In-laws live in another state away from adult children in other states. Recently there were some medical emergencies and there was no plan in place. How and what can we do to make them realize they need help even though one of them stubbornly thinks they can do it all themselves. None of the adult children feel confident in their parents abilities to be by themselves. What and where to start?
You should maybe consider paying for them to consult with an elder law attorney to create this paperwork and they can ask the lawyer anything and he'll give them unvarnished answers and a dose of reality -- like if something happened to them with assigning a PoA then it ties the hands of their children to legally manage their care and they'd have to pursue guardianship through the courts which is expensive, and the only other option is to become a ward of the county.
In the end, all you can do it give them accurate information so they can make informed decisions, assuming they have enough cognitive clarity to understand. Mild memory impairment is not as big an issue in creating legal docs, but impaired ability with reason and logic would be. The attorney would take each of them separately and privately perform a brief interview to assess their abilities to comprehend what they'd be signing, so there's no concern for coercion or abuse.
Also, you can have them read some of the posts from this forum written by distraught and burned out children who are valiantly attempting to help parents who didn't prepare for the inevitable. I was raised Catholic so I'm fond of using guilt because it is a potent motivator in some cases ;-) Wishing you much patience, wisdom and success.
Will they consider AL? At least there is someone there to help the spouse that is not in the hospital etc.
Get all Paperwork necessary together. Getting a stubborn parent to get a POA can also be challenging. When they believe they can do it all. That was one of my most challenging aspects with .y aging dad. His refusal to give control of his health or finances even if he knew I would not be able to do anything unless he was declared incompetent.
AL is usually also a absolute no. They don't want to give up their freedom or spacious living.
The hospitals generally won't help you place them. Our neighbors mom has been in hospital 9 times every thing from broken bones, burns, etc. While it was suggested for AL coerced or forced choices to an elder can equate into elder abuse. It takes an evaluation that confirms the elder is not competent to make a good decision.
I would just keep suggesting to your parents you love them, and worry about them and you would feel better if they would consider moving into a place where they could have a care tea. In event of emergency. You could consider an emergency button.
Best wishes.
Otherwise the children need to help them with shopping for a new place and moving. I would guess that none of the children are offering to move closer to them and I wouldn't anticipate that. It feels the same for the folks. They likely want to remain in their home.
Could they bring in help? Remember do it legally by talking to an elder law attorney to prepare caregiver agreements first. Folks probably will not agree to that either. It is EXPENSIVE! Maybe they are situated that they can pay for that or they have a long term care policy?
What can help in the immediate future is to find a geriatric care manager. They could check in on the folks on a regular basis. If there is a hospitalization they can monitor that situation and their needs. https://www.aginglifecare.org/.
Good luck, this will be a journey. Do not expect the folks to do anything you wouldn't want to do.
The mother is back now. She did have a helper come in the afternoons most days, but that has ended. So she's all alone now. I guess her children are waiting for the "event" to happen to force a permanent change. Their mother is very stubborn. This is a common tale.
Maybe mom feels railroaded in the group meeting. Get her alone and ask her what kind of things might help HER take care of dad - even though that might not be the case. Perhaps she would admit a little house cleaning or laundry help would be nice. It might get your foot in the door with her.
If mom gets argumentative, the child calms her. Stay in the home with them long enough to get the ball rolling. In the future, just add another hour or so that mom won't notice much and will be more helpful to dad.
It sounds like a change of location - for family or aging parents is necessary. Or find a good person (care manager, as I am) to be the family's 'eyes and ears' as needed. Many people cannot afford a case or care manager. And, I believe case mgrs are licensed (social workers or medical social workers). I am not licensed so I call myself a care manager - I manage all kinds of care (hire and supervise caregivers, work with attorneys, empty out entire large homes, pick up rush prescriptions . . . ) and work with out-of-state (or local busy professional family members, or those who travel for work.
People / family 'try to reason' (as you know) because they do not understand dementia and they 'think' / 'react' as if they are talking to the parent they knew before dementia. It is a very difficult, challenging situation - even for the best or more experienced of us. I always say DO NOT ARGUE. Argue, change the subject and do what needs to be done.
I appreciate your response.
Gena / Touch Matters
It became more of a problem when FIL developed end stage dementia and kept MIL up all hours of the day and night. She stopped feeding them both. When BIL visited, both were emaciated. He arranged meals for them and cleaned up their home but no day-to-day caregivers. FIL ended up dying later that year of dehydration and organ failure.
MIL ended up in hospital a year later with urosepsis. I "think" social work became involved and may have involved authorities since we can never get a straight story from BIL. He was "told" he needed to put full size refrigerator, full size stove, and hospital bed in their condo. They had round the clock home health aides. Nobody was allowed into her condo to visit per home health aide.
Now, MIL has 2 fulltime caregivers that take runs living with her during COVID. We call her primary caregiver for updates. We can see MIL via Facetime.
All this to say, you can arrange "services": meals, housekeeping, lawn service... The most important "service" that aging parents need is daily check-ins by caring family and friends.
If they know their neighbors, offer to pay someone to drop by each day and observe the living situation and report back to you. Would be some extra cash for an older teen or college student who is mature enough to check things out. You need some eyes in the room on a regular basis.
There are Care Managers that can be hired. Not inexpensive. And I would think "Iffy" in an emergency unless they are contacted right away.
(You do not mention In-Laws in your profile so not sure what their overall health is)
A move to Assisted Living or even Independent Living would have a "community" around them so if something happens they will not be alone when it happens so care might be more prompt.
Moving them closer to one of the other family members might be an option. Or less likely a family member moving closer to them. (neither ideal as the "lucky" family member may become an unwilling caregiver.)
another option would be to hire caregivers that would come in a few times a week to check in on them do light housekeeping, fix several meals if needed and in general make sure they are alright.
(this is with the assumption that there is not a diagnosis of dementia with either or both. If there is then more aggressive measures should be taken.)
IF no one has POA for health or financial decisions that should be done.
Does your husband or his siblings know what the health care wishes are of the parents? If not that should be discussed. A visit to an attorney that is versed in estate planning, elder law might be in order.
* Hiring a care / case manager may be expensive although you need someone to 'manage' care - be it screening, hiring, supervising caregivers - and letting you know how they are doing. I provide a written assessment when I work with family members - who are either out-of-state, in the area professionals, with their own families, or who live close by and travel for work.
PLEASE READ below "Donna F777" -
she knows what she's talking about and I concur 100%.
Gena / Touch Matters
In my support group we talk a lot about “lies of love”. In order to get assistance or services we’ve told our loved ones lies. Sometimes they accept different ideas. One person was able to bring in a part time nurse saying the nurse needed the work so they were helping her. One person hid paperwork that needed signing in another stack of bills so they could get access to finances to pay the bills. Thankfully many financial things can be managed online. Tell them someone is knew in the neighborhood and wants to be their friend. They don’t need to know the person is being paid to visit. I started managing the cash in my husband’s wallet so he couldn’t over tip waitstaff at restaurants. (He once left a $100 tip for 2 cups of coffee!) You do what you have to do to make sure they are cared for. As long as it’s done out of love (and the rest of the family understands) there is nothing to feel guilty about.
Don't treat them like children. Sit down and say "You have had some emergencies lately and we need a plan in place in case there is a next time." Maybe plant a seed about them moving closer to one of the children. "What do you think about moving closer to one of us? That way if you have this type of emergency again, at least one of us is close by. No decision now, just think about it." My daughter has worked rehab/NH for 20 yrs and she says "let them think they made the decision". She used getting a bath as an example. She doesn't say "do u want to get a bath" because the answer is no. "Time for a bath" may get a no. When she gets a no she says "Mrs M wouldn't you feel so much better with a nice bath and clean fresh clothes" Mrs M agrees because she was allowed to make the decision.
TG my MIL had good neighbors because she lived 16 hrs from us, 12 from another son and 8 from the son who held the POA. But I don't think we should expect neighbors to help out. These neighbors could easily be taken advantage of and we have read of this on the forum. One OP the neighbor started relying on her too much and the woman needed more help than the neighbor could give. Thats when family needs to get involved or u call APS.
She used to be an immaculate housekeeper, but I have noticed a lot of things that are no longer as clean as they were. She told us she was down to 89 pounds at her doctor's visit (she is 5'6"), and her doctor about had a fit and told her to gain weight. She claims she is over 90 pounds now, and says she eats well, although there never appears to be a lot of food in the house. She still drives a 21-year-old vehicle.
She keeps all her financial info private, including not wanting my husband to see her will. We think she probably cut us out of a lot. It's her money to do with as she wishes, but we think maybe the mega-church she attends talked her into giving them a bundle when she passes.
If she has any dementia, she hides it well, because she still seems very "with it". Her memory is probably better than mine. :-) Right now she has neighbors who keep tabs on her, and they have our phone numbers. So, there isn't anything we can do until a crisis occurs. The idea of dealing with all that fills me with dread. I wish she would deal with her big house and the stuff in it while she still can.
Consider and respect their need for independence. Listen. Respect their decisions. Implement and honor them - do not interrupt. Virtually any course they choose can be followed.
So many people are not given the grace to make these choices for themselves these days.
Make a list, of all accounts/ get signed up for online banking,
make certain that you’re able to get information by having your loved one giving permission for you to talk to the various companies. I hadn’t done that so I was stonewalled a few times. But since I have all the passwordsSecurity phrases etc. I was able to get the information I needed
Make sure you have Social Security numbers ,Medicare numbers, insurance numbers , doctor numbers , basically all the information that you will need to transact with.
I took over paying the bills probably three or four years ago, should’ve done it sooner.
and don’t take your loved ones word for how well they’re doing. My mother wasn’t doing as well as I thought. I thought she was handling her medication pretty good. Even when I came to visit I thought that. Not until I got her placed into an assistant living but I realize I was wrong.
Amazon is your friend along with Instacart. grocery deliveries.I also used Costco.
Contact your counties aged and disability departments. They will have all kinds of information to help you along this journey
I started with having in-home care come in, and yes she sent them away, and yes she paid for someone not to be there, but I persisted. Eventually she accepted it.
I was able to move my mom into an assistant living. It was difficult she didn’t like it, she made waves. I have just recently moved my mom , here by me. What I did not do , that I wished I had, was toured some of the assistant living places here. I had always known I was going to have to move my mom from where she was , when she ran out of money. I found there are a number of good assisted-living‘s by me , if you self pay for one, two, or three years , dependent upon the company, will not make you leave or make you share a room, whatever there company policy is, when going on to Medicaid.m I’m lucky I found one that was only a year.
it’s a process…
Inite them to live with you.
Also, prepare a list of all the legal documents, medical release forms, doctor and medication lists, etc. that might be needed. Then sit down with the parents and review the list. Tell them that all of this information will be needed at some point and someone, doesn’t have to be you, needs to know where to find the information.
When Mom ended up in the hospital with a broken hip Dad and I searched for a week to find the checkbook she had hidden away! After that I gave them the information about drawing up wills and POAs. I told them that SOMEONE needed to be trusted to act for them if they were incapacitated. It took several years but they finally did it.
Georgia has their own department on Aging. Or Area Agency on Aging.