Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op - thanks for the above. And yes she will refuse assisted living or any kind of group home. Likely going to buy apt in nyc near us shortly. Care manager is good idea. But it’s mainly how to provide company for a person who refuses to make friends and refuses to move into care facility, when the time comes. I cannot be the answer to that is my concern

A care manager doesn’t have to be a certified one. Hire her a friend, give an ultimatum that this is her contact person for all her requests. Ask the person to suggest activities. Pay the person well but keep an eye on them so that there’s no scamming or anything like that.
Ideally this person will later coordinate care. Use mother’s money to hire the person.

No. A care manager and a companion are completely different functions requiring different skill sets. A companion can schedule hair salon and things like that, they don’t oversee medical care management. They can accompany to medical appointments and can and should have a good working relationship with a care manager, but those are separate positions.

I am sorry but this is so American, to have an expensive “expert” for everything! How do we all manage our own medical care without a certification?! All it takes for an elderly person is for someone to take them to the dr and memorize what was said. That’s what I do for my own father.
This is “overseeing medical care management”.
I mean it’s your money or future inheritance, you have a right to spend it on “experts” but this is so unnecessary.
Ask anyone in any diaspora what they think about it. Heck, ask most Americans!

I think it really depends on what the medical issues are. My mom is 88, still lives alone and is still able to manage her complicated medical care, which involves a rare disease that is not age-related along with a heart issue that probably stems from a childhood illness but wasn't diagnosed until way into adulthood plus the age-related stuff. My mom is also a retired nurse. She is probably an outlier, but even her doctors have said her care is more than just memorizing what they say as she has to keep track of how all the pieces fit together. Could I keep track of it myself? Sure, I probably could if I needed to. Could my husband, even though he works in healthcare? Maybe, maybe not. He and his brother are helping their mother navigate a new serious medical diagnosis, and they're doing OK, but it's one diagnosis that runs in the family.

I think at 88 it doesn’t really matter anymore. All you do for someone that age is take them to appointments and then write down what the dr prescribed and hope they follow instructions. I’m not going to be upset if an 88 yo forgets to take their pill.

Anonymous wrote:

Anonymous wrote:Op - she would never move into senior community. Is complete introvert. Best I could probably do is arrange for live in carer to be her friend

This carer might walk off with the money.

Yes this is a possibility

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op - thanks for the above. And yes she will refuse assisted living or any kind of group home. Likely going to buy apt in nyc near us shortly. Care manager is good idea. But it’s mainly how to provide company for a person who refuses to make friends and refuses to move into care facility, when the time comes. I cannot be the answer to that is my concern

A care manager doesn’t have to be a certified one. Hire her a friend, give an ultimatum that this is her contact person for all her requests. Ask the person to suggest activities. Pay the person well but keep an eye on them so that there’s no scamming or anything like that.
Ideally this person will later coordinate care. Use mother’s money to hire the person.

Yes, it should be a professional. Our care manager had contacts for every type of home-based service (OT/OT/ST, aides, doctor who does house calls, hospital bed and wheel chair rental, medical transport.) She could arrange for anything as needed and she also kept track of all medical information.

If you do assisted living you can hire a CM to manage whatever is needed for emergencies. Then you show up when you need to and you don't reinforce the codependency.

Sounds relatively easy to research it all online. Someone reasonably smart can do it, who isn’t a professional.
How do we all manage our own care?

Anonymous wrote:Op - she would never move into senior community. Is complete introvert. Best I could probably do is arrange for live in carer to be her friend

This carer might walk off with the money.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There really is a world in which you don’t have to enable all this. But you also have to get comfortable that they may die earlier than they would without all these protections (and might die alone and in pain and not be found for a while). I’m always unclear why we are so scared to let people “live their best life” just because they might die.

Because if they don't die. Honestly. That's why. If they don't die, the first call is to the people who let them have their independence and now these people are in charge of hospital visits, surgery decisions, rehab, financials, etc. So these people are not so "independent" when push comes to shove.

DP. But that's coming at the end for a lot of people anyway. Why do extra work with in-home care for difficult people? Just do it at the end.

I’m the poster who said this, and I agree with you. The end will come and then you decide what to do. Some people will do more than others, but you don’t have to enable them every step of the way. Let them live life on their own terms. And you can either take the call and run off to do something… or not. But the call about the broken hip isn’t necessarily going to disappear because you moved them to a senior facility. Maybe it will be less likely, but it can still happen.

If the OP’s mom is going to refuse anxiety meds, refuse to move and refuse a companion, then all OP can do is wait for the emergency phone call and then decide what to do. But arguing about all this and agonizing about it is a waste of emotional bandwidth.

In my case, I have a child for whom I have to do massive caretaking. It is like I have been dealing with a patient with late stage Alzheimer’s for almost 17 years. She cannot communicate, doesn’t know who I am, sometimes screams all day for months on end, we change diapers, feed and bathe her. There truly is only so much you can do. Save your energy for the moments that really matter. Arguing with someone who is competent and isn’t going to do a darn thing you ask is just a waste.

Anonymous wrote:There really is a world in which you don’t have to enable all this. But you also have to get comfortable that they may die earlier than they would without all these protections (and might die alone and in pain and not be found for a while). I’m always unclear why we are so scared to let people “live their best life” just because they might die.

The mom in this scenario has significant mental health issues. The daughter is looking for solutions to caring for her given her limits and boundaries and taking into account the challenges of caring for an elder with mental health challenges. She's not looking to discard her mother.

Anonymous wrote:

Anonymous wrote:There really is a world in which you don’t have to enable all this. But you also have to get comfortable that they may die earlier than they would without all these protections (and might die alone and in pain and not be found for a while). I’m always unclear why we are so scared to let people “live their best life” just because they might die.

Because if they don't die. Honestly. That's why. If they don't die, the first call is to the people who let them have their independence and now these people are in charge of hospital visits, surgery decisions, rehab, financials, etc. So these people are not so "independent" when push comes to shove.

DP. But that's coming at the end for a lot of people anyway. Why do extra work with in-home care for difficult people? Just do it at the end.

Anonymous wrote:There really is a world in which you don’t have to enable all this. But you also have to get comfortable that they may die earlier than they would without all these protections (and might die alone and in pain and not be found for a while). I’m always unclear why we are so scared to let people “live their best life” just because they might die.

Because if they don't die. Honestly. That's why. If they don't die, the first call is to the people who let them have their independence and now these people are in charge of hospital visits, surgery decisions, rehab, financials, etc. So these people are not so "independent" when push comes to shove.

There really is a world in which you don’t have to enable all this. But you also have to get comfortable that they may die earlier than they would without all these protections (and might die alone and in pain and not be found for a while). I’m always unclear why we are so scared to let people “live their best life” just because they might die.

Anonymous wrote:Op - she would never move into senior community. Is complete introvert. Best I could probably do is arrange for live in carer to be her friend

That's not how it works with live-in care. It's done on rotation and it's not always the same people. It would be illegal to expect 1 person to be with her 24-7 and have to be her "friend." You don't want to take advantage of someone undocumented or desperate for money by expecting that level of care from 1 person.

Anonymous wrote:

Anonymous wrote:Op - thanks for the above. And yes she will refuse assisted living or any kind of group home. Likely going to buy apt in nyc near us shortly. Care manager is good idea. But it’s mainly how to provide company for a person who refuses to make friends and refuses to move into care facility, when the time comes. I cannot be the answer to that is my concern

A care manager doesn’t have to be a certified one. Hire her a friend, give an ultimatum that this is her contact person for all her requests. Ask the person to suggest activities. Pay the person well but keep an eye on them so that there’s no scamming or anything like that.
Ideally this person will later coordinate care. Use mother’s money to hire the person.

Yes, it should be a professional. Our care manager had contacts for every type of home-based service (OT/OT/ST, aides, doctor who does house calls, hospital bed and wheel chair rental, medical transport.) She could arrange for anything as needed and she also kept track of all medical information.

If you do assisted living you can hire a CM to manage whatever is needed for emergencies. Then you show up when you need to and you don't reinforce the codependency.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op - she would never move into senior community. Is complete introvert. Best I could probably do is arrange for live in carer to be her friend

I wouldn't give her a choice. You say, this is the thing I'm willing to help you with (ie find and move into a senior living community). If she doesn't went to, she can arrange her own help at home, or she will go when there's an emergency and she won't have a say in the matter. I doubt you have time to manage at-home care (it's not like a one-and-done thing) so you should only offer what you have the the capacity (and desire) to deal with. This isn't a knock on you, btw- this is exactly what I plan to do with my own difficult parent eventually.

NP. She'll just say no and OP will be back at square one. My mother was like this. We found a part-time companion through Nextdoor who would take her on errands and appointments and help with household tasks. It became full-time as my mother's abilities declined.

Not really- you just say "good luck to you." That's what my siblings and I are going to do with my mom. Eventually she won't have a choice and we will move her. But we won't manage care for her in her home bc she has a lot of interpersonal problems and health issues, and we can't take that on.

Anonymous wrote:Op - she would never move into senior community. Is complete introvert. Best I could probably do is arrange for live in carer to be her friend

Do you have POA? What does your father have to say about this? My dad was fully competent into his 90s and handling their affairs.

Is your father ill? Why do you think he will die first?

Anonymous wrote:Don't wait for a crisis. Put her in senior living that can adjust to assisted living.

You can't do this without her approval. She's not incompetent.