This may work for parents who aren't extremely stubborn! My MIL is not one of those people though. She believes that if you put a loved one in a home, no matter what home it is, especially a NH, then you don't want to fool with them anymore. She absolutely refuses to even discuss the possibility. If the words nursing home are even brought up, she'll adamantly say she's not going. She's been to rehab twice and the second time she was on the phone with dh, telling him "you're not putting me away!". I don't know what we're going to do. She can't keep staying in her own home for too much longer and living with us is not an option. She'll have a Medicaid transfer penalty to deal with when she does go, so she's in a pickle. And in my state, even if she didn't have the Medicaid transfer penalty, Medicaid doesn't cover an ALF, only a nursing home. I don't know that she needs a NH right now, but she at least needs an ALF right now.

It is often hard to convince parents to move into an assisted living. However, there are some misconceptions about these facilities which make it harder to convince them. Also, due to doubts and stubbornness brought about by aging, they refuse to move in. But if their condition requires them to go to an assisted living home, there are ways to "convince" them, not "force" them. We can start by hiring a caregiver who would do the chores but not assist them in daily living, by doing this, you can introduce long term care services and make them realize that life is easier with the aid of a caregiver. You may also talk to someone that your parents trust so much, to convince them. If all else fails, we can still gradually discuss to them the importance of moving into a skilled care as they age, just keep your patience. Don't force them because they might feel unwanted. As days go by, they may be able to realize your point just like a thread as it unravels, they may consider moving especially when they started to experience the difficulties. Like when they notice having difficulties with walking or doing other tasks, and they can no longer bear it, they will seek assistance and will finally surrender to the idea of moving into an assisted living.

POA is good for folks who have certifiable confusion issues - AKA dementia or AL, but not good for forcing someone to get help if they can't be proven incompetent. Most POA are only good if the principle is incapacitated. My father, who is living alone but would be much better served in Assisted Living, can't be forced. It's going to take a debilitating injury or illness to force the issue, I'm afraid. No amount of leading up to it or talking will do it.

Some places give bad names for elder care places. But we take pride in listening and being active with the clients! Some people fear they get treated badly once they get moved in, and not EVERYONE is like that. There's going to be bad choices that CAN be made, but if you take a lot of time in making sure you find a GREAT one, the decision can't be wrong!

Maggiesue, My question is how do you get her to sign it! My MIL is 96 and mentally ill. She's very smart and has been institutionalized for a year in 1960. She received over 100 electric shock treatments in that year. She WILL not allow anyone except us , of course, to come into HER house OR will she leave. Should I talk to her Dr & see if he can help?. She listens to him.

I found this free ebook, its a great help for transitioning into assisted living care! It's called The Journey of Aging... check it out. Definitely worth a read...

I will be facing this difficult decision someday with my mother and it is with so much guilt and despair. I have Durable Power of Attorney of my mom, but I am so reluctant to use it when the time comes. She wants to live independently as long as possible, but then when the time comes to move in with me, which cannot be possible. I pray she dies peacefully in her own home then to have to move her to assisted living or a nursing home. What good is longevity if there is not the quality of life seniors so desperately want?

Elements of all these stories are familiar to me. We struggled for quite a while with how to move my 82-year old mom out of her house into the dementia care unit of an ALF. She has had dementia/AD for the past 6 or 7 years and had gotten quite paranoid, combative with my dad, stubborn, etc etc. Since for years she had been threatening to "move out and get my own place!" (but constantly accused all of us of being "in cahoots" to "put her in a home"!), here is the storyline we used: My dad's twin sister was having a few health issues of her own, and my dad wanted to travel to see her. It was winter. So we told my mom that dad had asked us to look for somewhere where mom could be safe, since it was winter and if there was a storm or a power outage she might not be safe in the house. Once we knew where my mom was going to be, I went to their place on Move In Mom Day, and said, "You know how you've always wanted to move out of here and be on your own? Well, what with Daddy having to travel, and it's winter, we think we've found you a very nice apartment in a safe community." Mom: "Really? When are we going?" Me: "Right now - get your handbag and coat. It's just a short ride." When we got there, she was thrilled -- not what we expected! As a family, we had set up a number of scripts to reinforce our storyline. Sort of "if mom says x, we say y"). Once she had seen the furnishings that were provided, we said, "Yes, but it needs some of your things, Mom - some of us can go pick them up, and you and I can meet the other people who live here." Note we never said "back home", and we never implied that the move was temporary, or that she could change her mind. We made two or three trips during the day, bringing in her favorite chair, a chest of drawers, pictures for the walls. Well, we were very lucky - mom was in a good mood that day, the story worked, and it did help to ease the transition. Of course mom took a few weeks to adjust to her new apartment, wondered what her mom and dad were doing "back home", and what's with all these "old people who live in this complex, anyway?" The change didn't help with her dementia or her hallucinations, but at least now when she says that people are taking her stuff, she might be correct - there are a few kleptos in the community (who I'm sure think it's their own stuff). The good news is that over time it's entirely changed her relationship with our dad - she no longer refers to him as "that guy", and no longer seems to remember how much she couldn't stand "that man" when she was living in the same space with him. At the same time, my dad has seen how being in a community can be helpful, and that you do not lose your independence or autonomy, and we are now looking at a more active adult retirement community for him. I think the lesson we learned is to try as many approaches as it takes, search for the one thread that will help unravel their ball of fear and anxiety about this big step, build a story around it that everyone in the family can stick to, and realize that even someone who is hostile, angry and stubborn in an assisted living community is safer than they are isolated in their "own home."

Any advice for us? My mom was unsafe at home and so after a fall and a pest infestation, we got her out of the house and then took her to an ALF after a night at my sister's (without her prior knowledge due to her absolute refusal to go and feeling that her daughters should be taking her in). She is livid and feels betrayed and abandoned. We have been told to limit our visits with her to give her a chance to integrate into the community there. I am afraid she will just continue to get madder and she has a tendency for vindication and holding a grudge (she has "written off" 3 of my sisters. I am afraid she will continue to get so mad that she won't adjust or forgive us. Any suggestions???? Sound like someone you know???

JDay; Good post. I'd like to add that not only are seniors putting themselves in harm's way sometimes but they are shutting themselves off from having a social life in the remaining years of their lives. Take my mother for instance. She thinks that staying in the home is maintaining independence but since she needs someone to be here 24/7 what independence does she have? She hardly leaves this house except for dr appts and the occasional hair appt She's a virtual recluse and so am I as her 24/7 caregiver who moved across country givin g up my job and boyfirend to "help her". Her friends rarely stop by.They call a little more often but not often enough. If she were in a NH or other type of skilled facility, she would be around people her own age and have activities. That would enable me to be around people my own age and pursue MY own activities again :)

Dear Connie,

As a staff member of an Assisted Living community, I can tell you that what you are struggling with is the most difficult obstacle all children face regarding their parents - convincing them that they need to make this move.

Seniors have an illusory perception of their independence, meaning that they think they can only be "independent" if they are still living in their own home. Contrarily, they are limiting their so-called independence by leaps and bounds by insisting they maintain a lifestyle that is much more challenging and dangerous, and therefore run the risk of creating a situation that will not even afford them such an independent lifestyle as can be found in assisted living. Rather, they could end up in a skilled nursing home if something were to happen to either one, or both

Jennifer

Some AL and even some nursing homes accept couples. I know a nursing home in VA did for my aunt and uncle. (She was diabetic and wheelchair bound due to neropathy and he due to advancing dementia). She passed away in 2008 and he is still there. He was a WWII vet and Vet Affairs helped out -- as best they could. Good luck

Thank you anne123 I appreciate your response.

Yes, AL will accept couples, but some of them only accept those in "good health". So if I were you, I would google, and then contact, various AL facilities in your parents' area, and gather information. I agree that this is more difficult than raising kids. My one tip for you would be to focus on what's best for your parents, listen compassionately to them, but know that ultimately you will need to build a thick skin and make tough decisions which may anger/upset them. You have to remember that you are functioning from a position of greater physical and cognitive strength, and you can see things they can't about the situation. For example, my father became very angry and upset when we told him he needed to stop driving, but we weathered that storm because we knew we were doing the right thing. He eventually calmed down and accepted it. Good luck!

Hello everyone, I'm actually writing this from Japan-my parents live in Wisconsin. Two days ago my 77 year old aunt died-she lived with my parents and was actually their caretaker! We never figured on her passing FIRST! SHE was the healthy one! Mom is 75, confused, has various ailments but the biggest issues is her mental instability and confusion. Dad is 82, has had cancer twice, is a full blown diabetic, has emphysema is on 24/7 oxygen that barely helps anymore. Neither one is capable of taking care of the household chores. Dad takes a lot of medication that needs to be organized-the nurse was there 4 times trying to teach them and finally the nurse told my sister -who is there for a week from Colorado- that they were not able to handle the medication disbursement. They absolutely REFUSE to even talk about assisted living. They want to "do it" alone for as long as they can - which probably wont be very long. I am due to fly home in about 2 weeks for a short time. We want them to go to an AL home...not sure how much they can afford, they are not rich. How/who can help with this sort of thing? I've been living outside the USA for 30 years so I'm clueless....but I can't burden my sister with all of this..I have to help her...any advice at all would be appreciated. Would they even qualify for assisted living? Can couples go to assisted living? I have no idea. This is the most stressful thing I have ever faced...even more stressful than raising KIDS!

newtonjoyce, that doesn't work with her. She thinks the doctors are wrong. When she was diagnosed with Alzheimers she did not believe it and constantly tells us there is nothing wrong with her memory and why would the doctor say there was. She believes she passed all the tests they gave her. She is still upset that the doctor recommended she not drive anymore and has been talking about getting her license back for the past two years. She is very stubborn. More than one doctor has told her she needs to be in an ASF, but she refuses to believe it. When we try to talk to her about it, she gets very upset and says, "family should take care of family." It is very frustrating. I don't think she is trying to cook anymore and only eats (if she eats) frozen dinners cooked in the microwave. She is not taking any medicine that I can tell. Her sons just say that she rejects their help and that they can not cope with her. I feel like my hands are tied, since I am an indirect member of the family and do not want to cause problems in my daughters marriage.

trishbob, somebody has to get power of attorney asap for one thing. Her memory will not improve. Who cleans her house? Is it safe there? Make a doctor appt for her and go with her and have the doctor tell her that she cannot live alone anymore. If you tell her the 'doctor' says, she may take that authority over anyone elses. Tell the doctor, not the nurse, ahead of time what you want the doctor to do for her protection.
That is what I have had to do in the past and it seemed to work pretty much.

My Son-In-Law's Grandmother is 86-yrs old and has alzheimers. She was diagnosed some years ago. She lives alone in a town that is 1hour and 15minutes away from us. We try to visit as often as possible and she has a friend that takes her to the grocery store and bank about every ten days. We know she is not eating right and is frightened to be alone, but will not allow caregivers in the home. She refuses to move into an ALF (although we are told she can afford it) and her two sons who live in the same state, but hours away, seem to have given up on her because of her stubborn refusal to leave her own home and her accusations that they do not love her because neither one will allow her to live with them and their wives. They don't seem to (or want to) accept the fact that their mother does not know or believe that she has a problem. She has no concept of time anymore and repeats stories from the past constantly, She believes "people" are coming into her house and stealing her things, even though she barricades the doors. How can we help her? She thinks there is nothing wrong with her memory and can no longer understand how very ill she is. Talking to her son doesn't get us anywhere.

Thanks JDay. I forgot to mention that I did check out the local Adult Day Care when she first came to live with us. It just seemed like it was for a much different level of folks (most have more severe dementia / Alzheimers). So we tried the Senior Center and she went a couple of times, but then found it boring and felt like there were established cliques there that she couldn't penetrate. So, I can't get her to go anymore. I may have to go back to the Adult Day Care and just insist that she go at least one day a week when she doesn't have a caretaker coming at all.
Sigh!

JaniceJ,

A couple of thoughts come to mind...

1. Check in your area for adult day care to alleviate some of the daily care burden and give you and your husband the well-deserved break from full-time caregiver.
Some assisted living and memory care communities have day-care centers built into their service plan. Others are stand-alone. Some also accept a medicaid waiver or have other financial assistance resources available.

2. After having worked at both a medicaid and luxury private pay community, I know there are options out there to meet everyone's needs. Chances are, there is a referral agency or certified geriatric care manager in your area that can help you identify the right solution to meet your needs and those of your folks.

Best of luck to you. Don't give up hope. Sometimes, that's all we have at the end of the day.

Hugs,
JDay

My mother lives with my husband and me. We both work full-time. My job requires travel occasionally. It's been almost impossible for me to arrange care for her while I'm gone, not to mention the huge expense.

My mother doesn't have long-term care or enough money to pay for expensive assisted living facilities. I couldn't bear to put her in a Medicaid facility. Our lives have been totally transformed. We feel like we're a prisoner in our house because someone has to be with her at all times. We have a caregiver several times a week during the day for a couple hours at a time so I can totally focus on work (I work at home), but it hardly makes a difference. I love my mom dearly and she used to be my best friend, but I don't feel like I know her anymore--she's so difficult to get along with. I'm at my wit's end. I live out of state from my siblings so I have no help. I'd love for my mom to live in an assisted living facility because I know after some time, she'd probably be happier and a lot less lonely. Help!

Mom has mild alzheimers and is disabled . She now needs more care than we can provide at home. One of the problems we are running into is the astronomical expense of a residential care home, nursing home, or other facility where she can get the 24 hr care she needs. She has no assets, just the monthly social security, my dad left her with nothing. No survivor's benefits, pension, etc. She lives with my single brother. Medical does have places she can go, but finding them is like a needle in a haystack. Medical will not help with the search but even with a list of places to call, so far everything is private pay. That's anywhere from $3,000 to $7,000 a month. We don't have that kind of money. What happens to people in this situation? We are investigating the Veteran's Administration Aid & Assitance program for widows of sevice men, but that takes 6-9 months to process once they are qualified. The amount of paperwork and documentation they require is mind boggling. I do have a non-profit - A Place For Mom - helping me with the research but it's just disheartening. My 58 yr old brother's under so much stress with her for the last 2 years that his Dr. told him he needs to find a solution. I'm 68 and have just developed high blood pressure along with the stress....Thanks for letting me talk about this!

I work in an Assisted Living Community and can tell you from my experience, the conversation with mom or dad about the need for a transition is extremely difficult for most. From the elder's perspective, moving to Assisted Living is like admitting that they are no longer independent, and as a result, may make them feel like they have less value as a person. Today's seniors grew up in an age when being self-sufficient might have been all they had. They are very proud, and they were taught that buying a home was one of the greatest things they could achieve. Assisted Living communities didn't exist back then, and nursing homes were by and large places you didn't remember fondly. In their experience, families typically took care of the elders in their own homes until they passed. This is why your loved one may expect that you do the same. For all these reasons, it's understandable their resistance to the suggestion that they move out of their home.

Without a doubt, it is best for seniors to be in an environment that is safe, provides for necessary care and assistance with activities of daily living (bathing, dressing, meals, transportation, etc.), and offers a social model to keep them connected and active as possible. Entering that initial conversation can be frightening for a lot of adult children, but it can help to do some homework on the options ahead of time. Research the communities in your area and consider taking mom or dad to your favorite one for lunch to introduce them to the idea. Being in a public place may reduce your risk of an extreme reaction to the subject. :) Best of luck to you!

I agree @PirateQueen, @maggiesue, The movies about the benign seniors with dementia are deceiptful!

Even the ALFs and nursing home staffs could offer no really helpful advice. I mean, short of sedating my FIL, there would be no way to get him to agree to moving. He really is doing better being around people his age, and at least we know he is fed and cared for. He is now in a nursing home,in FL (we live in NY and UT) and we have a trusted aide visit unannounced several times a week to monitor and see he is properly cared for. Since we cannot visit often enough, we have some peace of mind. Gail has been an angel for us. Had he not fallen, we would still be dealing with everything long distance and worrying sick about him...

There was an old fart on TV I saw not too long ago. His weeks were absolutely numbered and it was costing like 5K a day to keep him alive. He said he'd never do it if HE had to pay for it-he had a grin on his face. In a case like that, our taxpayer dollars/govt. should cut someone off of this welfare system. I had an older relative with untreatable cancer (she was living like a vegetable from all the drugs to ease the pain in a very expensive hospital). She finally went to a hospice-a family member was finally able to step in. She died peacefully with dignity.

Excellent post. If they insist on living dangerously, and acting like a child demanding help, you have to treat them like you would a child - doing something unsafe.

Dear Kedwards,
I do understand what you are saying. Down the road it just may come to what you are looking for. I just saw a program on TV about the new health care plans our goverment would like to do. When someone is too old or there is no hope for improvement in their health, the new health care plans want people to do just that, end their life. The main reason for this plan, is to provide more money in the healthcare plans to pay out to younger persons who could have more hope for recovery. One part of me saids, it is a good idea, and another is not so sure, I am concerned how far our goverment would go in drawing the line. And my faith concerns me too. I guess we better keep this conversation on our parents, I am sure there will be someone out there who will not like what we are talking about. This was just a little conversation between you and me. The best to you and your love ones.

I agree with you Cindy. And not meaning to sound morbid but I think us baby boomers who are facing not enough good ALF and finances to provide for it should be able to make decisions regarding when we would like to go in the event that we become so disabled or demented. Why is it that we would put a dog or cat out of its' misery and call it humane but allow our fellow human beings to continue until "God" calls them. I'm telling you after seeing my mom's decline with PD, I want Kevorkian on speed dial if anything remotely happens to me and I want to be able to end it all on my terms.

How are we going handle our outcome when we get to our parents age? Are we going to do the same? I sure hope my memory does not fail me. I hope I will be able to understand what will be best for me. I told my kids what we are going through, and said to them, if my memory goes just find a nice place for me to be safe and around people who really care for the elderly. My daughter's eyes filled up with tears. I think these are issues we should be talking about with our children now, 20-25 years from now is too late. Maybe we should put in writing what we would like to be done about the possibilities that could happen to us. I think we should consider who would be best for power of attorney. handling our financial affaires, things like that. It would be less worry for the kids. I think it would help them not feel as if they are stepping over the line with us. They could see how much we trust them and not make it too hard on them. Just some food for thought.