Marriage Conflict surrounding eldercare

[lucky penny]

I am sort of at the other side of where your wife is. Mom age 90 in a CCRC has dementia. I am retired and have been doing the bulk of the work helping mom out for the last several years. My younger sister is retiring this summer and I have asked her to take over half the the tasks I have been doing. It seems to me the BIL has been doing most of the caregiving for your MIL and now it is your wife's turn.

What kind of care is needed for a family member in the nursing home or memory care section of a CCRC? I'm thinking a lot about this since I imagined that once you move into a CCRC you don't have to rely on family members for assistance, but from what I'm reading now I'm having doubts.

 

[latexman]

What kind of care is needed for a family member in the nursing home or memory care section of a CCRC? I'm thinking a lot about this since I imagined that once you move into a CCRC you don't have to rely on family members for assistance, but from what I'm reading now I'm having doubts.

The CCRC's business model is to bankrupt the members. Prices for every consumable/service - meds, diapers, washing clothes, etc. is jacked way up. That's one reason why. Another reason family members have to care for them is to keep the CCRC help from abusing your loved ones. MIL is in one of the better CCRC. I've seen this first hand. Occaisonally, the CCRC staff are not good people. The CCRC's are short staffed like a lot of places and sometimes a bad one gets through. Guess who finds them? The members and their families.

 

[easysurfer]

At times of a family crisis, that's one of the times when you see the true colors of family members. Stressful. Probably too, most families don't have plans or discussions ahead of time. So, what ends up happening is there are those who step up (maybe even too much, like a martyr) and there are those who step away and do the best to justify washing their hands from the situation.

I'm not talking about the OP's situation in specifically but from my own personal experience with own family dynamics.

 

[harllee]

What kind of care is needed for a family member in the nursing home or memory care section of a CCRC? I'm thinking a lot about this since I imagined that once you move into a CCRC you don't have to rely on family members for assistance, but from what I'm reading now I'm having doubts.

Mother is still in independent living. She is still able to live on her own with help, fortunately not yet needing memory care. She can no longer drive so a family member takes her to most doctor appointments. We use the CCRC transportation to take her to some appointments like the dentist but a family member needs to go to major appointments like cardiologist and neurologist. I am her POA so I have taken over all her financials which are complicated. I prepared her tax returns this year, they were a mess. We are having her meals delivered from the CCRC and we have CCRC aides morning and night so that is a major help.. The aides also take care of her medication. I am starting the application for her long term care insurance, what a pain. So far MetLife is refusing payment for the aides saying mother's dementia is not yet bad enough. I am going to ask my sister who is retiring and who is a CPA to help with the taxes and with the LTC insurance application and to help with doctor appointments.
The CCRC is doing a lot, thank heavens mother is there. But there is still many things a family member or a power of attorney must do, especially relating to finances.

 

[harllee]

The CCRC's business model is to bankrupt the members. Prices for every consumable/service - meds, diapers, washing clothes, etc. is jacked way up. That's one reason why. Another reason family members have to care for them is to keep the CCRC help from abusing your loved ones. MIL is in one of the better CCRC. I've seen this first hand. Occaisonally, the CCRC staff are not good people. The CCRC's are short staffed like a lot of places and sometimes a bad one gets through. Guess who finds them? The members and their families.

I guess it depends on the CCRC. My mother is still able to live independently with aides furnished by the CCRC. Overall the aides have been excellent but I am hands on and talk to the aides daily and visit frequently. I am so grateful my mother is in a good CCRC but I think one reason it has worked out so well is that I am so involved in her care. The CCRC would not dare assign a bad aide to my mother--they know they would be hearing from me. I don't understand about the CCRc business model being to bankrupt the residents--mother's CCRC is a nonprofit Church owned and they do not seem that way at all. It is expensive, but we knew that going in and fortunately my mother can afford it.

 

[foxfirev5]

Tough part about ER. I'm an only child and the only one DM can depend on. DW is very understanding. It takes the FI part to be able to travel numerous short trips and work the schedule. As members of a small family with significant assets I guess that's how it works. I would still rather be in this situation than hiding behind the " I've got work so I can't help" crutch.

 

[Walt34]

The CCRC's business model is to bankrupt the members. Prices for every consumable/service - meds, diapers, washing clothes, etc. is jacked way up. That's one reason why. Another reason family members have to care for them is to keep the CCRC help from abusing your loved ones.

It is unfair and unreasonable to paint all nursing homes with the same broad brush. Some are excellent; my mother and FIL were fortunate enough to stay in two of those. However, FIL did have a brief stay - about a week - in one that was "not so good" to put it mildly. We were on the verge of pulling him out and bringing him home with us when he was released anyway.

That said, there is usually a relationship between costs and the level of care. DW was writing five-figure checks every month for FIL's stay and that was almost ten years ago. Not many people can sustain that for long. But it did buy FIL an excellent level of care.

Getting back to the OP's issues, I wish them the best of luck, everyone's situation is different as are the personalities involved. We were fortunate that my mother had the foresight to move into a CCRC long before she needed to, and FIL had the financial resources (mostly the equity in his paid-for house) to pay for the level of care he needed. And finances aside, he had to be there. He was bedridden and it would have been physically impossible for us to give him the care he needed.

 

[athena53]

It is unfair and unreasonable to paint all nursing homes with the same broad brush. Some are excellent; my mother and FIL were fortunate enough to stay in two of those. <snip>

We were fortunate that my mother had the foresight to move into a CCRC long before she needed to, and FIL had the financial resources (mostly the equity in his paid-for house) to pay for the level of care he needed. And finances aside, he had to be there. He was bedridden and it would have been physically impossible for us to give him the care he needed.

Agreed on both. My dad was incontinent, needed a lift to get him between his bed and a wheel chair, and his mind was failing after his stroke and he lived for 18 months after that. My DSIL, also a retired RN, felt torn apart with guilt because they didn't take him in. I don't begrudge the LTC a dime of the $$ it cost to take care of him even though it made a bit of a dent in his estate. That's what the money was for. I hope I don't deteriorate the same way but am financially prepared if I do- and I'll make sure I'm close to DS and DDIL so they can look in on me. At some point, the family just can't do it all without burning out.

 

[braumeister]

Don't forget that Medicare rates nursing homes on several different criteria, so it's important to check that before letting a relative enter one.

Overall star rating for nursing homes

It's easy to see their ratings here:
Find & compare providers near you

 

[Dtail]

After reading these posts, I feel lucky. My mom is 90, but doesn't need special care currently. 2 siblings of mine live within 30 minutes from her and assist with whatever is needed. I take care of all her finances, which is not hard for me.
If she needed special care, it would not fall on me.
However, my DGF and I do take care of my brother, who lives with us full time and has some high functioning autism characteristics. So there is that.

 

[Morgan22]

The other point I forgot to mention is that we are a one car family, so the frequent doctor appts take a double toll. The conflict has ratcheted up lately, but I figure I am in a loose loose situation. I still have pretty current IT skills, so am actively looking to get back on the road and do a gig or two....

It sounds like buying a 2nd car would help the situation? That way you (maybe) don't feel trapped at home without a car when your DW is taking care of MIL's needs. If you need to, you would be able to justify the cost especially if you started working again.

 

[livingalmostlarge]

I'm curious how this will end. I don't know how it will end for me. As I write this I'm home helping my mom. Unsure how to get her to hire accept more help than to beg me to come home every month.

 

[Fermion]

We don't have any kids so I don't have to worry about putting them through all of this.

I think if we did have kids though, I would not want them wasting 10 years of their life and possibly their marriage cleaning up after me while I have dementia.

 

[ncbill]

Mother is still in independent living. She is still able to live on her own with help, fortunately not yet needing memory care. She can no longer drive so a family member takes her to most doctor appointments. We use the CCRC transportation to take her to some appointments like the dentist but a family member needs to go to major appointments like cardiologist and neurologist. I am her POA so I have taken over all her financials which are complicated. I prepared her tax returns this year, they were a mess. We are having her meals delivered from the CCRC and we have CCRC aides morning and night so that is a major help.. The aides also take care of her medication. I am starting the application for her long term care insurance, what a pain. So far MetLife is refusing payment for the aides saying mother's dementia is not yet bad enough. I am going to ask my sister who is retiring and who is a CPA to help with the taxes and with the LTC insurance application and to help with doctor appointments.
The CCRC is doing a lot, thank heavens mother is there. But there is still many things a family member or a power of attorney must do, especially relating to finances.

Over on bogleheads a poster who sells LTCi recommends having whatever health care agency one uses to provide care do the LTC application since they have experience with that.

If the CCRC is the one providing aides they should be able to do the same.

And I hope she has a geriatrician to co-ordinate her health care between the various specialists.

 

[latexman]

I guess it depends on the CCRC. My mother is still able to live independently with aides furnished by the CCRC. Overall the aides have been excellent but I am hands on and talk to the aides daily and visit frequently. I am so grateful my mother is in a good CCRC but I think one reason it has worked out so well is that I am so involved in her care. The CCRC would not dare assign a bad aide to my mother--they know they would be hearing from me. I don't understand about the CCRc business model being to bankrupt the residents--mother's CCRC is a nonprofit Church owned and they do not seem that way at all. It is expensive, but we knew that going in and fortunately my mother can afford it.

Elder abuse can happen anywhere, even in a family home. This is a private, non-medicare/medicaid facility with sizeable endowment. FIL is independent living, and MIL is in memory care. He is with her many hours every day, and he's sharp as a tack. Nothing gets by him. At ~$140k/year, it's not cheap. This is their 2nd place, and we helped them select it after seeing/interviewing about a half dozen places. Money won't prevent elder abuse. It's not common, but it happens.

 

[latexman]

It is unfair and unreasonable to paint all nursing homes with the same broad brush. Some are excellent; my mother and FIL were fortunate enough to stay in two of those. <snip>

That said, there is usually a relationship between costs and the level of care.

I think it was clear I was relaying a personal experience. Elder abuse doesn't happen in all nursing homes, but it can happen in any nursing home. The abuse of MIL I saw happened in a private, non-medicare/medicaid facility with sizeable endowment. FIL is independent living, and MIL is in memory care. At ~$140k/year, it's not cheap. Don't be naive; money won't prevent elder abuse. It's not common, but, unfortunately, it happens, even in the best of places.

 

[Teacher Terry]

I helped my parents and they were always there for me. I also helped 3 friends stay at home and eventually one died, one went to memory care and I was her guardian and one to assisted living. My friend in AL was in an expensive one but regardless if we left medical appointments to them he missed many. So usually a friend or I took him besides visiting once a week and the facility calling us frequently to come over for various things.

 

[harllee]

The thing about doctor's appointment for someone with memory loss--sure you could get someone at the CCRC to drive them to the appointment but that driver would not go into the appointment and talk to the doctor and help decide a course of treatment. Without a family member or a friend in attendance a doctor's visit would be a waste.

 

[Teacher Terry]

Good point Harlee. For my friend with Parkinson’s disease he has always been significantly hearing impaired so Parkinson’s made him talk slower and between the two doctors would think he was stupid or had dementia. Neither was the case and I made sure that they knew that and also that he got all his questions answered. I was so knowledgeable about his medical history that once when he couldn’t answer the paramedics thought that I was his wife. They were shocked that I was just a good friend.

 

[youbet]

What kind of care is needed for a family member in the nursing home or memory care section of a CCRC? I'm thinking a lot about this since I imagined that once you move into a CCRC you don't have to rely on family members for assistance, but from what I'm reading now I'm having doubts.

CCRC means "continuing care retirement community." But there are different financial arrangements within different CCRC's providing different levels of care at different ongoing costs. I suggest you refer to the CCRC "sticky" here on the forum for additional information.

 

[lucky penny]

CCRC means "continuing care retirement community." But there are different financial arrangements within different CCRC's providing different levels of care at different ongoing costs. I suggest you refer to the CCRC "sticky" here on the forum for additional information.

I've been looking into CCRCs for a couple of years & have visited several; since I'm single with no family nearby, the concept seems like a sensible one, in the abstract.

My question was prompted by the descriptions here of what family & friends have done to assist people living in CCRCs. I'd been assuming that if I found a good one that provides a continuum of care (assisted living, memory care, skilled nursing) & moved in with a Type A contract, I wouldn't have to rely on others for assistance. I certainly recognize the value of having family check in regularly, help with finances & provide other help when needed, but wonder what happens without that. CCRCs (at least ones I've seen) have social workers on staff, but maybe outside professionals, like care managers, could be hired to perform oversight & assistance if/when that's needed(?).

It's a lot to think about. Thanks to all for the comments here.

 

[Act2]

My parents were in a very nice Type A arrangement at a CCRC for the last several years of their lives. I, too, was surprised that there were a large number of things I needed to do for them, or that they wanted me to do for them, that I had not foreseen. Some were more a matter of choice - for example, although the CCRC had weekly shopping excursions by bus to the nearby superstore, both parents preferred that I drive them there, every week.

It is true that having someone - usually me - at medical appointments was very helpful. Initially they were sufficiently helpful to each other at appointments, but abilities declined and then that wasn’t enough. The parents had a large number of such appointments, and it was difficult to manage job-wise for me. I could not go to all of them, especially for
my Dad. I was able to hire an aide to go with my Dad when I could not go, but I never knew how much information was lost in the process. From the medical professional’s perspective, not having me there probably made for a much less useful visit. But the sheer number of appointments was simply not something I could accommodate. I tried to go to all the ones I considered essential, and any related to any kind of surgery. But there are a large number of ‘check in’ visits with every specialist as one ages, apparently.

 

[JBTX]

When working as an RN, my wife was able to deflect some eldercare responsibilities because she had work commitments. Now that she has recently retired, the flood gates have opened. The family calendar is littered with elder doctor visits, emergency visits, etc. This has been going on for decades, but since my wife's retirement, it is constant. Not that it matters, but the elder is question is my wife's mother, who really did nothing to help us out when we needed it with a young family, but who has required constant support for at least 2 decades.

I have considered consoling to address the marriage issues this is creating, or simply going back to work in a contract ( ideally travel ). At least then, my schedule is my own.

Anyone else had a similar experience? What approach worked best?

So if you had your way, what should happen?

 

[ncbill]

What goes around comes around.

My wife & her family were a great help when my mom was terminally ill 15+ years ago.

Now that I'm retired I expect I'll be helping out a lot with her now-octogenarian parents.

 

[Sunset]

She is in a retirement home but still in the independent living level. But I agree, she should be in assisted living.

There are two siblings locally. My wife's brother has spent years building a dependency ( really, because he had nothing else to do ) and my wife now feels obligated to step it up. Of course there are 3 other siblings out of town that do next to nothing.

The mother is 92, but can easily live to 100. She ain't going anywhere.

I can't see any of this changing.Just looking for a way to escape. It has taken over the day to day.

I do think this is something you need to discuss in detail with your wife.

Perhaps one answer is to examine all the help the MIL needs and figure out what is actually important and what can be offloaded, even if she doesn't like it as much.

Example: lots of retirement homes have "shopping trips" where they bus folks to a Mall, some family's do the favor of driving their relative to the mall so they won't have to take the bus, maybe your MIL should take the bus.

Perhaps blocking off a month here and a month there with planned trips at those times, and having the BIL take over fully for those months is an option he could agree too.

Lastly, paid help might be the answer, if MIL has $$$ then it may need to be spent to take up the work load. You could also have the other 3 distant pay their share, and maybe their share is 25% each since they have freeloaded for so long already. Or maybe their share is equal 20% as they also didn't get help raising their families from MIL like you.

Perhaps some of the needs are really socialization, and MIL wants more visitors, rather than has an actual need. Here even paid help for some simple tasks would answer that socialization while under the guise of outdoor walks or shopping events. Getting her into some clubs at the retirement home would help with that as well.