Caring for Elderly Parents

[mythbuster]

Good news Paul. In some ways, a short window is a good thing in terms of focusing everyone with purpose. I just hope you have good assisted living options with openings, if you go that route. If you go route #3, with the parents moving in with you I suggest connecting with your county social workers about training and support groups for you and your spouse for elder care, prescription management, helping someone who has fallen etc. That can be an exhausting road- so if you do that you might still consider having some help come to your house so the two of you gets some time off as well.

Best of luck and please keep us all posted.

[clean]

Progress is a good thing!

congratulations on making progress, and good luck on the decisions.

[paultuttle]

Thanks, mamselle! Yes, initially I felt rather like a parent trying to explain the birds 'n' the bees to an adolescent--you know, awkward all around, with no one wanting to look in anyone else's face--but after a moment, they started nodding thoughtfully at my points and became receptive to the broad brushstrokes of my ideas (options 1-3).

Mythbuster, absolutely, and thanks for the reminder! I think Option 3 is dependent on (1) how much $ my parents have and (2) whether there are any affordable assisted living openings--or, for that matter--housing availability--in one of the most expensive real estate markets in the country. If the stars don't align financially and/or practically, we may have to look for a small-town facility somewhere on the edges of this hotter-than-hot market (NC's Research Triangle Park).

Thanks, clean! I appreciate the encouragement.

[apl68]

Glad to hear that your parents are coming around to the difficult choices.  It's an unfortunate but necessary milestone.  Your family will make it through.

[Harlow2]

It sounds like you approached this with sensitivity and care, and I wonder if your parents are somewhat relieved as well.  I lived in Durham for 30 years and a friend is in a Continuing Care Retirement Community (CCRC) in the area. I've watched the area transition to a very expensive one when I've visited since I left. Feel free to PM me if that would be useful;  I haven't talked to my friend since last fall though.

A couple of things that can complicate matters for couples considering assisted living or CCRC:  If they share an apartment and one needs to go into memory care, they can end up needing to pay for both situations. This may not always be the case. Places also have somewhat differing policies on whether they will allow you to stay if you run out of funds.  You may already be aware of this, and of Medicaid look-back policies, and I haven't read back to your posts from last year. At any rate, Bogleheads.org has some very helpful discussions on CCRCs and AL places. Best wishes as all of you sort through the options.

[paultuttle]

Thanks, apl68 and Harlow2! Much appreciated.

[wellfleet]

Good news, Paul! I'm glad you are all exploring options and have a short timeline.

Having spent the last week taking care of my mom who (finally) got covid, I am all for shared housing, but that model's been working well for my family for years now. I hope you all find the best option for your situation.

Mom's on the mend, covid-wise, after an antibody infusion on Sunday.

[apl68]

Those infusion treatments have been such a huge benefit!  Our local hospital was one of the first in the state to start giving them.  I sure they've saved several lives locally.

[wellfleet]

Mom was started on one of the oral antivirals (the one that's not contraindicated by her other meds) as soon as she tested positive, but she couldn't handle the side effects after 24 hours, so they moved on to the infused antibodies as plan B. So far, so good!

[Harlow2]

That's good. I wasn't aware that the oral form had those side effects.

[wellfleet]

I wouldn't generalize beyond my mom's experience. Her drug reactions can be . . . special. That's why her doc didn't want to mess with her other ongoing therapies by trying the other oral antiviral.

For the thousandth time, I'm glad I live with her and with my nurse practitioner spouse.

[paultuttle]

A lot has happened.

1. My father had a cardiac procedure in mid/late-November that (fortunately) worked very well; he's regained a lot of his energy, though it was touch-and-go for a bit during the Thanksgiving holidays. (He's a bad patient: Guess which of the seven dwarves he was while he was recovering after his brief hospitalization? If you said "Grumpy" and "Dopey," you win the prize!)

2. My mother and father went to a physical therapy session on their 59th wedding anniversary in mid-December (not the way I'd choose to celebrate it, if it were me) and Mom was able to deal with the activities and getting home by herself (well, with her walker) in the moment. However, a week later, she couldn't stand on her own, which began several days of me living with them and lifting her from bed to (quickly rented) transport chair to toilet and so forth, culminating in an emergency room visit for neurological assessment (after Mom began complaining about nerve pain running down her leg) followed by a stay in a Raleigh hospital over Christmas and then a stay in a rehab facility in Mom and Dad's hometown. The bad: Mom still cannot stand by herself. The good: She's now in a place where she can be taken care of, including some physical activity so she won't just curl up in a ball in bed and some cognitive stimulation so she can maintain her interest in the world and in other people. A BIG plus: Her long-term health care insurance pays for all of it, as long as the price remains $250/day. (Above that, Dad can contribute, based on their pensions and other retirement income, perhaps for a long time, even the rest of her life, which is indeed fortunate.)

Dad initially was like a lone duckling with no mother, wandering everywhere he could in his mind, me needing to help him focus. But he's now adjusted somewhat, although he's lonely, and he visits Mom every day at her facility (~15 minutes from their house). And it helps him to get phone calls from his children, extended family members, friends, and Sunday school classmates.

They are each other's POA, and I was made alternate POA two days (yes, TWO days) prior to Dad's heart surgery. (Nothing like waiting till the last blessed moment, is there?) So I've been more involved in all of this than I could ever have expected, which has been at once revealing/educational and psychologically/physically tiring.

A bout of COVID about two weeks ago, which my husband also had, put half the icing on the cake; the other half was served by an older brother's heart surgery (four or five states away). He came out of it rather well, even better than expected, which is a real blessing.

In sum, everything's looking up except my mother's cognitive abilities, which are . . . variable, to put it politely. (As one example, last weekend, we entered her corridor to hear her shouting for Dad, as though she were still in her own home. She said she knew she wasn't at home, but she also said she expected to be able to call Dad's name and have him come. So that lets you know where she is, cognitively speaking.)

Dad's thinking of moving into a smaller house/apartment perhaps by himself or (maybe even) with the two of us. Fortunately, he's being hypervigilant about his own wellness, carrying a phone around with him everywhere he goes, watching his every step in the house and outside, and so forth. So thankfully, I haven't had to deal with both of them needing hands-on care. But I know things could change in an instant, as they do.

This is the "new normal" (TM), it seems. Glad that it wasn't worse, and glad that they have the resources to provide the care for Mom that she needs. Onward and upward, to infinity and beyond, right?

And thanks to everyone whose advice helped me be ready for all of this. VERY much appreciated. 

[Juvenal]

Eventually (as I did) you will outlive all of this and as I did... move on?

"Moving on" is one thing; doing something after is another.  What are one's duties, post mortem, I wonder?

Both mine are gone; both of their ashes--I sort of blush to say this--are on a shelf in the garage (the ashes include those of a favorite dog, intermixed!).  To be frank, I don't really care what becomes of them (two, plus dog).  They are gone; I'm not.  When I join them, I'm indifferent as to what's next.  Should I tell my executors the tulips in the back yard need some bone meal?  Arf!

[Morden]

I'm glad things are settling a bit, paultuttle. Eldercare sort of comes in waves, so I hope you have a chance to rest a bit. Best wishes to your family.

Juvenal, I think tulips would be a lovely place to wind up.

[wellfleet]

Goodness, Paul--thanks for checking in. It's great that your mother can get the care she needs and that your dad seems to be handling the change well. I've found living with my mother much less stressful than living away from her, but everyone's situation is different. If y'all are all ready to be respectful of each other's space and time (and if you and your husband have room for your dad and you all agree this is a good idea), co-habiting can make many, many things easier.

For example, my mother (82) is in really good shape, cognitively, so long as she's not otherwise ill or in pain. But as soon as something flares up (often connected to her rheumatoid arthritis), her ability to mentally cope goes down a bit until she's on the mend again. Us living with her makes this all much easier to handle. She knows she'll be safe during these periods, which reduces her overall stress a lot, and we now know what to do to make her as comfortable as possible and to keep these flares as short as we can make them. Steroids, man. Steroids are great.