"I want to stay home as long as I can." What does that actually look like?

I detest all those "why" questions! "Why won't he wear his shoes?" Seriously??? It seems like the people who ask those "why" questions have never had to contend with being hands-on caregivers. It makes me want to respond with "He hates having anything on his feet and takes socks and shoes off within seconds of me putting them on. Do you recommend I use Elmer's or Krazy glue?" And then wait for the look on their face.

Getting back to your question of what it looks like. If there's lots of money, it looks just fine and dandy, and Adult Protective Services never gets called because the person who doesn't wear shoes is considered "eccentric". If there's no money, it looks and smells horrible. If there's some money, it's just plain hard because they are squeezed of every last cent before qualifying for assistance.

You will run out of spots to put grab bars - trust me when I say that we did.

Falls will happen more frequently. Nutrition will decline; personal hygiene will too. Their brain will turn to mush as they withdraw from engaging with their community and people their own age. Depression, anxiety, and mental illness may set in. They may become reckless, and drive or take risks to assert themselves and their self determination. They may get scammed out of money.

USA is no place for old people who never prepared themselves for being old.

Beatty, if it comes to guardianship I think it's better you have it than the state. If the state has it you will have absolutely no say where your parents go (and they won't be obligated to make it nice or close). Pursuing guardianship will require you to prove their "incapacity" plus it costs money and time. I'm not a legal expert but if you do get guardianship you may be able to reimburse yourself for the cost if your parents have the means, but like I said, not sure if this is legal. Keep very detailed records and receipts. Ward of state should be last option but don't feel guilty if that's how it goes.

look for a place that meets those requirements that also takes Medicaid in your state. If she has any money, she can spend that for care and then can apply for Medicaid to pay when she is out of money. I suggest you do it that way rather then look for a place that takes Medicaid and have to move her there later. The odds are better to find a place you like, have her live there for a while at private pay and then they will help you apply for Medicaid when it is time. And don't look for her to agree, just tell her, once you have decided where she should go, that she has to move and take her to see it. My mother did not want to move either they never want to move. She said she was "not interested" and felt my sister and I could come to see her twice a day to give her meds. She did not eat on her own, did not clean or pick up anything, do laundry. She sleep 20 out of 24 hours (maybe even more). So while she was saying, "not interested", we just moved forward and got her moved. She adjusted, and is in good hands now

"Go and check out suitable assisted living facilities by yourself, then tell her what is available'. You are right. She has no plan so I must (for my own sanity!) I have her on a list for a place connected to her church, enquired at 2 other places & booked a proper tour of the closest facility. It's small, clean, too $$$ for long term but may be a very good place to land for emergency respite.

I am breathing easier already :)

Unfortunately due to shortages of beds in AL and SNF and the influx of Baby Boomers into the system, insurances and the government are pushing for seniors to be cared for at home by family. They will even keep the patient in the ER for 23 hours to keep from admitting them to the hospital and send them home as an outpatient.

They do not have a plan. One time, when we were still married, I actually asked my husband what would happen to his parents and their situation if he was in a car accident and had to be in the hospital. He said, "That won't happen." Seriously. He's got three siblings but they are extremely content for him to be the caregiver. It is a terrible situation.

Here's what it looks like in my ex-husband's family. He is full-time, 24/7 caregiver for his parents, who are both 93 years old. Both are in wheelchairs. His mom has late-stage Alzheimer's disease. He has to feed her. Although dad can still get into and out of the wheelchair on his own, he has fallen a few times, and now they have a mechanical lift so my ex can somewhat safely help his dad get up. Mom can't move on her own at all. Dad and mom have enough money to hire help but dad is resistant to doing so. I assume that he will never consent to moving out of the house. The issue might be forced if something happens to my ex, which is a strong possibility, given that he has been providing caregiving services for the past six years almost non-stop.

Is their "aging in place" plan dependent upon you providing all the care? Do you have any Power of Attorney?

My inlaws tried to pull the same baloney with us, MIL gave her son/my DH DPoA but her turd of a husband wouldn't. And they were not only broke but in debt. They had never given a thought to their "sunset years" except to assume we'd take care of them hand and foot (without our permission).

Since I did the bulk of the care and management, (he had Parkinsons and Lewy Body at 6'5") I told him we're not running 2 people over there in the middle of the night every time he keeled over or couldn't get out of his recliner. His wife would call 911 every time we refused to go help. This meant they'd take him to the hospital, then to rehab, then came the medical bills they couldn't pay. Over and over. Finally I informed him of his choices: either give someone PoA, apply for Medicaid and get yourself into AL or be prepared to become a ward of the state. He didn't believe me. He died as a ward of the state. But there was nothing we could do so I don't feel guilty about it. The lived in a house with stairs to get to the main floor. My MIL had profound short-term memory decline and wasn't remembering to eat. We got my MIL onto Medicaid and into a very nice facility and doing well. even though she didn't want to leave her home. It took her almost 2 years to adjust. Now her mental state is the best its been in years.

The only thing you can do is lay out the realistic options and even then they may not believe you, or they may have enough dementia that "reasoning" is a waste of time. For your own peace of mind you may wind up calling social services on them so they are on their radar as vulnerable adults. Not sure about your sister...she's on her own. Or should be.

What is an OT assessment? Is that for cognitive decline? Goo luck!

she needs a cognitive evaluation to determine if she is able to make rational decisions for herself. If she is not mentally competent to make decisions, then her wish to "stay home" probably is not a very good idea. They always want to stay home, and they want that past when it is safe. And they cannot "stay home" without a village of support which shows that they are not independent. And certainly they don't care what keeping them at home does so the people who have to care for them. I have a mother in a supportive living community and inlaws now in memory care who. None of hem wanted to move but finally they did

It sounds like you have already decided what is best. Even sounds like she’s had the same suggestions from medical professionals.

If her doctor and OT recommended assisted living and she refuses then that is tough. Sometimes they listen to others better than family members.

I would say to her that she is out of options since she isn’t cooperating. I have the lockbox and I love having it.

I am here with mom so I let emergency workers in and I still put a lock box with key out front.

Your mom should have a lock box. I’m curious as to why she wouldn’t. Seems like it would give her peace of mind.

If she is not able to do the basic things like food prep can she at least get meals on wheels delivered? Have you contacted your local Council on Aging for assistance?

Go and check out suitable assisted living facilities by yourself, then tell her what is available. It really does sound like it’s at that point to me.

Best wishes to you and your family.