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My in-laws live out of state. They are both declining, but want to remain in their own home. However, every time my husband and I arrange for in-home help for cleaning, medication management, etc. they fire them. We get their consent before hiring, but they keep firing them. We even offered to pay in case the costs are a concern for them.

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My mom did the same. It was less about independence and more about paranoia about stranger stealing from her and/or knowing her business and reporting something negative -- such as she was "declining, or having bad food in refrig, etc." Everyone I hired, she fired except for lawn mowers who didn't come in her house.

I finally gave up. It was hard, but I let her go and stopped going in and propping her up by cleaning, cleaning out refrig, etc. It was excrutiating to watch and painful as mom kept saying "my house is dirty.. but thats my perogative". Then I stopped staying at the house for visits. Mom continued to deteriorate in other ways and I let protective services get involved until finally after 6 yrs, APS took action and removed mom from her home and we placed her in fantastic memory care where mom is thriving.

Lesson: Don't prop parents up when they make these bad decisions that circumvents their independence. It is awful to watch, but the only way. They have to hit bottom and then you state "either let help in or next stop will be that you move to residential care" -- it's your choice, Mom & Dad".
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Arranging anything long distance is really tough, I absolutely feel your pain on that one. I can say from my own experience with my mom that it is hard to bring people in that you don't know. Mom lives with me and when I had to start to bring paid help in it was not easy or fun for either one of us. Mom resisted for a long time but then she gradually settled down and now, with the continued decline, she does better, but she has her moments. She is in the later stages of dementia and she still resists help from some people, not everybody. Also, because it's my home, I have had to make a lot of mental adjustments. It's like having roommates! Very little privacy. The list goes on. But it's doable because it helps me keep mom home which is what she wanted. The best explanation I could give mom that she would accept was that I have to bring in help because I have to be able to work to pay the bills and I want to keep her home with me and so it's the only way. Otherwise, she would have to move into a nursing home. You say nursing home to my mom and she will typically agree to anything. It doesn't necessarily make it easier on the aides but it works. The aides had to be tough and had to be able to put up with a lot from my mother, so it took going thru a number of people to find the right fit, but it's working pretty good for the moment. Don't give up. Just rethink and reach out to others to help you come up with the right plan. If they really want to stay home, then you need to find the hot button for them to understand it will take in home help to keep them home. The suggestion above about a social worker or doctor or priest or someone outside that could explain it to them might work. It's definitely worth a try. Take care of yourself.
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The outcome described by BlackHole is exactly what happened with my MIL. She fired any and all help arranged by me, but would call 911 whenever she felt dizzy or short of breath. After multiple transports to the hospital, the social worker called me. As the DIL I had been reluctant to take the bull by the horns, but after a conversation about the situation with the social worker, it was off to AL. The social worker was a great help, basically telling MIL that it was doctor's orders that she not live at home alone. In home help may have postponed the move, but MIL refused to "have strangers in her home".
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My mom had LBD, and we didn't know it. All I knew was she stopped cooking dinner for my Dad and after all those years it was strange. So I started cooking for both of them and doing things for them they were no longer doing. I know you would feel better knowing someone was taking care of them, but maybe they just don't want that.Maybe your in laws resent people in their home. If they can function, maybe it would be best to leave them alone for now and just check in on them and see how they are doing.
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Oh, I really have no suggestions but lots of empathy.

Before my mom went into Assisted Living, she fired everybody. Before he died my father begged her not to fire the handy man--who was worth his weight in gold. She fired him. She fired a string of very nice and excellent cleaning ladies.

It was so embarrassing!!!!!!!!!!!!!!!!!!!!!!! This is a small town. I teach at the university five minutes from her house. It was awful.

The answer for us was assisted living.

I do agree with those who say you should let them fend for themselves. See how they manage or do not manage. In our case we asked the Area Agency on Aging to visit my mother and they recommended placement. It was excruciatingly hard to do. Traumatic for them and for me. But they told me she would adjust and she did.

She is in very good hands now. I visit her every day (and could never do what they are doing.)
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"Having help makes one MORE independent." Jeanne Gibbs is so right, as is Zdarov. Having said that, I hope your in-laws are not in a spiral where age-fueled paranoia colors all there decisions and non-decisions.

My mom had the type of mental decline that left her math skills, word choices and (most of) her memory intact, but eroded her ability to reason. With that came .....strong ideas about people (supposedly) looking in her windows and going through her trash. Inability to distinguish between a PBS fundraising drive and a documentary. Would only buy one brand of toothpaste because "the Chinese add poison to all the other brands."

And -- of course -- the world at large was conspiring to rip off Mom and/or get in her house and steal things.

Mom would have lucid moments (lucid enough to pretend she was rational) and concede that she needed professional help with her day-to-day. But the real Mom -- as years passed, the only Mom -- was furious at the suggestion that she could not manage. (Yard looked like h*ll; interior looked like a thrift store and Office Max exploded; did all "cooking" in the microwave; gutters handn't been cleaned for 10 years -- and how dare I notice this with my 2 good eyes and my functioning brain.)

Mom only allowed real help from me and another close relative. And minimal errands from 2 long-trusted neighbors. With this mentality, Mom cheated herself out of a lot. She also cheated me out of peace of mind.

For the in-laws, give the situation your best eye. Make calm, rational suggestions that fit their budget. (Leave your money out of this.) Regardless of what they accept or don't accept, prepare for a worsening future.

When one of them winds up in the hospital or ER, say this to intake, discharge, social worker and everyone in-between: "He/she has no help at home and it is an unsafe environment for him/her to return to."

Keep sifting this forum for advice and ideas. These are lousy, unsatisfying years, and many here have walked your path. We learn from each other. Take care and good luck.
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sandjen, good responses here so far. I'll dovetail off jgibbs response, I've newly got someone going in to my mom's house and I frequently repeat that the helper is *how* she gets to stay at home. As others say, you really need a family or close friend nearby to help see what's going on, or go to town yourself for a short while - stay at a hotel or friend's nearby and say you're attending a conference or something, and go at the start or end of the person's shift several times. With the company I'm using, they pointed out that the person can't just walk in and start telling them what to do or rearranging their stuff, it should be just 'visits' at first. I set up my mom's by saying it's for help with meal planning, grocery shopping, and cooking - which is less threatening than the going through meds, mail, clutter, etc., that hopefully will come later. Is this a company you're using, or private people? A company is maybe more likely to manage the subtleties better... that the person comes in saying 'what can I do' vs. 'here's what we're going to do'? Wishing you luck.
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If you happen to know someone in their area who could casually mention how much their lives changed once someone else did their housecleaning, that would be ideal. But it's a pretty long shot.

More feasible is that you simply have to leave them in the "waiting for a crisis" folder. If MIL injures herself cleaning and she has to have her wrist in a cast for 6 weeks that might be enough to change their attitude. Let's hope the crisis is not more serious.

You can't force them to accept help, so you might as well give in graciously.

BTW, I take 16 pills each day. I HATE managing them. Really and truly I dread the days I have to sort them into the daily boxes. I put it off as long as I can. If someone arranged help to come in and manage my pills, I would be extremely grateful. I've had a cleaning person for long periods in my life. Having children and working outside the home was enough for me, thanks. I'd have one now but I'd rather spend the money on outings. So I will be a very easy sell when it is time to send in help.

The attitude of so many loved ones our members post about is hard for me to understand. Having help makes one MORE independent.
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Sorry for so many questions. I see you are caring for your mother so give us more info about your Inlaws. Have they been tested for cognitive decline? How old are they? Are you going though an agency for the help? Does your husband have POA?
Is there anyone local to the parents who could go over to check on the help when they first start the job? Is there a pattern other than firing? Is it on pay day? My aunt fired her first caretaker but I didn't blame her. She wanted to be a sitter and we didn't hire nor need a sitter. IMHO it would be very difficult to manage their care w/o seeing with your own eyes what is going on. You say out of state but how far away is that? You might be able to hire a care manager to help oversee the help and let you know what is going on? Cameras might be a choice. I would want them to stay in their home as long as possible BUT you may have passed that point. I know this is hard. I would start with their testing and having an assessment on their ability to stay in their home.
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if your in-laws are of sound mind -step back and let them figure it out. It sounds harsh - i know. Do not pay for the in-home help - your in-laws need to.
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Dear SandGen,

Its so hard. I know many seniors want to stay home as long as possible. And it sounds like you are trying to do the right thing by hiring help. Maybe there is a deeper issue. Maybe they are scared of what it means if they accept help. Do you think having a social worker talk to them would help? Maybe if a third party talk to them and explained their options they might be more willing to accept help. I know its tough and you are only concerned for their safety. My other suggestion would be to visit them in person and see if that might help calm their fears as well.
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