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Medical Forum / Diseases and Disorders / Alzheimer's / August 2005AL decisions
Hello all, I've been quiet recently because my dad went back in hospital last Thursday. His pacemaker was infected, so it had to be removed (friday) and new one put in (yesterday) in new location, plus lots of antibiotics, dressing changes, close monitoring of blood sugar (diabetic), etc. So I have been living with Mom, taking her back and forth to hospital, taking her to all meals or having someone else do so, coordinating his care with nurses and docs (he has three -- surgeon, cardiologist and infection specialist!), not to mention running my business and own household, including inlaws visiting from up north! Plan is that he will be discharged tomorrow, with home health nurses coming in for dressing changes, but he won't be driving for at least two weeks, so I won't be totally "off the hook." Later next week one of Dad's best friends and I are going to sit down with him for an "intervention" about Assisted Living. If he weren't there, Mom would be well past point for it, and he is not doing what needs to be done. House is downright unsanitary (may be cause of his infection), they are eating nothing but Lean Cuisines, and she is bathing once a week. He is not paying any attention to her needs at all. (He does not prompt her to bathe, eat, take meds, anything -- and from a week, I know how much prompting she needs!) I have located a place that could take them immediately in a 2-BR apt, with all meals provided and health staff onsite, that is within their means. Mom could get additional AL type services, such as bathing assistance, while continuing to live with him. (All beds are licensed for either independent or AL, so as he needs more care, he can get it too.) I know the administrator well and it is less than a mile from my home. I mentioned idea last week when Dad first learned he was going back in hospital, and he was adamant that they should stay where they are to build more equity in home. I could care less about that -- I want them to be healthy and well cared for. If Dad wants to go to hell in a handbasket (you don't WANT to know all the sugary goodies he has in the house with both of them diabetic!), I can hardly stop him, but Mom is trying hard to stay healthy as she can and he's not helping. My brother suggests just telling him "Mom's moving into AL. Are you going with her or not?" (I do have legal power to do that -- but oh the World War III!!!!) Any suggestions on how to approach him? We've discussed this some here before -- but I need another pep talk please! Songbird > Hello all, <snip> from what you have posted before, i think your brother is correct, your father seems to need ultimata(??) before he'll act. you might point out that the place is available *now* and may not be in a few months time, how many years would it take for the equity to increase and is it really realistic that he'll be able in his current state to look after her in a few months let alone a few years?  SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com Hi.... An idea that I'm kicking around is having my mother try assisted living on "temporary basis" just to see if she likes it. Some places will let you try this. Maybe if you take the approach that this is temporary and if you don't like it......Usually the facilities will really try to make it comfortable and fun to keep a resident there. We have a friend that tried this with success with his mother. Good Luck >> Hello all, >> [quoted text clipped - 6 lines] > realistic that he'll be able in his current state to look after her in a > few months let alone a few years? > Hello all, > [quoted text clipped - 42 lines] > > Songbird Hi Songbird, I hate to say it, but your brother may be right. A family meeting is probably in order. How to handle it is the biggie. Maybe if you start out by stating your (brother's and yours) case gently, but if you meet with any resistance whatsoever, allow your brother to come into the discussion with a more firm attitude. Then if you re-enter the discussion backing your brother up, your dad may realize that BOTH his children have their resolve set on this, and that it is for everyones ultimate good. You have timing on your side now, especially since he has recently had this health crisis. If I were you I would stress how ill he has been and how difficult it is for him to take care of both himself and your mom, and that a re-assessment of the situation makes you believe this would be the best course. You could stress the fact that getting them both healthy again is the primary concern, and that they need to have some of the more mundane worries of life taken off their shoulders. Some have suggested that you accentuate that this might be only temporary, and there is certainly no reason you couldn't say that. Of course, you and your brother both know very well that your mom is not going to be getting better, she will most likely need more care as time goes on. There is something very pitiful and painful about seeing two lovely old people bravely struggling in their later years trying to keep abreast of medications, health issues, housekeeping, shopping, food preparation, and all the things that healthy young people take completely for granted. It becomes doubly so when one of them has alzheimers. It is probably the greatest gift you could give them, taking that responsibility off their shoulders. They can rest, knowing their bills are paid regularly and on time, and medications miraculously appear at the right time with a glass of water every day, and somebody else makes the dinner, does the wash, food shopping and housecleaning. Like being on vacation. I hope you can sell the idea to your Dad. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') Songbird, I can jsut tell you what I did with my dad. We had tried him in Assisted Living and I was called about Midnight that he was bothering the other people trying to find his daughter. So I had to go pick him up. Then one Sunday morning, I sad down with him and told him that he had always wanted to make his own decisions so I was giving him the opportunity to do so. He could decide that he was going to the nursing home, or I would have to decide for him. He decided he would go! Just a play on words, but it worked with him. Gwen > Hello all, > [quoted text clipped - 42 lines] > > Songbird Hi, Sorry your dad is so ill also. Just what you didn't need on top of your mom and other normal life. I'm so new to all of this, I can't offer any sound advice. I've read the thread & you got lots of great comments. I really like the tactic that Gwen mentioned. To sit down & talk to him about them moving to AL but somehow twist it around so he ends up thinking it is his idea. Perhaps mention each & every good point you can think of - all those positives vastly outweigh the pain of letting go of the house. No words of wisdom, but I send you lots of good luck vibes for you and your brother to make it through such an important discussion with him. > Hello all, > [quoted text clipped - 42 lines] > > Songbird > My brother suggests just telling > him "Mom's moving into AL. Are you going with her or not?" (I do have legal > power to do that -- but oh the World War III!!!!) > > Any suggestions on how to approach him? We've discussed this some here > before -- but I need another pep talk please! if he's as irascible and intractable as you suggest, about the only thing i can suggest is getting his bishop (who CAN give him orders!) to TELL him that he MUST do so, since he obviously can't even take care of himself. also ask the bishop to NOT allow him to continue working if he insists on keeping your mother at home. if that won't work, my suggestion is to do what you have to do to keep your mother healthy and place her even if he raises holy hell. he will probably eventually come around. the most important thing is that you and your sibling(s) ALL need to be singing from the same page; you need to agree beforehand on what you will tell him, anticipating all his objections, and you need to be very firm with him. just tell him that the way he treats your mother is not only unacceptable, but could be considered neglect if the authorities were to find out, and that she needs to be where she can be taken care of in ways that he can't do, and then JUST DO IT. Thanks to all of you for your suggestions. Dad came home today and we discovered another wrinkle that will be a good argument (I hope.) The skin pouch where they removed the infected pacemaker is still healing, and it has to be swabbed out with hydrogen peroxide twice a day and redressed. (Up until yesterday they were packing with gauze as well.). The home health agency expected to be able to teach my mom to do this in two visits, even after case manager advised of her memory loss. (Yeah, right.) When Dad explained Mom's condition, they said they would write it out and Dad could coach her through it! (He cannot do it himself, because 1) where it is you cannot see on yourself too well and 2) the new pacemaker on the other side restricts the movement of that arm for now.) I then called home health nurse and explained that Mom has a pronounced hand tremor due to thyroid issues and was just as likely to puncture the pocket as to clean it. We negotiated for the nurses to do it until next Wednesday (by which point it will hopefully be healed). She told me home health will not normally accept a patient unless there is a caregiver in the home who can be taught to carry out those tasks. So that means that if Dad ever needs any kind of help -- he cannot get it where he is now, unless I am willing to provide it -- and I am not. And another update -- Mom is getting a needle biopsy of her breast lump sometime in next month. She sat there today and calmly told nurse there was no breast cancer in the family -- her mom died of it age 47. She also denied her own history of a golf-ball sized breast cyst and taking estrogen in menopause. I was kept busy piping in to augment the record! Thanks to all of you for your support. My husband tries but he has trouble supporting me through this because he never has gotten along with my dad, so he takes a "slash and burn" approach. I don't mind tough love, but if you go in with both barrels blazing ... Dad shoots back. (Metaphorically, of course. I took his gun for *safekeeping* during his move and 13 months later I have *forgotten* to return it.) Songbird > Hello all, > [quoted text clipped - 42 lines] > > Songbird Hi Songbird - comments from a newbie About 3 1/2 yrs ago, my mother's health began to fail, and she was hospitalized in a facility about 75 miles from where my parents were living at the time. On the sly, my dad purchased an apartment in a multi-level retirement facility in that town, so that my mother would be eligible for the nursing home facilities there (justly regarded as the best in their state) He remained in their home, unable to drive, with two cats his only company and completely dependent on various friends and volunteers to take him to see my mother. Or to get him anywhere else for that matter, grocery store, MD, haircut, dentist, hardware store, church, etc. When his five kids realized that (1) he owned an apartment where he would have access to the daily shuttle for errands; and (2) where he could walk to see our mother - we all went home the same weekend, packed up a truck, and took what household posessions he would need to live there and moved him. He was quite resistant vocally, but in reality did almost nothing in opposition when push came to shove. We did not argue, we did not attempt to change his mind, we just moved him. The opportunity for your parents to go to an available 2 BR apartment seems to good to be true. I wish your comments about the home health care planning were a rarity, but I hear far too many stories like that. Keep us posted SignatureA R Pickett aka Woodstock "Sometimes the facts threaten the truth" Amos Oz, prize winning Israeli author Read my book reviews at: http://www.booksnbytes.com/reviews/_idx_ws_all_byauth.html Remove lower case "e" to respond > The opportunity for your parents to go to an available 2 BR apartment > seems [quoted text clipped - 5 lines] > > Keep us posted Hi "Woodstock" It amazes me too that so few people actually plan for the time when they will be too old to care for themselves, or for their own deaths, no matter how inevitable we know these things are for all living beings, somehow we all see ourselves as immortal. Nobody realizes that they could conceivably simply drop dead of some catastrophic sudden illness, they always think they will have plenty of time to put their affairs in order. Few are that lucky. Or worse yet they think they will somehow "jinx" themselves by making a will, planning for their old age, or whatever. My elderly father is just in the process of kicking his son out of his house in a fit of totally unrealistic fantasy. My brother moved there to look after him because he was living alone at the time and we all felt better knowing there was someone in the house with him. Since that time a friend of my deceased mother's moved into the house with him and is essentially looking after him, taking him to the doctor or getting groceries from the store, or whatever else is needed, so all of a sudden my brother has become unnecessary. My brother pays a decent rent ($400 a month) for his room, religiously on time, (plus a little extra so my father wouldn't complain about the electric bill too much). Here is a guy who gets up at 6:15 in the morning, works all day, doesn't even shower there or cook there, or do laundry there, (does all that at his girlfriend's house) he doesn't drink or do drugs, comes home about 8:30 every night, only to go to bed and do it all again the next day. Anybody would be glad to have him as a boarder, excepting his own father. My father is 93 years old, irascible and difficult and ornery and cantankerous..... and did I mention crotchety and paranoid? Yet he is kicking his only son out of the house for no good reason at all. There is absolutely no dealing with this man, and the very things he complains about in my brother are the things he created by his own fatherly ineptitude in raising him. I will grant you he is far from perfect, but neither is the old man. My father has absolutely no long term care insurance, and he absolutely will not consider gifting his kids with the legally allowed amounts in order to protect his assets. At 93 he put a forty year roof on the house!..... He really does believe he is immortal. Sometimes there is no justice out there, and human beings often think they are going to live forever. Truth is that nobody knows when their time will come, and it can happen very suddenly, or we can linger long with some awful illness. The only certain thing is that sometime or other we aren't going to be here anymore. Facing that is only common sense. But nobody wants to face it. We are all ostriches, with our heads in the sand when it comes to facing our own infirmity and mortality. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') I hear you Evelyn! We have a lovely neighbour and old family friend, who is the widow of a university professor here in Toronto. She is almost 80, and has thus far recently survived cancer and a stroke, but is in increasingly precarious health. She has three adult sons, who live in Boston, Washington and Kentucky, respectively, each with families of their own. She has no family here at all. She lives in the family home, which is a huge place - 5 bedrooms, three floors, and crammed to the rafters with "stuff" (books, antiques, heirlooms, and 40 years of family debris). Now, this is a very intelligent woman who has always been resoundingly practical and competent, but increasingly we are looking at her with alarm, and really can't fathom why she isn't taking some steps to at least downsize, never mind move closer to family. She had some serious surgery in June to clear a blocked artery in her neck, and the sons took turns coming in from their distant homes to look after her - but the whole logistical thing of her living here is becoming increasingly difficult, and yet...she makes no move to do anything. Every day she delays making a start makes the situation more of a concern - imagine the challenge of managing her house full of things that will need to be sorted and disposed of, or dispersed to family members, particularly since her family are all so far away. We help out when we can, but she needs a push to move to a more sustainable situation. Every time I go over there, all I can do is look around the house and start to worry!! I swear, as soon as my kids are out of the house, I'm moving to a smaller place so there is less in the way of extraneous junk to get rid of. Scary! Mary >I hear you Evelyn! > [quoted text clipped - 29 lines] > > Mary Hi Mary, My aunt who cared for her husband through many years of Alzheimers disease, just died herself after only a little more than a year of freedom from being a caregiver. Same scenario. Big house, lots of stuff for the kids to have to sort through. I swear I am going to go through this place and get rid of all the stuff I have been keeping for years that I never use. I am not all that old, but it is time to travel a little lighter through life. I don't want my kids to have to go through the same thing. I have another aunt (the last one still alive) and she used to say "If you haven't used it in a year, get rid of it." I haven't followed that advice, myself...... and come to mention it, neither did she, but it sure sounded like good advice! :-) SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') I hear you too Evelyn!! I had moved out after college, and came back after a lengthy illness put my mother in a nursing home (but she was only approved for a short-term stay). I moved back home and got Mom home. I repeatedly asked my Dad if he wanted money. After all, I was used to being on my own. He said "no" time after time, so I took it upon myself to pay the bills that I knew of (like utilities). Lo and behold, he had a large balance on every credit card, even those he wasn't using. $300 on a gas credit card? And on a credit card that is never used for lottery tickets, cigarettes, or snacks??? Our house was desperately in need of a lot of repairs. For the past six years, a lot of birthday/Christmas/anniversary gifts have been a replacement of something. Remember after 9/11 how the interest rates on mortgages were a lot lower than in recent past? Every financial advisor was saying "Remortgage Now!". Well, my father did. He had remortgaged the house while I was away without telling anyone. So he was smart in getting a lower interest rate. But he took out a 30 year mortgage. He was 75 at the time! And he took out a bigger mortgage than he already had, to pay for a new roof and siding. He will never be alive to see the end of the mortgage. So guess who will have to take over payments? Does anyone else out there feel like they are the only ones making sane decisions? Who would approve a bigger mortgage for an elderly couple?? "Who would approve a bigger mortgage for an elderly couple?? Any mortgage company. They never look for a loan to be paid in full. Most houses are sold and new owners refinance.........that's for young people or old people like me. I'm 76 and have a 28 year mortgage left! Gwen > I hear you too Evelyn!! I had moved out after college, and came back > after a lengthy illness put my mother in a nursing home (but she was [quoted text clipped - 20 lines] > Does anyone else out there feel like they are the only ones making sane > decisions? Who would approve a bigger mortgage for an elderly couple?? > Does anyone else out there feel like they are the only ones making sane > decisions? Who would approve a bigger mortgage for an elderly couple?? remember, a mortgage is *secured* debt. the banks don't worry because not matter what happens to the estate, they will get their cash, either from the heirs paying off the mortgage or from the sale of the home at a foreclosure sale. it's often the case that elderly folks who have a paid off mortgage don't have much in the way of assets except for the increased equity in their home, and if they need cash, a mortgage is the lowest cost way to get it. i despaired at the fact that my mother would waste money on the most expensive (and IMHO, poorest performing) plumbing company in town, paid what the dealer asked for her last new car, and always charged 25% below market rent for her upstairs apartment, but i finally just gave up. she also used some money from her last mortgage to give a grandaughter a substantial amount for a wedding present. unless you can prove they're incompetent, your parents have the right to manage their own financial affairs, no matter how poorly they do so. >I hear you too Evelyn!! I had moved out after college, and came back > after a lengthy illness put my mother in a nursing home (but she was [quoted text clipped - 20 lines] > Does anyone else out there feel like they are the only ones making sane > decisions? Who would approve a bigger mortgage for an elderly couple?? Hi, The bank doesn't care...... they always have the value of the house itself, insuring that they will get their money back. Basically they assume that you know what you are doing, that you are in your right mind, and that you are refinancing for some good reason. Some people will refinance for home improvements and some will do it to finance a business venture, or to even pay for a defense in a lawsuit, or even to buy another home elsewhere while the present one is put up for sale. They never ask you why you are refinancing, if your credit is good enough and if the house is worth enough, they know they can't lose. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') |
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