What do we do with our parents who live in a remote town and make unsafe decisions?

Jcarroll616: I am so sorry for your loss. I'm trying to picture how this occurred...was she not putting the car in park while trying to get into the vehicle? Or did someone else get behind the wheel of her vehicle and not know she was standing behind it? I don't know. My own brother has run over his wife twice in his driveway because their lives are so frantic. His wife lived, though. I just can't imagine doing that!

Not sure if original poster is still around but as a Vet have to say his parents must be totally confused about their medical care options! Number one if they primarily use the VA hopefully only mom is paying for a medicare supplement. Two in an emergency you have the right to go to the LOCAL ER. Someone just needs to call the VA within a certain time, 48 hours?, and get the care authorized and they will pay. Will arrange for transfer to VA hospital if situation warrants. And third, the new Veterans Choice program allows you to choose a local doctor if the VA is too far, can't provide the needed service or the wait is over 30 days for a needed service or specialist.
So, like the 911 confusion, there are many things your parents dont understand - in their defense it IS confusing - someone in the family really needs to get the facts and advocate for them. It might save an awful lot of mis steps and pain for them and you!

Nano, does your dad smoke inside his house? mine, at least for the most part, really, at least confined his smoking to his attached garage, thankfully, for the day he dropped his butt in his recliner but also thankful for great neighbors but even so they just "happened" to be going by and see the smoke coming out from under the door and went in and got him out - would his do that? Can his housekeeper also shop for him, like dad's could? she didn't often; he was still driving at that point, then he did eventually, on his own, sign up for the homebound meals, so maybe yours might as well but at 85 he wasn't thinking in terms of assisted living either

Nano, your dad sounds more functional and is clearly competent, with really a pretty good support system, as long as he is actually taking care of himself OK, other than smoking, and the house is not a wreck. At an hour away, you can always order him a pizza when you can't get there. This sort of situation really calls for a specialized OT driving evaluation before asking docs to sign off or just assume he is not able, if he was OK before. Things may get to a point where this is not going to work anymore, it's true, but it sounds like you are not there yet.

I am faced with the same problem. My father is an hour away and we lost my mother in June. He had a brain tumor and then surgery and is actually doing a bit better than he was before the surgery since we did not know what was causing his decline and found out this. However, I brought him to my house for awhile to recover and he was impossible to deal with because all he wants to do is be at home. The hospital insisted on a nursing home and he told us that he would refuse all treatment and food and just die. I am sure that this would have been the case. He has a cat and his home and just wants to stay there. My sister and I go every other weekend and shop for him and he has a housekeeper and great neighbors. I think that he is not getting enough nutrition and I worry that he will burn the house down with his smoking but how can you make someone move if they are not willing and all of the doctors say he is competent to make his own decisions? He is not driving YET because each doctor says that the other doctor has to sign off and we have several to see! He refuses meals on wheels or any other senior service and says he will not be put in assisted living and made to play cards etc with a bunch of "old people;" He is 85. Is there much else we can do?

Sorry, I'm having one of those days when my brain is set on Portuguese and expressing my thoughts in English is a challenge.

When dealing with obstinate people in a much different wavelength, the only thing you can do is make a couple of suggestions and let them take it from there. They know paying those exorbitant premiums doesn't make sense when you're living in a one-clinic town. There must be a method to their madness, but you can't see it.

Unless they're on self-destruct mode let them make their own decisions and live their lives as they choose. At their age, the last thing you need is someone telling them what to do.

or go to a doctor of your choice

Having health insurance in addition to the VA is something my brother does for my Dad only because he might like a second opinion. Technically the VA does it all, and nothing more should be needed. They might be wasting what little money they have on that extra health insurance policy. the VA even provides cheap prescriptions. And a law passed recently that says you don't have to drive that far to a VA, they must come to you.

My mom was pretty far gone, getting lost driving was the last straw. She took a fall in her house one day and in all the hub bub of people getting her up, examined, etc. I ran around and took all the car keys off key rings I could find. I knew where the extra keys were hidden, too. She called me up a time or two asking if I had any spare car key, but that was really all, guess I was lucky! I had her nephew move her car to his house and we sold it for cash....Now, I have heard of people selling a parent's car and using the money to set up an account with a local taxi service. The same driver would come as often as possible, take them to the dollar store, grocery shopping, to church. It sounds a bit expensive to me, but this didn't go on forever as their conditions (physical and cognitive) declined, and it seemed to work out well from what I'd read.

I lost my grandmother yesterday from injuries she sustained from being run over by her own vechile Dec 16. She suffered a devastating injuries to her legs and ensured 4 weeks of pure agony. We brought her home at her request with me serving as her primary caregiver for her last days. This was a horrific accident. I have worked in long term care for +20 years and have seen many thing in this population but never in my mind could a projected anything like this. It leaves me asking questions? What could have been done? Why? I am angry that the medical personnel in her life, her primary care physician's did a report that to the department of transportation as she was undergoing treatment for dementia for several years. Our families questioned her ability to drive and of course came under fire from both her my grandfather when we did so . I've seen this population become very bitter about losing their independence about driving but killing Themselves or someone else is certainly the worst case scenario. Our family is devastated. I find myself searching for ways to reach other people, communicate what happened to us in hopes of preventing this from occurring to others in the future. There are not enough agencies to help people who can't drive . It's something I'm going to look into . What can I do now? Although her journey is over mine continues w a message from
Her. This doesn't need to be your family. Speak to them, be up front. Hope that they can reason. If not speak to primary care physician. Call Your driving agency, report it. The worst thing is to do nothing!

It would be helpful for your parents and family to contact an Aging Life Care Professional (Geriatric Care Manager) who can assess the situation and develop a plan of action to include the safety, well-being and advocacy of your parents. There are resources available to assist your parents, which an ALCP/GCM can put together for you. Good luck to all of you...

Also check into the Aid and Attendance VA program people talk about on here; at that income, especially for both of them, they should easily get it, well, assuming they need it, which is somewhat the question here, isn't it? after dad fell, I learned about it but, true, it wasn't actually until he got grandson moved in with him that he got it; he was going to sell his house and move into assisted living but your parents aren't there yet, either; he did say before then that if we had fixed and/or found him a place to live he would have moved closer to me but you say you don't have the means to do that, not even if they sell their house? - at least assuming they have one but considering where it is, is it sellable? we didn't think we could either - or, rather in my case, hub didn't, but I think we could have, considering some other things, think lots of times depends on what really want to do, not saying in your case, just mine, but just wondering if maybe that's what your parents are dealing with, them thinking they don't have the means and neither do any of their kids to help them so what else can they do? also re the driving, even after dad had his cataract surgery, maybe because he'd waited so long, but anyway he ended up with glaucoma and that's when his eye doctor said for him to quit driving. I had a good relationship with dad's VA doc; wonder if you know, by any chance, if your dad's told his doc he doesn't want 911 or the ambulance called; he can do that, you know; dad was going to tell his doctor that at his next appt. but things happened before he got a chance to; he didn't want to go through all that either. Also you can have social services come make a visit but unless things are much worse than what you're describing, as bad as you think they are or could get, unless they're actually there, they're probably not going to force anything - elder rights are very strong for just that reason but like someone said it could at least protect you; they might contact their doctor but only if they tell them who it is; also the VA never came out to see my dad as long as he could get to them, which was as long as; he didn't want them coming to see him, either, just like hub's uncle and, besides, their current doctor has to approve the "rural health option", as it was called anyway, so you can't do it by stealth; again, for the same reasons, the VA is very protective of their veteran's rights, so they have to request it themselves and besides, even though I've heard that mileage as being the requirement as well, what the local VA clinic told me was the exact opposite, that they won't go that far; that's the mileage at which they will pay, however, for you to go to a nonVA clinic, if the VA clinic is that far away, but possibly any clinic is if they live in that remote an area, not even in a town at all? it is a hard situation in that case, like where we are with hub's aunt and uncle; oftentimes they just really want to get out and go somewhere, at least his aunt and my mom did so I tried to take her to the store so she could; aunt never gets to go anywhere I don't think; seems one issue I'm reading as far as things to do to their house is the lack of funds to do any of that with; otherwise, the whole remote internet monitoring would be a good thing to set up; I'm just glad we had an understanding doctor when the time came that agreed that we'd given him as much independence as we could to live the way he wanted

until the neighbor's get tired of it, like my dad's did; maybe they were trying to force the issue; if he hadn't had a grandson in the area who finally agreed - yes, he did, after a bad fall after which the VA helped us, actually they're the ones, the social worker at his local clinic, who told us about the homemaker/home health aide program they have, and got her for us, coming in every day for 4 hrs. and yes, somewhat running errands, although dad was still driving as well, when he shouldn't have been, too, finding out about accidents after the fact, not actually finding out about the one involving someone else in the next town over until way later that had to involve his insurance by his agent telling him that another one and his insurance would be cancelled, so they evidently didn't let it go, but has anyone considered his eyesight? turns out dad had extremely bad cataracts that needed to be removed but he'd been so busy trying to take care of mom that he hadn't been to the eye doctor himself and was almost too late by the time he went; also his local VA doc - and if your dad goes to the VA he must have a local one as well; don't know of anywhere where the closest local would be 2 hrs. away, maybe the ER, yes, but not the local - is the one who said he wasn't able to make that 2 hr. trip that he'd been having to make as well, not for ER, but for specialty docs, but he's also the one that approved him to go to local ER and them pay but especially if your parents are paying that much for insurance, don't see anyway that's just for Medicare so they should be having a supplement and at that rate shouldn't be having high deductibles and actually not sure should be having any anyway no matter what, at least my dad never did and think just read somewhere they're not supposed to but places are "billing" anyway just to get people like your and my parents - these WWII era people that believe in paying their bills to pay more than what the insurance is paying so might also be something to check into - but, yes, right, they can get by on nothing, good thing they're veterans. Also the police did stop my dad after that one evening as he was coming home from church he had to make a left hand turn onto his street and he thought the street light was an oncoming car so he stopped for forever, had traffic backed up for miles, seemingly so apparently somebody called the cops but he finally drove on to the next street where guess there wasn't a light and turned but then not sure if he then missed his street coming from the other way because he wound up basically back up on the main road where two of them closed him in; one of them left his car, got in dad's and drove him home while the other one followed them and told him not to drive after dark anymore so that ended him driving to church at night so that might be something. I'd really encourage you to see about the VA program because I seriously doubt the local AAA will/can do anything with them being so rural, at least that's the way it is here; in theory maybe but in reality they can't seem to find anybody to service the rural areas.

Hopefully there is little traffic in the wide open spaces, when your father gets behind the wheel of the car. If he is still cleared to drive, both of them are still getting around, and don't have dementia or Alzheimers, sounds like they want to stay there till the bitter end. I don't know how you can force them to move, etc. until something bad happens. Can you arrange for a neighbor to keep an eye out for anything amiss?

#1 need-prayer, #2 thinking about applying for Medicaid, #3 dad stops driving before he has a vehicular manslaughter charge on his record and #5 this generation can get by a sliver of soap, e.g. very little.

Again, never ever ever touch someone else's car unless you want the risk of getting in legal trouble. All the rightful owner has to do is catch you in the act of tampering with their car and have the cops right on your back, especially if there are other witnesses around. It's not worth risking getting in trouble over, so leave the car alone no matter what some TV show said. Let the authorities do their job since they are proper authorities who are in the position to have the car pulled over and safely towed to an impound lot. The proper authorities do this kind of thing every day, and this would be no different for them.

What you can do while waiting for the cops to arrive is block by a car in. This would be a far better alternative messing with someone else's car.

Ok. They are not independent, really, and they are not safe. You could ask for a DMV evaluation or a specialized OT evaluation and see if that will get Dad off the road. I'm sorry for him and for you, but he needs to be off the road. With $1200 a month income between the two of them, they need a cheaper health plan and they will qualify for Medicaid or PPACA-based care, unless they have assets beyond house and car you don't know about. They need help understanding this and navigating the system, that's for sure. Remote and rural may be a bad fit for them, unless there is a local Area Agency on Aging that can fill the gap. Realize too that Dad is not necessarily going to be "independent until I die" but sort of semi-independent until something bad enough happens that he can't be anymore. If your best efforts - getting POA, maybe even APS or guardianship though it may not be that bad "yet" fail and the bad thing does happen, it will not be your fault. Ia55cagirl is right about things too...so hey, welcome to the hit-your-head-on-the-wall club. Hope we can cushion the blows a little here.

Good advice from someone here: sit down and ask your parents, what do they want? That's a good start. Remember, as someone else said: they have lived through a lot. Have you ridden with your father? Is he a capable driver? I lived 1500 miles away from my Dad. But I would visit a lot and make sure to check out his driving. He stopped at 92, died at 94. Lived alone from the age of 90 in his own home where he wanted to be. He was in debt, but was a Veteran. So, I filed for Veterans benefits for him. It helped him to get a few hours a day caregiver who eventually ran the errands for him, did some cleaning and kept him company and cooked for him. Might be something you could suggest for them. It took about a year for my Dad to warm to the idea of someone helping in his house.. He finally agreed when he could see he really needed it. Do you know any of your parents' friends or neighbors there in that area? It might be a
good idea to reach out to them and begin to form a connection with them. Could be valuable help later as your parents age. ALso, I phoned my Dad every single day (except for when I was there visiting with him) for 4 years after Mom died. Maintaining that connection, even long distance, over time, will ease yours and their mind and could build trust between you. RE: the driving. Maybe Dad's Doctor could be the one to finally tell him he is unfit (if he is). Reaching out to your parents' doctors is a good thing to do anyway, so you know each other if/when the time comes they are not as fit as they are now. Hope this is some help to you. Good luck.

I mean, such high premiums to be on Medicare.

Your description of your parent's behavior in the subsequent post is quite alarming. It sure sounds like there is something wrong with your dad's driving. Multiple accidents like that raise my suspicions. Plus, the other behavior of how he acts when he's sick.....very concerning. I think I would focus on that first, since it could really hurt them and other people or worse. I'd contact his doctor and share my concern and ask him to help or contact his state's DMV and ask for guidance to get his license.

Then, I would try to stay with them for 24 hrs, to see just how bad things are in the house. Are they really caring for themselves.

Why such a high insurance premium? I've never heard of someone paying those high prices.

Parents will often take the advice of others and not their own children. No matter how old you get you are still the child and they still see their role as t he adult. There are agencies in all locations that can help. There are both caregiving services and private duty caregivers. I have been in health care for many years and also do private duty w/ wexcellant references so do not let the media scare you away from having someone help them in their home. Get in touch w/ a social services dept and have someone do a home visit. They can make a determination for you that leaves you out of the decision but will foce them to make the right move that's in their best interest. Also see if there is an Ombudsman in the area. They can be very helpful as well. If they are in jeopardy of injuring themsleves or others do not waste time in getting advice and assistance. Just because they resist does not mean they are able to make the right decisions for themselvs.

I'm thinking that the VA nurse or doctor who will definitely come out to see your parents (they do it for my Dad) will assess the whole situation perhaps just on a personal level, and that might help. (That may also be exactly why your parents might not want the doctor to come to them instead of vice versa...... )

I don't understand other people talking about dementia, I didn't read you mention any, perhaps there is some implied in the situation? Important to remember that the VA will come to you if you live more than, I think, 45 minutes away. Perhaps they were somehow able to opt out of that situation. That is where perhaps stealth might help, can you call as your mom and request what I think is called the "rural health option"? Ppl are entitled to live their lives to the end as they wish, as long as they don't hurt anyone, and I surely sympathise with your situation. Never sure of doing the right thing for them or for those they may affect. Dealing with this too. Please let us know what solutions, if any, that you do find.

It is a difficult and emotional situation for both. There are resources, even in remote desert areas. (I provide services in a rural desert town 30 miles from the Mexico border in New Mexico.) It is with your genuine concern and love for your parents that you need to have this very important, heart to heart and respectful conversation with them. Regardless of how stubborn, they have some awareness of their decline due to age.

I hope that your family will find the support needed that will allow your parents to remain at home and for you to have peace of mind. There are a lot of resources (like my small business) in America, even in remote desert areas.

I go with the small lies. Dementia patients ca no longer reason. I have a problem where when we r out and I stop for milk or bread with Mom in the car she gets mad that she doesn't have money to buy stuff. Husband stays in the car while I go in. I want to get in and out. Taking her would slow me down. So, when we get home I haveto hear about she has no money and yes she does if she really wants something, blah, blah. I told my husband we will no longer stop when she is in the car. I can't take one more time of explanation that she will not remember. He says just don't let it bother me, but it does. Because no matter what you say...they can't comprehend.

I think this is more common than most of us realize. They do have a right to live their lives the way they want to, even if it causes anxiety for their families.

Perhaps the best you can do is to help put in place systems that will protect them to the extent possible.

For the car breakdowns, such as flat tires, etc., get AAA or some other road service. To stop them from driving, first locate alternate transportation services before you can any action that would leave them stranded at home.

Upgrade their house to prevent falls, install exterior motion lights, security sensors, a lock box outside for emergency personnel, alert the local fire and police departments, ask if periodic wellness checks can be made, arrange for meals on wheels, etc.

Honestly, even if they lived next door to you, with all the precautions available, there still could be that one moment when something happens that changes everything.

I've spent hours agonizing over how to protect my father and am still battling with the concept that there's a limited amount I can do. You could even get in-facility care in assisted or independent living and one moment of inattentiveness could cause a fall that could change their lives.

The difficulty in caring is acknowledging and accepting (easier said than done) that these are high risk situations and there's a limited amount we can do to protect our loved ones.

I'm not saying give up or just accept their situation - but rather do as much as you can think of to protect them, recognizing their independence and refusal to accept change to a safer living environment.

As far as tampering with the car goes, have you ever listened to Car Talk? They gave many ways to stop someone's car (for their own good!) on that show. for example, loosen one of the distributor cap thingys. It will take them forever to find it. Sometimes you just have to be practical.

And, uwantcr66, yes, trick them!!!!!!!!!!!!!! Tell her she has an appointment at Yale tomorrow...and tomorrow...and tomorrow. Trickery was the only way I got my mom into AL! That was only 18 months ago and today she is so far gone that she is afraid to leave the AL building.

As my therapist said, you don't need to what is right int his situation, you need to do what works.

for cak2135: you seem to be doing ok. of course as we get older things change. & eventually you will need more help than you do now. one person is not a support system. as we need more help we can't rely on only one person. developing a support network and / or being near supportive family is always the best option than coasting on our own .. because things do change.

I had my 62nd birthday in September plus I am disabled due to a serious and debilitating injury five years ago. I went to a new health plan which has 0 dollar premiums plus a low deductible plus low doctor visit copays plus low copays for meds; this is just great. I haven't driven since 2011 but I would like to again, and I managed to get my rent lowered. I have a sister who moved to NE Pennsylvania, and I am planning on moving there to be near her as I do not have any immediate family in my area. I do, however, hang with a former coworker when I want to go on a grocery run or go out to dinner. I think going to senior center would be a good idea, too; I really do not have any very good friends in the apartment complex in which I reside. Any suggestions here?