breaking point, and how far the shockwaves will spread when it does.

Though this isn’t an article about land invasions or airborne assaults on foreign soil, I do think it appropriate to end with this quote from Lyle Goldstein in his U.S. Naval Institute article comparing Gollipoli and Hormuz:

A closely related point, of course, is that U.S. forces fighting on Iran’s sovereign territory would once again confront the anger of a people defending their homeland. It is no coincidence that the father of modern Turkey, Mustafa Kemal Ataturk, arose out of the single extraordinary battle at Gallipoli. After the bitter lessons learned from wars in Vietnam, Afghanistan, and Iraq, U.S. strategists should be wary of brazen challenges on foreign soil.

The lesson is simple: chokepoints are inevitable, but chokeholds are not. They emerge when efficiency replaces resilience and when alternatives are ignored. Like in wrestling, the key is not to overpower the hold, but to avoid being caught in it in the first place.

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I recently noticed I had a few items, both personal and professional, that were stagnating on the “back burner” of my to-do list for way too long. When it came down to it, these were things I needed to do, but they were neither fun nor easy, and thus I was avoiding them. Basically, I was procrastinating. I’m sure you can relate.

I read about a time-management system called “Getting Things Done” by David Allen. I won’t go into detail about his system, because there’s a lot packed in there, but one piece of advice stood out to me: when you’re overwhelmed by a project and everything it requires, identify the very next step you need to take, and then take it. He isn’t suggesting that you think only in the short term or avoid building a comprehensive plan for your project. Rather, his advice is about focusing on the immediate future: what is the very next step you must take to move toward the overall end state?

This sounds really simple and obvious, but when it comes to those stagnating “to-do” items, it can be liberating because it takes your mind off the overwhelming scope of the project and instead has you focus on just the next step. You identify the next step and take it. Then repeat.

One Step…

Of course, this idea isn’t new. You’ve likely heard the saying, “How do you eat an elephant?” and the corresponding response, “One bite at a time.” The elephant symbolizes some huge, overwhelming thing you must accomplish. The idea, then, is that you don’t focus on the whole elephant; you focus on the next bite.

I hate to mix food metaphors, but there’s another great saying (possibly by Mark Twain, but that’s unconfirmed) that goes, “Eat a live frog first thing in the morning, and nothing worse will happen to you the rest of the day.” The point is, if you do the gnarliest thing on your list first, then you’ve gotten it out of the way and can go through the day knowing that the other things on your list should be easier to swallow.

The productivity translation of these two metaphors is: identify the next bite you have to take and take it. Get the hard part out of the way and make progress.Those of you who have been through challenging periods in life—where the sheer amount of time you were going to be challenged seemed overwhelming—can relate to these metaphors. Maybe it was military training, or a difficult class, or even a loved one struggling with health issues. You made it through those times by taking it one step at a time. You didn’t make it through by thinking about the enormity of your ordeal. You made it through by thinking about that day, the next meal, the next hour. You made it through by taking the next step, over and over again.

The same holds true for fitness. You don’t focus on losing 80 pounds or running 26 miles—those are overwhelming numbers. You focus on showing up each day. You focus on the next lap, the next rep, the next pound lost. They add up until one day you find yourself halfway to your goal, then halfway the remaining distance, then halfway again, and then eventually all the way there. But this requires taking the next step, over and over again.

The same holds true for education. Whether it’s a bachelor’s, master’s, or even a doctorate degree, when you think about the number of classes you have to take, the number of papers you have to write, or the length of time it’s going to take, it’s overwhelming. Instead, you focus on the next semester, the next class, the next assignment, the next 2,000 words. You make it through by taking the next step over and over again.

The same holds true for managing emotional or health struggles. The enormity of difficulties in life can be overwhelming, and your present condition versus the future better condition can seem a thousand miles apart. But you get there by taking one step after another. Whether it’s overcoming depression, or stress, or an addiction, it’s about making it through one day, then one week, then a month. Then it adds up.

The same holds true for those who accomplish huge feats like making it to the top of Mount Everest—you take one step after another—be it buying gear, training, or literally taking steps up the mountain. Over and over and over and over again.

…Then Another

Those of you who have been through challenging periods in life—where the sheer amount of time you were going to be challenged seemed overwhelming—can relate to these metaphors. Maybe it was military training, or a difficult class, or even a loved one struggling with health issues, you made it through those times by taking it one step at a time. You didn’t make it through by thinking about the enormity of your ordeal, you made it through by thinking about that day, the next meal, the next hour. You made it through by taking the next step, over and over again.

The same holds true for fitness. You don’t focus on losing 80 pounds or running 26 miles—those are overwhelming numbers. You focus on showing up each day. You focus on the next lap, the next rep, the next pound lost. They add up, until one day you find yourself halfway to your goal, then halfway the remaining distance, then halfway again, and then eventually all the way there. But this requires taking the next step, over and over again.

The same holds true for education. Whether it’s a bachelor’s, master’s, or even a doctorate degree, when you think about the number of classes you have to take, the number of papers you have to write, or the length of time it’s going to take, it’s overwhelming. Instead, you focus on the next semester, the next class, the next assignment, the next 2,000 words. You make it through by taking the next step over and over again.

The same holds true for managing emotional or health struggles. The enormity of difficulties in life can be overwhelming, and your present condition versus the future better condition can seem a thousand miles apart. But you get there by taking one step after another. Whether it’s overcoming depression, or stress, or an addiction, it’s about making it through one day, then one week, then a month. Then it adds up.

The same holds true for those who accomplish huge feats like making it to the top of Mount Everest—you take one step after another—be it buying gear, training, or literally taking steps up the mountain. Over and over and over and over again.

Decisiveness + Momentum

This really comes down to two things: taking a step (decisiveness) and continuing to do so (momentum). The more you do this, the more you get used to it, the more progress you make, and the more you get used to making progress.

This reminds me of the book by Bill Bryson titled “A Walk in the Woods,” in which he details his hike on the Appalachian Trail. He tells about the trials of hiking for days and miles on end, and how it all comes down to taking one step after another. Some hikers, as he tells it, make it to the end of the entire 2,168-mile Appalachian Trail journey only to find themselves turning around and continuing back the other way simply because it’s what they’re used to doing—taking the next step.

When making decisions and moving forward becomes normal, you find momentum of action. This isn’t to say that hard decisions become easy, but it means you’re not putting them off, and when you get used to making hard decisions, your ability and process for making hard decisions becomes more routine.

Illustrations from Physics

Physics provides us a couple of illustrations as well: Newton’s third law and friction.

Simply put, Newton’s third law states that an object that is at rest will stay at rest unless a force acts upon it, and an object that is in motion will not change its velocity unless a force acts upon it. Said even more simply, an object at rest stays at rest, and an object in motion stays in motion.

As a quick physics refresher, static friction is friction between two objects that are not moving; kinetic friction is friction between two objects that are moving relative to each other. What’s interesting is that static friction exerts greater force than that of kinetic friction. As an example of this, think about a time when you had to push something heavy across the floor—getting the object moving took more effort than keeping it moving, once it overcame static friction.

OK, I know mechanical physics doesn’t play a direct role in accomplishing your to-do list, but there is a bit of psychological physics that comes into play. First, your stagnating to-do list items likely won’t accomplish themselves—you will have to exert some force, some action. Second, it may require a lot of force to get it going, but once you overcome the initial force resistance, less work should be required.

Application

So, what’s been stagnating on your to-do list? What are you dreading doing? Identify the next step, and take it. “Eat the frog,” as Mark Twain might say. Then repeat. Be decisive (make decisions and take a step forward), then keep your momentum and do it again.

As Tony Stark from the Avengers said, “I need a day when there aren’t twenty crises to deal with, but I don’t see that coming any time soon.” So, you might as well start dealing with the crises now.

Go forth and take action!

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