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My 91 year old mother recently received a diagnosis of possible early Alzheimer's disease. She broke her hip last year and recovered well for her age. Her mobility is slow with the aid of a walker. She has a caregiver stay with her 4 nights a week. However, she is alone 3 and a half days. She doesn't drive. The caregiver prepares meals for her which are labeled with reheating instructions. I go over one afternoon a week and bring groceries, manage her meds, collect mail, pay bills, etc. I also take her for doctor appointments, etc. She navigates her email pretty well and stays in touch with friends. We have talked about changing her care-plan to have someone come every day in the mornings instead of overnight to cut some of the cost. We have also discussed AL. Mom wants to stay in her condo until she dies. However, I am concerned that the cost of in-home care will not warrant it as her disease progresses. What to do?

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We would all like to retain the abilities and independence we had in our earlier years. But as we age, that becomes tougher and tougher to do, and often we need the help of others to live a meaningful and enjoyable life. One of the major concerns of the elderly (whatever that means, and whenever it kicks in) is the loss of independence and the feeling of having to be cared for. But caring for someone doesn't mean impinging on their independence, or their freedom to do what they want to do, even with “possible” early AD. Possible doesn't mean probable. Your mom may display some symptoms of AD, but it may be too early to definitively diagnose her. Nevertheless, if safety or personal care is a concern, she should not be left alone.

It may be time, however, to research AL facilities. Residents in assisted living facilities (not MC) are free to carry on a normal life. The errands you run for her now like bring groceries, manage her meds, collecting mail, will be included with her monthly fee. In addition, you will still be able to pick her up and take her to lunch or to a dr. appt, or just go for a walk.

The cost of AL may not be the financial burden you think it will be. The sale of the condo can fund the cost of AL. In addition, she will be relieved of all the monthly and annual costs of living in a condo., including utility fees, condo fees, property taxes, food costs, owner responsible repairs, cable charges, etc., not to mention her current cost of home care. She'll also have the company of other residences and be able to participate in activities and outings the facility will offer. Check it out.
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Wanting to age and then die at home is a very romanticized notion by elderly LOs. When they eventually require 24/7 care it will cost more than a facility and *someone* has to coordinate it all day in and day out for who knows how long, plus whatever PoA responsibilities are required. My opinion is that the caregiving arrangement only works if it works for both parties. You are under no obligation to drive your life into the ground because well-meaning but clueless people ask for something the collateral damage of which they have no idea. You can certainly take on this role but please go into it with your eyes very widely open. Please do not make promises to them that you aren't absolutely sure you are willing *and able* to carry out. Please read the many posts on Burnout on this forum by loving adult children just like yourself. The time to have important discussions with her about this is sooner rather than later. May you gain much wisdom and peace in your heart as you travel this journey with your LO.
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It’s an unfortunate part of life that her condition will continue a decline. There are too many possible scenarios to predict. I’d say her time living alone is limited at best as her age and conditions march forward. Time to be sure all needed documents are in order, will, POA, advance directive. My dad didn’t have any dementia but was definitely a fall risk and basically a sitting duck living alone. He moved so slowly with his rollator for each step. We knew it was a bad idea to be on his own, a fire or burglary either one would have been horrible. Have an honest talk with your mom now, discuss the options of full time care in her home vs moving to where help is available, making sure to include the finances You’ll have to respect her choices, for now, but know a day may come when her decisions aren’t to be relied upon.
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What she wants and what she needs are two different things. Needs come before wants. You will have to tell her that she can’t afford private care if you are concerned that the money won’t last.

Best wishes to you and your mom.
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