What to do when parents insist they're fine at home, when you know they're not?

Your considering them incompetent isn't the legal definition, so, until there is a diagnosis you cannot really make decisions. RealyReal used to point out to our members that "incompetency" isn't the same as "dementia". And in the eyes of the courts a HIGH standard must be met before a citizen has their rights to their own decisions taken from them.

Now is certainly the time for you to have all POA papers done so that you CAN make the decision when the time comes, for this is something that you will eventually see "come to a head" and it will have to be dealt with.
What so often happens is that one or the other will fall ill, and the one "left standing" will think they can do the care.
Many elders so fear leaving their home for safer living conditions that they will fall into denial that cannot be shaken.

I am glad they can now afford the home health. I would stay as much in contact with those administering the care as you are able. And be ready to act when the time comes. Even so far as to explore what is out there that will match their assets.

I am so sorry. You fit right into the slot here for families seeing the train bearing down on them, hoping they can get everyone off the tracks in time. This is hard. You aren't alone.

MissKate, I had a similar problem except it was my Mom [90+] who insisted they are fine living at home with no caregivers. My Dad [90+] thought otherwise, but to keep the peace with agree with Mom. Their house was no longer elder friendly due to all the stairs.

Many of us here in the forum usually have to wait for one or both of our parents to have a serious fall or a serious illness.... 911... hospital.... rehab.... Assisted Living/Memory Care.

It took a bad fall for my Mom to spend her final months in a Nursing Home. Dad got around the clock caregivers for himself as he was a fall risk, then later sold the house and moved to senior living. Dad was paying $20k per month for around the clock caregivers at his house, and when he found out that senior living was $5k-6K per month, he couldn't pack fast enough. What a relief, no more stairs for Dad to tumble down.

Hi Miss Kate
Welcome to the forum.
I love your name. My first caregiving role was for a lady called Miss Kate. I was 8 years old. I have many fond memories.

What makes you think your parents need ALF now?
What type of HH do they have? Outside agency, private hire, home health through Medicare?
If an RN is seeing them on a routine basis, you could discuss this with them and get an informed opinion.
Of course they could continue with their HH in an ALF.

I always used the ADLs (Activities of Daily Living) to help me make a decision on where my loved ones were in their decline and added help accordingly. To be honest your parents sound like they may need more than an assisted living would provide but maybe not quiet ready for a NH.

You, on the other hand, may need more help than you are getting. It’s a fine balance.

They will decline when you move them. There is so much new for them to adjust to.
They are probably more comfortable at home. But that is just part of the puzzle.

Have you tried cameras? They helped me see how well my DH aunt was doing. I could check in periodically and see her watching tv, letting her dog out, turning off the lights and going to bed.
After awhile I added a morning aide who helped with her meds, meals, getting dressed and housekeeping. She was amazing.
Then aunt became bed-bound, completely incontinent and on hospice.
Then there was an event in her home that caused her to need extensive repairs. This was about 18 months ago.
She first went to an Alf for a few months, still on hospice and still with her morning aide with plans to return to her home.
Then she went to a NH. That was a terrible learning curve for both of us. She was hospitalized during the holidays and lost a lot of weight. There were medications mixups that contributed to her decline.

Being in a facility does not stop the need for oversight. In fact, that part of a caregivers responsibilities increases as the information you need is not always readily available or apparent and sometimes the same problem has to be handled multiple times. That’s just been my experience. Not speaking for anyone else.

Aunt has been at the NH for more than a year now and I can honestly say that she has turned a corner and we are both doing much better. She is 96, has dementia and is bed bound so truly she needs the 24/7 care.

The care she receives is not as personal and the staff changes often but she is at a stage of her dementia where she is content most of the time and that’s come to be my goal for her.

There is no one way to care for loved ones. I hope you find the way that works best for all of you.

It is hard being responsible for others lives and don’t forget that you must look out for your own life and that seems to be the hardest of all to balance.

First, unless you are their DPoA or legal guardian you have no power to make them do anything no matter what. If their daily lives become a poop show, and without PoA and their cooperation, you will need to report and keep reporting them to APS. At that point, either you pursue guardianship or the county does.

If you are currently their PoA then make sure you read the document to know when and how your authority is activated. Then use it, regardless if your parents buy into the help or not. The caregiving arrangment has to work for both parties: receiver and giver.

That being said, a good strategy in the meantime is to continue to have small, non-threatening conversations with them about helping. When my 2 very elderly Aunts were needing more in-home but refusing, I'd ask them, "If there's one or two tasks that you'd really like to take off your plates, what would it be?" I also said I already did a lot of research about the types of available help, the cost, the provider, etc. so that when they felt ready for it, the hard part was already done. And, I'd help them every step of the way to make things easy.

Then I'd explain what would happen if they weren't realistic about their needs: the burden it would put on you and how much more (unnecessarily) difficult they would make caregiving for you. I'm not afraid to wield a little guilting, if that's what it takes. In my case my Aunt eventually called me back 6 months later and said they were ready for more care. It has gone as well as it can.

A friend avoided making that decision..she put it off even though her mom was unsafe at home. Her parent went to the ER and the doctor brought in a social worker . The decision was out of the families hands..there are laws about elderly who are unsafe at home..tough decisions..

Thank you AlvaDeer. I have DPOA now and your comment reminds me l need to learn more about the legal definitions. Now that we're on the tracks, l realize the best thing l did long ago was to sign dad up for LTCI. I'm starting the claim now. My people are long-lived and it's no longer a mystery why the money runs out. Thank you!

Schedule an Adult Protective Services to do a welfare evaluation on both of them. If necessary, a group appointment with a Geriatric Psychiatrist who can provide medication that can help with compliance.

How are they not fine? Do they fall? Are they sending money to scammers?

I understand your concern, of course, Miss Kate, and have the same situation with my mom…we're one bad fall away from a nursing facility, and she won't make sensible changes. BUT…it's her life, she's not incompetent and I can't activate power of attorney until a doctor decides she is.

Unfortunately, it seems like most seniors aren't willing to move until there's a crisis. Sounds like you're just going to have to wait them out, while hoping they die peacefully in their sleep. I wish you all the best!

hire in-home help. even the most 'lovely' facility will not be as good as being at home. and when it comes down to it all of those places p[ut profits before the care of their residents.

If they’re still managing with Home health care then let it be. Just plan and get financially ready. Home is mentally the best place for them.