Aging parents

stepping_up_IHB

stepping_up_IHB

New member
Well, it happened on July 25th, the day I've known was coming for the last few years. This year the imminence was more evident with each passing month. I have to admit that I had expected the event to be much more tragic, so I"m very thankful that it wasn't as bad as what I had been envisioning. My 82 year old mom is coming to live with us.



The event was a fall, most likely caused by a severe urinary tract infection. Luckily nothing was broken, but she was on the floor for 22 hours, unable to get up. She was here for a week Memorial Day and I was up in Paso in June. I had asked that she come spend some time with me here in July. The week leading up to her Amtrak booking had me concerned. I was going to go up and get her instead because I knew she hadn't booked a kennel for her nearly 18 year old pug terrier. I called many times on Sat, but couldn't reach her, so I called 911.



This isn't the first time I've called 911, but it was the first time my mom was not angry at me for doing so. The first time I was on the phone with her and her speach suddenly became slurred and she was very confused. The paramedics came out and examined her and said everything was fine. Still, it spooked me and her mental state seemed to be suddenly declining along with her mobility. This was in Feb. I made an appt with her primary care doctor and went up to have him look at her and discuss my concerns.



He said everything was fine, but that the biggest danger is a stroke. He suspected that the incident on the phone was a mild stroke. I really was not happy with him as a doctor and came away feeling that I still didn't have the answers I was looking for.... what is going on and what do we need to do. He even said that he could order an MRI but he really didn't think it was necessary and discouraged it. Now I'm really angry with him and feel guilty that I didn't insist on it then.



She was in the hospital up there for a week. They did a catscan and later an MRI. Her doctor was supposed to meet me at the hospital at 5:00 pm, but didn't show up until 7:00. He told me there was evidence of two minor strokes, but they couldn't place when they occurred, only that it was not the cause of the fall. I learned yesterday that one of them was not the mild transient, rather it was an actual CVA. I cannot believe that her doctor did not fully inform me of this or even suggest that I have her see a neurologist. All he told me is that she was going to need to go to a convelescent facility for rehab and that she could no longer live on her own.



She has been in a really nice facility for the last 3 weeks and has improved dramatically. When we left the hospital she could only walk a few feet with the aid of a walker and could not get up or down at all. She is physically better than I've seen in nearly three years, but because of neglect her diabetes is now pretty severe, so severe that it's not something she can manage on her own. Our preference was for an assisted living facility near us, but the only one that was remotely affordable turned out to be a place I would not have her in. She would die of depression there.



A few things that I've learned



1). UTI's are devastating on older people. Cranberries have something in them that lubricates the bladder so infections cannot stick. They have cranberry capsules, so if your folks aren't taking them, perhaps you should have them talk to their doctor about it.



2). MediCare rocks! Mom has suplementary insurance, compliments of retiring from the County, but the foundation of her healthcare is socialized medicine and it has covered all her needs with good quality care. A week in the hospital, a walker, 20 days in the rehab with physical therapy 2-3 times per day and 80% coverage for the following days as long as she is still improving. The PT has been doing wonders for her, so she is able to stay until the end of next week, which will make it 4 weeks in that facility.



3). Don't wait for the event that forces you to intervene. I had power of attorney for several years, but I allowed my mom to resist making changes that I knew needed to be made. I had cleaning ladies and an organizer go in to help keep the place up, which she could afford, but still didn't want to spend the money on, so I had to pay the organizer. I should have had a CNA going in at least once a day, which is affordable, but something she resisted with all her might. I should have just done it.



4). Having Power of Attorney is a god send when something does happen.



5). I'm glad we are planning our retirement because barring any tragedies, we will be able to afford good quality help or assisted living if and when that time comes.



6). Wiping your mom's butt is a transforming experience. The first time you do this simple act, your role and who you are changes.
 
stepping, thanks for sharing. Sorry to hear about your mom's fall. My parents and my wife's parents aren't too old right now but I am concerned about the changes that will inevitably take place in the future. I know I need to be more involved with their health care decisions (among other things). I still lose track of all the meds that they are taking and it is really important to know that in case something happens. Your post has reminded me that I need to renew my efforts regarding this.
 
[quote author="stepping_up" date=1250987163]



3). Don't wait for the event that forces you to intervene. I had power of attorney for several years, but I allowed my mom to resist making changes that I knew needed to be made. I had cleaning ladies and an organizer go in to help keep the place up, which she could afford, but still didn't want to spend the money on, so I had to pay the organizer. I should have had a CNA going in at least once a day, which is affordable, but something she resisted with all her might. I should have just done it. </blockquote>


Thanks for sharing your story, and thank you for #3. My 90-year-old grandmother lives by herself in a big house will all of the bedrooms upstairs. It has bothered me for about 5 years and lately it has really been on my mind. A few months ago her knee hurt so bad that she couldn't walk. For 3 days, she slept downstairs in one of those chairs that goes up and down (we bought it for my grandfather when he was dying of cancer). The doctor said that she has a degenerative knee. She had a cortizone shot and has been doing well since. When the knee problem occurred, I encouraged my mother to speak with her siblings about having a talk with my grandmother. I also spoke with my aunt about it. Everyone is tip-toeing around the issue-- and it's the big fat elephant in the room. The house has long been paid off, and she has more than enough money to afford a single story house/condo in a retirement community. In fact, we took her to see one such nice community in the Lake Forest/Mission Viejo area about 3 years ago. It's frustrating for me to watch my mother and her siblings not be proactive. I understand the sensitivity and that they don't want to upset their mother. However, you just have to plan for these things!
 
point 6, I assimilated this event in the following way: is not the physical or mechanical action of doing it, is the fact that you have in your arms one of your pillars of your life, that human being that when you were a little child, you couldn't believe how big and strong she was!, how smart and beautiful she was!, now, is right there incapable of doing something as simple as that, now is very fragile, and from this point on you have this pillar of your life depending you, I'm her/his rock, that is what transformed me, and is inevitable.



There's no question about it, this the most stressful time that a human being goes through, forget about losing a job or a house, very few events are similar for caregivers of sick or aging loved ones, what helped me to assimilate or process this better, and get strength from, was increasing my spirituality getting closer to my religion and what I believe, there's nothing wrong to approach religion or increase you personal spirituality at this moment, you can allow yourself to do it.



Here's one good book, Why Faith Matters?

<a href="http://www.amazon.com/Why-Faith-Matters-David-Wolpe/dp/B002EQ9LFS/ref=sr_1_1?ie=UTF8&s=books&qid=1250971073&sr=1-1">http://www.amazon.com/Why-Faith-Matters-David-Wolpe/dp/B002EQ9LFS/ref=sr_1_1?ie=UTF8&s=books&qid=1250971073&sr=1-1</a>
 
Step, thanks so much for sharing? that is a reality that we never ever think about! Not to generalize but, my wife wanted a daughter so that she can take care of my wife when we get older. I know sons are great but they are not known for detail elderly care. And, since I?m most likely sure he?ll be the only child, well, we got to really teach him responsibility early. Do you have siblings that you can consult with and help? That is like the main argument against having only one kid; we hate to leave it all up to him/her. I hope my mom lives well into her 80s?
 
I'm a RN with more years of experience than I really want to recall, and also the personal experience of caring for my mom in her last years, complicated by dementia. So, from both professional and personal experience:



Have the tough conversation(s) before you really need them. How does your dad/mom (or whoever...) feel about dying? Would they want to try every possible means to keep going, even if it meant days/weeks/months in a facility dependent on technology? If they say "yes" then fine, you know what they want, and can facilitate that. If, however, they say "no" - that it's more important to them to have some ability to make choices and don't want to be dependent on technology, then you'll know that, and be able to facilitate those types of decisions.



Unlike TV and the movies, there are rarely simple "black and white" choices. And technology, these days, comes in all sorts of forms. Most people are pretty clear on the complexities involved in accepting or declining to be placed on a ventilator, for example. But what about "simple" surgery? I've had situations where elderly people (80 years or older) have had a colon mass. The patient doesn't really want surgery, and the resultant colostomy, but the children feel that mom shouldn't "give up" yet, and push for the surgery. The result is that the surgery is sucessful, but the patient can't manage the colostomy care independently, the children don't want to learn or are too far away, and mom ends up in a skilled nursing facility, which she never wanted in the first place.



Once you have those tough conversations, and you believe you understand what your mom or dad wants, then get medical POA (financial as well, if they will agree...) and keep the forms handy. You'll need to fax them to physicians and hospitals to prove your right to obtaining medical information and making decisions if your mom/dad can't.



If you don't live close enough to your parents to check on them frequently, consider hiring a nurse case manager, or a geriatric case manager. They will meet with your parents, make a baseline assessment of their abilities and needs, and check with them periodically to make sure that the situation is still "ok." Nurse case managers have a slightly more "medical" perspective, and geriatric case managers tend to be social workers, so they have a slightly different perspective, but either can be very helpful. You can decide based on your parents history.... if they have a number of chronic medical issues, such as diabetes, heart disease, kidney disease, my bias would be towards a nurse case manager. If it's more a case of needing household assistance, the social worker model might be best. You can find referrals to such case managers thru most counties "Office on Aging" or similar agencies. Once a case manager is involved, they can find the best providers of additional services if needed.
 
This may be a complicated question... but how does one get power of attorney over their parents and can it be done without the parent's consent? (This topic is sort of upsetting to me. I am estranged from both of my parents as it is their will and not mine. As my mom has gotten older, she has cut everybody... and I mean everyone... out of her life. The day will come when she needs help as my father is 15 years older than her and in his 70's now. I will be there for them when they eventually will need help. But I don't know how someone in my shoes would be able to do that when the other party is resistant and prefers isolation.)
 
No, you can't get POA without consent. What you would have to do is petition the court, show cause why your mom/dad isn't competent to make their own decisions, and have the court appoint you as guardian. If the relationship is so strained that you don't really want to be the decision maker, yet you know they need help, the court can appoint an independent person to be guardian. That person would then have the headache of trying to get your mom help, and bear the brunt of her irritation at being told what to do.



If you really want to stay at arm's length (and believe me, I know there are multiple situations where this is the only reasonable alternative....) the best you can do is make a referral to the local Adult Protective Services office. In my experience, APS is not really helpful unless it's a situation of some severity.... rats in the pantry, animal hoarding, no electricity or plumbing. In not quite so dire situations, they usually take the approach that competent people have the right to make bad/poor decisions.
 
[quote author="roundcorners" date=1251019055]Step, thanks so much for sharing? that is a reality that we never ever think about! <strong> Not to generalize but, my wife wanted a daughter so that she can take care of my wife when we get older. I know sons are great but they are not known for detail elderly care. </strong> And, since I?m most likely sure he?ll be the only child, well, we got to really teach him responsibility early. Do you have siblings that you can consult with and help? That is like the main argument against having only one kid; we hate to leave it all up to him/her. I hope my mom lives well into her 80s?</blockquote>


You are generalizing, and I find it quite ignorant. I speak from experience, when it was my dad taking care of my grandmother, and then when it was me helping take care of my dad. Whomever told you this nonsense, please let them know I would love to meet them, so I care share my experience of how what they say is a bunch BS. I will try my best not to kick them in the nuts, but no promises.
 
step,



I know it is not that close to you, but I know of great place in Orange that took care of my grandmother. I also know of a place in CM that my grandmother lived at before the place in Orange, but I'm not sure if they offer the level of care you would need. PM if you are interested, and I can get you the details on the places.
 
[quote author="graphrix" date=1251027939][quote author="roundcorners" date=1251019055]Step, thanks so much for sharing? that is a reality that we never ever think about! <strong> Not to generalize but, my wife wanted a daughter so that she can take care of my wife when we get older. I know sons are great but they are not known for detail elderly care. </strong> And, since I?m most likely sure he?ll be the only child, well, we got to really teach him responsibility early. Do you have siblings that you can consult with and help? That is like the main argument against having only one kid; we hate to leave it all up to him/her. I hope my mom lives well into her 80s?</blockquote>


You are generalizing, and I find it quite ignorant. I speak from experience, when it was my dad taking care of my grandmother, and then when it was me helping take care of my dad. Whomever told you this nonsense, please let them know I would love to meet them, so I care share my experience of how what they say is a bunch BS. I will try my best not to kick them in the nuts, but no promises.</blockquote>


I'm a woman and I wouldn't want my boys wiping my ass if I could help it, so yes, a daughter would come in handy. I can understand how RC's wife feels. You can't, so I guess you're "ignorant". I hope you like that.



(Old SoCal would have said: "Graph, I'm really sorry. It sounds like something happened to your dad. You're a good son for taking care of him." New SoCal isn't going to be as nice with you.)
 
I'm not a moderator, but this is MY thread and I will not have it hijacked by any petty bickering. I will answer RC's question about where my brothers are (or not are in this situation) tomorrow. Parent are parents, kids are kids and people are people. We all ultimately make our own decisions about the kid and person we are going to be, and for some the kind of parent they are going to be.



I truly want to thank everyone who posted and will respond better tomorrow. It's been a hard year, but the last month has been especially difficult. In the meantime, I just want to let the community know how much it means to me to come here today and post a glimpse. I can't tell you all how much I appreciate not only this outlet, but also the overwhelming support that a group of relative strangers have extanded here.



Life isn't always easy
 
My dad did it for my grandmother. I don't think either of them really was "into it". I think the comment is/was sexist at a minimum, but I sincerely think no malice was intended.
 
[quote author="stepping_up" date=1251029049]I'm not a moderator, but this is MY thread and I will not have it hijacked by any petty bickering. I will answer RC's question about where my brothers are (or not are in this situation) tomorrow. Parent are parents, kids are kids and people are people. We all ultimately make our own decisions about the kid and person we are going to be, and for some the kind of parent they are going to be.



I truly want to thank everyone who posted and will respond better tomorrow. It's been a hard year, but the last month has been especially difficult. In the meantime, I just want to let the community know how much it means to me to come here today and post a glimpse. I can't tell you all how much I appreciate not only this outlet, but also the overwhelming support that a group of relative strangers have extanded here.



Life isn't always easy</blockquote>


Step, please feel free to come here anytime you need to talk as you enter this new stage as caregiver to your mom when she comes to live with you. It is an overwhelming responsibility and I hope that we could be of any help to you to make the transition any easier.
 
Step,



I am truly sorry for what you are going through right now. I mean, I can't even imagine what you are going thru. When you take care of your 82 year old mother she will not forget the kindness that you have extended to her before she leaves this world. I've always believed that blessings will come upon you when you take care of your parents when they need you the most. Take care of them while they still are alive, so you will live your life with no regrets because the worst feeling is when you want to provide for them, but they are no longer there to receive. I respect you very much for the difficult responsibilites you are taking on and I will pray for you and your mom.
 
The most valuable thing that aging parents want is moment with their children regardless of gender or age. In the parents eye a 50 year old daughter or son is still a child in their mind. The chore is very difficult and you may need additional help but it is very important that you are there for your mother. Make sure that she does not feel she is being alienated at the hospice care if this is the only option.



I wish the best for you and your mother. Your mother is blessed to have a daughter like you. The most precious and priceless thing is your time with your mother.
 
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