Caring for a declining parent

[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

[Anonymous]

Anonymous wrote:As hard as it is to watch, they can make their own choices and "own" the outcomes.

What you get to decide is how much energy you are going to spend trying to convince them to change their plan AND how much of yourself you will give to them.

Typically there is a catastrophic event that occurs that forces change - i.e. your dad falls and breaks a hip or your stepmom reaches a breaking point.

Until then you are unlikely to convince them of anything. It is super hard to watch.

+1

We had to wait for the event. Dad was majorly against moving to AL.

If older people set up their houses for aging in advance, that would help a lot. I decided not to take on guilt for their own choices. However, I did worry a lot and waited for the fall or major event that would precipitate moving to an AL. Horrible thing to do to your kids.

I’m far too young for AL but I live in a house with a bathroom and shower on the first floor. I could avoid stairs, if needed. My parents did not and that was an issue.

[Anonymous]

I wouldn’t worry about the DNR. When he starts to really decline, that will be revisited by his medical team.

[Anonymous]

Anonymous wrote:I wouldn’t worry about the DNR. When he starts to really decline, that will be revisited by his medical team.

Following up on this, I second the advice to look into palliative care.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I wouldn’t worry about the DNR. When he starts to really decline, that will be revisited by his medical team.

Following up on this, I second the advice to look into palliative care.

OP here - how does one access this? Through his PCP or after a hospitalization?

[Anonymous]

OP here - how does one access this? Through his PCP or after a hospitalization?

We contacted a hospice provider directly and they did the evaluation. Not sure if palliative is different. She was accepted into hospice same day, we dropped many medications and focused on end of life comfort. She died in a few weeks after a fracture and advanced dementia. I was surprised the ER did not suggest hospice but maybe they were waiting for me to ask.