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As my mom's dementia, mobility and ability to care for herself in general keep worsening, my dad also is starting to have his own problems with energy, mobility and awareness, not to mention being mostly deaf. They're both 90. My feeling is that my dad is "in control" of the situation, and quite stubborn. I can see why they want to spend every last day together in their own home, it's only natural. But at the same time the two of them together in their confusion, they're just egging each other on to stay put and not budge. It's also hard to get them to communicate with each other, because of her congitive decline and his hearing. They do have support of a PCA, a couple of friends and neighbors and my and a sibling. My main question is as she gets worse, how will we all convince him that he cannot give her the care she needs? If we ever took her to a home or in with other family, he would explode. We've invited both of them to one of our houses but they won't consider it. He's in control and plans to stay that way, is my impression.

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I think that the day you take them into your home and he ACCEPTS that invitation will be the day your life descends into utter chaos. What about the idea of having them in your home in this condition appeals to you? This is likely not the time to move her in a home except under the most dire circumstances. Covid is about to explode again in our country. No matter our good intentions there will be no help for those who are gathered together in groups in prisons, schools, hospitals, LTC. detention centers, or anywhere else. We know it's airborne now, something long suspected. If you are watching you are already seeing the uptick. By mid-November this will be almost certain crisis time again. Be as supportive as you can be to keep them now in their own home would be my advice, and let them be in control of their own lives while able. There are NO GOOD CHOICES right now, imho.
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canonlylaugh Oct 2020
You're right about the covid thing, a NH or ALF is really not on the table for us right now for various reasons including that one. The reason we want them to move in with one of my siblings, who has invited them, is because it's safer that their own house which needs a lot of care and is very crowded with stuff also. The real issue for them is my dad feeling that he has to be in control, and do everything, but not being able to really give mom the care she needs for various reasons. He's in control and in some denial about her condition. Maybe it's best as you say to just let them have the illusion of control as long as possible, which probably won't be too much longer anyway...
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Yes, been there and done that with both my in-laws tanking simultaneously. Alva is correct in pointing out that moving them during covid -- especially if you're in a state where "essential caregivers" don't yet have inside access to their LOs -- would not be advisable.

So, keeping them in their home for now is probably the only thing that can happen, but you'll need to do a little prep work first. An important question is: who is legally able to act on their behalf? Who has durable PoA for them? With my in-laws when we fully realized how bad their cognition had become, we immediately made a plan for one of us to take them out for several hours while the others went through the house to assess how bad it was by looking at their checkbooks (in total disarray), found unopened mail piled up, found dozens upon dozens of boxes of blank checkbooks (because they kept losing them and called up the bank to order more), and just gathered all their sensitive paperwork, medical info, etc to secure it from prying eyes; took picks of all their prescription bottles and counted the pills, and on. Once you do this the PoAs can set up online banking and BillPay for them. If necessary, have their mail go to a PO box. Make copies of their house keys and keep a secret one outside should emergency or neighbors need to access their home inside. You may need to consider some additional agency companion care for them who also does some light housekeeping. Someone will need to be checking in on them every day, especially if they have medication to take. Check their fridge and garbage pail to make sure they are eating (my MIL wasn't). Do not rely on what they tell you they did. Only trust what you actually see them do. They may think they did something (like take meds) but didn't actually.

If you haven't already help them seniorize their home for safety as well (remove area rugs, make sure their bath/shower has handrails and a seat, etc). There are lots of checklists for this found online. They won't like all this fuss but you just tell them it's for YOU and your siblings so you all can feel confident that they're safe and being well cared for. Good luck!
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Frances73 Oct 2020
Since March my mother has been to the hospital, rehab, nursing home, now Memory Care and has not been exposed to Covid. We did a lot of research and found a place that has been an excellent fit for her.

Mom's new home has a separate staff for Memory Care and has had no cases there. MC residents are not confined to their rooms or required to wear masks, it’s just not feasible with them. AL residents on the other hand have to isolate in their rooms and wear masks when in the hallways.

No facility has been with out some form of Covid, you have to consider what their response to cases is. The main problem with moving anyone into a facility now is the isolation and lack of activities is just as hard on them as if they were isolated in their own homes.
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I totally disagree that a NH is out of the question due to covid. NHs have learned a LOT about how to handle new patients, etc.

The need for people to have sanity and have their loved ones safely cared for is huge and can not be outweighed by fear of covid.

For example, my uncle needs rehab for his severe health problems and the facility is putting him in 2 week quarantine. I think that is reasonable and safe. It is not 100% safe, but NOTHING is. There is no guarantee that one of us caregivers will not get it and give it to our LO. It happens. There are lots of risks in this world.

Your parents obviously need help. They can be as stubborn as they want re: wanting to be in their own home forever but it is just NOT reasonable. Who is providing care at home for them now? I would think at the least, they could go in to an assisted living facility together. If they refuse, it is possible to cut back on what you are doing to keep them afloat to help them see that they can NOT take care of themselves any longer.

So hard. I'm sorry you are going through this.
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canonlylaugh Oct 2020
Indeed I do plan to visit less often. They have a PCA for 4 hrs/week, some friends and neighbors bring them food sometimes and have a 1 day/week Meals on Wheels delivery. My dad has a visiting nurse 2 times/week for a recent leg problem. They will not however ever dream of going to a home or facitily of any kind. My dad's mindset is that he has to do everything (pride, as well as his imagined interpretation of the marriage vows). He is also practically deaf so can't even properly communicate with my mother. He thinks he's taking care of her but she needs more and so it seems like he's actually kind of an impediment to her care at this point.
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I think I should clarify the issue. They have an amount of support and some in-home care. The issue is with my father. He is the gatekeeper in every sense of the word. Mom can't make decisions, rational ones anyway, so he decides everything. This is the problem. He is also starting to show cognitive decline and mobility issues himself, and the fear is that as mom declines more he will be more of an impairment to her care than anything else. He will not listen to me and he's deaf so he doesn't know what's happening anyway. He's the barrier to getting her the care that she needs, in my opinion. She can walk, barely, with a walker, hardly eats, can't remember when she last showered and has other chronic health problems. He's simply not capable of taking care of her, and won't let anyone else do it, either.
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dogparkmomma Oct 2020
Either get him to the doctor with her and prime the doctor beforehand, or try to get some type of evaluation done. by the in home caregiver. If she is not being taken care of adequately, you are going to have to put on your big boy pants and deal with your father. I doubt if he has given anyone POA so if he won't see to reason, you might need to talk to a lawyer to discuss options. I will tell you I have been there with inlaws. Fortunately, I was able to get him to see, not that he could not take care of her, and he was doing a crappy job, but that if anything should happen to him first, she could not live alone. He thought he was taking good care of her. He was not. He did let me get involved; I am a nurse and he let me go to doctor's appts with him. But if he had not, we would have had to have him declared incompetent so we could spring the POA. He had vascular dementia so he was good at fooling doctors. I know this is really hard but you cannot allow her to be neglected.
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Do you think you'd be able to have a trusted person take your dad out for the day (or half day) assuring him that a trusted relative/person would stay with your mom, or have the neighbor come and distract him...and then try and get some things done for your mom, like hygiene, foot care, change of clothes, a meal, some love...? Caring for your mom gives his life purpose, whether he does it well or not, and that's part of the reason he can't let go. You will need to make end-runs around him.
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I’m so sorry that you are struggling with this situation. I cared for mom and dad at the same time in their home. It’s really hard.

After my dad died and mom lost her home in Hurricane Katrina she moved in with us. That is an adjustment for the parent and the entire household. This would not be my first choice if I were you.

I realize that a facility is not what everyone desires, especially during Covid. I would still start looking for a facility to be prepared. Not all people can remain at home. They need the help of an entire staff.

Best wishes to you and your family.
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My 96 yr old Dad stayed by himself in his own home until he was 95 at that time I started with hiring a Caregiver for Daytime then he now has 24 7 Caregivers.

He feels loved, safe and failure in his own home.

I promised him he could stay in his own home and I'm keeping my promise.
I don't worry about not having an inheritance as the money is going to pay the Caregivers.
I
I am considering hiring a Live In as my next step as it would be 1/4 to 1/3 the cost.

In the meantime just keep watch.

If they have a gas oven and they are forgetting to turn it off or accidentally hitting the knob and turning it on then turn off the gas for the stove and hVe them only cook with a microwave.

Hundreds of microwaveable meals out there that wojld be easy for them to make.

My Dad loved the frozen waffles, pancakes, Jimmie DeN sausage egg and cheese breakfast biscuits and crusaints. Stealthy Request and Lien Cousins dinners...everything just pop in the microwave.
I use to shop for my Dad every week but now I just order his groceries weekly and the Caregiver puts it all away.

Let them live out their time together in their own home.








At Leave them alone. They would die if separated.

They would not be happy to leave their home, neither would the person who thinks they can move in with them.

Have Nest Cameras installed to be able to see what's going on anytime day or night just view them on your cell or computer.

If they can't still use a phone easy than Make sure they have a Fall Alert necklace to wear around their neck in case of a fall and they can't get up.

Check with their Insurance and see if any type of Home Health, ect is covered.
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bolliveb Oct 2020
Make sure you realize that the fall alert necklaces have to be charged just like a cell phone. If the wearer can't remember to do that, where they put it, or to put it back on, or there is no one available to make sure it happens, they are useless.
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Why does mom need to be removed? Is she not getting bathed, toileted, fed...? If those are your concerns, then having a personal care or home health aide along with family and friends can meet those needs in their home. It might be helpful to keep a journal in the home, where guests can write down when they visited and what they did to help. I hope that 1 family member has medical and financial POAs in place to overlook the whole situation and make decisions. As long as both people are safe and healthy, they will be OK.
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When it is safe to do so, help both parents to move to AL, (assisted living), together. Or Senior housing with extra caregivers coming in. Together.

There is often a small window of opportunity to keep them together once there is decline in one or both. Getting them in a safe place can keep them together and decrease the burden(s) to both.

Depending on how resistant one parent is to any help coming in at all, their chances of remaining together decrease.

One will go to hospital, one left behind may not be able to fully care for self. Adult children separate them, one goes to Al, one goes to live with another family member, or in an apartment. One dies from neglect. I have seen it happen. It is because the couple have supported each other for all those years, and may notice daily if one (say, for example) has taken their insulin.

That window of opportunity can vary, but within a year, they may have to be separated by circumstances.

However, I am in favor of bringing in caregivers to their home as long as that is working, and if they accept that help.
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My suggestion is to be proactive and begin to look at facilities that can take both your parents in the future. For the present I would get a camera in their house that you could check on them anytime. I would also look at the possibility of getting a PSA. My guess that soon, based on their described condition that living in their home will become unsafe.
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canonlylaugh Oct 2020
What's a PSA? I don't think I've seen that term before.
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The answer is not to take them into your household - you just have to trust me on this one. This might be the time to find a facility which can fulfill both of their needs and (hopefully) you can help them build their excitement up for the next part of their life together (like when they got their first apartment or house). They might not be in the same room or unit depending on their needs at the time but you need to start looking now rather than later. And please make sure you have your legal ducks (DPOA, Living Will, Health care proxy and will) signed and in a waiting row. If Dad has problems hearing and that extends to the phone see if the facilities you like will (or already have) phone equipment to help the hearing impaired (CapTel?? is one, there are many others) because with covid 19 you are going to do a lot of visiting via phone and computer.
Try to get them (or at least Dad) to the point where he is willing to go and visit your top two choices (sell the this is a 5 star hotel Dad, routine but don't tell him how much it will cost to move in........... he'll freak out for sure.
So sorry you have to go through this but know that you are not alone. Safe travels and peace on this journey.
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for my parents at 95, the roles are reversed. Mom is the stubborn one-saying dad is fine-Not. Dementia, catheter, pacemaker, swallow problem, sleep apnea, weakness, balance problem-why dad needs 24 hour care. ditto on the stay at home-mom says "nursing home will kill her". Mom is living in her "reality" dad along for the ride he can not say no-even if dad did not agree, mom would over ride as she did about his DNR. They always said they want to be at home and no where else. They have home care for the past year. Pricey for sure. Facility says that dad due to long list of needs would be nursing care. Mom could do okay in assisted. Two units one for each. Mom refused. The price for 2 units would not be much less than cost of home care. Mom will probably survive dad she says she would go to facility after dad passes. but she has made no plan to do that-get on a list. Current first choice facility is one year wait for studio-their money might be gone by then as they are paying to keep a house going groceries, housekeeper, yard guy, insurance property tax adds up to more.
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Imho, start the process of looking at facilities for them sooner rather than later. It is not a good idea to have them live with you. Prayers sent.
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I remember my great-grandparents with something similar. Both were in their late 80's and in failing health. Gramps was wearing himself out taking care of Gramma and refusing to accept help from their 9 children.

Their children finally convinced him that she needed more help than he could give her and they agreed to move to a senior facility. Grammy died soon after the move but he lived on for several years and had a great time chasing nurses and raising hell.

I think the key was that he was harming her by not accepting that they were not coping alone.
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