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My mother is now 95 years old, and is still very sharp mentally. However, in the last few months, I see that she is rapidly declining physically. She lives on her own, very close to my home, so I am easily able to be with her every day. Sadly, she has never been able to quit smoking. She purchases her cigarettes online, and has them delivered to her house. Her lungs must be in terrible condition now, because I can easily hear her breathing, even when I am in the next room!! I've tried everything to help her to quit, but she is adamant that she cannot do so. We've tried counseling, hypnosis, Chantix, Nicorette, etc., etc., etc......all to no avail. Now, I need to have someone come in to help me with her care, and although she uses her walker at all times, I want to do so before something happens and she falls and becomes completely disabled. I have always assured her that we will have home care, and that she won't have to go into a nursing home, which she absolutely refuses to do. We are fortunately in a position to afford home care. Has anyone had the experience of trying to determine what to do in the interim between obtaining home care and something catastrophic happening to their loved one? I realize that my question is somewhat ambiguous, but I'm desperate to make sure that she's safe! I can't live with her 24/7, and she can't live with us due to her smoking. Please advise on what you or others have done in such a situation.

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I would highly consider getting her a medical alert alarm, especially until you have home care, but continuing after that as I assume she won't be in the company of a caregiver 24/7?

I would also, or have a handyman if you can find one, install a lock box next to the front door.   A key for the front door would be left in it; you and the medical alert company would have the key code (in numbers), and you probably would give it to a caregiver.   

It's safer to have it in this kind of locked box than leave it somewhere else.   It needs to be immediately accessible for first responders, who would need it when called, so whoever calls can give them the key code.   It's also safer than a lock with a handle, similar to those used for gym lockers (at least in my schooldays) as clever thieves can saw through a lock

My father and I both tested this, and we confirmed that the handle locks can be sawed through if a straight bladed saw can fit through the handle.

Another consideration for safer walking is to switch from a walker to a rollator. We did that and found the latter much safer, and able to accommodate items in the carriage basket.   If you consider it, check out a DME store; good staff can help find one that fits, as height will be a factor in accommodating it to your mother's needs.
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Reply to GardenArtist
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Let your mom enjoy the remaining time of her life. For some families while the mind is still there, make sure you have documents in place
( financial POA and more..) Are her wishes in place? You will be empowered if you know your moms wishes when she goes to the hospital. Blood thinner = high Fall risk- hopefully your mom is not taking it. Regarding Aide at home-Maybe you can tell her that you are very concerned that if she falls and break a hip, you cannot imagine her being in bed. Hopefully she is not on water pill that makes her go to the bathroom frequently and maybe in a hurry to prevent accidents=high fall risk. That’s why Aide is important. Good luck to you.
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Reply to Caregiving2020
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95, smoking & buying them online! Wow. This gal's sure living her way!

Minimise what risks are within your control & yes, do hire caregivers. This will add more eyes for safety (& give yourself a break). There will be things outside of your control too of course. Even with full supervision, people fall, have heart attacks, strokes etc.

Just remember that if a catastrophe happens - she lived her way.
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rovana Nov 21, 2020
95?? Why not let her do it her way?
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- "seniorize" her home if this hasn't already been done (add bars and chair to shower, remove area rugs, move furniture to create larger walk paths, provide raised toilet seat, provide potty chair in her bedroom so she doesn't go far at night, etc)

- I agree with others to leave the smoking thing alone. BUT if she has COPD and ever needs/agrees to oxygen, then she won't be lighting up any matches in that scenario.

- make sure all her legal ducks are in a row: she has assigned you as her durable PoA, you are her medical representative with all her doctors. If you aren't already her PoA and she wont' agree to doing it, that's a separate discussion.

- with in-home care there will be strangers coming and going in her home. Make sure all her sensitive info is locked down and away from any prying eyes or where it could tempt someone (checkbooks, bank statements, IDs, credit cards, digital devices and passwords, passport, medications). You can put everything in a fireproof safe in her home and keep it locked and retain the key yourself, not her. Sign her up for credit alerts. Make sure you have an extra key to her house stashed outside so that EMTs/police can get entry in an emergency.

- make sure you know all the locations of critical documents like her Advanced Care Directive, Will, Insurances, Deeds, titles, passwords, investments, SSN, Medicare info, prescriptions.

- consider installing cameras inside and out to add an extra layer of security.

- Make sure you do background checks on any privately hired help and to remember that they are paid from her monies and are therefore her employees and must report income and pay taxes as such. If you don't want this headache, then hire through an agency.

This is plenty to think about for now. I hope it all goes smoothly!
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898luvmymom Nov 3, 2020
Thank you so much for your input, Geaton777. Virtually all the items you've mentioned have already been done, except for the cameras and the credit alerts. She still handles all her finances quite adequately, and uses Quicken to keep track of all expenditures. I really appreciate your providing a great check-list for me!!
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It's that pesky in-between period of immovable object (parent won't move to assisted living or accept any outside caregivers/helpers) and catastrophe (falls and breaks hip, burns house down, etc). It's like searching for a unicorn. I agree with other posters that you have to give up on the smoking issue. The only real danger with smoking at this point is setting the house on fire. And give up on the idea of her living with you as that never ends well for any caregiver. So now you are looking at getting her familiar with having some help in the home and hopefully someone besides you. Right now you should have a paid helper come in a couple of days of week just to give yourself a break from being there every day. Then keep upping the days and hours of the paid help as needed. She will hopefully get used to having outside people around and will accept their help. Now, the warning is she probably won't want the outside people in her house, she won't see that they are "doing" anything and she'll want to get rid of them. For some of us our parent either became hateful to the caregiver or outright fired them so this didn't work out very well but for some people it works fine. But realize that until you reach the point of having a caregiver 24/7 there will always be a risk of the fall, pot-on-the-stove, etc and having the catastrophe occur. There really is no solution to the interim in-between period.
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898luvmymom Nov 3, 2020
Thank you for your insights, jkm999. I appreciate it! I am hopeful that she'll accept a helper one or two days a week to start, and I've assembled a long list of questions to ask.
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A lot of people on this forum are unfortunately in a similar position as you, waiting for something catastrophic to happen before their LO will agree to any kind of care, whether in home or a facility. It's a shame it has to be that way, but it is what it is. You are smart to be getting your ducks in a row now, as I always believe it's best to be prepared, and not left scrambling when something bad does happen, as then we tend to make poor and hasty decisions, which aren't always in the best interest of our LO.

Sounds like getting some home health care lined up sooner than later is the best for your mom right now. You can get around the clock care if you feel that's what she needs. And as far as her smoking is concerned, she's 95 years old. If that's what she enjoys, for Pete's sake, let the poor woman smoke. If it hasn't killed her yet, I doubt it will now. It reminds of a neighbor man I had years ago, who was a heavy smoker and was diagnosed with stage 4 lung cancer. I used to see him out walking the neighborhood just puffing away on his cigarettes, and I remember thinking at that time, my goodness why doesn't he quit smoking since he has lung cancer. But then my thought process changed to, good for him, he is still able to do what he enjoys in his final days here on earth. At 95 you already know that your mom's days are numbered, so just let her enjoy her simple pleasures, and be grateful that she is mentally in tact. That is not the case for most peoples LO's on this forum. Best wishes in getting moms care lined up.
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Reply to funkygrandma59
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898luvmymom Nov 3, 2020
Thank you so much! Although it pains me to see her smoking her life away, I do understand that, at her age, it probably can't be helped! I appreciate your perspective on this!
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