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.
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.
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.
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 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.
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.
I have to disagree here just because so done can potty, bathe and feed themselves that doesn't necessarily mean they are safe to live alone. Sure it makes it easier if they can do those things but what about mental ability to stay safe and make smart choices? What about being able to safely administer medication and not forget? People pray on the elderly and they often fall victim to scams and don't always make the safest choices. Assisted living is wonderful if you find a great facility. They are out there you just have to search long and hard. After many sleepless months wondering if my mom was ok by herself I'm relieved to know she is being looked after and has those extra eyes on her if she needs help. I would much rather deal with the guilt of "putting her away" as she loves to calls it then god forbid having something terrible happen that could have been prevented.
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.
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.
for me that says it all!
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
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
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