If I had it all to do over again, here's what I would do differently...

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My eldercare journeys are over now. But looking back, here's what I would do differently. Maybe this will help someone. And help us all as we think about our own aging, and what's needed at each changing stage.

#1 I would insist on getting the hospital bed, and wheel chair, before they were "needed." Because when the elder person gets pneumonia, or flu, or anything that weakens and incapacitates them, suddenly there you are, with the necessity to move an adult person, and that equipment is what you need to save your back!
#2 I would buy our own wheelchair for her to have at rehab when she first went to the nursing facility with pneumonia. Because that's why she got pressure sores on the outside of her thigh -- their wheelchair they sat her in was too tight!
#3 I would take training in how to wash and diaper a prone person, before that skill was needed.
#4 I would talk about the paranoia and irrationality that can come with pneumonia, and bladder infections (if I had only known!), and make agreements ahead of time. And set up calming routines of music and words.
#5 I would study bladder and bowel issues in elderly, so I could know when something was an emergency or not.
#6 I would find a doctor who would come to the house.


Singing, I am just starting on the road of eldercare. Thank you so much for the advice!
If I had it to do over, I would:
1. As POA, override her DNR and have them do everything possible. After a major stroke, because of the DNR, she wasn't a candidate for rehab, not eligible to stay in the hospital, but not physically able to return to AL care. Therefore, she went to hospice and died within a week.

2. Would not use inpatient hospice.

3. Would not sign up to be the caregiver to begin with!
Singingway, excellent ideas. I know I was glad I learned all I could about dementia long before my parents had any issues with the disease. It sure helped me coup.

If I had to do it all over again, I would not have enabled my parents to help keep them living in their 3-story single family house. I just couldn't say "no" to all of their request to help.

If I hadn't enabled them, then they would have moved to a retirement community to enjoy their later in life years..... instead of dealing with home ownership, all those darn stairs and falling being in their 90's.... [sigh].
freqflyer I can relate! If I had it to do over again, I would have firmly guided my mother into purchasing a duplex with me (and getting her out of a terribly INACCESSIBLE house, BEFORE that long gray-area period -- where no doctor wanted to designate her as incompetant, but growing dementia made it impossible for her to follow-through on decisions, and impossible to budge her out of this house where the bathroom was not wheelchair accessible, stairs everywhere, and it took me years to get a ramp outside...etc..
I would not let them do a "high enema" (which the hospital calls a 'colonic' but that is NOT what a colonic is) for a supposed bowel blockage/constipation. The emergency room nurse was too aggressive with it, and perforated the lining between her bowel and vagina. Instead, I would use home enemas or if constipation is a regular thing, a colema board, or take her to actual colonics (at natural health clinic) which are much gentler, painless, non messy, easy, and, I believe, more healthy for the colon. For myself, as I age, colonics will be a part of my health maintenance routine, surely!
I'm remember more and more, from the years... When she got cataract surgery, the doctor implanted lenses FOR DRIVING DISTANCE. For a woman whose greatest joy in life at that time was serious reading. And she had wisely given up driving. The implanted lenses gave her 20/20 vision, but she had to use adaptive glasses to read, and she never could make them work. It was so difficult, that she lost her joy of reading. So if I had it to do over again (who knew?) I would talk directly to the doctor, telling him that READING is the MAIN GOAL. She should be able to read without glasses, as she did before the surgery.
If I had it to do over again, I would opt for the girdle stone procedure instead of the partial hip replacement. Because by the time she fell and broke a hip (at 88, while in rehab for infection at the nursing facility) she was not up to the exercise and effort required to make the hip replacement work. Everything would have been easier on her to just take out the broken bone and let her come on home.
Which is what ended up happening anyway, because the nursing home dislocated the partial hip replacement. (A therapist twisted it). So she had to go through two more surgeries -- one to try to force it back in (unsuccessful) and one to take out the prosthesis.Then I could bring her home again, and she was comfortable for six months until she died.
I would have the conversations with parents and in-laws about what their plans are as they age and need gradually increasing assistance to full blown nursing home. (We would flesh out earlier that there are NO plans - so then we could start getting resources and discussions in place)
Everyone just hopes and assumes for themselves that they are going to be independent until they die. If I had it to do over, I would have had my mother pay for other people's assistance, so she would have gotten used to other people helping her, other than just me.

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