<p>eyemamom, sorry. It never ends, does it?</p>
<p>Eyeamom- this stuff can take you to places you never wanted to see. Best with the visit. </p>
<p>Really scary that local family is refusing to address the driving issue. Often the reticence to take away the keys seems to correspond to the reality that in many cases, once there is no car, the entire living situation must be re-assessed or adjusted. </p>
<p>Eyemamom, try out Travelnut’s “fiblet” idea. You may have to set it up in advance- the idea that work obligations, meetings on your schedule, some other needs, etc, preclude a stay for more than the visit itself. Best wishes.</p>
<p>Agree, travelnut. And not just the living situation, but the entire relationship. It’s often the first step of parenting your parents, something no one really wants but which becomes necessary. </p>
<p>So true, LasMa. It is easy to deny, despite the life and death nature of this. Sometimes people don’t want to step up to the transition and I have also seen financial concerns about inheritance influence this. If AL or NH or daily aides are required, the money goes faster. Nightmare territory!</p>
<p>Offering this for anyone who doesn’t know the concept: <a href=“http://www.amazon.com/Getting-Yes-Negotiate-Agreement-Without/dp/0743526937”>http://www.amazon.com/Getting-Yes-Negotiate-Agreement-Without/dp/0743526937</a> You can peek at the intro via Amazon or search for the phrase “people find themselves in a dilemma” for words about soft vs hard negotiating and what the authors propose. </p>
<p>We get them to give up driving- and it opens new challenges. I keep getting, “Well I thought you agreed to drive me places.” As if I don’t. Or an expectation we’re like a limo service, ready when she needs, willing to rearrange our other plans- and be cancelled at the last minute. (This cancellation habit was our final straw.) Like others, my mother refused taxis for a long time (too expensive) though she lives downtown, most rides would be $5- and the taxi stand is across the street. She does now use senior ride service. And grocery delivery.</p>
<p>Thanks for that, LF, I’m going to check that out. Sometimes i go to confrontation first, when i probably don’t need to (surprising, I know :p)</p>
<p>I’m sorry you’re going through this with your mom. Sounds like at least some solutions are being found step by step. </p>
<p>No suggestions, but so sorry you are going through this, tlpmom. My grandfather has dementia and it has been very difficult to watch him go from the kind, Southern gentleman to the extreme that he’s been my whole life into a grumpy, paranoid, mean-spirited person (all tied to the dementia.)</p>
<p>Check out the parents caring for parents thread; literally tons of good advice.</p>
<p>Have you talked to her doctor? Or have the staff/nurse ask–perhaps medication needs to be adjusted? How long has it been going on (agitation/refusal to bathe)? Are you sure she doesn’t have a UTI ? (common cause of agitation/ behavioral changes in the elderly)</p>
<p>Sorry to hear this, tipmom. A lot of us are dealing with eldercare issues on the parents caring for parents thread in this parent cafe (near the top of page one). Cross posting with HGFM here. You are likely to get good feedback either way, but it may be worth checking out that section. </p>
<p>Hard to comment in detail without knowing circumstances, so my comments are general and may not apply. How much 1:1 support for bathing and dressing is available in your mother’s AL? Are they actually trying to bathe her or discuss hygiene issues when she is agitated? Is she expected to independently bathe and dress herself? Her behaviors may reflect a decline necessitating more care and/or a setting that is geared to those with memory loss or dementia. The staff at my father’s skilled nursing level memory care facility seem to have an infinite number of clever ways to allow necessary daily routines to occur, despite having many very severely impaired residents. </p>
<p>I’d focus on getting a hygiene routine where she lives set up, enlisting necessary help and expertise. If there is a memory care unit affiliated with the AL, perhaps someone from there could meet with you and the staff to share strategies. As a family member, I would be looking for the staff to lead the way with this. If this is beyond the AL staff’s knowledge base and perhaps more than they are staffed or licensed to handle, wrapping your head around an option that will serve your mother over the long term could bring much peace of mind. It’s hard to know what type of AL she is in and whether or not the staff is concerned not only about her hygiene, but also about what setting would best serve her needs, so I may be way ahead the curve here. Best with this. </p>
<p>Funny story now, but was mortified at the time. I thought that I was so smart in arranging for the senior bus to pick up my mother for her appointments. This was about 6 years ago after we convinced her to give up driving and I had spent about 1 year being “the on call limo driver” only to have her cancel and change appointments at the last minute. I arranged to have the bus come to her door and was with her to show her how to use the stairs or the lift. I bought a book of tickets for her and thought we were good to go. Well, the first few rides were ok, then her nasty complaints and snide remarks started. Finally, one day I got a call from the bus company that she acted up so much and was so verbally abusive to the driver that he just drove her back to the main terminal and threatened to call the police. She gave them my number, I showed up and of course she blamed the driver. They showed me the bus video and I was horrified. They banned her from the bus! </p>
<p>Dharma, I thought that Genesis, Glen Hill offered AL, rehab, respite and long term care? I agree that it would be far better to go with a facility that offered levels of care. Not to send you on a wild goose chase, but Bethel Health Care Center offers the Cascades which is AL and also long term care. If you can place your mom, asap, do not worry about selling the house. The facility’s social service office will assist you with the timimg and application for medicaid. Most facilities will accept a patient with about 4-6 months of liquid assests. They will not put a patient out. During this time they will help you negotiate applying to medicaid. You are not forced to sell the house so quickly. I would suggest that you place your mom, list her assets and take a breather on the house. When you do decide to list the house, medicaid will collect at that time what they have spent on your mom. In the meantime, she is at a facility that can meet her current and future needs.</p>
<p>I agree with travelnut. First, I suggest you post on the Parents Caring For Parents thread, because issues like this are what we discuss there.</p>
<p>Second, what do the staff at the AL place suggest to deal with your mom’s hygiene issues? What you describe is a common problem with people in the middle stages of dementia. Your mom is far from the first person who is refusing to bathe and change. How does the staff usually deal with this common problem? </p>
<p>It is funny, ECmom, though sad and challenging.<br>
Will Medicaid pay for someone who still owns a home? Is that what you’re saying? Somehow, they wait for it to sell? Or?</p>
<p>ECmotherx2- Wow. This is rarely an easy road. Literally. I guess that video provided more info than one ever wants to have…</p>
<p>I agree about the value of facility that offers a continuum of care, though they are not always available. While this doesn’t change how DW will proceed, Medicaid is not involved in paying for most assisted living placements, but rather comes into play at the long term skilled nursing home level of care. In some states, some ALs (usually those with built in medical components), may allow residents to access separate state “emergency” funding for this assisted living if they become indigent. In my experience, this is not typical and should be researched. When I checked out more hotel-like, for profit ALs for my parents, the resident usually was expected to move if assets were depleted. Many people’s AL stay is correlated to both their assets and capabilities diminishing simultaneously, allowing for the transition to Medicaid funded nursing home care. </p>
<p>Good info, ECmom. The only caveat I’d throw in for Dharma’s particular case is that this is peak house-selling season (50% of homes are sold during the summer, according to realtor dot com). Of course, a house can sell in any season; it’s just that the asking price may need to be a bit lower in the off-season. And it varies by area; it could be that in Dharma’s area, there’s a vibrant market year round.</p>
<p>Here again, I think it would pay to consult a realtor now. That person is an expert on the local market, and could best advise Dharma. If the decision is made to take a breather and wait until spring to sell, the realtor will be happy to take the listing at that time. He/she could also say how much of a hit Dharma would take if she decides to sell in, say, December. In other words, she could make an informed decision now about when to sell, rather than guessing or worrying for the next 6 months. It’s so reassuring to have a professional giving you personalized advice on these things.</p>
<p>Aversion to bathing and changing clothes is pretty common with dementia victims. </p>
<p>With my home care clients with bathing aversion (common with dementia) I take the sneak attack on a gradual basis. </p>
<p>When I have her in the bathroom, I’ll say that we taking off her clothes. Then I’ll tell her that I am going to help her step into the bathtub/shower. EVERY step is introduced one by one. Usually if they express fear or reluctance to the shower I can assure them by saying that we will get it over as quickly as possible.</p>
<p>Often I find that the person is afraid of having the clothes that they are wearing disappear, so I assure them that the clothes are going right there in that hamper, and they will be safe. Or we change the shirt one hour, the pants the next, so long as it all gets done in a day (same with a sponge bath… who says it all has to be done at once).</p>
<p>One tactic I worked with a couple of clients that worked - I told them that my boss expects me to get certain things done during the day, and that I would get extra credit with the boss if the client would take a shower for me. That put the focus on them doing something to help me,and they were glad to do it. </p>
<p>Thanks everyone. I’m a regular lurker on the Parents Caring for Parents thread but posted outside of that so as to not redirect the thread from its current issues. Anyway, we have met numerous times with the nurses and techs at the AL. They are not allowed to force bathing, etc unless there is a UTI which they asked our permission to test for. Mom flat out refused to give a urine sample so they set her up with the psychologist. Mom refused to talk to him. She is in denial about her cognitive issues. And yes, the AL has a memory care unit but they have not suggested a move there as of yet. The staff at the AL seem to be trained more for physical issues. The head nurse said they are increasing training for the staff re:dementia. How they are dealing with the clothes and sheet issue is coming in to grab her clothes while she’s sleeping (she will change into PJ’s before bed) and washing her sheets while she is out with us for dinner, etc. But if she catches them she is very unpleasant to deal with and she scares the young techs. Anyway thanks for your input. I think I’ll go back and discuss everything with the head nurse and possibly a move to the dementia unit. It took Mom over a year to adjust to the AL so we’ve been hesitant to consider moving her and start the whole process over again. But that may be best for all involved. Thanks.</p>
<p>Not sure why she would wait. Strike while the iron is hot, get it done. There is no advantage to waiting- house projects, house viewing, and moving things, is much harder in first quarter, where, as we say, “there’s weather.”</p>
<p>Plus, she continues to pay for upkeep, some utilities, taxes and insurance, etc. Cut that drain.</p>
<p>Thanks KKMama those are great ideas. I will share them with my sister and the techs at the AL.</p>
<p>Excellent advice here on many posts. I printed out 4249, 4250 and 4251, and will ask tomorrow’s guide to read them and answer particulars.</p>
<p>ECmotherx2. What a mortifying thing to have happen. But no unlike what my mother would do.</p>
<p>I took her to the shrink today and one of the things he did during her visit was call the last hospital she was at because he wisely questioned some meds she was prescribed. They to to sedate her because she acted violent out of control.</p>
<p>While my mother walked her long path to the ladies room, the MD told me he URGED her into AL and follow my well-intentioned guidance. He asked me for an update soon and to be in touch at any time. So I feel relieved.</p>
<p>I am just about to start a cost breakdown of selling house/ AL rent / remaining assets / and how long they will last, and bring it to my mother this evening or tomorrow morning. I can do much of it but I will need DD1s help to complete and she says she will be happy to oblige. I will make it clear that some figures are estimates, but that the page should give her a fair idea of how this will plan out.</p>
<p>As LasMa says, itis vital to have her move asap, not just to save money because the trees are still green and will be pretty in October. Telling her this at our near-future meeting may be difficult. My DD1 is 20 years old, an adult, and does not need to be shielded (the sensitive 16 year old does), and I may ask her to come along to explain the math if I need help; also, I think her presence will make my mother reign in her temper. </p>
<p>Oh yes, ECmotherx2, the Gardens and adjoining facilities in Danbury has a nursing home and a rehab just across the street. So of course they are connected. . In my dullness, it would have made it CLEAR if the guide had explained about HOW they are connected and how a patient progresses one to another.This progress should have been explained clearly. She simply pointed them out as if they were interesting neighboring buildings. But, they will not drive my mother to her MDs in NY State (Maplewood will) so for all intents and purposes it is ruled out. It is vital she likes the facility in Carmel tomorrow because the “idea” of proximity (Danbury is NOT far) is what she wants. </p>
<p>Yes, LasMa, if the talk goes well (and I will be insistent that I will drop out if she does not comply) I will stop in the prominent real estate agency tomorrow. </p>