Caring for Elderly Parents

[irhack]

I'm still reading through the thread on the old forum, but wanted to resurrect it here.

My mother's situation is too complicated to go into here, but the short version is she is living on her own, with some paid help. Her mobility has been declining steadily for years and the paid help called me last week (they never call me) to tell me how concerned they are. Apparently mom can barely walk with her walker or get out of her lift chair, is not bathing yet refusing help with bathing (and other personal care issues, sigh). Refused to go to the doctor after a fall. I live 1000 miles away and my brother a four hour drive. I'm flying out to assess the situation but can't stay long due to having school age children and an ever traveling spouse (and we don't live near any family to help us, either).

I just don't even know where to get started. But I'm sure I'll be posting here a lot.

[Morden]

Hi irhack,
Thank you for resurrecting this thread. I have found useful posts here on the other forum as my parents are elderly.
I am sorry to hear about your mom. I hope you and your brother have a chance to talk when you are out there.

[Morris Zapp]

I have one of those elderly parents who wasn't particularly nice before he got old and sick.  Now he's turning into the stereotypical crochety old man who yells at the TV and waves his cane around.  I foresee a rotating cast of caregivers over time as everyone refuses to stay.
The person I feel really bad for is my mom who is his primary caregiver.  At what point do you deem the older person as abusive and how does that play into the decision to put someone in a home?  Funny how there's no course in how to do this . . .

[bopper]

Perhaps enlist the help of a geriatric care manager?

https://newoldage.blogs.nytimes.com/2008/10/06/why-hire-a-geriatric-care-manager/

or your parent's local county Office of Aging/Elder Services

[mamselle]

I started to see that caregiving/coordinating function develop as I was doing a stint as a unit coordinator at a hospital awhile ago.

It makes a huge difference to have someone on your and your parent(s)' side who know the language of social work re: medical care and know your state's and town's laws and provisions for elder services.

A good coordinator is very helpful throughout the time of your parent's need; you need to vet them and get referrals since skills and approaches vary widely, but especially when everyone is far away, it's  an important part of the family picture.

M.

[wellfleet]

Totally endorsing the idea of a geriatric care manager--good ones can be amazing.

I live with my elderly mom, along with my nurse practitioner husband. But in the absence of a blended household like ours, professional guidance really can help elders stay at home if that's what they want. I have to say, though, irhack, your description above makes it sound to me like your mom's time in her own house may be pretty short. Have you talked with her doctor recently?

[irhack]

I don't even know her doctor's name. I found out the name of a cardiologist she sees and left a long message for her. One of my goals with my visit is to get the contact information for all these folks - and then contact them, and find out what they need from me to enable them to talk to me.

I've been spending a lot of time looking at various options for moving her closer to me, though of course I need to have more information to focus that search. Like what does she even want? After I see her in person, what do I think she needs vs. what does she think she needs. What does her doctor think she needs.

[wellfleet]

I hope your mom cooperates with your efforts. Finding out what she wants and being prepared to honor those wishes should help, but it doesn't necessarily make any of this easier.

[mamselle]

I don't even know her doctor's name. I found out the name of a cardiologist she sees and left a long message for her. One of my goals with my visit is to get the contact information for all these folks - and then contact them, and find out what they need from me to enable them to talk to me.

I've been spending a lot of time looking at various options for moving her closer to me, though of course I need to have more information to focus that search. Like what does she even want? After I see her in person, what do I think she needs vs. what does she think she needs. What does her doctor think she needs.

In terms of who can say what to whom, you can always (try to) tell the MDs and RNNPs things, with or without a release; they just may not be able to reply, other than to thank you for your input.

My parents were into playing "guess my illness" with their PCPs: they'd say things like, "I have this runny nose all the time..." and I'd say, "Have you asked your MD about it?"

To which they'd reply: "No, that's their job, to figure out what's wrong with me and fix it!"

<<me: exasperated silent screams offstage, of course...>>

Any effort to try to get them to be up-front about stuff was stonewalled like this, because, well, a professional should know their business and not have to be told stuff, right?

I wrote long-ish letters when I realized they were not being upfront; MDs couldn't reply because only two of the four sibs had been given reportage privileges...and I wasn't one of them.

But at least the MD knew what to think and ask about, even if they discredited it (which they aren't supposed to do if it's reasonable).

Good luck...

M. 

[polly_mer]

I hope your mom cooperates with your efforts. Finding out what she wants and being prepared to honor those wishes should help, but it doesn't necessarily make any of this easier.

One possibility is to get medical power of attorney, if Mom will cooperate. 

[wellfleet]

And there are situations where information really just doesn't make things better, either. I've had to do a lot of shifting away from "if only we understood this, we could fix..." to "understanding helps us build empathy, because fixes just aren't happening." Knowing in *precisely which ways* my mom's skeleton is falling apart really doesn't help her much, on a daily basis.

Getting old can suck. 

[irhack]

Mom actually seemed okay when I visited, though I have no doubt she was putting her best foot forward for me. However for the first time ever she seemed willing and perhaps even eager to leave her home and move to be closer to me. I'm looking into senior housing options, hoping for more of an independent apartment with in home help like she has now to start off with at least. I've got a call into some local geriatric care managers- I think a couple hours with one would be really helpful in plotting out all the details.

And I'm reading "A Bittersweet Season" by Jane Gross which I'm finding really helpful.

[polly_mer]

That's encouraging, irhack.

[professor_pat]

I'm just beginning the search for an assisted-living facility (ALF) for my dad. He has to move to Florida, where one of us three sibs has just moved. My role at the moment is to do the research to choose some for the three of us to visit in a few weeks, then to schedule visits with the top choices. Dad doesn't want to be involved in all this planning, at least for the time being.

What questions should I be asking in my initial phone call before visiting?

Obviously I need to ask (1) if they have an opening, and find some way to (2) get a sense of price ranges. My dad is in his 90's, so we may be looking at 5-10 years of residence, which will probably affect whether he buys in or simply rents.

We want him to have (3) lots of activities to choose from, especially lectures and performances if possible, and he'd love to have a woodworking shop available. Info about medical staff is available on the state website, so I don't necessarily need to ask about that.

When we're on site we can ask other questions, but since I'm a total novice at this, I'd be really interested to hear your experiences. And if anyone is familiar with Florida ALF's, feel free to PM me.

[irhack]

Met with geriatric care manager, who wisely pointed out we should be focusing our search on subsidized housing, since her monthly income if she moves here will be her tiny social security check. It's so tiny I realize we will really be paying any expenses she has. Ugh.