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I live in Canada and my parents live in the US. I am within driving distance - it's a 4-5hr trip down. I am married and we have three kids who are not babies but still young - 10, 10 and 13. We have no relatives or friends here who could take my kids for any long period of time and my spouse has a very intense job where he is "on call" 24/7. I have to raise my kids. We used to visit my parents on a pretty regular basis once every three months or so. I phoned and they phoned us - all the time. Then my dad's health declined and bit by bit they no longer want me or my husband involved - we are seen as interfering. This after multiple times of dropping everything and racing there to help them. I have a sibling who lives in the same town as they do and he is not reliable. They don't like it when I ask nurses and doctors questions. The kind of questions you are supposed to ask doctors and nurses when your parents have arrived by ambulance. Nothing out of the norm. I used to ask my parents about their medications, their eating (my dad is a diabetic who does not eat appropriately), etc. No more. I am persona non grata. Lately we are in a Groundhogs Day scenario. My dad has an incident - lately a diabetic coma, or a fall where he ended up OK, and a fall where ribs were broken. He is pretty much confined to his chair because he is wobbly on his feet. After a hospital or rehab hospital stay - they eventually "dismiss" the home care people; stop doing the physical therapy, and send the nurses away and begin eating junk food and things which a diabetic just should be limiting if not eliminating entirely. He goes into a hospital, comes out, an incident happens, back in the hospital, and on and on. Lately both of their cognitive abilities have been poor - my dad thinks he's back in 1958 sometimes. My mom can't remember what yesterday's trip to the hospital resulted in which diagnosis. They are either lying or they just can't keep it all straight. Sometimes both at once. He won't wear his hearing aids and she lies. My sibling is trying but does not have the capacity to understand much of this. He has his own family as well. After the last hospitalization (broken ribs) and subsequent trip to the rehab hospital - my dad came home and not two days later my brother has then back into the hospital. My dad's insulin was fine but he was dehydrated. I've lost track of how many of these same scenarios we have had. In the last year+, my parents no longer call us. They no longer ask about their grandkids, send birthday cards to them and pretty much have told other relatives that I "ask too many questions" and my kids riffle through their things when we visit - they do not. They sit, they smile, they speak and they are polite. My two youngest are afraid of their grandma - she's just mean. My dad will point blank say in front of my kids that "our life is none of your business" directing that comment at me. We have spent nearly $30,000 or more I've lost count trying to help them renovate a bathroom to make it safer, to get them furniture that they can actually sit in and get out of, meals delivered in so they get some nutritional food in them. We were supposed to visit them briefly (we always stay in a hotel) in the next couple of weekends on our way to visit other family friends. I finally just phoned and said we would not be able to visit them. I told my husband (a saint) that I can't see how driving all of us down there for a 9:30/10PM arrival where we would go to sleep in the hotel, then get up and visit them for about 30 minutes before they just stop talking to us and stare at us. They also refuse to eat a meal with us - they only eat junk (donuts, fast food, etc) so our "healthy" i.e. normal eating - we might bring in breakfast like pancakes, eggs, etc to eat as a family - was flatly rejected on their last visit. Three times we brought them food to share and three times it was placed in their fridge lost to time. I have three kids to raise; I have a marriage that I enjoy; I want to share my life with my parents but they don't want to. I began to throw in the towel with this last phone call. I'm not sure what else I can do. I can't be their guardian because I live out of the country. My brother couldn't manage it because he's not that kind of guy. Leaving their home is not an option. They would rather die broken and incoherent in their home than move to a facility. I'm lost and exhausted. I have become a child that I never believed I would become.

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Hi RRC and Everyone,
Great advice given here. RRC, you can only do what you can do and what they will allow you to do. Their actions do not sound like normal aging. Were they like this before? You have a family that is your main priority. To me it would be different if they were not being so difficult and refusing help. I agree with PolarBear.. call them periodically, send a card and let them know you love them. Since your brother lives in the same town, he needs to check in on them periodically. If things continue to decline, you and your brother may have to have a long talk about possibly putting them in a retirement home with graduated care levels. Know it is difficult to think of. I took care of my Mom and Dad until both passed away. You can't force your parents to allow you to help them and you can't let it destroy you, your family and finances. Thank heaven you have the love and support of your immediate family. Hang in there. My thoughts and prayers are with you.
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The parents' withdrawal, suspicions and defensiveness would all make sense if they were undergoing not standard 'age-related decline' but in fact one of the many and varied forms of dementia that would be very common among people of their age and, in the father's case, state of health.

And if that is so, then for one thing there are treatments available for the consequent mood disorders they may be suffering from and reinforcing in one another; and for another they morph from being marvellously independent to being vulnerable and at risk.

So. Where does that leave the OP?

She's still in a different country, with the attendant obstacles to assisting her parents, and with a husband and children and a life to attend to.

And although brother too has his own life and family to manage, he is right there. If only for the sake of practicality, this is HIS problem.

The OP can find out online what assessment services are available in her parents' location, gathering information and contact numbers. Then give these to brother and tell him to get busy.
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RRC - I tried to think what more I would/could do if I were in your shoes, and I couldn't think of anything.

You are powerless. Since they told you clearly that they didn't want any help, there isn't anything you can do. Let them be as they requested.

The only thing I would do is send them a card/letter and tell them that you love them and that you are there for them if and when they want your help. Then call them periodically to say hi to make sure they are still alive. That's all you can do.
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I've noticed sometimes education or educating the patient on their condition and drugs helps. Especially a second or third time by a second and third party which helps reinforce it. Just to spite you they might ignore you.

I noticed a lot of nurses and therapist explain medical condition and treatments better than the actual doctors sometimes. And sometimes having another person explain the same thing get's the patient thinking 'there must be something to this'.

Try different ways and people to explain the same thing.
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You have reached the painful conclusion you have to leave your parents to their own devices. I think that is 100% correct. I doubt your brother has any ability to change their behavior either. He's probably given up too, which is necessary to protect his own family.

It's sad when seniors want to live the way your parents are living, but that is their choice. Just disengage and let them live how they choose. And learn from their lesson, which it sounds like you've already done. {{{Hugs}}}
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It sounds to me as though you've already figured out that nothing you spend or do will make things better for your parents. If you have reached the place where you are ready to step back from this dysfunctional relationship then I for one can not fault you, that old saw about leading a horse to water but not being able to make it drink applies here. Perhaps your brother will manage better when he realizes that you are no longer going to pick up the pieces, but even if he doesn't you said "They would rather die broken and incoherent in their home than move to a facility", so you are respecting that they are masters of their own destiny.
The unfortunate reality is that if they continue to self neglect they may end up broken, alone and placed in a facility by the state, but you don't have to ride the crazy train along with them until that day arrives.
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You can't force care upon folks who are deemed to be competent to manage their own affairs.

It's a terribly painful situation, and one that many relatives, neighbors and strangers don't get. They will say 
" where is their daughter?"

You are 
 going to have to let your parents fail until APS or the Canadian equivalent forces them into a professional care situation
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