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My sister who is in IL with my parents now (we three sisters have been taking turns traveling back and forth to IL this summer) wants to know what it is about us girls that we don't just take charge and let Mom and Dad know that if they are realistic about selling their home in IL we need to get dumpsters and throw items out! Truthfully, my mom and dad NEED MORE CARE and we are very unsettled by their current situation. Myself, my husband, my 73 and 84 year old in-laws (who moved to MN from New Mexico to be near our family a year ago--so far they are independent-- although Roy 84 years old has serious heart and some health issues-we see them 1-4 times each week) live about 20 minutes from us. We are happy they have joined our family here in MN. They bought and live in a one bedroom one bath unit of a Co-OP for 55+). Unlike my parents, they seem to be making decisons that allows them both independence AND family support. Also living in MN, are my two sisters and some of our children (ages 20,23,24, 26) and son-in-law (age 30) and grandson (18mos). Seems logical to us to have my parents live in an Assisted Living/ Nursing Care facility here in MN. My parents claim that they want to sell their home in IL and return to AZ to continue to live with their in- home health and living care. My folks w/ my brother have lived away from us for many years. Seems like we'd see them once a year in AZ and then several times during the summer in IL. We all have our own jobs and lives, but if they lived in MN we would do our best to pull together to offer "family" of love and support to my parents with visiting and taking them places they needed and wanted to go as well as advocating for them.


None of us live in homes where a bathroom and shower is on the main level. For the past 30 years our parents have spent 9 months in AZ and 3 summer months in the house in IL that they purchased back in the early 1960's. Mom is of sound mind (except has hoarding issues). She has serious leg wounds (which she gets in home skilled nursing care or goes to wound center appointments) plus she has both bladder and bowl incontinence. She seems to go into the hospital due to infection and blood clots and then spends weeks in rehab to regain strength. She is in pain due to needing a hip replacement but doctors won't operate due to serious leg wounds. Dad, had a neurological work up a few months ago. He has serious short term memory loss (dementia mixed w/ Alzheimers-memory issues). He basically shuffles and needs help knowing what to do next. When he is driven to visit my mom in hospital or rehab he asks what he is doing there. My mom tells him that he is visiting her (we feel that he is afraid that he might be the patient there). To complicate everything, my 59 year old brother has mental health issues and has lived with them most of his adult life. The past year he has helped greatly with their care (driving them to some of their appointments and some of their errands, some grocery shopping, taking Dad out to eat, we set up the pill boxes for Dad and our brother checks off on charts created by my sister (RX, Blood pressure readings, breakfast, lunch ,dinner and shower 2x each week (the meds and blood pressure check seems to happen..but Dad won't always take himself in for a shower). Our brother helps with getting mom some food throughout the day when she is home. My brother is capable and good intentioned, but still plagued with his own issues so not sure of timeliness and consistenecy. However, Mom ( who is an intelligent and kind person) won't let go of items in her house (including things like lots of cardboard and plastic bags and old sets of encylopedias and too much stuff where there is no table space and not much walking or living space (true hoarding issues but is blind to this aspect). Even with the help they have in AZ we still feel that they are vulnerable without family nearby. Their health issues are significant and getting worse. Any advice?

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THANK YOU to those who read and responded to my quite lengthy explanation of our situation.......I appreciate your input and have passed it on to my sisters....we do have paper work with powers of attorney etc (as my Dad was good about setting that all up and it was recently updated). My one sister who has been willing for the past two years to help with the bills has finally been granted their permission to to handle their bill paying for them. Her husband passed away from colon cancer about 6 years ago. Her children are in their early 20's now and she is thinking of seeing if my parents would employ her so that she can be their personal "live-in" coordinator to avoid leaving them as what seems to us as "vulnerable adults". This would require her leaving one job and putting her own business on hold . Her plan would be to commit to doing this for one year with the ultimate hope being to try to help them transiton to Assisted Living in AZ. Mom and Dad have made it clear that they want to be in AZ. Once they would get back to AZ she would try to help them to figure out their in home health care needs as that is their wish to remain in their home in AZ with in home health care. She hopes to be there to help see IF their wishes can be viable for them OR if Assisted Living is truly the option that we as their children must try our very best to get them to agree.......or do parents not agree but children still insist and require and demand that they move to Assisted Living/Memory Care??? Dad has paid for Long Term Care for he and my mom for over 20 years. Included in that Long Term package, for Dad, is some in home health care benefits (but not for Mom). Truth is even their doctors for the past year have said that they need more care so they did hire more in home care. A big issue has been my brother's mental health issues and the fact that he has lived with them most of his adult life......but doctors have told my mom that she must do what is best for she and my dad and "let the chips fall where they fall" for my brother..... In the meantime, my sister would hope that the IL house could be cleaned out and sold. We did a Bagster (soft flexible fabric that has specific regulations for pick up, yet can hold p to 3000 pounds---it hasnt been weighed by the pick up folk so keeping our fingers crossed we didn't go over the limit) but will need a dumpster (s) down the road. Actually proud of Mom with allowing some items to be sorted (keep, donate, toss, give to family or friend)......progress for her..but unrealistic as hardly a dent in the overall job. We've had to take pictures of everything and send it to her at Rehab for her direction of what to do (a cupboard full of old telephone books hold some type of meaning to her)----very frustrating to us as so much that needs to go........perhaps she'll end up selling "as is".........seems a waste to not make the best profit on the sale. Her house is full of stuff everywhere, but thankfully it is clean (not dirty piles just piles everywhere and they do not own any animals so no issues there). Tomorrow, my husband and I are taking my Dad for 15 minute eye laser surgery (relieve pressure on the optic nerve as he has glaucoma). He is anxious and repeats the same questions every ten minutes. He shuffle walks and has very limited strength. Most debilitating is his short term memory loss. We just discovered that Dad was to have this proceedure so we extended our stay by one more day. We were told that there is no recovery needed from this Trabeculoplasty............I hope that is truth as we are heading back home the following day..........we'll see what eye doctor says. TRUTH is my folks need Assited Living. Nobody expects or has asked my sister to do what she is planning to do, but she feels that she is in the best place job/family wise to do this....I'm thinking that it is really too, too much for her ....she will plan to fly home several times throughout the year to reconnect...
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If the hoarding and incontinence issues are creating an unsound environment you need to act AS A UNITED FAMILY. That means it is time to go together now to see, and to family conference. This is coming, but whether it is here or not yet, remains to be seen. There needs to be knowledge of where important papers are. There should be the drawing up of advanced directives and powers of attorney. Start there. You all as sisters need to meet, visit together, and then speak to one another and come to best decision for now, and plan for future. You need to act on paperwork now if you are ABLE. You state your Mom is of sound mind but you speak of incontinence and hoarding, and you may need an adult protective services opinion to help you come to conclusions.
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From your story, the only line that matters is "mom is of sound mind". She is in charge of her husband....for now. She might not be making the choices that you want for them, but she has a right to do so. You cannot make them move against their will, as good a decision as that would be. It's an unfortunate situation. You may have to wait until things get worse before they get better.
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Sometimes when there are multiple issues, it's not clear where to start or which is the most pressing to try and solve. I will ask some questions and maybe it will help clarify things:

1) Have your parents designated someone(s) as their durable PoA? Is all their other important paperwork in order, like Medical directive, HIPAA waivers with their docs, will, etc? If not, this is very important.

2) Is your brother willing and able to continue providing them care as it rapidly ramps up (as it most certainly will)?

3) Does anyone know the full scope of their financial means if your brother can't continue to provide in-home care by himself and outside help needs to be brought in for the short-term?

I think as long as your brother understands that he stands in the gap temporarily if there is a serious crisis with one parent, as this will trigger a sequence of decisions and actions regarding their future care. It will buy you some time. If your brother has to provide round the clock care to 2 compromised people he will burn out quickly, mental health issues or not. He and your sisters should privately come to an agreement about what will happen, and where your parents will be resettled, in this event. I personally don't think there's any reason to get buy in from your mom as caregiving practicality will then trump their unrealistic desires. Marie Kondo-ing them against their will is not energy well spent at this time. Your brother can box up stuff and senior-ize the place gradually until the crisis point occurs. Good luck!
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