I consider myself very lucky. Mom has been in slow cognitive decline since suffering a stroke 17 years ago. All these years dad has been her caregiver and has been able to hold everything together. Mom is now 82, and dad is 91.
Last month everything changed when dad was in a single car accident- he got lost at night and drove into a median. I had instructed him never to drive at night and to only drive to familiar places but he didn’t listen.
Dad is recovering nicely from spinal fusion surgery but his cognitive decline is apparent and seems to have been more noticeable since coming out of general anesthesia.
Prior to his accident they were fairly self sufficient. Sure there were more and more calls dealing with technology issues, like how to download and print an emailed photograph, but otherwise, dad seemed to be managing fine. But it is no longer the case.
Since coming come from the hospital we have had to put 24/7 home care in place, mostly since my dad can’t take care of my mom like he did in the past. But he is improving rapidly and we are starting to cut the home nursing back to a 6 hour shift from 8-2 and then a 4 hour evening shift from 6-10.
Dad himself needs little to no help. His only deficiencies is that he can no longer drive, and he does get a bit confused at times. But otherwise he is quite capable.
Mom on the other hand could not survive a day without dad. While she is capable of dressing herself, feeding herself, bathing, toileting, She cannot cook, cannot manage her meds, and would starve.
At this point, a part of me feels that it is a good time to move them out of their independent living situation and into assisted living, but another part of me feels that a move to assisted living would be very stifling for my dad, who treasures his freedom to be able to go about and do things for himself.
He has already resumed cooking dinners even though there is a home aide there prepared to do it for them, and he has started using the shuttle service at their retirement community to go to the shopping plaza to buy groceries. We are also putting in place home aides who are able to drive mom and dad on errand runs.
I’m really at a loss as to what to do. Every time I ask my dad for input he just says, “what do you think is best?”. The home nursing is very expensive- in fact, placing them in assisted living would be the less expensive option. But I want to do what is best for mom and dad, not necessarily what is more economical.
Any insight or advice from this community would be much appreciated.
Cheers-
It truly sounds like your parents NEED Assisted Living not Independent Living.
I think you should begin to actually count how many hours you spend helping them in the past and how many more that will creep into.
I think if you are spending more hours now than in the past then you need to put your foot down and the choice for them would be make the move to Assisted Living or hire caregivers that will come in X number of days per week for X number of hours.
The last thing you need is for dad to reinjure himself while helping mom.
Last thing...it also sounds like it is a good thing your dad is no longer driving. With the restrictions you placed on him it seems to me you were concerned about his driving yourself. That accident could have been much worse killing someone else or himself.
I would be EXTREMELY unavailable to your parents for the next month.
Let them exercise all that "independence".
Not snark-- just allow them to see the tasks they need help with. When they call, ask them to start a list. Tell them "I'll get to it when I have a chance".
If they complain, point out that THIS is why they need to be in that CCRC.
Alternatively "Mom, Dad, this is your chance to move somewhere on YOUR terms. If one of you gets ill or injured, there won't be such nice choices."
So my many many hours of research, inquiries, visits to facilities, gathering of files and documents to construct an accurate picture of my parents financial situation going forward had culminated in a visit and tour today of the place I targeted for my parents along with an assessment appointment to see if they would be accepted at the CCRC.
This process had all begun 4 weeks ago when my father, still laid up in the hospital, expressed a desire to move out of his condo and into a place that would be closer to my sister and me, a place where he could be better taken care of and have a better life going forward now that he would no longer be driving.
When I would check on him in the hospital, rehab center, and then at his home, he would tell me what his wishes were for the new place- he wanted space, and he wanted a garden where he could walk. He was so excited when I told him I had found the perfect place and a unit that was actually bigger than his present condo and would give him walkable access to so many more amenities, stores, and shopping than his current living situation.
So today was the day that I took dad and mom to take a look at the place I had put a hold on for them and do the assessment. He and mom did the assessment, then dad looked at the campus and the unit and absolutely loved it! It was perfect for him..... only he told me he didn't want to move. He was happy where he was, and he was happy with the limited shuttle service at the place where he lives now that he can no longer drive.
I was shocked. Up until today all he ever talked about was moving to a new place. It left me speechless. Speechless, disappointed, and angry. All the time and energy I had spent on this had been for naught. between online researching, visits to potential places, reconstructing his financials to crunch the numbers and gain a true picture of his situation, enquiring with his various financial institutions, filling out applications, I had probably spent 40-50 hours on this endeavor. And in the end he says he doesn't want to move.
I wish he had told me this a month ago. It would have made for a much less stressful December.
Oh- and the CCRC called me at the end of the day to give me the exciting news that mom and dad had passed the assessment.
Beware of "caregiver creep." He can't drive to errands, the grocery store, doctor's appointments and so forth? There's instacart for that. There's Uber for that. That should be the extent of your help setting that up.
I ask because we have a poster that is horrified that the facility is demanding that mom be moved to the MC that is like a dark dungeon. They didn't check it out because IL looked so great.
Something to consider since both of your parents will need future increased care.
So I went and visited 3 Assisted Living Facilities, and one CCRC community that has it all, from independent living, assisted, living, memory care, to skilled nursing.
Here are my impressions-
The Assisted living facilities we're nice, but at this time I do not feel that it is the appropriate place to put my father- he is too healthy. For my mom, its another story, but not dad- he would wilt in an ALF. The residents we saw in the AL facilities looked so bored, and everyone was just sitting around as if waiting to die. There was one facility where we did see some action- two table of board games, but that was it.
When we went to the CCRC, it was another story. We went to visit the IL section that would be more appropriate age-wise for my parents, and it was so vibrant, full of people going about and doing things. They had an on sight CVS, bank, Dr's office, PT office, a meal plan with 9 restaurants on site, a "movie theater", and a couple of gyms and pools. The entire campus is connect via a series of enclosed walkways between buildings, so you could traverse the entire 132 acre campus without ever setting foot outside. It was like a giant cruise ship on land! Wife and I noticed that my dad looked physically healthier than many of the residents we saw going about their daily activities.
This Independent living community is a bit more hands on than where my parents are living now. There is a daily morning wellness check to be sure the residents are ok, and their campus shuttle system and off campus shuttle system offers more destinations than the place where my parents are presently living.
So we have decided on moving forward with trying to move mom and dad to the new place. They would probably need only 2 hours a day of home nursing aide help given all that the place has to offer. We already found a unit that would be perfect for them. The biggest obstacle would be passing the entrance assessment. Dad should have no problem with it, the big question mark will be how they look at mom. If they consider them a package deal we should be ok. But if not, then we will have to go in a different direction.
Thanks again to all of those who took the time to respond. They were very helpful.
I do get a sense of the things that are important to him. He really likes the space he has in his condo, so an assisted living situation where he has ample room would be best. He also likes having his freedom to go out and about. He also likes his Chinese food (mom and dad came from China in their teens). He also likes the fact that the home nursing aides are prepping meals for the both of them, doing their laundry, and helping mom get ready in the morning and when she goes to bed so he doesn’t have to deal with it.
Beatty- fortunately, “stay home with my things” is not the answer I hear from my dad. He does love his things, so that will be an issue, but luckily they have never considered the condo they live in as their home- they have no real fond attachments to it, probably because shortly after they moved in my mom suffered a stroke, so all they have ever known there is the struggle of dealing with that.
Going through this process of writing down my thoughts is really helping me to focus in on what would be best for the long term and more and more I am gravitating towards finding an assisted living facility that will meet the needs of mom and dad.
I've seen people with no plans. When unable to return home, handed 3 shiny brochures from a Social Worker: to choose their next home from. Nice photos of smiling people & flower gardens etc. How can anyone choose from that?
What are your folks top priorities?
Staying HOME with my things is a common answer.
Pull that apart... What is *home*? What *things*?
Does this mean under that exact roof? With ALL their belongings.. paying for 24hr care? Or does this actually mean staying TOGETHER? That 'home' can be somewhere else, with just a few treasured things? (If so, AL together when home is not possible sounds right)
What's Dad's top goal? Independance? (Him IL + Her MC same place is a common occurance. Meet up for meals)
Or maybe Dad wants to stay a full time carer? AL could have staff to help him stay a carer..
Maybe tour 2 places that offer different levels of care nearby?
My family has no plans (not told to me anyway) but I have said if it all falls on me to arrange, the nearest decent care home (with aging IL, AL & MC) is it.
My parents were 90 (dad) and 87 when I had to move them into AL and they really liked it. Even dad who was shy & introverted for the most part got up and OUT of his apartment and involved with the other men in the ALF! My mother was always the busy body so she never had an issue making friends or getting involved, even with her dementia. Dad had more physical issues in force, while mom had mental issues to deal with. After dad passed in 2015, mom felt comfortable enough to stay in the same AL and move to a smaller apartment. Let me tell you, that was a HUGE feat considering the woman is a nervous wreck and was totally reliant on dad for everything.
She's still alive at 95 next month and now living in the Memory Care bldg of the same ALF. She has a lot of social stimulation, still in MC, and that has been CRUCIAL for her after she lost dad. Had she been home alone with aides coming in to help her, I doubt she would have lasted long after he passed away, honestly. Isolation is a killer for the elderly while having social stimulation in AL is a HUGE plus.
It's been a huge relief for me (as their only child) to know that both of my parents were safe and well cared for in Assisted Living (and now MC for mom). I think you will have that same feeling once your parents are in AL and in good hands. Just make sure you look around and find a place where the RESIDENTS are happy with the staff and the amenities. That's what I did; I spoke to the residents about how THEY liked living there, and got good feedback that way.
Wishing you the best of luck!
home (independent living situation with home nursing)
vs.
AL
this is just my opinion:
keep them home.
make life as positive as possible in their own home.
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however, i also see that MJ’s post below mine, has many good points.
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wishing you and your parents well! :)
Dad's been through a pretty traumatic injury and surgery, plus, well, he's 91. That in and of itself is a challenge. The strain of caring for you mom in any capacity after what he's been through is likely to lead to a sharper decline than you might have expected. At his age, no one ever returns to "normal" after something like that.
I'd move them now while Dad is still healthy enough to find his way around, meet some folks, and feel settled. You could lose him in a minute, then you'd have to deal with Mom's grief PLUS moving her immediately. It's better to be in the level of care that would be the best for her if Dad wasn't around, because you just never know when he won't be there.