Caring for Elderly Parents

[mamselle]

Thanks

We were to do TG with FIL/MIL but are now just doing the immediate FishProf family and we'll have another get together when things have settled down (assuming)

It's hard when the less ill person tries to take up all the oxygen in the room...in a way, good that you're not going there and having to deal with the secondary drama.

But the disruptions are hard to deal with; I hope your own immediate family can at least enjoy your time together.

M.

[FishProf]

We went over yesterday.  MIL did indeed try to take up all the Oxygen.  While it works on her kids, it doesn't on me and I was able to extract some useful intel from FIL that was previously withheld or obfuscated.

I am not afraid to poke the bear.

[mamselle]

How 'bout them bear-pokers,
Ain't they a scare?
Scalin' them cliff-hangers,
Pokin' them bear!*

;--}

Well-done.

M.

* With apologies to Mason Williams, and all his imitators...
   https://digicoll.library.wisc.edu/cgi-bin/Literature/Literature-idx?type=div&did=Literature.Williams.i0008&isize=text&pview=show

[paultuttle]

(sigh)

We're at the point where--in my coldly logical estimation--my parents cannot truly take care of themselves any longer. Yes, Dad can drive, and yes, he and Mom still cook (or microwave) what he catches and kills (grin) in the grocery stores near them, but they can't keep up with the increasing pace of medical appointments, haircut appointments, taking the trash to the local facility, and such while also maintaining their house (washing dishes in the sink, vacuuming, laundry, etc.).

They're also--of course--trying to maintain their feeling of independence, stubbornly holding on with (metaphorically) white-knuckled hands. But it's truly revealing that their birthday and Christmas presents from us from the last 3-4 years (books, clothes, shoes, and so forth) are still in their gift bags in a corner of their bedroom.

Here's the thing: Dad's becoming increasingly shaky, and some blips on a recent abdominal MRI could (yes) turn into cancer in about 15 years. Or sooner. Also, Mom attended her last remaining sibling's funeral in January; Dad and I had to go into the women's bathroom in the church to help her onto and off of the fixtures. Dad already can't pick Mom up off the floor, so I'm sure that in a short while, he might be joining her there (on the floor) from time to time--which will truly test her worsening memory regarding what buttons to push on their landline (!!!) phone in order to call me.

Complicating things further, housing--including retirement and assisted living--in their area is becoming nearly as astronomically priced as the DC, NYC, and San Francisco areas (the logical result of announcing gleefully to the world that "Apple's coming"). Two bedroom/two bath apartments that would have been $1200-1400 just six months ago are now $1600-2000, and the end is not in sight.

Yes, we'd planned to move closer to them so we could do some of the housekeeping kinds of things for them to relieve them of that burden, but now we'd need $6000 in cash (first and last month's rent plus one month security deposit) to start a year's lease, and the rent PROBABLY WILL RISE EVEN MORE after that first year, leaving us trapped in an ever-increasing spiral of money flying out of our wallets without ever being able to buy a house.

(On Zillow, rentals are announced daily; in a single day, more than 100 inquiries per rental are typical, plus more than 25 applications for each. The real estate market is even crazier: Sales happen BEFORE houses are officially announced as up for sale, and many of them are going for cash and at least 10% over the asking price. Yes, this is due to real estate speculators; why do you ask?? :rolls eyes:)

So we have to figure out how to get my parents into an affordable assisted living situation--if that's not a unicorn, where they live--and how to do it in such a way that they accept it and even willingly go into that situation.

To me, this is like watching a cat (or a toddler) get closer and closer to a priceless crystal figurine on a coffee table: You know the crash is coming, and the only question is when.

So . . . keeping in mind that I'm STILL not their power of attorney, even though we've been discussing it for nearly a decade, I'm considering pushing toward a resolution of at least that issue by giving them 30 days to make a decision regarding who they want as their power of attorney and another 15 to make it happen (whether they want me to be their power of attorney OR want someone else to serve in that role for them, I think it needs to happen now, before some difficult-to-handle event occurs).

(Coincidentally, given the timeline above, that resolution of the "who'll be my parents' legal power of attorney" question should occur right before Mom's 85th birthday, so I might be able to present it as a birthday present for her, and by extension for both of them.)

I'm just frankly tired of being in a legal limbo, worried about them and not legally being able to do anything if there's an emergency (particularly the nightmare scenario of both of them being unconscious and not being able to speak up for each other, considering that currently they're each other's power of attorney). As a side note, my ex once had to decide whether to approve his mother's emergency brain surgery to relieve pressure from a stroke, as ALL OF HIS FIVE SIBLINGS didn't want the responsibility of making a decision that might kill their mother; I'd rather not be in that particular kind of hell anytime soon, thank you very much.

Any considerations in either pushing the power-of-attorney issue or holding off? (Or the assisted-living issue, for that matter?)

[Wish me well, but also check my July 2019 post in THIS SAME THREAD.]

[Hegemony]

Paultuttle, I'm sorry you're facing this complicated and challenging scenario.

Do you have an attorney specializing in eldercare issues at the ready? A friend of mine is that kind of specialist, and I've been impressed at the resources she has — because of course she faces these issues every day of her working life. If you happen to live in the Bay Area, I can recommend her.

One thing I'd suggest, at least, is bringing in a professional to help persuade your parents to sign those powers of attorney. If they have a trusted longterm legal advisor or other professional, that would be ideal, because they will already trust that person. If not, anyone who seems professional and reliable and who can project an air of matter-of-fact authority might be the best.

Do you know the Eldercare Locator? https://eldercare.acl.gov/Public/Index.aspx

There are also books on handling the psychological aspect of urging your parents to move. And of course there's Roz Chast's Can We Talk About Something More Pleasant?

Sending you strength.

[clean]

Could you hire someone to visit for 4 hours every 2nd or 3rd day to clean up and take them places?  Perhaps that person/company can act as a reminder of what they need to do the next few day window?

Meals on Wheels?   It would provide a daily check in for them.

[mamselle]

It runs in my mind you're an only child, also, yes?

Or do I have that wrong?

More worries, if so, because there's no support system for you...

Thinking of you.

M.
 

[Morden]

Hi Paultuttle, I think you should push the power of attorney issue (whether it winds up being you or someone else). It's just such a nightmare if they don't have one, can't make their own decisions because of sudden incapacity, and you have to go to the courts to get guardianship. If they are reluctant to cede control (and really that describes most elderly parents) maybe you can point out that if it has to go to court, they have no control whatsoever--the court can appoint whoever it wants. Without a power of attorney, you can't even get them into a nursing home should they suddenly need care because the home will want someone to be financially responsible for them.

I don't have any suggestions on how to get them to shift into assisted living, even if you can find some you can afford in their location. Sometimes (as was the case with both my parents) they just wait until a fall or injury means they physically can't go home again.

I don't know if the area they're in has some sort of home care system. My parents had someone come in to make sure they took their medication properly; they didn't really like it, but I did, not only because it meant they actually took their medication as prescribed but because it meant that someone had eyes on them morning, noon and night. I just said it was what the doctor wanted. And they respected their doctor a lot more than their children.
Good luck with what will be a really challenging phase.

[clean]

Something to consider...
My best friend's inlaws needed help. Of course, they hid it.  He and his wife lived a block away and on occasion, they would find that the fire department had visited the parents after one fell.  Of course, they denied that anyone fell, and that anyone had to help them! 

Eventually, my friend's wife hired a home health helper.  Her mom was not happy and regularly fired the helpers.  However, my friend and his wife made it clear to the helpers that they do not work for MOM, they work for HER!  Therefore Mom can not fire you! 

Among the mom's concerns was that it was too expensive and that she would run out of money.  To resolve that, my friend and his wife paid for the help, but made it clear to the other siblings that they were doing this to give her mom piece of mind but that she expected to be reimbursed for the expenses from mom's estate before anything was divided.  The brother was more than happy that his mom was being taken care of, and that his sister was taking charge (relieving him of the task).  And the other sister didnt have any money to split the expenses, and was not healthy enough herself to actually help physically herself.

The take away from this is that IF your parents are worried about the money running out because they need help, hire them yourself. 

IF you have siblings, and your parents continue to worry about money, hopefully you can either split the fees with your siblings or like my friend, one can pay and be reimbursed by the estate afterwards. 

Good luck!

[wellfleet]

Good luck, Paul. Assisted living and POA sound like good goals. Some people are sticky about the legal stuff, and I have no advice there except to explain that you won't be able to help in the ways they need most if they have "protected" themselves against. . . you. But I've had POA for my folks, now my mom, for so long that I don't remember when I got it. It was their decision, and I have never once used it yet, but am glad it's in the drawer.

[mythbuster]

Adding sympathetic thoughts here for Paul. In terms of POA, it's definitively not about them giving up control. Rather it's about ensuring that if needed, the people making big decisions are the people that they want (rather than Drs, Lawyers, or the government!). It's an insurance policy. Hopefully they can see that.

This becomes especially important if you are looking at assisted living. I'm guessing they don't have any sort of long term care insurance.  Do your parents have their money set up in a trust? If not you really should discuss this with a professional. The last thing you want is assisted living wiping out all the savings and claiming all continuing income/ pensions etc.. Mechanisms such as trusts can help to protect those funds. You also should investigate what programs their State has for Elder Care and financing of assisted living. I have an uncle in assisted living in California entirely funded by the Medi-Cal Program. Since his daughter lives in his home, it's currently protected from being claimed as asset. This is in the Bay Area, so you can imagine the costs!

My advice on looking at assisted living is, when touring, to see if they have residents that have less mobility/worse issues than your parents do currently.  What happens if your parents conditions further deteriorate? When looking for my Mom we saw one place that basically kicked you out if you needed too much care.  And definitely try the food! The one place my Mom and I both liked it was not as "fancy" with the hotel level decor, but the food was really good and the dining room was really lively- it was clear that the residents all knew each other and had a social group. They also had really nice outdoor space where the residents could garden.

Best of luck- this is really hard. Be kind to yourself.

[paultuttle]

Thanks, y'all, for all the encouragement and excellent suggestions. (You can tell I was born and raised in NC, right, with the "y'all" jumping right on out there.)

Much appreciated at a time when I've been feeling just about at the end of my rope, in terms of my patience. Thanks for talking me off that particular ledge, because it's not pretty when I lose patience, and I need as much of it as I can find so I can take the necessary time to persuade my parents that these are truly going to have to be the next steps: POA, first, and a different living situation (either with people coming in to help or them going to a smaller apartment/assisted living facility), second.

Truly, VERY much appreciated. More when there are breakthroughs to report.

[mamselle]

We'all'uns got yer back... (I can say that, I was born in Lenoir).

M.

[paultuttle]

Very good news! We had The Talk, and now we have choices to make by the end of July (yes, 2022, which also happens to be my mother's 85th birthday) regarding The Next Living Arrangement:

1. Pay for people (home health care and housekeeping) to come in and help.

2. Move into an assisted living facility (we're going to check on costs).

3. Move in together into a house in which Mom and Dad have one wing and my husband and I have the other, so we can be extra close by (my parents have gotten rather shaky rather quickly, so they are a bit worried about being fall risks).

So--onward and upward, to infinity and beyond! <grin>

(In a side discussion, Dad and I talked about the need to do this kind of adjustment concurrently with the POA arrangement(s), and he was receptive to that, so things are definitely looking up. I think their increasing recognition of how difficult it's become for them to just move around in their own home has helped me persuade them that the time is now.)

[mamselle]

Whew.

Just breaking the ice is huge.

Good for all of you.

M.