What are the next steps? - AgingCare.com

What are the next steps?

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I have an 85 year old Grandmother who is more like a mother to me whose health is failing. The plan has always been for her to relocate to Atlanta with me once the Doctor stated, "she's no longer able to live alone". Well this time came this Summer. I flew home to Seattle in May to meet with her doctors and to get all of her affairs in order once I received the call that she's @ Stage 4 Kidney disease and uncontrolled Diabetes. Within the 1st month of being home we had 12 doctors appointments (getting them updated), managing finances, preparing meals, attempting to put the house on the market.. And the list goes on.
She no longer will move. Refuses dialysis. AND LIVES ALONE against the doctor's orders. After reaching complete burn out - I arranged for family to FINALLY take turns to assist with dr appt's, checking in via phone and in person. I pay for meals on wheels to deliver meals. However, I don't want to relocate back to Seattle. Yet, I feel guilty for coming back home. My daughter is in college in the South and I don't want to be that far away from her.
Grandmother isn't nursing home ready. And can't afford assisted leaving. She wants to remain in her home but cant afford the upkeep. I am no longer employed- running through 401K trying to help as best I can. Yet, I can't afford a private nurse. I don't know what to do!

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SeaAtl, I'm sorry your GM has made a choice that is so stressful for others, but it is her choice for the moment. I do not blame her for not choosing dialysis at stage 4, but know it may lower her life expectancy. Still, after knowing people who were on dialysis, I know it is not such a good life if there is no hope of a transplant in the future. As hard as it is, I would say to go with her decision until she becomes ill enough for nursing home care. I know it is a painful solution for you, but sometimes we have to follow the wishes of our loved ones and know we are doing our best. I personally believe that our best goal is to help them enjoy their lives as much as possible, and worry less about the length of the lives. It is okay to follow her lead and let others know what you are doing. It would be good to have everyone aboard.
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Without dialysis, she won't be long for this world. If that's the case, honor her decision and contact hospice. This will stop the Dr's appointments.
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WHAT IF she moves to assisted living with the help of VA "Aid & Attendance"?
If she is the surviving spouse of a wartime vet, she can get help. A good facility will help sort out the aid that is available.
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It is Grandmother who needs to be able to afford a private nurse or assisted living or a nursing home. For you to be going through your own 401K is well-intended, but, gracious! who is going to bail you out when you are 85? You have just gone through GM's finances so you know what she can and can't afford. Should she be applying for Medicaid? Isn't she eligible for free meals on wheels?

With stage 4 kidney disease and refusing dialysis, is this dear woman ready for hospice? What is her prognosis? If she qualifies for hospice (expected life span 6 months or less) would you consider keeping her in her home and moving in with her? Not for years and years, not to permanently relocate, but during the hospice period? Keep family involved. Get hospice involved. Spend some weekends back in Atlanta. Do NOT use more of your own money for her care (unless you are wealthy, and that doesn't sound like the picture you are drawing).

It is wonderful that you feel so devoted to this ailing woman who was like a mother to you. That devotion does not require you to impoverish yourself. (In fact, if GM understood what you are doing, would she approve?) It does not require you to support her self-destructive decisions. If you can give her some of her final wishes and enable her to die at home, that would be awesome. But if you cannot, there is nothing to feel guilty about.

I am so sorry you are in this painful situation. I respect your devotion. I urge you to express your love in ways that will not put your own daughter at risk of facing this situation some day.
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