Plan for first talk w/ aging parents: that didn't go over well

[Amethyst]

I'm totally in tune with the elders who try to insist on independence. Doesn't mean they should get their way, but boy, do I "get" them.

I put myself in the elder's place. I've spent my whole life setting things up so I don't have to do things other people's way, express the opinions everyone else wants me to express, like the things everyone else wants me to like, kowtow to the queen bee/kingpin of the clique, etc.

Sure, the workplace and the school exert their tyranny over all, but home is the Non-Institution. Now you say I have to go live in an institution full of Other People and Rules for Everyone? Where the spaces are so tight, you can't avoid other people no matter how you try? Gaaaah. I'd be like an animal that gnaws off its leg in a trap. Isn't this the same impulse that drives us to try to get out of the working world as soon as possible?

Neither my husband nor I will be the ones we are always hearing about who "love it after they get there." We will be forced to go when we can absolutely no longer get up off the floor by ourselves, and we won't fit in.

Amethyst

What it gets down to is that she wants her house, her way. She has very strong views of what she likes and doesn't like and wouldn't like not being the one in charge.

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[LauAnn]

Out situation is that Dad (now 86) has been in assisted living for past 18 months because neither he nor Mom (now 84) could deal with his diabetes (insulin, weakness, incontinence, bowel episodes). He has been miserable even though Mom visits every day. Fortunately she lives two miles away from him. Still, this is very hard on her -- both emotionally (guilt ridden) and physical (toll on driving to see him). Not to mention the stress she is under. Then there is the fact that Dad accuses her of having an affair every other time she visits him; and tries to make her feel guilty when she does not stay for more than an hour.

My sister and I each visit him at least 3 times a week. Plus I take him home to Mom's on Sundays. But the Sunday outing is getting increasingly more difficult each time as he is very weak and getting out of the car and up the steps is a challenge.

Dad no longer watches television nor listens to music nor reads the paper. He just sits in his chair with his eyes close. But (except for his short term memory) and the infidelity accusations, is mind is pretty good.

There was an episode a month ago when he pulled a pairing knife on an aid because he didn't want to go for a bath. So no sharp object allowed any more.

In the last month, I have seen Mom begin to deteriorate -- mentally and physically. But for now she is still able to take care of the house, cook, launder, and pay the bills. She even goes for a weekly violin lesson. If not for my Dad, she would have been thriving these past two years. We've talked about her moving in with me, but not too seriously yet.

I have a brother who is in the house with her, but IMHO except for helping with paying the utility and food bills, he is more of the problem than the solution as he is a hoarder and also has physical issues. No amount of reasoning with him will get him to clean up his act. Consequently this just adds to the Mom's (as well as my own) stress levels.

 

[rodi]

I'm totally in tune with the elders who try to insist on independence. Doesn't mean they should get their way, but boy, do I "get" them.

I agree with this. But I've also seen these decisions made well and made poorly.

My step mom decided that when she could no longer drive she'd sell her home and move to a community that has independent apartments and assisted living. She didn't quite follow the timeline - she gave up driving (due to neuropathy in her feet) about a year before moving... but heck - she was still teaching nursing (just taking a shuttle bus to get to campus). When she "LRed" (late retired) at age 87, she was ready to move into her new apartment. She dove into the social scene and loves it.

My parents both passed before assisted living was needed.

My next door neighbors sound like some of the cases here - wife had health issues (cardiac) husband had dementia. They worked together to take care of each other. But they reached a point where medical issues had them taking turns at the hospital, or calling kids out in the middle of the night. They moved to assisted living a few months ago - at age 87 and 90. There were some tough decisions with the kids to get this to happen, but they both realized it was time (or past time.)

My in-laws... Oye. FIL was wheelchair bound with some issues from strokes and dementia for the last 10 years of his life. With support from SIL (when they were at their home) and us (when they were in our casita part of the year) MIL was able to take care of FIL. Until she wasn't... Dementia is scary... she'd forget to feed him, change him, etc. But didn't realize she was forgetting. She was dead set against him going to a nursing home - my husband had to go to court and get legal guardianship of both parents. NOT the reccomended path unless there are no other options. He was able to get my father in law in a nursing home where he could get the care he needed. Even with his dementia - when asked if he wanted to go back home he clearly said no. MIL has continued to live in her own home, with SIL visiting daily. DH pays her bills and I did her taxes. But she's wandered out of her house twice, disoriented. Most of the time she's ok - but there are more and more episodes. DH leaves in a week or so to take her to her grandaughter's wedding, then take her to see some pre-identified,arranged assisted living places in her hometown. We're hoping she'll agree to one of them. If not, DH may have to put her in one, against her wishes. (He has the legal authority, but doesn't want her angry at the staff of whereever she ends up.)

These are tough issues.

I do know that this board has been very helpful. Nords posted his experience with guardianship for his dad which was VERY helpful for us. Walt posted about his wife's involvement with his FIL. These accounts, and others, were very helpful to me as I've been navigating this stuff.

 

[anethum]

When my parents were in their 80s and both still in great shape, my dad told me one day that another family member was yelling at him, telling him they should sell their house. I asked my dad if he'd ever discussed it with my mom. He said no, but that he was certain she'd want to stay in the house as long as possible.

Around when my dad turned 90, his mental and physical health started to decline. He had numerous mini-strokes vascular senility. My mom gradually took over some things that he used to do, and I took over many other things. I live just 10 minutes away. My mom must have said to me at least 30 times, "I never thought he'd get this way."

Then last year, my dad had a serious stroke and suddenly required full-time care. For the last 8 months of his life, there was an RN with him during the daytime, and a nursing assistant with him at night. This wasn't cheap, but he was getting excellent care, and my mom was certainly much happier with my dad around. My parents had always LBYM'd and could afford the home nursing care, a decision the whole family supported.

My dad died at home 3 months ago at 94. Now, my 93 year old mom is living alone in the house they bought new in the 1950s (for $21K, I believe). She still drives, but only short distances. I take her to places further away. She still loves to cook. She does the cleaning and pays the bills, like she always has. Her short-term memory has become awful, but otherwise she's OK mentally. There was one heartbreaking moment about 6 weeks ago. My mom called me one morning much earlier than she would normally call. She had just gotten up and told me she looked all over the house and couldn't find my dad anywhere. She didn't freak out when I had to tell her that he had died about 6 weeks earlier. After a second of silence, she said, "Oh, what is wrong with me." I imagine she may have been dreaming about my dad just before she woke up. Fortunately, she hasn't been confused about his death again.

My mom has made it clear to me that she does indeed want to stay in her house. My life would certainly be easier if she moved, but I think she would be miserable if she moved to an apartment. So I do what I have to do, just as she and my dad always did for us.

One thing which simplified matters, was that my parents created all of their necessary documents 20 years ago and we all had copies. They had Revocable Trusts, and also POA documents and Advanced Directives. They also had purchased cemetery plots. During the time my dad needed nursing care, I made sure my mom had money in her checking account to pay the nurses. I also made sure that the nurses were aware of the Advanced Directive my dad had signed. A copy was in his room. I had heard too many stories of Advanced Directives not being followed for one reason or another. My dad's wishes were followed.

 

[BTravlin]

... Then there is the fact that Dad accuses her of having an affair every other time she visits him ...

....There was an episode a month ago when he pulled a pairing knife on an aid because he didn't want to go for a bath. So no sharp object allowed any more.....

These could be signs of Alzheimer's or dementia creeping up on him. MIL exhibited the same types of behavior and they got steadily worse over a year until she was diagnosed with Lewy Body Dementia.

 

[Nords]

So my brother and I have been talking to our mom about what the future plans are for residency, care, finances, etc.

Last Sunday I was talking with my mom as I do every Sunday just to catch up and we were talking about maybe me and my brother would come out and help with the 'heavy' chores that are getting harder for my folks to do.

And we also talked about using this trip as an opportunity to open a dialog to discuss what their plans are as my mom has some health problems and my dad has what my mom calls 'good days' and 'bad days'.

Well, I guess my dad overheard some of the conversation and my dad was 'livid' to use my mom's words (message left on my phone).

So the trip is off for now until things calm down.

Question is, how should we approach this?

My mom is all for planning downsizing, moving to more convenient services that wouldn't require either of them having to drive anymore, and closer to care.

My dad...well...that's the problem.

Any sage experience or advice from others who have been here before?

Thanks!

Thanks for sharing, folks - I appreciate the camaraderie and advice.


Next steps will be slow after the pot settles back from its boil.

My mom wants to keep this quiet and we'll correspond by email (which my dad does not do).

She'll work on my dad that we are not scheming to put them in a 'home', but just start a dialog on what their plans are and what can be done in the more immediate future to start prepping (they have a lot of junk that certainly could be throw/given away).

Sure, it could be issues with independence and control, but it could just be your dad's simple frustration with mobility and with people treating him as if he can't take care of himself. Maybe he hates being sidelined and he feels irrelevant. (Especially if you're doing the heavy chores that he taught you how to do all those years ago.) It's not always a problem with declining cognition.

A local care business pointed out to me that I can't change my Dad, but I can change my behavior. She suggested waiting him out. Eventually the elders work through the thought process-- or they simply tire of struggling and seek help. Maybe there's an emergency, but ideally the lines of communication stay open long enough to reach a decision without calls from the hospital or the police.

If you're not near their home (or unable to respond to that 2 AM call) then you could interview a few geriatric care managers in your parents' area. The GCMs completely understand that you just want to open a file for your folks but that you don't need anything else right now. They're frequently called in by the police or the hospital to help with these emergencies anyway, so they're very happy to have a chance to get ready before it happens. You don't even have to tell your folks about this step, or you could leave their contact info with your mom if she needs to make the call.

Another advantage of the GCM is that you can coordinate with them to be the "bad cop". If they're called in to help your folks, they can tell them the stories of what could happen and share the facts of what they could do about it. You could arrive on the scene as the good child ready to help your parents (and "save" them from the eldercare system). Your parents could grumble about the GCM forcing their hand, but it gives them a focus for their anger (other than you) and moves them in the safe direction.

The GCM that I hired for my father (a year before his emergency surgery) immediately got off to a bad start with Dad. He felt that she was threatening his independence (correct) and not listening (well, she had a short-term memory, he didn't) and wouldn't leave him alone (also correct). Before this he had not wanted to look at assisted-living or care facilities (they were for "old people") and he just wanted to go back home to resume his independent (yet very scary) life. I told Dad that since she was on his case, I could get him out of the hospital so that he could visit my brother in Denver and check out a few places for rehab-- while also escaping her nagging. We also had the surgeon write a "prescription": the only way Dad could check out of the hospital was to report to a skilled nursing facility for the healing and rehab that would help him get ready to return to his independent life. (Not-so-coincidentally the SNF is also a full care facility.) The authority figures did all the heavy persuasion and I just had to be there to help Dad "escape" from their attention. It worked like a charm.

If your dad doesn't already have an "Emergency" folder of phone numbers and logins/passwords, your mother could ask him to update that list for her. He may be more inclined to "help her" (or at least avoid the nagging) than to deal with your perceived threat about getting his affairs in order. That way she can run the finances if he's "recovering from an accident" in the hospital and she has to take care of the house. Your contribution (if necessary) could be to offer the forms or the word-processing files for them to fill out.

It would be just bonus if they already have a current will, a medical directive, and maybe even a power of attorney. But if you have the first two and a cooperative mother then the third isn't an issue.

An extremely informative and helpful book is "When The Time Comes" by Paula Span. She also writes occasionally for the NYT on elder issues.
Book review: "When The Time Comes" - Military Guide
The Pitfalls of Your Parents' Finances - Military Guide

I do know that this board has been very helpful. Nords posted his experience with guardianship for his dad which was VERY helpful for us. Walt posted about his wife's involvement with his FIL. These accounts, and others, were very helpful to me as I've been navigating this stuff.

Thanks. It's as much self-directed writing therapy as it is advice...

Dad's doing fine, although he's tiring more quickly and his light is slowly dimming. He just turned 81 years old and spends most of his time working jigsaw puzzles. (A long-time hobby that actually helps Alzheimer's patients.) Now that his LTC insurance policy has finished paying out I'm even doing less financial work. One of my next projects is to list his assets on Personal Capital to see whether their dashboard & reports will simplify the process of generating conservator reports and financial plans for the probate court.

If that goes well then I'm signing up for my own PC account next...