Home care or placement?

Wow! You’re parents are very lucky to have you. Many facilities offer what they call a ‘respite stay.’ A respite stay is not only an opportunity for the caregiver to get a break (a respite), but also for the seniors to try out in assisted-living without feeling as though they fully committed.  We encourage the families to talk to the facilities, as many require a 10 day minimum stay. The majority of seniors who do a respite stay actually opt to stay in the assisted-living long-term. After two weeks many find they enjoy the socialization of others, the assistance they need at their fingertips, and the ability to spend time with their family as a family not just caregivers. 

Since your parents are "well off" I would suggest an assisted living/Alzheimer's facility.  What you want to do is commendable but you will get BURNED OUT!  No matter how much we love our parents that dynamic will change and trust me you will start to feel exhausted, irritable and resentful.  I think at 57 years young you need mental and physical and emotional stimulation.  And if you don't care for yourself your health will suffer.  Also their attitudes and personalities change with age and they can become combative, and just plain mean.  I'm not sure if you are single or married.  But trying to care for two aging parents will wear you down to a pulp.  Plus - these older people can really hang on for what seems like forever.  And if you were to "retire" it can be very hard to secure a job at that age.  Trust me I know because I'm 58 and have been there.  I only have one parent - my mother - who is 92  and can still drive!  I think the rest of my family really expects me to quit working and care for her.  I have retired at 49 with 31 years of service.   But I was always going to continue working and get an annuity and a salary.  I'm single and that is the only way to make it in this very expensive world.  I let her move in with me again - stupidly thinking this time she would be appreciative.  Nope -didn't last.  Her personality is changing and I'm stuck wondering how much longer she can stay by herself all day.  I have two siblings that help very, very little.  I recently quit my job and was going through major depression, and some health issues.  I was trying to find work closer to home but after applying for 50 jobs - never heard back except for two.   Luckily one of them was my previous employment who really wanted me back.  I was almost to the point that I was going to sell my home and move and she could get her own apartment because I'm so tired of this.  No privacy, no time to myself - and forget about dating.  I have friends, hobbies, interests and these have mostly been put on the back burner.  I sometimes feel like there is no light and she could live to be a 100!  Her recent physical exam was perfect.  I've suffered shingles, eczema, heart palpitations, and extreme fatigue.  I recently have scheduled my yearly exams because last year I didn't get them.  Hopefully I'm healthy and can still keep trucking but it still doesn't change my home dynamic.  I'm the only one really helping but if I don't everything she wants - when she wants it - there is a problem.  So for whatever it's worth these are my 2 cents.  Good luck to you!

I was between jobs when my mother's health began to deteriorate and I realized she shouldn't be alone any more. I too looked at the economics involved and decided that living with mom and accepting a modest salary would actually be beneficial to both of us, and things went pretty well for a few years. I had every intention of keeping my mother with me until her final breath but I underestimated the amount of care that was needed and the physical and emotional toll it took - I crashed and burned looking after one parent, I can't even imagine trying to care for two. Perhaps you are stronger than me - many people on the forum have stuck by their commitment to see things through until the end - but if you do keep them at home you must have a plan B in place in case you find that those 5 years (and more) are longer than you ever dreamed possible and are are more than you can bear.

I am so grateful for this online community. I have read each and every one of your suggestions and considered them as I made my decision. I checked them in to the lovely facility this morning. We walked into the front door and Mom exhaled. Big. We turned Dad’s care over to the professionals and enjoyed exploring the many amenities of the facility. I will take off a few days and then resume my normal life. Thank you for sharing your experiences and advice!

It will only get more difficult as they decline. As has been said, care giving takes a toll on the health of the caregiver. You could have 10 or more years of care giving 2 elders. I am 81 and mother is 106. I never thought it would last this long and though she is in last stage of vascular dementia, which, by the way, was only diagnosed after she was 100, there is no end in sight. Mother is in an NH now, well cared for but I still have the jobs of financial and health POA, At times , I feel it is too much to deal with along with my own affairs and a few health issues of my own. Take care of yourself first. You don't know what lies ahead and the final chapters could be very long,

I would never try to tell you what you “should” do, as in the end, only you know what is right for you. I applaud you for seeking input here and I think you’ve gotten good food for thought. I can only share my experience. I did decide to retire three years ago to help my folks get moved and settled into a graduated care facility, and to continue supporting them through their transitions (I live 2100 miles away, not working would make traveling to them much easier I thought). I worked part time with a new employer for a couple years and continued to educate myself as a care giver.

Then my mother’s only brother was also diagnosed with AD (their mother suffered from it for many years and finally died from it). Then my mother’s maternal aunt (the youngest of her mother’s siblings) ended up in the same facility as my folks, also with AD. My education quickly began to include prevention measures given this seemingly strong genetic link.

I quickly realized I needed to go back to work. Supporting the parts of my parents’ care that were not covered by insurance/Medicare was becoming a source of stress, as financially it limited my ability to visit, and their care was quickly becoming my world. I was disengaged, not mentally stimulated, stressed out over finances, depressed and not coping well in terms of diet and exercise (sounds like early motherhood, except, in most cases, you have a sense of hope that things will improve as your baby grows). This, along with genetics made a perfect recipe for me ending up exactly like my folks.

I am now back to working full time and I have no plans to retire this time until/unless I become physically, mentally, or emotionally unable to work. Being at work has also helped me build better boundaries with my folks and rely on the facility in a more healthy way. I know this is what the parents who raised me would want for me, and I am a better daughter, wife, aunt, and person for it. As I said, this was my decision and may not be the best for you. I only tell you this in hopes of providing more food for thought. Wishing you clarity and peace as you navigate the road ahead.

Traveler - for those whose parents are in their 90’s to me it’s a vast unknown. For nonagenarian’s, well, their outside of any of the standard actuarial tables / studies and just as likely to hit 100 or another 6 months. So because of the unknowns on 90+er’s, you need to over plan like for having 1 or both a decade.

so are they financially well off with at least 800k+? 1M+? More?
If not, then they will likely outlive their $. I’ve been on this site now for years and over & over folks think their parents will have enough $ only to find that the costs of care are horrendously expensive.
If they live long enough, their needs will get beyond your ability & they will run out of assets so the requirements for Medicaid eligibility need to be a consideration. Plus caregiver burnout is a very real thing.

The costs of private pay NH could easily run 8k -15k a mo each. NH avg stay is 2.5 years so 240k-450k each.
In-home care seems to average $20 hr. So 2Ok a year part time for each; 40k paid to you via a legally drawn up caregiver agreement with taxes & FICA done. If by “backfill” you mean your folks match your current salary, that could pose a problem if they outlive their $ and they end up applying for Medicaid.

Really you as their dpoa need to pull together exactly what their financials are and take them with you to meet with an elder law atty. I’d suggest you get with one that is NAELA or CELA level of experience as their situation is more an estate planning if they truly have significant assets.

ALSO really where is your husbands input in all this?
Does he share your view of his own late 50’s & 60’s as having your parents living with you both and your life as a couple revolving around being 24/7 oversight and caregiver to your parents?

I did this at 60 to help with ALZ MIL. She was 93 and very quickly we realized she needed to be in a Memory Care. The stress of all of what we were dealing with (family, her house and belongings) moving her three times was too much to not affect my job. The week she died my mother was diagnosed with dementia. Our entire world revolves around devastating financial decisions she continues to make (she lives alone but I am POA) dr appointments, hospitals, rehabs from falls.

As selfish as it sounds, I should’ve kept my job/friends it’s important to your own mental health. Nothing will change the trajectory of these diseases.

I too thought about leaving the workforce to care for my now 95 year old mother but I have no pension to take down

I kept her home far longer than I should through numerous falls with little to no outside help - it took a huge toll on me - I tried to bring in caregivers for 12 hours a day while I worked but she did not cope well with strangers in the house - ran outside and fell - caregivers too are not reliable and will leave in the middle of a shift

nearly 3 years ago, I placed mom in a "nice private pay memory care facility" straight from the hospital following a fall - it has been an incredibly difficult journey as well and we are nearing the depletion of financial resources as it has been necessary to have private caregivers with her in the facility

set expectations realistically for both yourself and your parents - assume the cost of the facility is double of what you think going in and you'll need 10 years of care and if their resources can cover it then that should make the decision easier

if you keep them at home, is the situation set up for advanced care needs - think wheelchair access and use of the bathroom and shower
my mom went from being able to stand and walk a few feet to being immobile in a couple of days

is your dad exhibiting any behavior issues - wandering, sleep disorders or aggressive actions - these are often the reason families place loved ones in a facility

There is no right answer and cost and quality of care depends a lot on where you are located but if you can make a decision before you are in a crisis or medical emergency then your road should be easier than most

That’s a tricky one, because you and your parents are well off financially, so you have lots of options. For the near future, if they stay with you, working out the ‘deal breakers’ is a good idea, and making a guess about when that could happen is also in there. You don’t want your mother to be exhausted, but her capability is still an important part of how things will work. There is also the question of your own life. At 57, you won’t want to be tied hand and foot. Of course you wouldn’t be while your mother is still so well, but that might change overnight. The next 20 years should be a retirement when you have a chance to travel and enjoy yourself if you can. If your parents live with you, that could require organising quite extensive (and expensive) in-home care, as well as ‘back-filling’ your own salary. Do you want to share your home with carers as well as your parents?

You could also think about ‘post deal breaker’. If the situation deteriorates quickly and they go into a nursing home at $5000 a month each, how does this work with the finances? And will you miss your work if you take quite an early retirement, and then end up living on your own? I am sure that you could find other worthwhile things to do, but if you are really committed to what you do now, you could regret an early retirement that turned out not to be necessary.

This may be the last thing on your mind, but demographics today mean that a 57 year old man (I guess you are male) with his finances in order is a highly attractive marriage proposition. How could a relationship in three or four years' time alter things?

These are all fairly negative ‘what if’s’. Living together might be a good idea that works well for you, your mother and your father. However thinking about the down side is the best insurance for not regretting things that are hard to change later. Doing it should make you more confident about your decision, whichever way it goes. Best wishes.