Concern over elderly Mom's choice of assisted living for dad.

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My 90 year old parents have wished to continue to live in their own home, despite my father's severe health issues, which made my mom his full time care giver for a couple of years. I have been struggling to try to get my mom to hire some in home care. She has not wanted strangers in the home, a change to their routine, and has had many fears about it. When I have visited, I have experienced my mom treating my dad very impatiently and scolding him much of the time. My mom has always been very controlling and subject to yelling at me as well, so I have feared what life has been like when I am not around. My dad is very cooperative and has been doing everything he could to be no bother. When I last visited, this had worsened and I was relieved when I was able to get my mom to consider some in home care. They have resources for affording this or possible assisted living, but my dad no longer understands their finances at all and my mom is confused about them and afraid to spent money. I have power of attorney on them both and feel certain they will not outlive their resources.
After my dad had a fall last weekend, my mom suddenly moved my dad into the cheapest board and care assisted living home she could find, close to where they live ($60 per day). I spoke with her as she was at the hospital with him, prior to choosing one and she was so overwhelmed and angry, she screamed for me to leave her alone. The hospital case worker and a non profit agency that took my mom around looking at places, shared that she claimed there was no money for care for him and wanted to only be shown the cheapest places.
While I was there a week ago, she insisted to an in home care agency person that they could not have anyone without perfect English, because my dad is hard of hearing. He is now in a place where there is very little English spoken. I have been unable to get someone there to arrange a time when I could try to speak with my father on the phone. From my Mom's description, I think he is deteriorating quickly.
I think that due the severe impact on her own quality of life, my mom is no longer to be compassionate about him. I realize this is pretty understandable after being his care giver for so long. But she is resistant to have us help in any way. I strongly feel he should be moved to a better quality place. I am 800 miles away and cannot get down there again for at least a few weeks without jeopardizing my work and own finances. My only sibling doesn't want to get involved and thinks I am overreacting, but they only briefly visit them yearly.
I don’t think that doing nothing is something I can feel good living with, despite likely some very ugly repercussions from my mom. I am wondering what others think and/ or if anyone else has had a similar situation.


I don't think that you are overreacting. And I think if you possibly can find a more suitable place for dad, perhaps working through the agency and the hospital social worker, that is what you should do.

It is too bad that they weren't willing to bring help into the home. That might have been the best solution. But it is what it is, If you can arrange an upgrade for Dad that may be the best you can do.
I'd take some time to go and see them in person and take it from there, sounds like they need you now.
It's best not to argue with your mom. So, as much as possible, have others deliver any news that your mom might not take well. That way you can be 'on her side' and be in the position of helping her rather than opposing her. I'd start by sending a fax to your parent's doctor. Be candid and concise. Tell him or her about their inability to manage their finances and their financial status. Explain your dad's current living situation and what you feel would be best for them. Ask for his help in 'prescribing' a more suitable situation for your dad. In the meantime, do your research. Call several assisted living communities and explain the situation. They've heard it all before. If you explain that 'full disclosure' may not be the best tactic when it comes to discussing rates, and that you have power of attorney, they may be able to help you with your mom. Again, do whatever you can to take the role of supporting her in finding a suitable place rather than opposing her about where he is now. It's an important distinction.
and remember the Family Medical Leave Act that require an employer to hold a position for a period of tim in case of family medical emergency. These rules apply to employers with a minimum number of employees and a specific amount of time.

You need to address this now, you have poas.
Don't rush to judgment until you see him, in person, at the place he is in now. Do not depend on your mother's assessment, she likely believes he will wither and die without her. The most important aspects of care are kind eyes and warm touching hands. I would rather hear sweet tones in a language I did not understand than be barked at in English. Go see for yourself.
My mother was resistant to accepting outside help for a couple reasons; she believed as his wife she'd taken a vow to provide for his care "in sickness and in health", and was embarrassed that others would see she was not keeping up. We got an estate attorney and his wife, an RN to talk with them about having money to provide outside services. We talked with them both that mom had not had a chance to "retire" from her homekeeping tasks and she deserved to retire the same as dad. The doctor is the one who played the "bad guy" telling them they both needed more care and could not live alone. That left we children "required to comply" with the doctor. Assisted living can be expensive and not covered by insurance, but skilled nursing may be covered. Mom's behavior might improve if she gets help without feeling guilty or afraid. My mom enjoyed talking to the in home help, it relieved her isolation. Finally they did come to live with me. My brother has financial POA and reassured them he was taking care of the money so it would last. My mom has passed, and dad (93) continues to live with me and is calm and happy. I hope this helps you. Understanding your mother's motivation, that anger is sometimes fear and shame, may help you deal with her. They grew up with rather restricted marital roles of the 40's and 50's.
As you have POA, you do have some say in what is happening with your Dad. Even if you can't leave immediately, you have a phone & email. Contact his Dr and get his opinion on his health and what type of care he is needing. Call their social worker and let them know there are funds for a better facility. Check them out online & make phone calls. I am 400 miles from my Dad but was able to take care of quite a bit over the phone. When I was able to be there, I was able to be much more efficient in getting things taken care of with the legwork already done via phone and email. Once you have info from the Dr, you may be able to take FMLA time off, even if for only a couple days to help get him moved & resettled and give you a chance to evaluate thing for yourself first hand.
If you are POA, wouldn't your dad likely pay for your expenses, to go and take care of this situation? I would write myself a check. My family wouldn't expect me to pay for a plane ticket, when it is 100% for them.
I would be very suspicious of a care facility that can't arrange for you to talk to your dad on the phone.

Can you hire a geriatric case manager in his town to check on him in the nursing home, to give you an independent assessment of the situation? If you have POA and your parents have the money, this is a valid use of their funds. The case manager should visit with and without your mom to see whether her visits help or harm the situation. Sometimes the facility behaves better or worse when a loved one is visiting.
At a minimum you should contact a geriatric care manager immediately. They are familiar with many facilities and would know the quality of the one dad is in. GCM's can also help you find a suitable situation for dad that has a good reputation. Your mom must be completely overwhelmed with all of this. I cannot imagine what a spouse must go through caring for someone they have known for so long change into a completely different person, not even a shadow of their former self.

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