Let’s Flatten The Curve together

As I am writing this, I should be wrapping up our departure plans and packing suitcases to head back to France for some family business. However, another life form, a virus, decided otherwise.   

Many of you, like me, have been spending the last few weeks trying to figure out what is fact vs. fiction about the Covid-19 virus (a.k.a Corona Virus). What precautions and measures do we need to take without falling into the panic buy frenzy?

The situation has not only been fluid but has been escalating with exponential proportions. When I booked our tickets in January I had no idea what was unfolding, first in China and rapidly across the world. The epicentre of the epidemic has now shifted to Europe. In the last 48 hrs, France closed its borders and ordered confinements of its population. Yesterday, Australia announced a ban on all travel to the EU and the Schengen area for the next 30 days under a Level 4 threat.

With my trip now cancelled, I ventured to my local supermarket in an attempt to get some fresh supplies, (since we had focused on clearing up freezer and pantry before our trip). All I was met with were empty shelves and dismayed shoppers trying to grasp what was going on. Most items are now limited to two of the same type per transactions. I praise the decision to limit bulk buys but it clearly came too late. It is also a bit of a joke given the check out attendant offers to bypass the restriction by purchasing the items under a second transaction.

This morning our Prime Minister was stressing the importance of “social distancing”. Personally I prefer to call it “physical distancing”. We are blessed to have mobile technology, high speed internet. This is the time to get closer, virtually, to our families, friends and neighbours. While the grand children cannot go and visit grandparents, they can still keep in touch daily with phone calls, Skype, Facetime and Whatsapp calls.  This is a time to show compassion, pull our resources together, show initiative and be innovative.

In that context, I want to share two websites my sister sent me. The first one is from Johns Hopkins University (JHU) and shows data about the cases on Covid-19 around the world.

While I do not have medical training, my degree in Biological Sciences taught me the value as well as the pitfalls of data collection. Realistically, confirmed cases are only the tip of the iceberg because:

  • The asymptomatic aspect of the virus, means people can be carriers but show no symptoms for many days or weeks
  • Similarity of the symptoms with flu means that people might not seek medical advice for several days
  • Confirming a case requires testing. Most countries do not have enough test kits. Testing is still very sparse. As testing ramps up, we should expect numbers to increase even further.

The bottom line is that there is a delay between someone being actually infected and being confirmed positive. Over that period they will infect many people.

This brings me to the second article my sister sent me:

Coronavirus: Why You Must Act Now, by Tomas Pueyo.

I urge you to read that article, and take time to let the data and projection sink in. Pay particular attention to the mortality rates and its drivers. There is some valuable advice on what actions each one of us needs to take now. This is particularly important for business leaders and owners.

No health system in this world including Australia can sustain the onslaught of this epidemic. While it shouldn’t be lethal to children and healthy people below 60 years of age, it’s our ability to carry and spread this disease that we need to stop, and we need to start now.

TL;DR: Start physical distancing TODAY, not tomorrow.

Let’s Flatten The Curve together.

Lessons learned – Critical Information Gathering

Part 2

As recounted in a previous article , losing a parent for those of us living overseas carries some extra challenges. During my own ordeal I learnt some hard lessons that I wanted to share.

In Part 1 “laying the foundations” I outlined how my sister and I leveraged off available technologies. This allowed us to scramble and start ordering and saving valuable information we needed or would need, at the time our father fell ill.

This article however goes a bit deeper into the kind of information gathering that we wished we had been able to do, long before the whole nightmare started.

The irony in our story is that back in 2016, both my sister and I attempted to get a plan in place with Dad to avoid problems down the line. We both had had personal experiences that highlighted to us the importance of having some basic knowledge and elements in place. However, trying to get Dad to act was impossible. All we got was “not to worry, it was all taken care of”, or, that he was going to or had made an appointment with his Notary, which of course never happened. I wish I had been more forceful and proactive at the time. Hindsight is such a great virtue!

My recommendation is to start with what you know or can find out on your own. That will help you to have a more specific conversation with your loved ones as well as identify what you don’t know. For example:

  • Find out what your responsibilities are in your home country towards your parents? E.g
    • Are you expected to pay for their medical bills
    • Pay for a retirement home/home care
    • Pay for their funerals
  • If your parent was to become unable to look after themselves or even make decisions:
    • What can you do now to have the authority to act in their behalf and protect them and their assets?
      • E.g. In France we used a Mandat de Protection Future
    • What services and help is available to them (e.g. home care, nurses visits etc)
    • If your parent has to be institutionalised, what are the options? Costs etc?
  • Get to know the succession laws in your home country
    • Is a Will needed or not
    • what is the max timeframe between death and funeral (this is important if relatives have to travel from far away)
    • What are your legal requirements
    • Who has to be notified and when (in some cases, it is within 24hrs)
    • What is the succession process, milestones, timeframe and costs
  • Understand how Taxes (income, local, state, succession etc) work and when returns need to be lodge
    • deadlines and timeframes
    • Consequences of missing deadlines
    • is there online access
    • Local office contact details
    • Tax agent used by the parent(s), if any
    • What taxes and cost are associated with successions
  • How much do funerals cost?
    • Consider your options carefully; some are merely payment plans with very high interests’ rates.
    • What is your parent wish (e.g. cremation or inhumation? Religions?)
    • Does the family own a plot in a cemetery? Where? Is there room?
  • Do you have someone, local to your parents, that you can entrust with a Power of Attorney, should the need arise?

By no means is the above list definite, if anything it shows how one question leads to another.

Information you might have to get from your parent(s):

This for us was the biggest hurdle and a complete failure. We tried to get some information out of Dad back in 2016 and it was like asking a teenager to do their homework.

If your parents are open to the conversation then make the most of it. The more you know and understand, the better prepare you can be and have everything in place. Also you will discover what you don’t know and need to know or act upon. This will not only save you headaches and money but will give you the most important thing: time with your parent, when it is needed.

The other sad reality is that when it comes to elderly care, cost and availability are key factors that define what choices are available.

Generally speaking, nobody wants to talk about death. Some parent might also be reluctant to discuss the repartition of assets between siblings, or even some of their wishes. At best, all you can do is stress the importance of having a family notary or lawyer and to have a Will or at least some clear instructions. This is important not only after death of course, but also long before that, should they become unable to make decisions or express their will. Some decisions about care etc will have to be made and that responsibility could most likely fall on you.

Some of the details to get from your parent include:

  • Contact details of their General Practitioner and Specialist(s)
    • If possible, get to know these people, or make sure you are known to them
  • Contact details of the family Notary/lawyer and financial adviser
    • Again, try to know these people or be known to them
    • Discuss what legal measures can/should be put in place (e.g. in France a Mandat de Protection Future)
  • Where are the bank accounts with?
    • Banks may need a specific document signed despite having Power of Attorney
  • If a Will is in place, ensure that it has been properly registered and is valid
  • Contact details of the executor of the Will
  • If a Will is required but nonexistent, then you will need to press for this to be done
  • Where is their pension(s) coming from
  • Health insurance (Private mutual)
  • Medicare or equivalent
  • Home & Content Insurers
  • Car insurers
  • Life Insurer, if any
  • Local Tax office
  • Credit cards
  • Loans
  • Get added as a contact/authority under key accounts such as:
    • Mobile phones
    • Cable TV
    • Home/Internet phone
    • Utilities
  • Ideally, use/setup online access to those accounts for your parent(s), especially if you live some distance away
  • Last but not least, make a list of their friends and contact details

Then there are those delicate questions:

  • What are your parent wishes, for example DNR, retirement home, palliative care
  • What is your parent funeral wish (e.g. cremation or inhumation?), Religious or not?

It might sound self-serving to ask parents what their assets are. However, when someone passes away a Notary will have to aggregate the deceased assets and liabilities and identify who is entitled to the succession. Accepting a succession may, as it does in France, means you also accept responsibility for the debts of the deceased, so this is no trivial matter. There also are a number of methods parents, while alive, are able to donate assets to their children without incurring taxes of fees. This is worth investigating when you consider that one of the most common family assets being the family home. Over the years it might have significantly increased in value and inheriting it might result in significant succession costs and/or tax bills.

Overall, while getting some of those answers can be challenging and emotionally draining, having this in place will be a blessing when the time comes. The key word here is “time”, our most precious asset.

Lastly, when someone passes away it doesn’t all end there and then. Successions can be a lengthy and costly process that also includes emotions and tough decisions. Managing that process when living in a different country and with time zones is a challenge. Any pre-emptive preparations will lessen the burden significantly.

Disclaimer: I do not provide any kind of legal or financial advice. You should seek counsel from professionals on those matters to ensure it suits your situation. The advice provided is purely based on personal opinion and experience.

Places to visit: Mackinac Island. MI, USA

First published on my LinkedIn profile on 13 June 2018

Of all the places I have visited in my life so far, Mackinac Island holds a special place. Those of you who know of my French heritage, would be forgiven to think this is a place off the Brittany coast in France; but no…this is a small island in north Michigan, on Lake Huron, right next to one of the longest bridge in the world: Mackinac Bridge.

I confess I would never have picked Michigan as a holiday destination, although those great lakes have always fascinated me; the thought of a cottage on a lake shore in the middle of nowhere during fall has always had some romantic appeal, but having family in Michigan certainly helped with discovering the region.

My first visit to the island was some two years ago in October 2015, just as the trees were turning golden and crimson, the sun was lower and the season was ending. I promised myself that I would return in spring in order to experience one of the island attractions: Lilacs in blossom. So this past weekend I had the delight to walk the streets of Mackinac Island, under a warm spring sunshine tamed by a fresh breeze carrying the scent of hundreds of blooming Lilacs.

Another quaint characteristic of the island is the absence of cars and combustion vehicles of any sorts (except for an ambulance I caught a glimpse of, at the medical center). All transport is either by horses & carriages or hundreds of bicycles readily available for hire. Access to the Island is by Ferry, which run every 30min at this time of the year.

Despite the natural consequences of using horses and their never ending capacity to produce fertilizer, a team of efficient street sweepers on bicycles are pacing the streets back and forth, keeping any “unpleasant” smells and sights well under control.

There is no shortage of places to stay to meet any budget although the Grand Hotel holds the lead role; even if you don’t get to stay there, it is possible to enjoy their renowned buffet lunch and dinners as well as access to the hotel grounds. You can get a virtual tour of their rooms on their website too.

So if you happen to be in Michigan and a bit at a loss as to what to do, why not head north on Interstate 75 and hop on a Ferry. We used Sheplers Ferries, who offers good value bundles that include parking, ferry crossing and island activities. Say “hi” to Mark, our friendly Taxi driver; the 70th Annual Lilac Festival is on and there is a big parade on Sunday 17th June.

Lessons learned – Laying out the foundations

Part 1

As recounted in a previous article , losing a parent for those of us living overseas carries some extra challenges. During my own ordeal I learnt some hard lessons that I wanted to share.

This first step is about laying the foundations for information safekeeping and sharing before anything happens. This is not about the emotional turmoil and dilemmas you might be facing. In our case, our father was diagnosed with terminal cancer without any previous warnings; we were not prepared; we had to scramble. I was faced with the decision of staying with him in France or going back to my life in Australia, I chose to stay with him. The process does not end when someone passes away either, as another starts. For that it was a few more months before I could return to Australia.

The first step is to start collecting information and documents and keeping them in a central location as early as possible. For that, we leveraged technology. Getting started before anything happens to your parent will free up precious time and resources at a time when they’re most needed. This is even more so critical if you have siblings or live at distance. This of course assumes that like my sister and I, you have total trust and are open to share information.

From a technology perspective we needed to securely store documents as well as be able to access them at anytime, from anywhere and with any device.

We also discovered that internet speed in our hometown in South West France was abysmal. We only had ADSL at home and poor cell tower coverage outside the main towns. It was at time very frustrating. So being able to have offline access was critical.

So here is what I recommend:

  • Cloud base storage to keep copies of important documents. We used GoogleDrive, but there is DropBox, OneDrive and others; store:
    • Birth/death certificates
    • Livret de famille (France)
    • Photocopies of passports, ID cards (certified)
    • Power of attorney
    • Insurance policies
    • Vehicles registration papers
    • Property titles
    • DNR or other instructions (if there are any)
    • Medical certificates
    • Medical records
    • Doctors death certificate with cause of death (required by insurances)
    • Photos
      • Including photos of jewellery, paintings, furniture
      • Pictures of documents taken with phone
    • Personal Banking info (IBANs, RIBs)
    • Proof of residency less than 3 months old (you will need this for Tax purposes, opening bank accounts etc)
      • Water, gas/electricity bill, phone, rent
      • Tax File Number/TIN (USA) and other documentation required for FATCA
  • Scan/upload important documents and old mail, so you can access at any times from anywhere
  • Scan all relevant/important incoming new correspondence
  • Save all outgoing correspondence, including emails
  • Gmail account to be share between siblings (for all electronic correspondence with banks, insurances, notary etc). We use Labels to reflect the Cloud storage structure
  • OneNote, to share research, web links, daily to do lists, notes taken on the run, drafts etc
  • Get online access and go digital as much as possible for:
    • Banking
    • Taxes
    • Insurances
    • Agencies such as Medicare and pensions
  • Password Manager (eg LastPass, 1Password)
    • For your own use and your parent(s)
  • Local cell phone/SIM Card to have a local number and data access (it might be easier to have one added to your Parent existing account if overseas, more on this in future article)
  • A Skype subscription and credits and even getting a Skype (VOIP) number or similar. This allows you to get calls redirected to you overseas at a lower cost and send SMS.
  • Excel to start keeping tracks of bank accounts, loans, investments, expenses
    • In France, the first stage of a succession is for the Notary to collate the deceased assets vs. liabilities. Having already done this gave us a head start.
    • Keep a spreadsheet of who is spending/paying for what (this is important between siblings too)
  • Create Word templates for emails and letters with your contact details as well as the Notary/Will executor contact details. Being consistent in communications is important. We came to realise that we were not a fluent in French as we were in English!
  • Keep a good size USB key on your key-ring; you never know when you might need to copy something (remember to virus scan!)

In my next post I will look into the facts finding or discovery that you can do remotely, long before anything goes wrong. In the meantime, feel free to drop me a line or comment below. By no means is the above meant to be an exhaustive list, and everyone’s case is unique. I hope it can guide you to being better prepared.

Things worth scanning: one of my best friends (Maité) and I when we were ~ 7 years old

Disclaimer: I do not provide any kind of legal or financial advice. You should seek counsel from professionals on those matters to ensure it suits your situation. The advice provided is purely based on personal opinion and experience.

When life doesn’t go as planned

View over the Pyrenees from the family house in France

This article is a bit long, because there can be no cutting corners if I want to give justice to the last 18 months.

You know that feeling, when you think you have it all planned, sorted, under control, all ducks are lined up, you’re going full steam ahead, and then, bang, something totally unexpected comes from left field and throws you right off track…

2018 started full of hopes and plans and rapidly turned into a horrible year. I found myself powerless and even hopeless; I had to make some hard choices and heartbreaking decisions. Nothing I could do could have changed its ending.

When we are immersed in our busy lives, it easy to lose track of time and to forget that our parents are getting older. This is particularly true when those parents are living some distance away, or like me, in a different country (France). If you are in that same boat, you might use Skype or FaceTime, and have a clock either in the house or on your PC set to Mum & Dad’s local time. No matter how often you call and chat, the reality is that at distance, it can be hard to detect signs that something is wrong.

In our case, Mum passed away 9 years ago at 66, and both my sister and I were relieved to see Dad bouncing back; he was involved in the local community in our South West of France village, and even started his own B&B in the family home. Weekly Skype calls were the norm. When Dad somehow in late 2017 “broke Skype” as he called it, things got a bit more difficult, and weeks would pass without a chat. Yet, I was not worried, each time we spoke, everything was always “great”.

In 2018, I decided to take the plunge and start my own business as a freelance content writer/creator. But before I got too busy, I figured that it would be a good time to visit Dad and spend a few weeks with him. My partner had never been in France, so this trip was going to be awesome. We all had planned tons of things to do, people to catch up with, places to visit, restaurants to eat at.

It was during the trip planning process that a few things rang alarm bells. Dad often forget our previous day’s conversation, and even became unable to perform simple email tasks. He would also cut the phone calls short on some pretence, especially when I would asked new questions. Then I noticed he would re-hash the same “canned” conversations… something wasn’t quite right.

Then by some lucky coincidence, I was able to talk on the phone to a friend visiting Dad that day; she whispered that there was a problem. He hadn’t been talking his diabetes medications, he had had falls. The situation turned from holidays planning to emergency intervention. We had to Google search for his doctor’s contact details and make calls and write emails in the middle of the night. Time was of the essence. Distance brings that sense of powerlessness. Time differences seem to lengthen any attempts to resolve a problem.

Dealing with a different country’s medical field and administration, became a mountain difficult to climb. I also came to realise that my French was somewhat limited. It is one thing to have a conversation with Dad and another to talk to a doctor, bank manager or insurer or to put something in writing in my mother’s tongue.

We finally managed to get Dad to check-into hospital for a 2-days health check but we did not know then what was going to hit us all very hard.

The 2 days health check turned into 10 days hospitalisation. Tests revealed the presence of a cancer and even the early onslaughts of dementia. When we arrived in France, Dad was still in hospital; I found him confused and restless; eager to get out and go home. Yet, detached and unaware of his situation and condition. In his mind, there was nothing wrong.

From that moment on, I became his carer. I was so unprepared. Dad’s condition, especially mental, was a lot worse than expected. Yet, at that point, we could still have a “normal”conversation.

Thanks to the help of the French social services I was able to navigate my way through organising some homecare to take care of the daily injections and medications. Each day was another doctor’s appointment or some tests. Within a week we got confirmation that Dad was suffering from colon cancer and the tumour was blocking his intestine. The risk of an occlusion was high; surgery was critical and urgently needed. Dad was at times cognizant of the seriousness and risks and had agreed to have the surgery, but at other times, he was in denial because he felt no pain. The surgery however represented another problem: the anaesthetic would most likely accelerate the dementia. There was no alternative. While my sister and I understood the dangers and most likely outcome, Dad was rather oblivious and detached (a common behaviour with dementia, as it turns out). If I can stress anything here is: get your colonoscopies done. This cancer is sneaky and Dad had no symptoms, or none that could directly point towards this cancer.

The day of the surgery came fast. It was a warm sunny summer day in the Basque Country. Dad was tired but he insisted in pulling his small suitcase across the hospital car park; he had refused being dropped off at the front, but ultimately had to accept my help when he started struggling. It hit me at that point how much he had changed and how weak he had become. This man who used to own and run a business with over one hundred employees, had driven trucks across Europe, made deals and haggled with suppliers in Tunisia and sailed boats across oceans, this man, my Dad, needed my help.

Unfortunately the tumour was huge and had spread into the duodenum and the surgeon was unable to remove it. All she could do was create a bypass with a colonostomy bag; there were metastases in the abdomen, lungs and liver. Stage four. No way out. No treatment. I clearly recall sitting in that “family room” at the hospital, my partner (who doesn’t speak French) by my side, two doctors in front of me. My sister was still overseas so she was on Skype, on speaker. The conversation was very factual and clinical. The French surgeon was talking in her jargon; good thing we are educated and could ask clarifying questions to understand it all, I thought.

The plan was to let Dad recover from the surgery in hospital and then to relocate him to a palliative care centre a few km away. It was rather surreal. A few weeks earlier we were planning our holiday together, restaurants to eat at, places to go. A few days earlier we had watched and celebrated France win of the Soccer World Cup. Now the doctors are eluding his days are numbered. Yet, they won’t give us any timeframe nor any indication as to what the speed of evolution is.

Two days after the surgery my sister arrived in the evening and I took her straight to the hospital to see Dad. While he was awake and in no pain, his lucidity fluctuated. Our frustration at the time was with the surgeon because she had not yet explained to our father his condition and prognosis. It took a few more days before we were able to press her to talk to him. We felt it wasn’t our role to explain the outcome of the surgery. This aspect of the French medical field threw us, as we weren’t accustomed to this in neither US nor Australia. His mental state fluctuated from total detachment, to despair and everything in between. The dementia was a blessing and curse. Each day we found ourselves having to re-explain to Dad why he was in hospital, it was heart breaking.

I recall taking his cell phone and going through the contact list. Calling his friends, letting them know what was going on, and organising visits. The uncertainty over the speed of decline created this sense of urgency.

The transfer to the palliative care was seamless and straight forward. Dad was still very weak and had been bed ridden more than a week. The next day he wasn’t even conscious. That Friday morning will be etched in my mind forever. My sister and I were with Dad, each one on either side of the bed, holding his hands, watching him struggling with each breath. We looked at each other tearfully. The doctor’s words still resonating in our heads; he had eluded that based on his current condition Dad might only have 3 weeks left.

So we decided to activate the Mandat de Protection Future, a legal document that our father had agreed to sign days before the surgery. That notarised document, along with a medical certificate from an approved doctor, and counter signed by a judge, was giving me the powers to act on my father’s behalf at all levels. This was necessary, because unknown to us before our arrival, Dad had stopped taking care of his finance and other matters since ~ mid 2016. At home, there were piles of documents, letters etc. At the post office, I was handed a crate full of mail going back to April. We had our work cut out. At a time when we needed and wanted to be with him, we had to step up and resolve problems we didn’t even know existed.

While Dad recovered from the surgery, his mental health did not. He slept during the day and at night would try to get up and fall off his bed. His behaviour was also an issue as he became more aggressive and verbally abusive towards the people looking after him. In his mind he was a prisoner, and all he wanted to do was go back home. The dementia had become a bigger problem than his cancer.

Dad at the palliative hospital a few weeks after recovering from surgery

Each day we would take the 50 minute drive to the hospital unsure of what state of mind he would be in. Some days he would be telling the staff and us some amazing imaginary stories. Some other days he wouldn’t even wake up to eat his dinner. Some days he would agree to do physiotherapy to regain his strength and mobility and then refuse to move from his bed minutes later. Yet, all he wanted to do was going back home. This request seemed innocent enough but the logistics and implications were not.

First, Dad needed full time care. Whilst he was in no pain and in need of little medications, he had lost his mobility. He would forget about that detail, and then try to get up, and fall; the risk of injuries and fractures were very high. He needed 24×7 monitoring. Homecare assessment concluded his condition and state precluded a return to the family home. Staying in the palliative care centre was no longer an option. We needed a solution. Once again, the French Aide Sociale was great. They helped me find a a retirement home capable to look after Dad and his condition. In the middle of August, in regional France, this is no easy feat. I discovered that many families place their parent(s) or grand-parents in Homes so they can take a holiday break in the summer. This meant my applications were being rejected or added to a very long waiting list.

View over the Adour river at the Retirement Home

Eventually, after a month of intensive search, we got a place in a Home, 45 minutes drive from our home town. It was in a beautiful area, overlooking a river. A nice small house, surrounded by a garden and flanked by corn fields. A small unit, with around 20 residents, where Dad received all the care and attention he needed, up until his last breath, late last year. Dad was 73 years old.

Our last best day together

Due to the long distance to the retirement home, I ended up at odds with a lot of his close friends. All I can say in my defence, was that I did the best I could, for him. His care and comfort were my priority, nothing else. A good friend of mine had warned me: after a while, people stop visiting because they can’t handle seing the deteriorations.

My time in France last year was challenging. Yet, I was blessed to have had the economic capability to take more than a year off work and to have spent that time with my Dad during his last few months.

In hindsight, there are many things I wish I had done long ago, to be better prepared. My main regret is that so much of our time, and head space, was consumed with dealing with administrative and legal matters. They detracted us from the most important part: Dad. It is true, that dealing with someone terminally ill and who has dementia is testing. Dealing with those administrative matters provided needed distractions at times. Nonetheless, we could have done without them.

Socoa – minutes from our house, Dad used to dive with his best friend there

I have now returned to Australia, to my house, my life. I am busy laying the foundation to my new business but I am also reflecting on what I have learnt from this.

Over the coming weeks, I will be posting some check lists, and tips, of the lessons learnt. I hope that in there, you will find something helpful to be better prepared and free up that precious time that can be better spent.

As J. R. R. Tolkien said through Gandalf: “All we have to decide is what to do with the time that is given us.’”