Almost six and a half years ago I wrote a post about how we exhibit love when we care for our parents as they age. Just last week I re-read that post and felt a twinge: I still had both of my parents when it was written. I wanted to share this with you again since this is something virtually all of us must deal with at some point. I haven't changed the original text which was written while both were still alive.
For many of us, One of the toughest things we face is dealing with our parents as they age. Watching someone you love decline is not pleasant. My mom and dad are struggling so I am learning as I go. Since they live in town that makes my wife and me the primary caregivers, though my brothers do what they can by long distance.
Almost 4 years ago, my parents had the foresight to move into a retirement community. It offers independent and assisted living options as well as a nursing care center. They wanted to avoid the situation where one or both became unable to care for themselves or too sick to be accepted into such a facility. We had discussed other options: caring for them in their own home for as long as possible, or even moving in with us.
But, in the end mom and dad insisted that the benefit of the three level system was best. As it turned out their timing was excellent. Within 18 months my mom’s health began to take a dramatic turn for the worse. Dad is a trouper but his failing memory and hearing loss often leaves him somewhat befuddled.
Anyone with aging parents knows about all the daily decisions that I faced. Can anything be done to make their home safer to help prevent falls, burns, or other accidents? Do the bathrooms have grip bars? Are the throw rugs slippery? What in-home services does the facility offer? Asking these questions directly to my parents usually didn’t generate helpful responses. For quite awhile their contention was that they could handle everything even when that was not so. Finally, I had to just go ahead and take the necessary steps.
Older folks often suffer from poor nutrition. Meals are skipped or poorly planned. If the person’s eyesight is failing or gone, even the heating of meals becomes a big challenge. Luckily, the facility where my folks live has a few dining options so two of the three daily meals are taken care of. Breakfast at home or a light lunch doesn’t create an insurmountable obstacle, at least for now.
Next on my list were financial issues. Again, some foresight proved very helpful. Various health and legal directives were up to date. What about paying bills and taking care of taxes? I assume that this can be an area of conflict, particularly if the relationship between parent and grown child isn’t the best. The fear of being taken advantage of is very real for seniors.
Careful explanations of the consequences of missing credit card payments, utility bills, or tax problems are required. My dad was more than willing to turn almost all of that over to me. I now can interact directly with their investment counselor and make decisions. After being added to the checking account I can pay bills. My dad still wants to receive copies of the bills and statements so going paperless hasn’t happened yet.
One the biggies I have yet to deal with is the taking away of the car keys. From discussions with friends and what I read in various blogs, I know this will not be fun. My mom has been unable to drive for a few years due to increasing loss of vision. So dad is the one who takes her (and himself) to all the doctor’s appointments, food shopping, and all the errands of daily living. I check his car every time I visit for new dents or scratches. So far so good.
When he begins to forget enough to become a danger, or has an accident, I will have to step in. Their community has constant shuttle and on-property transportation but it will be a major withdrawal of independence when the car keys disappear.
Each parent takes multiple pills every day, so the management of that can’t be left to chance. I have met with their family doctor and I do have the legal authority to intercede if needed. But, there is no one to guarantee that the right pills are taken, at the right time, and in the correct dosage. I am watching for signs of trouble and will have to find a solution when that step becomes crucial.
Memory loss comes with age. Already I sometimes have those frustrating “senior moments.” Both parents were having issues in this area that are becoming worse. In my mom’s case, she broke her leg and ankle about 17 months ago. That put her in a hospital for almost two weeks and then into the nursing center. She doesn’t remember breaking her leg. I assume some of that is the brain blocking out bad experiences. But, it is still amazing to me that whole episode is not real to her at all.
Dad has almost no short-term memory either. Luckily, he is a list-maker. His daily to-do list is written down in great detail in a notebook he carries with him always. Within the last year I have taught him how to feel comfortable with using a cell phone. If he gets lost, or has an auto breakdown, I’m hopeful he will call me for help.
The broken leg really accelerated mom’s decline. She is confined to the health center, except for regular trips to the hospital for other issues. While she is allowed to “visit” their apartment, she will not be allowed to return there to live. That awareness, along with her almost total blindness have left her with little to fill her day and mind, so the slippage continues. Dad spends most of each day sitting in her room, reading the paper, or discussing doctor appointments, but that is causing his world to close in too.
I’m afraid this is not a post that will end of a burst of optimism. Dealing with aging parents is mostly about facing reality. On several levels my folks are blessed. They have the financial resources to be in the facility they are. They have family in town who visits at least once a week, sometimes more.
After 63 years of marriage they remain deeply in love and committed to being there through good and bad. Mom and dad were there for me. It is my time to be there for them.
I will feel eternally grateful that I was able to help mom and dad during the last few years of their lives. It wasn't easy but it was important.
Giving up the car is a big one, but it must be done for the safety of all. One solution: My mother-in-law gave her car to a younger woman in her facility in return for rides when she needed them. Worked out for both. Anyway, best to you and your parents, and may it all go as smoothly as possible.
ReplyDeleteGiving the car to someone else in her facility is an excellent idea. New services like Uber and Lyft have added another option for those without an automobile.
DeleteMy father gave his car to his great-granddaughter; she needed a car and he didn't.
Both my parents are gone now, but the message of this post still remains: helping those we love when they need it most.
We are dealing with that now. My parents were in an independent living situation and refused to sign up for assisted living or long term care. We hired 24/7 care for them to but the aids really aren't qualified to do much more than clean and bathe them. Then my mom got pneumonia and my dad was found to have multiple fractures in his spine. We did get them into long term care but now even though we know where the money is there is no way to get at it to pay the bills because my parents were very secretive about that. My dad now has dementia and mom cannot walk. We have no idea how we will pay all the bills. The lesson I have learned is to make sure one of your kids (if you have them) has all your financial records as well as a way to access the money. Power of attorney is NOT enough. My brother has that and still cannot get into the accounts. Also, make a plan to go into assisted living or at least get on a list so that when you are ready they will take you.
ReplyDeleteTwo very important reminders, Roberta. My parents established a trust 25 years ago, so when the time came the financial management was easier. Almost two years after my dad's death I am still managing the remnants of the estate for the benefit of the three sons.
DeleteWaiting too long to apply for an assisted living and nursing care facility can be a very serious problem. What you don't want is one or both of your parents to be too far gone to be accepted. Then, you are left with the option of having them spend their last few years in some sort of public facility or in your home, with full time nursing care. The decision to move to a nursing home cannot be left until the moment it is needed. Then, it is too late.
I am now 74 and my husband will be 69 shortly. We still have the family home and the outdoor stuff is essential to his emotional wellbeing. I am ready to downsize and get on one floor. And especially to get into the queue for a retirement home with the three levels of continuing care. His parents did that and went directly into the nursing unit where Mom died withing 3 weeks. At 97 years, however! Dad will be celebrating his 96th birthday next week and his been well cared for for nearly 6 years with memory lapses but still enjoying life, albeit getting more and more frail.
ReplyDeleteHow old were your parents when they went to the retirement home? I know all too well the risk of waiting too long and not being eligible when needing the change. Like all the rest of life, it is all a gamble.
Thanks, Jeannine
Mom and dad moved from their single family home to Friendship Village, a three-level retirement community in Tempe, when Dad 80 and Mom was 77. Mom had started to lose her sight so they moved a bit earlier than originally planned.
DeleteThey lived in an independent cottage on campus for 2 years before mom started to go down hill rather rapidly. She went directly into the nursing care facility for the last 2 years of her life and died at 83. Dad managed to live in assisted living until his death at 91.
One of my dearest friends had a 2 year plan.. at the end of that time, at age 75, she would be ready to move into Friendship Village. She was in excellent health at the start of the plan.Well, a year in, she developed viral meningitis, and then non-hodgkins lymphoma.. she came close to NOT being eligible anymore, for the 3 tier living situation that was to be her safety net.She's been divorced for many many years and no kids. Well, a happy ending: She fully recovered from both bouts of illness and immediately bought in to a lovely Casita in the Village. She LOVES IT! She works part time, we meet for lunch at her restaurants there, or at the Mall.. she uses their transport to go downtown to shows and the Opera.. it's been a great introduction, to me, of how we can age gracefully..I'll be keeping it in mind. My own Dad is in a Senior subsidized apartment with my step Mom, in New Jersey. So far so good. My in laws stubbornly kept their very large home and had so many problems,till eventually,they did pass .. it was very very hard on the family when they refused to make different,safer arrangements. I learn what NOT to do by watching my elders,too.
ReplyDeleteInterestingly, my parents lived at Friendship Village but rarely took advantage of all the activities and transportation options while they were still healthy enough to do so. Dad refused to use their bus system. Both would take us to a Christmas concert but dad wanted to leave after 3 or 4 songs. We did join them for lunch several times a week, but otherwise they rarely left the Casita.
DeleteBetty and i will have one driving principle when it is our time to make that move: don't wait so long that we put a big burden on our kids. WE know they will be there for us whatever comes, but if we can take the drudgery part away from th4m, that would be wonderful.
My hope for my old age is that I can be proactive about the necessary arrangements. We just celebrated my widowed mother's 84th birthday today. She's adamant about staying in her home although the 2 acre yard is really more than she can handle any more, but don't say that out loud! She is still able to drive 13 miles to town; going to the grocery store is one of her favorite outings. She was never a good driver and now she's worse and thank goodness we live in a rural area. She's very contrary and admits that she likes to say "no"; there's a lot of attack and resistance. When an offer of assistance is made, she refuses and when the offer isn't made, she's upset. I may choose to be more reactive than proactive with her.
ReplyDeleteDuck and cover? That sounds like the safest approach for now.
DeleteSeriously, at some point her situation will turn for the worse. Hopefully, she will allow you to do what you must.
We were fortunate, if you want to call it that, to have both our parents for fairly quickly when they deteriorated enough. But up until that point they were surprisingly good. Dad went much earlier than Mom due to cancer, and died at home after hospice was brought in. Mom continued for 17 years in a three tier place, which was wonderful for her, and only ever went beyond the first level for about two weeks. She was a resilient Irish woman.
ReplyDeleteThe important thing was that I managed Mom's investments, did her taxes, made sure all the legal paperwork was in order, and most importantly, kept the financial wolves from her door. The fact she wholeheartedly wanted to work with me to insure she was not a burden to her kids made all the difference in the world. I feel for those whose parents are not as agreeable.
Compared to many you did have a good situation,. My parents' willingness to allow me to handle their finances after they established the trust made a huge difference.
DeleteIf my ex-MIL lives until June 14, she will be 101 years old. She still lives alone in a huge home on a hill with a very long drive way. She was born in NJ, only has an 8th grade education and liked her whiskey sours and packaged coconut cookies. She worked briefly during her son's 4 years of college and didn't learn to drive until she was 67 because her husband got cancer. If you look at a list of dos and don'ts, she would fall into the don't column as far as her habits. Her husband smoked unfiltered Camels for years and since she didn't drive she was exposed to his smoke almost daily. She dyed her hair back when hair dye wasn't regulated like it is now. She has always permed her hair and worn nail polish. My point being that my mother died about a year ago at age 86 and didn't do any of those things. She ate from an organic garden before it was called that. She worked doing farm chores, was active in her church, never smoked or drank so she followed the Do List without realizing it. Although she also lived alone she was showing signs of dementia at the end and needed my sisters to drive and do her financial upkeep. It still makes me chuckle when I see the studies about longevity.
ReplyDeleteI am pretty sure your ex-MIL is an anomaly, with her ability to survive this long explained by genes and not her habits! But, for whatever reason, more power to her. Being 100 is still an impressive milestone. Too bad Willard Scott isn't still on TV wishing happy birthdays to folks who make that mark.
DeleteWe are now sharing care of my MIL (93) with my SIL who lives close. as we are both retired and we get a break and some adult sitting help it is not too bad - and only since November. It is harder than it looks - kind of like having a big 3 year old. She is pleasant to be with but needs continuous care and watching. No dementia - just poor short term memory and on O2 all the time.
ReplyDeleteWe did make one error. Mom was in an independent living facility for about a year. What we failed to do was to have a plan in place when she could no longer stay at the independent living place as it did not have a tiered offering. We ended up having to move her out in a crisis mode and as result we had no choice but to do in-home care in our homes.
I wish we had developed a plan so we could have moved her into an assisted living place which would have given us time to really figure out if we could handle doing the in-home care.
Once she go here with family there is no chance of moving her into a facility without major angst so we will have her for as long as it takes. She is really still pretty strong and no ready to go yet. It could be years- I'm not sure we were ready to handle that prospect. I think her kids thought she would go fairly soon after leaving the independent living place but that is not happening.
We will manage - as we have to - but this is not how I wanted to spend my retirement.
Your story is an important one for folks to read. Thanks for sharing your honest feelings.
DeleteNone of us knows what the timing on anyone's health with be. A sudden decline in mental or physical health can throw the best-laid plans into the trash can and or uncover a problem in planning.
What is the answer? I have no solid answer. It is easy to say make the moves for the elderly early. But, who knows when that is?
Thanks again, Bob
For what it's worth the division of couples is a sore subject with me, even as I understnad it on some level. My mom in law was to go to asssted living from independent and be separated from my dad and it was the night before the move that she passed away. It's almost like there should be accomodations for mixed groups or the understanding that if you can afford it you can get private care to stay where you are.
ReplyDeleteExcellent point. While the assisted living arrangement where my dad ended up did allow for couples, nursing care rooms never do. Dad spent many a night sleeping in a chair in mom's room during the last months of her life.
DeleteBecause of the level of constant care involved in a nursing home environment I can understand the inability for two people to be together on a permanent basis. But, that should not be the case in assisted living. Separation is the final indignity.