As caregivers, many of us have taken an oath to do no harm. Sometimes we decide an individual can no longer live alone based on his/her ability to care for themselves. But there's a lot more to it than that.
There has to be an ethical component that includes the impact our decisions will have on the individual and ourselves. In a nutshell, we'll have to be able to live with the decisions we make on behalf of others under our care and supervision. Consulting others in the care team is the best way to know we're doing the right thing.
In the meantime, keep coming back to this site and surf the Net for information. If you go to ask.com and post a question such as the one you're asking here, it'll lead you to many useful articles. On http://www.alzheimer.ca/english/care/ethics-alone.htm, you'll find some tips that you can tailor to your Dad's needs.
Leda: we probably need a little more info. about your Dad's current state....
My philosophy is that parents are much healthier and more mentally stimulated if they can remain in their homes. I am a big fan of the "aging-in-place" movement and have been gathering as much info. for my Mom as I can. I was just speaking to a friend yesterday and we marveled at how all our grandparents lived in their homes/apts. until their deaths(they were all in their 70s to 90s and had various illnesses - it was unheard of not to stay in your home back then.)
So far, my Mom has been able to live in her apt. with lots of care from us and a little by a caregiver who comes in once a month or so. As time goes on she may need more in-home care. However, if it gets to the point where she needs more medical and physical supervision that we all can offer, it is in her best interests to be given a safer environment.
You have asked the 64 million dollar question. And there is no one-size-fits-all answer, other than "you will know it when you see it." In the meantime, you can be looking for both in-home alternatives and care facilities in your area.
We have been struggling with the same question for 2 years. We went with my father in law to doctors visits over and over the dr. kept telling us that he should not be living alone but the dr. would not do anything positive to make that happen. Dad refused to move willingly. It was totally up to us. We knew he was declining, physically and mentally but we were stuck in knowing "how" to go about it. We recently met with a Geriatric Care Management Professional for a counseling session. It was so helpful! We had to put the emotions aside and know that if there was danger and health concerns with him living alone, we had to do something for his welfare. The transition just happened and so far we are shocked at how much easier it has been than we anticipated. He is actually seeming to be relieved. We are still praying this one through that the adjustment will take and he will be more and more accepting. Good Luck! Keep in mind safety and health come first.
all situations different- my mom wanted to die in her home- my 44 year old brother has never moved out- they have not good relationship- she 79- always crying and said once that he ignores her- whenever i went over there i wuld have to go to the other living room to see him - never talks to her - she would not admit it - seemed scared- she said she wants to live with me so now she is- has dementia- he has refinanced 4 times and has used up most of equity - he called last week cuz he had someone come over to refi but was not comfortable doing it cuz said she doesnt seem to know whats going on- no one has power of attorney - he asked if i could bring mom to livermore cuz he found someone who would refy the home and give him $39,000- he wants to put siding , new lino, carpet and new cabinets in the kitchen- i said yes- called my other brother and he said no - so now i am calling probate to see what i need to do to get conservatorship- he also told me not to change the soc. sec. deposit into my account that he would write me a check for $600 each month- he kept feb. check - not surprised- so anyway thats where i am at- my mom was not willing to move from her home of 40yrs. and then 1 day she wanted to get the heck out- everyday she asks can i stay here? do you have a bed for me? i say of course you can- and she smiles=yahoo!!!
We just put my mom in a residential/assisted living/nursing home yesterday. She no longer could stay home because of depression and self neglect. She lost her husband, my dad in October, I've been giving her time to grieve but she was going downhill, staying in bed all day and not bathing. She needed alot of help and I had to take her to the emergency room and they put her in a Senior Behavioral Center for a week while I looked for places for her to go into. With the help of A Place for Mom agency we found this small homelike facility for her to be transferred to. It only has 23 residents and 24 hr nursing.She was not happy about being there and had a little tantrum. The manager says it will take about 2months for her to adjust and she will have her good days and her bad. It's been the hardest thing in my life to do but we know it is for the best. I tried to keep her in her home with caregivers but it just wasn't working. We were not qualified to give her the type of care she required.
All of the things posted previously are wonderful indicators and helpful links. Read them. Take them in. Think and ponder on each and every one of them. The answer will come. Keep in mind, it may not be the one you LIKE, but it will be the best one. Whatever the choice you make, you should make without guilt. It's the right choice. If the tables were turned, your parent(s) would do the same thing. It's whatever is best for them at this point. Good luck. Come back to this site. It's a great one.
I'm glad that you were realistic enough to deal with it despite how hard it was to do.
My elderly step-dad whose 85 and in a wheel chair and his non CNA or from an agency helper thought they could care for my mother even though she had one seizure after another.
Instead of looking at this as being so bad and hard, try to see it as you did the responsible adult like thing in your role as now the parent type for the aging parent who needed for someone to make this decision for their benefit that they were not able to make for themselves and like a child for whom a parent has made some new rules it's going to be an adjustment. My biggest advice to not hold yourself responsible for her feelings. Let her deal with her feelings instead of absorbing her feelings into your emotions which will get things all chaotic and enmeshed which makes the transition more difficult.
Home health care tried to telling them she was not safe. PT as well as some rescue people who had taken her to the hospital told her that she was really taking a risk staying at home. Her neurologist who she loves so much and the only doctor she has never fired tried to tell her. During that very touch and go year, I was calling my mother twice a day to make sure she took her medicine which was becoming a problem due to her dementia.
I gave them a chance after she got out of rehab with a lot of success after 20 days which now I regret for every bit of progress the gained they allowed her to lose in 8 days at which point she was undernourished, dehydrated, etc.
When I came up to go with her for a doctor's appointment I was appalled at her condition. The doctor told me and the helper that anyone who loved my mother would have her in a nursing home. We got her to a hospital and to a rehab place where she was doing really well once again. That place also has assisted living. It looked like things were looking up until she fell and broke her hip or as I think happens more often broke her hip and fell.
The total impact of this drama led my mother away from fighting the idea of a nursing home to accepting it. Anyhow, that's what she'd been paying premiums for since buying a long term care health insurance plan the year her mother died in 1996. My step dad was afraid to put her in the nursing home and use the insurance because he was afraid the insurance would imprison her there. He is so out of touch with reality that he does not realize that with his limited income, he should thank God she got that policy or he would be homeless. No wonder they got behind on taxes since 2004 and poor things hid the truth from me and my step-siblings which now is almost completely resolved.
To this day, my step-dad thinks the nursing home caused my mother's decline when in fact he and his helper almost killed her trying to care for her at home for they were not qualified and still don't get it that they are not qualified.
It is also tragic that I was not able to get durable or medical POA any sooner than last February for some things would have changed.
For one thing, I would have found that insurance policy sooner and seen all the riders she paid for to cover home health care and home builder care for her.
Dumb step dad would rather not use that for her but instead got some non agency person off the street to help who forged checks for over $15,000, but did not want to believe it when it happened nor did my mother want to believe.
On top of that, my step dad gave the thief some money for his defense against them charging him forgery from three banking accounts. I'm thankful that he never got a hold of the big account which is my mother's private one.
Even more stupid is my step brother does not or refuses to see how incompetent his dad has become, but he's not whom I'm authorized to help. My step-brother has medical and durable POA over my step-dad, but refuses to use it.
And I feel stupid for not picking up on evidence of things not being right. It did not help any that I went on full disability in 2003 with their secret downfall starting in 2004 with my wife going on full disability in 2002.
Let's hope that the place is clean, and that the CNA's are going out of their way to help on all levels. Let's hope also that they don't require the residents to rise at dawn and sit in wheelchairs all day long.
It is clean! The staff are passionate and full of energy. No one is taken out at sunrise as if they are in boot camp or worse. Those who want to get up and sit, sit. Those who want in their wheelchair, do. But if like my mother they do not want to, they don't.
I visit in a very unpredictable time, part of the day and which day every week. I might and do sometimes show up after the office staff has gone home. The social worker has commented on how observant I am which is true. Take any martial arts for about 10 years like I have and you will become incredibly observant and aware of your surroundings.
I'm complimentary of those I see work with the most compassion for the residents; passion for their work; helpful competency. I also point out areas where I think things really must be done better next time. I find these things are most easily dealt with directly and at the time instead of working through the director of nursing or other administrator type person. When I actually worked, this is how I interacted with people and I still do. Also, when I see an administrative person showing some really good leadership, I'll compliment that too. Mediocrity does not get complimented on purpose so maybe people will notice what kind of worker I do compliment which realistically speaking is not often the case, but one can try.
Assisted living is usually considered an option if someone cannot perform basic ADLs (activities of daily living) independently, or if their behavior could jeopardize themselves or someone else.
Basic and Complex ADLs (Activities of Daily Living) are those activities that are essential to independent living. They consist of basic and complex activities.
Basic activities include: Feeding one’s self Using the bathroom appropriately Maintaining good personal hygiene Dressing appropriately for the season
Some select warning signs: Late bill payments Changes in mood or behavior Missed medications or medications taken incorrectly Repeated accidents in the kitchen or bathroom
We’ve all had these symptoms, And a time or two doesn’t usually indicate a problem caring for one’s self or staying safe. However, if they occur often, you may want to consider a geriatric screening. A geriatric screening is an exam usually conducted at a hospital where you can identify (or rule out) signs of aging that may impair your loved one’s ability to live independently.
Trust your instincts if you feel something’s wrong. If you start to see symptoms, be proactive and consult a doctor.
Different people have different views on when a person can live alone, depending on whether the person is your parent, your patient or your neighbor. I think you need to ask these questions. These are the questions a health facility look at on discharge. Are they physically safe? Can they get in and out of bed by themselves? In and out of the bathroom? Can they get themselves out of the house in case of a fire? Are they mentally safe? Can they call 911? Can they lock and unlock doors appropriately to let good people in and keep bad people out? That is really about it. Now the question becomes would their lives be better (safer, improved quality, etc) if they: went to assisted living, moved closer, took a smaller place, on and on. Those are questions only the elder can answer. I see parents in the same light as my semi adult children. I know what is a good decision and I can see the train coming sometimes, but I cannot force them. Sometimes I beg and plead. In the same mind, it is my choice whether or not I pick up the pieces when the train hits.Yes I feel morally and ethically responsible, but it is a decision. Most of us want the best for our parents and we also want decisions that will ease the burden of caregiver that we have assumed. Often our parents motives aren't the same, they want to continue to live at the very edge of their abilities and have the offspring help maintain that style. Caregiving would be much easier if those we cared for accepted the limitations that aging has presented. My mom is a perfect example. She has Parkinson's and had been living on the edge for months in spite of pleas to enter assisted living. She fell at home (thankfully had a cell phone), fractured her arm and has not been able to live alone since then. She is unable to get out of bed and into a wheelchair by herself. I hope these answers have helped.
I had to put my mom in nursing care after a fall which resulted in a broken leg. She wasn't able to do the physical therapy to get mobile again, plus her mind is getting progressively worse. Knowing that she could no longer manage her daily needs, such as preparing food, bathing, etc. also helped me make this decision. A word of warning...this will be the most , or one of the most difficult decisions you will ever make in your life. The change is extremely hard for them and for you. There will be guilt and just down right sorrow involved in the whole experience, so make sure it is the last resort before going ahead. God bless you.
Thank you for your response. My Mom is good physically, but can't hear, gets confused about the mail, etc. She accusses me of taking her money. I hear this is normal, but I get so upset and offended. My sisters think it's funny, but they don't live her, I do. I left my abusive husband of 45 years and God put me here to take care of Mother.
I'm struggling with this now and feel guilty that she isn't safe living alone but also feel guilty if I move her into a nursing facility, something she defiantly opposes. She is not safe living alone and I have caregivers coming in but she is constantly sending them home saying she doesn't need them. She is confused, disoriented, and mentally ill on top of having COPD and being on oxygen 24/7 - takes her canula off and forgets to put it back on, falls, can't read the clock, can't make her own meals, can't bathe (refuses to bathe and will only use baby wipes for cleaning), and on the problems go. She is angry, hostile, abusive, and refuses her food, water, and medication. She has also refused to assign a POA or guardianship so there is nothing I can do but pray. All I can say in response to this question is that I have tried EVERYTHING and nothing has worked and I'm finally recognizing my limitations and have basically given up.
A Nursing Home is not a death sentence. It is not prison, but it is very difficult to adjust to. If the time comes: Can't wash, can't feed oneself, can't go potty without assistance, can't lift oneself onto anything, then some type of intervention is necessary. Notice that I didn't say, can't take medication, can't drink fluids.....these can be handled by a caregiver who comes to you. Of course it's a difficult decision, but what's the alternative?
debmcd, your response hit home. I am in begging and pleading stage with my mother while trying to respect her right to make her own choice (she's mentally alert but extremely physically limited). I feel that if she made the choice now she would have a better quality life for some time than if I let the train hit that I see coming down the tracks. But you are also right that she expects me to compensate so she can live on the edge and this is causing me not only the additional workload but resentment, criticism from family members, and confusion over whether what I am doing is right or not. I mean I am enabling her to stay in her home while believing the best thing she could do is get out of her home. Where do you draw the line? I do her laundry, cleaning, pet care, cooking all her meals and am at her beck and call 24/7. I pay for a medical alert system (which she uses frequently) because I'm terrified that I cannot get to her on a timely basis. You would think she would care about what she's doing to the quality of my life, but she doesn't, she's completely self absorbed. What do others do in this situation? Do you stop extending help so that reality sinks in for the elder person? She is quite resourceful so she'll get neighbors, church members others to do her bidding if I withdraw but it will ruin our relationship. It is hard to say no to the mother you have loved all your life and think that she could die any minute while angry with you. I resent this situation so much and feel that I am being manipulated. No one else in my family will help.
sovery: We have all been through these emotions....I could have written your post several months ago. You are 100% correct about a senior's resoursefulness at getting people, even total strangers, to do their bidding. They just turn on that "helpless, no-one-will-help-me" schtick. Whenever I tried to set boundaries or have Mom be responsible for the consequences of her decisions, she did an end run around me and found some other victim...of course, they thought I was "just terrible" for not helping her. (let them walk in my shoes for just one week.) And you are also correct, they will NEVER acknowledge how much strain they are putting on your life. I did the 24/7 routine for three years. I knew that she needed more care than I could provide, but I thought I could do it all. It finally took a toll on me physically and mentally. So YES you do need to draw the line. Start gathering information about ALFs in her area. Visit them by yourself and talk to the director. Be very candid about your Mom's needs. They will promise you the moon...if they do, have them put everything in writing. After you have found a few, hand the information to your Mom and let her mull over it. Do not get into emotionally manipulative conversations (ie "you don't love me, you are trying to get rid of me, I'll call someone else in the family...") Just say, "take a look at these and we will talk later." Create a time line and stick to it. But the best and most respectful thing is to try and get buy-in from your parent. This takes time, so start right away. You do not have to completely withdraw from her life. However, if she rejects you just because you cannot keep up this pace, she isn't being a very good mother to you. (we never think of it that way, do we?) In the meantime, stop the grunt work. I hired two paid caregivers to come by once a week. One did personal care such as bathing, etc. The other did light housework, shopping, errands. I took care of everything else, but the extra help made things a little easier. good luck
Soverytired - I'm in the same situation - it's amazing how many of us are fighting the same battle - and I was drowning in the emotions of anger, resentment, sadness, frustration, love, and even feeling hatred at one point when I nearly collapsed from exhaustion. Then I found this site recently and what a difference reading and learning about others' struggles has made. My mom has refused to go to ASL or a nursing home and so I've set up caregivers, she has lifeline, there is food and all of her basic needs are being met. I cut back from visiting every day for 4 hours to visiting every 3 days now for 1 hour because I know a caregiver are coming in 2 hours each morning and evening, and there is a neighbor checking in on her, also. I call each morning and each evening before her bed time. She is not safe living alone but this is her choice and despite my begging and pleading, it only made matters worse. So recognized your limits and realize you have the right to take care of yourself. I don't know where any of us got the message that we should sacrifice our health, our lives, our spouses, friends, etc. or end up killing ourselves to take care of a parent, particularly a parent like mine who is narcissistic, emotionally abusive, and not concerned with my needs at all. I love what Lilliput said about how these mom's aren't being very good mothers to us when they act like this. And although some our disoriented, confused, and sick, I believe most of them know the basic difference between right and wrong and many take advantage of us through manipulation, power, and control for their own selfish reasons without any regard for the toll it is taking on our own lives. As a Christian, I feel an obligation to do what is right and I love my mother, but I came to the point that I recognized my mother has the right to live on her own independently if that is what she chooses and I have the right to take care of myself and not give up my life so she can have what she wants.
Wow this is just what I needed to read to realize I am not alone in this struggle. I too feel very manipulated by my Mom sometimes, I am a sole caregiver and I've often encouraged her to atleast consider an adult community or assisted living, but to no avail. Once I had her almost considering it until my useless sister told her it was so expensive and why would she want to consider spending all of that money every month. Nice. Easy for her to say since she only visits once every two weeks if at that. I love my Mom more than anything and its so difficult managing the balance between allowing her to live at home which is what she wants and still retaining my life and my sanity. I can't help but wonder sometimes if she knows she is manipulating me or if it truly is something she is not aware of.Its very frustrating and the stress is wrecking havoc on me.
joym, my sisters have also resisted (and even undermined) my attempts to get my mother in an alternate living situation with the excuse of saving money in case it is needed. A somewhat effective counter-argument to that is that if they live on their own until the train wreck, the costs of 24/7 nursing homes blows through the savings much, much faster than making the choice of a senior community now. Of course that argument hasn't worked for me yet but I think it made some headway.
joym - I went through the process of trying to figure out if my mom was deliberately manipulating me or if she was unaware and then came to the conclusion that although it was probably a combination of both, it didn't matter. What mattered is that I recognize the manipulations when they are happening and don't succumb to the traps. I've basically taken a tough love approach where I'm learning how to balance giving love, support, compassion and doing what needs to be done with limit-setting on how much I can and will do. This is extremely challenging but it is helping me to cope without all the guilt for not doing more and feeling at peace knowing I'm doing enough. I don't have children but some of what I've been learning from other posts is that it's similar to having a child - you don't give your child everything they want whenever they want it. The stress I was having when I was caught in my mother's vortex of endless needs, wants, manipulations, etc. was so overwhelming but a few days ago, I finally said enough! And slowly, I am feeling like I've gained some sense of control back over my life and learning how to manage the stress.
wow and thanks to all the posts here, this is exactly what I'm experiencing and it's just so frustrating and all I can see is a bad end coming my mom's way. I'm just going to keep trying to figure it out and know that I'm not alone in this sinking boat.
you are definately not alone here trying hard, this is a great support group for those of us who are trying to do their best for their aging relatives. Its not an easy role to fill but one we do from our hearts, often with no appreciation from other siblings. Stay strong and always remember to try and take care of you too, I know that sounds easier than done but its really important for you to keep your sanity through all of this and not make your self nuts questioning whether you are doing your best.
Wow. This conversation is great. I have a similar situation, but with a kink. My dad, 88, has dementia. My mom, 86, fell and broke her hip and is not in a "Rehab Center" for at least 6 weeks. I am not sure she will be out at 6 weeks, as she is so doped up all the time. I requested they reduce the pain meds somewhat, but the doctor said she needed them. So we are trying to keep Dad home until she returns. We are having trouble letting him stay alone, as it seems whenever there is no one with him, he gets on the phone and calls all of us (3 sibs) and wants to know why we haven't come to take him to the hospital to see Mother. Even if we just left him at home after taking him to see her!! My brother and sister want to put him in assisted living or memory care home. I am afraid if we do that, he and Mother will never be together again (they have been married over 65 years- she has been covering his dementia for the last 3). What should I do? Agree with them and feel guilty the rest of my life? Try to keep Dad at home (I could live with him short-term, but don't want to jeopardize my marriage be being gone for months)?
For me, my Mom's been ok/not ok for so long that I figured I was imagining things. I got her a Lifeline button and she wore it but couldn't remember why, so I got her one to call just me and she won't wear it. I got her a 5-star responder (great unit, by the way), and she couldn't remember how it worked or why that person talked to he when she pushed the button, but she "knew how a cellphone worked", so I got her a Jitterbug with the 5-star feature on it, and she can remember to keep it charged, but not to carry it with her - or carries it and doesn't turn it on. Then she sits down to a computer and sends e-mails and reads the news. I've been going crazy trying to 'place' her progress for several years now (she lives alone next door to me). My line-of-demarcation came not long ago when she walked out in front of a truck. She wasn't hit due to the driver's quick response and my grabbing her arm, and even then, I could see where it was dark, there was a lot of activity (Christmas festivities in town), etc. -- People make mistakes. But when I talked to her about it the next day (allowing time for me to be calm and her to be rested), it "never happened". That oblivion rang the bell. This past week, she told me about 'someone' coming to visit and her dog really liked them, but she could not ever remember who came to visit. Her doctor is going to refer her to a neurologist for workup and she'll probably be in an ALF or NH pending those results. I'm relieved. It's always a hard decision, but, with her, it was harder because somedays she really seems to be ok. My Dad had Alzheimer's and his decline was steady - faster at some times than others, but always travelled in a declining motion. Mom's been up and down all over the charts, which I've learned is characteristic of some types of dementia. I guess the bottom line is that when you've covered all the bases you know to cover and still find that nothing works because of the accusations, the hiding, and the probability of endangering themselves or others, you do what you can to help them be safe --- and you do what you can to preserve your own life too. I'm learning that we, as caregivers, still have a right to have a life, to laugh, to love, to go on vacation, to enjoy our own families (spouses, children, grandchildren,etc). I guess some will say I'm cold-hearted, but with working 2 jobs, a disabled husband, a 50 acre farm, sons and grandsons that I only see a couple of times a year...Mom will always have my love, but she can no longer have my life.
As caregivers, many of us have taken an oath to do no harm. Sometimes we decide an individual can no longer live alone based on his/her ability to care for themselves. But there's a lot more to it than that.
There has to be an ethical component that includes the impact our decisions will have on the individual and ourselves. In a nutshell, we'll have to be able to live with the decisions we make on behalf of others under our care and supervision. Consulting others in the care team is the best way to know we're doing the right thing.
In the meantime, keep coming back to this site and surf the Net for information. If you go to ask.com and post a question such as the one you're asking here, it'll lead you to many useful articles. On http://www.alzheimer.ca/english/care/ethics-alone.htm, you'll find some tips that you can tailor to your Dad's needs.
Stay sane, Leda. And let us know how it goes.
-- ED
My philosophy is that parents are much healthier and more mentally stimulated if they can remain in their homes. I am a big fan of the "aging-in-place" movement and have been gathering as much info. for my Mom as I can. I was just speaking to a friend yesterday and we marveled at how all our grandparents lived in their homes/apts. until their deaths(they were all in their 70s to 90s and had various illnesses - it was unheard of not to stay in your home back then.)
So far, my Mom has been able to live in her apt. with lots of care from us and a little by a caregiver who comes in once a month or so. As time goes on she may need more in-home care. However, if it gets to the point where she needs more medical and physical supervision that we all can offer, it is in her best interests to be given a safer environment.
You have asked the 64 million dollar question. And there is no one-size-fits-all answer, other than "you will know it when you see it." In the meantime, you can be looking for both in-home alternatives and care facilities in your area.
Good luck...
I believe this books lists some concrete criteria that will help you answer this question. The same material can probably found elsewhere also.
My elderly step-dad whose 85 and in a wheel chair and his non CNA or from an agency helper thought they could care for my mother even though she had one seizure after another.
Instead of looking at this as being so bad and hard, try to see it as you did the responsible adult like thing in your role as now the parent type for the aging parent who needed for someone to make this decision for their benefit that they were not able to make for themselves and like a child for whom a parent has made some new rules it's going to be an adjustment. My biggest advice to not hold yourself responsible for her feelings. Let her deal with her feelings instead of absorbing her feelings into your emotions which will get things all chaotic and enmeshed which makes the transition more difficult.
Home health care tried to telling them she was not safe. PT as well as some rescue people who had taken her to the hospital told her that she was really taking a risk staying at home.
Her neurologist who she loves so much and the only doctor she has never fired tried to tell her. During that very touch and go year, I was calling my mother twice a day to make sure she took her medicine which was becoming a problem due to her dementia.
I gave them a chance after she got out of rehab with a lot of success after 20 days which now I regret for every bit of progress the gained they allowed her to lose in 8 days at which point she was undernourished, dehydrated, etc.
When I came up to go with her for a doctor's appointment I was appalled at her condition. The doctor told me and the helper that anyone who loved my mother would have her in a nursing home. We got her to a hospital and to a rehab place where she was doing really well once again. That place also has assisted living. It looked like things were looking up until she fell and broke her hip or as I think happens more often broke her hip and fell.
The total impact of this drama led my mother away from fighting the idea of a nursing home to accepting it. Anyhow, that's what she'd been paying premiums for since buying a long term care health insurance plan the year her mother died in 1996. My step dad was afraid to put her in the nursing home and use the insurance because he was afraid the insurance would imprison her there. He is so out of touch with reality that he does not realize that with his limited income, he should thank God she got that policy or he would be homeless. No wonder they got behind on taxes since 2004 and poor things hid the truth from me and my step-siblings which now is almost completely resolved.
To this day, my step-dad thinks the nursing home caused my mother's decline when in fact he and his helper almost killed her trying to care for her at home for they were not qualified and still don't get it that they are not qualified.
It is also tragic that I was not able to get durable or medical POA any sooner than last February for some things would have changed.
For one thing, I would have found that insurance policy sooner and seen all the riders she paid for to cover home health care and home builder care for her.
Dumb step dad would rather not use that for her but instead got some non agency person off the street to help who forged checks for over $15,000, but did not want to believe it when it happened nor did my mother want to believe.
On top of that, my step dad gave the thief some money for his defense against them charging him forgery from three banking accounts. I'm thankful that he never got a hold of the big account which is my mother's private one.
Even more stupid is my step brother does not or refuses to see how incompetent his dad has become, but he's not whom I'm authorized to help. My step-brother has medical and durable POA over my step-dad, but refuses to use it.
And I feel stupid for not picking up on evidence of things not being right. It did not help any that I went on full disability in 2003 with their secret downfall starting in 2004 with my wife going on full disability in 2002.
I visit in a very unpredictable time, part of the day and which day every week. I might and do sometimes show up after the office staff has gone home. The social worker has commented on how observant I am which is true. Take any martial arts for about 10 years like I have and you will become incredibly observant and aware of your surroundings.
I'm complimentary of those I see work with the most compassion for the residents; passion for their work; helpful competency. I also point out areas where I think things really must be done better next time. I find these things are most easily dealt with directly and at the time instead of working through the director of nursing or other administrator type person. When I actually worked, this is how I interacted with people and I still do. Also, when I see an administrative person showing some really good leadership, I'll compliment that too. Mediocrity does not get complimented on purpose so maybe people will notice what kind of worker I do compliment which realistically speaking is not often the case, but one can try.
Basic and Complex ADLs (Activities of Daily Living) are those activities that are essential to independent living. They consist of basic and complex activities.
Basic activities include:
Feeding one’s self
Using the bathroom appropriately
Maintaining good personal hygiene
Dressing appropriately for the season
Complex ADLs include:
Cooking
Shopping
Effective communications
Following directions
Taking medications appropriately
Money management
Some select warning signs:
Late bill payments
Changes in mood or behavior
Missed medications or medications taken incorrectly
Repeated accidents in the kitchen or bathroom
We’ve all had these symptoms, And a time or two doesn’t usually indicate a problem caring for one’s self or staying safe. However, if they occur often, you may want to consider a geriatric screening. A geriatric screening is an exam usually conducted at a hospital where you can identify (or rule out) signs of aging that may impair your loved one’s ability to live independently.
Trust your instincts if you feel something’s wrong. If you start to see symptoms, be proactive and consult a doctor.
That is really about it. Now the question becomes would their lives be better (safer, improved quality, etc) if they: went to assisted living, moved closer, took a smaller place, on and on. Those are questions only the elder can answer. I see parents in the same light as my semi adult children. I know what is a good decision and I can see the train coming sometimes, but I cannot force them. Sometimes I beg and plead. In the same mind, it is my choice whether or not I pick up the pieces when the train hits.Yes I feel morally and ethically responsible, but it is a decision. Most of us want the best for our parents and we also want decisions that will ease the burden of caregiver that we have assumed. Often our parents motives aren't the same, they want to continue to live at the very edge of their abilities and have the offspring help maintain that style. Caregiving would be much easier if those we cared for accepted the limitations that aging has presented. My mom is a perfect example. She has Parkinson's and had been living on the edge for months in spite of pleas to enter assisted living. She fell at home (thankfully had a cell phone), fractured her arm and has not been able to live alone since then. She is unable to get out of bed and into a wheelchair by herself. I hope these answers have helped.
Of course it's a difficult decision, but what's the alternative?
And you are also correct, they will NEVER acknowledge how much strain they are putting on your life. I did the 24/7 routine for three years. I knew that she needed more care than I could provide, but I thought I could do it all. It finally took a toll on me physically and mentally.
So YES you do need to draw the line. Start gathering information about ALFs in her area. Visit them by yourself and talk to the director. Be very candid about your Mom's needs. They will promise you the moon...if they do, have them put everything in writing. After you have found a few, hand the information to your Mom and let her mull over it. Do not get into emotionally manipulative conversations (ie "you don't love me, you are trying to get rid of me, I'll call someone else in the family...") Just say, "take a look at these and we will talk later."
Create a time line and stick to it. But the best and most respectful thing is to try and get buy-in from your parent. This takes time, so start right away.
You do not have to completely withdraw from her life. However, if she rejects you just because you cannot keep up this pace, she isn't being a very good mother to you. (we never think of it that way, do we?)
In the meantime, stop the grunt work. I hired two paid caregivers to come by once a week. One did personal care such as bathing, etc. The other did light housework, shopping, errands. I took care of everything else, but the extra help made things a little easier.
good luck
It's always a hard decision, but, with her, it was harder because somedays she really seems to be ok. My Dad had Alzheimer's and his decline was steady - faster at some times than others, but always travelled in a declining motion. Mom's been up and down all over the charts, which I've learned is characteristic of some types of dementia. I guess the bottom line is that when you've covered all the bases you know to cover and still find that nothing works because of the accusations, the hiding, and the probability of endangering themselves or others, you do what you can to help them be safe --- and you do what you can to preserve your own life too. I'm learning that we, as caregivers, still have a right to have a life, to laugh, to love, to go on vacation, to enjoy our own families (spouses, children, grandchildren,etc). I guess some will say I'm cold-hearted, but with working 2 jobs, a disabled husband, a 50 acre farm, sons and grandsons that I only see a couple of times a year...Mom will always have my love, but she can no longer have my life.