<p>I am a BIG supporter of neuropsych testing :)</p>
<p>I am a BIG supporter of punching out brothers.</p>
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<p>I have the same problem with my brothers. We had an issue last summer where I was telling them about an escalating problem, but my parents would tell them everything was fine. My brothers thought I was being alarmist – until one of them visited and saw for himself, and then convinced the other brother that I had been giving them an accurate picture of the situation after all. Since then, I’ve noticed that when I tell them something, they’re more inclined to believe me, no matter what Mom and Dad say.</p>
<p>I have been reading this thread on and off preparing for when these issues become mine. The time is here. However, I don’t think anyone else has presented the problem I’m having with my parents. </p>
<p>Mom fell and broke her nose after a day of confusion, dropping things, spilling things, and finally an inability to get off the toilet that led to the fall. She was taken to the hospital and long story shortened, it was determined that she’d had a bad reaction to the pain medication she’d taken earlier that day for back pain. Meanwhile, the doctors, social workers and Physical Therapists at the hospital said she should be sent to a nursing home for rehabilitation exercises to try and build up her strength. Mom is 95.</p>
<p>There is nothing wrong with her mind. She is as sharp as ever. Other than physical weakness her only other problem is some hearing loss. </p>
<p>Here is the problem: Eventually, after the PT program is finished, she wants to return home. My dad, overwhelmed with the responsibility of taking care of her, wants her to stay in the nursing home. He doesn’t want a home health care worker. Says he doesn’t want a ‘stranger’ in the house. He doesn’t want to put handicapped features in the bathroom, says he doesn’t want the mess, the workers, the stress of remodeling. </p>
<p>My sister and I have tried and tried to convince him otherwise. He won’t listen. I wouldn’t think that if Mom is discharged from the PT program that he could ‘commit’ her to the nursing home against her will. But she is pretty much walker and wheelchair bound and is not going to fight for her own way. </p>
<p>I really think that Dad is just relieved to have her out of the house and not his responsibility anymore. It means more freedom for him. He is 87 and still in good health. A home health worker could help, but unless she were there 24/7, he would still have to care for her at night. </p>
<p>Has anyone else faced this dilemma? And what am I to do about it being 2000 miles away?</p>
<p>Your father may be in good health for 87, but can he really take care of a 95 year old wife who is walker/wheelchair bound?</p>
<p>Is there a compromise in some sort of assisted living arrangement so they can live together in a retirement/nursing home apt? It may be time to think about this eventuality.</p>
<p>My MIL is wheel chair bound and FIL (also 80s & 90s) has taken care of her for years. Over the past 10+ years we started with a helper about 4 hours a day to do meals and dressing & showering. Now he is up to about 8-10 hours a day, but seems to fight the idea of live in care desperately and also fights assisted living.</p>
<p>Getting MIL up in the middle of the night is rough on FIL, he needs his sleep and she is tough to move, she weighs about the same as him and is mostly dead weight. When she falls, it is nearly always slipping off the bed in the middle of the night, resulting in calls to friends, neighbors, or paramedics. </p>
<p>Can they afford the nursing home care after she would normally be released?</p>
<p>It is a situation that can be viewed two ways- “that’s not fair to her to just put her in a nursing home because of his convenience” vs. “that’s not fair to him to just expect him, at his age, to spend 24/7 caring for an invalid”</p>
<p>So, what if he were dead, how would she be cared for? Would she be in a nursing home then or have home health assistance?</p>
<p>Dad is much too healthy to go to either assisted living or nursing home. He works in his garden, mows the lawn, takes walks…his father lived to be 97 so long life with good health runs in the family.</p>
<p>What I see coming down the road is Mom wanting to come home and Dad saying ‘no’. If I went there and hired a home health agency to assist her, she could be at home. Dad, however, would object to that. He does not want another person in the house. I do not want to be in the middle of it, but I am tending more to Mom’s side. His reasons for not wanting home health or a bathroom remodel just do not weigh as heavily as a person wanting to live in her own home.</p>
<p>Is your dad prepared to private pay about $5,000 a month for your mom’s care? I’m sure he is feeling relieved right now, but a better alternative would be assisted living for the both of them. They would be together, there are different levels of care and services offered. If they have a home, there are financial arrangements with these facilities to cover costs. It is so painful for us as children to see the roles of parent/children reversed. If your mom was admitted to the hospital for 3 days or longer, medicare will cover 180 days in rehab. as long as your mom is making progress. There are weekly team meetings to evaluate goals and length of stay. It may buy a short amount of time where the social worker can work with your dad and explain the various options.</p>
<p>Dad is well aware of the costs. At this point he would not go to assisted living. He would absolutely refuse. And health wise assisted living for him is not necessary. </p>
<p>They do not have Medicare, but the states plan for retired teachers. </p>
<p>Legally I suppose there is nothing to prevent her from moving home and hiring help but the arguments between will be bad. Actually they will be bad either way. A very sad way to end nearly 60 years of marriage.</p>
<p>Tatin, I agree with mommusic. I think it is asking too much of your dad to be your mom’s caregiver, even parttime. </p>
<p>Your mom seems like a candidate for Assisted Living. Your dad could probably move in with her there, and they could just be a married couple again, with staff taking on the burden of caregiving.</p>
<p>Long-distance parenting your parents is tricky. A good first step for you might be to explore Assisted Living options in your area, so that you get a feel for what these places are like and what services they provide. I think you might be pleasantly surprised. Then I think it’s unavoidable that you, or someone, would need to make a trip to your parents’ city and check out some ALs there. The “tour” takes an hour or two, so you can squeeze several into one day if you line them up ahead of time. Once a decision is made, the move can happen pretty quickly.</p>
<p>ETA – above written before your last post.</p>
<p>I’m sorry to hear about your dad’s opposition to Assisted Living, but I think that’s very common. My dad was the same way, and now he loves it. Does your dad understand what AL is? Could someone take him to visit one? Before I started this journey, I pictured a dreary warehouse situation, and it’s not that at all.</p>
<p>ETA II – ECmotherx2 had an excellent suggestion: Get someone else involved to explore options with your dad, eg a social worker. You know how sometimes your kids are far more willing to listen to someone besides you? It’s the same with elderly parents.</p>
<p>I am absolutely certain that Dad will not go to AL now. Never, no way, no matter how nice they are, he just will Not go. So going together to assisted living is not an option.</p>
<p>Then IMO your mom needs to go to AL by herself, and your dad can always move in with her down the road, if he changes his mind or his own abilities diminish.</p>
<p>ETA
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<p>You’re probably right. Caregiving is a heavy, heavy burden, even for someone half his age. It is taking a toll on him, and IMO that should be a factor in this decision.</p>
<p>Have you laid this all out for the social worker? It is best if they become aware that your mom needs an advocate now. How sad for her to be aware of the turmoil and your dad’s thoughts. I do believe that your mom needs an adult advocate, it is best that one is assigned now at the beginning of the process than after bitter arguments. An outsider will not have the vested emotions that you have, they will know the process, the law and your dad may possibly listen to them. If worse comes to worse, I would look at extended care facilities for your mom, or tell your dad that your mom needs 24 hour care, preferably in her own home and it is HE who will have to move to a small apt.</p>
<p>It would be better for a third party to be involved. How do I get a social worker involved? I know she saw one at the hospital, don’t know if there is one at the nursing home. </p>
<p>It is her house too and she has a right to live there even if she needs a round the clock helper. But Dad would not like having an ‘intruder’ in his home. This is a no-win situation.</p>
<p>It is tough to be in this situation. We all want to respect their wishes, both of them have a right to have their opinion, yet they are at cross purposes.</p>
<p>One note, my Dad had untreatable cancer and when diagnosed, we got him to agree to move to live by two of his kids, but in this market, the house did not sell. And he would not even discuss renting it and moving to rent a place, he wanted to stay in his home area as long as possible.</p>
<p>After 1-2 years of this, he had emergency surgery and Mom trumped him while he was weak, she called the kids and we all went there and moved them out of their home and into a condo near the kids.</p>
<p>Within a couple of months Dad was discussing how much he liked being in the new area. No he was no longer involved with his friends and volunteer activities, but he was seeing one or the other of his kids and grand kids all the time. He did not realize how wonderful it would be to be near family. So, forcing the change was a good thing.</p>
<p>But, my goodness, it is difficult to know when to force someone and when not to!</p>
<p>Good idea to involve a social worker and all short term rehab places have someone assigned to aftercare planning. Additionally, many families find it helpful to hire a geriatric social worker to navigate these transitions. It will help to involve someone outside the family, as well as to keep a very open mind yourself as to what would work best here. I would not want my mother to think that I felt the only good option was returning to home as it might not be best or even feasible, depending upon her health. I have a lot of experience with elders who are prone to falling and it is daunting. I believe that forcing caregiving or caregivers on a household could be disastrous for all concerned. Yes, they share a house, but to be unsteady on your feet and dependent on someone who is not on board with helping or having help there is unlikely to be anyone’s best interest.</p>
<p>Playing devil’s advocate here, consider that it takes a lot of navigating of logistics to have 24 hour a day help in (absenteeism, personality clashes, different ways of doing things, days when either parent may not want someone to come-ironically often when they don’t feel well, etc.) and that in many parts of the country, nurse’s aides cost at least $20/hr. (YMMV) That adds up quickly. </p>
<p>There are elder facilities that have independent living, assisted living and nursing home care all on one campus and these can be ideal for couples who are just a walk away from each other if necessary. Your mother might like having relationships with caring staff members and sociable peers. Her husband might like being a spouse, but not having more responsibility than is bearable right now. </p>
<p>I have empathy not only for each of them, but also for you, Tatin G. Try to get as much info. as possible about all alternatives, and give it a bit of time to sort out. I would also want to understand her spouse’s concerns and determine exactly what worries him most. The aftercare planner might also know social workers who can follow through with all of you post-discharge, perhaps including you by phone as this unfolds. That would most likely involve private pay, but it could be the ultimate peace of mind to have someone local, well versed in quality of resources and options, who knows the family well. Best to you.</p>
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<p>This was the situation that one of my friends faced. Wife became ill and could no longer look after husband when he started needing more help. In the end, he went into assisted living and she did not. The assisted living facility was just down the road from the home, so she visited every day. </p>
<p>My friend (the wife) was very conflicted about her decision. But it really was the best thing. Even if you have in home 24 hour care (if you can find it), you are still fretting over the other person–there really is no true relief of the burden.</p>
<p>My uncle’s wife also went into assisted living and he did not. It is not as uncommon as you’d think.</p>
<p>Tatin, I think we can all relate to your frustration, the feeling that there are no good options. We’ve all felt it on a gamut of issues, from living arrangements, to medical problems, to financial matters, on and on. It’s one of the hardest things about this business of parenting your parents, the obligation to sort through things and try to come up with the best decision on their behalf from among a bad lot. Not to be a downer, but I wanted to let you know you’re not alone.</p>
<p>That brings up another thought, which is that the further down this road you go, the more you’ll have to take the reins from them. Even if there’s no dementia, they become less and less able to be rational and informed, and more and more reliant on you to make the best decisions for them, even if it’s a decision they don’t like. Just last month, my brothers and I had to take away my parents’ beloved dog, for health reasons (both the dog’s and theirs). Of course, that was really, really hard for everyone, and if it were up to my parents, the sick dog would still be there with them. We considered their wishes, and tried for more than a year to make it work, but in the end, we had to override them. They simply were not capable of understanding the situation or the implications of their desires. We had to do that thinking for them.</p>
<p>When my brothers and I decided it was time for them to move to Assisted Living, it was not a decision which my dad welcomed. But two things were very clear to us: first, that they were no longer able to manage living in their house, and it was becoming increasingly dangerous and unhealthy; and second, that Dad was never going to admit that. We listened respectfully to his objections, but in the end – for his good – we had to go against them. While it felt terrible at the time, ultimately, we believed it was the loving thing to do. (And we’ve never regretted it; in fact, we think we got them out of the house just in time.)</p>
<p>I’m not giving you advice. Your situation is different than ours was, and I retract my not-well-thought-out post above. This is a decision that only you and your family can make, although there are resources for you which others have posted about. None of this is easy, and you’re among people who really get that. Hugs to you as you work this out.</p>
<p>TatinG - You are receiving such wonderful and caring thoughts, ideas, and attention on this site. I am feeling your pain and am so sorry this is so hard, and unfortunately, will continue to be. I totally agree with “somemom” when she says it is difficult to know when to force someone and when to not. I mean, these are our parents. They raised us. They made the desicions, and now it’s our turn?? Doesn’t seem right… There’s also the fine line between what we would really like, and what would be unsafe. Sure, I might really like if Mom would shower more, but if shower safety becomes an issue, i may have to let it go… I bet this is all harder on those of us who like to have it all in control and do it all the way we think it should be done. Talk about clashing minds! </p>
<p>Is there a stubbornness gene that begins to express itself around 80? If so, I’d like to fight it and just willingly go to someplace nice… not much help tonight. It’s alsmot 3 am, jsut filled one more bag for vets to pick up for donation. then off to moms ps and to get her started packing for her own move to assisted living. One day she is anxious to go and the next she wonders if we should really hurry… I keep telling her tht we don’t need to sell house immediatley, but she just gets so confused. … speaking of confused… i’m so tired and it’s a long stressfull day confirming her move for tomorrow. I just want to make it til New Yearsss… Then will it settle down?</p>
<p>Maybe it will settle down. I find that things go up and down. We’ll have a lull for a few months, when things go along fine. Then a period of crises, and they never seem to come one at a time. Then another lull. I’ve learned to enjoy the lulls, and gather my strength for the next crisis period.</p>