Mom (84) is the caregiver and I am worried.

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My mom married her husband 12 years ago. He has Alzheimer's. He has been living at home. He barely is able to walk with a walker. He tires after walking for a few minutes. He has trouble standing up to use the walker. He is very weak. He is incontinent and has had bm accidents. He cannot have conversation. He is generally good natured but will argue in the evening about having to go to bed. I believe it is too much for my mom to care for him. She gets so frustrated and is not patient with him. She says things like " you know how to do this" to him when it is obvious to me he does not remember at all how to do it. He has fallen in the past and I am afraid he will do so again and hurt himself. I don't see this as a good arrangement for either of them. How do you know if it is time to put him in assisted care and convince my mom. She seems too concerned about the financial aspect of it instead of the actual reality of the situation.


Your concerns are certainly valid; your mother's facing a daunting task. There are some actions you can take.

1. Falling - fall proof the house as much as you possibly can, with the installation (by a professional carpenter) of grab bars in the bathroom, along walls and other places as needed. Remove throw rugs and other trip hazards. Try to position soft furniture along his travel routes so if he does fall, he might be able to cushion the fall on softer furniture.

2. If you're familiar with their finances, address the payment for care situation yourself - determine if they can afford AL, but also investigate a higher level of care for your father that might involve Medicaid.

3. If you're proxy under a legal or medical POA, ask one of his doctors to script for home care. He could get PT, OT and a visiting nurse, albeit for a limited amount of time. Still, it would help his balance and medical conditions to be monitored, and avoid the more discomforting and challenging effort of going to a doctor (especially as heat waves ravage the nation).

4. I'm guessing your mother is too overwhelmed to step back and make an impartial judgment. Are there any tasks that can be hired out, or any family to help through a transition period?

5. If this is a second marriage, are the adult children from your parent's respective first marriages involved? Can you get together with them, by phone or in person, to address the situation and ask for their help and support in identifying a safer course of action than the current situation?

As with many posts similar to yours, the issue isn't so much whether extra support is needed, it's rather how to get it and pay for it as well as how to convince the elders they need help.
Garden Artist, thank you for your input. My mom has the POA. A year ago we moved them from their big old 2 story house into a senior community. There are many facilities here. There is even an Alzheimer's care building. I believe with him not being able to walk other than a few steps the odds of falling are there and he could get hurt. The duplex house they live in, even though it is in a senior facility, doesn't seem to be set up for a wheel chair and mom isn't strong enough to move him. I think we are looking at either hiring full time in home care or moving him to the Alzheimer's facility to live. You are correct in that mom is in my mom is perhaps not seeing the reality of the situation. It is pissing me off that she is being so concerned about the money though. Can't she see the quality of his and her life? I think she is endangering him. How do I convince her it is time for a change and that she has to accept that it costs money?
I would question if it's really about the money with your mom. Will she share financial information with you? Can you inquire if she has met with an Elder Law attorney and IS very informed of where she stands? Did they have a prenupt when they got married? I think I would assist her in really finding out the facts about the finances. What he can afford, if he qualifies for financial assistance, etc. Make sure the attorney is familiar with the state laws on Medicaid and if their state has financial assistance for people who need Assisted Living or Memory Care. Some states do provide that for those who a doctor says is in need, (usually disabled, like your step dad and meet certain income and asset requirement).

I would then discuss it with your mom and explain that it's not fair to either of them to continue that way. I'd see if it would help to have someone come in to help, but it's really not feasible to expect that one senior, would be able to properly provide care for an incontinent, dementia patient with severe mobility issues around the clock. Maybe, a professional, like his doctor could help explain that to her and then recommend some options.

At any rate, I'm not sure how good your communication is, but I would let her know that I wouldn't let it lye. That situation is extremely risky for both parties and that we would work on it together for a better solution. I would consult my own attorney to see what evidence that I needed to file report with authorities, if that was the last resort, but based on what you have seen, it sounds like they really do need help.
And I think she is endangering her health also. As all caregivers have said this is a huge job with a lot of stress and she is 84.
While your mom is five years younger than my mother - who was extremely effected by The Great Depression - it is likely your mom either saw the hardship the majority of people went through during that era or experienced it herself. Plus, people of that generation just have a different mind-set regarding money, I've found. "Use it up, make it do and do without" seems to be very ingrained. If your mother can afford it - by your estimation not hers - perhaps see if you can get her to start small in hiring some in home help. Perhaps find a valid task or reason to bring someone in a few days a week for a few hours each time. I would think that after a short while she would see and feel the benefit of getting a break and be amenable to extending more days and more hours. But who knows? This generation can also be very stubborn!
In similar situation - Dad with COPD and dementia, Mom caregiver at thier own home with arthritis and both around 90 - From advice on this site, I made an appt. with home care agency Mom and I we had talked to previously. But she refused services. This time I told Mom this is what we're going to do. Another sib said same. So she talked and listened to agency rep, with me present, and signed up. Starting this week. I promised to be ther entire first time and me and another sib to check in on. Question: How do we keep money,credit card, financial files safe from this new caregiver?
Gogurlz can you (or your siblings) just take over parents' financials? In other words, you handle the credit cards, get bills sent to you, pay them and get online access so there's nothing for the caregivers to see? If you can't do all of that, get online access so you can check their accounts daily/a few times a week.
Here is one thing to ask those Mom's who are in their 70's and older, the last time they were in the hospital or a rehab center, were there any Staff members who were in their 70's and older? I bet they can't name one person... well there is a reason, the work is too daunting for someone that age.

My Mom wouldn't listen, either.... I remember back when my Dad had a heart attack, my Mom refused for him to go to a rehab center after his hospitalization, Mom told everyone she could take care of her husband.... well HELLO, Mom was in her early 90's, what was she thinking or was she thinking? Poor Dad had to sleep in his recliner because his legs were like rubber and no way he could go upstairs to the bedrooms... so Mom slept on the living room sofa until Dad got stronger. Poor Dad, lot of sniping and snarling going on because Mom was in denial that he wasn't able to do certain things until he got stronger.

And yes, the financial aspect. My parents saved big time for rainy days, and it was dark clouds overhead but Mom refused to hire any help. It was her generation where it was "her job" to take care of the house and take care of her husband.
GOGURLZ, since you are going through an Agency, they are licensed, bonded and insured... thus less worry about someone taking anything. We had dozens upon dozens of caregivers from an agency for a couple of months and not one thing was missing.... and Dad use to keep his wallet out, coins, financial statements, etc.

But if it makes you feel more comfortable, ask your Mom if you can take care of the bills for her, it would be one less thing for her to worry about. Thus you gather up all the past bills, the current bills, the checkbooks, etc. and take them home with you. Ask your parents if you can change the address over to your address so the bills come directly to you. You can have either parent sign the checks when the bills come in if you want, or have your parents go to the bank to add your name "or Jane Smith" so that you can sign the checks yourself. Chances are you will eventually be doing this down the road, why not start now.
Thanks for idea of taking over bills etc. so no need to keep credit cards, checkbook in house. Mom does like to keep several hundred dollars in house to pay kids aback for grocery shopping etc. but can figure that out too.

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