As a columnist for a newspaper on the High Plains, I often have readers write me that they are begging their parents to "come back home." Many people, after retirement, like to leave our cold winters behind, so they summer up north (often in the Minnesota lake country) and then go to the southwest for the winter months. We even have a name for them – snowbirds.
Not all of these people even come back for the summer. Many make a permanent home in a warmer climate that is easier on aging bodies. There are communities in Arizona that have more people from North Dakota than many towns out on the prairie have in total population. So, what happens when Mom and Dad have lived like this for two decades, and then one of them gets ill or one dies and the other is left alone?
The adult children are in a quandary. They know that their parents have formed a close relationship with the people down south. Most have joined a church. Many have joined community clubs and enjoy community events. This is their home and these are their "people." Yes, they visit the kids and grandkids, wherever they live, but then they are anxious to get back to their adopted home.
However, health issues become a problem as parents age. I advise the adult children on ways to find long distance help through the eldercare locator (www.eldercare.gov) and other avenues. I advise them on how to check references and make sure the folks get as much help as possible. But let's face it – long-distance caregiving is hard, especially when not even one family member lives nearby.
Often the adult children need to travel south to handle sudden hospitalizations or other emergencies. This causes problems with jobs and kids at home. So they beg their parents to come "back home." Parents balk. "This is my home, now. I don't want to leave my friends. I don't want to leave my church. I don't want to live in the cold and risk a fall on the ice."
Then there's the reverse.
I saw this with my friend Grace. Grace lived in the same apartment building as my parents, before my parents one-by-one entered Rosewood On Broadway, a nearby nursing home. Grace's husband also lived at Rosewood, as he'd had a stroke several years before. Grace didn't drive and had been totally dependent on her husband. It was one of those relationships where she hadn't even been writing checks, until he became ill.
I took Grace under my wing as much as I could, considering I was at the time, primary caregiver to five elders and two sons, one of whom has chronic health problems. When Mom was still living in the apartment building, I'd pick up Grace at the same time I picked up Mom and I'd take them both to visit the men in the nursing home. It grew more complicated after Mom went into Rosewood. How much could I help Grace?
Fortunately, Grace had many friends and she also qualified for senior rides so she did get a lot of assistance. Eventually, Grace's husband died. She was, of course, devastated. Her health deteriorated and I found myself on call for her many emergencies. This was extremely difficult for me to handle with all of my other obligations, but I couldn't ignore Grace either.
Grace's kids were caring and did their best, but they each lived hundreds of miles away from Grace, in different directions. It slowly became evident to them when they visited that Grace couldn't continue to live on her own. What to do?
Grace didn't want to move from Fargo. She'd live here nearly 50 years. This is where her friends were. This was home. But her kids couldn't move back here, either. They had jobs elsewhere and their kids were settled in schools. Yet, they didn't feel they could give Grace the care she needed, from such a distance. So, unwillingly, Grace moved to be close to one of her sons.
The family did everything possible to make it a good experience. They found her a beautiful apartment close to their home. She spent much time with them. They arranged for time with women friends she'd met when she'd visited through the years. They did everything possible. Still, when Grace contacted me she cried. She missed Fargo. She missed me. She missed her friends. She missed her church. She was depressed.
What was the right decision for Grace? I think her kids did the only thing they could do. But, obviously, it wasn't a perfect scenario. I'm not sure Grace ever totally adjusted.
So, do we move the folks so we can keep a closer eye on them or do we stumble along with visits and long-distance caregiving? I wish I could say which is best. I tell my readers that both options are imperfect and will present difficulties.
But is that any different than deciding if elders should stay in their home when their home is lonely because the neighborhood has changed, and it's impractical and dangerous as the only bathroom is on another floor as opposed to moving to an assisted living center – even a highly rated, wonderful center – with lots of socialization and good food and available help, but which means leaving many beloved belongings and a familiar way of life? Which is right?
What is the Solution for Housing Elderly Parents Who Have Moved?
The answer? Both and neither. Every situation is different. Every family is different. Every person is different. You will face resistance no matter what you do, and your elder will likely be unhappy, for at least awhile, no matter what you do.
So, do you move Mom and Dad back home? If possible, plan early, and talk with them about it before significant health problems or a death. When you visit them, say, "What do you think you'll want to do if you get so you can't be alone? Maybe we should drive around and look at what this area has to offer and compare it to back home."
As with all things involving your aging parents, communication and starting the talks early can make a lot of difference.
When they visit you, take them around and show them the great new assisted living complex being built in your town. See if they have any old friends still living in the area that they can re-connect with. Show them the best you have to offer.
Change is difficult for most people, and it seems to get harder for many as we age. If you throw dementia into the mix, you'll really have a challenge. Often you can talk and agree and all is just cozy and nice during the early stages, but when dementia happens, or a heart attack, or a death – in other words when real life happens – they may totally change their minds, or even deny saying they agreed to anything.
Aging may not be for sissies, but neither is caregiving. You will have a challenge no matter what decision you make. You may have to make the decision for them, and they won't like that. You'll second guess yourself all the way through. But, as with all other things in caregiving, if you make your decisions with the best in mind, for all involved, then that's all you can do. Everyone isn't going to be pleased all the time. All you can do is all you can do.
So make a decision and cope. Be kind. Be thoughtful. Realize the elder has choices and some of those choices may lead to decisions you don't consider right. Talk it over with a spiritual advisor if that helps you, or a counselor. Talk to other caregivers so you can share your story with people who understand. And then do what you have to do. Let your elders stay where they want and do your best to deliver long-distance care, or move them closer to you and help them adjust as much as possible.
Your best effort needs to be good enough.