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Both parents walk with a walker and wear adult diapers for incontinence issues. Father has advanced congestive heart failure which is managed by meds. My mother has diabetes and requires twice daily insulin injections. Dad has very mild dementia.
You can't. Some will tell you to call APS, but they do very little, if anything at all. My aunt refuses, also. Sometimes you just have to step back and let them fail.
There is very little you can do. Being their child (both literally and figuratively in their eyes) you have very little say of what they take into consideration. Welcome to the club and hugs for all your worry.
Sadly, it will take an emergency for them to recognize that they need assistance. Or if the emergency is severe they will be forced into a higher level of care.
It isn't easy for anyone but it is the honest truth.
The best way to convince your parents that they need more help than what they're admitting, is to quit propping them up in any way. If there is anything that you now do for them, just stop doing it, and soon enough they will realize that they need way more help than they thought. Otherwise you just have to wait until an "incident" happens as sooner or later it will, and then things will have to change whether they like it or not.
As usual, you are completely right. As long as the children provide the help free, no movement will be made toward a parent paying for a real solution.
I really wish I could have persuaded my sisters to quit doing Mom's housework for her. They complained about how difficult it was to do their own and hers as well. However, they simply wouldn't stop doing it. If they had just stopped, told Mom that the additional work was too hard on their backs and knees (it was), Mom would have either hired help or gone to assisted living. They couldn't bring themselves to "abandon" Mom that way and she wouldn't spend a penny that she didn't have to. That continued for years, until Mom's death.
Is anyone the PoA for either of them? Or are they PoA for each other? If you or another sibling are PoA for them, they need to read the PoA to see what activates the authority. If it's a medical diagnosis of impairment, then the PoA and family will need to employ therapeutic fibs to get them in for exams and more therapeutic fibs to get them to either accept in-home care or a move to AL. Facilities are well-acquainted with therapeutic fibs to make moving less stressful. It will be rocky until they are receiving appropriate care. It won't happen overnight and they won't like it but it will happen eventually if you insist that they are not driving the care bus, the caregivers are). It took my elderly Aunts 6 months to accept in-home aids. Then we got one who was just awesome and they had her 5 days a week for 6 years. I wish you a smooth transition and peace in your heart as you work to get them appropriate care.
I hate to say this but... If your parents are legally cognizant If your parents are not an actual danger to themselves, each other or others You may have to wait for the proverbial "catastrophic" event that will force some decision on their part. What you can do is maybe have a discussion like this... "Mom, Dad, I know you do not want help in the house, I know you don't want to move to "Sunny Farm Community" so what I need to know is if something happens to either one of you what do you want me to do? At this point you go over Advance Directives, Where they would want to go for Rehab if that is needed.
AND...If you are doing ANYTHING to make them feel like they are independent then you stop propping them up. If you have been helping with laundry, cleaning, shopping, making meals STOP. These are all things that would be taken care of if they were in Assisted Living or if they had a caregiver a few hours each week. ( It would not have to be daily unless they need that it could be 5 or 6 hours 3 days a week whatever works for their schedule)
I agree with Grandma1954! I'm learning the hard way to step back from my emotions and the FOG, (Fear, Obligation, Guilt,) so that she can see (maybe?) just how incapable she is these days without my help. I also plan to bring in the help as my "friend" who is there to help *me* to help her, so hopefully she'll be more willing to accept.
If your mother doesn't have dementia having her doctor tell them they must have homecare coming might do it.
If not, you should do as others have suggested and stop propping up their false sense of independence by doing for them. Don't do anything for them for a few days or a few weeks depending on how long it takes to wear down the asinine stubbornness.
Many times our seniors have to learn this way by being taught a practical lesson. Or in other words, they have to learn the hard way.
So make yourself scarce and unavailable for a while. If one of them needs something tell them no and press the point about them needing homecare. Then take that step back and let them fail as Tiredniece23 writes in her comment.
Here we go again....another couple of elders who made no plan for care in their old age other than their children, who already have enough on their plates.
This was wrong on their parts. It is not okay for elders to throw up their hands, expect their grown kids to step in and look after them to the detriment of their own lives and families, and go, "Oh, here we are, we can't walk, get to the bathroom, figure out our medicine, drive or get to the store so it's our kids' job!"
No, it isn't. Let them flounder about for a bit, explain their options (and none of which is you destroying YOUR life to make theirs HAPPY HAPPY HAPPY, which they will never be anyway).
When you and the rest of the family insist on living your own lives as you choose, they'll get the idea. Hopefully, while one or both of them has enough brain power left, they'll hire an aide or sell their house and go to Shady Palms Assisted Living,, where they can live their best lives and so can you without the burden of their care wrapped in a stranglehold around your neck.
My husband and I are elders of an advanced age and would never shift the responsibility of our old age care upon others. I'm so sick of hearing these sad stories where sick old parents ruin their grown kids' lives when they should have made another plan. Horrible.
Your advice below is great, and I've nothing to add but to say that eventually, this being such a common problem for the progeny of seniors, it will come to a head when one or both end up hospitalized. That's the time to work hard with the discharge planning social workers in hospital or rehab to get the help they need. I am not sure in-home would work, because with the incontinence issues they likely need 24/7 care now, but anything would help. Good luck, Victoria.
Find the right fit! I've been a caregiver for over 20 years. I have a list of people & agencies who contact me specifically for situations like this and for clients who are noncompliant in certain areas of daily living. It takes a lot of patience on your part & the right caregiver. You want to seek out caregivers who possesses certain skills & personality traits. I just joined this site, but if you would like to chat more on how to go about this, id be happy to chat via phone, email, or text! I don't know if there are any rules against my offering this, but I don't see any. Feel free to reach out!
Good job finding this forum and asking the question at this point.
There is great advice here about not propping up your parents. Please follow it and then stick to your guns.
Alternatively, the years will slip by and your parents will still end up in AL at best, or a SNF after a medical catastrophe. In the meantime, you'll spend increasing amounts of time, energy, and money propping them up so they can stay in their house because it seems like the right thing to do. In the process, your health, marriage, and friendships will all suffer while you habitually cancel, miss, or leave early from vacations, parties, and holidays because a parent is having an emergency or simply calls begging "Please come over! We need your help!" I'm sorry to be blunt about that.
Plus, your parents will have a better quality of life in AL or at least with a home healthcare aid because they will receive more care than you can provide. Think of it as helping them to thrive not just survive.
Don't allow them to refuse. With our late father, we found three assisted living centers thst would be suitable. We let him visit each one, and then told him he had to choose the one he liked the best. He could no longer stay with my brother, his wife, and daughters. Brother had his own business, his wife had a job, one of their daughters was in college, and the other in high school with a part-time job. He wasn't happy about it, but appreciated that we let him pick the one he preferred.
Your parents are making foolish decisions. OK, at least you tried to help, so just leave your parents alone. Hope no fire happens!
A very difficult decision is to let their chips fall where they may until an ER visit forces one or both to an AL or NH? Unless one or both is found dead. Good Luck with their welfare!!
Yep, fire “happens.” I know a case where it “happened” when the husband decided to cook (which he’d never done before) and left the pot on the burner while he went for a long walk. Fortunately the couple’s friend dropped in and called 911. Their dog survived.
Have they set you or a trusted person up as their individual financial and healthcare POA? If not, you will have great difficulty navigating this situation. Get their legal affairs in order (POAs/Will/Trust/Hippa authorizations/etc) before you move on to anything else. Use an experienced attorney and make sure the POA covers as much as possible. Do your own research on that before meeting with the attorney. If you have all of that set up, then I recommend taking them to a neurologist for an exam to determine their executive decision making ability. If the neurologist finds that they are not capable of making rational important decisions, they will give you a medical report stating same which will help you in using your POA powers to make the best decisions for them. It is a real role reversal for sure - but necessary to protect them and your sanity. If the neurologist assesses that they are still capable, all you can do is try to guide them to the right decisions. If, in the end, you cannot get their cooperation and hit a wall of frustration, your choice is to continue to deal with it or to let them fail. That is the hard truth.
One tip that can be helpful is that if they ever have to be hospitalized, and have at least a three day stay, get with the hospital care coordinator and have them discharged (under Medicare) to a rehab facility for at least 20 days. That will buy you time to find an AL or SNF facility to send them to permanently. Start looking around at your options now - so you know what is out there. Or, look for home care help but understand it is expensive and there are often times when a caretaker calls out sick or misses for other reasons. In that situation, there has to be a family member who can temporarily step in.
You have not convinced me that your parents require any out of home care. I will be 82 years of age in two months, I use a walker and sometimes a wheelchair, I wear diapers when I am away from home for long periods of time, I have type two diabetes for which I take insulin twice a day and I have high blood pressure for which I take medication. I also take an anti-depressant medication. My wife has a serious kidney condition and also takes anti-depressant medication. You will have a very difficult time convincing either one of us that it is time to begin receiving in home or out of home help.
Of course you don't. Until you do. What plans do you have in place for the time when you no longer can manage on your own? Have a POA? Medical directives in place? An agency for nursing care; for instance, after one of you falls and breaks a hip? Or has a stroke?
Or do you expect your children to jump in and manage all of it? Or do you even have children?
I'm very curious to know your thinking on the matter.
One cannot look through a crystal ball for elder welfare. No one can predict what will hapoen between independent living and final passing. An injury or a sudden illness can send someone to the ER, rehab, assisted living or nursing home long-term care in a one-second instant. Without a health directive for your loved ones or friends, finding care can turn into a nightmare. Without a POA, that affected loved one may become a ward of The State.
How are your parents managing groceries, cooking or meal prep, cleaning, laundry, showers, taking the trash out, getting to doctors appointments, changing lightbulbs, and paying bills?
Do they have an answer to what will they do if one of them falls and can’t get up? Or if there is a fire or leak or the electricity goes out?
Sooner or later, a crisis will occur and will force the issue. You can point this out and also point out that if they wait for a crisis, they will have a lot less choice in where they go or who moves in to help them. This still may not convince them.
I’m in a similar position but my dad passed so it’s now my mom living alone. I think a lot just want to “take their chances” even though they know the risks.
These are good questions. If Victoria is doing these things, she has to stop. Propping someone up makes them think they're independent when they're not.
They need to be allowed to fail, so that a change is made.
We are about to embark on having a caregiver in, two hours in the morning and two in the evening. It starts tomorrow!
My daughter and I have been caring for my Mom for five years. With two of us, we managed, though at times she wanted even more company and we really couldn’t give any more.
While she had, to date, refused to have strangers in the house, we finally had to be calm but firm that it was happening. (We did remove any valuables just in case).
We hung on as long as we did precisely because caregivers are not free. We wanted to make every effort to stretch out her savings as long as possible. She has too much money to be on Medicaid, which is under jeopardy anyway as a care plan these days.
I sense trying to 'convince' is an approach that doesn't work. Why? * a loved one/elder do not want to change * they are unaware of the potential medical issues, falls, etc. * they want to rationalize that they are 'okay' and 'can manage.' * they have family in place and/or caregivers (needed care) and therefore do not see any reason to change the status quo. * they are cognitively impaired and can no longer make decisions on their own behalf for their welfare/care. * For your sake and best approach / communication, I would reframe from thinking that they are being stubborn. They are not 'being' stubborn intentionally. They are scared, fearful of the unknowns and changing what is familiar and what feels safe / secure.
What Do You Do?
* Always remember to balance compassion(ate reflective listening) with boundary setting and the reality of what needs to be done. In other words, change is hard on the family unit - you listen and then you make needed decisions (if you legally can) regardless of their emotional response.
You say "I hear you and your concerns." You do not try to convince them they are wrong. That just antagonizes the situation.
* It is a given they will not want to change which you need to consider ... to know how to PREPARE for when this / these talks happen. What I've done in many situations with clients inflicted with dementia ... "I don't know ... I'll think about that and get back to you." In other words, give them a response that leaves the door open for further discussion ... and know its A OKAY to not have all the answers. You don't. None of us do.
* Try once to 'talk to them' (logic). I wouldn't go on and on as logic won't work. They are in denial (fear, scared of the unknowns/their future).
* Hire a 3rd party to intervene such as an ind medical social worker. Often family members will listen to a stranger/professional in ways they will not listen to their own family. Having a third party will ease the tension that a discussion of this magnitude will present.
* Get legal documents in place for you to make legal decisions as needed (if not already).
* Realize that you may need to make decisions that they will 100% disagree with. If you do not have legal authority and they are of sound mind, they can make their own decisions. This is a hard one to accept because you see the writing on the wall and they do not. You have to accept if they are medically diagnosed to be of 'sound mind' / able to make decisions in their best interest.
Then... What happens?
* They have a medial emergency / a fall putting them in the hospital, then in a rehab facility * They are deemed unable to care for themselves without ('adequate') help caregivers at home. * They are forced to move into Assisted Living. * You / they will drain their financial resources with 24/7 care at home when they need to be in a facility that also offers medical / nursing station and a social worker (and more).
* You or another family member are then SCRAMBLING to sell a house, find placement ... in an emergency situation. You want to avoid emergency changes - you want to be as pro-active as you can be within your legal rights to do so.
Yes, my parents refused until my dad had a medical emergency (severe dehydration from the flu) and had to go to the hospital, then rehab. Even while in rehab, the Dr. told us "we cannot force him to leave his home. He has the right to make his own decisions even when he is CLEARLY making bad decisions." We pleaded for a different answer stating that he was not only making bad decisions for himself, but also for his wife who is incapable of advocating for herself. The Dr. agreed with us, but could not force him to give up his poor decision making. We got the social worker at the rehab involved and somehow she convinced him to go to AL (although with his vascular dementia he honestly thought he only agreed to VISIT an AL). Boy was he angry with us when we packed up his things and moved them. The verbal abuse we took was overwhelming. I refused to visit him without a "shield" (aka a friend or cousin) because he wouldn't dare show his anger in front of an outsider. But I digress... He never admitted it to me or my sister, but he did admit to my son that "things are easier for us here (don't tell your mother!)". Unfortunately due to the unnecessary stress he put on his body during those last 3 years of feigned independence, he only lived for 3 months in AL before he passed of pneumonia. We then moved my mom into the memory care portion of the AL. She still asks to come home but doesn't recognize pictures of the home she lived in for 57 years...but she is happy and well cared for - better than I could ever care for her on my own or even with help from family and friends. I believe that if my dad had agreed to move to AL sooner, he would likely still be alive (his brother is 92 and his sister is 94, my dad was 88 when he passed). The years of improper nutrition (they more often than not would eat questionably cooked/partially spoiled food) and dealing with stress from my mom's ALZ (which he refused to believe) really took a toll on his health. Bottom line is - you cannot force them to move. Sometimes you just have to wait for the inevitable and take their choice away from them. It's heart breaking. My only prayer is that I do not put my children in such a difficult situation and I can be amenable to moving into AL BEFORE it becomes a necessity.
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My aunt refuses, also. Sometimes you just have to step back and let them fail.
Sadly, it will take an emergency for them to recognize that they need assistance. Or if the emergency is severe they will be forced into a higher level of care.
It isn't easy for anyone but it is the honest truth.
If there is anything that you now do for them, just stop doing it, and soon enough they will realize that they need way more help than they thought.
Otherwise you just have to wait until an "incident" happens as sooner or later it will, and then things will have to change whether they like it or not.
I really wish I could have persuaded my sisters to quit doing Mom's housework for her. They complained about how difficult it was to do their own and hers as well. However, they simply wouldn't stop doing it. If they had just stopped, told Mom that the additional work was too hard on their backs and knees (it was), Mom would have either hired help or gone to assisted living. They couldn't bring themselves to "abandon" Mom that way and she wouldn't spend a penny that she didn't have to. That continued for years, until Mom's death.
If your parents are legally cognizant
If your parents are not an actual danger to themselves, each other or others
You may have to wait for the proverbial "catastrophic" event that will force some decision on their part.
What you can do is maybe have a discussion like this...
"Mom, Dad, I know you do not want help in the house, I know you don't want to move to "Sunny Farm Community" so what I need to know is if something happens to either one of you what do you want me to do?
At this point you go over Advance Directives, Where they would want to go for Rehab if that is needed.
AND...If you are doing ANYTHING to make them feel like they are independent then you stop propping them up. If you have been helping with laundry, cleaning, shopping, making meals STOP. These are all things that would be taken care of if they were in Assisted Living or if they had a caregiver a few hours each week. ( It would not have to be daily unless they need that it could be 5 or 6 hours 3 days a week whatever works for their schedule)
I'm learning the hard way to step back from my emotions and the FOG, (Fear, Obligation, Guilt,) so that she can see (maybe?) just how incapable she is these days without my help.
I also plan to bring in the help as my "friend" who is there to help *me* to help her, so hopefully she'll be more willing to accept.
If not, you should do as others have suggested and stop propping up their false sense of independence by doing for them. Don't do anything for them for a few days or a few weeks depending on how long it takes to wear down the asinine stubbornness.
Many times our seniors have to learn this way by being taught a practical lesson. Or in other words, they have to learn the hard way.
So make yourself scarce and unavailable for a while. If one of them needs something tell them no and press the point about them needing homecare. Then take that step back and let them fail as Tiredniece23 writes in her comment.
This was wrong on their parts. It is not okay for elders to throw up their hands, expect their grown kids to step in and look after them to the detriment of their own lives and families, and go, "Oh, here we are, we can't walk, get to the bathroom, figure out our medicine, drive or get to the store so it's our kids' job!"
No, it isn't. Let them flounder about for a bit, explain their options (and none of which is you destroying YOUR life to make theirs HAPPY HAPPY HAPPY, which they will never be anyway).
When you and the rest of the family insist on living your own lives as you choose, they'll get the idea. Hopefully, while one or both of them has enough brain power left, they'll hire an aide or sell their house and go to Shady Palms Assisted Living,, where they can live their best lives and so can you without the burden of their care wrapped in a stranglehold around your neck.
My husband and I are elders of an advanced age and would never shift the responsibility of our old age care upon others. I'm so sick of hearing these sad stories where sick old parents ruin their grown kids' lives when they should have made another plan. Horrible.
There is great advice here about not propping up your parents. Please follow it and then stick to your guns.
Alternatively, the years will slip by and your parents will still end up in AL at best, or a SNF after a medical catastrophe. In the meantime, you'll spend increasing amounts of time, energy, and money propping them up so they can stay in their house because it seems like the right thing to do. In the process, your health, marriage, and friendships will all suffer while you habitually cancel, miss, or leave early from vacations, parties, and holidays because a parent is having an emergency or simply calls begging "Please come over! We need your help!" I'm sorry to be blunt about that.
Plus, your parents will have a better quality of life in AL or at least with a home healthcare aid because they will receive more care than you can provide. Think of it as helping them to thrive not just survive.
A very difficult decision is to let their chips fall where they may until
an ER visit forces one or both to an AL or NH? Unless one or both is found dead. Good Luck with their welfare!!
Get their legal affairs in order (POAs/Will/Trust/Hippa authorizations/etc) before you move on to anything else. Use an experienced attorney and make sure the POA covers as much as possible. Do your own research on that before meeting with the attorney.
If you have all of that set up, then I recommend taking them to a neurologist for an exam to determine their executive decision making ability. If the neurologist finds that they are not capable of making rational important decisions, they will give you a medical report stating same which will help you in using your POA powers to make the best decisions for them. It is a real role reversal for sure - but necessary to protect them and your sanity. If the neurologist assesses that they are still capable, all you can do is try to guide them to the right decisions. If, in the end, you cannot get their cooperation and hit a wall of frustration, your choice is to continue to deal with it or to let them fail. That is the hard truth.
One tip that can be helpful is that if they ever have to be hospitalized, and have at least a three day stay, get with the hospital care coordinator and have them discharged (under Medicare) to a rehab facility for at least 20 days. That will buy you time to find an AL or SNF facility to send them to permanently. Start looking around at your options now - so you know what is out there. Or, look for home care help but understand it is expensive and there are often times when a caretaker calls out sick or misses for other reasons. In that situation, there has to be a family member who can temporarily step in.
Or do you expect your children to jump in and manage all of it? Or do you even have children?
I'm very curious to know your thinking on the matter.
Most older people still prefer to live in their own homes for life.
Do they have an answer to what will they do if one of them falls and can’t get up? Or if there is a fire or leak or the electricity goes out?
Sooner or later, a crisis will occur and will force the issue. You can point this out and also point out that if they wait for a crisis, they will have a lot less choice in where they go or who moves in to help them. This still may not convince them.
I’m in a similar position but my dad passed so it’s now my mom living alone. I think a lot just want to “take their chances” even though they know the risks.
Propping someone up makes them think they're independent when they're not.
They need to be allowed to fail, so that a change is made.
My daughter and I have been caring for my Mom for five years. With two of us, we managed, though at times she wanted even more company and we really couldn’t give any more.
While she had, to date, refused to have strangers in the house, we finally had to be calm but firm that it was happening. (We did remove any valuables just in case).
We hung on as long as we did precisely because caregivers are not free. We wanted to make every effort to stretch out her savings as long as possible. She has too much money to be on Medicaid, which is under jeopardy anyway as a care plan these days.
Hope to report how well it’s going in the future.
Why?
* a loved one/elder do not want to change
* they are unaware of the potential medical issues, falls, etc.
* they want to rationalize that they are 'okay' and 'can manage.'
* they have family in place and/or caregivers (needed care) and therefore do not see any reason to change the status quo.
* they are cognitively impaired and can no longer make decisions on their own behalf for their welfare/care.
* For your sake and best approach / communication, I would reframe from thinking that they are being stubborn. They are not 'being' stubborn intentionally. They are scared, fearful of the unknowns and changing what is familiar and what feels safe / secure.
What Do You Do?
* Always remember to balance compassion(ate reflective listening) with boundary setting and the reality of what needs to be done. In other words, change is hard on the family unit - you listen and then you make needed decisions (if you legally can) regardless of their emotional response.
You say "I hear you and your concerns."
You do not try to convince them they are wrong.
That just antagonizes the situation.
* It is a given they will not want to change which you need to consider ... to know how to PREPARE for when this / these talks happen. What I've done in many situations with clients inflicted with dementia ... "I don't know ... I'll think about that and get back to you." In other words, give them a response that leaves the door open for further discussion ... and know its A OKAY to not have all the answers. You don't. None of us do.
* Try once to 'talk to them' (logic). I wouldn't go on and on as logic won't work. They are in denial (fear, scared of the unknowns/their future).
* Hire a 3rd party to intervene such as an ind medical social worker. Often family members will listen to a stranger/professional in ways they will not listen to their own family. Having a third party will ease the tension that a discussion of this magnitude will present.
* Get legal documents in place for you to make legal decisions as needed (if not already).
* Realize that you may need to make decisions that they will 100% disagree with. If you do not have legal authority and they are of sound mind, they can make their own decisions. This is a hard one to accept because you see the writing on the wall and they do not. You have to accept if they are medically diagnosed to be of 'sound mind' / able to make decisions in their best interest.
Then... What happens?
* They have a medial emergency / a fall putting them in the hospital, then in a rehab facility
* They are deemed unable to care for themselves without ('adequate') help caregivers at home.
* They are forced to move into Assisted Living.
* You / they will drain their financial resources with 24/7 care at home when they need to be in a facility that also offers medical / nursing station and a social worker (and more).
* You or another family member are then SCRAMBLING to sell a house, find placement ... in an emergency situation. You want to avoid emergency changes - you want to be as pro-active as you can be within your legal rights to do so.
Many elders wear disposal underwear.
Gena / Touch Matters
Bottom line is - you cannot force them to move. Sometimes you just have to wait for the inevitable and take their choice away from them. It's heart breaking.
My only prayer is that I do not put my children in such a difficult situation and I can be amenable to moving into AL BEFORE it becomes a necessity.