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Do you think its best for the children to help out when able or hire outside help?

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Yes, I do. There is nothing worse than an adult child that is stingy with her time, and self-centered. If the adult child does not help out with caregiving, there should be offers made (at least an occasional offer) to help with groceries, doctor's appointments, just something, anything, to show some good faith. I think adult children should do something helpful even if the parents can afford it; at least for a few hours, every few weeks. Situations are different, if the adult child lives in another city, of course, that is different, or if the adult child works full time, their available time may be somewhat limited. What is the worst is an adult child that doesn't even offer words that she will help if needed, and will not help out her siblings in any way whatsoever when asked. I often wonder how these spoiled siblings maintain marriages, and what their spouses think about them. I would have doubts if I were married to someone, who didn't lift a finger with his parents and had a bad attitude about it. Some siblings who live near their parents, breeze in once or twice a YEAR to their parents home, with a box of candy, almost like a long-lost relative who is rarely seen. I do not like arrogance in people, and I find siblings that do not help have a tremendous amount of arrogance and/or narcissism, when confronted about helping with their folks. It is very unfortunate that we cannot choose our siblings, and I am sorry to say, that some of us are stuck with some real losers!
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Yes, I do, but within reason. Each situation is different, including the parents and the children. I'm an only child, and have been helping my mother and aunts for over 20 years. Two of my aunts have passed, and my mother is 86 and my aunt is 90. None of my cousins were involved, and left it all to me. I have done my best, but my elders are very demanding and I have had to develop some reasonable boundaries. There are some needs that require outside help, and they are very reluctant to let anyone come in. They would rather I do it all, but I work and also have a family. I think you have to examine the situation and consult with professionals privately, like senior social workers and their doctors. My mother and aunt's doctor is totally frustrated with them because they don't listen, and then get in trouble. Both have different levels of senile dementia, and really shouldn't be living alone. But my mother just renewed the lease on their apartment for another year. It can be very frustrating when you give what you can and then some, but are made to feel like it's never enough, and get nasty, sarcastic comments instead of appreciation.
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It depends on your parents. I was always there for my parents but did not involved unless I was needed. I moved to Tampa 5 years ago to be closer to my parents. Three years ago my mother had to be placed in a NH because of her advanced Alzheimer. My sister decided to take care of her up in Mass because of MassCare. I took over care of father here, but he wanted to continue to live alone. I let him until about three months ago when I had to step in because he could no longer take care of himself. You should keep an eye on the situation until and allow them to make decisions for themselves and try to communicate with them to plan for the future. You should only step in only when they can not longer make the correct decisions themselves or are putting themselves or each other in harm's way. Try to get them to think about the future now and get them to put it in writing so you will know what their wishes are and assure them they you will carry them out exactly how they want it to be.
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