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My grandparents can barely walk with walkers, they're in constant pain, they have a ton of family members breathing down their necks telling them what they should do but at least we got my grandmother on anti anxiety meds (that only helps so much). Everyone is wearing themselves out helping my grandparents but it just angers them. We can't even convince them to let someone meet with them for an hour just to discuss the idea of getting some profession in home care. Before I was supportive of everyone helping but I've changed my attitude. Now I feel my grandparents (and everyone for that matter) are so stressed and upset that everyone needs to just back off. Will one of them end up in the ER or worse--yes. Will their lives be easier if they had prof. help--yes. Will they accept help--NO a hundred times over. I feel they need love in the form of good conversation and distraction from the topics of health and death. What is the right thing to do? Force them to get help when they're already furious or back off? The entire, huge extended family is miserable at this point. How can we help my grandparents move on gracefully? (they don't qualify for hospice just yet but they did come by one day)

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The counselor and you agree. Back off, force them to realize they cannot function alone. Hopefully they will then agree to Assisted Living. If they already spoke to Hospice, then they are not afraid of dying, just afraid of giving up their home. If they don't want 911 calls, that's OK, just make sure you have advanced directives signed, so you are not liable. They have the right to refuse further medical poking and prodding, just have them sign the DNR.
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Agree: back off. Sometimes it takes an ER visit to make folks realize they need help.

Instead try to think of ways to help them maintain their independence, without criticizing or inferring they can't take care of themselves.

It's hard to recognize that our brains and bodies are declining - it can be a denial situation until something happens and they become so scared they reach out.
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Yes, back off, for all of the good reasons given above AND that you already know. The point is, that while your grandparents do need help, the family is not helping. So stop.

Make sure each of your grandparents knows who to call if he or she has a change of heart, or if there is an actual emergency - this could be either a social worker, or ONE agreed-upon family member who is available most of the time. Ideally arrange for the number and name to be prominently displayed near the phone.

Gosh, I hope your large family is also the type that can agree on one spokesman? Fingers crossed.
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As someone who has gone through this, make sure they have a Life Alert system of some kind, make the house as safe as possible- remove loose rugs, handles in the bathroom, double railings on any stairs and just let it go... you may be surprised at how they might complain that no one helps them, leaving a opening for outside help. Use your visits for just that visiting and listening.
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Kristen, I agree that a Life Alert system would set everybody's mind more at rest - KAT, if you were to point out to your grandparents that this would also make everyone GO AWAY and give them a bit of peace, do you think they might agree?

Making the house as safe as possible - although I agree it is desirable, of course - is a much thornier issue. I'm guessing that sweeping into their home and meddling with their possessions is exactly the kind of thing that makes them see red and chase everyone away, brandishing their walking sticks and yelling "and don't come back!" Tread extremely carefully. It's their house, their lives, not yours.
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I agree that everyone should back off. People like your grandparents often feel bullied by all of this pushing. They may eventually agree to some help if they are given what you mentioned - loving attention and distraction. If they feel free to make their own decisions they may become more reasonable.

I also agree that if they aren't too resistant to wearing personal alarms to call for help that would be a step forward. Because of all the pushing in the past, they may even refuse this for awhile, but in the future you could gently mention that this form of help is non-intrusive and possible so that you'll set it up if they decide they want it. To me the magic words are "they decide."

I know it's hard to watch this and not try to fix it, but human dignity and the ability to decide for oneself is important. Good luck to you all,
Carol
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I come from a large extended family. We all think we know best. You can't change them, but you can change yourself. You back off from helping aka interfering and enjoy your grandparents. Listen to what they want and do it. Don't offer suggestions, wait till they ask before offering advice. You be the one person they can turn to that honors their authority, intelligence and their automony. Soon others will follow.
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Hi,

If they are in chronic pain, they are irritable to start with, I imagine. I think your stance as you presented it is very wise. I will tell you a scenario that worked for me in case you can try it later, but it had to do with helpful chores that I was willing to do myself.
My mother's "significant other" beau needed but refused help...I would sometimes force the issue if it was something like cleaning up outside, where his own adult children just always backed off. He lived in a retirement community, so he coudln't just ask or pay some local teens to do this kind of work. In his case it was pride that made him refuse, but I found if I went ahead, he accepted the help gladly. (He put up a grouchy, tough front.) I made sure HE directed what was done...I was just the "worker", so he felt he had control. This won't work with every one but may work with some. But I agree with the others, a "cooling off" period is necessary for everyone in your case...just maybe let your grandparents know that you will provide help if they direct what they want done. They may come around, but if not, it seems you have done what you can. They just want some peace.
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From my experience it is very common that some seniors will not give up their independence. God Bless them! Until one of them ends up in the hospital and its too late. That is very common and it not lack of the family trying to help. You would think that seniors would listen to their children first but sometimes if a stranger helps them with their options they may make a independent choice on their own.
Make sure the family is really listening to the reasons why they don't want help?
Explain or have someone explain the options they have and what the outcome will be if they do not do something now. (one may end up in the nursing home or hospital and the other one at home) Then if that does not help back off they are adults and need to be treated with respect.
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On p. 54 of my book, “What to Do about Mama?” I state:
“A productive family meeting can build a strong foundation for family caregiving. Do you share common values? Talk about what is most important to all of you—autonomy or safety. Establish common goals. Divide responsibility based on the strengths and abilities you bring to the family. It is important to be specific. Develop a contract that delineates the commitments family members have made, and solidify those commitments with signatures that verify that everyone understands and agrees to the plan. Be sure to date the contract in case changes are needed later on.”
In your situation you have an extensive family, so finding consensus will be a challenge. I agree with all responders that the family needs to back off for now (this would be part of your family plan) and allow your grandparents to regain their sense of autonomy. Once they feel a greater sense of control, they MIGHT be ready acknowledge their need for more help and make the choice to accept it (offered up in small steps). If they don’t, then they will suffer the consequences, and none of you should feel guilty, say “I told you so,” or allow those consequences to become YOUR consequences.
If you feel the situation is very dangerous, you can always call your local Area Agency on Aging with a report of need. The report can be made anonymously.
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Definitely back off, no one likes to loose their independence and it's difficult for some when they begin to loose skills such as their ambulation skills. It's good they can use a walker but it sounds like they could use some physical therapy to strengthen their ambulation skills. Many don't like strangers coming into the home, and it may be that your grandparents area afraid that if someone comes in they will be 'made' to go into a nursing home. Assure your grandparents that is not the case, there are many programs out there to keep people in their homes such as a waiver or senior care program. Call your local Area Agency on Aging to see what's available in your area or to speak to someone for caregiver support. You can arrange someone to come out to visit your grandparents to explain about home and community based programs that are designed to keep people at home and they can reassure your grandparents that no one wants to see them in a nursing home. They have a right to make choices, but the choices need to there so they can choose. I'm a caregiver, I'm over 50 and I have medical issues that have brought on a decline in my functioning so I know how difficult it can be to accept assistance. You grandparents have always 'done' for themselves and now that they can't it's difficult for them to admit that and accept help. Continue to reassure them that you want them to stay in their home and there is help available to those who need it to keep them in their home. Most important of all is to let them know you love them and want them to be around for a long time.
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Some folks are checking out of this world their way. It's painful to watch, but it is their prerogative. Once one passes, the other will suddenly become far more dependent on family members. Stay strong.
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suggest that they at least try someone for a couple of days and see if it works out. then them an emergency button and suggest someone come in and help with the laundry, the small everyday chores
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Give them time it is VERY hard for them to give up their independence. Your grandparents will admit soon or later that they are ready for help. This is what I have done with my parents. I started helping them with daily things washing dishes, dusting, mowing, etc. It was very hard to work at their pace! However I found my self doing more and more. We had some amazing talks and special memories were made. Just take it slow and be thankful you have people who wants to help them.
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KAT, for crying out loud. Tell your family to get off their backs. My mom is 82 and unsteady on her feet. She still works in her garden every day. Heaven help a weed. If mom dies in her garden, she will have a smile on her face and I will call her blessed. If your grandparents are ok with a emergency alert system, this should be enough. If they can manage their meds, and are eating right and are of sound mind, leave them alone.
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KAT, for crying out loud. Tell your family to get off their backs. My mom is 82 and unsteady on her feet. She still works in her garden every day. Heaven help a weed. If mom dies in her garden, she will have a smile on her face and I will call her blessed. If your grandparents are ok with a emergency alert system, this should be enough. If they can manage their meds, and are eating right and are of sound mind, leave them alone.
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Unless they have been diagnosed with dementia and incapacitated, it is their lives to do with what they want. Everyone in the family might have control issues (which were probably taught by their parents), and unless there is some real crises, leave them to their golden years, and when THEY ask for help, then you can step in. Otherwise, leave them alone for now.
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Life line is a very good idea, but sometimes elders won't use it. They seem to fear going to the hospital more than fracturing their leg or being in pain for hours! I agree you need to let them alone as far as determining what they feel is "best" for them.
It is so difficult to help the independent. They are hanging onto their ability to self determine!
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We went around and around with my husband's brother (only the two of them) regarding my in laws and this issue. When my father in law died on Christmas day, 2006, immediately the brother began bullying mil into selling everything in her home and 'moving on' into assisted living. She was older and somewhat frail, but at 86 she had lived with her husband in the same home since 1952 and was not ready to go yet. Both sons had been made POA and were on the deed to the house as well as joint executors, etc. She wanted it that way but it caused dissention at every turn for my husband, because the brother lived there in town and all we EVER got was 'you don't understand'. Also, we saved for retirement and brother didn't and he flat out told us that he thought of her money as his inheritance. Very bad. He forced the sale of her stuff and then showed her the tally, letting her know her precious antiques and things were not worth that much. Made an appointment for her with the assisted living place and sat there in front of the person there pressuring her to sign up for the move. Shortly after going into assisted living, she fell while dressing and broke her hip. That began the downward spiral into a nursing home and she never left there, but she did last much longer than I would have ever thought. She passed away let summer, four months shy of her 93rd birthday. She wanted cremation but her 'other son' forced a full out embalming, open casket, etc. (He is in the funeral business!) and she conceded. This stuff has caused such a rift in the family. My husband and I feel that she should have been treated the way we want to be treated. And it says in the Bible that 'the first of these is love'. That includes respect for another's wishes, particularly the people who raised you and sacrificed for you. Yes, maybe they will fall and break something. Maybe something 'big' has to happen for them to get that they need to leave their home. But all we have to do is think that one day WE too will be in their shoes and treat them the way we want also to be treated. I say back off, unless they have dementia and cannot reason. Maybe they would rather 'go out' at home than in a nursing home. And who can blame them. Eventually we are all going to die. Sometimes that seems to be lost on people, even those who mean extremely well.
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The same type of issues were coming up with my dad. We knew he could not live alone, the doctor even said that he should not live alone, but he wanted to stay in his home, and the family was getting so stressed out and worn down, making sure he had meals, personal hygiene, outings or some social life and keeping his home clean, getting him to doctors appointments, etc. it took all four of us full time just to get it all done. After years, he could still not see all of the work it took, so the 4 of us decided to back off. We made sure that he had food, made the house as safe as possible, life alert, cell phone, he could not drive a car, so we sold the car, we did not want him getting behind the wheel, but wanted him to keep his social contact, like meeting the guys at McDonald's for coffee, so we got him a electric scooter, and worried in silence that he did not get hurt. We visited him everyday, but did not push him. Then something happen! He said that he wanted to see us all, he told us that he could not do it by himself. He told us he was willing to visit a Assistant Living Facility, he decided which facility he preferred. Your grandparents will never see how much is being done for them, unless they experience it for themselves. They still see that they are able of doing it on there own. They have to see for themselves that they can not do it on there own. If they have a fall, or they miss a meal, be there to support them, when they are ready, they will be ready on there terms. Your biggest problem is your family. Unless, the whole family can agree to step back, the grandparents can not ever figure it out. Why should they, as long as they are the center of attention, and being waited on for every need, I wouldn't be in a hurry to change either.
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Life alert and meals on wheels are 2 programs that allow seniors to stay in their homes and do not cost a fortune. Otherwise leave them alone. In my experience there will be a defining moment - usually an ER visit after a fall - that sets all of the other stuff into motion- social workers, placement ect.... That is when the family is going to need to come together to arrange other living situations. Bless their hearts, they are trying to stay independent.
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People born in the 20's, 30's and 40's were a very independent lot. Many grew up in rural areas and cared for crops and livestock. They took pride in their independence. My dad was one of those farm folk. He refused help, although he had the early stages of dementia. I finally convinced him to sign power of attorney over to my sister so she could handle his financial affairs. What she discovered was appalling! If we hadn't intervened, he would have died in that house, filthy as it was, without utilities. She took him to live with her, where he had a new lease on life. His health improved, he was happy, surrounded by loving family on a ranch where he could garden, dig in the dirt and do all the things he loved. He was given free run of the ranch until his dementia got so bad he had to be put in an assisted living situation. I have a friend who's in her 70's and lives alone on her 100 acre spread, complete with livestock. She cares for the place by herself and wouldn't have it any other way. She said when she's too old to function on her own, she plans on wandering off into the wilderness to die alone in her beloved woods. I fully expect in 15,20 or 25 years from now, when I come out to visit her on one of my frequent trips, I won't be able to find her anywhere. I'll know she's gone because the goats won't have been milked and the dog's food dish will be empty. I'll arrange a search party and we'll all look for her, but she won't be found.
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I understand from your description that they have mobility and pain issues. If they are feeling bullied or pushed around by too many children and grandchildren, some backing off is required.

I would imagine their is one or two children are grandchildren who have the respect of your grandparents (Perhaps their "favorite son or daughter"). Inlaws need to really back off as help needs to come from the children --same with advice.

Let things cool off, then have the "favorites" visit to make sure medications and doctor visits are being handled. If they are on walkers they need help with these things. Make sure they are eating well. Get someone to clean for them. See how they do alone.

The favorites should talk to them in unrushed visits about what they want to do. Take them out to eat, to church not just medical trips. Reduce their loneliness and sense of isolation.

Always remember the elderly know they are losing ground. At 45 yrs old, people think they should be exercising more, doing this or that, but the 45 year old has no idea the pain they are feeling.

In the short run, less is more. Be guided by what they want done for them.
As time goes by, they will realize what help they need.

Good luck.
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That's what I'm doing today with my mom -- I'm backing off. She had a doctor's appt but her intestinal problem continues. We agreed last night that I would take her to the ER to get it checked out as her NP advised. This morning she yelled that she wasn't going anywhere, that she was tired of "all these doctors." [She's not seeing any as she keeps cancelling appts, but with good reason.] So I backed off. You can't force them to go. Either my mom will come to the decision that she needs to see someone or she'll end up in the ER anyway. I will gently try again, but for now I have to back off or I'll upset her further. Maybe she's afraid of what they'll find? Maybe she will listen to someone else. When my father was sick, he stopped listening to my mother. But he finally listened to me. He died a week later. She does understand what's happening, so all I can do is respect her decision and back off for now. I hate it, but I'll have to respect her choice and support her.
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Oh, I feel for you. I have the same problem... With my parents, but we are opposite of a big extended family... It's just me...no brothers or sisters, the closest relative is 4 hrs away. I also live in a different state! I've asked my folks about assisted living, getting someone in to do laundry, shop, play cards....they won't even have someone come in every two weeks to clean! My mom uses a walker barely... My dad had good mobility, still drives, but has always been more of a depressed personality. I know as you do, that it's going to end up going thru an ER, THEen rehab, and then maybe assisted Iiving or a nursing home. My dad keeps telling mom, don't worry, I'll never put you away.... I'm miserable also but they are parents who are proud and refusing to give up independence. I agree, back off... It's not helping... My thoughts and prayers are with you.
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Ps... I fly down every 6 weeks to keep tabs, but is not easy, as I also need to work!
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Do not back off but choose one person to be in charge of the situation. your grandparents sound too weak to fight you other than words. they are smart enough to know how bad they are and so let them vent as you move forward to help. assisted living might be good but don't waste time explaining or waiting for their approval. terie novak - author of ebook "Bold Actions for Helping Older Parents"
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I am slowly backing off from my parents.... if I start helping them with cleaning or yard work, they would expect it every week but then my own house would decline while their would look great. I decided since it was their decision to remain in the single family home, they need to take on the responsibility of their decision.... just don't drag me into it.

My parents' [in their 90's] primary doctor recommended a Life Alert type of device but my Dad say "no, that's for old people"..... ooooook, I guess we will bring up the subject in a few years when they are in their early 100's.... [sigh].
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I think it is very hard to know oneself is fading and losing vitality and strength. For people who have always been somewhat of a force, it is especially hard to get older and more unable to do what they used to do.
Personally (we are 59 and 63) my husband and I have been taking mental notes on how we want to ease into our later years and have been 'doing it' for some time. Our parents (his are both gone and mine are in their eighties) were, with the exception of my dad, never active physically. We are making sure that we have been making lifestyle changes to keep our bodies stronger. We have experienced parents who cut medications in half because THEY don't think they need that much or that it is cheaper to use less. However, they rarely questioned their doctors about what could be done as an alternative to taking medications or so much of it. We have intentionally moved into a home with a small enough lot to be able to pay for lawn service rather than 'realize' a dream of having acreage or even a huge yard knowing it won't be long before we cannot care for it and then be forced to sell a home we love. When we purchase something (new wine glasses) we get rid of the old ones, so we don't have more than we need and jammed closets and storage that one day someone else is going to have to go through and throw out. We have a current will and directives. (Our parents did do that). We also have financially been responsible so our kids won't have to take care of us financially (ours did that too and we were raised that way, thankfully). We have chosen carefully and realistically the one of our six kids who we trust to execute things for us if and when we are unable and have NOT stuck our heads in the sand about 'wanting everybody to just get along', knowing the personalities we have between them all, including the people they are married to (or not married to!). My advice would be to back off and let things be, at least for a while. The more you push people who do not want to be pushed the more they will resist. Independence is a fundamental need for a person as an adult and from birth, we all are straining to achieve it. Who would want that wrenched from them? Put yourself in their place. Be kind. You'll catch more flies with honey than vinegar! Bad things MAY happen if every eventuality isn't covered, but, frankly, that's life. Those events are the things that do push the envelope and it does help point out to the elderly person that a change does need to occur. Most of all, it would be helpful for everyone to think about how they would want to be treated (empathy) and also, learn from these events to make changes for their own futures and families. As for my own parents, my dad, who ran a successful company and had the wherewithal to retire at 50, has had two knee surgeries, two hand surgeries, two back surgeries (fusions) and we cannot stop him from climbing on the roof to clean out gutters or from strapping a huge gas powered leaf blower in the fall to keep his 3.5 acres leaf-free (impossible). He should not be doing these things. I am sure he feels that he'd rather die from a fall off the roof than give up what he loves, his home. He was a builder and developer. He has the most beautiful and enviable home in his neighborhood, a huge source of pride for him. (Pride is one of the seven deadly sins and I fear that could be the case if common sense doesn't prevail, which it won't). What he fails to see is that he could take a spill and end up in a wheelchair and not dead. But he is a stubborn GROWN UP and it is his right to live his life. The five of us siblings cannot agree on what to do and believe me, he would resist ANY type of 'directive' from any of us. I have totally backed off, and, as I said, taken lessons from their behavior, tried to understand and realize that when and if I am needed to help pick up the pieces, that's when I will be there.
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Great example, "lostfamily" of using the approach I outlined above. And as I said on p. 50 of "What to Do about Mama?": Of primary importance is the individual who needs the assistance and care. If that person’s values and wishes are not respected and taken into consideration, you are bound to run into resistance and conflict. Who doesn’t want to remain in the driver’s seat of life? It is imperative to respect your loved one’s independence and dignity—it is, after all, that person’s right to make choices and decisions.
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