Caring for a declining parent

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hire a once a week aid for 3 or 4 hours (most agencies have a 3 or 4 hour minimum) .

When the aid comes in call them a cleaning lady (to father),

Let MIL drive off for the 3 or 4 hours so she gets a real break.

Tell her she can drive off and go to the spa, get her hair done, go to the mall etc.

Can I make a request that you not say this? People mean well but “go to a spa” is so insulting. She’s probably going to go to the dentist, to which she’s overdue. Or cry alone in a parking lot. Or go to target and buy stuff they need. The idea that 3-4 hours of respite care is so amazing and restorative to a caregiver that they’ll “go to a spa” is so out of touch with their reality that it borders on cruel.

I disagree. Caregivers often need to be nudged not just to accept help and respite, but also to give themselves permission to have their own needs addressed. Is she not allowed a professional haircut or a pedicure? For many people as they age, those become needs, not wants.

Weekly help for stepmom will hopefully mean she can do something nice for herself occasionally. That could be a walk, coffee with a friend, a nap, visiting a relative, a yoga class, making her own health appointments or going to them, running errands, sitting in a park or on the porch, whatever she needs.

It’s a start.

OP, please do read the article on geriatric care managers in their area and see if you can find one (there are links on that page) who they could meet with. The GCM might be able to move the needle with finding them additional resources they’ll trust, as well as with them being willing to accept more help and make some changes that are beneficial for both your dad and stepmom.

Yeah of course, she should do whatever she needs wants during her time off. I’m just saying when you’ve set someone who has been a 24/7 caregiver up with 3-4 hours, don’t tell them to “go to a spa” or even give them instructions at all. She’ll figure it out.

[Anonymous]

Anonymous wrote:

Their absolute priority is to keep him out of a facility (for better or worse - they won't budge on this issue).

This is the only problem

+1

It is too much burden on you (and any siblings) and your Step mom if he wants to be cared for at home. That is what facilities are for. So if they won't budge, you don't need to budge on providing additional assistance and disrupting your life weekly/daily.

[Anonymous]

Anonymous wrote:I don’t know what it is with the elderly/severely disabled (and their kids) not wanting to be put in a facility. And yes they’re generally awful (and will likely get worse with this administration and PE) but hopefully you have more money and can get into the “nicer” ones. But let’s be realistic. The vast majority of middle class or even upper middle class families with aging parents CANNOT AFFORD to age in place!!

This!!! A good facility runs 10-15K (depending upon level of care needed). At home care is easily $30-45/hour if not higher. That is 20K+ per month. And someone has to manage that care, and what happens if someone doesn't show up on time or at all? That doesn't happen in a facility.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hire a once a week aid for 3 or 4 hours (most agencies have a 3 or 4 hour minimum) .

When the aid comes in call them a cleaning lady (to father),

Let MIL drive off for the 3 or 4 hours so she gets a real break.

Tell her she can drive off and go to the spa, get her hair done, go to the mall etc.

Can I make a request that you not say this? People mean well but “go to a spa” is so insulting. She’s probably going to go to the dentist, to which she’s overdue. Or cry alone in a parking lot. Or go to target and buy stuff they need. The idea that 3-4 hours of respite care is so amazing and restorative to a caregiver that they’ll “go to a spa” is so out of touch with their reality that it borders on cruel.

Well Step mom is doing this to herself, by refusing to even consider putting her husband in a facility.
If you don't like the solutions others are offering, then you suck it up, stop complaining and deal with it (she's doesn't need to but if she's refusing to do the logical thing, well that's on her)

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hire a once a week aid for 3 or 4 hours (most agencies have a 3 or 4 hour minimum) .

When the aid comes in call them a cleaning lady (to father),

Let MIL drive off for the 3 or 4 hours so she gets a real break.

Tell her she can drive off and go to the spa, get her hair done, go to the mall etc.

Can I make a request that you not say this? People mean well but “go to a spa” is so insulting. She’s probably going to go to the dentist, to which she’s overdue. Or cry alone in a parking lot. Or go to target and buy stuff they need. The idea that 3-4 hours of respite care is so amazing and restorative to a caregiver that they’ll “go to a spa” is so out of touch with their reality that it borders on cruel.

I disagree. Caregivers often need to be nudged not just to accept help and respite, but also to give themselves permission to have their own needs addressed. Is she not allowed a professional haircut or a pedicure? For many people as they age, those become needs, not wants.

Weekly help for stepmom will hopefully mean she can do something nice for herself occasionally. That could be a walk, coffee with a friend, a nap, visiting a relative, a yoga class, making her own health appointments or going to them, running errands, sitting in a park or on the porch, whatever she needs.

It’s a start.

OP, please do read the article on geriatric care managers in their area and see if you can find one (there are links on that page) who they could meet with. The GCM might be able to move the needle with finding them additional resources they’ll trust, as well as with them being willing to accept more help and make some changes that are beneficial for both your dad and stepmom.

Yeah of course, she should do whatever she needs wants during her time off. I’m just saying when you’ve set someone who has been a 24/7 caregiver up with 3-4 hours, don’t tell them to “go to a spa” or even give them instructions at all. She’ll figure it out.

She is a stubborn caregiver who is refusing help and refuses to consider a facility. At somepoint you have to stop being concerned about her well being if she doesn't want assitance

[Anonymous]

OP I was in your situation five or so years ago, except both are my parents. I wish I had insisted on getting them a home health aide. If they want to stay home, your stepmom must get help. My mother refused, burned herself out and now they are both in a facility because her health has declined to the point where she can’t take care of my dad or herself. I would do all you can to get them help at home but also know that it will likely take some precipitating event to force the issue.

[Anonymous]

It is very, very odd that he is full code at such an old age. Are you sure he understands what that means? I can't fathom anyone of sound mind making that choice.

[Anonymous]

Anonymous wrote:They won't move him, and they are resistant to your help. At this point you just let them do what they want to do. Until something happens (major fall for example), they won't be amendable to anything. So stop wasting your breath and stress.

This is my experience as well with a very difficult mother (deceased now which was frankly a relief) and an easier but still quietly obstinate father. I used to empathize but when nothing changes it becomes old

[Anonymous]

Anonymous wrote:It is very, very odd that he is full code at such an old age. Are you sure he understands what that means? I can't fathom anyone of sound mind making that choice.

Yes I think OP needs to talk to him about it, maybe in the form of a story how a family friend didn’t realize etc etc

[Anonymous]

Anonymous wrote:It is very, very odd that he is full code at such an old age. Are you sure he understands what that means? I can't fathom anyone of sound mind making that choice.

OP here - I think it’s because, as unhappy as he is, the idea of dying is still scary. He has so many chronic conditions that won’t improve and will only get worse. I don’t feel like any of his doctors have been totally transparent with him. Could I talk to his PCP and suggest that his PCP review his code status with him and what the different choices mean?

[Anonymous]

Anonymous wrote:

Anonymous wrote:It is very, very odd that he is full code at such an old age. Are you sure he understands what that means? I can't fathom anyone of sound mind making that choice.

OP here - I think it’s because, as unhappy as he is, the idea of dying is still scary. He has so many chronic conditions that won’t improve and will only get worse. I don’t feel like any of his doctors have been totally transparent with him. Could I talk to his PCP and suggest that his PCP review his code status with him and what the different choices mean?

Don’t waste your time. Elderly people often get incredibly selfish as they age. When your step mother complains tell her to get an aide or move to an independent/assisted living community instead of staying in their home. And repeat over and over. Don’t get sucked into it being your problem if they won’t do either.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hire a once a week aid for 3 or 4 hours (most agencies have a 3 or 4 hour minimum) .

When the aid comes in call them a cleaning lady (to father),

Let MIL drive off for the 3 or 4 hours so she gets a real break.

Tell her she can drive off and go to the spa, get her hair done, go to the mall etc.

Can I make a request that you not say this? People mean well but “go to a spa” is so insulting. She’s probably going to go to the dentist, to which she’s overdue. Or cry alone in a parking lot. Or go to target and buy stuff they need. The idea that 3-4 hours of respite care is so amazing and restorative to a caregiver that they’ll “go to a spa” is so out of touch with their reality that it borders on cruel.

You are right on! My Dad has someone comes in every weekday for 8 hours, and it is still all hands on deck in the evening and at night for my mother, I and my brother.

[Anonymous]

Have you looked into palliative care? We used it for my mother, who had many chronic illnesses plus mobility issues. Palliative care coordinated all her specialists and helped pare down her drug regimen. They also drew her blood, did xrays and ultrasounds at home when needed.

They also had a social worker that helped her complete a MOLST form and think about future options. Honestly, the only downside was convincing my parents they weren't "giving up" by enrolling

[Anonymous]

Anonymous wrote:OP I was in your situation five or so years ago, except both are my parents. I wish I had insisted on getting them a home health aide. If they want to stay home, your stepmom must get help. My mother refused, burned herself out and now they are both in a facility because her health has declined to the point where she can’t take care of my dad or herself. I would do all you can to get them help at home but also know that it will likely take some precipitating event to force the issue.

+1. I went to visit my family recently, and saw the toll my mom was taking on my dad. I insisted on a home health aid, that stays 10 hrs a day. It’s expensive, but it’s better than having my dad die from the stress of taking care of my mom, and my mom ending up in a facility that she hates anyway.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hire a once a week aid for 3 or 4 hours (most agencies have a 3 or 4 hour minimum) .

When the aid comes in call them a cleaning lady (to father),

Let MIL drive off for the 3 or 4 hours so she gets a real break.

Tell her she can drive off and go to the spa, get her hair done, go to the mall etc.

Can I make a request that you not say this? People mean well but “go to a spa” is so insulting. She’s probably going to go to the dentist, to which she’s overdue. Or cry alone in a parking lot. Or go to target and buy stuff they need. The idea that 3-4 hours of respite care is so amazing and restorative to a caregiver that they’ll “go to a spa” is so out of touch with their reality that it borders on cruel.

+++1