Caring for Elderly Parents

[apl68]

Did he make you lay brick with him?

;--》

M.

No, just stapling replacement plastic up in a section of wall over the front porch that really needs some siding or something.  Dad built the house out of cinder blocks below and lumber above many years ago, and never got around to adding the planned brick veneer.  Another case of "the cobbler's children have no shoes."  It gives the house a homemade look.

[mythbuster]

Well, I've made it one week so far as Mom's caregiver so far. Its a great regimen for me to lose weight! Mom is essentially non mobile. She walks with a walker VERY slowly and has a tremor in her legs that made it all very unsteady. But of course on our trip today to the Neurologist she offered to drive!
     We are investigating assisted living this week, but I come here to gripe about how Mom has fallen into the Primary Care Physician Pit. Here normal PCP has been out for months on medical leave, so Mom essentially does not have a PCP. Of course all the others in the group are full and no one seems interested enough to actually solve this issue. They all just shrug and see she will get the person on fill in duty. The neurologist today did catch a possible drug interaction, so that was good (something a good PCP would catch), but every time we need a specialist we get told of talk to the PCP first! It's such a nasty cycle and I'm not sure who to complain to. Any ideas?

[San Joaquin]

A relative of mine in health care suggests also checking how care facilities smell. 

[ciao_yall]

Well, I've made it one week so far as Mom's caregiver so far. Its a great regimen for me to lose weight! Mom is essentially non mobile. She walks with a walker VERY slowly and has a tremor in her legs that made it all very unsteady. But of course on our trip today to the Neurologist she offered to drive!
     We are investigating assisted living this week, but I come here to gripe about how Mom has fallen into the Primary Care Physician Pit. Here normal PCP has been out for months on medical leave, so Mom essentially does not have a PCP. Of course all the others in the group are full and no one seems interested enough to actually solve this issue. They all just shrug and see she will get the person on fill in duty. The neurologist today did catch a possible drug interaction, so that was good (something a good PCP would catch), but every time we need a specialist we get told of talk to the PCP first! It's such a nasty cycle and I'm not sure who to complain to. Any ideas?

Sit down with the head of the practice and explain to them that you need to be assigned to a new PCP, and this is why.

[mamselle]

Yes, that individual's case load should have been re-distributed within 2 weeks of the beginning of their extended absence.

M.

[wellfleet]

And while geriatric specialists can be hard to find, if your parent needs a new PCP and is looking at assisted living, a geriatrician is what you want.

[mamselle]

Reviving thread, since it was mentioned as potentially helpful elsewhere.

M.

[apl68]

Thank you, mamselle.

I've realized in recent years that Mom and Dad were nearing the end of their lives.  Since they've been generally well I've put it out of my mind and not worried about it.  Worrying wouldn't do any good.  But since Sunday I haven't been able to put it out of my mind.  At this time it's still only minor lapses that Mom is experiencing.  But they're pretty clear harbingers of greater trouble in the future.


It's not their deaths that I fear.  That's not such a terrible thing to contemplate for people that you have good reason to know have something better waiting beyond it.  It's the thought of what they and I will face between now and then that troubles me.  That and the fact that I have no family of my own, and no geographically close family members.  When they're gone, there doesn't seem like there'll be a lot left for me until my own times come.  I have plenty of answers for those concerns in my rational mind.  It's my emotions that have been getting the better of me for the last couple of days.

[mamselle]

Thank you, mamselle.

I've realized in recent years that Mom and Dad were nearing the end of their lives.  Since they've been generally well I've put it out of my mind and not worried about it.  Worrying wouldn't do any good.  But since Sunday I haven't been able to put it out of my mind.  At this time it's still only minor lapses that Mom is experiencing.  But they're pretty clear harbingers of greater trouble in the future.


It's not their deaths that I fear.  That's not such a terrible thing to contemplate for people that you have good reason to know have something better waiting beyond it.  It's the thought of what they and I will face between now and then that troubles me.  That and the fact that I have no family of my own, and no geographically close family members.  When they're gone, there doesn't seem like there'll be a lot left for me until my own times come.  I have plenty of answers for those concerns in my rational mind.  It's my emotions that have been getting the better of me for the last couple of days.

First, are you all alone in this? As in, are you their only surviving descendant?

My folks began to decline in their 80s; both died in their 90s, but there were four sibs to share the care/responsibility/joy/sorrow/frustration/lack of communication/housecleaning/transportation/etc. with.

If you're by yourself, that's indeed much harder, and more mind-occupying. (Although a friend with two terribly dysfunctional brothers who ignore Covid protocols, have serious anger-management issues, let their diabetic dad eat whatever he wants, etc. might say that she'd rather deal with the whole thing herself than have to battle her brothers and their spouses at every turn).

So there's that.

Second, I forget if you're a close drive away or rather far from them. I was 800 miles away by plane, one sib still lived in town (and for other reasons moved in with them for almost the whole time) and the other two were a shorter distance away and often drove down. So coverage wasn't perfect but it could be made to work.

Third, will that change? As in, do your folks plan on staying in the home they're in now? Or do they want to/do you want them to/do they need to move to an assisted facility?

Fourth, do you have allies (local church members, visiting health caregivers, longstanding MDs/PAs they know, other friends) or are you completely alone in the ADL's (activities of daily life) if they need help with food procurement, getting to the MD's office, etc.?

It may help if you break down the issues into a group of topics that you can then do a +/- sort of page on--to objectify them so they stop running around in your mind, making you worry, and let you start thinking about positive options under each heading, or areas where you need to see what's what.

All good thoughts and prayers.

M.

[apl68]

I have lots of living family, including a brother, nieces, etc.  But no wife or children of my own (I tried--we were not able to have children, and she turned out to be abusive and eventually abandoned me.  Which with hindsight may be the best thing she ever did for me).  Mom and Dad live over two hours away, as do most of the rest of my family.  My brother and nieces live much farther away, out of state.  We have very amiable family relations.  It's just the distance thing.  I'll have to take most of the sibling responsibility simply because I'm much closer and unmarried. 

I really don't know what the long-term logistics will look like.  I've always assumed that Mom will outlive Dad by some years--they're the same age, and she didn't smoke or struggle with her weight for most of her life, as he did.  They've lived in the same town for nearly 50 years--the same house for 45 and counting--and have a number of friends and relatives still living nearby, so I've tended to figure that it would be best for them to age in place.  I'm prepared to bring Mom here eventually if she decides that's what she would rather do.  Or Dad, for that matter, but I'd still be very surprised if he did not predecease Mom.  I talk to them all the time by telephone, and try to visit in person once every month or two and at holidays.  More often is awkward, since I come in to work six days a week and am an active member at church here.

Again, rationally I know that we can figure out how to work things out.  Any caretaking that becomes necessary will be doable, if not necessarily easy.  We're far better off than families that are chaotic, or destitute, or have long histories of poor health.  Something about the prospect of having to parent my parents, and watch them die, and then no longer have a home to go to for a visit--it all just has my emotions out of balance. 

When I washed out of my PhD program, Mom and Dad were there for me.  When my wife left me and started turning really hateful and threatening, and I had to get a court order to feel safe in the house or at work, they were there again.  And when I've had a couple of medical issues to deal with that are long since better.  I've been very blessed to have them and a home where I can go now and then.  But in a few years it will in all probability be gone.

[mamselle]

It sounds like you're doing some anticipatory grieving on top of everything else. I recognize it because it's something I also do.

I'm sorry for the way things have turned out with your former spouse, and for the fact that your unmarried state makes you the most likely caregiver--people in families do that, sometimes, and it's not really fair.

Have your folks ever talked about what they want? (Or can they?)

I had a conversation a long time before it was necessary about things like final care decisions, which made it easier when the time came to think through the issues. That can also take some of the burden off--the anticipation of that conversation is hard to deal with, but once the ice has been broken, it's also easier to think about everything else because you're getting input from the ones involved--your folks.

If you know one of their ministers, that might be another avenue to connect with. If would be within their minster's remit in terms of pastoral care if you were to just mention your own concerns--they may not be able to respond directly for confidentiality's sake, but just knowing you've talked to someone and they know what you're concerned about would mean you wouldn't be so alone in it all.

I wasn't able to do this in my family, but a friend told me her mom wanted to plan her funeral service with her, and that helped--they didn't need it for another 10 years but it was another way of opening up conversational pathways.

Just sort of thinking out loud about what kinds of support you might be able to find that would feed forward into resolutions that might be needed later.

M.

[apl68]

Yes, that's anticipatory grieving, all right. 

Dad IS their pastor!  I've tried having some of those conversations with them.  And with my brother.  He has been more open to them than they have been so far.  I haven't yet pushed too hard.  My brother has aging in-laws where he lives.  They will be absorbing most of his and his wife's attention.

It seems like I'm doing what I can do.  It's just hard to figure out, and worrisome to try to think about.  There are times when I feel like a boy trapped in a middle-aged man's body.

Again, I'm confident of the ultimate result, for both them and for me.  It's just that there's this ordeal looming between then and now, and it has me shaken.

[wellfleet]

It can hit hard, but I'm glad you are talking about it with us, and, I hope, with your own church family.

I live with my mom now, which has been the right decision for us. Being around for the fun parts and the little needs has made handling the big, difficult needs much easier for me, but it helps that mom is totally on board with this situation; not everyone would be.

[Morden]

Hello apl68,
I lost both my parents within a couple months of each other last year. They were in their 90s, had been blessed with relatively good health for most of their lives, and didn't suffer a lot at the end. And I think about them every day. It is a huge identity shift--especially as I was their primary family caregiver. One thing I wish I had done differently is take more time to do little enjoyable things with them. Towards the end, so much of the time was spent worrying about them that it crowded out other things. Along with anticipatory grieving, I did a lot of anticipatory worrying--and really none of the worry helped. It will be hard, and you will get through it. Wishing you strength and peace.

[mamselle]

Just checking in.

How are things today?

M.