Hello:
Since the pandemic, my 82 year old mother has been isolating and not being very active. She lives alone in a large home, and as a result, her short term memory is fading. The doctor said it's depression because the memory loss is fast and she is aware she is forgetting things. Doctor said that if it were Alzheimer's or dementia, the memory loss would be slow and she would not know she is forgetting.
Mom is still independent, as she still drives. Pre pandemic, she use to have a regular schedule of exercise class at the senior center, bible study, and church. Now she is just going to church and we are in the process of helping her get back into her normal routine. I took her to the exercise class yesterday which made her feel very good. She said she will be going back on her own.
My maternal grandmother and grandfather, at some point, had a similar memory loss, but not dementia or Alzheimer's. My mom and aunt took care of them. My mom needs help with finances and I also see decline in other areas like food choices, home care etc. My husband and I are thinking of selling our home and building a 1200 square foot ADU on her property as she has the room, and us move into her 2800 square foot home. She thinks this is a great idea because she never wants to go to a assisted living, nor does she want to move off her property and away from her familiar surroundings. We also know that by doing this, we will be signing up to be her caregiver for life. We just want to make sure we are going into this with our eyes open.
Can anyone foresee any issues with doing this? Thanks in advance for your answers!
Not a problem with mom but, could be an issue with renters.
I think taking care of your loved one is great, as long as it works for everyone. You all obviously have had good relationships throughout life or you wouldn't be considering doing this and that makes it doable. You have been blessed with a mom that planned and knows you all matter.
Best of luck with this new season in your life.
2. A neuro-psychologist can do thorough testing (2-3 hours) as opposed to the mini-mental test with about a dozen questions routinely done by various providers. If you do this, ask up front will that doctor be doing the test or someone else like a social worker... only accept this test by the specialist. Here is a presentation that can give you insights.... https://www.parkinsonvoiceproject.org/ShowContent.aspx?i=1960
Even though it relates to Parkinson's Disease issues, he also explains what to expect from the provider. My husband was tested and we received insights how to deal with the specific issues that were identified and told he did not show signs of Alzheimers (AD) or Lewy Body Dementia (LBD) but could not promise he never would. I then asked to be tested because of concerns about memory issues and was told how to address mine which were identified as stress/anxiety (which I expected) and I also did not presently show signs of AD or LBD.
Odd behaviour started 10+ years ago. I took over her finances, meds, etc. But she was certain her mind was absolutely fine. She expected to rule the roost.
She’d come over as I was getting the kids ready for school, eat their breakfasts and complain that I wouldn’t sit and chat and eat with her. I was busy trying to make sure nobody missed the bus! (and had something to eat) She wanted to visit THEN and was angry about the school bus’ timing.
She’d invite friends to her home and bring them into my home when they were hungry.
She’d accuse us of stealing everything she misplaced.
She’d de-clutter her house by entering my house when I was out, covering my kitchen and dining room tables with stuff.
She’d chastise us for being out too late.
She’d think our cars were someone else’s and accuse us of secretly entertaining without her.
She’d be certain each and every one of our guests really came to visit her, not us, and interrupt as we hosted.
She’d come over gunning for a fight about something - anything - if she was in a bad mood.
She’d come into our house and go through our things.
She’d pound on our bedroom door as we slept, yelling about some perceived slight, regardless of the time of day or night.
As she worsened and she had to admit she was declining, she’d rage, accusing me of causing it.
She expected 24/7 access to me. We tried in-home care for a few months but she raged and tried to block the PSW from entering. I was to do everything for her.
Those are just a few examples. We have no family history of dementia. Hers came as a shock and the stress of caring for her nearly killed me.
It might be a great arrangement for both of you. Or you may find yourself tethered to an angry, delusional, demanding stranger literally 24/7.
One final thought: please consider a 2nd medical opinion.
1. See an Elder Law Attorney, (already mentioned)
2. Your Income Tax advisor,
3. Establish some boundaries. For example, don't just walk into each other's house without knocking. My mother's lack of boundaries helped break up my last marriage.
4. What about furniture, silverware, knickknacks. You will be moving into HER house she almost has to have feelings about what is in it. How will she feel when you paint the front room a color she hates?
5. I am 87 and as all my friends die, many of them younger than me, you do feel depressed, because you are never going to get better, younger, have less pain and wrinkles. This makes me smile at saying one of my girlfriends said. "We always have something to be grateful for, as for me, I am glad wrinkles don't hurt".
6. Will she expect you to be her sole source of entertainment. For example, if you have friends over, will you be expected to include her EVERY time.
It is doable, Personally, it is not for me. I wish you well, and be sure everyone is on the same page on all of these practical matters.
I'm not saying your mother has it, or will get it, or some other care- intensive disease, but that you are riding your whole plan on the presumption that she will not progress to dementia or something else, and I don't think you have adequate knowledge of that.
In my view, your plan should include the possibility of her needing more care at some point - maybe a back up plan to that effect. Be sure you calculate the cost, in all senses, of that possibility. Many people as they age need more and more of the kind of care that would strain the situation you are setting up.
I am 84 and still drive, and live alone and am not depressed though I don't go out much - in fact very little compared to what I did. There are other ways to engage with people. eg. using the internet. I agree with glad that "She lives alone in a large home, and as a result, her short term memory is fading." is not likely the cause and effect here. Therefore, the solution is not necessarily to move her to a smaller home where she has more people contact, as desirable as that may be from several points of view.
If I were to start losing my memory quickly, I would want my loved ones to have me very thoroughly assessed before making any major changes in anyone's living arrangements.
Having said all of that I wish you the very best in what lies ahead. Aging is not easy for anyone. ((((((hugs)))))
As for a alternate plan, we do have that in place. Mom is pretty well off and has the finances to fund alternative arrangements if needed.
Again, thank you so much and wishing you very well.
So consider at some point you likely will need assistance to do this in the long run. Also, might speak with a tax advisor prior to selling your house so you don't give up your windfall to capital gains taxes.
You could always lease your house out so you had a "plan B" just in case while generating positive (passive) cash flow hopefully.
If you have your ducks in a row, sounds like a win for both parties.
We also have another rental, which is a two on one, that could be our "Plan B" if needed. Even so, we are also considering leasing our primary home due to us liking it so much. To be completely honest, if it were big enough to put another home on this property, this is the one we would choose. :-)
If it gets to the point where mom cannot live in her own place, and we can still provide for her at home, then she will move into the main home with us and we will rent out the ADU. Now, if mom declines to the point of needing additional care beyond what my husband and I can provide, the decision will be made to either bring in care or move her into assisted living whichever makes more sense at that time.
Basically, I would be receiving my inheritance early to do whatever I choose to do with it. I choose to take care of mom as long as I can.
Thank you again!
https://danceforparkinsons.org/
Watch the video on the upper left side of the screen, and note how many older folks are participating, whether freestanding, sitting, or leaning on a chair. There are a variety of videos, including one for in home activities, that your mother could do at home when the weather isn't conducive to going to a class.
Accessory Dwelling Units might be unique, not just in terms of concepts but in terms of residential/city/township/county land use. It seems though that this issue has been addressed, but permitting, water and electrical extension, EMS access as well as proximity to your house would be concerns as well as Mom ages. I think though that you've got a good "handle" on what would be necessary.
It might also be worth considering future as well as emergency access, although I suspect that your thoroughness has a plan for this already! A home with separate entrances would provide for direct access by EMS if necessary.
You wrote that this is your inheritance home. I'm assuming the deed is either in your name already, or titled in your mother's name with rights of survivorship to you? If so, succession shouldn't be an issue.
I'm still thinking over the possibilities and scenarios for this arrangement, including property tax issues, so that you get local credits if possible. Do you plan to separate upkeep costs, such as electricity and water & sewer, so that separate billing could be enacted? What about property insurance? Will your insurance company, or hers, cover this kind of building?
What would be the future use for the home after your mother passes? Would you still keep it, including with the extra square footage?
I remember decades ago babysitting for a family which had this kind of arrangement. The large house was sectioned in two units, one for the younger family and their children, and the other for one of the grandmothers. I thought it was one of the most progressive, thoughtful and practice arrangements I had seen.
We actually grew up in a similar situation. My grandparents owned the duplex; they lived on one side and we lived on the other. There was a lot of interaction which benefited all of us, especially we children, as we grew up with grandparents right next door to us.
I wish you all the success available if you do implement this plan. Also, please check your Profile for a private message, in about 1/2 hour. 1:02 p.m.
Best wishes!
All in all, I think this is an excellent idea, and would work well for both your families, even as your mother ages.
of course have to take good care of your mom …
before you build have a full work up on your Mom done. Find out what you are likely facing in the future.... also the mini mental test is not a true test for dementia it is used to find a baseline.
Smart demented people can loose a LOT of themselves and still pass with flying colors. And Less intelligent might fail but not have dementia at all.
But facts help plan. I would get as many facts on her memory problems as you can. Memory exam sound scary but can be a good baseline.
If Mom loves the property, moving to a smaller space may be just what she needs. Helping her retain what independence she can with a smaller space to manage. But be warned.. depression is sneaky, it comes with you wherever you go.
I think regardless of the specifics - the usual aging stages are moving from Fully Independent to Semi-Dependant. This will be an adjustment for all of you.
Mom's comments about never going to 'assisted living' are probably based on fear of the unknown + based on her current way of living + not wanting to change. Understandable.
Alas, we all DO change as we age.
When we need more help to live our life - we need assistance ie 'assisted living'.
That may be in a residential care facility or provided by family/+ aides in a home environment.
This could be your ADU... Where Mom lives but you provide all the assistance.
Just keep in your mind that if/when her needs exceed what you can do, you hire help, or consider alternatives too - as lone caregivers burnout.
Best of luck with your decision.
The doc said that? It makes no sense. Was she checked for a UTI? She may have some other sort of infection.
All memory loss is dementia. Dementia is a catch all term for all sorts of memory loss. Alzheimer's is just one type of dementia.
https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia
Perhaps most importantly, do you have other family members who may question some of the transactions involved? Mother at 82 may be happy about this now, but many elders start to make allegations of theft, fraud, breach of contract (legal or just implied), and other nasty things as they get a bit older. If there are other family members who have dipped out financially over this, you need to think about protecting yourselves and mother if things change in the future.
PS If this all seems too pessimistic, remember that lawyers are trained to look for problems. If nothing goes wrong, you can do it all with a smile and an airkiss. But you can’t fix problems after they’ve happened.
Thank you for this very thorough answer. I greatly appreciate this feedback and will take all into consideration:
I must add when I originally posted this I was at work and left out a few very important details. Here they go:
1. When memory loss started, doctor sent mom for CT scan which came back normal.
2. Doctor then sent her to a Neurologist who did a test of her memory. Not sure the name of the test but I believe it’s the one you mentioned above. She passed the memory test with flying colors. At that point he said he saw more depression then anything else and that she needed to have a structured schedule. since then she have started back to church and exercise classes. Memory appears to not be worsening but pretty much staying the same.
She still drives and is able to find her way around town. She drives to her usual places like church, senior center, dollar stores, post office and grocery store.
I feel that she is still independent but would benefit from having others around. Both her parents, ended up moving in with her and her siblings when they started aging. Neither had dementia or Alzheimer but normal memory loss due to aging.
Lastly, this home where I would be building the ADU is my inheritance home and my name is already on the deed. Fortunately it is zoned for multiple dwellings which would allow us to build an additional home on the property.
I suggest you read several posts that in the Burnout / Care Topics section because *no one* can ever really imagine how intense the caregiving may get. If she eventually becomes bed-ridden then she will be totally isolated in the ADU and you will be tethered to her. You may eventually need to hire a night nurse for 24/7 care.
One very good benefit of a care community is the exposure to people and activities: as much or as little as she desires. My 87-yr old MIL is in LTC in a great facility and is bed-ridden but certainly enjoys the people popping in and out of her room and being wheeled to events and activities, and having visiting musicians and comfort pets come in. She would be getting 0 of that in our home. At your home, you will eventually be your mom's entertainment committee. And, once her memory declines further, she won't remember that you just took her for a day out or played cards with her or that she just ate lunch. She will not be able to keep herself busy (and out of trouble) or she will just be watching tv. Again, I have nothing against in-home hands-on care but -- yes -- you do need to go into it with your eyes very wide open. Pay close attention to what is written to you in response to your question.
My Mum wants to go shopping most days as bored & needs constant supervision.
You also mention mom is needing help with finances plus you are seeing a decline in other areas like food choices & home care, etc. This does not bode well for her future and wanting to live alone, it really doesn't.
FWIW, my mother has advanced *and diagnosed* dementia and still knows she's forgetting things and losing her mind! Doctors who make diagnoses on patients without doing any formal testing are just guessing.
I would get your mom formally tested for cognitive impairment (which is NOT just normal aging OR depression) before you go building ADUs or making any life changing decisions on her behalf. You need to know what you are TRULY dealing with in regard to her mental health. If she is really depressed, fine, then her doctor should be writing her a script for anti-depressants and then, according to his assessment, you should see an improvement in her memory AND in her general behaviors. My mother has taken the max dose of Wellbutrin since 2011 and while it hasn't done a darn thing for her memory, it has improved her overall mood. Exercise also helps with endorphins which elevate one's mood as well.
You can never really go into elder care with your eyes open. There's just too many unknowns that blow up in our faces along that journey, to be perfectly honest. Building an ADU in the yard sounds scary to me for a few reasons; being that close is potentially problematic, imo, and having mom further decline cognitively can leave you with an empty ADU and her living back in her house which you've now moved into. You just don't know what the future holds. But at least with a cognitive exam out of the way, you'll KNOW what you are or aren't dealing with on the dementia scale.
I'd never knowingly sign up to be a caregiver for life to my parents, especially if dementia was at play b/c there is just TOO MUCH involved with it. My mother went from a vibrant and mouthy woman with a ton of outspoken opinions to a wheelchair bound, incontinent, illness ridden person who's a mere shell of who she once was. She can't even understand the English language anymore and tries to speak to her grandson when I show her a video of him on my phone. She thinks he's there in the room with her. No lie. Ergo my point to KNOW what you're dealing with here BEFORE you make any big decisions. Memory Care Assisted Living (where my mother lives) has been a life saver for both of us, literally. I have no idea where I'd be without it. She was diagnosed with progressive dementia via a MoCA exam (15 minute oral test with one drawing to do by hand) in 2016. By 2019 she had to go into Memory Care.
Wishing you the best of luck moving forward, however this all turns out.
Thank you for this very thorough answer. I greatly appreciate this feedback and will take all into consideration:
I must add when I originally posted this I was at work and left out a few very important details. Here they go:
1. When memory loss started, doctor sent mom for CT scan which came back normal.
2. Doctor then sent her to a Neurologist who did a test of her memory. Not sure the name of the test but I believe it’s the one you mentioned above. She passed the memory test with flying colors. At that point he said he saw more depression then anything else and that she needed to have a structured schedule. since then she have started back to church and exercise classes. Memory appears to not be worsening but pretty much staying the same.
She still drives and is able to find her way around town. She drives to her usual places like church, senior center, dollar stores, post office and grocery store.
I feel that she is still independent but would benefit from having others around. Both her parents, ended up moving in with her and her siblings when they started aging. Neither had dementia or Alzheimer but normal memory loss due to aging.
Lastly, this home where I would be building the ADU is my inheritance home and my name is already on the deed. Fortunately it is zoned for multiple dwellings which would allow us to build an additional home on the property.
Is a unit like this allowed in your area? Some Villages, County or even HOA's have regulations about these.
Is there an option where you can make an "in-law" suite in your house with a separate entrance and a small kitchenette?
There are great Continuing Care Communities where she can live independently with many of the activities already on site. And often transportation provided to many local areas for shopping, dining and some even transport to medical appointments.
AND...What does your mom think about your plan? Is this something that she would want to do.
AND ..are you ready to have her live in your backyard? (BOUNDARIES a very important word to learn and enforce)