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Our parents live on about $1200 a month and pay almost half of that in health care premiums. They live in a remote desert town with minimal healthcare services. Our father is 89 and still driving when he probably shouldn't be. They are stubborn and won't take advice. We can't afford anywhere else for them to live and we can no longer always provide the transportation and help they need. They make bad decisions and cause more problems for themselves.

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Sounds to me like a situation begging earnest prayer...And in addition, get with their local, state or even federal agencies for advice, as well as an elder care attorney. (local agencies would include social services type folk.)

Grace + peace,

Bob
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Listen to OldBob, that is about it.

But we all do send you our empathy and prayers. This is hard.

Do they have neighbors who could be paid to drive them places???? If so, you could disengage their car somehow. You can't afford to have them kill someone else. That would be a truly worst case scenario.

Hugs!
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They need your help and advocacy. Please do whatever you can to assist them as your parents. You cannot pay people to love and protect your parents like you would--please keep that in mind. Maybe move them closer to you?
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First, I'm not sure of the condition of your dad. However, since they live in a remote area, they probably need to drive since the area is as you said, remote. Anytime you live in a remote area you have to drive since everything is so much further apart in those areas.

As for your parents being stubborn, I think we all are to some degree or another. Call it becoming set in our ways as we age. The longer we've been doing the same thing, the more ingrained it will become into us. This is why we become stubborn, because things we've been doing for so long become part of us because their second nature. Another thing to consider is that maybe your parents actually like it in their current location and they really don't want to move. Therefore, I can't really say that I blame them because living out in a wide open space is normally very expensive. I'm sure that there are things your parents really like about this area including the wide-open space. If your parents happen to be competent enough to make their own decisions, this may be one of those particular situations where you might have to step back and let whatever happens happen as sad and hard as it may be to watch. As hard as it may be, we may have to lat go and let our love ones make their own mistakes face their own consequences. Given enough times you can only hope that they will come to a point of realizing that something needs to change. Sometimes letting go and stepping back is the only option no matter what happens. Again, I know this is hard, but I had to do it with my surrogate dad at one point. You can only do so much before you've reached your limit. When you reach your limit, sometimes the only thing left to do is to step back when you're out of options and you can't get any help. The only other thing besides stepping back is to alert the APS closest to your parents. As for your dad driving, I can only wonder if he has had any accidents. If he's had no accidents, then other things should be considered such as dementia and Alzheimer's. In order to live in a remote area where vehicles are needed, a person must be able to handle such living arrangements. If your parents are no longer able to handle this kind of living arrangement, and you've tried everything possible to help them to no avail, then it's time to step back. If your dad is mentally stable enough to drive, then I'm not sure there is really going to be much of anything you can do about him driving. If by chance he's mentally able to drive and he has had no accidents then that's a very good thing. As long as he poses no threat behind the wheel then he should be fine regardless of age. Sometimes people well up until they're very old age still drive as long as they remain safe drivers. However, if there are any conditions that could hinder safe handling of a vehicle, that should be seriously considered. One condition would definitely be mental decline as well as blindness. These are two very serious conditions among others where a person should not be behind the wheel. I don't know the conditions of either of your parents, but again, sometimes all you could do is step back and watch when all else has failed. Sometimes this is all you can do until the right help along and intervenes
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Maybe they just want to be left alone to die on their own instead of drag it out? That is what I'd want
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I was a mention for the idea of disabling the car, it's not a very good idea to tamper with someone's car unless you want the risk of getting in trouble for vehicular vandalism, so don't ever touch someone else's car. What you can do instead is to alert the local police department and Highway Patrol about any concerns or questions that you have. You can take down the license plate description of the car as well as the drivers when you approach an officer about your questions or concerns. Cops can watch out for that specific car. Again, I don't know the condition of your parents, their driving history what if they ever had any accidents. Again, there are some factors to consider. Looking at the fact that they do live in a remote area where vehicles are definitely needed, it's going to be hard to get them off the road without the need to also move them into town where vehicles aren't needed quite as much as they are in remote areas. If you remove their driving privileges, they're going to be stuck out in the middle of nowhere with no way to get around if services are few and far between in that area. This is why moving them to a better location is definitely going to be a must if you take them off the road. Since they happen to be stubborn, the efforts of others are definitely going to be much harder since your parents are not likely to cooperate. I don't blame them for wanting to keep their independence like everyone else would, and I suspect this is really their only intent. I think they know that since they live out in a remote area that they have a responsibility to provide for themselves if they're going to live out there. I don't think they want to be out there without every possible provision for being able to actually survive in that area. Wherever a person chooses to live will require certain requirements and provisions to adapt to that area. I'm sure your parents have legitimate reasons for being stubborn because I think they have very legitimate reasons why they do things a certain way. No one likes for someone else to come along and upset the apple cart. In other words, no one likes disruption when they have things going a certain way for them and they're content. No one likes to be bothered in an area of contentment, no one. This is why it may be time to just step back and not stress yourself any further over this if there's nothing else you can do. Like it or not, somethings are just out of our hands because it's beyond our control.
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When I run across this dilemma (which is often!), I try to remember what these folks have lived through over the years. Born in 1926? That means they endured WW II on the home front, followed by the rebuilding of the American economy. This is the tail end of those known as The Greatest Generation. They have always made it through with a “pull yourself up by the boot straps” mentality. The end result is that at the tender age of eighty-nine, they are highly unlikely to see the error of their ways and start cooperating. Failure to recognize and accept this fact of life only results in a great deal of frustration and aggravation for all involved.

The good news is that there are steps you can take. The business of unsafe driving is the most pressing as the consequences of an error can be dire. You can research online the policies for drivers' licenses in their state. More and more states are responding to this dilemma with a process to report an unsafe driver without identifying the reporter. The state sends the elder a letter simply requiring them to report to the Dept. of Motor Vehicles for a standard driving test. The letter states the testing is mandatory with suspension of license for failure to appear.

No doubt there will be grumbling or worse, but you can play dumb and sympathize with what an inconvenience it is. A driving test will either clear him as safe or confirm your fears with a subsequent revocation of his license.

As to keeping an eye out, the others who have responded have great ideas. All you can do is alert the local "boots on the ground" about your fears and provide your contact information. Neighbors, clergy, physicians and the Dept. of Social Services can receive this heads up.

Families facing obstinacy in an elder often can only wait for a difficult event to break through the determination to remain independent. It may take a broken hip, a loss of a driver’s license, a disconnection of the electricity for an unpaid invoice to crack open a door to accepting help. Waiting is the hardest thing to do, but laws to protect the individual's right to make their own bad choices are tight.

Do what you can and pray for it not to take too great a fiasco to get through to them. Good luck and God bless!
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You say they make poor decisions and won't take advice. Have you asked them what they want? Please sit down, take a deep breath, express your concern and ask them how they want to deal with it. Take the problem areas one at a time. Go with what you have observed rather than what you've read or heard about old age. As others have mentioned, taking away the ability to drive from someone in a remote area is a seriously Bad Idea. Offer alternatives. Find other ways to get things done. A social worker could help with this. Find one. Check out resources.
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Be grateful they remain independent. Good for them! I hope I am living in a remote desert town at 89!!!
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I have to move my parents from NYC to CT for the same reasons- they just can't care for themselves as well anymore and I'm too far away to help every day. Dad is on board but my mom has the dementia and claims she's not leaving the city. Not sure if either of your folks has dementia/alzheimers but my plan (we'll see how it goes over) is to trick her and say dad needs to be evaluated by Yale (she likes hearing the name Yale) for a few months. She sort of takes that ok but I'm not going to know till the time comes. It's going to be a string of small lies until she settles here...Stay tuned...and wish me luck!
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Long ago life was much simpler. People got old and when their time came, they died at home. If every single old person had a team of offspring around them to control their every move, how could those people live their own lives? We are all being eaten prematurely by the horrible monster they name cancer. Everybody has the right to live in peace. If the elderly are stubborn because they want to live their own lives, that's very good. My parents are stubborn, mean and controlling. They DEMAND our assistance and don't even pay gratitude. We're treated like their rugs.
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Well at least they are being independent and not being a burden to you. At 89 with "a minimal healthcare services" sounds like they are doing better than most. Point is they have rights too--unless you are willing to go through some kind of legal process to prove them mentally incompetent and you will be responsible for their care, let them live their own life. You want them to live in a nursing home if you can't care for them? Sorry but Medicaid will only pay for nursing homes.
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Learn to say the serenity prayer over and over and over again, you will need it. Your idea of how you think they should live will be tested, and you should not force them to do what they do not want to do unless extreme issues of safety are present. Defining what those are takes patience, judgment, and acceptance.
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Unless you are willing to take care of them your choices are very limited..other than a nursing home once on Medicaid. Assisted living is an option but I doubt they will have enough for the rent so YOU will be paying for their rent out of your pocket. Actually you should explore that option of Medicaid for them--they may be eligible. Once on Medicaid, nursing home placement is not a big deal.
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And remember: Medicaid is only for people in poverty, as defined by their state.
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Thank you to everyone who responded. You gave me good food for thought. To elaborate and answer some of your questions here is additional info. Yes they have had accidents driving. They don't admit to them until later since my mother tends to talk non stop and will let slip information we were not aware of. Recently our father seriously injured himself changing a tire after hitting something and blowing out the tire. There are new scratches and dents on their car often. Our mother admitted some time ago that they hit another car but it was a nice older Mexican fellow who didn't want to do anything about it. After the tire change but also after moving a ditch witch and changing tires on the backhoe he already almost killed himself on but won't sell they called in a panic because his testicles swelled up and he had been feverish and ill for days. After a 2 hour drive to the VA and 12 hours in the emergency room the week of Christmas they said he has an inflamed ligament. Recovery time is 4 to 6 weeks. My mother had driven them part way to meet my sister to drive them, it's an hour round trip to their house in the opposite direction so to save time they met them and then my sister drove 2 hours from there to the VA. It's free so that's where they go, no place else. After the 12 hours and 2 hour drive back my mother was too nervous to drive so our father had to drive the hour drive home from there. She needs a hip replacement so had our father drive her an hour in the opposite direction the next day for her appointment. This after his serious injury and all night in the ER. He didn't feel well and was feverish for a week after. My older sister used to take them everywhere but she has ovarian cancer, has gone through chemo and is not at all well. They still call her when they have an emergency. They WILL NOT call 911. When our mother had an emergency with a heart problem my other sister called 911 then drive there. Our mother refused to get in the ambulance insisting that the sister drive her. She thought it would be cheaper but got a $900 bill since Medicare won't pay for 911 if you don't do what they say. They refuse to call 911 for our father since they won't take him all the way to the VA and they would have to pay the basic Medicare deductibles for him. They have been house sitting in Arizona every year and driving over from California. Two years ago they wouldn't admit that our father had shingles because it would cancel the trip so he drove over with shingles. I live here and took him to the VA every weekend that month. He made the statement " I'll will be independent until I die" all the while depending on me to take him to the hospital and bring them food on my days off of work. This should give you an idea of what we are dealing with. They want to be independent until they have a problem. They were pretty uninvolved parents. We did fun things together as a family but our mother worked nights so we only saw her on weekends and our father worked days but usually went out drinking and came home late. Our mother had twins when I was 9 and my sister was 10 and we did a big share of childcare, and all the cooking and cleaning. It's no surprise that out of 4 daughters not one of us had kids.
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Is it possible to hire someone from the small town they live near to being them groceries, drive them to Drs appts, get in the firewood, etc.? Put ad in local paper?
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unfortunately it's not an option for things to stay the same. eventually they will need intervention. as my mother did when she lived in Florida and I lived in New York, suffering demential & living alone. it was the same as if she lived in the wilderness. i brought her up to New York to live with me under false pretenses ~ a 'vacation' ~ & she eventually needed hospitalization & placement in a nursing home. & so she is in a nursing home an hour from me. sooner or later your hand will be forced, as mine was. don't wait until something horrible happens.
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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?
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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.
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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.
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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.
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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.
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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.
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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.
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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...... )
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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.
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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.
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I mean, such high premiums to be on Medicare.
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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.
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