Getting an elderly parent to give up living alone

[Dash man]

The problem of staying in their own home is the burden of caring for the aging parent. My DDIL found herself traveling regularly to her mother’s home across the country after her father passed. She had cameras installed, hired people to come in to care for (which her mother promptly fired), and was regularly called because her mother was calling for an ambulance whenever she didn’t feel well. When they finally convinced her to come live with them, she weighed 57 pounds. She’s now in assisted living, but still frequents the hospital.

 

[MichaelB]

This is one of the most difficult issues we face in life. It’s important to remember the observations we’re making here when we find ourselves as the older parent with children worried about us. Will we be easier to deal with?

A senior parent wants to remain in their home for any number of reasons. It’s important to understand the specific, real reason(s) and address them. They may be

- She doesn’t want to burden her children.
- She doesn’t want to give up control over how she lives her life.
- He can’t afford an independent or assisted living option
- He has a preconceived notion that a retirement facility is an unpleasant place to live.
- Her network and social circle is still strong and important to her.
- He’s afraid to make a change

These are legitimate objections. A long, honest, empathetic conversation with mom or dad can help understand the specific objections. That’s the key to finding an alternative that can be acceptable.

In my mum’s case, she had years of experience as a public health nurse dealing with seniors and very familiar with assisted living facilities, so she was adamant against it. Dementia clouded her judgment, however, so we enlisted her primary care physician to help. When the PCP and her neurologist both suggested she would be better off in an ALF she agreed to consider it. There is no doubt in my mind that move has extended her life.

There are good independent living facilities with good assisted living options. They’re not inexpensive but they do exist.

 

[pb4uski]

I know someone who had their mil living with them. Everyone was miserable but she refused going to AL. Then she went for a 2 week respite stay while my friends went on holiday. She loved it and shortly after moved in permanently.

Also in the UK my aunt lived with my cousin. She also went to a care home for respite a few times. When she progressed more my aunt chose to move to the care home permanently as she did not want to burden my cousin.

It is very kind of you and your siblings to go to such lengths to help her stay in her home op but it does seem so disruptive and burdensome to your lives. I would keep looking for other solutions. Good luck

Great post

 

[Stormy Kromer]

I would walk throu hell on Sunday for my parents.

One died in a nursing home at 90 after 29 days.

The other at 92 in Assisted living after 31 days.

In both cases I was spent, exhausted and worn out. They got to live the way they wanted til they couldn't. It wore me out.

People. There is no shame in dying in outside your home. Home is where your family can see you. Not the walls you own. Your home is where you live, not where you own.

I will never put that burden or expectation on my children. I have my long term plan in place and I'm 59. I didn't have children in order to be my LTC providors.

Off soapbox now.

 

[pb4uski]

^^^ I must be wired differently... give me a nice room with a bathroom and kitchenette and access to a dining room with good chow and I would be happy as a clam.

Need good internet too.

 

[Ronstar]

FYI, if she's starting to have memory issues and you think it might be the beginnings of dementia, rotating her between different living environments won't work for very long [in fact it's a terribly uninformed suggestion] and would be distressing for her (and you). Would try to push the AL/NH option. Might want to start getting her on waiting lists, admissions can be quite the ordeal.

Thanks for the info. The elder care lawyer suggested the rotating living arrangement several years ago before MIL started the onset of dementia.

 

[Stormy Kromer]

^^^ I must be wired differently... give me a nice room with a bathroom and kitchenette and access to a dining room with good chow and I would be happy as a clam.

Need good internet too.

Me too. A small bar would help too.

 

[Jerry1]

Sorry, Jerry, I wasn't trying to pick on you specifically or anyone for that matter. .

No harm, no foul. I understood you were speaking more generally. So too, was I. Though obviously through a personal prospective.

 

[bigcmagor]

My demented mother actually called 911 from her emergency room bed. The attending physician was not amused. I do wonder how the call between dispatch and the hospital went.....

 

[cbo111]

OP here. Thanks everyone for so many replies and suggestions. Your inputs are really valuable to me. My sisters and I are now almost 3 months in to our monthly rotation. Our goal is to figure out a way for DM to make a decision to move in with one of us or an assisted living facility. We just need to figure out how to help her reach this decision.

 

[Amethyst]

Either somebody misunderstood that lawyer, or he/she was talking through their hat. Nothing "starts the onset of dementia." Dementia comes on by itself, slowly destroying the brain for reasons that science doesn't yet understand.

Rotating moves (or any move, really) simply reveal the problem by stripping the person of familiar surroundings and routines, and presenting their poor sick brain with new ones that it can't cope with.

The elder care lawyer suggested the rotating living arrangement several years ago before MIL started the onset of dementia.

 

[Stormy Kromer]

Again. I would walk through hell on Sunday for my parents/elders.

Don't feel like a criminal if your best decision for their well being is bringing them somewhere that can take better care of them than you can.

At the risk of having stones thrown at me I'll even say that it is selfish for some elderly to expect their family to give everything they have to take care of them so that they can die at home.

I have been on that end may times and filled my duty, They would have had better lives elsewhere. Pride got in the way. Not money, there wasn't any left.

I'll duck now. Unless you've been there you don't know.

 

[Dash man]

Most of the year we have my FIL living with us. For a few years, only one brother of the other siblings offered to give us a break. One had reason since she was the primary caregiver for their mother for the last few years. We finally got one of the brothers to offer up his home while we’re in Florida for the winter. The other sister refuses because her husband won’t allow it. Even though she helped his mother for years. The original brother who spelled us, can’t have him anymore because he insults his wife. I could write a book.

 

[Sunset]

Either somebody misunderstood that lawyer, or he/she was talking through their hat. Nothing "starts the onset of dementia." Dementia comes on by itself, slowly destroying the brain for reasons that science doesn't yet understand.

Rotating moves (or any move, really) simply reveal the problem by stripping the person of familiar surroundings and routines, and presenting their poor sick brain with new ones that it can't cope with.

When working I had to contract in various States, and fly weekly to return home. At one point I noticed I'd open cupboard doors to get a coffee cup but it was plates in there !
It was confusing for a second until I realized wrong place And I (think) my brain is still ok..

 

[Spock]

For those who claim to have advance planning (trusts, executors, POAs, etc) all setup to take over "when its time", be aware that all of that can be thrown in the trash can if you get dementia.
Dad had designated me as POA, co-trustee, joint on his bank accounts, and turned over administration of his finances (rental properties, insurance, etc) to me to admin.
Problem is he forgot he did any of that. And the kicker is, at least in Arizona, the court lets a diagnosed dementia patient chose who their conservator is going to be.

Since Dad was mad that we (his lawyer, his CPA, his insurance agent, his property manager, and his family) disagreed with Dad's plan to give his home health aid a house and move in with her instead an assisted living facility (for which he has an LTC policy), the court let him fire all of those entities and throw out 15 years of estate planning. The court agreed he was incapable of making his own decisions, yet let him chose a 3rd party conservator (who is totally incompetent and whose only contribution has been to bring another lawyer's (hers) mouth to the feeding trough).



You may state (now) that you trust so and so, but when your bag of mental marbles is half empty to the point you've lost your ability to reason or control emotions, you might not even remember who that person is any more.




I have not found a dementia proof advance directive document to facilitate a transfer of authority "when its time". All of it can be rescinded by the patient short of maybe an irrevocable trust. If anybody has solved this problem, I'm all ears.

 

[Teacher Terry]

As others have mentioned rotating homes is extremely bad for people with dementia. It often hastens their mental decline.

Spock that’s terrible that Arizona allows someone with dementia to decide who will be their POA when there’s been a plan in place chosen when the person is competent. Ugh!!

 

[Sunset]

For those who claim to have advance planning (trusts, executors, POAs, etc) all setup to take over "when its time", be aware that all of that can be thrown in the trash can if you get dementia.
Dad had designated me as POA, co-trustee, joint on his bank accounts, and turned over administration of his finances (rental properties, insurance, etc) to me to admin.
Problem is he forgot he did any of that. And the kicker is, at least in Arizona, the court lets a diagnosed dementia patient chose who their conservator is going to be.

Since Dad was mad that we (his lawyer, his CPA, his insurance agent, his property manager, and his family) disagreed with Dad's plan to give his home health aid a house and move in with her instead an assisted living facility (for which he has an LTC policy), the court let him fire all of those entities and throw out 15 years of estate planning. The court agreed he was incapable of making his own decisions, yet let him chose a 3rd party conservator (who is totally incompetent and whose only contribution has been to bring another lawyer's (hers) mouth to the feeding trough).

You may state (now) that you trust so and so, but when your bag of mental marbles is half empty to the point you've lost your ability to reason or control emotions, you might not even remember who that person is any more.


I have not found a dementia proof advance directive document to facilitate a transfer of authority "when its time". All of it can be rescinded by the patient short of maybe an irrevocable trust. If anybody has solved this problem, I'm all ears.

Thanks for the warning... and OMG what a nightmare !!

I hope this 3rd party is just incompetent and not like some scammer type I saw on an expose show where she and accomplices took over and stole people's savings, including selling their home, etc..

 

[isisdave]

I've seen ads for "occupancy sensor" thingies on my Yahoo feed recently. I am sure there is one of those, or a camera, or a security system, that can be set to alert someone if unexpected stuff happens (front door opens at 3am), or expected stuff doesn't (no one walks past the bathroom door for 4 hours), even if it's in an assisted living facility.

Also, Assisted Living facilities often offer "Respite Care" which they promote as a week off for the caregiver, but which is really a trial run for the patient. And many times they'll have a visitor apartment, although a hotel will do for that.

Figure out Plan B in advance -- if the caregiver is suddenly ill or injures and there's no one else local, it'll be chaos otherwise.

 

[Wile E. Coyote]

For those who claim to have advance planning (trusts, executors, POAs, etc) all setup to take over "when its time", be aware that all of that can be thrown in the trash can if you get dementia.
Dad had designated me as POA, co-trustee, joint on his bank accounts, and turned over administration of his finances (rental properties, insurance, etc) to me to admin.
Problem is he forgot he did any of that. And the kicker is, at least in Arizona, the court lets a diagnosed dementia patient chose who their conservator is going to be.

Since Dad was mad that we (his lawyer, his CPA, his insurance agent, his property manager, and his family) disagreed with Dad's plan to give his home health aid a house and move in with her instead an assisted living facility (for which he has an LTC policy), the court let him fire all of those entities and throw out 15 years of estate planning. The court agreed he was incapable of making his own decisions, yet let him chose a 3rd party conservator (who is totally incompetent and whose only contribution has been to bring another lawyer's (hers) mouth to the feeding trough).



You may state (now) that you trust so and so, but when your bag of mental marbles is half empty to the point you've lost your ability to reason or control emotions, you might not even remember who that person is any more.




I have not found a dementia proof advance directive document to facilitate a transfer of authority "when its time". All of it can be rescinded by the patient short of maybe an irrevocable trust. If anybody has solved this problem, I'm all ears.

In my family we do not live long enough to get to any mental disorder. My elder siblings closing in on 80 are physical disasters, but, mentally the same as they have ever been. It remains to be seen if any of us make it past 80.

I am having regular meetings with my person as we are friends and when she agreed to do it last year I did give her a copy. I had held off asking for about 7 years even though I had decided and it was my intention. Things suddenly became clear to me after breaking my kneecap and at the same time Covid. I needed someone local for sure. My nieces and nephews are too professionally burdened to ever want to deal with it (besides some of the comments of my nephew because he is the grossly overqualified executor on my sis and bil (his parents). He does not want to deal with their stuff. So, my friend will deal with my stuff (and be well rewarded for it). She knows my intention is to continue to work on organizing it and that I may downsize if the numbers on that ever make sense. Most of the cash goes back to my family and my residence, contents, small life insurance (money to deal with closing things out and bequest to the agreed caretakers of any animals)...

Yes, things could change in ten years and I may need to revisit. I feel I have 18 to 23 years ahead of me (so there are not a ton of ten year segments for things to change dramatically). My Executor has time to plan around how to deal with her real estate reward and my Secondary Executor, my nephew, is grossly overqualified to deal with it if it fell to him. In no way does he need his cash share and it is split with a charity anyways. My primary is my brother (who will not outlive me) and my secondary is a split of friends, family and charity. First priority is my pet caretakers.

Regardless of what it is I will always have a plan going forward, especially as long as their are fur monsters in the picture.

 

[KarenF]

My Mom would not leave her house until she was in the hospital and I moved her to an Assisted Living place. She was unsafe living alone and it was awful. I am not doing that to my kids. I am putting into my long term memory to do what they say. I don't want them to ever have to stress about me. At the point in her life that this occurred Mom was not able to understand what she was doing to me, and I suggest your Mom does not understand either. You don't have to live with her for 1/3 of your life for years, potentially. I would find some Assisted Living places and take her on tours. She might like one of and the social life is good. You do have to really monitor and go visit at odd/different times to make sure she is getting good care.

 

[athena53]

At the risk of having stones thrown at me I'll even say that it is selfish for some elderly to expect their family to give everything they have to take care of them so that they can die at home.

No stones here. My Dad had a serious stroke at age 89 and never really recovered. My SIL was torturing herself for not taking Dad in but he was confused and incontinent and couldn't move himself from the bed to a wheel chair or anywhere else. Fortunately he had the money for a decent LTC facility and died after 18 months there.

My plan is to find an appropriate facility (CCRC, Assisted, whatever) near DS and DDIL when I can no longer live on my own. They're 3 hours away and I don't want them running down here to change a smoke alarm or drive me to doctor's appointments, let alone deal with me if I'm senile or incontinent. That's the primary purpose of my savings. I'll just be happy if they visit regularly.

 

[Closet_Gamer]

We are living this reality on both sides of our family.

I would make a big vote for finding a house helper who can clean, make meals, and drive to the store. After a major medical crisis with my mom, we initially hired 24x7 home health aid coverage. Over time that stepped down. She now has someone who comes her her house 20 hours per week. In addition to the practical duties, she good companionship. Mom has someone to talk to. The lady is in her 60a which is helpful as they are a bit closer in age culturally.

DW’s parents are simply headed towards a major crisis and are unwilling to even discuss the situation. One of these days the phone will ring and DW will have to dash out of town to deal with a really tragic and emotional situation.

Good luck.

 

[Happy30]

We have discussed having my brother and his wife to visit and check in every day. Shop, clean, cook, take to appointments etc …They will get paid a nice annual salary too.

If things become to difficult to manage we will hire an in home aid. My Mom & Dad do not want to leave their home. I am grateful they have financially planned for this!

 

[DaveLeeNC]

My Mom lived alone well past the time that most would think 'this is a problem'. And maybe we were lucky that she did not encounter a serious accident because of this. However she was still all there mentally and there came a time when she realized that she could not do that any more. So we moved her 700 miles to an assisted living place near where 2 of my siblings lived. There were things that she did not like about that but she had zero regrets because she knew that there was no other choice (and there were positives that she also recognized). But allowing her to make that decision on her terms was really important, IMHO.

dave

 

[zippy2020]

....If things become to difficult to manage we will hire an in home aid. My Mom & Dad do not want to leave their home. I am grateful they have financially planned for this!

I think you might want to actually talk to a professional Geriatric Care Manager (there are 2 professional associations certifying their members) to discuss the limits of what in-home health aides can do and cannot.

It is not unusual for an accident/illness to require specific medical equipment or procedures afterwards, and very few home health aides have such authority as it will often require a nursing certification.

You can consult with GCMs on a per-hour basis to discuss your situation and expectations, as well as what hourly fees are in your area. Being forewarned is definitely being forearmed, when dealing with eldercare issues!

Also, many states have info regarding ratings of convalescent and various types of seniorcare facilities on their websites. This is information you want to know BEFORE an emergency happens.

The two organizations are:
* American Case Management Association (ACMA)
* National Academy of Certified Care Managers (NACCM)