@kelsmom I have kind of a mixed reaction to this. Can the SIL come for an hour while you are there, or while you have lunch? It seems it is part of her routine. I think it is her choice, but you also have a right to a private visit. Nine to eight is a long time and precludes a visit by SIL which may be upsetting to her. I am not commenting on whether that is healthy. I just think everyone in a family should have the contact they choose with the older parent.
We have no issue sharing the visit with SIL. Although she can drive us nuts, we get along fine with her. But she tells us that being with her mom all the time is rough on her. She feels that itâs important for her mom to have interaction during the day, since she doesnât want to leave her room. While we are there, we can provide the interaction their mom needs - and she can get some much needed rest or take care of errands. We just think that she is missing the opportunity to rest. She is having trouble allowing others to step in. I think thatâs not uncommon when someone is used to being a caregiver, but unless the one offering to help wouldnât be able to handle it, itâs important to take the hand thatâs offered.
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What is the reason for the adult children feeling they have to be with her so much , so many hours every day while she is in assisted living?
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We all call it âunassisted living.â
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@compmom Sorry to hear that and that is sad. And so sorry for your recent loss. My MIL was in a continuing care place from 81-91. Independent to assisted living to memory care. Her care was luckily good enough , and we are grateful for that.
Not sure with SIL. Probably because MIL is, to be blunt, waiting to die. She has chosen to withdraw, and she refuses to interact with the other residents. SIL is providing the only daily interaction MIL will accept. MIL doesnât have anything in common with the other residents, and she has no interest in knowing them. Itâs not the ideal situation for her, but the whole situation around why she is where she is & why she will not consider a move is very complicated. She is being properly taken care of, though, to the extent she will allow the staff to help her. Itâs a much more difficult situation than when she lived in her former AL, but that was 3 hours from SIL & 13 from us. This was the best option available given circumstances.
H & I stay with her all day when weâre in town because we only get to see her every couple months. She moved closer to SIL last spring, and the AL is located in an area where there isnât really much to do. Itâs half an hour from hotels/Airbnb options. So we go all in, staying with her so much because weâre there & donât have anything else to do ⊠and we enjoy three days of togetherness (we always spent a week in the in lawsâ home when visiting, so weâre used to it). We enjoy doing things with her, including playing games and talking. Many conversations are repeated throughout the day, but we donât mind. Itâs good to be with her when weâre in town.
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Sorry that was a bit abrupt. Residents of assisted living are tenants, not patients. Our facility was strict about aides accepting a ânoâ without much coaxing. Many âtenantsâ have dementia and think they can shower, dress, go downstairs on their own, but canât. Many families go once or even twice a day to help with activities of daily living, while paying $9-10k/month.
One thing I want to do is get on a committee at a non-profit that is addressing issues with elder care.
Assisted living facilities tend to keep residents too long, in my opinion, often because the memory care spots are scarce. And they accept residents who already cannot find their room or the dining hall for obvious reasons, cashflow.
The hospice aide was able to wash and dress my mother. In seven years, the aides very rarely did either. I love the aides, donât get me wrong. They were limited by policy.
Oh- another good one. The facility could not do "wound care. My mother, in her dementia, took bandages off all the time (despite my signs, posters and phone calls, as well as visits). I lived a half hour away and had to constantly drive to replace a bandage/bandaid when the facility called. Just an example of the kind of regulations we dealt with (donât get me started on colostomy care!).
FIL had a special wound care nurse who came to the AL facility to dress and change his dressings. I suspect that the staff would have helped him if heâd pulled off his dressings, but I donât know. It was a very special place, and I would recommend it to anyone. The current AL facility MIL is in wonât do anything that they arenât supposed to do. I understand that, although it can make it very difficult for the family. I donât even want to think about what happens (or rather, doesnât happen) when thereâs no family around.
Assisted Living facilities vary from state to state and even within state locations. Some state regs are flexible enough, and as said, sometimes keep a resident longer than they should because they âknowâ the resident pretty well (they would not accept someone at their level of function, but the resident had deteriorated in mental or physical condition since they moved in). As said, sometimes it is a matter of the family finding other placement.
These reasons often make the all levels of care desirable - one buys into community and takes an apartment or even a detached building on the property, and when needed, goes to AL, Rehab, or skilled care within the facility. The people in skilled care have a discounted rate from someone not on the âbuy inâ. A popular place here will takes rehab patients in also from the community/public, but a coworker found that they didnât have as much PT/OT/ST services available as the facility we had worked in (rehab and skilled care - quite a lot of beds in both - and all our rehab beds were private rooms). Coworker had her mother moved from that facility to our facility â plus she could look in and visit with her every day.
I think this is state and facility dependent. My mother was very a much a patient, not a tenant or resident. She had a care plan that included all ADLs, medications, and activities that had to be followed every single day.
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Are you sure? My mother had a care plan with all ADLâs, medications and activities but she refused help and because she was legally a tenant, the aides and nurses had to walk away. I would be curious about regulations in other states. In my state, this tenant status results in a lot of family involvement.
I know in my state, years ago when I briefly worked for a stand alone AL facility, a person who was capable could manage their own meds. Those that couldnât paid a fee and there was a LPN that administered the meds.
I know from home town state, regs were not as closely attended to (at least at that time) so sometimes a resident stayed longer than they should - maybe due to family costs for higher level of care, and maybe not finding a facility that fits their criteria. Many families feeling the squeeze of wanting their family member taken care of well, but not moving back with a relative for a lot of relative intervention/oversight of care. Some people donât have assets, and some families donât want the assets spent down.
Some places have county provided visiting nurses and aids. When I was in nurseâs training, the relief a family had when they got approved for nurseâs aid to come give their family member a bath/shower/personal care (free of charge) 3X/week at home. Of course, budget cuts/state/local funds may have taken some of that away, IDK.
Yes capable people can do their own meds, family can do them, or family pays for the AL to do them.
I believe people stay too long in AL partly because of the financial benefits to the facility.
I am really curious about other states now. I use the term âtenantâ to refer to a legal status under MA state regulations, despite the fact that âtenantsâ have care plans and aides and nurses implement them. Under MA regulations the âtenantsâ in AL have the right to refuse specifics of care. This becomes problematic when so many AL residents actually have dementia or have a personality that results in refusing care. I assume some facilities allow more coaxing than others but I am not sure. Curious if this issue of tenant status and tenant rights in ALâs is universal.
My mom was in the memory care unit at a facility with all levels of care. Perhaps that was the difference? We actually wanted her in AL when we first moved her but the nurse said her ALZ was too advanced to be in AL even though she was still totally independent with ADLs and ambulatory. Their assessment was correct though. My mom would have been a flight risk in AL.
We saw many people moved from AL to MC over the two years my mom was there.
Yes I believe memory care residents are âpatientsâ and therefore coaxing by staff is allowed 
This is the main reason I was trying to move my mother to MC-then COVID hit. (None of us knows what really happened inside the AL during the long period when visitors were not allowed inside, but the decline from lack of family involvement was obvious in some.)
Weâre home from our visit with MIL. It turned out to be a very good trip on a couple fronts. It was good to be with MIL for a few days. She slept most of the final day we were there, but she was exhausted. She did get out of bed a couple times, which was good.
The other good thing was that SIL opened up about things & we were able to talk things through. She is going to continue visiting MIL daily, but she wonât stay as long when she goes. That will allow her to take care of herself. At this point, MIL doesnât âneedâ her there so much ⊠but down the road she may, so SIL promised not to burn herself out before that happens. Right now, MIL is content with how she is living, and SIL is beginning to understand that she doesnât want to go to all the activities. And SIL shared a burden MIL recently put on her. MIL wants SIL to promise to have a big funeral service at their church (choir & all) for both her & FIL (so far, SIL has managed to wiggle her way out of any promises). FIL died two years ago, and we had a lovely, very meaningful service in the church memory garden where his ashes are interred, with MILâs closest friends. SIL would like to do the same for MIL, and H agrees. They donât want a dog & pony show, and they donât want to relive their dadâs death while grieving their mom. H told her that she can promise anything their mom wants, but he & SIL can have the service that is comfortable for them. I could see the stress melt from SIL when he told her that.
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My mother wanted a memorial service at the church with reception, flowers, catering the whole shebang. I am also working with the church minister, cemetery dept. and etching/memorial company for a burial service for her ashes. Honestly it isnât a lot of work but it is very expensive! I am often questioning this route. I think it is harder on those of us left behind.
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Funerals are very important for many people, and I think itâs important to do what works for each family. I am actually surprised that SIL doesnât want a fancy funeral, but it turns out that she really liked the small service for FIL. MIL will be interred with FIL, 3 hours from SIL & 13 or so hours from us. There is no family there. In laws were very active in their church, but MIL is 95 & hasnât been an active part of the church in years. Whatever is done will be challenging, and truthfully, there will not be an overwhelming number of people who are able to attend the funeral. Keeping it simple and meaningful will allow those who attend to have necessary closure, while not taxing the two grieving kids. For our family, itâs the best option. For other families, it would not provide the closure they need. We all need to do what helps us comfortably honor our loved ones.
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@kelsmom, I couldnât agree more.
My dad recently (Sept 5) passed away. He was cremated and he always said he didnât want a funeral. He hated them. He didnât like to say goodbye when someone visited either. We got together as a family at the family cemetery (which was once part of the ranch Dad owned). JUST the family. All 9 grandkids and kids were there. Just us. We had no âserviceâ but my brother, BIL and I spoke briefly. We had the grandsons dig the hole for the urn. Everyone said it was great. Dad was very well respected in many communities but at 93, most people who knew him are already gone. The headstone wasnât finished so perhaps we will have a more community oriented event for the headstone setting time, probably in the spring. Because everyone knew it was what Dad wanted, everyone felt better.
Same thing with Momâs, it was more about what she wanted-ish. We had a catered luncheon, used her fancy service dishes (and sent them home as sort of door prizes since I had tried and failed to sell most of them already). She wanted the biggest event possible, but again, most of her friends were already gone. The people who came recognized the dishes and the slides show. And that made us feel better that she had an appropriate event for the survivors* who are the ones that count at that point, IMHO.
And I guess, tying it back to the thread title, all of us need to be cognizant that in our support of our parents, we need to keep an eye on our own health/values/lives and choose to support ourselves as well. Both in life and at the funerals too.
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